Trichomylin® Safety, Tolerability, and Pharmacokinetics in Healthy Adults and First in Human Osteoarthritis Pain Evaluation (HOPE)

This is an interventional treatment trial for Osteoarthritis focused on measuring Osteoarthritis, OA, Chronic Pain Read More

Inclusion Criteria:

1. Male or female volunteers, aged 18 to 65 years (inclusive at the time of consent);
2. Must have a Body Mass Index (BMI) ≥ 18 to ≤ 32 kg/m2 with weight ≥ 50 kg at Screening;
3. Must have a negative urine drug screen at the Screening visit and the day before dosing (Day -1); one repeat urine drug may be conducted for a suspected false positive result;
4. Must be willing to abstain from the use of cannabis and other cannabinoid compounds (other than the study drug) for the duration of the study (from the time of Screening until the EOS visit);
5. Must be willing to abstain from smoking (including the use of tobacco or nicotine products and e-cigarettes) for the duration of the study (from the time of Screening until the EOS visit);
6. Must not have any hepatic and/or renal impairment as judged by the PI;
7. Must be willing and able to comply with all study procedures and be available for the duration of the study (from the time of Screening until the EOS visit);
8. Must not be currently using anti-depressants (selective serotonin reuptake inhibitors [SSRIs], monoamine oxidase inhibitors [MOAIs], serotonin-norepinephrine reuptake inhibitors [SNRIs], or tricyclic anti-depressants [TCAs]) for 14 days or 5 half-lives of the drug, whichever is longer, prior to IP administration, and for the duration of the study;
9. Must not have any current or past allergic or adverse reaction or known sensitivity to olive oil, gelatin, glycerin and titanium dioxide, or to cannabinoid-like substances (including but not limited to Dronabinol/Marinol/Nabilone/marijuana/cannabis/tetrahydrocannabinol [THC], cannabinoid oil);

10. Females must be non-pregnant and non-lactating, and must use acceptable, highly effective double barrier contraception from Screening until study completion, including the follow-up period. Double contraception is defined as a condom AND one other form of the following:

    1. Established hormonal contraception (i.e. approved oral contraceptive pills)
    2. Long-acting implantable hormones, injectable hormones;
    3. A vaginal ring or an intrauterine device ([IUD], with or without hormones);
    4. Documented evidence of surgical sterilization at least 6 months prior to Screening (e.g., tubal occlusion, hysterectomy, bilateral salpingectomy, or bilateral oophorectomy for women or vasectomy for men [with appropriate post-vasectomy documentation of the absence of sperm in semen] provided the male partner is a sole partner).

    Women not of childbearing potential must be post-menopausal for ≥ 12 months. Post-menopausal status will be confirmed through testing of follicle-stimulating hormone (FSH) levels ≥ 40 IU/mL at Screening for amenorrhoeic female participants. Females who are abstinent from heterosexual intercourse will also be eligible.

    Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation methods) and withdrawal are not considered highly effective methods of birth control. Participant complete abstinence for the duration of the study and for 1 month after the last study treatment is acceptable.

    Female participants who are in same-sex relationships are not required to use contraception.

11. Males must be surgically sterile (> 30 days since vasectomy with no viable sperm), abstinent, or if engaged in sexual relations with a woman of childbearing potential (WOCBP), the participant and his partner must be surgically sterile (e.g., tubal occlusion, hysterectomy, bilateral salpingectomy, bilateral oophorectomy) or using an acceptable, highly effective contraceptive method from Screening until study completion, including the follow-up period. Acceptable methods of contraception include the use of condoms and the use of an effective contraceptive for the female partner that includes: OCPs, long-acting implantable hormones, injectable hormones, a vaginal ring, or an IUD.

    Males who are abstinent from heterosexual intercourse will also be eligible and must agree to complete abstinence for the duration of the study and for 1 month after the last study treatment.

    Male participants with same-sex partners are eligible when this is their preferred and usual lifestyle.

12. Women of childbearing potential must have a negative pregnancy test at Screening and Day -1 and be willing to have additional pregnancy tests, as required, throughout the study, at the Investigator's discretion;
13. Males must not donate sperm and females must not donate ova for at least 90 days after the last dose of study drug;
14. Must agree to adhere to the current state and national advice regarding minimizing exposure to corona virus disease of 2019 (COVID-19) from the first Screening visit until the EOS visit;
15. Must be willing and able to provide written informed consent after the nature of the study has been explained and prior to the commencement of any study procedures;
16. Must be in good physical and mental health as determined by absence of any clinically significant (in the opinion of the Investigator) abnormalities based on medical history, physical examination, vital signs, electrocardiogram (ECG), clinical laboratory evaluations, at Screening and prior to administration of the initial dose of study drug;

17. Must be able and willing to comply with all study requirements including:

    1. Confinement to the CRU prior to and during study drug administration and required follow-up periods for Part A SAD and Part B MAD
    2. Refraining from using the following:

    i. Any previous/current cannabis products within 2 months prior to Screening and throughout the duration of the study (from the time of Screening until the EOS visit); ii. Cannabis products (in the form of oil, vaporizer, or smoke) for the duration of the study; iii. Prescription medications 14 days prior to administration of the first dose of study drug; iv. Alcohol 48 hours prior to admission, and while confined to the CRU. In addition, participants must agree to refrain from regular use of alcohol (i.e. ˃ 10 units per week or ˃ 4 units on any given day for men and women [1 unit = 150mL of wine, 360 mL of beer, or 45 mL of 40% alcohol]) for the duration of the study; v. Recreational drugs for the duration of the study.

18. For Part A SAD, participants must not have used cannabis or cannabinoid products within 2 months prior to Screening.

Exclusion Criteria:

1. Pregnant or lactating at Screening or planning to become pregnant (self or partner) at any time during the study, including the follow-up period;
2. Has a past or present clinically significant condition, which would prevent or limit study assessments in accordance with the protocol, with particular reference to renal and/or hepatic impairment, OR it would be in the best interests of the participant to not participate;
3. Has been diagnosed with the following within 10 years of Screening: psychosis (secondary to, for example, substance abuse, major depression, a mood disorder with postpartum onset, bipolar disorder, schizophrenia, or borderline personality disorder), somatoform disorder(s) or chronic fatigue syndrome;
4. Has a current/active diagnosis of generalized anxiety disorder, panic disorder, obsessive compulsive disorder, post- traumatic stress disorder, a simple phobia(s), anorexia nervosa or bulimia nervosa;
5. Cognitive impairment and/or a psychiatric illness (e.g., dementia, Alzheimer's disease or psychosis), which in the opinion of the Investigator will prevent participants from reliably providing primary outcome data;
6. Has significant suicidal ideation as defined by the Columbia-Suicide Severity Rating Scale (C-SSRS) and Patient Health Questionnaire (PHQ-9);
7. History of abuse of substances such as opiates, amphetamines, barbiturates, cocaine, cannabis, hallucinogens within 12 months prior to Screening or positive urine drug screen at Screening or Day -1. A urine drug screen deemed positive due to prescription medications or for benzodiazepines or opioids is acceptable and inclusion is at the discretion of the Investigator;
8. Regular use of alcohol within one month prior to the Screening visit (i.e. more than 10 units of alcohol per week or 4 units on any given day [1 unit = 150mL of wine, 260 mL of beer, or 45mL of 40% alcohol]);
9. Symptomatic heart failure (per New York Heart Association [NYHA] guidelines), unstable angina, myocardial infarction, transient ischemic attack (TIA) or cerebrovascular accident (CVA) within 6 months prior to Screening;

10. Has an abnormal ECG of clinical relevance at Screening or Baseline, including but not limited to the following:

    1. QTcF interval > 450 msec
    2. Evidence of 2nd and 3rd degree atrioventricular (AV) block, or 1st degree AV block with PR interval > 200ms, left bundle branch block (LBBB) or right bundle branch block (RBBB) at Screening or Baseline. Incomplete RBBB will not permitted.
    3. Has a history of risk factors including hypokalemia, family history of Long QT Syndrome, or prior use of medications that prolong the QT/QTc interval
11. Has a resting heart rate < 45/minute, > 100/min upon one repeated measurement within 5 minutes;
12. Has abnormal blood pressure outside specified limits (90 mm Hg > Systolic > 160 mm Hg and/or 50 mm Hg > Diastolic > 95 mm Hg) upon repeated measurement;
13. Has clinically significant abnormalities in any of the clinical laboratory evaluations at Screening or Day -1 as determined by the Investigator;
14. Has a history of malignancy within the last 2 years except for adequately treated basal cell carcinoma, squamous cell skin cancer, superficial bladder tumors, or in situ cervical cancer. Participants with other curatively treated malignancies who have no evidence of metastatic disease and more than a 2-year disease-free interval may be entered following approval by the Study Medical Monitor (MM);
15. Has a history of major surgery within 6 months of Screening, OR has a history of minor surgery within the past month which would preclude inclusion as judged by the Investigator OR will not have fully recovered from surgery, OR has planned a surgery during the study;
16. Has current or past allergic or adverse reaction or known sensitivity to olive oil, gelatin, glycerin and titanium dioxide, or to cannabinoid-like substances (Dronabinol/Marinol/Nabilone/marijuana/cannabis/tetrahydrocannabinol [THC], cannabinoid oil);
17. Has known human immunodeficiency virus (HIV), hepatitis B virus (HBV), or hepatitis C virus (HCV) infection, or tests positive for any of these viruses at Screening;

18. Use of the following in the 14 days prior to study drug administration or 5 half-lives, whichever is longer:

    1. Sedative medications (e.g., barbiturates and other central nervous system [CNS] depressants)
    2. Warfarin (Coumadin)
    3. Antipyrine
    4. Disulfiram (Antabuse)
    5. CYP3A4 inhibitors, inducers or substrates
    6. CYP2C9 inhibitors, inducers or substrates
    7. CYP2C19 inducers or substrates
    8. CYP2B6 substrates
    9. CYP1A2 substrates
    10. P-glycoprotein substrates

    Note: this includes grapefruit juice or related products, Sevilla orange juice or related products, and St John's wort.

19. Unable to swallow an oral tablet/capsule (medication) or consume up to 300 mL of water within 30 minutes;
20. Use of any IP or investigational medical device within 30 days prior to Screening, or 5 half-lives of the product (whichever is the longest), or current participation in an investigational study, or participation in more than 4 investigational drug studies within 1 year prior to Screening.