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Assessment of Safety, Tolerability, Immunogenicity, and Pharmacokinetics of AZD3427

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AstraZeneca

Status and phase

Completed
Phase 1

Conditions

Heart Failure

Treatments

Drug: AZD3427
Drug: Placebo

Study type

Interventional

Funder types

Industry

Identifiers

NCT04630067
D8330C00001

Details and patient eligibility

About

This first-time-in-human (FTIH) study will be conducted to evaluate the safety, tolerability, pharmacokinetics (PK), pharmacodynamics (PD), and immunogenicity of single doses of AZD3427 in healthy volunteers and multiple doses of AZD3427 in patients with heart failure (HF).

Full description

This is a multi-center single and multiple ascending dose study (SAD and MAD).

Part A (SAD) will include 7 cohorts (8 healthy volunteers in each cohort) and will randomize to AZD3427 or placebo, in a 6:2 ratio. One cohort will entirely include participants of Japanese descent.

Part B (MAD) will include 6 cohorts (8 heart failure patients in each cohort) and will randomize to AZD3427 or placebo in a 6:2 ratio. Of these, 3 cohorts will contain participants with heart failure with reduced ejection fraction [HFrEF] and the other 3 cohorts will comprise of participants with heart failure with HF with ejection fraction (EF) ≥ 41%. There will be a maximum screening period of 27 days. Participants in part A and B will undergo study drug administration on Day 1. In addition, participants in part B will return for 4 additional doses on Days 8, 15, 22, and 29. Participants will be followed for at least 50 days after the last dose of study drug.

Enrollment

105 patients

Sex

All

Ages

18 to 75 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

  • Part A will include healthy men and non-pregnant, non-lactating females of non-childbearing potential with a body mass index (BMI) of 18-30 kg/m^2 and a weight of 55-100 kg. One cohort will require participants be of Japanese descent
  • Part B will include men and non-pregnant, non-lactating females of non-childbearing potential
  • Participants have a BMI of 18-40 kg/m^2 and a weight of 55-136 kg
  • Participants with a diagnosis of stage C HF New York Heart Association (NYHA) Class I-III on stable medical therapy for at least 12 weeks
  • Participants with diagnosis of HFrEF will be defined as those with EF ≤ 40% and HF with EF ≥ 41%
  • Participants either with N-terminal prohormone of brain natriuretic peptide (NT-proBNP) > 125 pg/mL or BNP > 35 pg/mL (46)

Exclusion criteria

Both Part A and Part B will exclude participants with any of the following:

  • Any clinically important illness, medical/surgical procedure or trauma within 4 weeks of the first administration of study drug or planned surgical procedure before study completion
  • History of vascular and left ventricular aneurysms or prior dissections
  • Any history of joint hypermobility, Marfan's syndrome, or any connective tissue disorder
  • Clinical signs and symptoms consistent with Coronavirus disease-19 or confirmed infection within the last 4 weeks
  • History of severe allergy/hypersensitivity or ongoing clinically important allergy/hypersensitivity, as judged by the Investigator, or history of hypersensitivity injection devices or to drugs with a similar chemical structure or class to AZD3427 or any component of AZD3427

In addition, Part A will exclude participants with any of the following:

  • Alanine Aminotransferase (ALT) > Upper limit of normal (ULN)
  • Aspartate Aminotransferase (AST) > ULN
  • Total bilirubin > ULN (unless due to Gilbert's syndrome)
  • Creatinine > ULN
  • White blood cell (WBC) count < Lower limit of normal (LLN)
  • Hemoglobin < LLN
  • Prolonged QTcF > 450 m
  • Shortened QTcF < 340 ms
  • Family history of long QT syndrome
  • PR (PQ) interval shortening < 120 ms (PR > 110 ms but < 120 ms is acceptable if there is no evidence of ventricular pre-excitation)
  • PR (PQ) interval prolongation (> 240 ms) intermittent second (Wenckebach block while asleep is not exclusive) or third-degree atrioventricular (AV) block, or AV dissociation
  • Persistent or intermittent complete bundle branch block, incomplete bundle branch block, or intraventricular conduction delay with QRS > 110 ms. Participants with QRS > 110 ms but < 115 ms are acceptable if there is no evidence of eg, ventricular hypertrophy or pre-excitation

In addition, Part B will exclude participants with any of the following:

  • Atrial fibrillation or flutter occurring in the past year
  • Clinically significant ventricular arrhythmias under treatment
  • High-degree AV block II-III or sinus node dysfunction
  • Implanted permanent pacemaker or implantable cardioverter defibrillator for which the participant is pacing-dependent
  • Severe right-sided valvular heart disease; severe mitral regurgitation; moderate or severe mitral stenosis, severe aortic regurgitation and mild, moderate or severe aortic stenosis
  • Other conditions where vasodilatory therapy may be contraindicated (hypertrophic obstructive cardiomyopathy, and restrictive cardiomyopathy)
  • Congenital heart disease
  • NYHA HF Class IV
  • Occurrence in the last 6 months of acute coronary syndrome, percutaneous coronary intervention, cerebrovascular accident or transient ischemic attack, HF hospitalization; history or suspicion of cardiac amyloidosis
  • ALT > 1.5 × ULN
  • AST > 1.5 × ULN
  • Total bilirubin > ULN (unless due to Gilbert's syndrome)
  • Impaired renal function, defined as eGFR < 30 mL/min/1.73m^2 assessed by the Chronic Kidney Disease Epidemiology Collaboration equation
  • WBC < LLN
  • Hemoglobin < 10g/L
  • PR (PQ) interval prolongation (> 220 ms)
  • Participants with persistent BBB and QRS (ECG interval measured from the onset of the QRS complex to the J point) duration > 130 ms. Participants with intraventricular conduction delay and QRS duration < 130 ms

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Double Blind

105 participants in 15 patient groups, including a placebo group

AZD3427: Cohort 1a
Experimental group
Description:
Participants will receive single SC dose A of AZD3427 on Day 1.
Treatment:
Drug: AZD3427
AZD3427: Cohort 2a
Experimental group
Description:
Participants will receive single SC dose B of AZD3427 on Day 1.
Treatment:
Drug: AZD3427
AZD3427: Cohort 3a
Experimental group
Description:
Participants will receive single SC dose C of AZD3427 on Day 1.
Treatment:
Drug: AZD3427
AZD3427: Cohort 4a
Experimental group
Description:
Participants will receive single SC dose D of AZD3427 on Day 1.
Treatment:
Drug: AZD3427
AZD3427: Cohort 5a
Experimental group
Description:
Participants will receive single IV dose E of AZD3427 on Day 1.
Treatment:
Drug: AZD3427
AZD3427: Cohort 6a
Experimental group
Description:
Participants of Japanese descent will receive single SC dose anticipated equal to the highest dose of AZD3427 in the global cohorts on Day 1.
Treatment:
Drug: AZD3427
AZD3427: Cohort 7a
Experimental group
Description:
Participants will receive single SC dose F of AZD3427 on Day 1
Treatment:
Drug: AZD3427
Part A: Placebo
Placebo Comparator group
Description:
Participants will receive single SC or IV dose of placebo matched to AZD3427 on Day 1.
Treatment:
Drug: Placebo
AZD3427: Cohort 1b
Experimental group
Description:
Participants with HFrEF will receive SC dose A of AZD3427 on Days 1, 8, 15, 22, and 29.
Treatment:
Drug: AZD3427
AZD3427: Cohort 2b
Experimental group
Description:
Participants with HF with EF ≥ 41% will receive SC dose A of AZD3427 on Days 1, 8, 15, 22, and 29.
Treatment:
Drug: AZD3427
AZD3427: Cohort 3b
Experimental group
Description:
Participants with HFrEF will receive SC dose B of AZD3427 on Days 1, 8, 15, 22, and 29.
Treatment:
Drug: AZD3427
AZD3427: Cohort 4b
Experimental group
Description:
Participants with HF with EF ≥ 41% will receive SC dose B of AZD3427 on Days 1, 8, 15, 22, and 29.
Treatment:
Drug: AZD3427
AZD3427: Cohort 5b
Experimental group
Description:
Participants with HFrEF will receive SC dose C of AZD3427 on Days 1, 8, 15, 22, and 29.
Treatment:
Drug: AZD3427
AZD3427: Cohort 6b
Experimental group
Description:
Participants with HF with EF ≥ 41% will receive SC dose C of AZD3427 on Days 1, 8, 15, 22, and 29.
Treatment:
Drug: AZD3427
Part B: Placebo
Placebo Comparator group
Description:
Participants with HFrEF or HF with EF ≥ 41% will receive SC dose of placebo matched to AZD3427 on Days 1, 8, 15, 22, and 29.
Treatment:
Drug: Placebo

Trial contacts and locations

10

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Data sourced from clinicaltrials.gov

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