Study of Pomaglumetad and Methamphetamine

The study design is a randomized, double-blind, placebo-controlled multiple ascending-dose
study of pomaglumetad in 24 non-treatment seeking participants with methamphetamine use
disorder. Three cohorts of 8 participants each (total N = 24) will be enrolled and within
each cohort participants will be randomly assigned in a 6:2 ratio to undergo methamphetamine
infusions and assessments during treatment with pomaglumetad (N = 6 per cohort) or placebo (N
= 2 per cohort). Participants in cohort 1 will receive pomaglumetad 40 mg orally twice daily
(BID) or placebo, cohort 2 will receive pomaglumetad 80 mg BID or placebo, and cohort 3 will
receive pomaglumetad 160 mg BID or placebo.

After completing outpatient baseline and screening/eligibility assessments, eligible
participants will be admitted to the UCLA Hospital and will remain hospitalized during all
experimental procedures (approximately 11 days and 10 nights).

A urine drug toxicology screen free of illicit substances (with the exception of THC) is
required for admission. Upon admission, participants will receive a sample/test infusion of
MA 30 mg IV. Participants tolerating the test infusion (no serious adverse advents and not
exceeding stopping criteria below) will be randomized to receive POMA (40 mg BID in cohort 1,
80 mg BID in cohort 2, and 160 mg BID in cohort 3) or placebo.

Following three days of MA abstinence and POMA/placebo dosing to achieve study medication
steady-state, participants will complete a MA self-administration session.

After two days for MA washout, participants will then have serial plasma samples collected
over 12 hours to assess PK for POMA. The next day, participants will receive a 30 mg MA
infusion followed by serial plasma sample collection over the following 48 hours for MA PK
analysis.

Measures of cardiovascular response, subjective effects, and adverse events will be assessed
following all MA infusions during self-administration and PK sessions.

Upon completion of the PK sample collection, participants will be discharged and a 14-day
post-discharge (± 7 days) follow-up outpatient visit will be completed for safety purposes.

Inclusion Criteria:

1. not seeking treatment for MA problems at the time of the study;

2. English-speaking;

3. age 18-55 years inclusive;

4. meet DSM-5 criteria for MA use disorder, moderate-severe as diagnosed via MINI;

5. have a self-reported history of using MA either via injection or smoking and provide
at least one MA-positive urine prior to admission;

6. provide a urine drug screen negative for all illicit drugs, excepting THC, on the day
of scheduled inpatient admission;

7. report methamphetamine use on 10 or more days in the past 30 days at baseline;

8. have a resting heart rate ≤ 100 bpm, systolic blood pressure ≤ 160 mm Hg, and
diastolic blood pressure ≤ 100 mm Hg prior to admission;

9. have a baseline EKG that demonstrates normal sinus rhythm, QTc ≤ 450 msec in men or
QTc ≤ 460 msec in women, and no clinically significant arrhythmias;

10. if female (except females of non-childbearing potential—e.g., at least 1 year
post-menopausal or surgically sterile), not pregnant confirmed by negative pregnancy
test nor lactating and willing to use a medically approved method of birth control to
prevent pregnancy during the trial and for 40 days after the last dose of study
medication;

11. if male, willing to refrain from donating sperm during the study and for 100 days
following the last dose of study medication and agree that they and their partners
will use a medically approved contraceptive method;

12. have a medical history and physical/neurological examination demonstrating no
additional clinically significant contraindications for study participation, in the
judgment of the investigators;

13. able to participate in all scheduled evaluations, likely to complete all scheduled
tests, and likely to be adherent, in the opinion of the investigator and;

14. agree not to post any personal medical data or information related to the study on any
social media site or website until the trial has completed.

Exclusion Criteria:

1. non-English speaking;

2. currently on probation or parole;

3. have current cocaine, opioid, marijuana, or alcohol use disorder, moderate-severe;

4. have liver function tests (total bilirubin, ALT, AST, or alkaline phosphatase) ≥ 2 x
the upper limit of normal or kidney function tests (creatinine and BUN) ≥ 2 x the
upper limit of normal;

5. current or past history of seizure disorder;

6. a history of head trauma that resulted in neurological sequelae;

7. major psychiatric disorder not due to substance abuse (e.g., schizophrenia, bipolar
illness but excepting stable major depressive disorder, generalized anxiety disorder,
etc.) as assessed by the MINI;

8. have a current neurological disorder (e.g., organic brain disease, dementia) or
medical condition which would make study compliance difficult or compromise informed
consent;

9. current ongoing treatment with psychotropic medications (e.g. antidepressants,
antipsychotics, antiepileptics, sedative/hypnotics, narcotic analgesics);

10. history of suicide attempt(s) in the past 6 months or active suicidal intention or
plan (score 4 or 5) in the past month as assessed by the C-SSRS;

11. evidence of clinically significant heart disease or hypertension;

12. evidence of untreated or unstable serious medical illness including: neuroendocrine,
autoimmune, renal, hepatic, or active infectious disease including active tuberculosis
infection;

13. have HIV infection and currently symptomatic, have a diagnosis of AIDS, or are
receiving antiretroviral medication;

14. have a medical condition that makes maintaining reliable intravenous access
impossible;

15. donated blood or plasma within 3 months of inpatient admission;

16. use of OAT1 inhibitor (e.g. probenecid, uricosurics, antivirals, nonsteroidal
anti-inflammatories, loop diuretics, angiotensin II receptor antagonists, proton pump
inhibitors, or statins) or CYP2D6 inducers or inhibitors within 14 days or five
half-lives, whichever is longer, from admission;

17. currently employed by UCLA or Denovo or a first-degree relative of UCLA or Denovo
employee or;

18. any other circumstances that, in the opinion of the investigators, would compromise
participant safety and/or successful completion of the trial.