Multiple Ascending Dose Study of Oxfendazole in Healthy Adult Volunteers
Condition: Helminthic Infection
MeSH terms: Helminthiasis
Intervention: Oxfendazole
Intervention description: methyl-5 (6)-phenylsulfiyl-2-benzimidazole carbamate, is a broad spectrum benzimidazole antihelminthic. It is the sulphoxide metabolite of fenbendazole.
Intervention MeSH terms: Oxfendazole
Phase: Phase 1
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Enrollment: 36.0
Sex: All
Minimum age: 18 Years
Maximum age: 45 Years
Healthy volunteers: Accepts Healthy Volunteers
Keywords: Helminths; Oxfendazole; Pharmacokinetics; Safety

Summary:

      This Phase I study is an open label multiple ascending dose evaluation of the safety and PK
      of oxfendazole (3, 7.5, or 15 mg/kg) given orally daily to healthy adult men and nonpregnant
      women aged 18-45 followed by a single dose cross over trial evaluating the safety and
      pharmacokinetics of a single dose of oxfendazole (3 mg/kg) given following an 8 hour fast or
      following a high fat meal. The study duration will be approximately 12 months with each
      subject participation lasting approximately 6 weeks. In the multiple ascending dose
      evaluation, between 8 and 24 subjects will be enrolled; each dose group will be comprised of
      eight volunteers. To enhance safety, one sentinel subject will be dosed for five days and
      monitored for 7 days from the time of the first dose for predefined adverse events. If there
      are no predefined safety events, a second sentinel subject will be enrolled and followed for
      a total of 7 days. If there are no predefined safety signals identified for either of these
      two sentinel subjects, the remaining subjects in the group will be enrolled. After all eight
      subjects have completed the 10 day follow up period, an electronic safety review of the
      electronic data will be performed. If none of the predefined safety events have occurred DMID
      will approve enrollment into the second dose group (7.5 mg/kg oxfendazole daily x 5 days) and
      will be monitored for a total of 7 days each for predefined adverse events prior to enrolling
      the remaining subjects in the group. After the 10 day follow up period has been completed for
      group 2, an electronic safety review will be completed and if no predefined events have
      occurred two sequential subjects (one at a time with 7 days between each subject) will be
      enrolled into the third dose group (15 mg/kg oxfendazole daily x 5 days) and will be
      monitored for a total of 7 days each for predefined safety events prior to enrolling the
      remaining subjects in the group. In the food effects evaluation, 12 subjects will be enrolled
      into the single dose cross over group where half of the subjects will initially receive a
      single dose of 3 mg/kg of oxfendazole following an 8 hour fast and the other half will
      receive a single dose of 3 mg/kg of oxfendazole following a high fat meal. Subjects will then
      cross over to receive a single dose following a high fat breakfast or fasting period (water
      is permitted). All subjects will have received a dose of oxfendazole following both a fasting
      period and a meal. The primary objectives are: 1) To assess the safety of oxfendazole
      administered daily for five days; and 2) To assess the safety of oxfendazole administered as
      a single dose with or without food.
    

Eligibility criteria:

        Inclusion Criteria:

          1. Males and nonpregnant females between the ages of 18 and 45 years, inclusive.

          2. Women of childbearing potential* must agree to practice adequate contraception** for
             the 28-day period before Day 0 through 4 months after the last dose of study
             medication.

             * A woman is considered of childbearing potential unless surgically sterile (tubal
             ligation, bilateral oophorectomy, or hysterectomy) or post-menopausal (=1 year).

             **Acceptable birth control methods include but are not limited to: abstinence from
             sexual intercourse with men; monogamous relationship with a vasectomized partner;
             double-barrier methods (condoms, diaphragms, spermicides); intrauterine devices; and
             licensed hormonal methods.

          3. In good health, as judged by the investigator and determined by vital signs*

             *Temperature < 38°C, heart rate <= 100 bpm and > 50 bpm, systolic blood pressure <=
             140 mmHg and > 89 mmHg, diastolic blood pressure <= 90 mmHg and = 60 mm Hg, medical
             history and a targeted physical examination. BMI >= 18 and <= 35. Athletically trained
             subjects with a pulse >= 45 may be enrolled at the discretion of the principal
             investigator or designated licensed clinical investigator. Acceptable screening
             laboratories: Hemoglobin, white blood cell (WBC) count, neutrophil, and platelet
             counts, INR and PTT within normal ranges. AST < 44 and ALT < 44 and total bilirubin,
             creatinine must be equal to or below the upper limit of normal (creatinine values
             below the normal range are acceptable). Random blood glucose must be <140. Urine
             dipstick testing must be negative for glucose and negative or trace for protein. The
             following serology tests must be negative: HIV 1/2 antibody, hepatitis B surface
             antigen (HBsAg), and hepatitis C virus (HCV) antibody. HIV and hepatitis C viral load
             PCR testing may be performed for individuals suspected of having indeterminate
             antibody testing.

          4. Male participants must be willing to ensure use of condoms and spermicides for 4
             months after the last dose study medication.

          5. Provide written informed consent before initiation of any study procedures.

          6. Willing to be available for all study-required procedures, and visits for the duration
             of the study.

          7. Individuals must agree to abstain from drug or alcohol use for 48 hours prior to
             enrollment through day 10 or 14.

          8. Able to provide a home phone number, and the name, address, and/or email of a person
             willing to assist with making contact during the follow-up phase of the study.

        Exclusion Criteria:

          1. Pregnant women, women who are planning to become pregnant in the next 4 months, or
             women who are breastfeeding.

          2. Body temperature >=100.4°F (>=38.0°C) or acute illness within 3 days before
             administration of study drug (subject may be rescheduled).

          3. Chronic or acute medical disorder*

               -  Disorders of the cardiac, pulmonary, liver, kidney, neurologic, gastrointestinal
                  or other system, such that in the opinion of the investigator participation in
                  the study creates additional risk to the subject, or to the validity of the
                  study.

          4. Use of chronic systemic medications* *Intermittent use of over the counter medications
             such as acetaminophen, ibuprofen, cold and sinus medications are permitted for
             enrollment Topical medications, nasal steroids are permitted throughout the study. Use
             of prescription medications used less than once per week on average are permitted for
             enrollment. If the subject has taken a short term prescription medication within the
             past 30 days (e.g. an antibiotic), they should be postponed from enrollment until 30
             days have elapsed since the last dose.

          5. Has history of sensitivity to related benzimidazole compounds (e.g., albendazole,
             mebendazole).

          6. A diagnosis of schizophrenia, bipolar disease, or history of hospitalization for a
             psychiatric condition or previous suicide attempt.

          7. A history of treatment for any other psychiatric disorder in the past 3 years.*

             *Past treatment for ADHD does not exclude participants from enrollment as long as the
             medications have been discontinued for a minimum of 3 months and symptoms are well
             controlled.

          8. Received an experimental agent* within 1 month before administration of study drug or
             expect to receive an experimental agent during the 10 or 14-day study period.

             *Vaccine, drug, biologic, device, blood product, or medication.

          9. Any condition that would, in the opinion of the investigator, interfere with the
             study.*

             *This includes any condition that would place them at an unacceptable risk of injury,
             render them unable to meet the requirements of the protocol, or that may interfere
             with successful completion of the study.

         10. A history of heavy alcohol* or illicit drug use**, or history of substance abuse#.

             *On average, greater than 7 alcoholic drinks per week. .

             **Other than occasional marijuana use (less than once per week for the past 60 days is
             acceptable).

             #Alcohol or illicit drugs within the past 3 years.

         11. History of chronic tobacco use in the past 60 days.* *A history of occasional tobacco
             use (less than 1 pack per week on average) is acceptable. Individuals will be
             counseled to abstain from use of tobacco and marijuana from screening through day 10
             or 14.