A First-in-Human Phase 1 Study of Plasmalogen Precursor PPI-1011 in Healthy Adult Volunteers to Assess Safety, Tolerability, and Pharmacokinetics
brief summary
PPI-1011 is being developed as a docosahexaenoic acid (DHA) containing plasmalogen precursor with good long-term stability, specifically for the treatment of rhizomelic chondrodysplasia punctata (RCDP), which is an ultra rare type of peroxisomal biogenesis disorder (PBD). The goal of treatment with PPI-1011 is to increase the levels of plasmalogens within circulation and tissues, with the hope that this will normalize plasmalogen levels in the body and result in clinical improvement to patients. The present study is a first-in-human (FIH), phase 1, randomized, double-blind, placebo-controlled, dose-escalation study to assess the safety, tolerability and pharmacokinetics (PK) of single and multiple ascending doses of PPI-1011 administered orally to healthy subjects. The study consists of 5 planned single-dose cohorts (n = 8 per cohort, total randomized 6 active: 2 placebo) with sentinel design. Following a review of the safety and PK data by the safety review committee and submission to Health Canada the study will be expanded to include 2 planned multiple-dose cohorts (n = 8 per cohort, total randomized 6 active: 2 placebo).
detailed description
This is a randomized, double-blind, placebo-controlled, first-in-human (FIH) study of PPI-1011 in healthy male and non-pregnant, non-lactating female volunteers. The study will consist of two parts: single ascending dose (SAD) and multiple ascending dose (MAD). The study will evaluate the safety, tolerability and PK in 5 planned SAD cohorts with sentinel design (n=8 per cohort, total randomized 6 active: 2 placebo) and 2 planned MAD cohorts (n=8 per cohort, total randomized 6 active: 2 placebo). Based on accumulating data, additional single-dose and/or a multiple-dose cohort(s) (n=8 per cohort) may be added to better assess the safety, tolerability, or PK profile of PPI-1011 to meet study objectives and try to determine the maximum tolerated dose.
A sentinel dose in 2 participants (1:1 PPI-1011: placebo) will be performed in each single-dose cohort to evaluate the safety and tolerability at planned doses. Additional cohort(s) will be dosed in case a different dose(s) is required based upon the emerging safety and PK data from the main cohort(s) to provide better assessment for the safety, tolerability, or PK of PPI-1011. A sentinel design may not be applicable when a cohort with the same or a higher drug exposure has already been evaluated.
Single Ascending Dose (SAD):
The 5 planned single-dose levels are:
Cohort A 10 mg/kg PPI-1011 or Placebo Cohort B 25 mg/kg PPI-1011 or Placebo Cohort C 50 mg/kg PPI-1011 or Placebo Cohort D 75 mg/kg PPI-1011 or Placebo Cohort E 100 mg/kg PPI-1011 or Placebo
Dose levels may be changed and/or additional cohorts may be added based on emerging safety and PK data. Subjects enrolled in the single-dose treatment cohorts will receive a single dose of the study drug (PPI-1011 or placebo) orally on Day 1.
A period of at least 24 hours will be required between administering study drug to the first 2 subjects (1 active, 1 placebo) and the 6 remaining subjects (5 active, 1 placebo) in the cohort. If no major safety concerns are observed following 24 hours of observation, dosing of the remaining 6 participants in that cohort may proceed. The dose-escalation may proceed after the Safety Review Committee review of the blinded safety data up to at least Day 3 from all participants in the preceding single-dose cohort. The dose escalation decision will be based on safety evaluation for an acceptable safety profile as determined by the SRC.
Cohorts A, B, C, D, and E will be dosed in a non-fasting state.
official title
A Phase 1, Randomized, Double-blind, Placebo-controlled, Combined Single and Multiple Ascending Dose Study of PPI-1011 in Subjects to Assess Safety, Tolerability, and Pharmacokinetics