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

Primary Purpose

Major Depressive Disorder

Status
Active
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
(2R,6R)-Hydroxynorketamine hydrochloride
Placebo
Sponsored by
National Institute of Mental Health (NIMH)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Major Depressive Disorder focused on measuring Healthy Volunteers, Depression, Antidepressant

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

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.

Sites / Locations

  • Duke Early Phase Clinical Research

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm 9

Arm 10

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Experimental

Arm Label

SAD Cohort 1

SAD Cohort 2

SAD Cohort 3

SAD Cohort 4

SAD Cohort 5

SAD Cohort 6

MAD Cohort 1

MAD Cohort 2

Placebo

CSF Capture Cohort 1

Arm Description

(2R,6R)-Hydroxynorketamine @ 0.1 mg/kg via slow IV infusion (40 minutes)

(2R,6R)-Hydroxynorketamine @ 0.25 mg/kg via slow IV infusion (40 minutes)

(2R,6R)-Hydroxynorketamine @ 0.5 mg/kg via slow IV infusion (40 minutes)

(2R,6R)-Hydroxynorketamine @ 1.0 mg/kg via slow IV infusion (40 minutes)

(2R,6R)-Hydroxynorketamine @ 2.0 mg/kg via slow IV infusion (40 minutes)

(2R,6R)-Hydroxynorketamine @ 4.0 mg/kg via slow IV infusion (40 minutes)

(2R,6R)-Hydroxynorketamine @ 1.0 mg/kg via slow IV infusion (40 minutes) on days 1, 4, 7, 10

(2R,6R)-Hydroxynorketamine @ 2.0 mg/kg via slow IV infusion (40 minutes) on days 1, 4, 7, 10

Control product (placebo) will be sterile saline also administered via slow IV infusion (40 minutes).

(2R,6R)-Hydroxynorketamine @ 0.25 mg/kg via slow IV infusion (40 minutes)

Outcomes

Primary Outcome Measures

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
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
Number of subjects with adverse events as a measure of safety and tolerability of (2R,6R)-Hydroxynorketamine
Vital signs (systolic and diastolic blood pressure, pulse rate, respiration, temperature)
Number of subjects with adverse events as a measure of safety and tolerability of (2R,6R)-Hydroxynorketamine
Vital signs (systolic and diastolic blood pressure, pulse rate, respiration, temperature)
Number of subjects with adverse events as a measure of safety and tolerability of (2R,6R)-Hydroxynorketamine
12 lead electrocardiogram including heart rate, rhythm, RR interval, QT interval, QTcF interval, PR interval, and QRS duration
Number of subjects with adverse events as a measure of safety and tolerability of (2R,6R)-Hydroxynorketamine
12 lead electrocardiogram including heart rate, rhythm, RR interval, QT interval, QTcF interval, PR interval, and QRS duration
Number of subjects with adverse events as a measure of safety and tolerability of (2R,6R)-Hydroxynorketamine
Clinical laboratory assessments (serum chemistry, hematology, urinalysis)
Number of subjects with adverse events as a measure of safety and tolerability of (2R,6R)-Hydroxynorketamine
Clinical laboratory assessments (serum chemistry, hematology, urinalysis)
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.
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.
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, minimum plasma concentration at the end of the dosing interval after each dose in the MAD study (Cmin)
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)
This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, plasma drug clearance (CL)
This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, renal drug clearance (CLr)
This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, apparent volume of distribution during terminal phase (Vz)
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)
This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, maximum cerebrospinal fluid concentration (Cmax)
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 cerebrospinal fluid concentration (tmax)
This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, minimum cerebrospinal fluid concentration at the end of the dosing interval after each dose in the MAD study (Cmin)
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) for cerebrospinal fluid
This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, apparent volume of distribution during terminal phase (Vz) for cerebrospinal fluid
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) in cerebrospinal fluid
This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.

Secondary Outcome Measures

Pharmacodynamics of (2R,6R)-Hydroxynorketamine, quantitative electroencephalography (qEEG) relative spectral power
An FFT analysis will be performed on the raw EEG. From this FFT analysis, the absolute and relative power spectrum will be determined across all frequency bands (delta, theta, alpha, beta and gamma).
Pharmacodynamics of (2R,6R)-Hydroxynorketamine, quantitative electroencephalography (qEEG) visual evoked time-locked data
Analysis of sensory processing will be conducted through consideration of the visual evoked potential to a contrast reversing checkerboard.
Pharmacodynamics of (2R,6R)-Hydroxynorketamine, quantitative electroencephalography (qEEG) source localization
Frequency-specific and time-locked source localization will be performed using sLORETA within regions-of-interest specifying Default Mode, Central Executive, and Somatosensory networks.

Full Information

First Posted
January 8, 2021
Last Updated
May 11, 2023
Sponsor
National Institute of Mental Health (NIMH)
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1. Study Identification

Unique Protocol Identification Number
NCT04711005
Brief Title
Phase 1 Evaluation of (2R,6R)-Hydroxynorketamine
Official Title
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
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
January 11, 2021 (Actual)
Primary Completion Date
April 30, 2023 (Actual)
Study Completion Date
May 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Mental Health (NIMH)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Major Depressive Disorder
Keywords
Healthy Volunteers, Depression, Antidepressant

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
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.
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
74 (Actual)

8. Arms, Groups, and Interventions

Arm Title
SAD Cohort 1
Arm Type
Experimental
Arm Description
(2R,6R)-Hydroxynorketamine @ 0.1 mg/kg via slow IV infusion (40 minutes)
Arm Title
SAD Cohort 2
Arm Type
Experimental
Arm Description
(2R,6R)-Hydroxynorketamine @ 0.25 mg/kg via slow IV infusion (40 minutes)
Arm Title
SAD Cohort 3
Arm Type
Experimental
Arm Description
(2R,6R)-Hydroxynorketamine @ 0.5 mg/kg via slow IV infusion (40 minutes)
Arm Title
SAD Cohort 4
Arm Type
Experimental
Arm Description
(2R,6R)-Hydroxynorketamine @ 1.0 mg/kg via slow IV infusion (40 minutes)
Arm Title
SAD Cohort 5
Arm Type
Experimental
Arm Description
(2R,6R)-Hydroxynorketamine @ 2.0 mg/kg via slow IV infusion (40 minutes)
Arm Title
SAD Cohort 6
Arm Type
Experimental
Arm Description
(2R,6R)-Hydroxynorketamine @ 4.0 mg/kg via slow IV infusion (40 minutes)
Arm Title
MAD Cohort 1
Arm Type
Experimental
Arm Description
(2R,6R)-Hydroxynorketamine @ 1.0 mg/kg via slow IV infusion (40 minutes) on days 1, 4, 7, 10
Arm Title
MAD Cohort 2
Arm Type
Experimental
Arm Description
(2R,6R)-Hydroxynorketamine @ 2.0 mg/kg via slow IV infusion (40 minutes) on days 1, 4, 7, 10
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Control product (placebo) will be sterile saline also administered via slow IV infusion (40 minutes).
Arm Title
CSF Capture Cohort 1
Arm Type
Experimental
Arm Description
(2R,6R)-Hydroxynorketamine @ 0.25 mg/kg via slow IV infusion (40 minutes)
Intervention Type
Drug
Intervention Name(s)
(2R,6R)-Hydroxynorketamine hydrochloride
Intervention Description
(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.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
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.
Primary Outcome Measure Information:
Title
Number of subjects with adverse events as a measure of safety and tolerability of (2R,6R)-Hydroxynorketamine
Description
Investigational product-related adverse events and serious adverse events
Time Frame
8 days post dosing (SAD)
Title
Number of subjects with adverse events as a measure of safety and tolerability of (2R,6R)-Hydroxynorketamine
Description
Investigational product-related adverse events and serious adverse events
Time Frame
19 days post dosing (MAD)
Title
Number of subjects with adverse events as a measure of safety and tolerability of (2R,6R)-Hydroxynorketamine
Description
Vital signs (systolic and diastolic blood pressure, pulse rate, respiration, temperature)
Time Frame
8 days post dosing (SAD)
Title
Number of subjects with adverse events as a measure of safety and tolerability of (2R,6R)-Hydroxynorketamine
Description
Vital signs (systolic and diastolic blood pressure, pulse rate, respiration, temperature)
Time Frame
19 days post dosing (MAD)
Title
Number of subjects with adverse events as a measure of safety and tolerability of (2R,6R)-Hydroxynorketamine
Description
12 lead electrocardiogram including heart rate, rhythm, RR interval, QT interval, QTcF interval, PR interval, and QRS duration
Time Frame
8 days post dosing (SAD)
Title
Number of subjects with adverse events as a measure of safety and tolerability of (2R,6R)-Hydroxynorketamine
Description
12 lead electrocardiogram including heart rate, rhythm, RR interval, QT interval, QTcF interval, PR interval, and QRS duration
Time Frame
19 days post dosing (MAD)
Title
Number of subjects with adverse events as a measure of safety and tolerability of (2R,6R)-Hydroxynorketamine
Description
Clinical laboratory assessments (serum chemistry, hematology, urinalysis)
Time Frame
8 days post dosing (SAD)
Title
Number of subjects with adverse events as a measure of safety and tolerability of (2R,6R)-Hydroxynorketamine
Description
Clinical laboratory assessments (serum chemistry, hematology, urinalysis)
Time Frame
19 days post dosing (MAD)
Title
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, maximum plasma concentration (Cmax)
Description
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), 12 days post dosing (MAD)
Title
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, time taken to reach maximum plasma concentration (tmax)
Description
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), 12 days post dosing (MAD)
Title
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, minimum plasma concentration at the end of the dosing interval after each dose in the MAD study (Cmin)
Description
This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.
Time Frame
12 days post dosing (MAD)
Title
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, area under the curve concentration (AUC)
Description
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), 12 days post dosing (MAD)
Title
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, plasma drug clearance (CL)
Description
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), 12 days post dosing (MAD)
Title
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, renal drug clearance (CLr)
Description
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)
Title
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, apparent volume of distribution during terminal phase (Vz)
Description
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), 12 days post dosing (MAD)
Title
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, half-life (t1/2)
Description
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), 12 days post dosing (MAD)
Title
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, maximum cerebrospinal fluid concentration (Cmax)
Description
This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.
Time Frame
1 day post dosing (CSF Capture)
Title
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, time taken to reach maximum cerebrospinal fluid concentration (tmax)
Description
This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.
Time Frame
1 day post dosing (CSF Capture)
Title
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, minimum cerebrospinal fluid concentration at the end of the dosing interval after each dose in the MAD study (Cmin)
Description
This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.
Time Frame
1 day post dosing (CSF Capture)
Title
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, area under the curve concentration (AUC) for cerebrospinal fluid
Description
This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected
Time Frame
1 day post dosing (CSF Capture)
Title
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, apparent volume of distribution during terminal phase (Vz) for cerebrospinal fluid
Description
This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.
Time Frame
1 day post dosing (CSF Capture)
Title
Pharmacokinetics of (2R,6R)-Hydroxynorketamine, half-life (t1/2) in cerebrospinal fluid
Description
This parameter will be calculated as appropriate and if possible for (2R,6R)-Hydroxynorketamine, depending on actual samples collected.
Time Frame
1 day post dosing (CSF Capture)
Secondary Outcome Measure Information:
Title
Pharmacodynamics of (2R,6R)-Hydroxynorketamine, quantitative electroencephalography (qEEG) relative spectral power
Description
An FFT analysis will be performed on the raw EEG. From this FFT analysis, the absolute and relative power spectrum will be determined across all frequency bands (delta, theta, alpha, beta and gamma).
Time Frame
3 hours post dosing (SAD)
Title
Pharmacodynamics of (2R,6R)-Hydroxynorketamine, quantitative electroencephalography (qEEG) visual evoked time-locked data
Description
Analysis of sensory processing will be conducted through consideration of the visual evoked potential to a contrast reversing checkerboard.
Time Frame
3 hours post dosing (SAD)
Title
Pharmacodynamics of (2R,6R)-Hydroxynorketamine, quantitative electroencephalography (qEEG) source localization
Description
Frequency-specific and time-locked source localization will be performed using sLORETA within regions-of-interest specifying Default Mode, Central Executive, and Somatosensory networks.
Time Frame
3 hours post dosing (SAD)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Be a healthy male or female between 18 and 65 years of age (inclusive). Voluntarily consents to participate in the study and provides written informed consent before the start of any study-specific procedures. Be willing and able to remain in the study unit for the entire duration of the confinement period and return for outpatient visits. Agree to comply with prohibitions and restrictions (section 8.5). 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. Females must be of nonchildbearing potential or agree to use appropriate birth control, as defined in section 8.4 Contraception Requirements. 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. BMI (weight [kg]/[m2]) between 18 and 35 kg/m2 (inclusive) and weighs between 50 and 120 kg (110 - 264 pounds), inclusive. 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. A 12-lead ECG with no clinically significant abnormality as judged by the Investigator and QTc interval ≤ 450 milliseconds at Screening and Day -1. Resting pulse rate between 45 and 100 beats per minute at Screening and Day -1. 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. Agree to comply with the rules regarding consumption of alcohol, caffeinated beverages, and tobacco/nicotine products during the study. Exclusion Criteria: 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. Clinically significant acute illness in the 2 weeks prior to dosing. 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. Preplanned surgery or procedures that would interfere with the conduct of the study. History of severe drug or excipient allergy, or hypersensitivity to be judged at the discretion of the Investigator. 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. 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. 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. History of unexplained loss of consciousness, epilepsy, or other seizure disorders, or cerebrovascular disease. Malignancy within 5 years of screening visit (except basal cell or squamous cell skin carcinoma). Inability to adhere to the study unit diet. 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. 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. History of suicidal or homicidal ideation. Significant primary sleep disorder. Known allergy to ketamine, heparin, or any of the IDP components (see section 10.0 Study Drug Information). Any strenuous exercise in the 2 days prior to study drug administration. 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. Use of tobacco or nicotine-containing products within 4 weeks prior to drug administration. Employee of the PI or study center with direct involvement in the proposed study or other studies under the direction of the study PI. Poor peripheral venous access. Close relative (parent, sibling, child) of clinical site employee. Subjects who, in the opinion of the PI or designee, should not participate in this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Shruti Raja, MD, MHS
Organizational Affiliation
Duke University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Duke Early Phase Clinical Research
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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

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