Conditions: Oedema, Pulmonary
Keywords: First Time in Human TRPV4 inhibitor Heart failure
Allocation: RANDOMIZED | Intervention model: SINGLE_GROUP
Enrollment: 61
Healthy volunteers: yes

Brief summary:
This study is the first administration of GSK2798745 in humans. This will be a sponsor un-blinded, placebo-controlled study to investigate the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of GSK2798745, given as single and repeat oral doses to healthy subjects and stable heart failure (HF) subjects. Approximately 28 healthy subjects will be enrolled in the study cohorts (Cohort 1-3) involving single and repeat dose escalations of GSK2798745, while up to 24 stable heart failure subjects will be enrolled in Cohort 4 involving single and repeat dose administration of GSK2798745, with the dose selected based on data from healthy subject cohorts. This would be followed by enrollment of up to 8 subjects with heart failure in Cohort 5 involving repeat dose administration of GSK2798745. The study duration, including screening and follow-up, is not expected to exceed 17 weeks for subjects in the study (in any cohort).

Detailed description:

Arms:
arm 1: Eight subjects will be randomized to 1 of 4 placebo-controlled dose sequences with 2 subjects in each sequence and each subject having four dose periods (3 active dose of GSK2798745 + 1 placebo dose). GSK2798745 will be administered in a liquid form (suspension or solution) in this cohort. In each treatment period, the subjects will be fasting from the prior midnight to four hours post-dose (Day 1). arm 2: Twelve subjects will receive GSK2798745 in three single-dose treatment periods in a fixed sequence. The actual dose-selected will be determined based on review of emerging safety and exposure data from Cohort 1. The dosing will be done in 3 study periods for investigating bioavailability and food effects. In Period 1, subjects will be fasting from midnight to four hours post-dose and will receive GSK2798745 in a liquid form (suspension or solution). In Period 2, subjects will be fasting from midnight to four hours post-dose and will receive a capsule formulation of GSK2798745. In Period 3, subjects will receive GSK2798745 capsule following a standard high fat/high calorie meal. arm 3: Sixteen subjects will be randomized to 2 repeat dose cohorts with 8 subjects in each cohort in a ratio of 6:2 (treatments: placebo). Food intake timing will be determined based on data from Cohorts 1 and 2 (if Cohort 2 is conducted before Cohort 3). Doses will be administered once daily from Day 1 through Day14. Based on data from Cohort 1, the second dose in the repeat-dose period may be skipped to estimate the time invariance in PK. Dosing may be altered to twice daily based on the results obtained in the initial study cohort. Subjects will be fasted from midnight to 4 hours after dosing on Day 1 and Day 14 that entail serial PK sampling. Meal timings on other days will be based on previous cohort data. arm 4: Eighteen stable HF subjects will be randomized in this cohort with a treatment:placebo ratio of 1:1. If required, an additional number of subjects (up to 24 total) will be randomized. An additional separate dose group of approximately 18 to 24 subjects may be randomized to GSK2798745 or placebo to gain additional safety, tolerability,pharmacokinetic and pharmacodynamic information, if needed. The subjects will receive GSK2798745 in a single dose (at least the first 6 subjects) followed by a 7 -days repeat dose. Based on data from the cohorts 1, 2 and 3, the dose will be 2.4 mg (initial) in the first group utilizing the capsule formulation administered with or without food. arm 5: Eight HF subjects will be randomized in this cohort with a treatment: placebo ratio of 3:1. This cohort will evaluate safety, pharmacokinetics, and lung permeability (DLco and DLno) in a boarder, more general population of patients with HF, NYHA Class II or III. Subjects will receive GSK2798745 or placebo (based on randomization) for 7 days. The dose will be 2.4 mg utilizing the capsule formulation administered with or without food. Subjects will remain in house from Day -1 until Day 4 and be fitted with a remote monitoring device; Day 5, 6 and 8 visits will be in home (on Days 5 and 6, they will receive study medication, collect samples for pharmacokinetic analysis, and assess vital signs); and subjects will return to the clinic for Day 7 visit.

Interventions: intervention 1: GSK2798745 solution intervention 2: GSK2798745 suspension intervention 3: GSK2798745 capsule intervention 4: Placebo solution intervention 5: Placebo suspension intervention 6: Placebo capsule
Intervention descriptions: intervention 1: Clear, colourless GSK2798745 (0.1 to 0.4mg) solution in aqueous citrate buffer with 4% captisol intervention 2: Aqueous suspension of GSK2798745 (\>=0.5 mg) intervention 3: White Opaque granule filled capsules of GSK2798745 (\>=0.5 mg) intervention 4: Clear, colourless solution of aqueous citrate buffer with 4% captisol intervention 5: Visually matching aqueous suspension of hypromellose acetate succinate powder intervention 6: Matching white opaque placebo blend filled capsule

Protocol document: