None listed
Conditions
Brief summary
The primary objectives of the study are to assess the safety, tolerability and pharmacokinetics of intact prodrug, PF329, as well as the pharmacokinetics of its pharmaceutically active form, hydromorphone, following increasing doses of a single oral administration of PF329 in healthy adult subjects
Interventions
This is a first-in-man Phase 1, partly double-blind, randomized, single oral dose study with two arms: The first arm is a dose escalation of both PF329 and hydromorphone hydrochloride by cohorts. Subjects in the dose escalation cohorts will be fasted overnight from 11:00 PM the night prior to dosing until 4 hours after administration of study medication. All subjects in the dose escalation cohorts will receive oral naltrexone to block the opioid effects of PF329 and hydromorphone hydrochloride.
This is a first-in-man Phase 1, partly double-blind, randomized, single oral dose study with two arms: The first arm is a dose escalation of both PF329 and hydromorphone hydrochloride by cohorts. Subjects in the dose escalation cohorts will be fasted overnight from 11:00 PM the night prior to dosing until 4 hours after administration of study medication. All subjects in the dose escalation cohorts will receive oral naltrexone to block the opioid effects of PF329 and hydromorphone hydrochloride. Three doses of naltrexone (50 mg each dosing) will be administered orally with 240 mL of water each at approximately the following times relative to study drug administration: 14 hours before, 2 hours before, and 12 hours after. The starting dose of PF329 was determined using safety data obtained from nonclinical animal studies, and applying the algorithm for estimating the maximum safe starting dose in initial clinical trials as set forth in the Food and Drug Administration (FDA) guidance on the topic. The hydromorphone hydrochloride starting dose is a fraction of the PF329 dose. Doses will be escalated by cohort based on safety and pharmacokinetic assessments, either 2 or 4 fold from the previous cohort dose. The maximum number of cohorts in this arm is 7, since the smallest increment of dose escalation from the starting dose of 1 mg to the maximum dose of 48 mg is two. If the initial cohorts yield measurable plasma levels of PF329, PF329 doses for each of the 7 cohorts would be: 1 mg, 2 mg, 4 mg, 8 mg, 16 mg, 32 mg and 48 mg. The doses of hydromorphone will start at 0.5 mg, and thereafter will be adjusted to yield plasma concentrations equivalent to the PF329 dose in the next cohort, based on results of hydromorphone plasma assays in previous cohorts. In the second arm of the study, a separate crossover cohort will receive a dose of PF329 without naltrexone, but 50 mg naltrexone will be given orally with 240 ml water 12 hours after dosing as an added safety precaution. There will be no hydromorphone doses given in the crossover cohort. The PF329 dose for this crossover cohort will be chosen based on data from the dose escalation cohorts in the first arm and will be a dose that is not expected to produce adverse opioid effects. In one treatment session of this cohort, the group will be given a standardized high fat (approximately 50 percent of total caloric content of the meal), high-calorie (approximately 800 to 1000 calories) meal to be started 30 minutes before study drug dosing, and in another treatment session, the cohort will be fasted until 4 hours after dosing. Pharmacokinetics under both conditions will be compared. The subjects may be asked to return for a third treatment session to received half the dose of PF329 as in the previous 2 sessions, to obtain additional pharmacokinetic data. Thus, in this crossover cohort, there is a minimum of two treatment sessions, and a maximum of three treatment sessions. The crossover treatment sessions will be separated by a washout period of at least one week. The study will evaluate the safety and pharmacokinetics of PF329 as well as the pharmacokinetics of hydromorphone at doses sufficient to characterize the extent to which plasma hydromorphone is produced and maintained following oral ingestion of PF329.
Sponsors
PharmacoFore, Inc.
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to 50 Years
Healthy volunteers
Yes
Inclusion criteria
1. Males or females, ages 18-50 years in good general health 2. Body Mass Index (BMI) between 18 and 30 kg/m2 (inclusive) 3. Subjects must have a negative screen for drugs of abuse, nicotine, alcohol, hepatitis B-surface antigen, hepatitis C and Human Immunodeficiency Virus (HIV) 4. Female subjects must have a negative serum pregnancy test at screening and a negative urine pregnancy test at randomization 5. Female subjects must use a medically acceptable method of birth control (oral or transdermal contraceptives, condom, spermicidal foam, Intra-Uterine Device (IUD), progestin implant or injection, abstinence, vaginal ring, or sterilization of partner) from the time of screening through two weeks after the last study treatment 6. Subjects must have normal findings in a physical examination and 12-lead Electrocardiogram (ECG), and normal vital signs (respiratory rate between 12 and 20 breaths per minute, blood pressure between 100-140/60-90 mmHg, heart rate between 48-99 beats per minute, temperature between 35.8 degrees Celsius and 37.8 degrees Celsius), and Oxygen Saturation measured by pulse oximetry (SpO2) > 96 percent in the absence of supplemental oxygen. 7. Clinical laboratory values must be within the normal limits as defined by the clinical laboratory, unless the Investigator decides that out-of-range values are not clinically significant 8. Subjects must be able to provide meaningful written informed consent 9. Subjects must be willing and able to follow study instructions and be likely to complete all study requirements
Exclusion criteria
1. History of allergy or sensitivity to hydromorphoneor sulfites 2. History of loud snoring or sleep apnea 3. History of medical problems encountered with opioid therapy 4. Urinary cotinine levels indicative of smoking or history of regular use of tobacco-containing or nicotine-containing products within 2 months prior to screening 5. History of alcoholism or drug abuse (prescription or illicit drugs) 6. Use of prescription or over-the-counter medications within 14 days of study drug administration, except for contraceptive medications used by female subjects 7. Use of any opioid within 30 days prior to screening 8. Donation of blood within 30 days prior to screening 9. Donation of plasma or participation in a plasmapheresis program within 7 days prior to screening 10. Acute illness (e.g., gastrointestinal illness, infection such as influenza, upper respiratory tract infection, or known inflammatory process) at admission to the clinical study unit 11. History of gastrointestinal disturbance requiring frequent use of antacid 12. Anticipated need for surgery or hospitalization during the study 13. Enrollment in an investigational drug study within 30 days prior to screening 14. Any condition, that in the Investigator’s opinion, (i) puts the subject at significant risk, (ii) could confound the study results or (iii) may interfere significantly with the subject’s participation in the study
Outcome results
None listed