A Study of PVP001, PVP002, and PVP003 in Healthy Adults and PVP001 and PVP002 in Adults With Celiac Disease

Study Overview
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Brief Summary
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It is hoped that different forms of the same medicine, called PVP001, PVP002, and PVP003, will help people with celiac disease. Both healthy adults and adults with celiac disease will take part in this study. There are many main aims of the study. To check if participants have side effects from different forms of the study medicine. These forms are called PVP001 (liquid in a cup), PVP002 capsule, and PVP003 tablet. To check how well PVP003 breaks down gluten. To check how much PVP003 participants can take without getting side effects from it. The study is in 4 parts. At the start of each part of the study, the study doctor will check to determine who can take part at the first study visit. Different groups of participants will be in different parts of the study. In all parts of the study, some participants will take 1 of the 3 forms of study medicine. Others will take a placebo. In this study, a placebo will look like the form of study medicine but will not have any medicine in it. This means that a placebo can either look like PVP001 liquid in a cup, the PVP002 tablet, or the PVP003 tablet. In Part 1, different small groups of participants will take lower to higher doses of PVP001 or PVP002 or a placebo. This is to work out the best dose of study medicine to take in other parts of the study. After treatment, participants will regularly visit the clinic to check that they have no problems with their treatment, including any side effects from their treatment. In Part 2, different small groups will take different doses of PVP001 or PVP002 or a placebo, either with or without a meal that has different amounts of gluten in it. This is to check if PVP001 or PVP002 has broken down gluten in the body. Participants will visit the clinic after treatment to check how much gluten has been broken down in the body. In Part 3, different small groups will take different doses of PVP003 or a placebo, either with or without a meal that has gluten in it. This is to check if PVP003 has broken down gluten in the body. Participants will visit the clinic after treatment to check if more gluten has broken down in the body. In Part 4, different small groups will take PVP003 or placebo 3 times a day for 5 days. After treatment, participants will visit the clinic to check that they have no problems with their treatment, including any side effects from their treatment.

Detailed Description
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This study has four parts. Each part of the study begins with a Screening Period of up to 4 weeks to allow for completion of screening procedures and subject scheduling. Each participant will be screened by means of medical history, medication review, Gastrointestinal Symptoms Questionnaire (GSQ), physical examination, vital signs, weight, height, laboratory tests, and ECG. The GSQ is being used as a separate safety monitoring tool in this study to ensure that all gastrointestinal complaints are reported by the participant. Following completion of all screening procedures, eligible participants will be enrolled in the study. Part 1 of the study in healthy participants will be completed prior to enrollment of any subject in Part 2 of the study. A participant enrolled in Part 1 of the study will participate in one of five dose Cohorts. Enrollment of healthy participants and participants with CeD in each of the five dose Cohorts will occur sequentially, but each of these dose Cohorts will be open to enrollment only after demonstration of the safety and tolerability of the same dose level in healthy participants. A healthy participant enrolled in Part 2 of the study will participate in one of three groups; within Groups 1, 2 and 3 enrollment may occur in parallel. A healthy participant enrolled in Part 3 of the study will participate in one of five groups; within Groups 1 to 5 enrollment will occur sequentially. A healthy participant enrolled in Part 4 of the study will participate in two cohorts; enrollment in Part 4 may occur in parallel with enrollment in Part 3. Each participant will be randomized to one of two possible treatment order. Participants who participate in Part 1 or Part 2 of the study, and who are not ADA positive, may participate in Part 3 or Part 4 of the study. No other participants may participate in more than one Part/Group of the study.

Official Title
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A Phase 1, Four-Part Study to Assess the Safety, Tolerability, Pharmacokinetics, and Gluten Degradation Activity of PvP001, PvP002, and PvP003 in Healthy Adult Volunteers and to Assess the Safety, Tolerability, and Pharmacokinetics of PvP001 and PvP002 in Adults With Celiac Disease

Conditions
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Digestive System Disease

Intervention / Treatment
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* Other: PvP001 placebo
* Drug: PvP001 100 mg
* Drug: PvP001 300 mg
* Drug: PvP001 900 mg
* Drug: Maximum Feasible Dose (MFD) of PvP002
* Drug: Maximum Tolerated Dose (MTD) of PvP001
* Drug: MTD of PvP001 following 7 days of PPI treatment
* Other: PvP002 placebo
* Drug: PvP001 600 mg
* Drug: PvP003 placebo
* Drug: PvP003
* Drug: PvP003 150 mg


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Part 1, Part 2, Part 3 and Part 4 Male or female age 18- 64 years, inclusive No relevant gastrointestinal symptoms Able to abstain from alcohol for 72 hours prior to the Screening Visit; for 72 hours prior to and after the Cohort Treatment Day (Part 1, Part 2, and Part 3); for 72 hours prior to the Safety Visit (Part 2 and Part 3); and for 72 hours prior to Day 1 of the first Cohort Treatment Period through the Safety Visit (Part 4). A female participant must have a negative pregnancy test at Screening and on Cohort Treatment Day -1 (Part 1, Part 2, and Part 3) or a negative pregnancy test at Screening and on Day -1 of each Cohort Treatment Period (Part 4), and must agree to continue acceptable birth control measures (example, abstinence, a stable hormonal contraceptive, double-barrier method, or vasectomy in partner) from the Screening Visit through the 28 ± 2 days. Follow Up ADA Blood Sampling Visit A male participant must agree to use acceptable birth control measures (e.g., abstinence, latex condom, or vasectomy), or must have a female partner who will continue birth control measures (e.g., abstinence, a stable hormonal contraceptive, or double-barrier method) from the Screening Visit through the 28 ± 2 days Follow Up Anti-Drug Antibody Blood Sampling Visit Able to read and understand English Able to provide written informed consent Additional Inclusion Criteria for Part 1, Part 2, Part 3, and Part 4 Healthy Adult Volunteers No use of over-the-counter or prescription medication, except for birth control medications for the duration of the study No history of gastrointestinal diseases or disorders No history of intolerance, sensitivity, or reactions to gluten or any other food or food ingredient Able to maintain a gluten-free diet for 24 hours prior to the Cohort Treatment Day (Part 1, Part 2, and Part 3), or usually ingests meals three times a day (that is, breakfast, lunch, and dinner) and is able to continue doing so during each Cohort Treatment Period (Part 4) Additional Inclusion Criteria for Part 1 Participants with Celiac Disease Documented history of Celiac Disease in medical records Maintaining a gluten-free diet for ≥6 months No use of over-the-counter or prescription medication, except for birth control medications and those allowed by the study doctor, for the duration of the study. No history of gastrointestinal diseases or disorders, other than Celiac Disease No history of intolerance, hypersensitivity, or reaction to any food or food ingredient Able to continue a gluten-free diet for the duration of the study Exclusion Criteria: Part 1, Part 2, Part 3, and Part 4 Current symptoms or signs of illness Chronic viral infection or immunodeficiency condition Any female who is pregnant, planning to become pregnant during the study, or breast-feeding; any male who is planning to father a child during the study Receipt (or planned receipt) of another investigational medication within 4 weeks prior to the Screening Visit through the duration of the study Alcohol consumption greater than (>) 5 drinks/week, alcohol consumption within 72 hours prior to any study visit (Part 1, Part 2, and Part 3), alcohol consumption within 72 hours prior to Day 1 of the first Cohort Treatment Period through the Safety Visit (Part 4), or a positive alcohol breathalyzer test at any study visit History of illicit or recreational drug use within the three years prior to the Screening Visit, or a positive urine drug screen at any study visit Use of tobacco or nicotine products, including smoking, smokeless tobacco, e-cigarettes, or nicotine replacement products within 12 months prior to the Screening Visit through the duration of the study

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 64 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: Randomized
Intervention Model: Sequential Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Part 1, Cohort 1A-1 to 1D-1 Healthy Participants<br>A single dose of PvP001 placebo, PvP001 100 mg, PvP001 300 mg, or PvP001 900 mg will be administered in ascending order to healthy participants in Cohorts 1A-1, 1B-1, 1C-1, and 1D-1. | Other: PvP001 placebo<br>* placebo<br>Drug: PvP001 100 mg<br>* PvP001 100 mg<br>Drug: PvP001 300 mg<br>* PvP001 300 mg<br>Drug: PvP001 900 mg<br>* PvP001 900 mg<br>|
| Experimental: Part 1, Cohort 1E-1 Healthy Participants<br>A single dose of the maximum feasible dose (MFD) of PvP002 will then be administered to healthy participants in Cohort 1E-1. | Drug: Maximum Feasible Dose (MFD) of PvP002<br>* MFD of PvP002<br>* Other names: MFD of PvP002;|
| Experimental: Part 1, Cohort 1A-2 - 1D-2 Celiac Disease (CeD)<br>A single dose of PvP001 placebo, PvP001 100 mg, PvP001 300 mg, or PvP001 900 mg will be administered in ascending order to participants with CeD in Cohorts 1A-2, 1B-2, 1C-2, and 1D-2. | Other: PvP001 placebo<br>* placebo<br>Drug: PvP001 100 mg<br>* PvP001 100 mg<br>Drug: PvP001 300 mg<br>* PvP001 300 mg<br>Drug: PvP001 900 mg<br>* PvP001 900 mg<br>|
| Experimental: Part 1, Cohort 1E-2 CeD<br>A single dose of the MFD of PvP002 will then be administered to participants with CeD in Cohort 1E-2. | Drug: Maximum Feasible Dose (MFD) of PvP002<br>* MFD of PvP002<br>* Other names: MFD of PvP002;|
| Experimental: Part 2, Cohort 2A - Cohort 2C Healthy Participants<br>Participants will be blinded to the PvP001 dose (placebo or MTD of PvP001) and will also receive MTD of PvP001 following 7 days of PPI treatment. | Other: PvP001 placebo<br>* placebo<br>Drug: Maximum Tolerated Dose (MTD) of PvP001<br>* Maximum Tolerated Dose (MTD) of PvP001<br>Drug: MTD of PvP001 following 7 days of PPI treatment<br>* Maximum Tolerated Dose (MTD) of PvP001 following 7 days of PPI (Proton Pump Inhibitor) treatment<br>|
| Experimental: Part 2, Cohort 2D Healthy Participants<br>Participants will receive PvP001 placebo or MFD of PvP001. | Other: PvP001 placebo<br>* placebo<br>Drug: Maximum Tolerated Dose (MTD) of PvP001<br>* Maximum Tolerated Dose (MTD) of PvP001<br>|
| Experimental: Part 2, Cohort 2E Healthy Participants<br>Participants will receive PvP002 placebo or MFD of PvP002. | Drug: Maximum Feasible Dose (MFD) of PvP002<br>* MFD of PvP002<br>* Other names: MFD of PvP002;Other: PvP002 placebo<br>* Placebo<br>|
| Experimental: Part 2, Cohort 2F- Cohort 2H Healthy Participants<br>Participants will receive the PvP001 placebo and either 300 mg or 600 mg of PvP001. | Other: PvP001 placebo<br>* placebo<br>Drug: PvP001 300 mg<br>* PvP001 300 mg<br>Drug: PvP001 600 mg<br>* PvP001 600 mg<br>|
| Experimental: Part 2, Cohort 2I and Cohort 2J Healthy Participants<br>Participants will receive the PvP001 placebo and 900 mg of PvP001. | Other: PvP001 placebo<br>* placebo<br>Drug: PvP001 900 mg<br>* PvP001 900 mg<br>|
| Experimental: Part 3, Cohorts 3A and 3B Healthy Participants<br>Participants will receive single dose of PvP003 placebo and 600 mg of PvP003 with pretreatment buffer solution before a standardized 1 gm gluten-containing study meal. | Drug: PvP003 placebo<br>* Placebo tablet orally.<br>Drug: PvP003<br>* PvP003 tablet orally.<br>|
| Experimental: Part 3, Cohorts 3C and 3D Healthy Participants<br>Participants will receive single dose of PvP003 placebo and 600 mg of PvP003 without pretreatment buffer solution before a standardized 1 gm gluten-containing study meal. | Drug: PvP003 placebo<br>* Placebo tablet orally.<br>Drug: PvP003<br>* PvP003 tablet orally.<br>|
| Experimental: Part 3, Cohorts 3E and 3F Healthy Participants<br>Participants will receive single dose of PvP003 placebo and 600 mg of PvP003 without pretreatment buffer solution after an approximately 50 milliliter (mL) portion of a standardized 1 gm gluten-containing study meal. | Drug: PvP003 placebo<br>* Placebo tablet orally.<br>Drug: PvP003<br>* PvP003 tablet orally.<br>|
| Experimental: Part 3, Cohorts 3G and 3H Healthy Participants<br>Participants will receive single dose of PvP003 placebo and 600 mg of PvP003 without pretreatment buffer solution before a standardized gluten-free study meal followed approximately 30 minutes later by a standardized 1 gm gluten-containing study meal. | Drug: PvP003 placebo<br>* Placebo tablet orally.<br>Drug: PvP003<br>* PvP003 tablet orally.<br>|
| Experimental: Part 4, Cohorts 4A and 4B Healthy Participants<br>Participants will receive multiple dose of PvP003 placebo and 600 mg of PvP003. | Drug: PvP003 placebo<br>* Placebo tablet orally.<br>Drug: PvP003<br>* PvP003 tablet orally.<br>|
| Experimental: Part 3, Cohorts 3I and 3J Healthy Participants<br>Participants will receive single dose of PvP003 placebo and 150 mg of PvP003 without pretreatment buffer solution before a standardized 1 gm gluten-containing study meal. | Drug: PvP003 placebo<br>* Placebo tablet orally.<br>Drug: PvP003 150 mg<br>* PvP003 150 mg<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Part 1: Number of Participants Reporting One or More Treatment Emergent Adverse Events (TEAEs) for PvP001 and PvP002 |  | Cohort Treatment Day up to 5 days after 24-hour safety assessment on Day 2 (up to Day 7) | 
| Part 4: Number of Participants Reporting One or More TEAEs for PvP003 After Multiple Doses |  | Day 1 of Cohort Treatment Period 1 up to 5 days after the Day 5 of Cohort Treatment Period 2 (up to Day 28) | 
| Part 1: Number of Participants Reporting One or More Treatment Emergent Serious Adverse Events (TESAEs) for PvP001 and PvP002 |  | Cohort Treatment Day up to 5 days after 24-hour safety assessment on Day 2 (up to Day 7) | 
| Part 4: Number of Participants Reporting One or More TESAEs for PvP003 600 mg After Multiple Doses |  | Day 1 of Cohort Treatment Period 1 up to 5 days after the Day 5 of Cohort Treatment Period 2 (up to Day 28) | 
| Part 2, Group 1, Cohort 2B: Median Percentage of Gluten Degradation by PvP001 in a Standardized 3 Gram (gm) Gluten-containing Study Meal After Administration of PvP001 | Median percentage degraded relative to placebo was derived using the formula: (1 - [active/placebo])*100. Gluten degradation was assessed using Enzyme-Linked Immunosorbent Assay (ELISA) based on the monoclonal R5 and G12 antibodies. | Cohort Treatment Day | 
| Part 2, Group 2, Cohort 2E: Median Percentage of Gluten Degradation by PvP002 in a Standardized 3 gm Gluten-containing Study Meal After Administration of PvP002 | Median percentage degraded relative to placebo was derived using the formula: (1 - [active/placebo])*100. Gluten degradation was assessed using ELISA based on the monoclonal R5 and G12 antibodies. | Cohort Treatment Day | 
| Part 2, Group 1, Cohort 2C: Median Percentage of Gluten Degradation by PvP001 in a Standardized 3 gm Gluten-containing Study Meal Following 7 Days of Standard Dose PPI Treatment | Median percentage degraded relative to placebo was derived using the formula: (1 - [active/placebo])*100. Gluten degradation was assessed using ELISA based on the monoclonal R5 and G12 antibodies. | Cohort Treatment Day | 
| Part 2, Group 3, Cohort 2G and 2H: Median Percentage of Gluten Degradation by PvP001 300 mg and 600 mg in a Standardized 1 gm Gluten-containing Study Meal at 20 Minutes After Administration of PvP001 | Median percentage degraded relative to placebo was derived using the formula: (1 - [active/placebo])*100. Gluten degradation was assessed using ELISA based on the monoclonal R5 and G12 antibodies. | Cohort Treatment Day: at 20 minutes post-dose | 
| Part 2, Group 3, Cohort 2G and 2H: Median Percentage of Gluten Degradation by PvP001 300 mg and 600 mg in a Standardized 1 gm Gluten-containing Study Meal at 35 Minutes After Administration of PvP001 | Median percentage degraded relative to placebo was derived using the formula: (1 - [active/placebo])*100. Gluten degradation was assessed using ELISA based on the monoclonal R5 and G12 antibodies. | Cohort Treatment Day: at 35 minutes post-dose | 
| Part 2, Group 3, Cohort 2G and 2H: Median Percentage of Gluten Degradation by PvP001 300 mg and 600 mg in a Standardized 1 gm Gluten-containing Study Meal at 65 Minutes After Administration of PvP001 | Median percentage degraded relative to placebo was derived using the formula: (1 - [active/placebo])*100. Gluten degradation was assessed using ELISA based on the monoclonal R5 and G12 antibodies. | Cohort Treatment Day: at 65 minutes post-dose | 
| Part 2, Group 3, Cohort 2J: Median Percentage of Gluten Degradation by PvP001 900 mg in a Standardized 6 gm Gluten-containing Study Meal at 20 Minutes After Administration of PvP001 | Median percentage degraded relative to placebo was derived using the formula: (1 - [active/placebo])*100. Gluten degradation was assessed using ELISA based on the monoclonal R5 and G12 antibodies. | Cohort Treatment Day: at 20 minutes post-dose | 
| Part 2, Group 3, Cohort 2J: Median Percentage of Gluten Degradation by PvP001 900 mg in a Standardized 6 gm Gluten-containing Study Meal at 35 Minutes After Administration of PvP001 | Median percentage degraded relative to placebo was derived using the formula: (1 - [active/placebo])*100. Gluten degradation was assessed using ELISA based on the monoclonal R5 and G12 antibodies. | Cohort Treatment Day: at 35 minutes post-dose | 
| Part 2, Group 3, Cohort 2J: Median Percentage of Gluten Degradation by PvP001 900 mg in a Standardized 6 gm Gluten-containing Study Meal at 65 Minutes After Administration of PvP001 | Median percentage degraded relative to placebo was derived using the formula: (1 - [active/placebo])*100. Gluten degradation was assessed using ELISA based on the monoclonal R5 and G12 antibodies. | Cohort Treatment Day: at 65 minutes post-dose | 
| Part 3, Groups 1 to 5, Cohorts 3B, 3D, 3F, 3H and 3J: Median Percentage of Gluten Degradation by PvP003 150 mg and 600 mg in a Standardized 1 gm Gluten-containing Study Meal at 35 Minutes After Administration of PvP003 | Median percentage degraded relative to placebo was derived using the formula: (1 - [active/placebo])*100. Gluten degradation was assessed using ELISA based on the monoclonal R5 and G12 antibodies. | Cohort Treatment Day: at 35 minutes | 
| Part 3, Groups 1 to 5, Cohorts 3B, 3D, 3F, 3H and 3J: Median Percentage of Gluten Degradation by PvP003 150 mg and 600 mg in a Standardized 1 gm Gluten-containing Study Meal at 65 Minutes After Administration of PvP003 | Median percentage degraded relative to placebo was derived using the formula: (1 - [active/placebo])*100. Gluten degradation was assessed using ELISA based on the monoclonal R5 and G12 antibodies. | Cohort Treatment Day: at 65 minutes | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Part 1 and Part 2, Cmax: Maximum Observed Plasma Concentration for PvP001 and PvP002 |  | Cohort Treatment Day pre-dose and at multiple time points (up to 480 minutes) post-dose | 
| Part 1 and Part 2, Tmax: Time to Reach the Maximum Plasma Concentration (Cmax) for PvP001 and PvP002 |  | Cohort Treatment Day pre-dose and at multiple time points (up to 480 minutes) post-dose | 
| Part 1 and Part 2, T(1/2): Terminal Disposition Phase Half-life of PvP001 and PvP002 |  | Cohort Treatment Day pre-dose and at multiple time points (up to 480 minutes) post-dose | 
| Part 1 and Part 2, AUClast: Area Under the Plasma Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration for PvP001 and PvP002 |  | Cohort Treatment Day pre-dose and at multiple time points (up to 480 minutes) post-dose | 
| Part 1 and Part 2, AUC∞: Area Under the Plasma Concentration-time Curve From Time 0 to Infinity for PvP001 and PvP002 |  | Cohort Treatment Day pre-dose and at multiple time points (up to 480 minutes) post-dose | 
| Part 1 and Part 2: Number of Participants With Anti-drug Antibodies (ADA) for PvP001 and PvP002 |  | At Day 14 and Day 28 | 
| Part 1: Maximum Tolerated Dose (MTD) of PvP001 | MTD was defined as the maximum dose that was determined to be safe and tolerable for Part 1 (1B-1 and 1B-2, 1C-1 and 1C-2, 1D-1 and 1D-2) in healthy or CeD participants. | Cohort Treatment Day up to Day 7 | 
| Part 2: Number of Participants Reporting One or More TEAEs and TESAEs for PvP001 and PvP002 |  | Cohort Treatment Day up to 5 days after the final Cohort Treatment Day (up to Day 22) | 
| Part 3: Number of Participants Reporting One or More TEAEs and TESAEs With PvP003 After a Single Dose |  | Cohort Treatment Day up to 5 days after final Cohort Treatment Day (up to Day 10) | 
| Part 3, Cmax: Maximum Observed Plasma Concentration for PvP003 150 mg and 600 mg Single Dose |  | Cohort Treatment Day pre-dose and at multiple time points (up to 480 minutes) post-dose | 
| Part 3, Tmax: Time to Reach the Maximum Plasma Concentration (Cmax) for PvP003 150 mg and 600 mg Single Dose |  | Cohort Treatment Day pre-dose and at multiple time points (up to 480 minutes) post dose | 
| Part 3, T(1/2): Terminal Disposition Phase Half-life of PvP003 150 mg and 600 mg Single Dose |  | Cohort Treatment Day pre-dose and at multiple time points (up to 480 minutes) post dose | 
| Part 3, AUClast: Area Under the Plasma Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration for PvP003 150 mg and 600 mg Single Dose |  | Cohort Treatment Day pre-dose and at multiple time points (up to 480 minutes) post dose | 
| Part 3, AUC∞: Area Under the Plasma Concentration-time Curve From Time 0 to Infinity for PvP003 150 mg and 600 mg Single Dose |  | Cohort Treatment Day pre-dose and at multiple time points (up to 480 minutes) post dose | 
| Part 3: Number of Participants With ADA for PvP003 150 mg and 600 mg Single Dose |  | At Day 14 and Day 28 | 
| Part 4, Cmax: Maximum Observed Plasma Concentration for PvP003 600 mg Multiple Dose |  | Cohort Treatment Days 1 and 5 pre-dose and at multiple time points (up to 240 minutes) post dose | 
| Part 4, Tmax: Time to Reach the Maximum Plasma Concentration (Cmax) for PvP003 600 mg Multiple Dose |  | Cohort Treatment Days 1 and 5 pre-dose and at multiple time points (up to 240 minutes) post dose | 
| Part 4, T(1/2): Terminal Disposition Phase Half-life of PvP003 600 mg Multiple Dose |  | Cohort Treatment Days 1 and 5 pre-dose and at multiple time points (up to 240 minutes) post dose | 
| Part 4, AUClast: Area Under the Plasma Concentration-time Curve From Time 0 to the Time of the Last Quantifiable Concentration for PvP003 600 mg Multiple Dose |  | Cohort Treatment Days 1 and 5 pre-dose and at multiple time points (up to 240 minutes) post dose | 
| Part 4, AUC∞: Area Under the Plasma Concentration-time Curve From Time 0 to Infinity for PvP003 600 mg Multiple Dose |  | Cohort Treatment Days 1 and 5 pre-dose and at multiple time points (up to 240 minutes) post dose | 
| Part 4: Number of Participants With ADA for PvP003 600 mg Multiple Dose |  | At Day 14 and Day 28 |