Effects of TAK-063 on Preventing Ketamine-Induced Brain Activity Changes as Well as Psychotic-Like Symptoms in Healthy Male Adults

Study Overview
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Brief Summary
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The purpose of this study is to determine whether ketamine-induced brain activity changes are modulated by TAK-063 administration using neuroimaging battery tests.

Detailed Description
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The drug being tested in this study is called TAK-063. This study will look at brain activity changes and treatment of psychotic-like symptoms induced by ketamine, in people who take TAK-063. The study will enroll approximately 27 participants. Participants will be randomly assigned to one of treatment sequences-which will remain undisclosed to the participants during the study (unless there is an urgent medical need). Participants will receive the following study medications by the end of the study: Ketamine intravenous infusion (IV) AND Placebo (dummy inactive pill) - this is a tablet that looks like the study drug but has no active ingredient AND Two doses of TAK-063 at one of three dose levels All participants will be asked to take 3 tablets and will receive a ketamine IV on the first day of 3 separate study periods. Participants will then be assessed for brain activity changes and other symptoms. This single-center trial will be conducted in the United States. The overall time to participate in this study is up to 7 weeks. Participants will make 6 visits to the clinic.

Official Title
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A Randomized, Investigator and Subject-Blind, Placebo-Controlled, Single-Dose, 3-Period, Incomplete Block Cross-Over Study to Evaluate the Effects of Single Oral Administration of TAK-063 on Preventing Ketamine-Induced Brain Activity Changes as Well as Psychotic-Like Symptoms in Healthy Male Adults

Conditions
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Ketamine-Induced Brain Activity Changes, Psychotic-like Symptoms

Intervention / Treatment
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* Drug: Ketamine
* Drug: TAK-063
* Drug: TAK-063 Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: In the opinion of the investigator, participant is capable of understanding and complying with protocol requirements. The participant or, when applicable, the participant's legally acceptable representative signs and dates a written, informed consent form and any required privacy authorization prior to the initiation of any study procedures. Is a healthy adult male. Speaks English as their first language. Is aged 18 to 45 years, inclusive, at the time of informed consent and first dose of study drug. Weighs at least 50 kg and has a body mass index (BMI) between 18 and 32 kilogram per metre square (kg/m^2), inclusive at Screening. A male participant who is nonsterilized and sexually active with a female partner of childbearing potential agrees to use adequate contraception from signing of informed consent throughout the duration of the study and for 12 weeks after last dose. Has a normal magnetic resonance imaging (MRI) scan and electroencephalogram (EEG) measurement at Screening. Exclusion Criteria: Has received any investigational compound or ketamine within 30 days prior to Day 1 of Period 1. Has received TAK-063 in a previous clinical study or as a therapeutic agent. Is an immediate family member, study site employee, or in a dependent relationship with a study site employee who is involved in the conduct of this study (e.g., spouse, parent, child, sibling) or may consent under duress. Has uncontrolled, clinically significant neurologic, cardiovascular, pulmonary, hepatic, renal, metabolic, gastrointestinal, urologic, immunologic, endocrine disease, or psychiatric disorder, or other abnormality (including MRI or EEG), which may impact the ability of the participant to participate or potentially confound the study results. Has a known hypersensitivity to any component of the formulation of TAK-063 or ketamine. Has a contraindication for ketamine. Has a positive result for drugs or alcohol at Screening or Check-in (Day -1 of Period 1). Has a history of drug or alcohol abuse or dependence (as defined by Diagnostic & Statistical Manual of Mental Disorders, fourth Edition [DSM-IV]) within 1 year prior to the screening visit or is unwilling to agree to abstain from alcohol and drugs throughout the study. Has taken any excluded medication, supplements, or food products listed in the Excluded Medications and Dietary Products. Has evidence of current cardiovascular, central nervous system (CNS), hepatic, hematopoietic disease, renal dysfunction, metabolic or endocrine dysfunction, serious allergy, asthma hypoxemia, hypertension, seizures, or allergic skin rash. There is any finding in the participant's medical history, physical examination, or safety laboratory tests giving reasonable suspicion of a disease that would contraindicate taking TAK-063 or ketamine or a similar drug in the same class, or that might interfere with the conduct of the study. This includes, but is not limited to, peptic ulcer disease, seizure disorders, and cardiac arrhythmias. Has current or recent (within 6 months) gastrointestinal disease that would be expected to influence the absorption of drugs (ie, a history of malabsorption, esophageal reflux, peptic ulcer disease, erosive esophagitis frequent [more than once per week] occurrence of heartburn, or any surgical intervention [e.g., cholecystectomy]). Has a history of cancer, except basal cell carcinoma which has been in remission for at least 5 years prior to Day 1 of Period 1. Has a positive test result for hepatitis B surface antigen (HBsAg), hepatitis C antibody (HCV), or a known history of human immunodeficiency virus infection at Screening. Has used nicotine-containing products (including but not limited to cigarettes, pipes, cigars, chewing tobacco, nicotine patch or nicotine gum) within 28 days prior to Check-in (Day -1 of Period 1) or cotinine test is positive at Screening or Check-in (Day -1 of Period 1). Has poor peripheral arterial/venous access or recent wrist trauma. Has donated or lost 450 mL or more of his or her blood volume (including plasmapheresis), or had a transfusion of any blood product within 3 months prior to Day 1 of Period 1. Has a Screening and/or Check-in (Day -1 of Period 1) abnormal (clinically significant) electrocardiogram (ECG). Participant has a supine blood pressure outside the ranges of 90 to 140 mm Hg for systolic and 50 to 90 mm Hg for diastolic, if out of range may be repeated once for eligibility determination at the Screening Visit or Check-in (Day -1 of Period 1). Has a resting heart rate outside the range 50 to 90 beats per minute (bpm), if out of range may be repeated once for eligibility determination at the Screening Visit and/or Check-in (Day -1 of Period 1). Has a QT interval with Fridericia correction method (QTcF) greater than (>) 430 milliseconds (ms) or PR outside the range 120 to 220 ms, if out of range may be repeated once for eligibility determination within a maximum of 5 minutes, at the Screening Visit and/or Check-in (Day -1 of Period 1). Has abnormal Screening laboratory values that suggest a clinically significant underlying disease or participant with the following lab abnormalities: alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) >1.5 upper limit of normal (ULN). Has a history of Axis I/II mental disorders according to DSM-IV Axis I/II such as depression, anxiety disorders, bipolar disorder, attention deficit/hyperactivity disorder (ADHD), autism spectrum disorders, anorexia nervosa, bulimia nervosa, and schizophrenia. Has a history of head injury or trauma. Has any condition that would prevent an MRI from accurately or safely being performed (e.g., claustrophobia, cardiac pacemaker, metallic implants or clips), as verified per study site's standard MRI assessment questionnaire. Has a risk of suicide according to the Investigator's clinical judgment (e.g., per Columbia-Suicide Severity Rating Scale [C-SSRS]) or has made a suicide attempt in the previous 6 months prior to Screening.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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Male

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: Randomized
Intervention Model: Crossover Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Sequence 1: Placebo + TAK-063 3 mg + TAK-063 30 mg<br>Period 1, Day 1: TAK-063 placebo-matching tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 2, Day 1: TAK-063 3 milligram (mg), orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 3, Day 1: TAK-063 30 mg tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight. Period 1 & 2 are followed by 7 day washout period. | Drug: Ketamine<br>* Ketamine intravenous administration.<br>* Other names: Ketalar™;Drug: TAK-063<br>* TAK-063 tablets<br>Drug: TAK-063 Placebo<br>* TAK-063 placebo-matching tablets<br>|
| Experimental: Sequence 2: TAK-063 3 mg + TAK-063 30 mg + Placebo<br>Period 1, Day 1: TAK-063 3 mg tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 2, Day 1: TAK-063 30 mg tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 3, Day 1: TAK-063 placebo-matching tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight. Period 1 & 2 are followed by 7 day washout period. | Drug: Ketamine<br>* Ketamine intravenous administration.<br>* Other names: Ketalar™;Drug: TAK-063<br>* TAK-063 tablets<br>Drug: TAK-063 Placebo<br>* TAK-063 placebo-matching tablets<br>|
| Experimental: Sequence 3: TAK-063 30 mg + Placebo + TAK-063 3 mg<br>Period 1, Day 1: TAK-063 30 mg tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 2, Day 1: TAK-063 placebo-matching tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 3, Day 1: TAK-063 3 mg tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight. Period 1 & 2 are followed by 7 day washout period. | Drug: Ketamine<br>* Ketamine intravenous administration.<br>* Other names: Ketalar™;Drug: TAK-063<br>* TAK-063 tablets<br>Drug: TAK-063 Placebo<br>* TAK-063 placebo-matching tablets<br>|
| Experimental: Sequence 4: Placebo + TAK-063 3 mg + TAK-063 300 mg<br>Period 1, Day 1: TAK-063 placebo-matching tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 2, Day 1: TAK-063 3 mg tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 3, Day 1: TAK-063 300 mg (participants enrolled before protocol amendment 3) or 10 mg (participants enrolled after protocol amendment 3), tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight. Period 1 & 2 are followed by 7 day washout period. | Drug: Ketamine<br>* Ketamine intravenous administration.<br>* Other names: Ketalar™;Drug: TAK-063<br>* TAK-063 tablets<br>Drug: TAK-063 Placebo<br>* TAK-063 placebo-matching tablets<br>|
| Experimental: Sequence 5: TAK-063 3 mg + TAK-063 300 mg+ Placebo<br>Period 1, Day 1: TAK-063 3 mg tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 2, Day 1: TAK-063 300 mg (participants enrolled before protocol amendment 3) or 10 mg (participants enrolled after protocol amendment 3), tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 3, Day 1: TAK-063 placebo-matching tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight. Period 1 & 2 are followed by 7 day washout period | Drug: Ketamine<br>* Ketamine intravenous administration.<br>* Other names: Ketalar™;Drug: TAK-063<br>* TAK-063 tablets<br>Drug: TAK-063 Placebo<br>* TAK-063 placebo-matching tablets<br>|
| Experimental: Sequence 6: TAK-063 300 mg + Placebo + TAK-063 3 mg<br>Period 1, Day 1: TAK-063 300 mg (participants enrolled before protocol amendment 3) or 10 mg (participants enrolled after protocol amendment 3), tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 2, Day 1: TAK-063 placebo-matching tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 3, Day 1: TAK-063 3 mg tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight. Period 1 & 2 are followed by 7 day washout period. | Drug: Ketamine<br>* Ketamine intravenous administration.<br>* Other names: Ketalar™;Drug: TAK-063<br>* TAK-063 tablets<br>Drug: TAK-063 Placebo<br>* TAK-063 placebo-matching tablets<br>|
| Experimental: Sequence 7: Placebo + TAK-063 30 mg + TAK-063 300 mg<br>Period 1, Day 1: TAK-063 placebo-matching tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight: Period 2, Day 1: TAK-063 30 mg tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 3, Day 1: TAK-063 300 mg (participants enrolled before protocol amendment 3) or 10 mg (participants enrolled after protocol amendment 3), tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight. Period 1 & 2 are followed by 7 day washout period | Drug: Ketamine<br>* Ketamine intravenous administration.<br>* Other names: Ketalar™;Drug: TAK-063<br>* TAK-063 tablets<br>Drug: TAK-063 Placebo<br>* TAK-063 placebo-matching tablets<br>|
| Experimental: Sequence 8: TAK-063 30 mg + TAK-063 300 mg + Placebo<br>Period 1, Day 1: TAK-063 30 mg tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 2, Day 1: TAK-063 300 mg (participants enrolled before protocol amendment 3) or 10 mg (participants enrolled after protocol amendment 3), tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 3, Day 1: TAK-063 placebo-matching tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight. Period 1 & 2 are followed by 7 day washout period. | Drug: Ketamine<br>* Ketamine intravenous administration.<br>* Other names: Ketalar™;Drug: TAK-063<br>* TAK-063 tablets<br>Drug: TAK-063 Placebo<br>* TAK-063 placebo-matching tablets<br>|
| Experimental: Sequence 9: TAK-063 300 mg + Placebo + TAK-063 30 mg<br>Period 1, Day 1: TAK-063 300 mg (participants enrolled before protocol amendment 3) or 10 mg (participants enrolled after protocol amendment 3), tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 2, Day 1: TAK-063 placebo-matching tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight; Period 3, Day 1: TAK-063 30 mg tablets, orally, single dose and ketamine, intravenous administration according to a bolus infusion adjusted to the participant's weight. Period 1 & 2 are followed by 7 day washout period | Drug: Ketamine<br>* Ketamine intravenous administration.<br>* Other names: Ketalar™;Drug: TAK-063<br>* TAK-063 tablets<br>Drug: TAK-063 Placebo<br>* TAK-063 placebo-matching tablets<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Ketamine-Induced Brain Activity in Regions of Interest During Resting State | Ketamine model was used to enhance the sensitivity to detect an effect of phosphodiesterase 10a (PDE10a) inhibition by TAK-063 by ketamine using neuroimaging battery tests. Ketamine induced robust blood oxygen level-dependent(BOLD) functional magnetic resonance imaging(fMRI) response while maintaining minimal accompanying psychotomimetic symptoms. The regions of interest include:left anterior cingulate cortex,right anterior cingulate cortex,left posterior cingulate cortex,right posterior cingulate cortex,left striatum,right striatum,left amygdala,right amygdala,left substantia nigra,right substantia nigra,left thalamus,right thalamus,left ventrolateral prefrontal cortex,right ventrolateral prefrontal cortex,left dorsolateral prefrontal cortex,right dorsolateral prefrontal cortex,left hippocampus,right hippocampus,left subgenual cingulate/Ba25,right subgenual cingulate/Ba25,left paracingulate gyrus/Ba32, and right paracingulate gyrus/Ba32. | Day 1: 4 hours post TAK-063 dose or placebo | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cmax: Maximum Observed Plasma Concentration for TAK-063 and TAK-063 Metabolite (M-I) |  | Day 1: pre-dose and at multiple time points (up to 24 hours) postdose | 
| Tmax: Time to Reach Cmax for TAK-063 and TAK-063 M-I |  | Day 1: pre-dose and at multiple time points (up to 24 hours) postdose | 
| AUC(0-tlqc): Area Under the Plasma Concentration-Time Curve From Time 0 to the Time of the Last Quantifiable Concentration for TAK-063 and TAK-063 M-I |  | Day 1: Pre-dose and at multiple time points (up to 24 hours) post-dose | 
| Percentage of Participants Who Experience at Least One Treatment Emergent Adverse Event (TEAE) |  | Baseline up to 14 days after last dose of study drug (Day 32) | 
| Percentage of Participants Who Meet the Takeda Global Research and Development Center, Inc. (TGRD) Markedly Abnormal Criteria for Safety Laboratory Tests at Least Once Post Dose | The percentage of participants with any markedly abnormal standard safety laboratory values collected throughout study. | Baseline up to 14 days after last dose of study drug (Day 32) | 
| Percentage of Participants Who Meet the TGRD Markedly Abnormal Criteria for Vital Sign Measurements at Least Once Post Dose | The percentage of participants who meet markedly abnormal criteria designated by TGRD. Vital signs included oral temperature, respiration, blood pressure and pulse (beats per minute). | Baseline up to 14 days after last dose of study drug (Day 32) | 
| Percentage of Participants Who Meet the TGRD Markedly Abnormal Criteria for Safety Electrocardiogram (ECG) Parameters at Least Once Post Dose | The percentage of participants who meet markedly abnormal criteria designated by TGRD measured throughout study. | Baseline up to 14 days after last dose of study drug (Day 32) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Drug therapy