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A Multiple Ascending Dose Trial Assessing Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of ZP7570

Early Phase 1
Completed
Conditions
Healthy
Interventions
Drug: Placebo
Registration Number
NCT04612517
Lead Sponsor
Zealand Pharma
Brief Summary

This is a randomised, double-blind, placebo-controlled, multiple ascending dose trial in healthy subjects, randomised to ZP7570 or placebo within each cohort

Detailed Description

Forty subjects are planned to be studied in four cohorts in this multiple ascending dose trial. Ten subjects will be allocated to four dose levels. Intermediate dose levels may be applied. A sentinel dosing approach (sequential dosing) will be applied. The entire observation period comprises 51 days starting with a 96 hours in-house stay after the first dose injection, where discharge is planned for Day 5, followed by one outpatient visit. For the second and the third injection dose a 36 hours in-house stay is planned. After the fourth dose injection there is also a 96 hour in-house stay where discharge is planned for Day 26, followed by five outpatient visits and an End of Trial Visit on Day 51. A blinded evaluation of each cohort will be performed by a Trial Safety Group to determine whether the trial will progress to the next planned dose level based on the stopping rules specified in the protocol.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Signed and dated informed consent obtained before any trial-related activities. Trial-related activities are any procedures that would not have been done during normal management of the subject.
  • Healthy male or female subject (only women not of childbearing potential) aged between 18 and 55 years, both inclusive.
  • Body Mass Index (BMI) between 18.5 and 28.0 kg/m2, both inclusive
  • A body weight of at least 60 kg.
  • Heart rate after 5 minutes rest in supine position inside the range of 50-90 beats/min at screening
Exclusion Criteria
  • Any history of a disorder which in the investigator's opinion might jeopardize subjects safety, evaluation of results or compliance with the protocol.
  • History of gallbladder disease or cholecystectomy.
  • History of pancreatitis
  • History of major depressive disorder or a Patient Health Questionnaire (PHQ-9) > 9 completed at screening, or a history of other severe psychiatric disorders (e.g. schizophrenia or bipolar disorder).
  • Any suicidal ideation of type 4 or 5 on the Columbia-Suicide Severity Rating Scale (C-SSRS) within 6 months prior to screening.
  • Family history of multiple endocrinological neoplasia type 2 (MEN2) or medullary thyroid carcinoma (MTC).
  • Clinically significant abnormal standard 12-lead ECG after 5 min resting in supine position at screening, including a QTcF > 450 ms (males) or QTcF > 470 ms (females), PR ≥ 220 ms and QRS ≥ 110 ms.
  • History of severe hypersensitivity to medicines or foods or history of severe medicinal/food induced anaphylactic reaction .
  • Any clinically significant abnormal hematology, biochemistry, or urinalysis screening tests, as judged by the investigator.
  • TSH values outside of normal reference ranges of safety laboratory
  • Estimated glomerular filtration rate (eGFR) < 90 ml/min/1.73 m2, as defined by - Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI).
  • Known or suspected hypersensitivity to IMP(s) or related products.
  • Systolic blood pressure < 90 mmHg or >139 mmHg and/or diastolic blood pressure < 50 mmHg or > 89 mmHg (one repeat test will be acceptable in case of suspected white-coat hypertension).
  • Symptoms of arterial hypotension
  • Women of childbearing potential
  • Men with non-pregnant partner(s) of childbearing potential not willing to use male contraception (condom) in addition to a highly effective contraceptive method until 28 days after dosing
  • Men with pregnant partner not willing to use male contraception (condom) until 28 days after dosing, in order to avoid exposure of the embryo/fetus to seminal fluid.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboCorresponding volume of placebo
ZP7570ZP7570Four ascending doses of ZP7570
Primary Outcome Measures
NameTimeMethod
Safety and Tolerability - Incidence of treatment emergent adverse events as assessed by type and severityFrom time 0 to 51 days after first dosing (29 days after fourth dosing) ]

The incidence, type and severity of treatment emergent adverse events

Secondary Outcome Measures
NameTimeMethod
Pharmacokinetics - Area under the plasma concentration-time curve - infinityFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

AUCinf, Area under the plasma concentration-time curve from zero to infinity concentration.

Pharmacokinetics - Volume of distribution - Vz/fFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

Vz/f, Apparent volume of distribution of ZP7570 during terminal phase

Pharmacodynamics - Plasma glucose concentration-time curvesFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the the forth dose

Plasma glucose concentration-time curves following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Area under the concentration-time curve - AUCplasma glucose,0-240minFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

AUCplasma glucose,0-240min, area under the acetaminophen concentration -time curve from 0 to 240 min post-ingestion

Pharmacodynamics - Area under the concentration-time curve - AUCfree fatty acids, 0-60minFrom time 0 to 60 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

AUCfree fatty acids,0-60min, area under the free fatty acids concentration-time curve

Pharmacodynamics - Area under the concentration-time curve - AUCfree fatty acids, 0-240minFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

AUCfree fatty acids,0-240min, area under the free fatty acids concentration-time curve

Pharmacokinetics - Area under the plasma concentration-time curve - throughFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

AUCτ, Area under the plasma concentration-time curve from zero to through concentration.

Pharmacokinetics - Maximum plasma concentration - CmaxFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

Cmax, Measured maximum plasma drug concentration after dosing

Pharmacokinetics - Time to maximum plasma concentration - TmaxFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

Tmax, Sampling time until reaching Cmax after dosing

Pharmacokinetics - Elimination rate constant - λzFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

λz, Elimination rate constant

Pharmacokinetics - Half-life - t½From time 0 to 51 days after first dosing (29 days after fourth dosing)

t½, Half-life of ZP7570

Pharmacokinetics - Body clearance - CL/fFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

CL/f, Apparent total body clearance

Pharmacokinetics - Mean residence time - MRTFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

MRT, Mean residence time

Pharmacodynamics - Maximum acetaminophen concentration - CmaxFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the the forth dose

Cmax, maximum acetaminophen concentration following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Time to maximum acetaminophen concentration - TmaxFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

Tmax, Time to maximum acetaminophen concentration following ingestion of mixed meal test and acetaminophene

Pharmacokinetics - Area under the plasma concentration-time curve - lastFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

AUClast, Area under the plasma concentration-time curve-from zero to last concentration.

Pharmacodynamics - Acetaminophen concentration-time curvesFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the the forth dose

Acetaminophen concentration-time curves following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Area under the concentration-time curve - AUCacetaminohen,0-60minFrom time 0 to 60 minutes at baseline, 24 hours after a single dose and 24 hours after the the forth dose

AUCacetaminohen,0-60min, area under the acetaminophen concentration-time curve from 0 to 60 min post-ingestion

Pharmacodynamics - Area under the concentration-time curve - AUCacetaminohen,0-240minFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

AUCacetaminohen,0-240min, area under the acetaminophen concentration -time curve from 0 to 240 min post-ingestion

Pharmacodynamics - Maximum plasma glucose concentration - CmaxFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the the forth dose

Cmax, Maximum plasma glucose concentration following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Time to maximum plasma glucose concentration - TmaxFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

Tmax, Time to maximum plasma glucose concentration following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Time to maximum insulin concentration - TmaxFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

Tmax, Time to maximum insulin concentration following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Time to maximum glucagon concentration - Tmax (optional)From time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

Tmax, Time to maximum glucagon concentration following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Area under the concentration-time curve - AUCplasma glucose,0-60minFrom time 0 to 60 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

AUCplasma glucose,0-60min, area under the plasma glucose concentration-time curve from 0 to 60 min post-ingestion

Pharmacodynamics - Insulin concentration-time curvesFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

Insulin concentration-time curves following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Maximum insulin concentration - CmaxFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

Cmax, Maximum insulin concentration following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Area under the concentration-time curve - AUCinsulin,0-60minFrom time 0 to 60 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

AUCinsulin,0-60min, area under the insulin concentration-time curve from 0 to 60 min post-ingestion

Pharmacodynamics - Area under the concentration-time curve - AUCinsulin, 0-240minFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

AUCinsulin,0-240min, area under the insulin concentration-time curve from 0 to 240 min post-ingestion

Safety - Injection site reactionsFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

Occurrence of injection site reactions

Pharmacodynamics - Area under the concentration-time curve - AUCglucagon,0-60min (optional)From time 0 to 60 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

AUCglucagon,0-60min, area under the glucagon concentration-time curve from 0 to 60 min post-ingestion

Pharmacodynamics - Glucagon concentration-time curves (optional)From time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

Glucagon concentration-time curves following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Maximum glucagon concentration - Cmax (optional)From time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

Cmax, Maximum glucagon concentration following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Area under the concentration-time curve - AUCglucagon, 0-240min (optional)From time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

AUCglucagon,0-240min, area under the glucagon concentration-time curve from 0 to 240 min post-ingestion

Pharmacodynamics - Time to maximum free fatty acids concentration - TmaxFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

Tmax, Time to maximum free fatty acids concentration following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Free fatty acids concentration-time curvesFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

Free fatty acids concentration-time curves following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Maximum free fatty acids concentration - CmaxFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

Cmax, Maximum free fatty acids concentration following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Triglycerides concentration-time curvesFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

Triglycerides concentration-time curves following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Maximum triglycerides concentration - CmaxFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

Cmax, Maximum triglycerides concentration following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Time to maximum triglycerides concentration - TmaxFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

Tmax, Time to maximum triglycerides concentration following ingestion of mixed meal test and acetaminophen

Pharmacodynamics - Area under the concentration-time curve - AUCtriglycerides, 0-60minFrom time 0 to 60 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

AUCtriglycerides,0-60min, area under the triglycerides concentration-time

Pharmacodynamics - Area under the concentration-time curve - AUCtriglycerides,0-240minFrom time 0 to 240 minutes at baseline, 24 hours after a single dose and 24 hours after the forth dose

AUCtriglycerides,0-240min, area under the triglycerides concentration-time curve

Anti-ZP7570 antibodies - Incidence and titresFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

Overall anti-ZP7570 antibody incidence and titers. Incidence of anti-ZP7570 antibodies cross-reacting with endogenous GLP-1 or GLP-2.

Safety Lab - Haematological values vs. reference ranges and baselineFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

Abnormal values or changes in haematology.

Safety Lab - Clinical chemistry values vs. reference ranges and baselineFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

Abnormal values or changes in chemical chemistry

Safety Lab - Urinalysis values vs. reference ranges and baselineFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

Abnormal values or changes in urinalysis

Safety - Vital signs: blood pressureFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

Changes in diastolic and systolic blood pressure (in mmHg)

Safety - Vital signs: pulseFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

Changes in pulse (beats per minute)

Safety - Physical ExaminationFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

Changes in physical examination of the body. Outcome will be measured as 'normal' or 'abnormal', if abnormal as 'not clinically significant' or 'clinically significant'.

Safety - ECGFrom time 0 to 51 days after first dosing (29 days after fourth dosing)

Changes or abnormalities in ECG parameters (in ms): Heart rate, PR, QRS, QT, QTcF

Trial Locations

Locations (1)

Profil Institut für Stoffwechselforschung GmbH

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Neuss, North Rhine-Westphalia, Germany

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