A Study of RM-718 in Healthy Subjects and in Patients With HO

Purpose

The purpose of this study is to evaluate the safety, tolerability, and PK of RM-718 in healthy subjects with obesity and in patients with hypothalamic obesity (HO).

Condition

  • Hypothalamic Obesity

Eligibility

Eligible Ages
Between 12 Years and 65 Years
Eligible Genders
All
Accepts Healthy Volunteers
Yes

Inclusion Criteria

Parts A and B: - Male and female subjects in good health aged 18-55 years of age at Screening. - Body mass index (BMI) ≥30 kg/m2. - Subjects who are medically healthy with normal or clinically insignificant screening results. - Subjects must use a highly effective form of contraception and follow the study contraception requirements. - Ability to communicate well with the Investigator, understand and comply with the requirements of the trial, and understand English and sign the written informed consent. Part C: - Male and female patients with HO, aged 12-65 years of age at Screening. - Patient has documented evidence of acquired HO defined as: - Diagnosis of craniopharyngioma or other brain lesion affecting the hypothalamic region and has undergone surgery, or chemotherapy, or radiation therapy involving the hypothalamus at least 6 months before Screening, OR - Documented injury to the hypothalamus at least 6 months before Screening for which surgery/radiation is not indicated. - Weight gain associated with the hypothalamic injury either before or following therapy (surgery and/or following chemotherapy or radiotherapy), and a BMI of ≥30 kg/m2 for patients ≥18 years of age or BMI ≥95th percentile for age and sex for patients 12 to <18 years of age. - Patients must use a highly effective form of contraception and follow the study contraception requirements. - Ability to communicate with the Investigator, understand and comply with the requirements of the trial, and understand and sign the written informed consent and assent (for patients aged <18 years), and informed consent for a parent or guardian of any patient <18.

Exclusion Criteria

Parts A and B - Any clinically significant abnormalities on screening laboratories or physical examination as determined by the Investigator. - Active or history of any significant medical condition such as and including renal, hepatic, pulmonary, gastrointestinal, cardiovascular, genitourinary, endocrine, immunologic, metabolic, neurologic or hematological disease. - Obesity due to genetic, syndromic, or endocrine etiologies. - History of renal transplant, end stage renal disease. - Diagnosis of severe psychiatric disorders. - Current, clinically significant pulmonary, cardiac, metabolic, or oncologic disease considered severe enough to interfere with the trial and/or confound the results. - Cigarette smoking or dependence on caffeine, alcohol or drugs; unable or unwilling to abstain completely from caffeine, alcohol and related substances for 24 hours prior to and after study visits. - History of recent surgery (within 60 days of Screening). - Participation in any clinical trial with an investigational drug/device within 3 months or 5 half-lives, whichever is longer, prior to the first trial dose. - Pregnant and/or breastfeeding or desiring to become pregnant during this trial. Part C - Diagnosis of Prader-Willi syndrome (PWS) or Rapid-onset obesity with hypoventilation, hypothalamic, autonomic dysregulation, neuroendocrine tumor syndrome (ROHHADNET). - Weight loss >2% in the previous 3 months for patients aged ≥18 years or >2% reduction in BMI for patients aged 12 to <18 years and/or anti-obesity medications for the treatment of obesity. - Bariatric surgery or procedure within the last 2 years. - Diagnosis of severe psychiatric disorders; any suicidal ideation, attempt or behavior. - Current, clinically significant pulmonary, cardiac, metabolic, or oncologic disease considered severe enough to interfere with the trial and/or confound the results. - History of renal transplant, end stage renal disease. - Participation in any clinical trial with an investigational drug/device within 3 months or 5 half-lives, whichever is longer, prior to the first trial dose, or previous participation in a trial with setmelanotide. - Pregnant and/or breastfeeding or desiring to become pregnant during this trial. - Obesity attributable to other genetic or syndromic conditions (eg, PPL [pro-opiomelanocortin (POMC), proprotein convertase subtilisin/kexin type 1 (PCSK1), leptin receptor (LEPR), collectively], Bardet-Biedl syndrome [BBS]) prior to the hypothalamic injury. Other protocol defined Inclusion/Exclusion criteria may apply.

Study Design

Phase
Phase 1
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
Triple (Participant, Care Provider, Investigator)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
RM-718 (Cohort A1)
Single dose of RM-718 (4) or placebo (2)
  • Drug: Part A: RM-718 or placebo (matched to specific RM-718 dose cohort)
    Single ascending dose of RM-718 or placebo (matched to specific RM-718 Part A dose cohort)
Experimental
RM-718 (Cohort A2)
Single dose of RM-718 (4) or placebo (2)
  • Drug: Part A: RM-718 or placebo (matched to specific RM-718 dose cohort)
    Single ascending dose of RM-718 or placebo (matched to specific RM-718 Part A dose cohort)
Experimental
RM-718 (Cohort A3)
Single dose of RM-718 (4) or placebo (2)
  • Drug: Part A: RM-718 or placebo (matched to specific RM-718 dose cohort)
    Single ascending dose of RM-718 or placebo (matched to specific RM-718 Part A dose cohort)
Experimental
RM-718 (Cohort A4)
Single dose of RM-718 (4) or placebo (2)
  • Drug: Part A: RM-718 or placebo (matched to specific RM-718 dose cohort)
    Single ascending dose of RM-718 or placebo (matched to specific RM-718 Part A dose cohort)
Experimental
RM-718 (Cohort A5)
Single dose of RM-718 (4) or placebo (2)
  • Drug: Part A: RM-718 or placebo (matched to specific RM-718 dose cohort)
    Single ascending dose of RM-718 or placebo (matched to specific RM-718 Part A dose cohort)
Experimental
RM-718 (Cohort A6)
Single dose of RM-718 (4) or placebo (2)
  • Drug: Part A: RM-718 or placebo (matched to specific RM-718 dose cohort)
    Single ascending dose of RM-718 or placebo (matched to specific RM-718 Part A dose cohort)
Experimental
RM-718 (Cohort B1)
Multiple doses of RM-718 (4) or placebo (2)
  • Drug: Part B: RM-718 or placebo (matched to specific RM-718 dose cohort)
    Multiple ascending doses of RM-718 or placebo (matched to specific RM-718 Part B dose cohorts)
Experimental
RM-718 (Cohort B2)
Multiple ascending doses of RM-718 (4) or placebo (2)
  • Drug: Part B: RM-718 or placebo (matched to specific RM-718 dose cohort)
    Multiple ascending doses of RM-718 or placebo (matched to specific RM-718 Part B dose cohorts)
Experimental
RM-718 (Cohort B3)
Multiple ascending doses of RM-718 (4) or placebo (2)
  • Drug: Part B: RM-718 or placebo (matched to specific RM-718 dose cohort)
    Multiple ascending doses of RM-718 or placebo (matched to specific RM-718 Part B dose cohorts)
Experimental
RM-718 (Cohort B4)
Multiple ascending doses of RM-718 (4) or placebo (2)
  • Drug: Part B: RM-718 or placebo (matched to specific RM-718 dose cohort)
    Multiple ascending doses of RM-718 or placebo (matched to specific RM-718 Part B dose cohorts)
Experimental
RM-718 (Cohort B5)
Multiple ascending doses of RM-718 (4) or placebo (2)
  • Drug: Part B: RM-718 or placebo (matched to specific RM-718 dose cohort)
    Multiple ascending doses of RM-718 or placebo (matched to specific RM-718 Part B dose cohorts)
Experimental
RM-718 (Cohort C1)
Multiple ascending doses of RM-718 (30)
  • Drug: Part C: RM-718
    Multiple ascending doses of RM-718 (specific to Part C dose cohorts)
Experimental
RM-718 (Cohort B6)
Multiple ascending doses of RM-718 (4) or placebo (2)
  • Drug: Part B: RM-718 or placebo (matched to specific RM-718 dose cohort)
    Multiple ascending doses of RM-718 or placebo (matched to specific RM-718 Part B dose cohorts)

Recruiting Locations

Brigham and Women's Hospital
Boston, Massachusetts 02115

More Details

Status
Recruiting
Sponsor
Rhythm Pharmaceuticals, Inc.

Study Contact

Rhythm Clinical Trials
(857) 264-4280
clinicaltrials@rhythmtx.com

Detailed Description

This is a first-in-human and first-in-patient, 3-part study that includes the evaluation of safety, tolerability, and PK of: single ascending doses (SAD) of RM-718 weekly (RM-718) in healthy subjects 18 to 55 years of age with obesity (Part A), multiple ascending doses (MAD) of RM-718 in healthy subjects 18 to 55 years of age with obesity (Part B), and MAD of RM-718 in patients 12 to 65 years of age with HO (Part C). Cohorts in Parts A and B are double-blind, placebo-controlled, and randomized 2:1 (4 subjects receive RM-718, 2 subjects receive placebo). Part C evaluates open-label dose escalation in patients 12 to 65 years of age with HO. Study participants will receive: 1 weekly dose of either RM-718 or placebo in Part A, 4 weekly doses of either RM-718 or placebo in Part B, and 16 weekly doses of open-label RM-718 in Part C. Study drug (RM-718 or placebo) doses are administered weekly via subcutaneous injection.