A Phase II, Multicenter, Randomized, Double-Blind, Placebo-Controlled, Multiple Dose Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of SAP-001 in Gout Patients With Hyperuricemia
Overview
- Phase
- Phase 2
- Intervention
- SAP-001
- Conditions
- Gout
- Sponsor
- Shanton Pharma Co., Ltd.
- Enrollment
- 40
- Locations
- 6
- Primary Endpoint
- AUC0-t
- Status
- Completed
- Last Updated
- 4 years ago
Overview
Brief Summary
This is a Phase II, Multicenter, Randomized, Double-blind, Placebo controlled, Multiple Dose study to evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of SAP-001 in Gout Patients with Hyperuricemia.
Detailed Description
This multiple dose study will include up to 4 cohorts. Each cohort will be comprised of 15 patients who will be dosed with SAP-001 or placebo once daily (QD) for 28 days. Dose escalation from Cohort 1 to Cohort 2 will occur after preliminary data are partially unblinded and safety data along with PK and PD parameters are analyzed and reviewed. Enrollment in Cohort 3 will begin after the last subject is randomized into Cohort 2. Prior to starting enrollment into Cohort 4, a complete safety assessment of Cohorts 1, 2 and 3 will be performed to select the dose to be used in Cohort 4.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Male or female ≥ 18 and ≤ 75 years of age.
- •Body mass index (BMI) ≥ 19 and ≤ 42 kg/m2 at screening.
- •sUA levels ≥ 7.5 mg/dL during screening and at check-in (Day -1).
- •Patients must meet the American College of Rheumatology scoring criteria for the classification of primary gout (Neogi et al 2015).
- •Patients must be able to take gout flare prophylaxis with colchicine 0.6 mg QD throughout the study as the primary method to prevent disease flare. If colchicine is not tolerated or contraindicated, naproxen 250 mg BID with or without H2 antagonists will be employed as a second line gout flare prophylactic agent. Gout flare prophylaxis will be initiated at the Day -1 visit in patients who are sUA-lowering agent naïve. For patients that discontinue an sUA-lowering agent(s) (ie, washout from current therapy) during the screening period, gout flare prophylaxis should be initiated at the time of discontinuation of the sUA-lowering agent(s).
- •Is a nonsmoker or light smoker (smokes fewer than 10 cigarettes per day).
- •Female patients either will be postmenopausal (female patients who state they are postmenopausal should have had cessation of menses for \> 1 year and have serum follicle-stimulating hormone \[FSH\] levels \> 40 mIU/mL and serum estradiol \< 20 pg/mL); or surgically sterile (including bilateral tubal ligation, salpingectomy \[with or without oophorectomy\], surgical hysterectomy, or bilateral oophorectomy \[with or without hysterectomy\]) for at least 3 months prior to screening; or will agree to use, from the time of check-in (Day -1) until 90 days following the last dose of study drug, the following forms of contraception: double-barrier method, hormonal contraceptives, barrier with spermicide, diaphragm or cervical cap with spermicide, intrauterine device, oral, implantable, or injectable contraceptives, or a sterile sexual partner. All female patients, except those with documented surgical hysterectomy in medical history, will have a negative urine pregnancy test result prior to enrollment in the study.
- •Male patients either will be surgically sterile or agree to use, from the time of check-in (Day -1) until 90 days following the last dose of study drug, the following forms of contraception: male condom with spermicide and a female partner who is sterile or agrees to use hormonal contraceptives, female condom with spermicide, diaphragm or cervical cap with spermicide, intrauterine device, oral, implantable, or injectable contraceptives. Male patients will refrain from sperm donation from the time of check-in (Day -1) until 90 days following the last dose of study drug.
- •Is capable of understanding the written informed consent, provides signed and witnessed written informed consent, and agrees to comply with protocol requirements.
- •Cohorts 1 through 3:
Exclusion Criteria
- •Female patient is pregnant, planning to get pregnant, or lactating/breastfeeding.
- •Has a history or presence of CS cardiovascular, renal, pulmonary, hepatic, gallbladder or biliary tract, hematologic, gastrointestinal, endocrine, immunologic, dermatologic, neurologic, or psychiatric disease, which in the investigator's opinion would not be suitable for the study.
- •Serum creatinine level \> 1.5 mg/dL and/or estimated glomerular filtration rate (eGFR) ≤ 60 mL/min/1.73 m2 calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation (Levey et al 2009; National Institute of Diabetes and Digestive and Kidney Diseases, Estimating Glomerular Filtration Rate) at screening.
- •History of stomach or intestinal surgery (except cholecystectomy, appendectomy, and/or hernia repair will be allowed).
- •History of prescription drug abuse, illicit drug use, or alcohol abuse according to medical history within 6 months prior to the screening visit or any alcohol use for at least 48 hours prior to dosing on Day
- •Positive test for human immunodeficiency virus (HIV).
- •Positive test for hepatitis B virus or hepatitis C virus (HCV) consistent with current infection. Confirmatory tests will be allowed at the discretion of the investigator to rule out false positives.
- •Clinically significant abnormal liver function test at screening or check-in (Day -1), defined as aspartate aminotransferase (AST) or alanine aminotransferase (ALT) \> 1.5 × upper limit of normal (ULN) or total bilirubin \> ULN; or a history of CS acute or chronic hepatitis (including infectious, metabolic, autoimmune, genetic, ischemic, or other forms), hepatocirrhosis, or hepatic tumors.
- •Positive screen for alcohol or drugs of abuse (except for patients with a positive drug screen if it is a result of a prescribed medication from their physician) at screening or check-in (Day -1).
- •History of a gout flare that is resolved within 14 days prior to the first dose of study drug on Day 1 (exclusive of chronic synovitis/arthritis). If a gout flare occurs during screening, patients may be rescreened after a period of at least 14 days has passed following the flare.
Arms & Interventions
Dose A
Dose A SAP-001 versus placebo
Intervention: SAP-001
Dose B
Dose B SAP-001 versus placebo
Intervention: SAP-001
Dose C
Dose C SAP-001 versus placebo
Intervention: SAP-001
Dose D (allopurinol patients)
Dose D SAP-001 versus placebo in gout patients who remain on allopurinol
Intervention: SAP-001
Outcomes
Primary Outcomes
AUC0-t
Time Frame: 28 days
Area under the plasma concentration-time curve from time 0 to time t
Incidence of Treatment-Emergent Adverse Events
Time Frame: 28 days
Assess the safety and tolerability of multiple ascending doses of oral SAP-001 over 28 days compared to placebo
tmax
Time Frame: 28 days
Time to maximum observed plasma concentration
CL/F
Time Frame: 28 days
Total body clearance
sUA
Time Frame: 28 days
Serum urate concentration, change from baseline, and percent change from baseline
Cmax
Time Frame: 28 days
Maximum observed plasma concentration
AUC0-24h
Time Frame: 28 days
Area under the plasma concentration-time curve from time 0 until 24 hours postdose
AUC0-∞
Time Frame: 28 days
Area under the plasma concentration-time curve from time 0 extrapolated to infinity
λz
Time Frame: 28 days
Apparent terminal elimination rate constant
t½
Time Frame: 28 days
Terminal elimination phase half-life
Vz/F
Time Frame: 28 days
Volume of distribution
Creatinine
Time Frame: 28 days
Creatinine levels, change from baseline, and percent change from baseline
Secondary Outcomes
- Urate Lowering Effect(28 days)
- Inflammation markers including cytokines IL-1β, IL-6, IL-8, and TNFα(28 days)