First-in-human Trial to Evaluate the Safety, Tolerability and Pharmacokinetics of C106 in Healthy Subjects

A Double-blind, Placebo-controlled, Randomised, First in Human Trial to Evaluate the Safety, Tolerability and Pharmacokinetics of Single and Multiple Ascending Oral Doses of C106 in Healthy Male and Female Subjects

This is a FIH, double-blind, placebo-controlled, within-group randomised, trial designed to evaluate the safety, tolerability, and pharmacokinetics (PK) of single and multiple ascending oral doses of compound 106 (C106) in healthy females of non-childbearing potential and healthy males.

The trial will be conducted in 2 parts:

Part A, single ascending dose (SAD) including a food interaction cohort: safety, tolerability, and PK in healthy males and healthy females of non-childbearing potential receiving single ascending doses of C106.

Part B, multiple ascending dose (MAD): safety, tolerability, and PK in healthy males and healthy females of non-childbearing potential receiving twice daily multiple ascending doses of C106 for 8 days.

Study Overview

• Status: Completed
• Conditions: Idiopathic Pulmonary Fibrosis; Pulmonary Hypertension; Tolerance; Safety Issues
• Intervention / Treatment: Drug: C106 solution; Drug: Placebo

• Study Type: Interventional
• Enrollment (Actual): 80
• Phase: Phase 1

Contacts and Locations

• Study Contact: Name: Cecilia Ganslandt, MD, MSc; Phone Number: +46 (0)705 797 075; Email: cecilia.ganslandt@vicorepharma.com
• Study Contact Backup: Name: Anne Katrine Cohrt, MSc; Phone Number: + 45 2011 1391; Email: anne-katrine.cohrt@vicorepharma.com

Study Locations

• Sweden
  • Uppsala, Sweden, SE-752 37
    • CTC Clinical Trial Consultants AB

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Willing and able to give written informed consent for participation in the trial.
2. Healthy males and females of non-childbearing potential aged 18-65 years inclusive.
3. Body Mass Index (BMI) ≥ 18.5 and ≤ 30.0 kg/m2
4. Clinically normal medical history, physical findings, vital signs, ECG, and laboratory values at the time of screening, as judged by the Investigator
5. Women of non-childbearing potential, defined as pre-menopausal females who are sterilized (tubal ligation or permanent bilateral occlusion of fallopian tubes); or females who have undergone hysterectomy or bilateral oophorectomy; or post-menopausal defined as 12 months of amenorrhea (in questionable cases a blood sample with simultaneous detection of follicle stimulating hormone [FSH] ≥ 25 IU/L is confirmatory).

Male subjects must be willing to use condom or be vasectomised or practice sexual abstinence to prevent pregnancy and drug exposure of a partner and refrain from donating sperm from the date of dosing until 3 months after (last) dosing with the IMP. Their female partner of child-bearing potential must use highly effective contraceptive methods with a failure rate of < 1% to prevent pregnancy (combined [oestrogen and progestogen containing] hormonal contraception associated with inhibition of ovulation [oral, intravaginal, transdermal], progestogen-only hormonal contraception associated with inhibition of ovulation [oral, injectable, implantable], intrauterine device [IUD]or intrauterine hormone-releasing system [IUS]) from at least 4 weeks prior to dose to 3 months after last dose.

Exclusion Criteria:

1. History of any clinically significant disease or disorder which, in the opinion of the Investigator, may either put the subject at risk because of participation in the trial, or influence the results or the subject's ability to participate in the trial.
2. Any clinically significant illness, medical/surgical procedure, or trauma within 4 weeks of the first administration of IMP.
3. Malignancy within the past 5 years except for in situ removal of basal cell carcinoma.
4. Any planned major surgery within the duration of the trial.
5. Any positive result on screening for serum hepatitis B surface antigen, hepatitis C antibody and Human Immunodeficiency Virus (HIV).

6. After 10 minutes supine rest at the time of screening, any vital signs values outside the following ranges:

   • Systolic blood pressure <90 or >140 mmHg, or
   • Diastolic blood pressure <50 or >90 mmHg, or
   • Pulse <40 or >90 bpm
7. Prolonged QTcF (>450 ms), PR interval < 120 ms or > 240 ms, QRS>115 ms, clinically significant cardiac arrhythmias or any clinically significant abnormalities in the resting ECG at the time of screening, as judged by the Investigator.
8. History of severe allergy/hypersensitivity or ongoing allergy/hypersensitivity, as judged by the Investigator, or history of hypersensitivity to drugs with a similar chemical structure or class to C106.
9. Regular use of any prescribed or non-prescribed medication including antacids, analgesics, herbal remedies, vitamins and minerals within 2 weeks prior to the (first) administration of IMP, at the discretion of the Investigator.
10. Planned treatment or treatment with another investigational drug within 3 months prior to Day -1. Subjects consented and screened but not dosed in previous clinical trials are not excluded.
11. Current smokers or users of nicotine products. Irregular use of nicotine (e.g., smoking, snuffing, chewing tobacco) less than three times per week is allowed before screening visit.
12. Positive screen for drugs of abuse or alcohol at screening or on admission to the unit prior to administration of the IMP.
13. History of alcohol abuse or excessive intake of alcohol, as judged by the Investigator.
14. Presence or history of drug abuse, as judged by the Investigator.
15. History of, or current use of, anabolic steroids.
16. Excessive caffeine consumption defined by a daily intake of >5 cups of caffeine containing beverages.
17. Plasma donation within one month of screening or blood donation (or corresponding blood loss) during the three months prior to screening.
18. Investigator considers the subject unlikely to comply with trial procedures, restrictions, and requirements.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: C106 solution; Part A: Oral administration start dose, Single dose 5 mg Part B: Oral administration start dose 20 mg twice daily for 8 days	Drug: C106 solution; selective nonpeptide angiotensin II type 2 receptor (AT2R) agonist
Placebo Comparator: Placebo; Part A and B: Placebo to C106 without the active pharmaceutical ingredient	Drug: Placebo; Placebo for C106 solution

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Treatment Emergent adverse events (AEs) and serious AEs (SAEs)	AE reporting and questioning. AEs must be recorded in the AE Log of the eCRF. The Investigator must provide information on the AE, preferably with a diagnosis or at least with signs and symptoms; start and stop dates, start and stop time; intensity; causal relationship to IMP; action taken, and outcome. If the AE is serious, this must be indicated in the eCRF. AEs, including out-of-range clinically significant clinical safety laboratory values, must be recorded individually, except when considered manifestations of the same medical condition or disease state; in such cases, they must be recorded under a single diagnosis.	From date of signing informed consent until End of Study, assessed up to Day 22
Number of reported clinically significant changes from baseline in 12-lead electrocardiograms (ECGs)	Single 12-lead ECG will be recorded in supine position after 10 minutes of rest using an ECG machine. Abnormalities will be specified and documented as clinically significant or not clinically significant	Part A: Up to Day 10. Part B: Up to Day 22.
Clinically significant changes in vital signs, systolic and diastolic blood pressure	Will be measured in supine position after 10 minutes of rest.	Part A: Up to Day 3, Part B: Up to Day 10
Clinically significant changes in vital signs, pulse	Will be measured in supine position after 10 minutes of rest.	Part A: Up to Day 3, Part B: Up to Day 10
Clinically significant changes in vital signs, respiratory rate	Will be assessed in supine position after 10 minutes of rest.	Part A:Up Day 3, Part B: Up to Day 10
Clinically significant changes in vital signs, temperature	Measured with digital thermometer	Part A:Up Day 3, Part B: Up to Day 10
Number of subjects with abnormal and clinically significant safety laboratory test results post-dose	Any lab values outside the normal ranges will be judged as not clinically significant or clinically significant. Abnormal post-dose findings assessed by the Investigator as clinically significant will be reported as AEs. Laboratory Safety variables are (haematology, coagulation, clinical chemistry and urine analysis	Part A: Up to Day 3, Part B: Up to Day 10
Number of subjects with abnormal and significant physical examination findings post-dose	Any abnormalities will be specified and documented as clinically significant or not clinically significant. Abnormal post-dose findings assessed by the Investigator as clinically significant will be reported as AEs. A complete physical examination will include assessments of the head, eyes, ears, nose, throat, skin, neurological, lungs, cardiovascular, and abdomen	Part A: Day 7, Part B: Day 22

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Measurement of the PK profile (Cmax)	To assess the maximum Plasma Concentration (Cmax)	Part A up to Day 3, Part B up to Day 10
Measurement of the PK profile (t1/2)	To assess the plasma half life (t1/2) of the drug	Up to Day 3
Measurement of the PK profile (total clearance)	To assess the total clearance of the drug	Up to Day 3
Measurement of PK profile (dose proportionality)	To assess the dose proportionality of the drug	Part A: Up to Day 3, Part B: Up to Day 10
Measure % of dose excreted unchanged in urine of single and multiple oral doses of C106 of healthy subjects.	PK sampling in urine in Part A and B.	Part A: Up to Day 3, Part B: Up to Day 10
To evaluate the effect of a high fat meal on the single oral dose PK of C106 in healthy subjects (Part A) by relative bioavailibity of C106 in fasted versus fed conditions.	PK sampling in plasma and urine after single oral doses of C106 in healthy subjects, PK parameters as for Part A.	Up to Day 3
Investigate Renal Clearance in Part A and B of single and multiple oral doses of C106 of healthy subjects.	PK sampling in blood and urine	Part A: Up to Day 3 Part B: Up to 8
Identify accumulation ratios (based on AUCtau and Cmax)	PK sampling in blood and urine after multiple oral doses of C106 in healthy subjects.	Up to Day 10
Evaluate the observed concentration at the end of a dosing interval, immediately before next administration (Ctrough)	PK sampling in blood and urine after multiple doses of C106 in healthy subjects	Up to Day 10

Other Outcome Measures

Outcome Measure	Measure Description	Time Frame
Evaluate the metabolite profile of C106 in plasma of healthy subjects at steady state (Part B).	Metabolite In Safety Testing (MIST) analysis of the metabolite profile in plasma in comparison with the metabolite profile in plasma from non-clinical safety studies. Blood sampling for future analysis of C106 metabolites will be performed at steady state in Part B (MAD), i.e., from Day 8 The same samples constitute an aliquot of separated plasma (750 µL) generated from each PK sample	Day 8
To estimate the excreted C106 and its metabolites and the metabolite profile of C106 in urine of healthy subjects at steady state (Part B).	Urine sampling (an aliquot of 5 mL urine taken from the PK urine samples) for future analysis of excreted C106 metabolites in the urine.	Up to Day 8
To collect and store ECG data for potential future evaluation of the effect of C106 on ECG parameters, including concentration-QTc analysis using Expert Precision QT (EPQT) assessment (Part A).	Continuous ECG recordings will be performed for 25 hours, starting 1 hour prior to dose administration and baseline ECGs will be extracted at 3 time points before dosing (-45, -30 and -15 minutes).	25 hours, starting 1 hour pre-dose day 1

Collaborators and Investigators

• Sponsor: Vicore Pharma AB
• Investigators: Study Director: Måns Jergil, PhD, CTC Clinical Trial Consultants AB (CTC); Principal Investigator: Helena Litorp, MD, PhD, CTC Clinical Trial Consultants AB (CTC)

Study record dates

Study Major Dates

• Study Start (Actual): June 15, 2022
• Primary Completion (Actual): June 22, 2023
• Study Completion (Actual): June 22, 2023

Study Registration Dates

• First Submitted: June 7, 2022
• First Submitted That Met QC Criteria: June 16, 2022
• First Posted (Actual): June 22, 2022

Study Record Updates

• Last Update Posted (Actual): December 18, 2023
• Last Update Submitted That Met QC Criteria: December 15, 2023
• Last Verified: December 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pathologic Processes; Cardiovascular Diseases; Vascular Diseases; Respiratory Tract Diseases; Lung Diseases; Fibrosis; Lung Diseases, Interstitial; Hypertension; Pulmonary Fibrosis; Idiopathic Pulmonary Fibrosis; Hypertension, Pulmonary
• Other Study ID Numbers: VP-C106-101

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No