Evaluation of Safety, Efficacy and Thermogenesis-induction of RZL-012 in Overweight and Obese Volunteers

Phase 2

Completed

Conditions: Obesity
Weight Loss
Overweight and Obesity

Interventions: Drug: RZL-012
Drug: Placebo

Registration Number: NCT03171415

Lead Sponsor: Raziel Therapeutics Ltd.

Brief Summary: Obesity is a direct result of food-intake in excess of body energy expenditure. Thus, induction of increased energy expenditure via the activation of thermogenesis at targeted anatomical sites can counterbalance obesity. This trial aims to study RZL-012, a novel compound, in treating obesity by activating thermogenesis in subcutaneous fat.

Detailed Description: Obesity is a direct result of food-intake in excess of body energy expenditure. Therefore, a feasible approach to combat obesity is via energy-consuming activities, such as physical exercise. Unfortunately, our modern society is moving in the other direction, spending more time in immobilized positions, at work and at home. An alternative strategy for the induction of increased energy expenditure is via the activation of thermogenic cells that utilize fat to produce heat.RZL-012 is a novel molecule that enables de-novo generation of thermogenic tissue at favorable anatomical sites. As a result, the extra fat accumulated in obese persons will be turned into heat. This is a double blind, randomized, placebo controlled, dose escalation Phase 2a clinical trial for the evaluation of safety, efficacy and thermogenesis-induction of RZL-012 in overweight and obese volunteers. This trial aims to study the ability of RZL-012 in treating obesity via the induction of thermogenic foci in subcutaneous fat.

Recruitment & Eligibility

Status: COMPLETED

Sex: Male

Target Recruitment: 32

Inclusion Criteria

Adult male subjects, 20-60 years old.
Subject is considered overweight and obese, with 27.5 < BMI ≤ 34.9.
Significant subcutaneous abdominal fat as defined by Waist to hip ratio (WHR) ≥ 0.9.
Subjects with stable weight in the last 3 months by medical history.
Not one of the following eating disorders by subject's declaration: anorexia nervosa, bulimia nervosa.
Generally considered healthy according to medical history, physical examination, electrocardiogram (ECG) and laboratory evaluation with a special emphasis on metabolic parameters (fasting glucose concentration < 100 mg, normal blood pressure).
Subject is willing to refrain from sexual activity or agrees to use a double-barrier contraceptive device (e.g., condom and spermicide) for 4 weeks after treatment with RZL 012.
Subjects must be able to adhere to the visit schedule and protocol requirements and be available to complete the study.
Subjects must sign an informed consent indicating that they are aware of the investigational nature of the study.

Exclusion Criteria

Subjects weighing less than 75 kg.
Subjects who have reduced/gained weight more than 5% of their current body weight in the last 3 months.
Unable to tolerate subcutaneous injection.
Subjects with uncontrolled cardiac, hepatic, renal or neurologic/psychiatric disorders, that in the opinion of the investigator put the subject at significant risk, are not eligible.
Subjects who test positive to either Hepatitis B virus (HBV), Hepatitis C virus (HCV), or Human immunodeficiency virus (HIV) are not eligible.
Subjects with a clinical history of primary or secondary immunodeficiency, autoimmune disease or subjects taking immunosuppressive drugs such as corticosteroids are ineligible.
As a result of medical review, physical examination, the PI (or medically qualified nominee) considers the subject unfit for the study.
Medication use on regular basis.
Positive drug and alcohol tests.
Known sensitivity to components of the injection formulation.
Prior wound, tattoo or infection in the treated area.
Excessive growth of hair in the abdomen region.
Claustrophobia or MRI incompatible device or implant.

Study & Design

Study Type: INTERVENTIONAL

Study Design: SEQUENTIAL

Arm && Interventions

Group	Intervention	Description
RZL-012	RZL-012	A single-time injection, multiple subcutaneous injections of RZL-012 administered into 8-36 sites (0.1mL per site): 1. 40mg RZL-012 -administered at 8 sites 2. 80mg RZL-012 - administered at 16 sites 3. 120mg RZL-012 - administered at 24 sites 4. 180mg RZL-012 - administered at 36 sited
Placebo	Placebo	A single-time injection, multiple subcutaneous injections of Placebo administered into 8-36 sites (0.1mL per site)

Primary Outcome Measures

Name	Time	Method
Safety: The Incidence of Treatment-related Adverse Events [AEs]	0-168 days	AEs will be assessed by significant clinical changes in safety parameter (e.g. vital signs, ECG, clinical laboratory evaluations)AEs incidence will be by body system, seriousness, severity and relation to study drug by cohort.
Efficacy: A Significant Thermogenesis at the Injected Site.	28-168 days	Thermogenesis is measured by thermal imaging is non-invasive, non-radiating Infra-Red thermal camera that passively measures the emitting infra-red radiation of body surface. Difference in temperatures between the sites (treated - not treated) by visit treatment along with the change from baseline (net-delta) in these differences by cohort and overall. Significant thermogenesis is defined as net-delta ≥ 1. Outcome measure data table represents the number of subjects who demonstrated an increase that is higher than 1 celsius degree.

Secondary Outcome Measures

Name	Time	Method
Pharmacokinetics: Establishing Pharmacokinetic Profile of RZL-012.	0.5, 1,2,3,4,5,6,8,12,16,24,30 hours	Averaged Tmax values by cohort.
Changes in Body Weight	56 days	Changes from baseline in body weight by visit, treatment, and cohort.
Changes in Waist to Hip Ratio [WHR]	56 days	Changes from baseline in WHR by visit, treatment, and cohort. WHR is calculated by measurements of waist circumference and hip circumference.
Elucidation of the Histological Changes Account for the Thermogenic Effect.	56 days	An abdominal subcutaneous adipose tissue biopsy will be taken from the injected side. Histology results will be assessed for 2 subjects who were injected with 120 mg RZL-012 and for one subject who was injected with placebo.
Change From Baseline in Inflammatory Markers and Cytokines. Testing of Inflammatory Markers and Cytokines Will be Conducted by Blood Sampling.	28 days	Changes from baseline in inflammatory markers and cytokines by visit, treatment, and cohort. Testing of inflammatory markers and cytokines will be conducted by blood sampling.
Duration of the Thermogenic Effect From Day 28.	28-168 days	The duration of the thermogenic effect for subjects in the active arm with thermogenic effect (net-delta ≥ 1) by visit and cohort.
Local Reduction in Fat Mass as Measured by MRI. Local Reduction in Fat Will be Measured by Periodically MRI Scans of the Abdomen.	28-168 days	Subcutaneous Fat Mass (SFM) ratio (treated sites / control sites) averaged over the MRI slices by visit, treatment and cohort and the change from baseline in SFM ratio (in % from the ratio at baseline) compared between the treatment arms.
Changes in Fasting Blood Glucose From Baseline.	56 days	Changes from baseline in fasting blood glucose by visit, treatment, and cohort.
Changes in Blood Lipid Profile From Baseline.	56 days	Changes from baseline in lipid profile by visit, treatment, and cohort.