Phase 1 Study of ELX-02 in Healthy Adult Subjects
Condition: Genetic Disease; Nonsense Mutation
MeSH terms: Genetic Diseases, Inborn
Intervention: ELX-02; Placebo
Intervention description: ELX-02 is a synthetic, designer eukaryotic ribosomal specific glycoside (ERSG) optimized as a translational read-through drug; Placebo
Phase: Phase 1
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Cohort 1: ELX-02 0.1 mg/kg or placebo SC twice a week for 9 doses;
Cohort 2: ELX-02 0.3 mg/kg or placebo SC twice a week for 9 doses;
Cohort 3: ELX-02 1.0 mg/kg or placebo SC twice a week for 9 doses;
Cohort 4: ELX-02 2.5 mg/kg or placebo SC twice a week for 9 doses;
Cohort 5: ELX-02 up to 2.5 mg/kg (50 mg/mL per injection) or placebo SC twice a week for 9 doses;
Cohort 6: ELX-02 2.5 to 5.0 mg/kg or placebo SC twice a week for 9 doses. Optional Cohort
Cohort 7: ELX-02 up to 5.0 mg/kg or placebo SC twice a week for 9 doses. Optional Cohort
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Enrollment: 62.0
Sex: All
Minimum age: 18 Years
Maximum age: 55 Years
Healthy volunteers: Accepts Healthy Volunteers
Keywords: Translational read through

Summary:

      Phase 1 Multiple Ascending Dose Study in Normal Healthy Volunteers
    

Eligibility criteria:

        Inclusion criteria: Subjects must meet all of the following inclusion criteria to be
        eligible for enrollment into the study:

          1. Be able and willing to provide written Informed Consent indicating that the subject
             has been informed of all pertinent aspects of the study.

          2. Healthy female subjects and male subjects who, at the time of screening, are between
             the ages of 18 and 55 years, inclusive.

             Healthy is defined as no clinically relevant abnormalities identified by a detailed
             medical history, full physical examination, including blood pressure (BP) and pulse
             rate measurement, 12-lead electrocardiogram (ECG), and clinical laboratory tests.

          3. Female subjects of non-childbearing potential must meet at least one of the following
             criteria:

               -  Achieved postmenopausal status, defined as follows: cessation of regular menses
                  for at least 12 consecutive months with no alternative pathological or
                  physiological cause; post-menopausal status will be confirmed by a serum
                  follicle-stimulating hormone level;

               -  Have undergone a documented hysterectomy and/or bilateral oophorectomy;

               -  Have medically confirmed ovarian failure. All other female subjects (including
                  females with tubal ligations) will be considered to be of childbearing potential
                  and may be enrolled if they have negative pregnancy tests at screening and
                  admission day and agree to use a highly effective method of contraception for 14
                  days before first study drug administration and 28 days after last study drug
                  administration. Female subjects of childbearing potential must agree to undergo
                  repeated pregnancy tests.

          4. Male subjects must be willing to use an effective method of contraception. They must
             agree to use a condom consistently and correctly, during the course of the study until
             28 days after last study drug administration.

          5. Not using any prescription medication and dietary supplements within 30 days or 5 half
             lives (whichever is longer) prior to the first study drug administration, except for
             contraceptives - nor be taking any over-the-counter (OTC) herbal or medicinal
             products. As an exception, acetaminophen/paracetamol may be used at doses of ≤2 g/day.

          6. Non-smoking and no use of any tobacco or nicotine products (by declaration) for a
             period of at least 6 months prior to screening visit.

          7. Be on no medication with potential to impair renal function (e.g., non steroidal anti
             inflammatory [NSAID]s) or with ototoxic potential (e.g., quinine, salicylates,
             aminoglycosides).

          8. Normal renal function (glomular filtration rate >60 mL/min) based on creatinine plasma
             concentration and the Modification of Diet in Renal Disease (MDRD) equation for
             estimated glomular filtration rate. Subjects with lower MDRD clearance can be included
             on the condition that they have a normal 24h creatinine clearance (determined by a 24h
             urine collection).

          9. Negative human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg),
             hepatitis C virus antibody (HCV Ab) serology tests at screening.

         10. No history of alcohol or DOA. Negative urine test for DOA and alcohol breath test at
             screening and Day -1.

         11. No personal history (or current) or hereditary hearing loss, persistent tinnitus,
             persistent vertigo, persistent imbalance and persistent unsteadiness.

         12. Body Mass Index (BMI) of 19.0 to 30.0 kg/m2 (inclusive); and a total body weight >50.0
             kg (110 lbs) and <100.0 kg.

        Exclusion criteria: Subjects with any of the following characteristics/conditions will not
        be included in the study:

          1. Subjects who are investigational site staff members directly involved in the conduct
             of the study and their family members, site staff members otherwise supervised by the
             Investigator, or subjects who are the Sponsor employees directly involved in the
             conduct of the study.

          2. Concurrent participation or participation in another clinical trial within at least 5
             tissue half-lives prior to dosing (calculated from the previous study's last dosing
             day). If the previous trial involved agents with delayed effects or prolonged
             metabolism, a 12 months interval is required.

          3. Evidence or history of clinically relevant hematological, renal, endocrine, pulmonary,
             gastrointestinal, cardiovascular, hepatic, psychiatric, neurologic, or allergic
             disease (including drug allergies). This includes any acute or chronic medical or
             psychiatric condition or laboratory abnormality that may increase the risk associated
             with study participation or investigational drug administration or may interfere with
             the interpretation of study results and, in the judgment of the Investigator, would
             make the subject inappropriate for entry into this study.

          4. Presence of mitochondrial mutations making subject susceptible to aminoglycoside
             toxicity.

          5. Subjects with any history of ear disease or surgeries, persistent dizziness or
             persistent tinnitus.

          6. Subjects with any abnormality at screening, that indicates the presence of a
             vestibular pathology, conductive hearing loss or balance problem (by an ENT).

             Subjects with abnormalities in audiometry results at screening as follows: any
             pure-tone threshold >55 dB and/or inter-ear difference in any frequency of >20 dB.

             Dizziness Handicap Inventory (DHI)-H score>16. Tinnitus Handicap Inventory (THI)-H
             score >14.

          7. History of regular alcohol consumption exceeding 14 drinks/week for females or 21
             drinks/week for males (1 drink = 150 mL of wine or 360 mL of beer or 45 mL of hard
             liquor) within 6 months of screening.

          8. Screening supine BP ≥ 140 mm Hg (systolic) or ≥ 90 mm Hg (diastolic), following at
             least 5 min of supine rest. If BP is ≥ 140 mm Hg (systolic) or ≥ 90 mm Hg (diastolic),
             the BP should be repeated two more times and the average of the three BP values should
             be used to determine the subject's eligibility.

          9. Screening supine 12-lead ECG demonstrating QTc >450 msec for men and >470 msec for
             women, or a QRS interval >120 msec. If QTc or QRS exceed these limits, the ECG should
             be repeated two more times and the average of the three QTc or QRS values should be
             used to determine the subject's eligibility.

         10. Subjects with ANY abnormalities in clinical laboratory tests at screening, considered
             by the study physician as clinically relevant. In particular, subjects with alanine
             aminotransferase (ALT), aspartate aminotransferase (AST), serum creatinine and total
             bilirubin ≥ 1.5 upper limit of normal will be excluded.

         11. Pregnant or breastfeeding female subjects.

         12. Subjects who donated blood or received blood or plasma derivatives in the three months
             preceding study drug administration.

         13. Unwilling or unable to comply with all scheduled visits, treatment plan, laboratory
             tests and other study procedures and the restrictions described in this protocol.

         14. Known relevant allergy to any drug and/or aminoglycosides.

         15. Subjects with an inability to communicate well with the Investigators and CPU staff
             (e.g., language problem, poor mental development).

         16. Subjects with visual impairment or inability to read and comprehend the DHI and THI
             scales.

         17. Subjects with any acute medical situation (e.g., acute infection) within 48 hours of
             study start, which is considered of significance by the Investigator.