STUDY TO EVALUATE THE EFFECT OF PF-06882961 ON SINGLE DOSE ATORVASTATIN, MEDAZOLAM AND ORALCONTRACEPTIVE PHARMACOKINETICS IN HEALTHY ADULT PARTICIPANTS

Study Overview
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Brief Summary
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The purpose of this study is to characterize the effect of PF-06882961, administered at 2 steady-state dose levels, on the PK of single doses of atorvastatin (20 mg) or midazolam (5 mg), administered separately, in healthy adult male and female participants (Part A), or an OC in healthy PM female participants (Part B).

Official Title
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A PHASE 1, OPEN-LABEL, TWO-PART STUDY TO EVALUATE THE EFFECT OF TWO STEADY-STATE DOSE LEVELS OF PF-06882961 ON THE PHARMACOKINETICS OF SINGLE ORAL DOSES OF ATORVASTATIN AND MIDAZOLAM IN HEALTHY ADULTS AND AN ORAL CONTRACEPTIVE IN HEALTHY POST-MENOPAUSAL FEMALES

Conditions
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Healthy Adults

Intervention / Treatment
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* Drug: PF-06882961
* Drug: Atorvastatin
* Drug: Midazolam
* Drug: Levonorgestrel & Ethinyl Estradiol


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Part A Only - Healthy male and female participants must be 18 to 65 years of age, inclusive, at the time of signing the ICD (healthy is defined as no clinically relevant abnormalities identified by a detailed medical history, physical examination, including blood pressure and pulse rate measurement, standard 12 lead ECG and clinical laboratory tests). Part B Only - Healthy PM female participants between 40 and 65 years of age, inclusive, at the time of signing the ICD (healthy is defined as no clinically relevant abnormalities identified by a detailed medical history, physical examination, including BP and PR measurement, standard 12 lead ECG and clinical laboratory tests). Subjects must be amenorrheic for at least 12 months. Women who are 60 years of age or younger must also have an FSH that is within the laboratory's reference range for PM women. Participants who are willing and able to comply with all scheduled visits, treatment plan, laboratory tests, lifestyle considerations, and other study procedures. BMI- 20.0 kg/m2 to <30.0 kg/m2 at Screening. Stable body weight, defined as <5 % change (per participant report) for 90 days before Screening. Capable of giving signed informed consent as described in Appendix 1, which includes compliance with the requirements and restrictions listed in the ICD and in this protocol. Exclusion Criteria: Evidence or history of clinically significant hematological, renal, endocrine, pulmonary, gastrointestinal, cardiovascular, hepatic, psychiatric, neurological, or allergic disease (including drug allergies, but excluding untreated, asymptomatic, seasonal allergies at the time of dosing). Any condition possibly affecting drug absorption (eg, prior bariatric surgery, gastrectomy, or any area of intestinal resection, active inflammatory bowel disease or pancreatic insufficiency). Other medical or psychiatric condition including recent (within the past year) or active suicidal ideation/behavior or laboratory abnormality that may increase the risk of study participation or, in the investigator's judgment, make the participant inappropriate for the study. Known intolerance or hypersensitivity to GLP-1R agonists. Known hypersensitivity to atorvastatin or midazolam (for participants in Part A), or LE and EE (for participants in Part B). Personal or family history of MTC or MEN2 or study participants with suspected MTC per the investigator's judgment. Symptomatic gallbladder disease. History of major depressive disorder or history of other severe psychiatric disorders (eg, schizophrenia or bipolar disorder) within the last 2 years from screening. Any lifetime history of a suicide attempt. Use of prescription or nonprescription drugs and dietary and herbal supplements within 7 days or 5 half lives (whichever is longer) prior to the first dose of study intervention. Systemic therapy with any of the medications that are moderate or strong CYP3A4/5, CYP2C9 and/or CYP2C19 inhibitors within 28 days or 5 half-lives (whichever is longer) or moderate or strong CYP3A, CYP2C9 and/or CYP2C19 inducers within 28 days or 5 half-lives (whichever is longer) prior to the first dose of study intervention. Systemic therapy with inhibitors of the BCRP transporter within 28 days or 5 half lives (whichever is longer) prior to the first dose of study intervention. Current use of any prohibited concomitant medication(s) or those unwilling/unable to use a permitted concomitant medication(s). Previous administration with an investigational drug within 30 days (or as determined by the local requirement) or 5 half lives preceding the first dose of study intervention used in this study (whichever is longer). Known prior participation in a trial involving PF-06882961. A PHQ-9 score ≥15 obtained at Screening or Day -1 in Study. Response of yes to question 4 or 5, or on any suicidal behavioral question on the C SSRS at Screening or Day -1 in Study. A positive urine drug test. Screening supine BP ≥140 mm Hg (systolic) or ≥90 mm Hg (diastolic), following at least 5 minutes of supine rest. BP should be measured in triplicate and the average of the 3 BP values should be used to determine the participant's eligibility. Note: At screening, the participant's arm circumference should be measured (eg, using a flexible anthropometric tape) at the midpoint of the length of the upper arm and the appropriate cuff selected and used throughout the study. Screening 12-lead ECG that demonstrates clinically relevant abnormalities that may affect participant safety or interpretation of study results (eg, QTcF interval >450 msec, complete LBBB, signs of an acute or indeterminate age myocardial infarction, ST-T interval changes suggestive of myocardial ischemia, second or third degree AV block, or serious bradyarrhythmias or tachyarrhythmias). If QTcF exceeds 450 msec, or QRS exceeds 120 msec, the ECG should be repeated 2 more times and the average of the 3 QTcF or QRS values should be used to determine the participant's eligibility. Computer interpreted ECGs should be overread by a physician experienced in reading ECGs before excluding participants. Participants with ANY of the following abnormalities in clinical laboratory tests at Screening, as assessed by the study specific laboratory and confirmed by a single repeat test, if deemed necessary: HbA1c ≥6.5%. Aspartate AST or ALT level ≥2 times the ULN. Total bilirubin level ≥1.5 times the ULN; participants with a history of Gilbert's syndrome may have direct bilirubin measured and would be eligible for this study provided the direct bilirubin level is ≤ ULN. TSH >1.5x the ULN or <LLN. Serum calcitonin > the ULN. Amylase or lipase > the ULN. Fasting blood glucose ≥126 mg/dL. Fasting C-peptide <0.8 ng/mL. eGFR <70 mL/min/1.73 m2 as calculated by the CKD-EPI equation. Positive testing for HIV, HepBsAg, or HCVAb. Study participants positive for HCVAb are to be excluded unless known to have been treated with a known curative therapy and negative for HCV RNA. Hepatitis B vaccination is allowed. A positive SARS-CoV-2 test. Participation in a formal weight reduction program (eg, Weight Watchers) within 90 days prior to Screening. History of alcohol abuse or binge drinking and/or any other illicit drug use or dependence within 6 months of Screening. Binge drinking is defined as a pattern of 5 (male) and 4 (female) or more alcoholic drinks in about 2 hours. As a general rule, alcohol intake should not exceed 14 units per week (1 unit = 8 ounces (240 mL) beer, 1 ounce (30 mL) of 40% spirit or 3 ounces (90 mL) of wine). Current use of tobacco or nicotine containing products in excess of the equivalent of 5 cigarettes per day. Known or suspected illicit drug use. Blood donation (excluding plasma donations) of approximately 1 pint (500 mL) or more within 60 days prior to dosing randomization (Day-1). History of sensitivity to heparin or heparin induced thrombocytopenia if Hep-lock is used for IV blood draw. Unwilling or unable to comply with the criteria in the Lifestyle Considerations section of this protocol. Investigator site staff or Pfizer employees directly involved in the conduct of the study, site staff otherwise supervised by the investigator, and their respective family members.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 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: Sequential Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Part A<br>To evaluate the effect of 2 steady-state dose levels of PF-06882961 on the Single Dose pharmacokinetics of atorvastatin (20 mg tablet) and midazolam (5 mg syrup). | Drug: PF-06882961<br>* Tablets<br>Drug: Atorvastatin<br>* Tablets<br>Drug: Midazolam<br>* Syrup<br>|
| Experimental: Part B<br>To evaluate the effect of 2 steady-state dose levels of PF-06882961 on the Single Dose pharmacokinetics of an Oral Contraceptive (Levonorgestrel 0.15 mg and Ethinyl Estradiol 0.03 mg tablet). | Drug: PF-06882961<br>* Tablets<br>Drug: Levonorgestrel & Ethinyl Estradiol<br>* Tablet<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Area Under the Concentration-time Curve From Time Zero Extrapolated to Infinite Time (AUCinf), as data permit, otherwise Area Under the Curve From Time Zero to Last Quantifiable Concentration (AUClast) | Evaluate the effect of PF-06882961 on the Pharmacokinetics (PK) of Atorvastatin in healthy adult male and female participants | Part A, Periods 1, 4, and 7 @ 0 hours (hrs) and 0.5, 1, 1.5, 2, 4, 6, 9, 12, 24, 36, 48 and 72 hrs post-dose | 
| AUCinf, as data permit, otherwise AUClast. | Evaluate the effect of PF-06882961 on the PK of Midazolam in healthy adult male and female participants | Part A, Periods 2, 5 and 8 @ 0 hr and 0.5, 1, 2, 3, 4, 6, 8, 10, 12, 16 and 24 hrs post-dose | 
| AUCinf, as data permit, otherwise AUClast. | To evaluate the effect of PF-06882961 on the pharmacokinetics of an oral contraceptive, levonorgestrel, in healthy, post menopausal female participants | Part B, Periods 1, 3 and 5 @ 0 hr and 0.5, 1, 1.5, 2, 4, 8, 12, 24, 48, 72, 96 and 120 hours post-dose | 
| AUCinf, as data permit, otherwise AUClast. | To evaluate the effect of PF-06882961 on the pharmacokinetics of an oral contraceptive, ethinyl estradiol, in healthy, post menopausal female participants | Part B, Periods 1, 3 and 5 @ 0 hr and 0.5, 1, 1.5, 2, 4, 8, 12, 24, 48, 72, 96 and 120 hours post-dose | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of Subjects reporting Treatment Emergent Adverse Events (TEAEs) |  | Part A Screening through Day 97 Follow -up telephone contact. Part B Screening through Day 101 Follow-up telephone contact. | 
| Incidence of treatment emergent clinical laboratory abnormalities |  | Part A Screening through Day 72 Follow-up. Part B Screening through Day 75 Follow-up. | 
| Incidence of treatment emergent vital signs |  | Part A Screening through Day 72 Follow-up. Part B Screening through Day 75 Follow-up. | 
| Change from Baseline in Modified Body Mass Index (mBMI) at Month X |  | Part A Screening through Day 72 Follow-up. Part B Screening through Day 75 Follow-up. | 
| Incidence of treatment emergent Electrocardiogram (ECG) abnormalities |  | Part A Screening through Day 72 Follow-up. Part B Screening through Day 75 Follow-up. | 
| Number of Participants with categorical scores on the Columbia Suicide Severity Rating Scale (C-SSRS) |  | Part A Screening through Day 72 Follow-up. Part B Screening through Day 75 Follow-up. | 
| Number of Participants With Response to Patient Health Questionnaire-9 (PHQ-9) |  | Part A Screening through Day 72 Follow-up. Part B Screening through Day 75 Follow-up. |