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Phase 1 Evaluation of (2R,6R)-Hydroxynorketamine

A Double-Blind, Placebo-controlled, Single Ascending Dose (SAD), Multiple Ascending Dose (MAD) and CSF Capture Study of the Safety, Pharmacokinetics and Pharmacodynamics of (2R,6R)-Hydroxynorketamine in Healthy Volunteers

Status
Completed
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04711005
Enrollment
74
Registered
2021-01-15
Start date
2021-01-11
Completion date
2023-05-31
Last updated
2024-06-06

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Major Depressive Disorder

Keywords

Healthy Volunteers, Depression, Antidepressant

Brief summary

A 6-cohort single ascending dose (SAD) study will be conducted in healthy volunteers utilizing a slow-infusion intravenous (IV) route of administration. Standard safety, pharmacokinetics (PK) and qEEG monitoring will be evaluated at all dose levels. Subsequently, a 2-cohort multiple ascending dose (MAD) study will be conducted. Doses will be administered on days 1, 4, 8, and 11. Standard safety parameters will be monitored, and PK will be evaluated at all dose levels. Finally, a single-cohort group with received a single dose by slow-infusion IV and have PK samples collected from both blood and cerebrospinal fluid (CSF).

Detailed description

A total of 48 Subjects are planned to be enrolled in a 6-cohort SAD study (36 in the treatment groups and 12 in the control groups). All SAD cohorts will have 6 Subjects in the treatment group and 2 Subjects in placebo group. All cohorts in the SAD study will incorporate sentinel dosing which will include 1 active and 1 placebo Subject. All remaining Subjects will be dosed at least 24 hours after the sentinel cohort participants. A total of 16 Subjects are planned to be enrolled in a 2 cohort MAD study (12 in the treatment groups and 4 in the control groups). All MAD cohorts will have 6 Subjects in the treatment group and 2 Subjects in placebo group. A total of 6 subjects are planned to be enrolled in a single cohort CSF capture study. The CSF cohort will have 4 in the treatment group and 2 in the placebo group. (2R,6R)-Hydroxynorketamine hydrochloride will be administered intravenously over a 40-minute period as a solution in a 25 mM sodium phosphate 0.9% w/v saline solution. The SAD doses will range from 0.1 mg/kg to 4.0 mg/kg and the investigational drug product will be diluted into a 53 mL total volume of formulant. Placebo will be made up of a 0.9% w/v saline solution (53 mL total volume) also administered via slow IV infusion over a 40-minute period. The MAD doses will range from 1.0 mg/kg to 2.0 mg/kg administered as a 40 minute infusion period in a solution of 25 mM sodium phosphate 0.9% w/v saline solution on days 1, 4, 8 and 11. The CSF capture doses will be 0.25 mg/mk and 2.0 mg/kg administered via slow infusion over a 40 minute period in 0.9% w/v saline solution. Serial PK blood samples will be collected during the SAD portion for each Subject receiving drug and placebo at 9 timepoints (preinfusion, end-of-infusion \[approximately 40 minutes\], 1, 2, 4, 8, 12, 24, and approximately 48 hr after the start of the infusion). Pharmacokinetic urine samples will be collected during the SAD study for each Subject receiving drug and placebo at set intervals following the initiation-of-infusion (0-4, \>4-8, \>8-12, \>12-24 hr). Serial PK blood samples will be collected for for each Subject receiving drug and placebo. Blood PK samples will be obtained at 8 timepoints for teh first and forth (last) dosing in the MAD study (preinfusion, end-of-infusion \[approximately 40 minutes\], 1, 2, 4, 8, 12, and approximately 24 hrs after the start of the infusion). Two PK blood samples will be collected for the second and third dosing in the MAD study for each subject receiving drug and placebo at approximately 10 minutes predose and at the end of the infusion. Serial PK blood samples will be collected for the single dose CSF capture study for each Subject receiving drug and placebo. Blood PK samples will be obtained at 8 timepoints (preinfusion, end-of-infusion \[approximately 40 minutes\], 1, 2, 4, 8, 12, and approximately 24hr after the start of the infusion). CSF samples will be obtained preinfusion, and at 2 timepoints (1h and 8 hours) post infusion. Safety will be assessed throughout the study. Baseline and follow-up safety assessments will include height, body mass index (BMI), weight, temperature, medical, visual and ocular history, physical examinations, ocular examinations, visual acuity, color vision tests, electrocardiograms (ECGs), vital signs (VS), clinical laboratory tests (hematology, serum chemistry, and urinalysis), the Profile of Mood States (POMS), the Columbia-Suicide Severity Rating Scale (C-SSRS), the Clinician Administered Dissociative States Scale (CADSS), and adverse events (AEs). Safety assessments will include AEs, ECGs, VS, clinical laboratory results, and physical observations. Assessment of each Subject's level of alertness/sedation will be accomplished using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S). Evaluation of safety in the MAD study will utilize the same safety assessments used in the SAD study. Evaluation of safety in the CSF capture study will utilize the same safety assessments used in the SAD and MAD study with the exception of the POMS and CADSS assessments. Monitoring of AEs will be governed by change from baselines established during prescreening and Day -1 examinations and clinical laboratory tests. Dose escalation in the SAD study or continued dosing in the MAD study may be stopped according to the predefined halting rules or if a Subject's scores demonstrate acute suicidality on the C-SSRS assessment or at the discretion of the study Principal Investigator and/or sponsor. Determination of whether to escalate to the next dose level in the SAD study or continue dosing in the MAD will be made by the Principal Investigator in consultation with the Medical Monitor and Study Sponsor.

Interventions

DRUG(2R,6R)-Hydroxynorketamine hydrochloride

(2R,6R)-Hydroxynorketamine is a metabolite of the drug ketamine. (2R,6R)-Hydroxynorketamine hydrochloride will be administered intravenously over a 40-minute period as a solution in a 25 mM sodium phosphate 0.9% w/v saline solution. The investigational drug product will be diluted into a 53 mL total volume of formulant.

DRUGPlacebo

Placebo will be made up of a 0.9% w/v saline solution (53 mL total volume) administered via slow IV infusion over a 40-minute period.

Sponsors

National Institute of Mental Health (NIMH)
Lead SponsorNIH

Study design

Allocation
RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Intervention model description

A 6-cohort single ascending dose (SAD) study will be conducted in healthy volunteers followed by a 2-cohort multiple ascending dose (MAD) study in healthy volunteers, followed by a 1-cohort single ascending dose study with collection of cerebrospinal fluid (CSF) and plasma for pharmacokinetics.

Eligibility

Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes

Inclusion criteria

1. Be a healthy male or female between 18 and 65 years of age (inclusive). 2. Voluntarily consents to participate in the study and provides written informed consent before the start of any study-specific procedures. 3. Be willing and able to remain in the study unit for the entire duration of the confinement period and return for outpatient visits. 4. Agree to comply with prohibitions and restrictions (section 8.5). 5. Females must have a negative serum β-human chorionic gonadotropin (hCG) pregnancy test at screening and a negative urine pregnancy test on Day -1 prior to study initiation. 6. Females must be of nonchildbearing potential or agree to use appropriate birth control, as defined in section 8.4 Contraception Requirements. 7. Males must be surgically sterile for at least 90 days before screening or agree to use a condom with spermicide when sexually active with a female partner who is not using an acceptable form of birth control during the study and for 90 days after study administration. Males must also agree to not donate sperm starting at enrollment and for 90 days after last study drug administration. 8. BMI (weight \[kg\]/\[m2\]) between 18 and 35 kg/m2 (inclusive) and weighs between 50 and 120 kg (110 - 264 pounds), inclusive. 9. Blood pressure (after Subject is in a supine position for approximately 5 minutes) between 90 and 145 mmHg systolic (inclusive) and no higher than 90 mmHg diastolic at Screening and Day -1. 10. A 12-lead ECG with no clinically significant abnormality as judged by the Investigator and QTc interval ≤ 450 milliseconds at Screening and Day -1. 11. Resting pulse rate between 45 and 100 beats per minute at Screening and Day -1. 12. Clinical laboratory findings and VS within normal range, or if outside of the normal ranges, deemed not clinically significant in the opinion of the Investigator. 13. Agree to comply with the rules regarding consumption of alcohol, caffeinated beverages, and tobacco/nicotine products during the study.

Exclusion criteria

1. History or presence of clinically significant medical illness including (but not limited to) hepatic, cardiovascular, pulmonary, renal, hematologic, endocrine, gastrointestinal, immunologic, dermatologic, neurologic, oncologic, or psychiatric disease that in the opinion of the Investigator would endanger the safety of the Subject or the validity of the study results. 2. Clinically significant acute illness in the 2 weeks prior to dosing. 3. Previous or current participation in any clinical study with an investigational drug, device, or biologic within 30 days or five half-lives of the investigational product to dosing. 4. Preplanned surgery or procedures that would interfere with the conduct of the study. 5. History of severe drug or excipient allergy, or hypersensitivity to be judged at the discretion of the Investigator. 6. Donation or loss of greater than 0.5 L of blood within 90 days before screening or study start. Donation of platelets within 40 days before screening or study start. Donation of plasma within 14 days before screening or study start. Receipt of blood products within 60 days before screening or study start. 7. Recent history (2 years) of alcohol or drug abuse at the discretion of the Investigator or a positive screen for alcohol or drugs of abuse (including marijuana) at screening and upon check-in. 8. Testing positive for hepatitis B, hepatitis C, or HIV, or a history of any of these diseases. Subjects whose results are compatible with prior immunization may be included at the discretion of the Investigator. 9. History of unexplained loss of consciousness, epilepsy, or other seizure disorders, or cerebrovascular disease. 10. Malignancy within 5 years of screening visit (except basal cell or squamous cell skin carcinoma). 11. Inability to adhere to the study unit diet. 12. Use of any prescription or nonprescription medication (including vitamins, herbal preparations, and nutritional supplements) within the 14 days prior to dosing except for common analgesics (acetaminophen, ibuprofen), hormonal contraceptives or hormonal replacement therapy or nonsedating antihistamines. Topical medications may be allowed at the discretion of the Investigator. 13. History or current diagnosis of mental illness including (but not limited to) psychotic disorder, bipolar disorder, schizophrenia, borderline personality disorder, and antisocial personality disorder, generalized anxiety disorder, obsessive compulsive disorder, posttraumatic stress disorder, and eating disorders. 14. History of suicidal or homicidal ideation. 15. Significant primary sleep disorder. 16. Known allergy to ketamine, heparin, or any of the IDP components (see section 10.0 Study Drug Information). 17. Any strenuous exercise in the 2 days prior to study drug administration. 18. Consumption of beverages or food that contain alcohol, grapefruit, poppy seeds, Brussel sprouts, pomegranate, broccoli, char-grilled meat within 2 days prior to drug administration. Allowances for a single isolated incidental consumption may be evaluated and approved pending PI approval for the potential interactions. 19. Use of tobacco or nicotine-containing products within 4 weeks prior to drug administration. 20. Employee of the PI or study center with direct involvement in the proposed study or other studies under the direction of the study PI. 21. Poor peripheral venous access. 22. Close relative (parent, sibling, child) of clinical site employee. 23. Subjects who, in the opinion of the PI or designee, should not participate in this study.

Design outcomes

Primary

MeasureTime frameDescription
Number of Subjects With Adverse Events as a Measure of Safety and Tolerability of (2R,6R)-Hydroxynorketamine8 days post dosing (SAD)Investigational product-related adverse events and serious adverse events
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Maximum Plasma Concentration (Cmax)3 days post dosing (SAD), 11 days post dosing (MAD)This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Time Taken to Reach Maximum Plasma Concentration (Tmax)3 days post dosing (SAD), 11 days post dosing (MAD)This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Area Under the Curve Concentration (AUC)3 days post dosing (SAD), 11 days post dosing (MAD)This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Half-life (t1/2)3 days post dosing (SAD), 11 days post dosing (MAD)This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.

Countries

United States

Participant flow

Participants by arm

ArmCount
SAD Cohort 1
(2R,6R)-Hydroxynorketamine @ 0.1 mg/kg via slow IV infusion (40 minutes) (2R,6R)-Hydroxynorketamine hydrochloride: (2R,6R)-Hydroxynorketamine is a metabolite of the drug ketamine. (2R,6R)-Hydroxynorketamine hydrochloride will be administered intravenously over a 40-minute period as a solution in a 25 mM sodium phosphate 0.9% w/v saline solution. The investigational drug product will be diluted into a 53 mL total volume of formulant.
6
SAD Cohort 2
(2R,6R)-Hydroxynorketamine @ 0.25 mg/kg via slow IV infusion (40 minutes) (2R,6R)-Hydroxynorketamine hydrochloride: (2R,6R)-Hydroxynorketamine is a metabolite of the drug ketamine. (2R,6R)-Hydroxynorketamine hydrochloride will be administered intravenously over a 40-minute period as a solution in a 25 mM sodium phosphate 0.9% w/v saline solution. The investigational drug product will be diluted into a 53 mL total volume of formulant.
6
SAD Cohort 3
(2R,6R)-Hydroxynorketamine @ 0.5 mg/kg via slow IV infusion (40 minutes) (2R,6R)-Hydroxynorketamine hydrochloride: (2R,6R)-Hydroxynorketamine is a metabolite of the drug ketamine. (2R,6R)-Hydroxynorketamine hydrochloride will be administered intravenously over a 40-minute period as a solution in a 25 mM sodium phosphate 0.9% w/v saline solution. The investigational drug product will be diluted into a 53 mL total volume of formulant.
6
SAD Cohort 4
(2R,6R)-Hydroxynorketamine @ 1.0 mg/kg via slow IV infusion (40 minutes) (2R,6R)-Hydroxynorketamine hydrochloride: (2R,6R)-Hydroxynorketamine is a metabolite of the drug ketamine. (2R,6R)-Hydroxynorketamine hydrochloride will be administered intravenously over a 40-minute period as a solution in a 25 mM sodium phosphate 0.9% w/v saline solution. The investigational drug product will be diluted into a 53 mL total volume of formulant.
6
SAD Cohort 5
(2R,6R)-Hydroxynorketamine @ 2.0 mg/kg via slow IV infusion (40 minutes) (2R,6R)-Hydroxynorketamine hydrochloride: (2R,6R)-Hydroxynorketamine is a metabolite of the drug ketamine. (2R,6R)-Hydroxynorketamine hydrochloride will be administered intravenously over a 40-minute period as a solution in a 25 mM sodium phosphate 0.9% w/v saline solution. The investigational drug product will be diluted into a 53 mL total volume of formulant.
6
SAD Cohort 6
(2R,6R)-Hydroxynorketamine @ 4.0 mg/kg via slow IV infusion (40 minutes) (2R,6R)-Hydroxynorketamine hydrochloride: (2R,6R)-Hydroxynorketamine is a metabolite of the drug ketamine. (2R,6R)-Hydroxynorketamine hydrochloride will be administered intravenously over a 40-minute period as a solution in a 25 mM sodium phosphate 0.9% w/v saline solution. The investigational drug product will be diluted into a 53 mL total volume of formulant.
6
MAD Cohort 1
(2R,6R)-Hydroxynorketamine @ 1.0 mg/kg via slow IV infusion (40 minutes) on days 1, 4, 7, 10 (2R,6R)-Hydroxynorketamine hydrochloride: (2R,6R)-Hydroxynorketamine is a metabolite of the drug ketamine. (2R,6R)-Hydroxynorketamine hydrochloride will be administered intravenously over a 40-minute period as a solution in a 25 mM sodium phosphate 0.9% w/v saline solution. The investigational drug product will be diluted into a 53 mL total volume of formulant.
6
MAD Cohort 2
(2R,6R)-Hydroxynorketamine @ 2.0 mg/kg via slow IV infusion (40 minutes) on days 1, 4, 7, 10 (2R,6R)-Hydroxynorketamine hydrochloride: (2R,6R)-Hydroxynorketamine is a metabolite of the drug ketamine. (2R,6R)-Hydroxynorketamine hydrochloride will be administered intravenously over a 40-minute period as a solution in a 25 mM sodium phosphate 0.9% w/v saline solution. The investigational drug product will be diluted into a 53 mL total volume of formulant.
9
Placebo
Control product (placebo) will be sterile saline also administered via slow IV infusion (40 minutes). Placebo: Placebo will be made up of a 0.9% w/v saline solution (53 mL total volume) administered via slow IV infusion over a 40-minute period.
19
CSF Capture Cohort 1
(2R,6R)-Hydroxynorketamine @ 0.25 mg/kg via slow IV infusion (40 minutes) (2R,6R)-Hydroxynorketamine hydrochloride: (2R,6R)-Hydroxynorketamine is a metabolite of the drug ketamine. (2R,6R)-Hydroxynorketamine hydrochloride will be administered intravenously over a 40-minute period as a solution in a 25 mM sodium phosphate 0.9% w/v saline solution. The investigational drug product will be diluted into a 53 mL total volume of formulant.
4
Total74

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004FG005FG006FG007FG008FG009
Overall StudyPhysician Decision0000000210
Overall StudyWithdrawal by Subject0000000100

Baseline characteristics

CharacteristicSAD Cohort 2SAD Cohort 3SAD Cohort 4SAD Cohort 5SAD Cohort 6MAD Cohort 1MAD Cohort 2PlaceboSAD Cohort 1CSF Capture Cohort 1Total
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Age, Categorical
Between 18 and 65 years
6 Participants6 Participants6 Participants6 Participants6 Participants6 Participants9 Participants19 Participants6 Participants4 Participants74 Participants
Age, Continuous43.0 years
STANDARD_DEVIATION 16.58
32.5 years
STANDARD_DEVIATION 6.5
32.7 years
STANDARD_DEVIATION 5.01
29.7 years
STANDARD_DEVIATION 3.88
32.0 years
STANDARD_DEVIATION 6.96
39.0 years
STANDARD_DEVIATION 2.68
36.7 years
STANDARD_DEVIATION 13.28
37.9 years
STANDARD_DEVIATION 10.45
36.2 years
STANDARD_DEVIATION 12.48
37.3 years
STANDARD_DEVIATION 13.28
35.4 years
STANDARD_DEVIATION 9.49
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants0 Participants1 Participants2 Participants1 Participants2 Participants0 Participants2 Participants1 Participants0 Participants9 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
6 Participants6 Participants5 Participants4 Participants5 Participants4 Participants9 Participants17 Participants5 Participants4 Participants65 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants1 Participants0 Participants1 Participants1 Participants0 Participants0 Participants2 Participants0 Participants0 Participants5 Participants
Race (NIH/OMB)
Black or African American
2 Participants2 Participants3 Participants2 Participants1 Participants4 Participants4 Participants5 Participants0 Participants2 Participants25 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants0 Participants1 Participants0 Participants1 Participants1 Participants0 Participants3 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
4 Participants3 Participants3 Participants3 Participants4 Participants1 Participants5 Participants11 Participants5 Participants2 Participants41 Participants
Region of Enrollment
United States
6 Participants6 Participants6 Participants6 Participants6 Participants6 Participants9 Participants19 Participants6 Participants4 Participants74 Participants
Sex: Female, Male
Female
2 Participants2 Participants4 Participants1 Participants2 Participants3 Participants3 Participants7 Participants4 Participants2 Participants30 Participants
Sex: Female, Male
Male
4 Participants4 Participants2 Participants5 Participants4 Participants3 Participants6 Participants12 Participants2 Participants2 Participants44 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
EG006
affected / at risk
EG007
affected / at risk
EG008
affected / at risk
EG009
affected / at risk
deaths
Total, all-cause mortality
0 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 90 / 190 / 4
other
Total, other adverse events
1 / 60 / 61 / 61 / 61 / 62 / 61 / 62 / 95 / 194 / 4
serious
Total, serious adverse events
0 / 60 / 60 / 60 / 60 / 60 / 60 / 60 / 90 / 190 / 4

Outcome results

Primary

Number of Subjects With Adverse Events as a Measure of Safety and Tolerability of (2R,6R)-Hydroxynorketamine

Investigational product-related adverse events and serious adverse events

Time frame: 8 days post dosing (SAD)

Population: Does not include the CSF cohorts as those were exploratory.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
SAD Cohort 1Number of Subjects With Adverse Events as a Measure of Safety and Tolerability of (2R,6R)-Hydroxynorketamine1 Participants
SAD Cohort 2Number of Subjects With Adverse Events as a Measure of Safety and Tolerability of (2R,6R)-Hydroxynorketamine0 Participants
SAD Cohort 3Number of Subjects With Adverse Events as a Measure of Safety and Tolerability of (2R,6R)-Hydroxynorketamine1 Participants
SAD Cohort 4Number of Subjects With Adverse Events as a Measure of Safety and Tolerability of (2R,6R)-Hydroxynorketamine1 Participants
SAD Cohort 5Number of Subjects With Adverse Events as a Measure of Safety and Tolerability of (2R,6R)-Hydroxynorketamine1 Participants
SAD Cohort 6Number of Subjects With Adverse Events as a Measure of Safety and Tolerability of (2R,6R)-Hydroxynorketamine2 Participants
Primary

Number of Subjects With Adverse Events as a Measure of Safety and Tolerability of (2R,6R)-Hydroxynorketamine

Investigational product-related adverse events and serious adverse events

Time frame: 19 days post dosing (MAD)

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
SAD Cohort 1Number of Subjects With Adverse Events as a Measure of Safety and Tolerability of (2R,6R)-Hydroxynorketamine1 Participants
SAD Cohort 2Number of Subjects With Adverse Events as a Measure of Safety and Tolerability of (2R,6R)-Hydroxynorketamine2 Participants
Primary

Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Area Under the Curve Concentration (AUC)

This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.

Time frame: 3 days post dosing (SAD), 11 days post dosing (MAD)

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
SAD Cohort 1Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Area Under the Curve Concentration (AUC)918 h*ng/mLGeometric Coefficient of Variation 22.9
SAD Cohort 2Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Area Under the Curve Concentration (AUC)2560 h*ng/mLGeometric Coefficient of Variation 23.5
SAD Cohort 3Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Area Under the Curve Concentration (AUC)5420 h*ng/mLGeometric Coefficient of Variation 15.2
SAD Cohort 4Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Area Under the Curve Concentration (AUC)11200 h*ng/mLGeometric Coefficient of Variation 14.5
SAD Cohort 5Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Area Under the Curve Concentration (AUC)19400 h*ng/mLGeometric Coefficient of Variation 15.1
SAD Cohort 6Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Area Under the Curve Concentration (AUC)38300 h*ng/mLGeometric Coefficient of Variation 23.7
MAD Cohort 1Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Area Under the Curve Concentration (AUC)9770 h*ng/mLGeometric Coefficient of Variation 10.6
MAD Cohort 2Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Area Under the Curve Concentration (AUC)18400 h*ng/mLGeometric Coefficient of Variation 15.1
Primary

Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Half-life (t1/2)

This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.

Time frame: 3 days post dosing (SAD), 11 days post dosing (MAD)

Population: Does not include the CSF cohort as that was exploratory.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
SAD Cohort 1Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Half-life (t1/2)7.10 hoursGeometric Coefficient of Variation 14.9
SAD Cohort 2Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Half-life (t1/2)7.41 hoursGeometric Coefficient of Variation 16.2
SAD Cohort 3Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Half-life (t1/2)7.92 hoursGeometric Coefficient of Variation 8
SAD Cohort 4Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Half-life (t1/2)8.18 hoursGeometric Coefficient of Variation 19.8
SAD Cohort 5Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Half-life (t1/2)7.84 hoursGeometric Coefficient of Variation 7.9
SAD Cohort 6Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Half-life (t1/2)6.67 hoursGeometric Coefficient of Variation 14.9
MAD Cohort 1Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Half-life (t1/2)8.01 hoursGeometric Coefficient of Variation 14.7
MAD Cohort 2Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Half-life (t1/2)7.60 hoursGeometric Coefficient of Variation 23
Primary

Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Maximum Plasma Concentration (Cmax)

This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.

Time frame: 3 days post dosing (SAD), 11 days post dosing (MAD)

Population: Does not include the CSF cohort as that was exploratory.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
SAD Cohort 1Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Maximum Plasma Concentration (Cmax)124 ng/mLGeometric Coefficient of Variation 31.1
SAD Cohort 2Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Maximum Plasma Concentration (Cmax)304 ng/mLGeometric Coefficient of Variation 38.9
SAD Cohort 3Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Maximum Plasma Concentration (Cmax)579 ng/mLGeometric Coefficient of Variation 21.3
SAD Cohort 4Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Maximum Plasma Concentration (Cmax)1200 ng/mLGeometric Coefficient of Variation 26
SAD Cohort 5Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Maximum Plasma Concentration (Cmax)2480 ng/mLGeometric Coefficient of Variation 30.3
SAD Cohort 6Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Maximum Plasma Concentration (Cmax)4280 ng/mLGeometric Coefficient of Variation 16.6
MAD Cohort 1Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Maximum Plasma Concentration (Cmax)1210 ng/mLGeometric Coefficient of Variation 20.8
MAD Cohort 2Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Maximum Plasma Concentration (Cmax)2610 ng/mLGeometric Coefficient of Variation 13.4
Primary

Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Time Taken to Reach Maximum Plasma Concentration (Tmax)

This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.

Time frame: 3 days post dosing (SAD), 11 days post dosing (MAD)

Population: Does not include the CSF cohort as that was exploratory.

ArmMeasureValue (GEOMETRIC_MEAN)
SAD Cohort 1Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Time Taken to Reach Maximum Plasma Concentration (Tmax)0.692 hours
SAD Cohort 2Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Time Taken to Reach Maximum Plasma Concentration (Tmax)0.683 hours
SAD Cohort 3Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Time Taken to Reach Maximum Plasma Concentration (Tmax)0.692 hours
SAD Cohort 4Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Time Taken to Reach Maximum Plasma Concentration (Tmax)0.825 hours
SAD Cohort 5Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Time Taken to Reach Maximum Plasma Concentration (Tmax)0.950 hours
SAD Cohort 6Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Time Taken to Reach Maximum Plasma Concentration (Tmax)0.975 hours
MAD Cohort 1Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Time Taken to Reach Maximum Plasma Concentration (Tmax)0.667 hours
MAD Cohort 2Pharmacokinetics of (2R,6R)-Hydroxynorketamine, Time Taken to Reach Maximum Plasma Concentration (Tmax)0.708 hours

Source: ClinicalTrials.gov · Data processed: Feb 5, 2026