Phase 1 clinical trial of losmapimod in facioscapulohumeral dystrophy: Safety, tolerability, pharmacokinetics, and target engagement
Michelle Mellion, Lucienne Ronco, Cécile L. Berends, Lisa Pagan, Sander Brooks, Michiel J. van Esdonk, Emilie M.J. van Brummelen, Adefowope Odueyungbo, Lorin A. Thompson, Michelle Hage, Umesh A. Badrising, Shane Raines, William Tracewell, Baziel G.M. van Engelen, Diego Cadavid, Geert Jan Groeneveld
Abstract
Aims Evaluate safety, tolerability, pharmacokinetics (PK) and target engagement (TE) of losmapimod in blood and muscle in facioscapulohumeral dystrophy (FSHD). Methods This study included Part A: 10 healthy volunteers randomized to single oral doses of losmapimod (7.5 mg then 15 mg; n = 8) or placebo (both periods; n = 2); Part B: 15 FSHD subjects randomized to placebo ( n = 3), or losmapimod 7.5 mg ( n = 6) or 15 mg ( n = 6); and Part C: FSHD subjects received open‐label losmapimod 15 mg ( n = 5) twice daily for 14 days. Biopsies were performed in FSHD subjects at baseline and Day 14 in magnetic resonance imaging‐normal appearing (Part B) and affected muscle identified by abnormal short‐tau inversion recovery sequence + (Part C). PK and TE, based on pHSP27:total HSP27, were assessed in muscle and sorbitol‐stimulated blood. Results PK profiles were similar between healthy volunteers and FSHD subjects, with mean C max and AUC 0–12 for 15 mg in FSHD subjects (Part B) of 85.0 ± 16.7 ng*h/mL and 410 ± 50.3 ng*h/mL, respectively. Part B and Part C PK results were similar, and 7.5 mg results were approximately dose proportional to 15 mg results. Dose‐dependent concentrations in muscle (42.1 ± 10.5 ng/g [7.5 mg] to 97.2 ± 22.4 ng/g [15 mg]) were observed, with plasma‐to‐muscle ratio from ~0.67 to ~1 at estimated t max of 3.5 hours postdose. TE was observed in blood and muscle. Adverse events (AEs) were mild and self‐limited. Conclusion Losmapimod was well tolerated, with no serious AEs. Dose‐dependent PK and TE were observed. This study supports advancing losmapimod into Phase 2 trials in FSHD. Clinical Trial Registration Clinical trial identifier ToetsingOnline: NL68539.056.18 Nederlands Trials Register NL8000.