Safety and Tolerability Study of Oral LGD-6972 for Type 2 Diabetes Mellitus



Status:Completed
Conditions:Diabetes, Diabetes
Therapuetic Areas:Endocrinology
Healthy:No
Age Range:21 - 65
Updated:3/16/2015
Start Date:October 2014
End Date:July 2015
Contact:Matthew W Foehr
Email:MFoehr@Ligand.com
Phone:858-550-7555

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Randomized, Double-Blind, Placebo-Controlled, Multiple Ascending Oral Dose Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of LGD-6972 in Healthy Subjects and in Subjects With Type 2 Diabetes Mellitus

Ligand Pharmaceuticals Incorporated is developing LGD-6972, a novel, orally-bioavailable
addition to diet and exercise to improve glycemic control in adults with type 2 diabetes
mellitus. The mechanism of action of LGD-6972 is to reduce the excess liver glucose
production characteristic of type 2 diabetes mellitus that is a major contributor to
hyperglycemia. This clinical trial will evaluate the safety and tolerability of escalating
doses LGD-6972 administered daily over 2 - 4 weeks in both healthy subjects and subjects
with type 2 diabetes mellitus.

This is to be a randomized, double-blind, placebo-controlled, sequential, multiple oral dose
study conducted in normoglycemic healthy subjects (NHS) (Part 1) and subjects with type 2
diabetes mellitus (T2DM) who are treated with monotherapy metformin (a stable dose at
randomization) along with diet and exercise (Part 2). Subjects with T2DM who are not on a
stable dose of metformin but meet all other entry criteria may be enrolled in the study at
the discretion of the Investigator, but must undergo a stabilization period of at least 12
weeks before determining eligibility for the study. In Part 1, a single group of healthy
subjects will be dosed with repeated oral doses of 15 mg of LGD-6972 or placebo once daily
(QD) for 14 days. In Part 2, a maximum of 3 groups of subjects with T2DM will be dosed with
3 sequential, increasing doses of LGD-6972 (5 mg, 15 mg or 30 mg) or placebo QD for 28 days.

INCLUSION CRITERIA:

Part 1

1. Healthy, adult man or woman, 21 to 65 years of age. If the subject is a woman, she
must be surgically sterile or naturally post-menopausal to be considered for
enrollment.

2. Willing and able to provide written informed consent.

3. Not diabetic and has a fasting plasma glucose (FPG) between 70 mg/dL and 105 mg/dL,
inclusive.

4. Good health with no significant concomitant pathology based on medical history,
physical examination, electrocardiogram (ECG), routine laboratory tests (chemistry,
hematology, lipid profile, international normalized ratio, and urinalysis), and vital
signs.

Part 2

1. Healthy, adult man or woman, 21 to 65 years of age. If the subject is a woman, she
must be surgically sterile or naturally post-menopausal to be considered for
enrollment.

2. Willing and able to provide written informed consent.

3. Has T2DM according to American Diabetes Association criteria.

4. Currently on stable metformin therapy (unchanged dose for greater than or equal to 12
weeks prior to screening). At the discretion of the investigator, subjects who are
drug naïve or whose metformin dose has not been stable for at least 12 weeks at
screening, may be started on metformin or have their metformin dose stabilized.
Following 12 weeks of stable metformin, they may undergo re screening including
assessment of HbA1c and FPG (inclusion criteria 5 and 6).

5. Has an HbA1c level between 6.5% and 10.5% at screening. One retest is permitted.

6. Venous FPG is 125 mg/dL and 260 mg/dL at screening and either the Day -1 venous FPG
or the Day 1 capillary blood glucose (CBG) is 115 mg/dL and 260 mg/dL. One retest is
permitted.

7. Has a body mass index between 20 and 45 kg/m2, inclusive.

EXCLUSION CRITERIA:

Part 1

1. Has a recent history of drug and/or alcohol abuse.

2. Unwilling to comply with tobacco, nicotine, alcohol, and caffeine restrictions as
specified in the protocol.

3. Unwilling to comply with restrictions on strenuous exercise as specified in the
protocol.

4. Has history of clinically significant cardiovascular, pulmonary, renal, endocrine,
hepatic, neurologic, psychiatric, immunologic, hematologic, gastrointestinal
(including pancreatitis), or metabolic disease requiring medical treatment or has any
medical problems that pose an increased risk during the study or that may compromise
the integrity of the study data.

5. Has liver transaminase levels (aspartate transaminase [AST] or alanine transaminase
[ALT]) >10% of the upper limit of normal (ULN), or has creatine kinase (CK) levels >2
× ULN at screening or admission to clinic (Day -1).

6. Has a plasma triglyceride level >400 mg/dL. If triglyceride level is between 400
mg/dL and 500 mg/dL.

7. Has a recent history of uncontrolled high blood pressure or has systolic blood
pressure <90 mmHg or >140 mmHg or diastolic blood pressure <60 mmHg or >90 mmHg at
screening.

8. Is taking prescription or non-prescription drugs, vitamins, herbal, and dietary
supplements, within 14 days or 5 half-lives (whichever is longer) prior to the first
dose of study drug, or is unwilling to refrain from taking any such medication until
after the last protocol-specified blood sample. The use of acetaminophen, not to
exceed a total daily dose of 1 g, is permitted up to 24 hours prior to admission to
the investigational site and then prohibited until after the last protocol-specified
blood sample. The use of stable hormone replacement medication by women, topical
steroids, and stable thyroid medication is permitted.

Part 2

1. Has a history of hypoglycemic unawareness or recurrent hypoglycemia requiring
assistance.

2. Has liver transaminase levels (AST or ALT) >10% × ULN, or has CK levels >1.5 × ULN at
screening or admission to clinic (Day -1).

3. Has history of clinically significant cardiovascular, pulmonary, renal, endocrine
(other than T2DM), hepatic, neurologic, psychiatric, immunologic, hematologic,
gastrointestinal (including pancreatitis), or metabolic disease requiring medical
treatment or has any medical problems that pose an increased risk during the study or
that may compromise the integrity of the study data.

4. Has a recent history of uncontrolled high blood pressure or has systolic blood
pressure <90 mmHg or >140 mmHg or diastolic blood pressure <60 mmHg or >90 mmHg at
screening. One retest of blood pressure within 24 hours is permissible at the
discretion of the Investigator. Therapy for hypertension (beta blockers excluded)
that has been stable for at least one month prior to screening is permitted. At the
Investigator's discretion, one anti-hypertensive medication (angiotensin converting
enzyme inhibitor, angiotensin receptor blocker, hydrochlorothiazide, or
dihydropyridine calcium-channel blocker) may be initiated, or the dosage of a current
antihypertensive medication up titrated, in a subject with blood pressure slightly
above the eligibility criterion at screening. After at least 4 weeks of stable blood
pressure treatment, if the subject's blood pressure has decreased to within the
140/90 mmHg limit, the subject will be fully reassessed for eligibility.

5. Has received insulin for more than 6 consecutive days within 6 months prior to
screening or has received insulin within 3 months prior to screening.

6. Has been treated with peroxisome proliferator-activated receptor gamma agonist,
incretin therapy, amylin mimetics, or sodium-glucose linked transporter-2 inhibitor
therapy within 12 weeks prior to screening; treatment with other diabetic medications
(excluding metformin) within 3 weeks prior to screening.

7. Is taking concomitant medications. At least 3 months of stable therapy for thyroid
replacement and hypercholesterolemia (gemfibrozil, Welchol, and cholestyramine are
not permitted) and at least 4 weeks of stable hypertension medications (as described
above) and low dose aspirin are permitted.
We found this trial at
3
sites
Tempe, Arizona 85283
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Tempe, AZ
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Cincinnati, Ohio 45212
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Cincinnati, OH
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Miami, Florida 33014
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Miami, FL
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