Clinical trial NCT03450187: A Phase 1 TP-271 Oral PK Multiple Ascending Dose Study
Official title: A Phase 1, Randomized, Placebo-Controlled, Double-Blind, Multiple Ascending-Dose Study to Assess the Safety, Tolerability, and Pharmacokinetics of Oral TP-271 in Healthy Adult Subjects
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Bacterial Infections
Lead sponsor: La Jolla Pharmaceutical Company
Sponsor class: INDUSTRY
Collaborators: name: National Institute of Allergy and Infectious Diseases (NIAID)
First posted: 2018-03-01
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Maximum age (years): 50
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: Up to 5 cohorts of 8 subjects each will be enrolled. Subjects in each cohort will be randomized 6:2 to receive multiple oral doses of TP 271 at 1 of 5 ascending doses of TP-271 or placebo once or twice daily for 7 days, as shown in the table below. Every effort will be made to dose all subjects in a cohort on the same day.

Proposed Oral Doses of Study Drug by Dose Cohort Cohort Dose Regimen Proposed Oral Dose A Once daily 50 mg TP-271 q24 (n = 6) or matching placebo (n = 2) B Once daily 100 mg TP-271 q24 (n = 6) or matching placebo (n = 2) C Once daily 200 mg TP-271 q24 (n = 6) or matching placebo (n = 2) D Once daily 300 mg TP-271 q24 (n = 6) or matching placebo (n = 2) E Once daily 400 mg TP-271 q24 (n = 6) or matching placebo (n = 2) Abbreviations: q24 = every 24 hours.
Primary purpose: OTHER

Brief summary: This is a phase 1, single-center, randomized, placebo-controlled, double-blind, multiple ascending-dose study to assess the safety, tolerability, and PK of oral TP-271 in healthy adult subjects. Male or female subjects aged 18 to 50 years who fulfill the inclusion/exclusion criteria will be enrolled in this study.

Detailed description: This is a phase 1, single-center, randomized, placebo-controlled, double-blind, multiple ascending-dose study to assess the safety, tolerability, and PK of oral TP-271 in healthy adult subjects. Male or female subjects aged 18 to 50 years who fulfill the inclusion/exclusion criteria will be enrolled in this study.

Up to 5 cohorts of 8 subjects each (up to a total of 40 subjects) will be enrolled. Subjects in each cohort will be randomized 6:2 to receive multiple oral doses of TP 271 or placebo. Every effort will be made to dose all subjects in a cohort on the same day.

Doses of study drug will be administered orally either once daily in the morning or twice daily in the morning and evening from Days 1 to 7. In all subjects, the morning dose will be administered following an overnight fast (minimum 8 hours) of food and all beverages, except for water. For subjects in Cohorts D and E only, the evening dose will be administered following a minimum 3-hour fast of food and all beverages, except for water. Fasting in all cohorts will continue for at least 2 hours following each study drug administration.

During the Screening Period (within 28 days prior to the subject receiving study drug), each subject will be assessed for eligibility. Each subject must sign and date an ICF prior to undergoing any study-related procedures.

Eligibility criteria: Inclusion Criteria:

1. Be within the age range of 18 to 50 years, inclusive, at the time of Screening
2. Voluntarily sign an Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved ICF to participate in the study after all relevant aspects of the study have been explained to and discussed with the subject and before undergoing any study-related procedures
3. Have a body mass index (BMI) ≥18.0 and ≤33.0 kg/m2
4. Have a negative history of and negative screening results for human immunodeficiency virus (HIV) types 1 and 2 and hepatitis B and C
5. Have the ability to communicate with the study unit staff in a manner sufficient to carry out all protocol procedures as described
6. Female subjects must be of non-childbearing potential, either 1-year postmenopausal or surgically sterile (i.e., bilateral oophorectomy, bilateral tubal ligation, or complete hysterectomy)
7. Male subjects must be willing and able to use a barrier method of contraception or practice abstinence (including male subjects who had a vasectomy) from dosing to 90 days after final administration of the study drug

Exclusion Criteria:

1. History and/or presence of any clinically significant disease or disorder, such as cardiovascular, pulmonary, renal, hepatic, neurological, gastrointestinal, endocrine, psychiatric or mental disease or disorder, or mental or legal incapacitation, which, in the opinion of the PI, may either put the subject at risk due to participation in the study, influence the results of the study, or influence the subject's ability to participate in the study
2. Clinical laboratory values that fall outside of the eligibility range specified in Appendix D are exclusionary; for clinical laboratory values that are not included in Appendix D, values outside of the reference range are exclusionary, except for those parameters listed in Table 4).

   Table 4 Acceptable Out-of-Range Clinical Laboratory Values

   Low Chemistry Values:

   Bicarbonate (a) Chloride GGT HDL cholesterol LDH LDL cholesterol Phosphorus

   High Chemistry Values:

   Chloride HDL cholesterol LDL cholesterol Phosphorus Triglycerides

   Out-of-Range Urinalysis Values; High or low specific gravity Cloudy Mucus Crystals Ketones (b) Hyaline casts High or low pH Urobilinogen (c)

   Out of Range Hematology Values; High hematocrit Basophils Monocytes MCV MCH MCHC RBC

   a Bicarbonate \>18 mEq/L. b Acceptable only when the concurrent blood glucose is normal. c Measured when monitoring the serum bilirubin concentration. Abbreviations: GGT = gamma-glutamyltransferase; HDL = high-density lipoprotein; LDH = lactate dehydrogenase; LDL = low-density lipoprotein; MCH = mean corpuscular hemoglobin; MCHC = mean corpuscular hemoglobin concentration; MCV = mean corpuscular volume; RBC = red blood cell.
3. Known allergy to tetracycline antibiotics or any of the excipients in TP 271
4. Clinically significant abnormality on a 12-lead ECG, which includes the following:

   * Rhythm other than sinus
   * Corrected QT interval using Fridericia's formula (QTcF) \>450 msec
   * Evidence of second- or third-degree atrioventricular (AV) block
   * Pathological Q-waves (defined as a Q-wave \>40 msec or depth \>0.4 to 0.5 mV)
   * Evidence of ventricular pre-excitation
   * Evidence of complete left bundle branch block (BBB), right BBB, or incomplete left BBB
   * Intraventricular conduction delay with QRS duration \>120 msec
   * ST segment abnormalities, unless judged by the PI to be nonpathologic
5. History of seizures
6. History within 3 years of a positive result on a urine screen for drugs of abuse or a positive result on a urine screen at Screening for any of the following drugs of abuse: tetrahydrocannabinols, cocaine, opioids, phencyclidines, amphetamines, benzodiazepines, barbiturates, and cotinine
7. Use of tobacco, nicotine, or nicotine-replacement products within 3 months prior to initial administration of study drug to the EOS Visit
8. Typical weekly alcohol consumption of 7 or more alcoholic drinks, where 1 alcoholic drink is defined as 1 glass of beer (approximately 10 to 12 oz), 1 can of beer (12 oz), 1 glass of wine (approximately 4 to 5 oz), or distilled spirits (approximately 1 oz or 30 mL of liquor)
9. Alcohol consumption within 48 hours prior to admission
10. Participation in a clinical study within 10 half-lives of the prior study treatment or within the previous 3 months (if the half-life of investigational agent is unknown) prior to initial administration of study drug or planned participation in another clinical study concurrent with the present study
11. History of difficulty donating blood or poor venous access
12. Recent blood donation (1 unit or approximately 525 mL) within 1 month prior to receiving study drug or plans to donate prior to receiving study drug or during the clinical study
13. Use of any prescription or nonprescription medication, including vitamins or herbal medications, vaccination, or immunization within 7 days or 5 half-lives (if known), whichever is longer, prior to initial administration of study drug, with the following exceptions: medications used to treat an AE are permitted, and the use of acetaminophen, naproxen, and ibuprofen is permitted, except for within 24 hours prior to dosing
14. Male subjects who donate or plan to donate sperm during the study or within 90 days after final administration of the study drug
15. Unwillingness or inability to follow the procedures outlined in the clinical study protocol
16. Previous participation in another TP-271 study

Primary outcomes:
measure: Adverse Events
timeFrame: From the time of signing of the informed consent form throughout study completion (approximately 39 days)
measure: A Directed Physical Examination including chest/respiratory
timeFrame: Day -1 to the End of Study visit, Day 21
measure: A Directed Physical Examination including heart/cardiovascular
timeFrame: Day -1 to the End of study visit, Day 21
measure: Vital Signs including Pulse Rate
timeFrame: Day -1 to the End of study visit, Day 21
measure: Vital Signs including respiration rate
timeFrame: Day -1 to the End of study visit, Day 21
measure: Vital Signs including body temperature
timeFrame: Day -1 to the end of study visit, Day 21
measure: Vital Signs including blood pressure
timeFrame: Day -1 to the End of study visit, Day 21
measure: ECG measurements including PR interval
timeFrame: Day -1 to the End of study visit, Day 21
measure: ECG measurements including QRS interval
timeFrame: Day -1 to the end of study visit, Day 21
measure: ECG measurements including QTcF interval
timeFrame: Day -1 to the end of study visit, Day 21
measure: Safety Laboratory results including clinical chemistry
timeFrame: Day -1 to the End of study visit, Day 21
measure: Safety Laboratory results including electrolytes
timeFrame: Day -1 to the End of study visit, Day 21
measure: Safety Laboratory results including hematology
timeFrame: Day -1 to the End of study visit, Day 21
measure: Safety Laboratory results including blood glucose
timeFrame: Day -1 to the End of study visit, Day 21
measure: Safety Laboratory results including coagulation
timeFrame: Day -1 to the End of study visit, Day 21
Secondary outcomes:
measure: Plasma concentrations
timeFrame: Days 1-7
measure: Urine pharmacokinetics
timeFrame: Days 1-7
measure: PK parameters - Cmax
timeFrame: Days 1-7
measure: PK parameters- Tmax
timeFrame: Days 1-7
measure: PK parameters AUC (0-last)
timeFrame: Days 1-7
measure: PK parameters - AUC (0-inf)
timeFrame: Days 1-7
measure: PK parameters- AUC% extrapolated
timeFrame: Days 1-7
measure: PK parameters - AUC (0-24)
timeFrame: Days 1-7
measure: PK parameters - Lambda-z
timeFrame: Days 1-7
measure: PK parameters - CL
timeFrame: Days 1-7
measure: PK parameters - Vd
timeFrame: Days 1-7
measure: PK parameters -T 1/2el
timeFrame: Days 1-7
Other outcomes:
Locations:
city: Austin
country: United States
facility: PPD Phase I Clinic
state: Texas
Study officials:
affiliation: Tetraphase Pharmaceuticals
name: Larry Tsai, MD
role: STUDY_DIRECTOR
References: