Title

A Randomized Phase 1 Dose-Escalation Study of Subcutaneously(SC) Administered RUC-4
A Randomized Phase 1 Dose-Escalation Study in Healthy Volunteers and Subjects on Aspirin With Stable Coronary Artery Disease to Assess the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of Subcutaneous RUC-4
  • Phase

    Phase 1
  • Study Type

    Interventional
  • Status

    Completed No Results Posted
  • Study Participants

    44
This study is designed to assess tolerability of the weight-adjusted dose of RUC-4 (mg/kg) required to achieve 80% or more inhibition of the initial slope of platelet aggregation to 20 µM ADP by Light Transmission Aggregometry (LTA) within 15 minutes of SC administration of RUC-4 with return toward baseline values within 4 hours in healthy volunteers and subjects on aspirin with stable coronary artery disease (CAD). In the Dose Expansion Part, VerifyNow PRUTest will be used to measure platelet aggregation in addition to LTA.

Since the goal of RUC-4 therapy is to achieve maximal antiplatelet therapy as rapidly as possible, first the tolerability of the weight-adjusted dose (mg/kg) that inhibits ADP-induced platelet aggregation by 80% or more in 5 of 6 healthy volunteers will be identified. A similar dose escalation will be subsequently performed in subjects with CAD who are taking aspirin. To facilitate administration using a single weight-adjusted (mg/kg) dose for a defined group of subjects weighing between 55 and 120 kg, the study will also evaluate the safety and biologic effect on platelet aggregation of the weight adjusted (mg/kg) dose when administered to subjects with weights at either end of this range.
Part 1 Dose Escalation:

Drug: RUC-4 0.05 mg/kg (Cohort 1) Drug: RUC-4 0.075 mg/kg (Cohort 2) Drug: Placebo (Cohorts 1-2)

Part 2 Dose Escalation Drug: RUC-4 (Cohort 1-3 doses to be defined) Placebo (Cohorts 1-3)

Part 2 Dose Expansion Drug: RUC-4 (dose to be defined, 1 Cohort) Drug: Placebo (1Cohort)
Study Started
Feb 18
2019
Primary Completion
Nov 01
2019
Study Completion
Dec 01
2019
Last Update
Feb 19
2020

Drug RUC-4 Compound

single subcutaneous administration of RUC-4

Part 1 Cohort 1 Experimental

Cohort 1: 0.05 mg/kg RUC-4/placebo 7 subjects will be enrolled: 6 subjects will receive a single subcutaneous dose of RUC-4 and 1 subject will receive matched placebo.

Part 1 Cohort 2 Experimental

Cohort 2: 0.075 mg/kg RUC-4/placebo 7 subjects will be enrolled: 6 subjects will receive a single subcutaneous dose of RUC-4 and 1 subject will receive matched placebo.

Part 2 Cohort 1 Experimental

Cohort 1: initial dose to be selected by the Safety Review Committee (SRC) after completion of Part 1 (the same initial dose used in Part 1 or one of the previously studied higher doses that is lower than the overall RUC-4 BED) 7 subjects will be enrolled: 6 subjects will receive a single subcutaneous dose of RUC-4 and 1 subject will receive matched placebo.

Part 2 Cohorts 2-3 Experimental

7 subjects (6 receiving RUC-4, 1 receiving placebo) will be enrolled in each dose cohort, with a safety evaluation performed after 2 subjects in a dose cohort receive RUC 4 and at the completion of dosing for all subjects in the dose cohort. Dose escalation to be determined by the SRC charter and will continue until identification of the overall RUC-4 BED or MTD

Part 2 Dose Expansion Cohort 1 Experimental

14 subjects will receive a selected dose of RUC-4 based on SRC review of dose escalation data. In the expansion cohort, 7 subjects weighing 55 to 65 kg and 7 subjects weighing 100 to 120 kg will be enrolled; 12 subjects will receive a single subcutaneous dose of RUC-4 and 2 will receive matched placebo

Criteria

Main Inclusion Criteria (all subjects)

weight between 55-120 kg, inclusive, and BMI between 18-38 kg/m2
females must be non-pregnant, non-lactating, and of non-childbearing potential.
good general health as determined by no acute illness and no clinically significant abnormal findings on medical history, clinical laboratory test results, vital signs, or physical examination
platelet count of 150,000/uL to 400,000/uL and mean platelet volume (MPV) within the normal range

Subjects with stable CAD, defined as history of documented myocardial infarction (MI) or angina, or evidence of CAD derived from cardiac stress test, or imaging (calcium score [greater than 100 or abnormal for age], angiography, computerized tomography, or magnetic resonance image); absence of angina, or presence of angina with no change in frequency, duration, precipitating causes or ease of relief for at least 60 days, and no ECG or biomarker evidence of myocardial damage in past 60 days

blood pressure control achieved with 4 or fewer anti-hypertensive medications
on a stable regimen of aspirin at a dose of 81 to 325 mg/day

Main exclusion criteria (all subjects):

history of prior stroke or clinically significant cardiovascular (e.g., unstable angina, New York Heart Association [NYHA] class II, II or IV heart failure), dermatologic, endocrine, gastrointestinal (GI), hematologic, infectious, metabolic, neurologic, psychologic, or pulmonary disorder or any other condition, including active cancer that in the opinion of the PI would jeopardize the safety of the subject or impact the validity of the study results
history of upper or lower GI bleeding requiring intervention or treatment within 12 months of Screening or endoscopic evidence of active peptic ulcer disease within 6 months of Screening
bleeding score > 3 on the International Society on Thrombosis and Haemostasis Bleeding Assessment Tool
coagulation abnormality, bleeding disorder, or history of documented prior hemorrhagic or thrombotic stroke
whole blood donation and/or diagnostic blood evaluation exceeding 500 mL within 8 weeks of Screening
surgical procedure, major injury, or dental procedure with high risk of bleeding within 30 days of Screening
alcohol consumption of >210 mL of alcohol per week within 6 months of Screening, or alcohol detected in urine at Screening
marijuana use within the past 3 months, or history/presence of substance abuse
febrile illness within 14 days of Screening
use of metformin within 7 days of Screening
use of herbal or nutritional supplements/medicines within 7 days of Screening
participation in another investigational product or device study within 30 days of Screening or during the study
Presence of HIV antibody, HCV antibody, or HbsAg in serum at Screening
employee of the Sponsor or The Lindner Center staff member directly affiliated with the study, or their immediate family member defined as spouse, parent, child, or sibling
abnormal platelet aggregation or in vitro inhibition of platelet aggregation pattern by RUC-4
receiving or have received in the past 30 days an anticoagulant or fibrinolytic agent
a cardiac pacemaker
history of allergy to any of the ingredients in the RUC-4 or placebo formulation

Healthy Subjects only:

medication known to have an impact on platelet function within 30 days of Screening.
abnormally low response to arachidonic acid-induced platelet aggregation
screening ECG abnormality that is interpreted by the PI to be clinically significant

Stable CAD subjects only:

medication known to have an impact on platelet function, with the exception of aspirin, within 30 days of Screening.

->4 anti-hypertensive medications required to achieve blood pressure control

incomplete inhibition of arachidonic acid-induced platelet aggregation
acute changes on ECG
No Results Posted