Evaluating the Safety, Tolerability, Pharmacokinetics and Receptor Occupancy of BMS-984923

Study Overview
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Brief Summary
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This project seeks to develop a novel disease-modifying compound for Alzheimer's disease (AD).

Detailed Description
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The primary objective of this study is to evaluate the safety, tolerability, and pharmacokinetics of BMS-984923 in healthy participants. A secondary objective of this study is to conduct a receptor occupancy sub-study aimed at determining drug receptor occupancy at each dose using [18F]FPEB Positron Emission Tomography.

Official Title
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An Open-Label, Single-Ascending Dose Study to Evaluate the Safety, Tolerability, Pharmacokinetics and Receptor Occupancy of BMS-984923

Conditions
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Alzheimer Disease

Intervention / Treatment
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* Drug: BMS-984923


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: No history of cognitive impairment Capable of providing written informed consent and willing to comply with all study requirements and procedures Participant is not pregnant, lactating, or of childbearing potential Non-childbearing potential for women is defined as postmenopausal (last natural menses greater than 24 months; menopausal status will be documented with serum follicle stimulating hormone (FSH) or documentation of bilateral tubal ligation or hysterectomy Male participants who are sexually active with a woman of child-bearing potential must agree to use condoms during the trial and for 3 months after the last dose unless the woman is using an acceptable means of birth control. Acceptable forms of birth control include abstinence, birth control pills, or any double combination of: intrauterine device (IUD), male or female condom, diaphragm, sponge, and cervical cap. Male participants must also agree not to donate sperm for 90 days after the last dose. - Glasgow Coma Scale Score of 15 (97) Clinical Dementia Rating Score of 0 (93) Has a reliable study partner who has frequent contact with the participant (e.g., average of 10 hours per week or more), who can be available for study partner assessments, who can accompany the participant for 48 hours, without absence, after discharge from Visit 2. Score on the Mini Mental Status Exam > 26 (95) Objective memory scores within normal range for age evidenced by a score no more than 1.5 standard deviations below the education adjusted cutoff on the Logical Memory II subscale (Delayed Paragraph Recall) from the Wechsler Memory Scale - Revised (the maximum score is 25). >8 for 16 or more years of education >4 for 8-15 years of education >2 for 0-7 years of education Receptor Occupancy Substudy Eligibility Criteria Eligibility for and enrollment in Main Study Participant consent to the optional substudy Exclusion Criteria: Body mass index (BMI) ≥ 35 kg/m2 or body weight < 50 kg. Significant cerebrovascular disease: Modified Hachinski score > 4. Any significant neurologic disease, such as AD, Parkinson's disease, multi-infarct dementia, Huntington's disease, normal pressure hydrocephalus, brain tumor, progressive supranuclear palsy, seizure disorder, subdural hematoma, multiple sclerosis, or history of significant head trauma followed by persistent neurologic defaults or known structural brain abnormalities. Major depression, bipolar disorder as described in DSM-IV within the past 1 year. Psychotic features, agitation or behavioral problems within 3 months, which could lead to difficulty complying with the protocol. History of schizophrenia (DSM IV criteria). History of alcohol or substance abuse or dependence within the past 2 years (DSM IV criteria). Clinically significant or unstable medical condition, including uncontrolled hypertension, uncontrolled diabetes, or significant cardiac, pulmonary, renal, hepatic, endocrine, or other systemic disease in the opinion of the PI, may either put the patient at risk because of participation in the study, or influence the results, or the patient's ability to participate in the study. Clinically significant abnormalities in B12 or Thyroid Function Tests that might interfere with the study. Use of psychoactive medications (typical neuroleptics, narcotic analgesics, antiparkinsonian medications, systemic corticosteroids, or medications with significant central anticholinergic activity) within 2 weeks or 5 half-lives (whichever is greater) prior to study drug administration and for the duration of the trial. Use of medications with significant CYP1A2, 2D6, or 3A4 inhibitor or inducer activity (See appendix for a list of these medications) within 2 weeks or 5 half-lives (whichever is greater) prior to study drug administration and for the duration of the trial. Use of anticoagulants within 30 days or 5 half-lives (whichever is greater) prior to study drug administration and for the duration of the trial. Use of investigational amyloid lowering therapies within 2 months prior to study drug administration and for the duration of the trial. Use of another investigational agent within 30 days or 5 half-lives (whichever is greater) prior to screening and for the duration of the trial. Neutropenia defined as absolute neutrophils count of < 1,500/microliter. Thrombocytopenia defined as platelet count < 100,000/microliter. Clinically significant abnormalities in screening laboratories, including Aspartate aminotransferase (AST) >1.5 times upper limit of normal (ULN); Alanine aminotransferase (ALT) >1.5 times ULN; Total bilirubin >1.5 times ULN; Serum creatinine >2.0 times ULN.

Ages Eligible for Study
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Minimum Age: 50 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The study will enroll four cohorts of 6 participants each. Study drug will be administered in sequentially increasing dose groups. For all 6 participants at a dose cohort, a safety assessment review will be completed prior to advancing the next higher dose level.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: 10 mg BMS-984923<br> | Drug: BMS-984923<br>* Day 1: Admission, administration of study drug, and 2 night in-patient stay; Day 3: Discharge following the completion of all scheduled procedures.<br>|
| Experimental: 40 mg BMS-984923<br> | Drug: BMS-984923<br>* Day 1: Admission, administration of study drug, and 2 night in-patient stay; Day 3: Discharge following the completion of all scheduled procedures.<br>|
| Experimental: 70 mg BMS-984923<br> | Drug: BMS-984923<br>* Day 1: Admission, administration of study drug, and 2 night in-patient stay; Day 3: Discharge following the completion of all scheduled procedures.<br>|
| Experimental: 100 mg BMS-984923<br> | Drug: BMS-984923<br>* Day 1: Admission, administration of study drug, and 2 night in-patient stay; Day 3: Discharge following the completion of all scheduled procedures.<br>|
| Experimental: 150 mg BMS-984923<br> | Drug: BMS-984923<br>* Day 1: Admission, administration of study drug, and 2 night in-patient stay; Day 3: Discharge following the completion of all scheduled procedures.<br>|
| Experimental: 200 mg BMS-984923<br> | Drug: BMS-984923<br>* Day 1: Admission, administration of study drug, and 2 night in-patient stay; Day 3: Discharge following the completion of all scheduled procedures.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Count of Treatment Emergent Adverse Events (TEAEs) | A count of participants that experience any adverse events found to be associated with treatment. All adverse events are summarized in the adverse events section. | Up to 7 days after last dose | 
| Count of Lab Abnormalities | Count of participants with clinical lab abnormalities. | Up to 7 days after last dose | 
| Count of Clinically Significant Changes in Safety Assessments | A count of participants that experienced any clinically significant changes in: Vital Signs, Physical Exam, Electrocardiogram, Neuropsychiatric Inventory - Q, Geriatric Depression Scale, Glasgow Coma Scale, Montreal Cognitive Assessment | Up to 7 days after last dose | 
| Maximum Plasma Concentration (Cmax) | Maximum plasma concentration as determined by pharmacokinetic modeling | Up to 7 days after last dose | 
| Time of Cmax (Tmax) | Time of Cmax as determined by pharmacokinetic modeling | Up to 7 days after last dose | 
| Area Under the Curve From 0 to 24h (AUC 24h) | Plasma drug exposure as determined by pharmacokinetic modeling, AUC is represented as ng∙h/mL. | Up to 7 days after last dose | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Receptor Occupancy | Metabotropic glutamate receptor subtype 5 (mGluR5) occupancy using [18F]FPEB Positron Emission Tomography | Up to 24 hours after last dose |