A Phase 1 Study of HBI-3000

This is a Phase 1 randomised, double-blind, placebo-controlled, serial cohort, dose-escalation study in healthy adult volunteers. It is planned to enroll 5 cohorts (Cohorts A to E) of 8 subjects. Up to 2 additional cohorts (Cohorts F and G) may be enrolled as needed to establish the safety profile of HBI-3000 over a clinically relevant range of doses. Subjects will be randomly assigned to receive a single dose of HBI-3000 or matching placebo in a sequential escalating manner (Regimens A to E and optional Regimens F and G), with a minimum of 7 days and a maximum based on logistics of interim review between dose groups.

As a safety precaution, in each cohort a sentinel dosing group of n = 2 (1 active:1 placebo) will be dosed at least 24 h ahead of the main group. Safety and tolerability will be assessed by the principal investigator or medically-qualified designee before continuing with dosing the remaining subjects. The first 2 subjects will be allocated to active or placebo in a 1:1 ratio. The remaining 6 subjects will be allocated to active or placebo in a 5:1 ratio.

Doses of HBI-3000 may range from 20 mg to a level at which it is expected that the drug exposure will not exceed an AUC(0-t) of 20 μg.h/mL and Cmax of 20 μg/mL (based on the no-observed-adverse-effect levels \[NOAEL\] in both 14 day repeat dose toxicology species the rat and minipig) and the expected therapeutic dose range. Following administration to each cohort, there will be an interim data review during which the PK and safety data will be reviewed to determine the dose to be administered in the next cohort. Dose escalation for serial cohorts will progress unless safety concerns preclude further dose escalation. If the selected dose does not provide the required data, a previously tested dose may be used in a subsequent cohort. However, if the dose level met the dose escalation stopping criteria, that dose level must not be repeated. A previously untested intermediate dose may also be used in a subsequent cohort.


Eligibility Criteria:
Inclusion Criteria:

1. Healthy males or non-pregnant, non-lactating healthy females
2. Age 18 to 50 years
3. Body mass index of 18.0 to 30.0 kg/m2 or, if outside the range, considered not clinically significant by the investigator
4. Minimum body weight of 60 kg
5. Must be willing and able to communicate and participate in the whole study
6. Normal hepatic function as evidenced by AST and alanine aminotransferase (ALT) \<1.5 × ULN and alkaline phosphatase (ALP) and total bilirubin within the normal range
7. Haemodynamically stable with systolic BP 90 to 150 mm Hg, diastolic BP \<95 mmHg and resting HR ≥45 and ≤100 bpm
8. Forced expiratory volume in 1 s (FEV1) \>80% predicted value and FEV1/ forced vital capacity (FVC) ratio \>0.7
9. Must provide written informed consent
10. Must agree to use an adequate method of contraception

Exclusion Criteria:

1. Subjects who have received any IMP in a clinical research study within the previous 3 months
2. Subjects who are study site employees, or immediate family members of a study site or sponsor employee
3. Subjects who have previously been enrolled in this study.
4. History of any drug or alcohol abuse in the past 2 years
5. Regular alcohol consumption in males \>21 units per week and females \>14 units per week (1 unit = ½ pint beer, 25 mL of 40% spirit or a 125 mL glass of wine)
6. Current smokers and those who have smoked within the last 12 months. A breath carbon monoxide reading of greater than 10 ppm at screening
7. Current users of e-cigarettes and nicotine replacement products and those who have used these products within the last 12 months
8. Females of childbearing potential who are pregnant or lactating (all female subjects must have a negative pregnancy test). A woman is considered of childbearing potential unless she is permanently sterile (hysterectomy, bilateral salpingectomy and bilateral oophorectomy) or is postmenopausal (had no menses for 12 months without an alternative medical cause and a serum follicle-stimulating hormone \[FSH\] concentration ≥40 IU/L)
9. Subjects who do not have suitable veins for multiple venepunctures/cannulation as assessed by the investigator at screening
10. Clinically significant abnormal biochemistry, haematology, coagulation or urinalysis as judged by the investigator, including:

    * Serum K \<3.5 mmol/L
    * Serum magnesium concentration of \<0.7 mmol/L
    * Serum phosphate \<2.5 or \>4.5 mg/dL
11. Positive drugs of abuse test result
12. Positive hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (HCV Ab) or human immunodeficiency virus (HIV) results
13. Evidence of renal impairment at screening, as indicated by an estimated creatinine clearance of \<80 mL/min using the Cockcroft-Gault equation
14. Evidence of any clinically relevant acute or chronic medical illness, including renal, hepatic, haematological, endocrine, pulmonary (including asthma), oncologic, neurologic or gastrointestinal disease, or psychiatric disorder, as judged by the investigator
15. History or presence of clinically significant cardiovascular disease, including coronary artery disease, myocardial infarction or ischemia, congestive heart failure, valvular disease, congenital heart disease or prior cardiac surgery
16. History or presence of cardiac arrhythmia or conduction abnormalities, including long-QT syndrome, TdeP, Wolff-Parkinson-White syndrome or bradycardia (\<45 bpm)
17. QTcF interval \>450 or QRS \>120 msec
18. Serious adverse reaction or serious hypersensitivity to any drug or the formulation excipients
19. Presence or history of clinically significant allergy requiring treatment, as judged by the investigator. Hayfever is allowed unless it is active
20. Donation or loss of greater than 400 mL of blood within the previous 3 months
21. Subjects who are taking, or have taken, any prescribed or over-the-counter drug (other than 4 g per day paracetamol and HRT/hormonal contraception) or herbal remedies in the 14 days before IMP administration (see Section 11.4). Exceptions may apply on a case by case basis, if considered not to interfere with the objectives of the study, as agreed by the PI and sponsor's medical monitor.
22. Failure to satisfy the investigator of fitness to participate for any other reason