A Safety Study of AZD4041 in Healthy Volunteers

Opioid Use Disorder (OUD) Clinical Trial

Official title:

A Randomized, Double-Blind, Placebo-Controlled Study to Assess the Safety, Tolerability, and Pharmacokinetics of Multiple Ascending Doses of AZD4041 in Healthy Adult Subjects

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT05209334
• Other study ID #: D7460C00002
• Status: Recruiting
• Phase: Phase 1
• Start date: December 17, 2021
• Est. completion date: April 12, 2022

Study information

• Verified date: January 2022
• Source: MedImmune LLC
• Contact: AstraZeneca Clinical Study Information Center
• Phone: 1-877-240-9479
• Email: information.center[@]astrazeneca.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a Phase 1, single-centre, randomized, double-blind, placebo-controlled, MAD study in healthy male and female adult subjects. The study will include up to 48 subjects (12 subjects per cohort) who will be randomized 9:3 to active drug or placebo. Each cohort will receive AZD4041 or placebo in a MAD study. A sequential cohort MAD design will be employed to assure that higher doses are administered to healthy subjects only after lower doses have demonstrated an acceptable safety profile. The total study duration will be up to 59 days (including Screening) per subject.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 36
• Est. completion date: April 12, 2022
• Est. primary completion date: April 12, 2022
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years to 55 Years

Eligibility

Inclusion Criteria

• Provision of signed and dated written informed consent form prior to any study specific procedures
• Stated willingness to comply with all study procedures and availability for the duration of the study
• Healthy adult male or female subjects. Female subjects must be of non-childbearing potential (postmenopausal and/or surgically sterile)
• If female, meets one of the following criteria:

1. Physiological postmenopausal status, defined as the following:

1. absence of menses for at least 12 months following cessation of all exogenous hormonal treatments (without an alternative medical condition) at Screening and prior to the first study drug administration; and

2. follicle stimulating hormone (FSH) levels = 40 mIU/mL at Screening; and

3. must have a negative pregnancy test result at screening and check-in. and/or

2. Surgical sterile, defined as those who have had:

hysterectomy, bilateral oophorectomy and/or bilateral salpingectomy, or bilateral tubal ligation. Women who are surgically sterile must provide documentation of the procedure by an operative report, ultrasound, or other verifiable documentation; and must have a negative pregnancy test result at screening and check-in. If postmenopausal and has an FSH of < 40 mIU/mL, but meets all other criteria in (1) or (2) above as well as all the other inclusion criteria, screening oestradiol serum level must be equal to or below 150 pmol/L.

• Men who are biologically capable of fathering children must agree and commit to use an adequate form of contraception for the duration of the treatment period and for no less than 120 days (4 months) after the last administration of study intervention. A male subject is considered capable of fathering children even if his sexual partner is sterile or using contraceptives.
• Men who are biologically capable of fathering children must also agree to refrain from sperm donation for the duration of the treatment period and for at least 90 days after the last administration of study intervention.
• Aged at least 18 years but not older than 55 years on the day of randomization
• Body mass index (BMI) within 18.0 kg/m2 to 30.0 kg/m2, inclusive
• Body weight of within 50 kg to 100 kg, inclusive
• Non- or ex-smoker (An ex-smoker is defined as someone who completely stopped using nicotine products for at least 180 days prior to the first study drug administration)
• Have no clinically significant diseases captured in the medical history or evidence of clinically significant findings on the physical or neurological examination (including vital signs) and/or ECG and/or safety laboratory tests, as determined by an Investigator
• Suitable veins for cannulation or repeated venepuncture Exclusion Criteria
• Female who is lactating
• Female who is pregnant according to the pregnancy test at Screening or prior to the first study drug administration
• Male subjects with a history of oligospermia or azoospermia or any other disorder of the reproductive system
• Male subjects who are undergoing treatment or evaluation for infertility.
• History of significant allergy/ hypersensitivity to AZD4041 or products related to AZD4041 as well as severe allergy/hypersensitivity reactions (like angioedema) to any drugs
• Presence or history of significant gastrointestinal, liver or kidney disease, or any other condition that is known to interfere with drug absorption, distribution, metabolism, or excretion, or known to potentiate or predispose to undesired effects
• History of any significant disease, including [but not necessarily limited to] significant cardiovascular, pulmonary, hematologic, neurological, psychiatric, endocrine, immunologic, or dermatologic disease
• Maintenance therapy with any drug or significant history of drug dependency or alcohol abuse (> 21 units/week or > 3 units/day for men; > 14 units/week or > 2 units/day for women; intake of excessive alcohol, acute or chronic)
• History of any significant psychiatric disorder according to the criteria of the Diagnostic and Statistical manual of Mental Disorders, 5th Edition (DSM-5, American Psychiatric Association 2013) which, in the opinion of the Investigator, could be detrimental to subject safety or could compromise study data interpretation.
• History of substance use disorder, other than nicotine or caffeine (as per DSM-5 criteria)
• Use of any prescription drugs, including hormone replacement therapy in the 28 days prior to the first study drug administration, that in the opinion of an Investigator would put into question the status of the participant as healthy
• Use of St. John's wort in the 28 days prior to the first study drug administration
• Positive test result for alcohol and/or drugs of abuse at Screening or prior to the first study drug administration
• Any clinically significant illness, medical/surgical procedure or trauma within the 28 days prior to the first study drug administration
• Any abnormal or clinically significant findings in laboratory test results at Screening that would, in the opinion of an Investigator, increase the subject's risk of participation, jeopardize complete participation in the study, or compromise interpretation of study data
• Positive screening results to HIV Ag/Ab combo, hepatitis B surface antigen, or hepatitis C virus tests
• Showing suicidal tendency as per the C SSRS questionnaire administered at Screening
• Any abnormal vital signs, after 10 minutes supine rest, as defined in the list below, at the Screening Visit/or Day -2 Out of range tests may be repeated once for each visit at the discretion of an Investigator.

1. Systolic BP < 90 mmHg or >140 mmHg

2. Diastolic BP < 50 mmHg or > 90 mmHg

3. Heart Rate <45 or >85 beats per minute (bpm)

• Any clinically important abnormalities in rhythm, conduction, or morphology of the resting ECG and any clinically important abnormalities in the 12-lead ECG which, in an Investigator's opinion, may interfere with the interpretation of QTc interval changes, including abnormal ST-T-wave morphology, particularly in the protocol-defined primary lead or left ventricular hypertrophy at Screening or prior to the first study drug administration
• Prolonged QT interval corrected for HR using Fridericia's formula (QTcF) > 440 ms at Screening or prior to the first study drug administration
• Shortened QTcF < 340 ms at Screening or prior to first study drug administration
• Known family history of long QT syndrome
• ECG interval measured from the onset of the P wave to the onset of the complex between Q and S waves (QRS complex) (PR [PQ]) interval shortening < 120 ms (PR > 110 ms but < 120 ms is acceptable if there is no evidence of ventricular preexcitation) at Screening or prior to the first study drug administration
• PR (PQ) interval prolongation (> 220 ms), persistent or intermittent second (Wenckebach block while asleep is not exclusive), or third degree atrioventricular (AV) block, or AV dissociation at Screening or prior to the first study drug administration
• Persistent or intermittent complete bundle branch block, incomplete bundle branch block, or intraventricular conduction delay (IVCD) with ECG interval measured from the onset of the QRS complex to the J point (QRS) > 110 ms. Subjects with QRS > 110 ms but < 115 ms are acceptable if there is no evidence of ventricular hypertrophy or preexcitation at Screening or prior to the first study drug administration
• In the pre-dose 24 hour telemetry, presence of = 10 ventricular premature contractions (VPCs) during 1 hour, or = 100 VPCs during 24-hours of telemetry, or any occurrence of paired VPC (ventricular couplets) or other repetitive ventricular rhythms, including non-sustained or sustained (> 30 second duration), slow (< 100bpm), or fast (= 100 bpm) ventricular tachycardias.
• Vaccination with the Coronavirus disease 2019 (COVID 19) vaccine less than 14 days prior to first study dose administration
• Scheduled immunization with a COVID-19 vaccine (first or second dose) during the study that, in the opinion of an Investigator, could potentially interfere with subject participation, subject safety, study results, or any other reason
• Use of any prescribed or nonprescribed oral and topical inhibitors/inducers of CYP3A4 (including shampoo).
• Excessive intake of caffeine-containing drinks or food (eg, coffee, tea, chocolate) as judged by an Investigator
• Subjects who have previously received AZD4041
• Any history of tuberculosis
• Involvement of any AstraZeneca or study site employee or their close relatives
• Judgment by an Investigator that the subject should not participate in the study if they have any ongoing or recent (ie, during the Screening period) minor medical complaints that may interfere with the interpretation of study data or are considered unlikely to comply with study procedures, restrictions, and requirements
• Presence of any tongue piercings or history of any tongue piercings in the last 90 days prior to the first study drug administration
• Subjects who have medical dietary restrictions
• Subjects who cannot communicate reliably with the Investigator
• Inclusion in a previous group for this clinical study
• Intake of an investigational product (IP) within at least 28 days or 5 half-lives; whichever is longer, prior to the first study drug administration
• Donation of 50 mL or more of blood in the 28 days prior to the first study drug administration
• Donation of 500 mL or more of blood in the 56 days prior to the first study drug administration

Related Conditions & MeSH terms

• Opioid Use Disorder (OUD)
• Opioid-Related Disorders

Intervention

Drug:
• AZD4041
On Days 1 to 14, an oral dose of the assigned formulation will be administered to subjects using a syringe. The dose will be administered directly into the subject's mouth.

Other:
• Placebo
On Days 1 to 14, an oral dose of the assigned formulation will be administered to subjects using a syringe. The dose will be administered directly into the subject's mouth.

Locations

Country	Name	City	State
Canada	Research Site	Laval	Quebec
Canada	Research Site	Laval	Quebec

Sponsors (2)

Lead Sponsor	Collaborator
MedImmune LLC	Altasciences Company, Inc.

Country where clinical trial is conducted

Canada, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Incidence and severity of Adverse events	Incidence, nature, severity and seriousness of adverse events from screening	59 days
Primary	Vital signs	Change from baseline in both systolic and diastolic blood pressure measured in millimetres of Mercury	33 days
Primary	Safety laboratory tests	Incidence from baseline in abnormal laboratory test results	33 days
Primary	Body temperature	Change in baseline in body temperature measured in degrees Celcius	33 days
Primary	Suicidal Ideation	Evaluation of presence or absence of suicidal ideation as measured by the Columbia Suicide Rating Scale (C-SSRS)	59 Days
Primary	Suicidal Behavior	Evaluation of presence or absence of suicidal behavior as measured by the Columbia Suicide Severity Rating Scale (C-SSRS)	59 Days
Primary	Electrocardiograms	Change from baseline in ECG rythm	33 Days
Primary	Electrocardiograms	Change from baseline in ECG heart rate	33 days
Primary	Electrocardiograms	Change in baseline in ECG conduction	33 Days
Primary	Electrocardiograms	Change in baseline in ECG PR interval	33 Days
Primary	Electrocardiograms	Change from baseline in ECG QRS interval	33 Days
Primary	Electrocardiograms	Change from baseline in ECG QT interval	33 Days
Primary	Electrocardiograms	Change from baseline in ECG RR interval	33 Days
Primary	Electrocardiograms	Change in baseline in ECG QTcF interval	33 Days