Not Yet RecruitingPhase 1ACTRN12625000452493

A Phase 1 Randomized, Double-Blind, Placebo-Controlled Study With A Food Effect Assessment To Evaluate The Safety, Tolerability, And Pharmacokinetics Of Single Ascending Doses And Multiple Ascending Doses Of PX578 In Healthy Adult Participants (Part C)


Sponsor

Pretzel Therapeutics Inc.

Enrollment

24 participants

Start Date

Jul 1, 2025

Study Type

Interventional

Conditions

Summary

This sub study (Part C) is part of a 3-part (A, B and C) Phase 1 Healthy Volunteer study to assess the safety, tolerability and pharmacokinetics (PK) of PX578 in healthy participants. Participants will be randomized to 1 of 2 open-label PX578 administration sequences, fasting or fed (standard high fat meal). Participants who have completed Part A or Part B will be eligible to enrol in Part C if they meet eligibility criteria (there must be at least 30 days between the last dose of study drug in Part A/Part B and Day 1 of Part C). PX578 may be indicated for use in patients with Mitochondrial disease, but a trial of the drug in healthy volunteers is needed before trials in Mitochondrial disease patients can proceed. Who is it for? You may be eligible for this study if you are aged 18 to 55 years and are in good general health without a clinically significant medical history. Study details All healthy volunteer participants who choose to enrol in this study will be assigned by chance to receive single or multiple doses of PX578 or placebo. All participants will have their vital signs checked (heart rate, blood pressure, temperature, etc), and will provide blood and urine samples for testing. It is hoped this research will determine the maximum dose of PX578 that can be administered safely without causing severe reactions. Once the dose of PX578 has been determined in healthy volunteers, a trial investigating the efficacy of PX578 as a treatment for patients with Mitochondrial disease may proceed.


Eligibility

Sex: Both males and femalesMin Age: 18 YearssMax Age: 55 Yearss

Inclusion Criteria7

  • Must provide written informed consent before any study-related activities are carried out and must be able to understand the full nature and purpose of the trial. including possible risks and adverse effects.
  • Healthy male or female participant, 18-55 years of age at the time of signing informed consent.
  • , Both male and female participants must agree to follow contraceptive requirements and gamete
  • donation restrictions during the Screening period and for 90 days following the last dose of study drug.
  • A body mass index (BMI) of between 18 and 32 kg/m2 at Screening with a minimum body weight of 45 kg.
  • Hematocrit or hemoglobin levels within normal limits for age and sex at Screening and on Day -1, prior to dose administration.
  • Be willing and able to comply with all study assessments and adhere to the protocol schedule, procedures, and restrictions

Exclusion Criteria28

  • Clinically-significant medical history or ongoing chronic illness that, in the opinion of the study Investigator, would jeopardize the safety of the participant or compromise the integrity of the data derived from their participation in this study.
  • Clinically-significant infection of any kind requiring systemic antimicrobial therapy or hospitalization within 4 weeks prior to the first dose of study drug.
  • Clinically-significant abnormal findings at Screening on physical examination, ECG, or laboratory testing in the opinion of the Investigator.
  • OTcF > 470 ms (females) or > 450 ms (males) at Screening or Day -1 based on the mean of triplicate ECGs.
  • Liver test results during Screening or at check-in day (Day -1) that are above the upper limit of normal (ULN) for gamma-glutamyl transferase, bilirubin (total), aspartate aminotransferase (AST) or alanine aminotransferase (ALT), unless a diagnosis of Gilbert syndrome. For history of Gilbert syndrome, the limit is extended to 2-fold above the ULN.
  • Positive test results for hepatitis B surface antigen (HBsAg), hepatitis C (HCV) antibody or human immunodeficiency virus (HIV) antibody at Screening. Participants who are positive for HCV antibody but do not have active HCV (ie, test negative for HCV RNA on a polymerase chain reaction (PCRI test) are eligible for the study.
  • , Estimated glomerular filtration rate (eGFR) <90 ml/min/1.73 m2 at Screening using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) 2009 formula.
  • History of active malignancy within 3 years prior to Screening, except basal cell carcinoma of the skin, curatively resected squamous cell carcinoma of the skin, cervical carcinoma in situ curatively treated or low-grade prostate adenocarcinoma for which appropriate management is observation alone.
  • History of surgery or hospitalization within 3 months prior to Screening, or surgery planned during the study.
  • History of hypersensitivity, allergic or anaphylactic reactions to the study drug ingredients or other therapeutic proteins.
  • History of drug or alcohol abuse (as defined by the Investigator) within 5 years prior to Screening, a positive urine drug or alcohol test at Screening or Day -1, or an unwillingness to abstain from drugs of abuse throughout the study, or from alcohol for 48 hours prior to Day -1 and for the duration of the study.
  • Participant smokes more than 5 cigarettes or equivalent nicotine-containing products per day, and/ or is unwilling to abstain from smoking or the use of nicotine-containing products for 72 hours prior to check-in on Day -1 and throughout the study.
  • Note: 1 average cigar equals approximately 5 average cigarettes: 1 average pipe session equals approximately 5 average cigarettes: 1 average nicotine liquid vape session equals 1 average e-cigarette equals 1 average cigarette.
  • Has a positive urine screen for cotinine at Day -1.
  • Unwilling to abstain from caffeine containing products for 24 hours prior to Day -1 and for the duration of the study.
  • Unwilling to abstain from eating cruciferous vegetables, charcoal-grilled meats, and poppy seeds for 48 hours prior to Day -1 and for the duration of the study.
  • Unwilling to refrain from consumption of Seville oranges, grapefruit or grapefruit juice, (pomelos, exotic citrus fruits, grapefruit hybrids, or their juices) within 14 days of Day -1 and for the duration of the study.
  • Substance abuse, mental illness, or any reason that makes it unlikely in the judgment of the Investigator for the participant to be able to comply fully with study procedures.
  • Females who are pregnant (positive pregnancy test at Screening or during the study), lactating, or, if having reproductive potential. are considered potentially unreliable with respect to contraceptive practice.
  • Use of prescription medication (with the exception of oral contraceptives) within 7 days or 5 half-lives prior to initiation of study drug dosing (whichever is longer) and for the duration of the study.
  • Participant is using medications which are exogenous modulators of CYP pathways as identified in the Flockhart table (Flockhart Table)
  • Participant has taken over-the-counter medications including herbal/dietary supplements, protein powders/creatinine, or homeopathic preparations within 7 days prior to initiation of study drug dosing (within 28 days of Day -1 or 10 half lives, whichever is longer, for St John's Wort). Prophylactic doses of vitamin/mineral supplements and occasional paracetamol or ibuprofen are allowed.
  • Participation in any clinical study of an investigational drug or investigational device within 30 days or 5 half-lives of the investigational drug (whichever is longer) prior to Day 1.
  • Administration of any live, attenuated vaccines within 30 days and all other vaccinations within 14 days prior to initiation of study drug dosing.
  • Participant has donated or lost greater than or equal to 400 ml blood in the 6 weeks prior to Day 1.
  • Participant is unable to swallow oral medication.
  • Participant has an inability to follow a standardized meal schedule and diet or inability to fast. as required by the study protocol.
  • NOTE: Potential study participants with abnormal laboratory values may be rescreened once for specific laboratory tests within the Screening period (up to 4 weeks prior to dosing) before being designated a Screen failure. Repeat values within the normal range must be confirmed at Day -1 for inclusion.

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Interventions

Part C: Single dose, food effect, 2-way crossover design evaluation of PX578 administered in the fed and fasted state to healthy adult volunteers. This sub study (Part C) is part of a 3-part Phase 1 H

Part C: Single dose, food effect, 2-way crossover design evaluation of PX578 administered in the fed and fasted state to healthy adult volunteers. This sub study (Part C) is part of a 3-part Phase 1 Healthy Volunteer study to assess the safety, tolerability and pharmacokinetics (PK) of PX578 in healthy participants. The Part A single ascending dose (SAD) and Part B multiple ascending dose (MAD) study has been registered separately. The dose will be determined by the Safety Review Committee (SRC) based on safety, tolerability and PK data from previous cohorts in Part A and/or Part B up to a maximum dose of 1000 mg. Participants who have completed Part A or Part B will be eligible to enrol in Part C if they meet eligibility criteria (there must be at least 30 days between the last dose of study drug in Part A/Part B and Day 1 of Part C). In Period 1 participants will be randomised to 1 of 2 open-label PX578 administration sequences, fasting or fed (standard high fat meal). On the morning of Day 1 each participant will receive a single dose of PX578. Participants randomised to Sequence 1 will be dosed fasted (required to fast for 10 hours pre-dose and 4 hours post-dose). Participants randomized to Sequence 2 will be dosed fed (participants will need to consume at least 75% of a standard high fat meal prior to receiving the dose) In Period 2 participants will switch to the alternative fed/fasting condition to receive a single dose of PX578 following a washout of approximately 48 hours (actual duration will be determined based on data from Part A). The contents of the high fat meal will be dependent on individual dietary restrictions, participants need to consume at least 75% of the high fat meal. As per the protocol, participants dosed in a fed state will follow FDA guidance of a standardised high fat meal (see the FDA Guidance for Industry; Assessing the Effect of Food on Drugs in INDs and NDAs – Clinical Pharmacology Considerations [June 2022]/, accessed online at https://www.fda.gov/media/121313/download). Participants will be dosed at the site and will receive study drug directly from the Investigator or designee, under medical supervision. Drug administration will be recorded and any discrepancies with the dosing regimen will be documented and explained in the eCRF and the source documents. The dose of study drug and study participant identification will be confirmed at the time of dosing by a member of the study site staff other than the person administering the study drug.


Locations(1)

Christchurch, New Zealand

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ACTRN12625000452493


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