A Study of M207 With Intranasal Zolmitriptan in Healthy Volunteers

• ClinicalTrials.gov Identifier: NCT03708744
• Recruitment Status: Completed
• First Posted: October 17, 2018
• Results First Posted: December 23, 2019
• Last Update Posted: January 18, 2020
• Sponsor: Zosano Pharma Corporation
• Information provided by (Responsible Party): Zosano Pharma Corporation

Study Description

Brief Summary:

This is a single-center, open-label, randomized, four-way crossover study. Each subject will receive each of the four study treatments once, followed by in-clinic monitoring and extensive blood sample collection for pharmacokinetic analysis.

Dosing will occur approximately 48 hours apart, until completion of dosing in randomized order per the treatment sequence tables. Plasma samples from the dosing days will be sent to the analytical laboratory for analysis and tolerability for each of the dose levels will be summarized.

After completion of the four dosing days, subjects will be assessed one final time and dismissed from the study.

Condition or disease	Intervention/treatment	Phase
Migraine	Drug: A: M207 3.8mg, 30 min, upper arm; Drug: B: M207 3.8 mg, 30 min, thigh; Drug: C: M207 3.8 mg, 1 hr, upper arm; Drug: D:zolmitriptan nasal spray	Phase 1

Detailed Description:

This is a single-center, open-label, randomized, four-way crossover study to compare the pharmacokinetics, safety and tolerability of:

M207 3.8 mg administered to the upper arm to M207 3.8 mg administered to the thigh, particularly with respect to skin irritation (erythema, edema, bruising, bleeding):

M207 3.8 mg worn for 30 minutes on the upper arm to M207 3.8 mg worn for 1 hour on the upper arm; and M207 3.8 mg to intranasal zolmitriptan 2.5 mg.

Each subject will receive each of the four study treatments once, followed by in-clinic monitoring and extensive blood sample collection for pharmacokinetic analysis.

M207 application sites will be observed for erythema, edema, bruising, and bleeding at various timepoints throughout the study.

Dosing will occur approximately 48 hours apart, until completion of dosing in randomized order per the treatment sequence tables. Plasma samples from the dosing days will be sent to the analytical laboratory for analysis and tolerability for each of the dose levels will be summarized.

After completion of the four dosing days, subjects will be assessed one final time and dismissed from the study.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 24 participants
• Allocation: Randomized
• Intervention Model: Crossover Assignment
• Intervention Model Description: Randomized, open-label four-way crossover
• Masking: None (Open Label)
• Primary Purpose: Treatment
• Official Title: A Randomized Open-label 4-way Crossover Study to Compare the PK, Safety, and Tolerability of M207 at Two Different Application Locations for 30 Minutes With Intranasal Zolmitriptan 2.5 mg and 1 Hour Wear Time in Healthy Volunteers
• Actual Study Start Date: November 1, 2018
• Actual Primary Completion Date: November 20, 2018
• Actual Study Completion Date: November 20, 2018

Arms and Interventions

Arm	Intervention/treatment
Experimental: Treatment A; Treatment A: M207 3.8 mg administered as two 1.9 mg patches, 30 min wear time (upper arm application)	Drug: A: M207 3.8mg, 30 min, upper arm; A: M207 3.8 mg administered as two 1.9 mg patches, 30 min wear time (upper arm application); Other Name: A: Zolmitriptan patch, 3.8 mg, 30 min, upper arm; Drug: B: M207 3.8 mg, 30 min, thigh; B: M207 3.8 mg administered as two 1.9 mg patches, 30 min wear time (thigh application); Other Name: B: Zolmitriptan patch 3.8 mg, 30 min, thigh; Drug: C: M207 3.8 mg, 1 hr, upper arm; C: M207 3.8 mg administered as two 1.9 mg patches, 1 hour wear time (upper arm application); Other Name: C: Zolmitriptan patch, 3.8 mg, 1 hour, upper arm; Drug: D:zolmitriptan nasal spray; D: 2.5 mg/0.1 mL intranasal zolmitriptan; Other Name: Zomig Nasal Spray
Experimental: Treatment B; Treatment B: M207 3.8 mg administered as two 1.9 mg patches, 30 min wear time (thigh application)	Drug: A: M207 3.8mg, 30 min, upper arm; A: M207 3.8 mg administered as two 1.9 mg patches, 30 min wear time (upper arm application); Other Name: A: Zolmitriptan patch, 3.8 mg, 30 min, upper arm; Drug: B: M207 3.8 mg, 30 min, thigh; B: M207 3.8 mg administered as two 1.9 mg patches, 30 min wear time (thigh application); Other Name: B: Zolmitriptan patch 3.8 mg, 30 min, thigh; Drug: C: M207 3.8 mg, 1 hr, upper arm; C: M207 3.8 mg administered as two 1.9 mg patches, 1 hour wear time (upper arm application); Other Name: C: Zolmitriptan patch, 3.8 mg, 1 hour, upper arm; Drug: D:zolmitriptan nasal spray; D: 2.5 mg/0.1 mL intranasal zolmitriptan; Other Name: Zomig Nasal Spray
Experimental: Treatment C; Treatment C: M207 3.8 mg administered as two 1.9 mg patches, 1 hour wear time (upper arm application)	Drug: A: M207 3.8mg, 30 min, upper arm; A: M207 3.8 mg administered as two 1.9 mg patches, 30 min wear time (upper arm application); Other Name: A: Zolmitriptan patch, 3.8 mg, 30 min, upper arm; Drug: B: M207 3.8 mg, 30 min, thigh; B: M207 3.8 mg administered as two 1.9 mg patches, 30 min wear time (thigh application); Other Name: B: Zolmitriptan patch 3.8 mg, 30 min, thigh; Drug: C: M207 3.8 mg, 1 hr, upper arm; C: M207 3.8 mg administered as two 1.9 mg patches, 1 hour wear time (upper arm application); Other Name: C: Zolmitriptan patch, 3.8 mg, 1 hour, upper arm; Drug: D:zolmitriptan nasal spray; D: 2.5 mg/0.1 mL intranasal zolmitriptan; Other Name: Zomig Nasal Spray
Active Comparator: Treatment D; Treatment D: Intranasal zolmitriptan 2.5 mg	Drug: A: M207 3.8mg, 30 min, upper arm; A: M207 3.8 mg administered as two 1.9 mg patches, 30 min wear time (upper arm application); Other Name: A: Zolmitriptan patch, 3.8 mg, 30 min, upper arm; Drug: B: M207 3.8 mg, 30 min, thigh; B: M207 3.8 mg administered as two 1.9 mg patches, 30 min wear time (thigh application); Other Name: B: Zolmitriptan patch 3.8 mg, 30 min, thigh; Drug: C: M207 3.8 mg, 1 hr, upper arm; C: M207 3.8 mg administered as two 1.9 mg patches, 1 hour wear time (upper arm application); Other Name: C: Zolmitriptan patch, 3.8 mg, 1 hour, upper arm; Drug: D:zolmitriptan nasal spray; D: 2.5 mg/0.1 mL intranasal zolmitriptan; Other Name: Zomig Nasal Spray

Outcome Measures

Primary Outcome Measures :

1. Cmax [ Time Frame: pre-dose, 2, 5, 10, 15, 20, 30, 45, 60, 90 minutes, 2, 4, 8, 12, 24 hours post-dose ]
   maximum observed plasma concentration

Secondary Outcome Measures :

1. Adverse Events [ Time Frame: 24 hours ]
   number of subjects that experienced at least one adverse event
2. t(1/2) [ Time Frame: pre-dose, 2, 5, 10, 15, 20, 30, 45, 60, 90 minutes, 2, 4, 8, 12, 24 hours post-dose ]
   apparent half-life

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 50 Years (Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes

Criteria

Inclusion Criteria:

1. Women or men 18 to 50 years of age.
2. Good general health with no clinically significant abnormalities as determined by medical history, physical examination, complete blood count (CBC), blood chemistry, urinalysis, and ECG.
3. Negative urine drug and alcohol screens and negative serum pregnancy tests (for female subjects) at screening.
4. Consent of female subjects to use a medically effective method of contraception throughout the entire study period and for 30 days after the subject completes the study. Medically effective methods of contraception that may be used by the subject include abstinence, use of diaphragm and spermicide, intrauterine device (IUD), condom and vaginal spermicide, hormonal contraceptives (subjects must be stable on hormonal contraceptives for at least the prior 3 months), surgical sterilization, and post-menopausal (≥ 2 years of amenorrhea).
5. Ability to read, understand, and provide written informed consent that they understand the purpose of the study and procedures required for the study before enrolling in the study, and willingness to comply with all study procedures and restrictions.

Exclusion Criteria:

1. Evidence of significant history of hepatic, reproductive, gastrointestinal, renal, bleeding, or hematological disorders including coagulation, pulmonary, neurological, respiratory, endocrine, or cardiovascular system abnormalities (especially hypertension, peripheral vascular disease, coronary artery disease, transient ischemic attacks, or cardiac rhythm abnormalities), psychiatric disorders, acute infection, or other conditions that would interfere with study participation or with the absorption, distribution, metabolism, or excretion of drugs.
2. Presence of two or more risk factors for cardiovascular disease (family history of premature heart disease, hyperlipidemia, or hypertension)

3. Any contraindication to zolmitriptan administration including:

   • History of coronary artery disease or coronary vasospasm
   • Symptomatic Wolf-Parkinson-White syndrome or other cardiac accessory conduction pathway disorders
   • History of stroke, transient ischemic attack, or hemiplegic or basilar migraine
   • Peripheral Vascular Disease
   • Ischemic bowel disease
   • Uncontrolled hypertension
   • Any history of hepatic impairment
4. History of contact dermatitis or known dermatological disorders that would interfere with the study procedures or assessments
5. Planned participation in activities which cause inflammation, irritation, sunburn, lesions, or tattoos at the intended application sites from 2 weeks prior to screening through their last day of study participation
6. Use of warfarin within 1 month prior to the first dose or heparin within 1 week prior to study drug administration

7. Use of prescription and over the counter medications other than the following:

   • Hormone Replacement Therapy (HRT)
   • Birth control pills, patches, injections, or implants (all hormonal contraceptives) are allowed provided the dose has been stable for at least one month prior to screening and may be continued throughout the study
   • Antihistamines
   • Intermittently used NSAIDS
   • Acetaminophen if medically necessary (not more than 2 g/day)
   • Exceptions may be allowed on a case by case basis
8. Subjects who have a known allergy or sensitivity to zolmitriptan or its derivatives or formulations
9. Known allergy or sensitivity to tapes, adhesives, or zolmitriptan
10. Regular or recent intake of prescription drugs, particularly drugs with an influence on blood pressure.
11. Use of any other investigational compound within one month of planned study drug dosing
12. On-going drug or alcohol abuse, or history of either deemed to be clinically significant by the investigator
13. Systolic BP (measured after remaining sitting for 5 minutes) greater than 140 mmHg and diastolic BP greater than 90 mmHg at screening
14. History of nasal pathology (e.g., polyps) or abnormal nasal exam
15. Body Mass Index (BMI) greater than 35 kg/m2
16. If, in the opinion of the investigator, the subject is not suitable for the study
17. Any positive urine drug screen result or alcohol breath test

Contacts and Locations

Locations

United States, New Jersey

Hill Top Research, Inc.

Neptune, New Jersey, United States, 07753

Sponsors and Collaborators

Zosano Pharma Corporation

Investigators

• Study Director: Don Kellerman, Pharm.D.; Zosano Pharma Corporation

  Study Documents (Full-Text)

Documents provided by Zosano Pharma Corporation:

Study Protocol  [PDF] September 12, 2018

Statistical Analysis Plan  [PDF] January 5, 2019

More Information

• Responsible Party: Zosano Pharma Corporation
• ClinicalTrials.gov Identifier: NCT03708744
• Other Study ID Numbers: CP-2018-002
• First Posted: October 17, 2018
• Results First Posted: December 23, 2019
• Last Update Posted: January 18, 2020
• Last Verified: January 2020

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Zosano Pharma Corporation:

Healthy; Volunteer; Pharmacokinetics

Additional relevant MeSH terms:

Oxazolidinones; Zolmitriptan; Serotonin 5-HT1 Receptor Agonists; Serotonin Receptor Agonists; Serotonin Agents; Neurotransmitter Agents; Molecular Mechanisms of Pharmacological Action; Physiological Effects of Drugs; Anti-Infective Agents; Protein Synthesis Inhibitors; Enzyme Inhibitors