Obesity
Conditions
Keywords
Obesity, Anti-Obesity Agents, Body Weight
Brief summary
The purpose of this study is to evaluate safety and efficacy of twice-daily ARD-101 in obese subjects with a body mass index (BMI) of 30-45 kg/m2.
Detailed description
This is a Phase 2, randomized, placebo-controlled study to investigate the effects of ARD-101, a small molecule targeting bitter taste receptors (TAS2Rs), in obese subjects with a body mass index (BMI) of 30-45 kg/m2. This study has a planned enrollment of 30 subjects and will be conducted in a single center in the United States. The study will consist of a Screening Period (up to 28 days), a Treatment Period (28 days), and a Follow-up Period (End-of-Study Visit within 14 days after receiving the last dose of ARD-101). The screening procedures will be initiated upon completion of the informed consent process. Following completion of screening procedures and confirmation of eligibility, subjects will be enrolled to receive ARD-101 in an outpatient setting and will be instructed to visit the clinical center periodically for safety and efficacy assessments.
Interventions
DRUGARD-101
Twice daily, oral administration
DRUGPlacebo
Twice daily, oral administration
Sponsors
University of California, San Diego
Aardvark Therapeutics, Inc.
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Subject)
Intervention model description
This study includes two arms: one placebo arm and one intervention arm.
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Male and female subjects, 18-75 years of age * Willing and able to provide signed and dated informed consent prior to any study-related procedures and willing and able to comply with all study procedures * BMI of 30-45 kg/m2 * Stable body weight by subject report (± 5%) in the previous 6 months prior to randomization * No abnormal findings or abnormalities of clinical significance in vital signs, physical examination, clinical laboratory tests (complete blood count (CBC), urinalysis, blood biochemistry, coagulation, pregnancy test (females of child bearing potential), urine drug test, nicotine test, etc.), 12-lead electrocardiogram (ECG) during the Screening Period. * Serum creatinine, alkaline phosphatase, hepatic enzymes (aspartate aminotransferase, alanine aminotransferase) and total bilirubin (unless the subject has documented Gilbert syndrome) not exceeding 1.5-fold the upper laboratory norm and estimated glomerular filtration rate (eGFR) \>30 mL/min * Standard 12-lead ECG parameters after 10 minutes resting in supine position in the following ranges; 120 ms \<PR \<220 ms, QRS \<120 ms, QTc ≤ 430 ms if male, ≤ 450 ms if female, and normal ECG tracing unless the Investigator considers an ECG abnormality within described limits to be not clinically relevant * Stable or well controlled blood pressure per Investigator's judgement during the Screening Period. Specifically: Vital signs after 10 minutes sitting in a chair (feet on floor, back supported): i. 95 mmHg \<systolic blood pressure (SBP) \<160 mmHg, ii. 45 mmHg \<diastolic blood pressure (DBP) \<100 mm Hg, iii. 40 bpm \<heart rate (HR) \<100 bpm * Prediabetes- defined as a fasting blood glucose between 100-125 mg/dL OR an HbA1c between 5.7-6.5% at screening * Type 2 diabetes- Defined as previous diagnosis by a healthcare professional OR a fasting blood glucose \> 126 mg/dL OR HbA1c \> 6.5% at screening * Patients with type 2 diabetes treated with metformin may be enrolled. However, patients with type 2 diabetes on any other therapy will be excluded * Female subjects must have negative serum pregnancy test and must not be lactating. For females able to bear children, a hormonal (i.e., oral, implantable, or injectable) and single barrier method (i.e., sponge), or a double-barrier method of birth control (i.e., condom with spermicide) or abstinence must be used/practiced throughout the study and for 90 days following last dose of study medication; for effective form of birth control * Females of non-childbearing potential, defined as surgically sterile (status post hysterectomy, bilateral oophorectomy, bilateral tubal ligation, bilateral salpingectomy, or bilateral tubal occlusion) or post-menopausal for at least 12 months (may be confirmed with a screening follicle stimulating hormone (FSH) level in the post-menopausal lab range), do not require contraception during the study * Males with female partners of childbearing potential must agree to a double-barrier method if they become sexually active during the study and for 90 days following the last dose of the study medication. Male subjects must not donate sperm for 90 days following their participation in the study
Exclusion criteria
* History of significant drug hypersensitivity or anaphylaxis * Prior bariatric or GI surgery (excluding cholecystectomy, hysterectomy or appendectomy) * Participation in a weight loss program or clinical trial for weight loss within 30 days prior to randomization * Diabetes treatment (unless metformin as outlined), or chronic oral steroids, or treatment with immune modulators, anti-obesity drugs, chronic opiate therapy, or antipsychotic medications * Received any experimental drugs or devices or have participated in a clinical study within 30 days prior to randomization * Currently receiving any drug-based therapy for weight management * Thyroid-stimulating hormone (TSH) level is outside of normal limit * The presence of diseases with abnormal clinical manifestations that need to be excluded based on their possible contribution to weight loss or weight gain, including but not limited to nervous, cardiovascular, blood and lymphatic system, immune, renal, hepatic, gastrointestinal, respiratory, metabolic and skeletal diseases * History of myocardial infarction, unstable angina, arterial revascularization, stroke, New York Heart Association Functional Class II-IV heart failure, or transient ischemic attack within 6 months prior to Visit 1 * Any malignancy not considered cured (except focal, treated basal cell carcinoma and squamous cell carcinoma of the skin); a participant is considered cured if there has been no evidence of cancer recurrence in the previous 5 years * History of major depressive disorder or history of other severe psychiatric disorders (e.g., schizophrenia or bipolar disorder) within the last 2 years. * Major surgery within 3 months prior to randomization or planned surgery during the study * Donated ≥200 mL of blood (blood components) or had massive blood loss, received blood transfusion or blood products within 3 months prior to randomization * Planned sperm/egg donation within 6 months post randomization * Positive urine drug test for any illicit non-prescription substances * History of consuming more than 14 units of alcoholic beverages per week or of alcoholism or drug/chemical/substance abuse within past 2 years prior to enrollment (Note: one unit = 12 ounces of beer, 4 ounces of wine or 1 ounce of spirits) * Smoking any amount within 3 months prior to randomization * Excessive consumption of tea, coffee, and/or caffeinated beverages (more than 8 cups, 250 mL for each cup) every day within 3 months prior to enrollment * Symptomatic viral, bacterial (including upper respiratory infection), or fungal (non-cutaneous) infection within 1 week prior to randomization * History of human immunodeficiency virus antibody or active hepatitis * A history of psychiatric and psychological condition that, in the judgment of the investigator, may interfere with the planned treatment and follow-up, affect subject compliance or place the subject at high risk from treatment-related complications * Poor venous access or inability to tolerate venipuncture * Any condition or active drug treatment that the investigator or primary physician believes may not be appropriate for participating in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Relative Change in Body Weight (%) | Run-in Visit (baseline), Day 28 | The percent total weight change at the end of treatment from baseline |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in TC | Days 1 to 28 | The change in total cholesterol (TC) at the end of treatment from baseline |
| Change in TG | Days 1-28 | The change in triglyceride (TG) at the end of treatment from baseline |
| Change in HDL | Days 1-28 | The change in high density lipoprotein cholesterol (HDL) at the end of treatment from baseline |
| Incidence (Number) of Treatment-emergent Adverse Events (TEAE) | Days 1-28 | The number of treatment-emergent adverse events (TEAE) reported by participants during the treatment period |
| Change in Waist Circumference | Days 1-28 | The change in waist circumference at the end of treatment from baseline |
| Change in % HbA1C | Screening to Day 28 | The change in % of hemoglobin A1c (HbA1c) at the end of treatment from baseline |
| Change in LDL | Days 1-28 | The change in low-density lipoprotein cholesterol (LDL) at the end of treatment from baseline |
Countries
United States
Participant flow
Recruitment details
Participants were recruited based on physician referrals at the clinical site between November 2021 and August 2022. A total of 30 subjects were originally planned, but only 20 subjects were enrolled, treated, and analyzed. The first participant was enrolled on November 15, 2021, and the last participant was enrolled in August 2022.
Pre-assignment details
A total of 20 subjects were enrolled and all 20 (100%) subjects completed the study.
Participants by arm
| Arm | Count |
|---|---|
| ARD-101 Dose 200 mg of ARD-101, twice daily for 28 days
ARD-101: Twice daily, oral administration | 14 |
| Placebo Comparator Placebo arm matching active arm ARD-101, 200 mg BID
Placebo: Twice daily, oral administration | 6 |
| Total | 20 |
Baseline characteristics
| Characteristic | Placebo Comparator | ARD-101 | Total |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 5 Participants | 5 Participants |
| Age, Categorical Between 18 and 65 years | 6 Participants | 9 Participants | 15 Participants |
| Age, Continuous | 49 years STANDARD_DEVIATION 9 | 57 years STANDARD_DEVIATION 12 | 55 years STANDARD_DEVIATION 12 |
| BMI | 35.2 kg/m^2 STANDARD_DEVIATION 5.5 | 34.1 kg/m^2 STANDARD_DEVIATION 3.6 | 34.5 kg/m^2 STANDARD_DEVIATION 4.1 |
| Body Weight | 101.6 Kg STANDARD_DEVIATION 23.8 | 95.4 Kg STANDARD_DEVIATION 12.4 | 97.3 Kg STANDARD_DEVIATION 16.2 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 1 Participants | 1 Participants | 2 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 5 Participants | 13 Participants | 18 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 2 Participants | 2 Participants | 4 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 3 Participants | 3 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 4 Participants | 9 Participants | 13 Participants |
| Sex: Female, Male Female | 3 Participants | 10 Participants | 13 Participants |
| Sex: Female, Male Male | 3 Participants | 4 Participants | 7 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 14 | 0 / 6 |
| other Total, other adverse events | 3 / 14 | 1 / 6 |
| serious Total, serious adverse events | 0 / 14 | 0 / 6 |
Outcome results
Primary
Relative Change in Body Weight (%)
The percent total weight change at the end of treatment from baseline
Time frame: Run-in Visit (baseline), Day 28
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ARD-101 | Relative Change in Body Weight (%) | -0.33 Percentage of body weight change | Standard Deviation 0.94 |
| Placebo Comparator | Relative Change in Body Weight (%) | 0.38 Percentage of body weight change | Standard Deviation 1.08 |
Secondary
Change in % HbA1C
The change in % of hemoglobin A1c (HbA1c) at the end of treatment from baseline
Time frame: Screening to Day 28
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ARD-101 | Change in % HbA1C | -0.17 Percent of HbA1c | Standard Deviation 0.22 |
| Placebo Comparator | Change in % HbA1C | -0.18 Percent of HbA1c | Standard Deviation 0.24 |
Secondary
Change in HDL
The change in high density lipoprotein cholesterol (HDL) at the end of treatment from baseline
Time frame: Days 1-28
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ARD-101 | Change in HDL | 0.2 mg/dL | Standard Deviation 7.36 |
| Placebo Comparator | Change in HDL | 4.0 mg/dL | Standard Deviation 6.1 |
Secondary
Change in LDL
The change in low-density lipoprotein cholesterol (LDL) at the end of treatment from baseline
Time frame: Days 1-28
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ARD-101 | Change in LDL | -6.8 mg/dL | Standard Deviation 16.95 |
| Placebo Comparator | Change in LDL | 1.3 mg/dL | Standard Deviation 15.15 |
Secondary
Change in TC
The change in total cholesterol (TC) at the end of treatment from baseline
Time frame: Days 1 to 28
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ARD-101 | Change in TC | -4.4 mg/dL | Standard Deviation 17.32 |
| Placebo Comparator | Change in TC | 5.7 mg/dL | Standard Deviation 19.31 |
Secondary
Change in TG
The change in triglyceride (TG) at the end of treatment from baseline
Time frame: Days 1-28
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ARD-101 | Change in TG | -0.6 mg/dL | Standard Deviation 93.81 |
| Placebo Comparator | Change in TG | 0.5 mg/dL | Standard Deviation 27.6 |
Secondary
Change in Waist Circumference
The change in waist circumference at the end of treatment from baseline
Time frame: Days 1-28
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| ARD-101 | Change in Waist Circumference | -0.2 cm | Standard Deviation 1.7 |
| Placebo Comparator | Change in Waist Circumference | -0.8 cm | Standard Deviation 3.3 |
Secondary
Incidence (Number) of Treatment-emergent Adverse Events (TEAE)
The number of treatment-emergent adverse events (TEAE) reported by participants during the treatment period
Time frame: Days 1-28
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| ARD-101 | Incidence (Number) of Treatment-emergent Adverse Events (TEAE) | Acid reflux | 1 Participants |
| ARD-101 | Incidence (Number) of Treatment-emergent Adverse Events (TEAE) | Nausea | 1 Participants |
| ARD-101 | Incidence (Number) of Treatment-emergent Adverse Events (TEAE) | No TEAE reported | 12 Participants |
| Placebo Comparator | Incidence (Number) of Treatment-emergent Adverse Events (TEAE) | Acid reflux | 0 Participants |
| Placebo Comparator | Incidence (Number) of Treatment-emergent Adverse Events (TEAE) | Nausea | 0 Participants |
| Placebo Comparator | Incidence (Number) of Treatment-emergent Adverse Events (TEAE) | No TEAE reported | 6 Participants |