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A Safety Study of AZD4041 in Healthy Volunteers

Primary Purpose

Opioid Use Disorder (OUD)

Status
Completed
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
AZD4041
Placebo
Sponsored by
AstraZeneca
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Opioid Use Disorder (OUD)

Eligibility Criteria

18 Years - 55 Years (Adult)All SexesAccepts Healthy Volunteers

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

Sites / Locations

  • Research Site

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

AZD4041

Placebo

Arm Description

Daily oral dose given by syringe directly into the mouth

Daily oral dose given by syringe directly into the mouth

Outcomes

Primary Outcome Measures

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

Secondary Outcome Measures

Full Information

First Posted
December 14, 2021
Last Updated
July 4, 2022
Sponsor
AstraZeneca
Collaborators
Altasciences Company Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05233085
Brief Title
A Safety Study of AZD4041 in Healthy Volunteers
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
Study Type
Interventional

2. Study Status

Record Verification Date
June 2022
Overall Recruitment Status
Completed
Study Start Date
December 17, 2021 (Actual)
Primary Completion Date
June 7, 2022 (Actual)
Study Completion Date
June 7, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AstraZeneca
Collaborators
Altasciences Company Inc.

4. Oversight

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

5. Study Description

Brief 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.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Opioid Use Disorder (OUD)

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Model Description
For each cohort, 9 subjects will be randomly assigned to receive AZD4041 and 3 subjects will be assigned to receive placebo. Within each cohort, 2 subjects will be randomized initially to AZD4041 or placebo (1:1 ratio) to allow a sentinel dosing approach. Providing no clinically significant issues have been noted after the first 3 doses of the initial 2 (sentinel) subjects in a cohort and provided the Day 3 safety laboratory tests for the 2 subjects have been reviewed, the remaining 10 subjects will be randomised to AZD4041 or placebo in an 8:2 ratio. All subjects will receive either AZD4041 or placebo administered once daily for 14 days.
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
36 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AZD4041
Arm Type
Experimental
Arm Description
Daily oral dose given by syringe directly into the mouth
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Daily oral dose given by syringe directly into the mouth
Intervention Type
Drug
Intervention Name(s)
AZD4041
Intervention Description
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.
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
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.
Primary Outcome Measure Information:
Title
Incidence and severity of Adverse events
Description
Incidence, nature, severity and seriousness of adverse events from screening
Time Frame
59 days
Title
Vital signs
Description
Change from baseline in both systolic and diastolic blood pressure measured in millimetres of Mercury
Time Frame
33 days
Title
Safety laboratory tests
Description
Incidence from baseline in abnormal laboratory test results
Time Frame
33 days
Title
Body temperature
Description
Change in baseline in body temperature measured in degrees Celcius
Time Frame
33 days
Title
Suicidal Ideation
Description
Evaluation of presence or absence of suicidal ideation as measured by the Columbia Suicide Rating Scale (C-SSRS)
Time Frame
59 Days
Title
Suicidal Behavior
Description
Evaluation of presence or absence of suicidal behavior as measured by the Columbia Suicide Severity Rating Scale (C-SSRS)
Time Frame
59 Days
Title
Electrocardiograms
Description
Change from baseline in ECG rythm
Time Frame
33 Days
Title
Electrocardiograms
Description
Change from baseline in ECG heart rate
Time Frame
33 days
Title
Electrocardiograms
Description
Change in baseline in ECG conduction
Time Frame
33 Days
Title
Electrocardiograms
Description
Change in baseline in ECG PR interval
Time Frame
33 Days
Title
Electrocardiograms
Description
Change from baseline in ECG QRS interval
Time Frame
33 Days
Title
Electrocardiograms
Description
Change from baseline in ECG QT interval
Time Frame
33 Days
Title
Electrocardiograms
Description
Change from baseline in ECG RR interval
Time Frame
33 Days
Title
Electrocardiograms
Description
Change in baseline in ECG QTcF interval
Time Frame
33 Days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
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: Physiological postmenopausal status, defined as the following: 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 follicle stimulating hormone (FSH) levels ≥ 40 mIU/mL at Screening; and must have a negative pregnancy test result at screening and check-in. and/or 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. Systolic BP < 90 mmHg or >140 mmHg Diastolic BP < 50 mmHg or > 90 mmHg 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
Facility Information:
Facility Name
Research Site
City
Laval
State/Province
Quebec
ZIP/Postal Code
h7v 4bc
Country
Canada

12. IPD Sharing Statement

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A Safety Study of AZD4041 in Healthy Volunteers

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