Study to Assess the Safety, Tolerability, Pharmacokinetics of E2027 in Healthy Adult and Elderly Subjects, and the Pharmacodynamics in Healthy Adult Subjects

Eisai

Status and phase

Completed

Phase 1

Conditions

Healthy Participants

Treatments

Drug: E2027

Drug: E2027 matching placebo

Study type

Interventional

Funder types

Industry

Identifiers

NCT02415790

E2027-A001-001

Details and patient eligibility

About

This first-in-human study, designed to assess the safety, tolerability, and pharmacokinetics (PK) of single oral ascending doses of E2027, will be administered to healthy adult participants to determine the maximum tolerated dose (MTD). Thereafter, the pharmacodynamic (PD) effects of single doses of E2027 on elevation of cerebrospinal fluid (CSF) cyclic guanidine monophosphate (cGMP) in healthy adult participants will be evaluated across a broad dose range, to establish the PK/PD relationship.

Full description

The study will consist of 4 parts, Parts A, B, C, and D. Part A is a single ascending dose (SAD) clinical pharmacology for evaluation of safety, tolerability, and PK characteristics up to the MTD in healthy adult (greater than or equal to 18 years and less than or equal to 50 years old). In Part B, the PK and PD effects of E2027 on CSF cGMP are evaluated in healthy adult (greater than or equal to 18 years and less than or equal to 50 years old). Participants in 2nd cohort of Part B will participate in the evaluation of food effect in Treatment Period 2. In Part C, the design is similar to Part A. This healthy elderly cohort (greater than or equal to 65 years and less than or equal to 85 years old) will provide bridging PK, safety, and tolerability data on E2027 compared to younger healthy participants in Part A and Part B. Part D will be conducted in healthy Japanese adult participants (greater than or equal to 20 years and less than or equal to 50 years old) and is designed to bridge the PK, safety, and tolerability data of E2027 between Japanese and non-Japanese participants. All parts of the study will have 2 phases: the Prerandomization Phase and the Randomization Phase. The Prerandomization Phase will consist of a Screening Period and a Baseline Period during which each participant's study eligibility will be determined and baseline assessments will be conducted. The Randomization Phase will consist of the Treatment Period and a Follow-Up Period. During the Treatment Period, participants will be randomized to receive a single oral dose of either E2027 or placebo matching E2027.

Enrollment

112 patients

Sex

All

Ages

18 to 85 years old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

Part A and B only:

Nonsmoking, male or female, age greater than or equal to 18 years and less than or equal to 50 years old at the time of informed consent

Part C only:
Nonsmoking, male or female, age greater than or equal to 65 years and less than or equal to 85 years old at the time of informed consent

Part D only:
Nonsmoking, male or female, age greater than or equal to 20 years and less than or equal to 50 years old at the time of informed consent
Born in Japan to Japanese parents and grandparents of Japanese descent
Been living outside Japan for less than 5 years
Lifestyle, including diet, has not changed significantly since leaving Japan

All parts:
Body mass index (BMI) greater than or equal to 18 and less than or equal to 30 kg/m2 at Screening

Exclusion criteria

Clinically significant illness that requires medical treatment within 8 weeks or a clinically significant infection that requires medical treatment within 4 weeks of dosing
Females who are breastfeeding or pregnant at Screening or Baseline
If females of childbearing potential who:
1. Had unprotected sexual intercourse within 30 days before study entry and do not agree to use a highly effective method of contraception
2. Are currently abstinent, and do not agree to use a double barrier method or refrain from sexual activity
Males who have not had a successful vasectomy (confirmed azoospermia) or they and their female partners do not meet the criteria above. No sperm donation is allowed during the study period or for 28 days after study drug discontinuation.
Evidence of disease that may influence the outcome of the study within 4 weeks before dosing
Any history of abdominal surgery that may affect PK profiles of E2027
Any clinically abnormal symptom or organ impairment found by medical history, physical examinations, vital signs, ECG finding, or laboratory test results that requires medical treatment at Screening or Baseline
A prolonged QT/QTc interval (QTc greater than 450 ms) demonstrated on ECG at Screening or Baseline
Persistent systolic blood pressure greater than 130 mmHg or diastolic blood pressure greater than 85 mm Hg at Screening or Baseline (Parts A, B, and D)
Persistent systolic blood pressure greater than 140 mmHg or diastolic blood pressure greater than 90 mm Hg at Screening or Baseline (Part C)
Heart rate less than 50 or more than 100 beats/min at Screening or Baseline
History of prolonged QT/QTc interval
Left bundle branch block
History of myocardial infarction or active ischemic heart disease
History of clinically significant arrhythmia or uncontrolled arrhythmia
Known history of clinically significant drug allergy at Screening or Baseline
Known history of food allergies or presently experiencing significant seasonal or perennial allergy at Screening or Baseline
Known to be human immunodeficiency virus (HIV) positive at Screening
Active viral hepatitis (A, B or C) as demonstrated by positive serology at Screening
History of drug or alcohol dependency or abuse within the 2 years before Screening, or those who have a positive urine drug or alcohol test at Screening or Baseline
Intake of caffeinated beverages or food within 72 hours before dosing
Intake of nutritional supplements, juice, and herbal preparations or other foods or beverages that may affect the various drug metabolizing enzymes and transporters within 1 week before dosing
Intake of herbal preparations containing St. John's Wort within 4 weeks before dosing
Use of prescription drugs within 4 weeks before dosing
Intake of over-the-counter (OTC) medications within 2 weeks before dosing
Currently enrolled in another clinical trial or used any investigational drug or device within 30 days (or 5 half-lives, whichever is longer) preceding informed consent
Engagement in strenuous exercise within 2 weeks before check-in (eg, marathon runners, weight lifters, etc.)
Any contraindication to continuous CSF sampling via indwelling lumbar catheter (Part B only)

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Double Blind

112 participants in 4 patient groups

Part A: PK of E2027 in healthy adults

Experimental group

Description:

Part A consists of 6 sequential cohorts of healthy adults. There will be 8 participants in each cohort, with 6 participants randomized to E2027 and 2 participants to placebo.

Treatment:

Drug: E2027

Drug: E2027 matching placebo

Part B: PK and PD of E2027 in healthy adults

Experimental group

Description:

Part B consists of 4 sequential cohorts of healthy adult participants. There will be 8 participants in the 1st cohort, with 6 participants randomized to E2027 and 2 participants to placebo. In the 2nd to 4th cohorts, there will be 7 participants in each cohort, with 6 participants randomized to E2027 and 1 participant to placebo. Participants in the 2nd cohort will then receive placebo/the same dose of E2027 again after their washout period in the fed state for the evaluation of food effect.

Treatment:

Drug: E2027

Drug: E2027 matching placebo

Part C: PK of E2027 in elderly cohorts

Experimental group

Description:

In Part C, 1 cohort of 8 healthy elderly participants will be enrolled, with 6 participants randomized to E2027 and 2 participants to placebo.

Treatment:

Drug: E2027

Drug: E2027 matching placebo

Part D: PK of E2027 in healthy Japanese adults

Experimental group