A Study to Evaluate the Effect of JNJ-53718678 on the Cardiac Repolarization Interval in Healthy Adult Participants

Study Overview
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Brief Summary
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The purpose of this study is to assess the effect of JNJ-53718678 on QT interval corrected for heart rate (QTc) changes using exposure response analysis in healthy adult participants (Part 2).

Official Title
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A Double-blind, Randomized, Placebo-controlled, 4-Period Cross-over Study to Evaluate the Effect of JNJ-53718678 on the Cardiac Repolarization Interval in Healthy Adult Subjects

Conditions
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Healthy

Intervention / Treatment
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* Drug: JNJ-53718678, 2000 mg
* Drug: JNJ-53718678, 3000 mg
* Drug: JNJ-53718678, 4500 mg or Dose to be decided
* Drug: JNJ-53718678 500 mg
* Drug: JNJ-53718678 Placebo
* Drug: Moxifloxacin 400 mg
* Drug: Moxifloxacin Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants must have a Body mass index (BMI) between 18 and 30 kilogram per square meter (kg/m^2) (inclusive), and body weight not less than (<) 50 kg at screening Participants must have a blood pressure between 90 and 140 millimeter of mercury (mmHg) systolic, inclusive, and no higher than 90 mmHg diastolic at screening Participants must have a 12-lead electrocardiogram (ECG) consistent with normal cardiac conduction and function at screening, including: a) Normal sinus rhythm (heart rate (HR) between 45 and 100 beats per minute (bpm), inclusive); b) QT interval corrected for HR according to Fridericia's formula (QTcF) between 350 milliseconds (ms) and 430 ms for male participants, and between 350 ms and 450 ms for female participants (inclusive); c) QRS interval of ECG <110 ms; d) PR interval of the ECG less-than or equal to (<=) 200 ms; e) Morphology consistent with healthy cardiac conduction and function A female participant must be of non-childbearing potential, defined as: a) Postmenopausal or b) Permanently sterile A female participant must have a negative serum beta-human chorionic gonadotropin (b-hCG) pregnancy test at screening and a negative urine pregnancy test (except if postmenopausal) on Day -1 (or Day -2 in the first treatment period in Part 2) Exclusion Criteria: Participants has a history of current clinically significant medical illness or certain laboratory abnormalities at screening Participant has a history of hepatitis A virus immunoglobulin M (IgM) antibody, hepatitis B surface antigen (HBsAg), or hepatitis C virus (HCV) antibody positive, or other clinically active liver disease, or tests positive for hepatitis A virus IgM antibody, HBsAg or HCV antibody at screening Participants with unusual T wave morphology (such as bifid T wave) likely to interfere with QTc measurements Participants with a past history of heart arrhythmias or with a history of risk factors for Torsade de Pointes syndrome (for example, hypokalemia or family history of short/long QT syndrome, or sudden unexplained death at a young age [<=40 years], drowning or sudden infant death in a first degree relative [that is, sibling, offspring, or biological parent]) Participants with any skin condition likely to interfere with ECG electrode placement or adhesion

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 55 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: Treatment
Allocation: Randomized
Intervention Model: Sequential Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Part 1 (Dose Escalation): Panel 1<br>Participants will receive single oral dose of JNJ-53718678, 2000 milligram (mg) suspension or matching placebo on Day 1, under fasted conditions. | Drug: JNJ-53718678, 2000 mg<br>* Participants will be administered JNJ-53718678, 2000 mg as oral suspension in Part 1 (Panel 1).<br>Drug: JNJ-53718678 Placebo<br>* Participants will be administered JNJ-53718678 matching placebo in Part 1 and 2.<br>|
| Experimental: Part 1 (Dose Escalation): Panel 2<br>Participants will receive single oral dose of JNJ-53718678, of maximum 3000 mg suspension or matching placebo on Day 1, under fasted conditions. | Drug: JNJ-53718678, 3000 mg<br>* Participants will be administered JNJ- 53718678, 3000 mg as oral suspension in Part 1 (Panel 2).<br>Drug: JNJ-53718678 Placebo<br>* Participants will be administered JNJ-53718678 matching placebo in Part 1 and 2.<br>|
| Experimental: Part 1 (Dose escalation): Panel 3<br>Participants will receive single oral dose of JNJ-53718678 4500 mg suspension (this dose may be used in Part 2, Treatment F) or matching placebo on Day 1, under fasted condition. | Drug: JNJ-53718678, 4500 mg or Dose to be decided<br>* Participants will be administered JNJ-53718678, 4500 mg as oral suspension in Part 1 (Panel 3). If this dose is considered safe and tolerable and if pharmacokinetic data require further dose escalation, then participants will receive JNJ-53718678 (Dose to be decided) in Part 1 (Panel 4). This dose (either from Panel 3 or Panel 4 ) will be used in Part 2 (Dose may be lower/higher based on review of safety, tolerability, and PK data obtained in Part 1).<br>Drug: JNJ-53718678 Placebo<br>* Participants will be administered JNJ-53718678 matching placebo in Part 1 and 2.<br>|
| Experimental: Part 1 (Dose Escalation): Panel 4 (Optional)<br>Participants will receive single oral dose of JNJ-53718678 (dose to be decided [this dose may be used in Part 2, Treatment F]) suspension or matching placebo on Day 1, under fasted condition, if 4500 mg dose in Panel 3 is considered safe and tolerable and if pharmacokinetic data require further dose escalation to reach the target exposure. | Drug: JNJ-53718678, 4500 mg or Dose to be decided<br>* Participants will be administered JNJ-53718678, 4500 mg as oral suspension in Part 1 (Panel 3). If this dose is considered safe and tolerable and if pharmacokinetic data require further dose escalation, then participants will receive JNJ-53718678 (Dose to be decided) in Part 1 (Panel 4). This dose (either from Panel 3 or Panel 4 ) will be used in Part 2 (Dose may be lower/higher based on review of safety, tolerability, and PK data obtained in Part 1).<br>Drug: JNJ-53718678 Placebo<br>* Participants will be administered JNJ-53718678 matching placebo in Part 1 and 2.<br>|
| Experimental: Part 2 Group 1: Treatment Sequence EHFG<br>Participants will receive single oral dose of JNJ-53718678, 500 mg suspension with single oral dose of moxifloxacin placebo and JNJ 53718678 placebo (Treatment E) in Period 1, then participants will receive single oral dose of moxifloxacin 400 mg with single oral dose of JNJ-53718678 placebo (Treatment H) in Period 2 then will receive single oral dose of JNJ-53718678, 4500 mg (dose will be based on review of safety, tolerability, and PK data obtained in Part 1 [either from Panel 3 or 4], this dose may be lower/higher) suspension with single oral dose of moxifloxacin placebo (Treatment F) in Period 3 followed by single oral dose of JNJ-53718678 placebo with single oral dose of moxifloxacin placebo (Treatment G) in Period 4, on Day 1 of each treatment period. There will be a washout period of at least 7 days between study drug intake in subsequent treatment periods. | Drug: JNJ-53718678, 4500 mg or Dose to be decided<br>* Participants will be administered JNJ-53718678, 4500 mg as oral suspension in Part 1 (Panel 3). If this dose is considered safe and tolerable and if pharmacokinetic data require further dose escalation, then participants will receive JNJ-53718678 (Dose to be decided) in Part 1 (Panel 4). This dose (either from Panel 3 or Panel 4 ) will be used in Part 2 (Dose may be lower/higher based on review of safety, tolerability, and PK data obtained in Part 1).<br>Drug: JNJ-53718678 500 mg<br>* Participants will be administered JNJ-53718678, 500 mg as oral suspension in Part 2.<br>Drug: JNJ-53718678 Placebo<br>* Participants will be administered JNJ-53718678 matching placebo in Part 1 and 2.<br>Drug: Moxifloxacin 400 mg<br>* Participants will be administered moxifloxacin 400 mg as capsule in Part 2.<br>Drug: Moxifloxacin Placebo<br>* Participants will be administered moxifloxacin matching placebo in Part 2.<br>|
| Experimental: Part 2 Group 2: Treatment Sequence FEGH<br>Participants will receive Treatment F in Period 1, then Treatment E in Period 2, then Treatment G in Period 3 followed by Treatment H in Period 4 on Day 1 of each treatment period. | Drug: JNJ-53718678, 4500 mg or Dose to be decided<br>* Participants will be administered JNJ-53718678, 4500 mg as oral suspension in Part 1 (Panel 3). If this dose is considered safe and tolerable and if pharmacokinetic data require further dose escalation, then participants will receive JNJ-53718678 (Dose to be decided) in Part 1 (Panel 4). This dose (either from Panel 3 or Panel 4 ) will be used in Part 2 (Dose may be lower/higher based on review of safety, tolerability, and PK data obtained in Part 1).<br>Drug: JNJ-53718678 500 mg<br>* Participants will be administered JNJ-53718678, 500 mg as oral suspension in Part 2.<br>Drug: JNJ-53718678 Placebo<br>* Participants will be administered JNJ-53718678 matching placebo in Part 1 and 2.<br>Drug: Moxifloxacin 400 mg<br>* Participants will be administered moxifloxacin 400 mg as capsule in Part 2.<br>Drug: Moxifloxacin Placebo<br>* Participants will be administered moxifloxacin matching placebo in Part 2.<br>|
| Experimental: Part 2 Group 3: Treatment Sequence GFHE<br>Participants will receive Treatment G in Period 1, then Treatment F in Period 2, then Treatment H in Period 3 followed by Treatment E in Period 4 on Day 1 of each treatment period. | Drug: JNJ-53718678, 4500 mg or Dose to be decided<br>* Participants will be administered JNJ-53718678, 4500 mg as oral suspension in Part 1 (Panel 3). If this dose is considered safe and tolerable and if pharmacokinetic data require further dose escalation, then participants will receive JNJ-53718678 (Dose to be decided) in Part 1 (Panel 4). This dose (either from Panel 3 or Panel 4 ) will be used in Part 2 (Dose may be lower/higher based on review of safety, tolerability, and PK data obtained in Part 1).<br>Drug: JNJ-53718678 500 mg<br>* Participants will be administered JNJ-53718678, 500 mg as oral suspension in Part 2.<br>Drug: JNJ-53718678 Placebo<br>* Participants will be administered JNJ-53718678 matching placebo in Part 1 and 2.<br>Drug: Moxifloxacin 400 mg<br>* Participants will be administered moxifloxacin 400 mg as capsule in Part 2.<br>Drug: Moxifloxacin Placebo<br>* Participants will be administered moxifloxacin matching placebo in Part 2.<br>|
| Experimental: Part 2 Group 4: Treatment Sequence HGEF<br>Participants will receive Treatment H in Period 1, then Treatment G in Period 2, then Treatment E in Period 3 followed by Treatment F in Period 4 on Day 1 of each treatment period. | Drug: JNJ-53718678, 4500 mg or Dose to be decided<br>* Participants will be administered JNJ-53718678, 4500 mg as oral suspension in Part 1 (Panel 3). If this dose is considered safe and tolerable and if pharmacokinetic data require further dose escalation, then participants will receive JNJ-53718678 (Dose to be decided) in Part 1 (Panel 4). This dose (either from Panel 3 or Panel 4 ) will be used in Part 2 (Dose may be lower/higher based on review of safety, tolerability, and PK data obtained in Part 1).<br>Drug: JNJ-53718678 500 mg<br>* Participants will be administered JNJ-53718678, 500 mg as oral suspension in Part 2.<br>Drug: JNJ-53718678 Placebo<br>* Participants will be administered JNJ-53718678 matching placebo in Part 1 and 2.<br>Drug: Moxifloxacin 400 mg<br>* Participants will be administered moxifloxacin 400 mg as capsule in Part 2.<br>Drug: Moxifloxacin Placebo<br>* Participants will be administered moxifloxacin matching placebo in Part 2.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Part 2: Placebo-Corrected Change from Baseline in QT Interval Corrected for Heart Rate (QTc) for JNJ-53718678 | Placebo-corrected change from baseline in QT interval corrected for heart rate (QTc) will be determined. The mean change from baseline in QTc in placebo treatment will be subtracted from the mean change from baseline in JNJ-53718678 treatment at the same time point to generate placebo-corrected change from baseline in QTc, which will be presented. | Baseline and Day 1 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Part 1: Number of Participants with Adverse Events as a Measure of Safety and Tolerability | An adverse event is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product. | Approximately up to 9 weeks | 
| Part 2: Number of Participants with Adverse Events as a Measure of Safety and Tolerability | An adverse event is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product. | Approximately up to 12 weeks | 
| Part 1: Change from Baseline in QTc Interval | The QT interval corrected for heart rate (QTc interval) using Fridericia method will be measured by electrocardiograms (ECG). | Baseline, 3, 24, 72 hours and at follow-up (10-14 days postdose) | 
| Part 1: Change from Baseline in Heart Rate (HR) | The HR will be measured by ECG. | Baseline, 3, 24, 72 hours and at follow-up (10-14 days postdose) | 
| Part 1: Change from Baseline in PR Interval | The PR Intervals will be measured by ECG. | Baseline, 3, 24, 72 hours and at follow-up (10-14 days postdose) | 
| Part 1: Change from Baseline in QRS Interval | The QRS Intervals will be measured by ECG. | Baseline, 3, 24, 72 hours and at follow-up (10-14 days postdose) | 
| Part 1: Percentage of Participants with T-Wave Morphology Changes from Baseline | Percentage of participants with T-wave morphology (Normal T-wave, Flat T-waves, Notched T-wave (positive), Biphasic, Normal T-wave (negative), Notched T-wave (negative) changes will be noted. | Baseline up to 72 hours postdose | 
| Part 1: Percentage of Participants with U-Wave Presence | Percentage of participants with U-wave presence will be noted. | Baseline up to 72 hours postdose | 
| Part 2: Change from Baseline in QTc Interval | The QT interval corrected for heart rate (QTc interval) using Fridericia method will be measured by ECG. | Baseline, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, and 24 hours postdose | 
| Part 2: Change from Baseline in HR | The HR will be measured by ECG. | Baseline, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, and 24 hours postdose | 
| Part 2: Change from Baseline PR Interval | The PR Intervals will be measured by ECG. | Baseline, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, and 24 hours postdose | 
| Part 2: Change from Baseline QRS Interval | The QRS Intervals will be measured by ECG. | Baseline, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, and 24 hours postdose | 
| Part 2: Placebo Corrected Change from Baseline in HR | Placebo-corrected change from baseline in HR will be determined. The mean change from baseline in HR in placebo treatment will be subtracted from the mean change from baseline in JNJ-53718678 treatment at the same time point to generate placebo-corrected change from baseline in HR, which will be presented. | Baseline, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, and 24 hours postdose | 
| Part 2: Placebo Corrected Change from Baseline PR Interval | Placebo-corrected change from baseline in PR interval will be determined. The mean change from baseline in PR interval in placebo treatment will be subtracted from the mean change from baseline in JNJ-53718678 treatment at the same time point to generate placebo-corrected change from baseline in PR interval, which will be presented. | Baseline, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, and 24 hours postdose | 
| Part 2: Placebo Corrected Change from Baseline QRS Interval | Placebo-corrected change from baseline in QRS interval will be determined. The mean change from baseline in QRS interval in placebo treatment will be subtracted from the mean change from baseline in JNJ-53718678 treatment at the same time point to generate placebo-corrected change from baseline in QRS interval, which will be presented. | Baseline, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, and 24 hours postdose | 
| Part 2: Number of Participants with Categorical Outliers for QTc Interval | Number of Participants with categorical outliers defined as QTc interval values greater than (>)450 and lesser than or equal to (<=) 480 milliseconds (ms), >480 and <=500 ms, and >500 ms at any time point and change from baseline QTc >30 ms and <=60 ms, and >60 ms will be determined. | Baseline up to 24 hours postdose | 
| Part 2: Number of Participants with Categorical Outliers for HR | Number of Participants with categorical outliers for HR will be determined for abnormality, where HR is abnormally low (<= 45 beats per minute [bpm]) and abnormally high (>= 120 bpm). | Baseline up to 24 hours postdose | 
| Part 2: Number of Participants with Categorical Outliers for PR Interval | Number of Participants with categorical outliers for PR interval will be determined for abnormality, where PR is abnormally high (>= 210 milliseconds [ms]). | Baseline up to 24 hours postdose | 
| Part 2: Number of Participants with Categorical Outliers for QRS Interval | Number of Participants with categorical outliers for QRS interval will be determined for abnormality, where QRS is abnormally low (<= 50 ms) and abnormally high (>=120 ms). | Baseline up to 24 hours postdose | 
| Part 2: Percentage of Participants with T-Wave Morphology Changes from Baseline | Percentage of participants with T-wave morphology (Normal T-wave, Flat T-waves, Notched T-wave (positive), Biphasic, Normal T-wave (negative), Notched T-wave (negative) changes will be noted. | Baseline up to 24 hours postdose | 
| Part 2: Percentage of Participants with U-Wave Presence | Percentage of participants with U-wave presence will be noted. | Baseline up to 24 hours postdose | 
| Part 1: Maximum Observed Plasma Concentration (Cmax) of JNJ-53718678 and its Metabolites (M5, M12, M19, and M37) | Cmax is defined as the maximum observed plasma concentration. Cmax will be assessed for JNJ-53718678 and its metabolites (M5, M12, M19, and M37). | Predose, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 36, 48 and 72 hours postdose | 
| Part 1: Time to Reach Maximum Observed Plasma Concentration (Tmax) of JNJ-53718678 and its Metabolites (M5, M12, M19, and M37) | Tmax is defined as actual sampling time to reach maximum observed plasma concentration. Tmax will be assessed for JNJ-53718678 and its metabolites (M5, M12, M19, and M37). | Predose, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 36, 48 and 72 hours postdose | 
| Part 1: Plasma concentration at 24 hours post dosing (C24h) of JNJ-53718678 and its Metabolites (M5, M12, M19, and M37) | C24h is defined as the plasma concentration at 24 hours post dosing. C24h will be assessed for JNJ-53718678 and its metabolites (M5, M12, M19, and M37). | Predose, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, and 24hours postdose | 
| Part 1: Area Under the Plasma Concentration-time Curve from Time 0 to 24 hours (AUC [0-24]) of JNJ-53718678 and its Metabolites (M5, M12, M19, and M37) | AUC (0-24) is defined as the area under the plasma concentration-time curve from time 0 to 24 hours. AUC (0-24) will be assessed for JNJ-53718678 and its metabolites (M5, M12, M19, and M37). | Predose, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, and 24 hours postdose | 
| Part 1: Area Under the Plasma Concentration-time Curve from Time Zero to the Time of Last Measurable Concentration (AUC [0-last]) of JNJ-53718678 and its Metabolites (M5, M12, M19, and M37) | AUC(0-last) is defined as the area under the plasma concentration-time curve from time 0 to the time of the last measurable (non-below quantification level [non-BQL]) plasma concentration calculated by linear-linear trapezoidal summation. AUC [0-last] will be assessed for JNJ-53718678 and its metabolites (M5, M12, M19, and M37). | Predose, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 36, 48 and 72 hours postdose | 
| Part 1: Area Under the Plasma Concentration-time Curve from Time Zero to Infinity (AUC [0-infinity]) of JNJ-53718678 and its Metabolites (M5, M12, M19, and M37) | AUC (0-infinity) is defined as the area under the plasma concentration vs. time curve from time 0 to infinite time, calculated as AUC (0-last) + Clast/ lambda (z), where Clast is the last observed measurable (non- BQL) plasma concentration. AUC (0-infinity) will be assessed for JNJ-53718678 and its metabolites (M5, M12, M19, and M37). | Predose, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 36, 48 and 72 hours postdose | 
| Part 1: Apparent Elimination Half-Life (T1/2) of JNJ- 53718678 and its Metabolites (M5, M12, M19, and M37) | T1/2 is defined as apparent terminal elimination half-life and is calculated as 0.693/lambda(z) and will be assessed for JNJ-53718678 and its metabolites (M5, M12, M19, and M37). | Predose, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, 24, 36, 48 and 72 hours postdose | 
| Part 2: Maximum Observed Plasma Concentration (Cmax) of JNJ-53718678 and its Metabolites (M5, M12, M19, and M37) | Cmax is defined as the maximum observed plasma concentration. Cmax will be assessed for JNJ-53718678 and its metabolites (M5, M12, M19, and M37). | Predose, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, and 24 hours postdose | 
| Part 2: Time to Reach Maximum Observed Plasma Concentration (Tmax) of JNJ-53718678 and its Metabolites (M5, M12, M19, and M37) | Tmax is defined as actual sampling time to reach maximum observed plasma concentration. Tmax will be assessed for JNJ-53718678 and its metabolites (M5, M12, M19, and M37). | Predose, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, and 24 hours postdose | 
| Part 2: Area Under the Plasma Concentration-time Curve from Time 0 to 24 hours (AUC [0-24]) of JNJ-53718678 | AUC (0-24) is defined as the area under the plasma concentration-time curve from time 0 to 24 hours. AUC (0-24) will be assessed for JNJ-53718678 and its metabolites (M5, M12, M19, and M37). | Predose, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 16, and 24 hours postdose |