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Phase I Trial of an Investigational Small Pox Medication

Primary Purpose

Orthopoxviral Disease, Smallpox, Monkey Pox

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
ST-246 Days 1 - 3
ST-246 Days 11 - 13
Sponsored by
SIGA Technologies
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Orthopoxviral Disease focused on measuring Orthopoxviral, Smallpox, Monkey pox

Eligibility Criteria

18 Years - 50 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. 18 to 50 years
  2. Available for clinical follow-up duration of study.
  3. Able/willing to give written consent.
  4. Good general health; no clinically significant medical history.
  5. Refrain from taking any medications from screening through 72 hours after last dose.
  6. Adequate venous access.
  7. PE and lab results without clinically significant findings within 28 days prior to receipt of drug.
  8. Meet Lab Criteria within 28 days prior to receipt of drug.
  9. Negative pregnancy test
  10. Non smokers
  11. No alcohol or caffeine
  12. Participant or partner has undergone surgical sterilization, or the participant agrees either to be abstinent or use two non-hormonal methods of contraception for duration of the study

Exclusion Criteria:

  1. Marked baseline prolongation of QT/corrected QT interval (QTc) interval (
  2. History of additional risk factors for Torsade de Pointes
  3. Clinically significant abnormal ECG
  4. Personal history of cardiac disease, symptomatic or asymptomatic arrhythmias, syncopal episodes, or prolongation of the PR interval
  5. Family history of Sudden Cardiac Death not clearly due to acute myocardial infarction.
  6. History of any clinically significant conditions including:

    • Asthma
    • Diabetes mellitus
    • History of thyroidectomy or thyroid disease
    • Serious angioedema episodes
    • Head trauma resulting in a diagnosis of TBI other than concussion
    • Seizure or history of seizure
    • Bleeding disorder diagnosed by a doctor or significant bruising or bleeding difficulties with intramuscular injections or blood draws
    • Malignancy
  7. Family history of idiopathic seizures
  8. History or presence of neutropenia or other blood dyscrasia
  9. Known Hepatitis B or Hepatitis C infection
  10. Known human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome illness.
  11. Current or recent history of a clinically significant bacterial, fungal, or mycobacterial infection.
  12. Known clinically significant chronic viral infection (or current clinically significant viral infection
  13. History of frequent or severe headaches or migraines
  14. Known chronic bacterial, mycobacterial, fungal, parasitic, or protozoal infection
  15. Woman who is pregnant or is breast-feeding or planning to become pregnant
  16. On any concomitant medications
  17. History of drug allergy that, in the opinion of the PI, contraindicates participation in the trial.
  18. Inability to swallow medication
  19. Body Mass Index above 35 or below 18,
  20. Current drug abuse or alcohol abuse.
  21. Inability to refrain from physical exercise for a period of 24 hr before and after a PK day or refrain from consuming xanthines, grapefruit or grapefruit juice
  22. Clinically significant lactose intolerance
  23. Received experimental drug within 30 days
  24. Vaccination within 30 days
  25. Total of more than 350 milliliters (mL) of blood drawn in 2 months
  26. Treatment with any immunosuppressant or immunomodulatory medication in 3 months
  27. Any condition occupational reason or other responsibility that, in the judgment of the PI, would jeopardize the safety or rights of a subject participating in the trial or would render the subject unable to comply with the protocol
  28. History or diagnosis that would affect absorption of study medication

Sites / Locations

  • Orlando Clinical Research Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

Group ST-246 Form I (followed by Form V)

Group ST-246 Form V (followed by Form I)

Arm Description

Each of six subjects receive a single oral 400 mg dose (2×200 mg) of ST-246 Form I (monohydrate) in the first intervention period, followed 10 days later (3 days post-treatment monitoring and 7 days wash-out period) in the second intervention period by a single oral 400 mg dose (2×200 mg) of ST-246 Form V (hemihydrate). Both forms of drug are orally administered within 30 minutes after a standard light meal consisting of 400-450 calories and approximately 25% fat.

Each of six subjects receive a single oral 400 mg dose (2×200 mg) of ST-246 Form V (hemihydrate) in the first intervention period, followed 10 days later (3 days post-treatment monitoring and 7 days wash-out period) in the second intervention period by a single oral 400 mg dose (2×200 mg) of ST-246 Form I (monohydrate). Both forms of drug are orally administered within 30 minutes after a standard light meal consisting of 400-450 calories and approximately 25% fat.

Outcomes

Primary Outcome Measures

Pharmacokinetic Parameters for a Single Dose of ST-246 Form I vs. Form V: t½
Mean terminal half-life (t½; hrs) for Forms I and V were calculated from [plasma] vs time profiles.
Pharmacokinetic Parameters for a Single Dose of ST-246 Form I vs. Form V: AUC0-τ
Area under the drug concentration-time curve from time zero to time t, where t is the last timepoint with a drug concentration ≥ lowest obtainable quantification (AUC0-τ; ng*hr/mL).
Pharmacokinetic Parameters for a Single Dose of ST-246 Form I vs. Form V: AUC0-∞
Area under the drug concentration-time curve from time zero to infinity (AUC0-∞; ng*hr/mL).
Pharmacokinetic Parameters for a Single Dose of ST-246 Form I vs. Form V: Cmax
Maximum drug concentration in plasma, determined directly from individual concentration-time data (Cmax)
Pharmacokinetic Parameters for a Single Dose of ST-246 Form I vs. Form V: Tmax
Time to maximum plasma concentration(Tmax; hrs) for Forms I and V were calculated from [plasma] vs time profiles.

Secondary Outcome Measures

Number of Study Participants Who Tolerated a Single Dose of ST-246 Form I vs. Form V as Determined by No Clinically Significant Changes in Safety Parameters
Evaluated safety parameters included: physical examination/vital signs electrocardiograms (heart rate, PR interval, QRS duration, QT interval, and QTc Bazett) laboratory safety tests (hematology, chemistry, urinalysis) adverse events For a), b) and c), summary statistics (mean,SD, median, minm, maxm)for values, and changes from baseline(Day 1 pre-dose) to each timepoint, were measured and compared to laboratory normal reference ranges. Values for a)- d) were assigned grades according to DAIDS AE Grading Table. Any Grade of 3 or higher was considered severe and significant.

Full Information

First Posted
August 1, 2008
Last Updated
June 22, 2015
Sponsor
SIGA Technologies
Collaborators
National Institutes of Health (NIH)
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1. Study Identification

Unique Protocol Identification Number
NCT00728689
Brief Title
Phase I Trial of an Investigational Small Pox Medication
Official Title
A Phase I Randomized, Double-Blind, Crossover, Exploratory Study of the Pharmacokinetics of a Single Oral Dose of Form I Versus Form V Capsules of the Anti-Orthopoxvirus Compound ST-246® in Fed Normal Healthy Volunteers
Study Type
Interventional

2. Study Status

Record Verification Date
September 2010
Overall Recruitment Status
Completed
Study Start Date
August 2008 (undefined)
Primary Completion Date
October 2008 (Actual)
Study Completion Date
October 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
SIGA Technologies
Collaborators
National Institutes of Health (NIH)

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study was to evaluate the pharmacokinetic parameters and safety of a single dose of ST-246 400mg Form I versus ST-246 400mg Form V capsules in fed normal healthy volunteers.
Detailed Description
This was a Phase I, double-blind, cross-over, single-dose study of the orally administered anti-orthopoxvirus compound, ST-246, to 12 healthy, fed volunteers between the ages of 18 and 50 years. Subjects were randomized such that 6 subjects received either ST-246 Form I (monohydrate) followed 10 days later after a wash-out period by Form V (hemihydrate), and 6 subjects received ST-246 Form V followed by Form I, as for the previous group. Both forms of ST-246 were similar in the way they were manufactured. The only difference between Form I and Form V may be related to how it dissolves, and this may affect the way that it is absorbed in the human body. Information about any side-effects that may occur will also be collected in this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Orthopoxviral Disease, Smallpox, Monkey Pox
Keywords
Orthopoxviral, Smallpox, Monkey pox

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group ST-246 Form I (followed by Form V)
Arm Type
Active Comparator
Arm Description
Each of six subjects receive a single oral 400 mg dose (2×200 mg) of ST-246 Form I (monohydrate) in the first intervention period, followed 10 days later (3 days post-treatment monitoring and 7 days wash-out period) in the second intervention period by a single oral 400 mg dose (2×200 mg) of ST-246 Form V (hemihydrate). Both forms of drug are orally administered within 30 minutes after a standard light meal consisting of 400-450 calories and approximately 25% fat.
Arm Title
Group ST-246 Form V (followed by Form I)
Arm Type
Active Comparator
Arm Description
Each of six subjects receive a single oral 400 mg dose (2×200 mg) of ST-246 Form V (hemihydrate) in the first intervention period, followed 10 days later (3 days post-treatment monitoring and 7 days wash-out period) in the second intervention period by a single oral 400 mg dose (2×200 mg) of ST-246 Form I (monohydrate). Both forms of drug are orally administered within 30 minutes after a standard light meal consisting of 400-450 calories and approximately 25% fat.
Intervention Type
Drug
Intervention Name(s)
ST-246 Days 1 - 3
Other Intervention Name(s)
Tecovirimat
Intervention Description
First Intervention is on Days 1 - 3, and includes 6 patients dosed once orally with ST-246 Form I (Arm 1), and 6 patients dosed once orally with ST-246 Form V (Arm 2).
Intervention Type
Drug
Intervention Name(s)
ST-246 Days 11 - 13
Other Intervention Name(s)
Tecovirimat
Intervention Description
Second Intervention is on Days 11 - 13 (after a 3 day post-treatment monitoring and 7 day wash-out period) where the 6 patients previously given ST-246 Form I (Arm 1) are now dosed once orally with ST-246 Form V, and the 6 patients previously given ST-246 Form V (Arm 2) are now dosed once orally with ST-246 Form I.
Primary Outcome Measure Information:
Title
Pharmacokinetic Parameters for a Single Dose of ST-246 Form I vs. Form V: t½
Description
Mean terminal half-life (t½; hrs) for Forms I and V were calculated from [plasma] vs time profiles.
Time Frame
Post-dose samples at 0.5,1,2,3,4,8,12,24,36,48,72 hrs
Title
Pharmacokinetic Parameters for a Single Dose of ST-246 Form I vs. Form V: AUC0-τ
Description
Area under the drug concentration-time curve from time zero to time t, where t is the last timepoint with a drug concentration ≥ lowest obtainable quantification (AUC0-τ; ng*hr/mL).
Time Frame
Post-dose samples at 0.5,1,2,3,4,8,12,24,36,48,72 hrs
Title
Pharmacokinetic Parameters for a Single Dose of ST-246 Form I vs. Form V: AUC0-∞
Description
Area under the drug concentration-time curve from time zero to infinity (AUC0-∞; ng*hr/mL).
Time Frame
Post-dose samples at 0.5,1,2,3,4,8,12,24,36,48,72 hrs
Title
Pharmacokinetic Parameters for a Single Dose of ST-246 Form I vs. Form V: Cmax
Description
Maximum drug concentration in plasma, determined directly from individual concentration-time data (Cmax)
Time Frame
Post-dose samples at 0.5,1,2,3,4,8,12,24,36,48,72 hrs
Title
Pharmacokinetic Parameters for a Single Dose of ST-246 Form I vs. Form V: Tmax
Description
Time to maximum plasma concentration(Tmax; hrs) for Forms I and V were calculated from [plasma] vs time profiles.
Time Frame
Post-dose samples at 0.5,1,2,3,4,8,12,24,36,48,72 hrs
Secondary Outcome Measure Information:
Title
Number of Study Participants Who Tolerated a Single Dose of ST-246 Form I vs. Form V as Determined by No Clinically Significant Changes in Safety Parameters
Description
Evaluated safety parameters included: physical examination/vital signs electrocardiograms (heart rate, PR interval, QRS duration, QT interval, and QTc Bazett) laboratory safety tests (hematology, chemistry, urinalysis) adverse events For a), b) and c), summary statistics (mean,SD, median, minm, maxm)for values, and changes from baseline(Day 1 pre-dose) to each timepoint, were measured and compared to laboratory normal reference ranges. Values for a)- d) were assigned grades according to DAIDS AE Grading Table. Any Grade of 3 or higher was considered severe and significant.
Time Frame
4 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: 18 to 50 years Available for clinical follow-up duration of study. Able/willing to give written consent. Good general health; no clinically significant medical history. Refrain from taking any medications from screening through 72 hours after last dose. Adequate venous access. PE and lab results without clinically significant findings within 28 days prior to receipt of drug. Meet Lab Criteria within 28 days prior to receipt of drug. Negative pregnancy test Non smokers No alcohol or caffeine Participant or partner has undergone surgical sterilization, or the participant agrees either to be abstinent or use two non-hormonal methods of contraception for duration of the study Exclusion Criteria: Marked baseline prolongation of QT/corrected QT interval (QTc) interval ( History of additional risk factors for Torsade de Pointes Clinically significant abnormal ECG Personal history of cardiac disease, symptomatic or asymptomatic arrhythmias, syncopal episodes, or prolongation of the PR interval Family history of Sudden Cardiac Death not clearly due to acute myocardial infarction. History of any clinically significant conditions including: Asthma Diabetes mellitus History of thyroidectomy or thyroid disease Serious angioedema episodes Head trauma resulting in a diagnosis of TBI other than concussion Seizure or history of seizure Bleeding disorder diagnosed by a doctor or significant bruising or bleeding difficulties with intramuscular injections or blood draws Malignancy Family history of idiopathic seizures History or presence of neutropenia or other blood dyscrasia Known Hepatitis B or Hepatitis C infection Known human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome illness. Current or recent history of a clinically significant bacterial, fungal, or mycobacterial infection. Known clinically significant chronic viral infection (or current clinically significant viral infection History of frequent or severe headaches or migraines Known chronic bacterial, mycobacterial, fungal, parasitic, or protozoal infection Woman who is pregnant or is breast-feeding or planning to become pregnant On any concomitant medications History of drug allergy that, in the opinion of the PI, contraindicates participation in the trial. Inability to swallow medication Body Mass Index above 35 or below 18, Current drug abuse or alcohol abuse. Inability to refrain from physical exercise for a period of 24 hr before and after a PK day or refrain from consuming xanthines, grapefruit or grapefruit juice Clinically significant lactose intolerance Received experimental drug within 30 days Vaccination within 30 days Total of more than 350 milliliters (mL) of blood drawn in 2 months Treatment with any immunosuppressant or immunomodulatory medication in 3 months Any condition occupational reason or other responsibility that, in the judgment of the PI, would jeopardize the safety or rights of a subject participating in the trial or would render the subject unable to comply with the protocol History or diagnosis that would affect absorption of study medication
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Thomas C Marbury, MD
Organizational Affiliation
Orlando Clinical Research Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Orlando Clinical Research Center
City
Orlando
State/Province
Florida
ZIP/Postal Code
32809
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
36263798
Citation
Hatmal MM, Al-Hatamleh MAI, Olaimat AN, Ahmad S, Hasan H, Ahmad Suhaimi NA, Albakri KA, Abedalbaset Alzyoud A, Kadir R, Mohamud R. Comprehensive literature review of monkeypox. Emerg Microbes Infect. 2022 Dec;11(1):2600-2631. doi: 10.1080/22221751.2022.2132882.
Results Reference
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Phase I Trial of an Investigational Small Pox Medication

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