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A Study to Assess the Safety, Effects and Palatability of Sisunatovir in Healthy Adult Participants

Phase 1
Completed
Conditions
Respiratory Syncytial Viruses
Interventions
Drug: Placebo
Registration Number
NCT05712460
Lead Sponsor
Pfizer
Brief Summary

This study is seeking healthy participants who are:

1. Aged 18 to 65 years of age. All fertile participants must agree to use a highly effective method of contraception.

2. Male and female participants who are overtly healthy as determined by medical evaluation. This includes medical history, physical examination, blood pressure, pulse rate, standard 12-lead ECG (electrocardiogram), and laboratory tests.

3. BMI (body mass index) of 17.5 to 35 kg/m2; and a total body weight \>50 kg (110 lb).

This study will consist of up to 2 cohorts (groups of participants).:

Cohort 1 is a randomized, 2-part, crossover cohort. Part 1 has 3 periods. Periods 1 and 2 are to evaluate the safety and effects of sisunatovir. Participants will take sisunatovir tablets or placebo by mouth once every 12 hours. A placebo looks like the study medicine but does not contain any active medicine in it.

Period 3 is an open label period to evaluate the food effect of the planned higher dose of sisunatovir. Participants will take the planned higher dose sisunatovir tablets every 12 hours. In Part 2, participants will take sisunatovir prepared in 4 different vehicles (water, infant formula, apple juice, and saline) to assess how palatable each form is. Participants will complete a questionnaire after tasting each form of sisunatovir. The palatability questionnaire will be completed for each vehicle, the questionnaire asks participants to assess each vehicle at 4 different time increments after tasting. At least 60 minutes will pass between tasting each vehicle. Period 4 may start after the last PK draw of Period 3.

A minimum 7-day washout period will occur between the last dose of Periods 1 and 2 and the first dose of Periods 2 and 3. We will assess the safety of participants following each study period and doses and adjust the doses for subsequent study periods as needed.

Cohort 2 is an optional cohort; the design of Cohort 2 is the same as Part 1 of Cohort 1. Dose levels studied in Cohort 2 will be determined after the completion of Cohort 1.

Participants will take part in this study for approximately 2 months, excluding the screening period. During this time there are 3 separate 7-day in-patient stays at the study clinic and a follow-up phone call that takes place 28-35 days after the last dose of study medicine.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
12
Inclusion Criteria
  1. Participants aged 18 to 65 years of age, inclusive, at the time of signing of the informed consent document (ICD).

    • All fertile participants must agree to use a highly effective method of contraception.

  2. Male and female participants who are overtly healthy as determined by medical evaluation including medical history, physical examination, including blood pressure, pulse rate, standard 12-lead electrocardiogram (ECG), and laboratory tests.

  3. Body mass index (BMI) of 17.5 to 35 kg/m2; and a total body weight >50 kg (110 lb).

Exclusion Criteria
  1. Evidence or history of clinically significant hematological, renal, endocrine, pulmonary, gastrointestinal, cardiovascular, hepatic, psychiatric, neurological, or allergic disease (including drug allergies, but excluding untreated, asymptomatic, seasonal allergies at the time of dosing).

  2. Other medical or psychiatric condition including recent (within the past year) or active suicidal ideation/behavior or laboratory abnormality, or other conditions or situations related to Coronavirus Disease 2019 (COVID-19) pandemic that may increase the risk of study participation or, in the investigator's judgment, make the participant inappropriate for the study.

  3. Use of prescription or nonprescription drugs and dietary and herbal supplements within 7 days or 5 half-lives (whichever is longer) prior to the first dose of study intervention with the exception of moderate/strong CYP3A inducers or time dependent inhibitors which are prohibited within 14 days plus 5 half lives prior to the first dose of study intervention.

  4. A positive urine drug test, confirmed by a repeat test, if deemed necessary.

  5. Screening supine blood pressure (BP) ≥140 mm Hg (systolic) or ≥90 mm Hg (diastolic), following at least 5 minutes of supine rest. If BP is ≥140 mm Hg (systolic) or ≥90 mm Hg (diastolic), the BP should be repeated 2 more times and the average of the 3 BP values should be used to determine the participant's eligibility.

  6. Standard 12 lead ECG that demonstrates clinically relevant abnormalities that may affect participant safety or interpretation of study results.

  7. Participants with ANY of the following abnormalities in clinical laboratory tests at screening, as assessed by the study specific laboratory and confirmed by a single repeat test, if deemed necessary:

    • glomerular filtration rate (GFR) <60 mL/min/1.73m2 based on the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation;
    • Aspartate Aminotransferase (AST) or Alanine Transaminase (ALT) level ≥1.5 x upper limit of normal (ULN);
    • Gamma-glutamyl transferase (Gamma-GT)> ULN;
    • Alkaline phosphatase > ULN;
    • Total bilirubin level ≥1.5 × ULN; participants with a history of Gilbert's syndrome may have direct bilirubin measured and would be eligible for this study provided the direct bilirubin level is ≤ ULN.

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Group C: PlaceboPlaceboPlacebo for sisunatovir dosed every 12 hours
Group A: Higher dose sisunatovirsisunatovirhigher dose of sisunatovir dosed every 12 hours
Group B: Lower dose sisunatovirsisunatovirLower dose of sisunatovir dosed every 12 hours
Group E: sisunatovir palatabilitysisunatovirSisunatovir in 4 vehicles (water, saline, apple juice, infant formula) to assess the palatability of sisunatovir in each vehicle. sisunatovir will not be swallowed, participants will swirl and spit to assess various aspects of the taste.
Group D: Higher dose of sisunatovirsisunatovirHigher dose of sisunatovir dosed every 12 hours under fasted conditions
Primary Outcome Measures
NameTimeMethod
Number of Participants With Treatment Emergent Adverse Events (TEAEs)From start of treatment to 28-35 days after last dose (maximum upto 66 days)

An adverse event (AE) is any untoward medical occurrence in a participant or clinical study participant, temporally associated with the use of study intervention, whether or not considered related to the study intervention. TEAEs were any AEs that occurred following start of treatment.

Number of Participants With Clinical Laboratory Abnormalities: Part 1Up to Day 5

Laboratory tests included haematology (Monocytes \[10\^9/L\] increase: \> 1.2\* upper limit of normal \[ULN\] and Monocytes/Leukocytes \[percentage\] {%}:\> 1.2\* ULN); clinical chemistry (serum) included Alanine Aminotransferase (units per liter \[U/L\]):\> 3.0\* ULN and Bicarbonate (milliequivalents per liter) (mEq/L): \>1.1\* ULN and in urinalysis (urine Hemoglobin (Scalar) more than equal to (\>=) 1, urine Bilirubin (Scalar) \>= 1, Hyaline Casts (/Low power field \[LPF\]) \>= 1. Number of participants with any clinical laboratory abnormalities is reported in this outcome.

Number of Participants With Newly Occurring Notable Abnormal Vital Signs: Part 1Up to Day 5

Supine blood pressure (BP) was measured with the participant's arm supported at the level of the heart and recorded after approximately 5 minutes of rest. Pulse rate was measured in the brachial/radial artery. Notable abnormal vital sign categories included: Systolic BP: \<90 millimeter of mercury \[mmHg\]; Systolic BP change from baseline: maximum increase and decrease \>=30 mmHg; Diastolic BP \<50 mmHg; Diastolic BP change from baseline: maximum decrease and increase ≥20 mmHg; pulse rate \<40 and \>120 beats per minute. Number of participants with newly occurring notable abnormal vital sign (i.e. change in supine systolic BP \>=30 millimeter of mercury \[mmHg\] increase) is reported in this outcome measure.

Number of Participants With Clinically Significant Changes in Electrocardiogram (ECG) Findings: Part 1Up to Day 7

Standard 12-lead ECGs utilizing limb leads were used to measure PR interval, QT interval, QTc corrected using Fridericia's formula (QTcF), and QRS complex. ECG was performed after the participant had rested quietly for at least 5 minutes in a supine position. Clinical significance was determined by the investigator.

Secondary Outcome Measures
NameTimeMethod
Area Under the Curve From Time Zero to End of Dosing Interval (AUCtau) for Day 1: Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8 and 12 hours post-dose on Day 1

Area under the concentration-time profile from time zero to time tau (the dosing interval), where tau = 12 hours for twice a day (BID) dosing.

Dose Normalized AUCtau (AUCtau [dn]) for Day 1: Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8 and 12 hours post-dose on Day 1

AUCtau(dn) was calculated as AUCtau/Dose.

Maximum Observed Plasma Concentration (Cmax) for Day 1: Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8 and 12 hours post-dose on Day 1
Dose Normalized Maximum Plasma Concentration (Cmax [dn]) for Day 1: Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8 and 12 hours post-dose on Day 1

Cmax(dn) was calculated as Cmax/Dose.

Time to Reach Maximum Observed Plasma Concentration (Tmax) for Day 1: Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8 and 12 hours post-dose on Day 1
Area Under the Curve From Time Zero to End of Dosing Interval (AUCtau) for Day 5: Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8 and 12 hours post-dose on Day 5

Area under the concentration-time profile from time zero to time tau (the dosing interval), where tau = 12 hours for BID dosing.

AUCtau(dn) for Day 5: Part 1Pre-dose, 1, 2, 3,4, 5, 6, 8 and 12 hours post-dose on Day 5

AUCtau(dn) was calculated as AUCtau/Dose.

Maximum Observed Plasma Concentration (Cmax) for Day 5: Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36 and 48 hours post-dose on Day 5
Cmax(dn) for Day 5: Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36 and 48 hours post-dose on Day 5

Cmax(dn) was calculated as Cmax/Dose.

Time to Reach Maximum Observed Plasma Concentration (Tmax) for Day 5: Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36 and 48 hours post-dose on Day 5
Apparent Clearance (CL/F) for Day 5: Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36 and 48 hours post-dose on Day 5

CL/F was calculated as Dose/AUCtau.

Observed Accumulation Ratio (Rac) for AUC for Day 5: Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8 and 12 hours post-dose on Day 1 and Pre-dose, 1, 2, 3, 4, 5, 6, 8, 12 hours post-dose on Day 5

Rac for AUC was calculated as AUCtau Day5/AUCtau Day1.

Observed Accumulation Ratio for Maximum Observed Plasma Concentration (Rac,Cmax) for Day 5: Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8 and 12 hours post-dose on Day 1 and Pre-dose, 1, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36 and 48 hours post-dose on Day 5

Rac,Cmax was calculated as Cmax Day5/Cmax Day1.

Plasma Decay Half-Life (t1/2) for Day 5: Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36 and 48 hours post-dose on Day 5
Apparent Volume of Distribution (Vz/F) for Day 5: Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36 and 48 hours post-dose on Day 5

Vz/F was calculated as Dose/(AUCtau \* kel \[Terminal phase rate constant\]).

AUCtau for Day 5: Evaluation of Food Effect (Sisunatovir 200 mg Fed Versus Fasted): Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8, 12 hours post-dose on Day 5
Cmax for Day 5: Evaluation of Food Effect (Sisunatovir 200 mg Fed Versus Fasted): Part 1Pre-dose, 1, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36 and 48 hours post-dose on Day 5
Assessment of Overall Liking Based on Palatability Assessment Questionnaire: Part 21 minute (immediately following dose), 5,10 and 20 minutes after tasting dose in each vehicle

Participants were required to answer the palatability attribute of overall liking by providing a mark on the colour bar. The data was rescaled to a score ranging from 0 (good) to 100 (bad), where higher scores indicated less overall liking.

Assessment of Mouth Feel Based on Palatability Assessment Questionnaire: Part 21 minute (immediately following dose), 5,10 and 20 minutes after tasting dose in each vehicle

Participants were required to answer the palatability attribute of mouth feel by providing a mark on the colour bar. The data was rescaled to a score ranging from 0 (good) to 100 (bad), where higher scores indicated worse mouth feel.

Assessment of Bitterness Based on Palatability Assessment Questionnaire: Part 21 minute (immediately following dose), 5,10 and 20 minutes after tasting dose in each vehicle

Participants were required to answer the palatability attribute of bitterness by providing a mark on the colour bar. The data was rescaled to a score ranging from 0 (good) to 100 (bad), where higher scores indicated more bitterness.

Assessment of Tongue/Mouth Burn Based on Palatability Assessment Questionnaire: Part 21 minute (immediately following dose), 5,10 and 20 minutes after tasting dose in each vehicle

Participants were required to answer the palatability attribute of tongue/mouth burn by providing a mark on the colour bar. The data was rescaled to a score ranging from 0 (good) to 100 (bad), where higher scores indicated more tongue/mouth burn.

Assessment of Sourness Based on Palatability Assessment Questionnaire: Part 21 minute (immediately following dose), 5,10 and 20 minutes after tasting dose in each vehicle

Participants were required to answer the palatability attribute of sourness by providing a mark on the colour bar. The data was rescaled to a score ranging from 0 (good) to 100 (bad), where higher scores indicated increase in sourness.

Assessment of Saltiness Based on Palatability Assessment Questionnaire: Part 21 minute (immediately following dose), 5,10 and 20 minutes after tasting dose in each vehicle

Participants were required to answer the palatability attribute of saltiness by providing a mark on the colour bar. The data was rescaled to a score ranging from 0 (good) to 100 (bad), where higher scores indicated more saltiness.

Assessment of Sweetness on Palatability Assessment Questionnaire: Part 21 minute (immediately following dose), 5,10 and 20 minutes after tasting dose in each vehicle

Participants were required to answer the palatability attribute of sweetness by providing a mark on the colour bar. The data was rescaled to a score ranging from 0 (good) to 100 (bad), Participants were required to answer the palatability attribute of sweetness by providing a mark on the colour bar. The data was rescaled to a score ranging from 0 (good) to 100 (bad), where higher scores indicated more sweetness.

Trial Locations

Locations (1)

Pfizer Clinical Research Unit - Brussels

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Brussels, Bruxelles-capitale, Région DE, Belgium

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