CORT125134 Single Ascending Dose (SAD) and Multiple Ascending Dose (MAD)

Corcept Therapeutics

Status and phase: Completed; Phase 1

Conditions: Healthy

Treatments: Drug: Glucose; Drug: Mifepristone; Drug: CORT125134; Drug: Prednisone; Drug: Matching Placebo of CORT125134

Study type: Interventional

Funder types: Industry

Identifiers

NCT03508635

CORT125134-120

2014-001951-21 (EudraCT Number)

Details and patient eligibility

About

The purpose of this study is to evaluate the dose-related safety, tolerability, pharmacokinetics (PK) and pharmacological effects (PD) of CORT125134 and its active metabolite CORT125201 after single and multiple ascending oral doses of CORT125134 in healthy participants.

Full description

This is a 3-part, single-center study of single and multiple ascending doses of CORT125134 in healthy participants.

Part I is a single dose study. Initially, participants will be enrolled sequentially into 1 of up to 6 cohorts, each containing 10 participants, in a double-blind, randomized, placebo-controlled assessment of single-ascending doses (SAD) of CORT125134. Within each cohort, 8 participants will be randomly assigned to receive a single dose of CORT125134, and 2 participants will be randomly assigned to receive a single dose of matching placebo. Thereafter, Cohort 7 will be a food-effect cohort, in which all 8 participants will receive a single dose of CORT125134 after a high-fat breakfast (open label). Cohorts 8 and 9 will be pharmacological effect cohorts, in each of which 10 participants will receive a challenge agent (prednisone, 25 mg) alone on Day -19; with an active comparator (mifepristone, 600 mg) on Day -12, and with CORT125134 on Day 1 in an open-label single sequence crossover design. Pharmacological effects will be explored by measuring effects on peripheral blood eosinophil, lymphocyte and neutrophil counts, serum osteocalcin, assay of messenger ribonucleic acid (mRNA) expression of FK506 Binding Protein 5 (FKBP5) and Glucocorticoid-induced Leucine Zipper (GILZ) in whole blood (proof of pharmacological effect Cohort 8) and by measuring effects on oral glucose tolerance (proof of concept Cohort 9).

Part 2 and 3 will be double-blind, randomized, placebo-controlled assessments of multiple oral ascending doses (MAD) of CORT125134. Participants will be enrolled sequentially into 1 of up to 4 cohorts (Cohorts 10-13), each containing 12 participants. Within each cohort, 9 participants will be randomly assigned to receive CORT125134 and 3 participants to receive matching placebo daily for 14 days (Days 1-14). The effects of CORT125134 on response to prednisone challenge will be additionally explored in Cohorts 12 and 13 in a single sequence crossover, with prednisone being given alone on Day -5 and in combination with CORT125134 or placebo on Day 14.

Throughout the study, routine safety tests and assessments of PK (CORT125134 and CORT125201) will be performed, and changes in serum cortisol and plasma adrenocorticotrophic hormone (ACTH) measured.

Enrollment: 130 patients

Sex: All

Ages: 18 to 60 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Provide written informed consent
• Weight <= 102 kilogram (kg); body mass index (BMI) 18-30 kg/meter squared
• Morning serum cortisol in reference range
• Willing and able to communicate, participate in the whole study and to abide by study restrictions including use of contraception

Exclusion criteria

• Participation in any clinical research study, received treatment with any investigational drug or device, or donated blood within the previous 3 months
• Has a history of alcoholism, substance abuse, or drug abuse within 1 year; positive screen for alcohol or drugs of abuse
• Current smokers, smoked and/or used tobacco and/or nicotine-containing products within 6 months, or positive screen for carbon monoxide
• Females of childbearing potential, pregnant or breastfeeding, and/or with a positive pregnancy test
• Has a condition that could be aggravated by glucocorticoid blockade or activation
• Has clinically relevant abnormal findings on vital signs, physical examination, laboratory screening tests, or 12-lead electrocardiogram (ECG)
• Has history of clinically significant cardiovascular, renal, hepatic, endocrine, metabolic, chronic respiratory, gastrointestinal or neurological disease
• Has used systemic glucocorticoids within 12 months

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

130 participants in 9 patient groups, including a placebo group

SAD Cohorts 1 through 6

Experimental group

Description:

Participants will receive single doses of 5 mg up to 400 mg of CORT125134 (capsule) in a dose escalation format. The doses selected will be subject to amendment based on emerging data.

Treatment:

Drug: CORT125134

SAD Cohorts 1 through 6 Placebo

Placebo Comparator group

Description:

Participants will receive single doses of Matching Placebo of CORT125134 (capsule).

Treatment:

Drug: Matching Placebo of CORT125134

Food Effect Cohort 7

Experimental group

Description:

Participants will receive a single dose of CORT125134 (capsule) with a standard high fat breakfast. The dose will be chosen such that it has been previously administered in a prior SAD cohort.

Treatment:

Drug: CORT125134

Pharmacological Effect Cohort 8

Experimental group

Description:

Participants will receive a single dose of 25 mg of prednisone on Day -19; a single dose of 25 mg prednisone and 600 mg of mifepristone on Day -12; and a single dose of 25 mg prednisone and a single dose of CORT125134 on Day 1. The dose of CORT125134 will be chosen such that it has been previously administered in a prior SAD cohort.

Treatment:

Drug: Mifepristone

Drug: CORT125134

Drug: Prednisone

Proof of Concept (POC) Cohort 9

Experimental group

Description:

Participants will receive a single dose of 25 mg of prednisone on Day -19; a single dose of 25 mg of prednisone and 600 mg of mifepristone on Day -12; and a single dose of 25 mg prednisone and a single dose of CORT125134 on Day 1. An oral glucose tolerance test will be administered on each study day. The dose of CORT125134 will be chosen such that it has been previously administered in a prior SAD cohort.

Treatment:

Drug: Mifepristone

Drug: Glucose

Drug: CORT125134

Drug: Prednisone

MAD Cohorts 10 and 11

Experimental group

Description:

Participants will receive the selected dose of CORT125134 (capsule) following receipt of data from Cohorts 1-9 up to a maximum frequency of twice a day for a total of 14 days.

Treatment:

Drug: CORT125134

MAD Cohorts 10 and 11 Placebo

Placebo Comparator group

Description:

Participants will receive Matching Placebo of CORT125134 (capsule) up to a maximum frequency of twice a day for a total of 14 days.

Treatment:

Drug: Matching Placebo of CORT125134

MAD of PoPE Cohorts 12 and 13

Experimental group

Description:

Proof of Pharmacological Effect (PoPE+POC). Participants will receive 25 mg of prednisone (both cohorts) and an oral glucose tolerance test (Cohort 13 only) on Day -5. Participants will then receive the selected dose of CORT125134 (capsule) for a total of 13 days. Participants may either receive a higher dose level than previously administered or a repeat of a dose level given in 1 of the previous 2 MAD Cohorts. Participants will then receive 25 mg of prednisone (both cohorts) and an oral glucose tolerance test (Cohort 13 only) on Day 14.

Treatment:

Drug: Glucose

Drug: CORT125134

Drug: Prednisone

MAD of PoPE Cohort 12 and 13 Placebo

Placebo Comparator group

Description:

Participants will receive 25 mg of prednisone (both cohorts) and an oral glucose tolerance test (Cohort 13 only) on Day -5. Participants will then receive the Matching Placebo of CORT125134 (capsule) for a total of 13 days. Participants will then receive 25 mg of prednisone (both cohorts) and an oral glucose tolerance test (Cohort 13 only) on Day 14.

Treatment:

Drug: Matching Placebo of CORT125134

Drug: Glucose

Drug: Prednisone