A Phase 1 interventional study of MEDI8367 and Placebo in Chronic Kidney Disease, sponsored by AstraZeneca. Completed at 1 site in United States. Open to participants aged 18 Years to 55 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2022-04-21.
Sponsored by AstraZeneca · Phase 1, Interventional, and Treatment
This Phase I First in Human (FIH) study is being conducted to determine the safety, pharmacokinetics (PK), pharmacodynamics (PD), and immunogenicity profile of MEDI8367 across the dose range.
This is a Phase I, FIH, randomized, blinded, placebo-controlled study, to evaluate the safety and PK of MEDI8367 as single ascending doses (SAD) in healthy subjects and as a single dose in healthy subjects of Japanese-descent and in subjects with chronic kidney disease (CKD).
Six cohorts, Cohorts 1 to 5 (healthy volunteers including Japanese subjects in Cohort 5) each consisting of 8 subjects (total 40 subjects), and Cohort 6 (subjects with CKD) consisting of 30 subjects, will participate in the study. The starting dose is dose A of MEDI8367 with up to 3 dose escalations planned (provisional doses of dose B, dose C, and dose D).
The study will comprise of:
Dosing for Cohorts 1 to 4 and Cohort 6 will proceed with 2 subjects in a sentinel cohort, such that one subject will be randomized to receive MEDI8367 and one subject will be randomized to receive placebo. The blinded safety data from the sentinel subjects up to 3 days post-dose will be reviewed by the site Principal Investigator (PI) before the remaining subjects in the cohort are dosed. Dosing is proposed to continue based on a lack of significant safety findings in the first 2 subjects dosed per cohort. The remaining 6 subjects in Cohorts 1 to 4, respectively, and 28 subjects in Cohort 6, will be dosed at least 3 days after the sentinel cohort.
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Females must have a negative pregnancy test at the Screening Visit and on admission to the Clinical Unit/study site, must not be lactating and must be of non-childbearing potential, confirmed at the Screening Visit by fulfilling one of the following criteria:
The subjects in Cohort 5 (subjects of Japanese descent) must fulfil the following additional criterion:
The subjects in Cohort 6 (subjects with CKD) must fulfil the following additional criteria:
Subjects must have CKD, defined as:
Stable BP meeting all of the following criteria:
Exclusion Criteria:
History of any disease or condition that, in the opinion of the site PI and/or medical monitor, would place the subject at an unacceptable risk to participate in this study or interfere with evaluation of the investigational product or interpretation of subject safety or study results, including, but not limited to:
Note: Abnormal urinary findings will not exclude subjects in Cohort 6.
Any laboratory values with the following deviations at screening or admission (for Cohort 6 see below):
Abnormal vital signs at Screening or Visit 2 (Day -1), after 10 minutes supine rest, defined as any of the following:
Any clinically important abnormalities in rhythm, conduction or morphology of the resting 12-lead ECG as considered by the site PI that may interfere with the interpretation of QTc interval changes, including abnormal ST-T-wave morphology or left ventricular hypertrophy, at screening or admission.
History of severe allergy/hypersensitivity or ongoing clinically important allergy/hypersensitivity, as judged by the site PI or history of hypersensitivity to drugs with a similar chemical structure or class to MEDI8367.
Use of any prescribed or nonprescribed medication including antacids, analgesics (other than paracetamol/acetaminophen), herbal remedies, mega-dose vitamins (intake of 20 to 600 times the recommended daily dose) and minerals with the 2 weeks or 5 half-lives prior to the first administration of IMP (Day 1) (whichever is longer). Further clarification regarding specific medications is provided below:
Note: subjects consented and screened, but not randomized in this study or a previous phase I study, are not excluded.
The following exclusion criteria apply to subjects in Cohort 6 (subjects with CKD):
Any laboratory values with the following deviations at screening or admission:
Use of any prescribed or nonprescribed medication including antacids, analgesics (other than paracetamol/acetaminophen), herbal remedies, mega-dose vitamins (intake of 20 to 600 times the recommended daily dose) and minerals with the 2 weeks or 5 half-lives prior to the first administration of IMP (Day 1) (whichever is longer). Further clarification regarding specific medications is provided below:
6 subjects will be randomized to receive MEDI8367 Dose A and 2 subjects will be randomized to receive placebo.
Drug: MEDI8367 · Drug: Placebo
6 subjects will be randomized to receive MEDI8367 Dose B and 2 subjects will be randomized to receive placebo.
Drug: MEDI8367 · Drug: Placebo
6 subjects will be randomized to receive MEDI8367 Dose C and 2 subjects will be randomized to receive placebo.
Drug: MEDI8367 · Drug: Placebo
6 subjects will be randomized to receive MEDI8367 Dose D and 2 subjects will be randomized to receive placebo.
Drug: MEDI8367 · Drug: Placebo
6 subjects will be randomized to receive MEDI8367 Dose D or the highest tolerable dose based on Cohorts 1 to 4 and 2 subjects will be randomized to receive placebo.
Drug: MEDI8367 · Drug: Placebo
15 subjects will be randomized to receive MEDI8367 Dose D or the highest tolerable dose based on Cohorts 1 to 4 and 15 subjects will be randomized to receive placebo.
Drug: MEDI8367 · Drug: Placebo
Subjects will receive subcutaneous (SC) single dose of MEDI8367, depending upon dose escalation strategy and Safety Review Committee results. The maximum dose will not exceed 600 mg. The dose will be administered as a single injection or multiple injections in the abdomen region.
Saline solution for injection and the placebo volume to be administered will be equivalent to the MEDI8367 volume administered for each dosing cohort.
Number of subjects with adverse events (AEs) and serious adverse events (SAEs)
To assess AEs as a variable of safety and tolerability of SC of MEDI8367
Time frame: From screening (Day -28) to follow-up period (Day 90 ± 4 days)
Number of subjects with abnormal systolic blood pressure (SBP)
To assess supine position SBP as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28) up to follow-up period (Day 90 ± 4 days)
Number of patients with abnormal diastolic blood pressure (DBP)
To assess supine position DBP as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28) up to follow-up period (Day 90 ± 4 days)
Number of subjects with abnormal HR
To assess change in supine position HR as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28) up to follow-up period (Day 90 ± 4 days)
Number of subjects with respiratory rate
To assess change in supine position respiratory rate as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28) up to follow-up period (Day 90 ± 4 days)
Number of subjects with abnormal oral body temperature
To assess change in oral body temperature as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28) up to follow-up period (Day 90 ± 4 days)
Number of subjects with abnormal electrocardiogram (ECG)
To assess electrical activity changes in ECG as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28) up to follow-up period (Day 90 ± 4 days)
Number of subjects with abnormal physical examination
To assess change in physical examination as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28) up to follow-up period (Day 90 ± 4 days)
Number of subjects with abnormal structured neurological assessment
To assess change in structured neurological assessment as safety and tolerability of MEDI8367. Any new or aggravated clinically relevant abnormal neurological examination finding compared to the baseline assessment will be reported as an AE
Time frame: From screening (Day -28 ) up to follow-up period (Day 90 ± 4 days)
Number of subjets with abnormal retinal imaging
To assess retinal imaging as a variable of safety and tolerability of MEDI8367. The presence of proliferative retinopathy or any other new retinal changes will be recorded. Any new or aggravated clinically relevant abnormal retinal imaging finding compared to the baseline assessment will be reported as an AE
Time frame: From screening (Day -28) up to follow-up period (Day 90 ± 4 days)
Number of subjects with abnormal Hemoglobin (Hb) level
To assess change in Hb as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal red blood cells (RBC) count
To assess RBC count as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal white blood cells (WBC) count
To assess WBC count as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal differential WBC count
To assess differential WBC count as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal hematocrit (HCT)
To assess HCT as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal mean corpuscular volume (MCV)
To assess MCV as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal mean corpuscular hemoglobin (MCH)
To assess MCH as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal reticulocytes absolute count
To assess reticulocytes absolute count as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal mean corpuscular hemoglobin concentration (MCHC)
To assess MCHC as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal platelets count
To assess platelets count as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal creatinine level
To assess creatinine level as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal blood urea nitrogen level
To assess blood urea nitrogen level as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urea level.
To asses urea level as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal bicarbonate level
To asses bicarbonate level as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal creatine kinase (CK) level
To asses CK level as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal follicle stimulating hormone (FSH)/luteinizing hormone (LH) level
To asses FSH/LH level for postmenopausal females as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28) to treatment period (Day -1)
Number of subjects with abnormal C-reactive protein (CRP) level
To asses CRP level as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal cystatin C level
To asses cystatin C level in Cohort 6 only (subjects with CKD) as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal glucose (fasting) level
To asses glucose (fasting) level as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal potassium level
To assess potassium level as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal sodium level
To assess sodium level as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal phosphate level
To assess phosphate level as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal calcium level
To assess calcium level as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal chloride level
To assess chloride level as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal alkaline phosphatase (ALP)
To assess ALP level as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal bilirubin level
To assess bilirubin level as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal alanine aminotransferase (ALT)
To assess ALT as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal aspartate aminotransferase (AST)
To assess AST as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal albumin level
To assess albumin level as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urine protein level
To assess change in urine protein as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urine glucose level
To assess changes in abnormal urine glucose as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urine pH
To assess change in urine pH as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urine ketone level
To assess change in urine ketone as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urine bilirubin level
To assess change in urine bilirubin as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urine blood level
To assess change in urine blood as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urine color.
To assess change in urine color as a variable of safety and tolerability of MEDI8367 following SC administration of SAD.
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urine appearance.
To assess change in urine apperance as a variable of safety and tolerability of MEDI8367 following SC administration of SAD.
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urine specific gravity level
To assess change in urine specific gravity as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urine leukocyte esterase level
To assess change in urine leukocyte esterase as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urine urobilinogen level
To assess change in urine urobilinogen as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urine nitrite level
To assess change in urine nitrite as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urine RBC level
To assess change in urine microscopy included RBC as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urine WBC level
To assess change in urine microscopy included WBC as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Number of subjects with abnormal urine casts level
To assess change in urine microscopy casts as a variable of safety and tolerability of MEDI8367
Time frame: From screening (Day -28 to Day -2) through follow-up period (up to Day 90 ± 4 days)
Plasma PK analysis: Maximum observed serum drug concentration (Cmax)
To assess Cmax of MEDI8367 following SC administration of SAD
Time frame: From treatment period (Day 1) to follow-up period (up to Day 90 ± 4 days)
Plasma PK analysis: Time to reach maximum observed concentration (tmax)
To assess tmax of MEDI8367 following SC administration of SAD
Time frame: From treatment period (Day 1) to follow-up period (up to Day 90 ± 4 days)
Plasma PK analysis: Terminal half-life (t½)
To assess t½ of MEDI8367 following SC administration of SAD
Time frame: From treatment period (Day 1) to follow-up period (up to Day 90 ± 4 days)
Plasma PK analysis: Area under the plasma concentration-time curve from zero to the last quantifiable concentration (AUClast)
To assess AUClast of MEDI8367 following SC administration of SAD
Time frame: From treatment period (Day 1) to follow-up period (up to Day 90 ± 4 days)
Plasma PK analysis: Area under plasma concentration-time curve from zero to infinity (AUCinf)
To assess AUCinf of MEDI8367 following SC administration of SAD
Time frame: From treatment period (Day 1) to follow-up period (up to Day 90 ± 4 days)
Plasma PK analysis: Apparent total body clearance of drug from serum after extravascular administration (CL/F)
To assess CL/F of MEDI8367 following SC administration of SAD
Time frame: From treatment period (Day 1) to follow-up period (up to Day 90 ± 4 days)
Plasma PK analysis: Volume of distribution (apparent) following extravascular administration (based on terminal phase; Vz/F)
To assess Vz/F of MEDI8367 following SC administration of SAD
Time frame: From treatment period (Day 1) to follow-up period (up to Day 90 ± 4 days)
Plasma PK analysis: Volume of distribution (apparent) at steady state following extravascular administration (Vss/F)
To assess Vss/F of MEDI8367 following SC administration of SAD
Time frame: From treatment period (Day 1) to follow-up period (up to Day 90 ± 4 days)
Plasma PK analysis: Area under plasma concentration-time curve from zero to the last quantifiable concentration divided by the dose administered (AUClast/D)
To assess AUClast/D of MEDI8367 following SC administration of SAD
Time frame: From treatment period (Day 1) to follow-up period (up to Day 90 ± 4 days)
Plasma PK analysis: Area under plasma concentration-time curve from zero to infinity divided by the dose administered (AUCinf/D)
To assess AUCinf/D of MEDI8367 following SC administration of SAD
Time frame: From treatment period (Day 1) to follow-up period (up to Day 90 ± 4 days)
Plasma PK analysis: Maximum observed serum drug concentration divided by the dose administered (Cmax/D).
To assess Cmax/D of MEDI8367 following SC administration of SAD.
Time frame: From treatment period (Day 1) to follow-up period (up to Day 90 ± 4 days)
Immunogenecity: ADA titer
To assess ADA titer of MEDI8367 following SC administration of SAD
Time frame: From treatment period (Day 1) to follow-up period (up to Day 90 ± 4 days)
Immunogenecity: Anti-drug antibody (ADA) incidence.
To assess ADA incidence of MEDI8367 following SC administration of SAD.
Time frame: From treatment period (Day 1) to follow-up period (up to Day 90 ± 4 days)
Plan to share: Yes
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