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PF06649751, Itraconazole

Phase 1

Idiopathic Parkinson Disease | Small molecule | Neurology |Pfizer, Inc.|Last Updated: Sep 22, 2023

Target and mechanism

ModalitySmall molecule

Also known as PF-06649751

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindCONTROLLED
Total Trials1
Total Enrollment18

FDA Designations

No designations recorded

Clinical trial landscape

PF06649751, Itraconazole · 6 trials · 3 indications

Phase 1 6
NCT03121664A Study To Estimate The Effects Of Itraconazole On Pharmacokinetics Of Pf-06649751 In Healthy Adult SubjectsHealthy
COMPLETED11 Analytics
NCT02373072A Study to Investigate the Safety, Tolerability, and Pharmacokinetics of PF-06649751 in Subjects With Idiopathic Parkinson's DiseaseIdiopathic Parkinson Disease
COMPLETED18 Analytics
NCT02262767A Study to Investigate the Safety, Tolerability, and Pharmacokinetics of PF-06649751 Co-administered With Trimethobenzamide Hydrochloride in Healthy SubjectsHealthy
COMPLETED9 Analytics
NCT02224664Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of PF-06649751 in Parkinson's DiseaseParkinson's Disease
COMPLETED50 Analytics
NCT02066909A Study To Observe Safety And Blood Concentrations Of PF-06649751 During And Following The Oral Administration Of Multiple Doses Of PF-06649751 In Healthy Adult Western and Japanese VolunteersHealthy
COMPLETED77 Analytics
NCT01981694A Phase I Trial to Investigate the Safety and Tolerability of PF-06649751Healthy
COMPLETED18 Analytics
PHASE1COMPLETED
A Study To Estimate The Effects Of Itraconazole On Pharmacokinetics Of Pf-06649751 In Healthy Adult Subjects
HealthyUnlock trial analytics
PHASE1COMPLETED
A Study to Investigate the Safety, Tolerability, and Pharmacokinetics of PF-06649751 in Subjects With Idiopathic Parkinson's Disease
Idiopathic Parkinson DiseaseUnlock trial analytics
PHASE1COMPLETED
A Study to Investigate the Safety, Tolerability, and Pharmacokinetics of PF-06649751 Co-administered With Trimethobenzamide Hydrochloride in Healthy Subjects
HealthyUnlock trial analytics
PHASE1COMPLETED
Safety, Tolerability, Pharmacokinetics and Pharmacodynamics of PF-06649751 in Parkinson's Disease
Parkinson's DiseaseUnlock trial analytics
PHASE1COMPLETED
A Study To Observe Safety And Blood Concentrations Of PF-06649751 During And Following The Oral Administration Of Multiple Doses Of PF-06649751 In Healthy Adult Western and Japanese Volunteers
HealthyUnlock trial analytics
PHASE1COMPLETED
A Phase I Trial to Investigate the Safety and Tolerability of PF-06649751
HealthyUnlock trial analytics

Study Endpoints

Primary Endpoints

PF-06649751 and PF-06752844 steady state Cmax
Day 11 and Day 25

Maximum Observed Plasma Concentration

PF-06649751 and PF-06752844 steady state AUC24
Days 11 and Day 25

Area Under the Curve From Time Zero to the end of the dosing period

Number and proportion of subjects with Adverse Events (AEs)
Day 1 through 61
Number of participants with vital signs data that meet criteria of potential clinical concern
Day 1 through 61
Number of participants with ECG data that meet criteria of potential clinical concern
Day 1 through 61
Number of participants with abnormal clinically significant laboratory measurements
Day 1 through 61
C-SSRS (suicidality assessment)
Day 1 through 61
Number of Participants With Adverse Events (AEs) and Serious Adverse Events (SAEs)
0 - 4 weeks

Counts of participants who have treatment-emergent adverse events (TEAEs), defined as newly occurring or worsening after first dose. Relatedness to PF-06649751 will be assessed by the investigator (Yes/No). Participants with multiple occurrences of an AE within a category will be counted once within the category.

Supine and standing vital sign measurements
0 - 4 weeks

Measurement of blood pressure and pulse rate.

Electrocardiogram (ECG)
0 - 4 weeks

Measurement of standard 12-lead ECG, single or triplicate

Number of Participants With Laboratory Test Values of Potential Clinical Importance
0 - 4 weeks

Pre-defined criteria were established for each laboratory test to define the values that would be identified as of potential clinical importance.

Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)
Baseline (Day 1) up to Day 30

An AE was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. An SAE is an AE resulting in any of the following outcomes or deemed significant for any other reason: death; Initial or prolonged in-patient hospitalization; life threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent were events between first dose of study drug to the end of study (up to Day 30) that were absent before treatment or that worsened relative to pre-treatment state. AEs included both serious and non-serious adverse events.

Number of Participants With Laboratory Test Abnormalities
Baseline up to Day 30

Criteria for laboratory abnormalities: Hemoglobin (Hgb),hematocrit, red blood cell(RBC) count: less than(\<)0.8\*lower limit of normal(LLN),mean corpuscular Hgb, mean corpuscular volume, mean corpuscular Hgb concentration:\<0.9\*LLN, greater than (\>)1.1\*upper limit of normal(ULN),platelet:\<0.5\*LLN,\>1.75\*ULN,lymphocyte,neutrophil:\<0.8\*LLN, \>1.2\*ULN, basophil, eosinophil, monocyte:\>1.2\*ULN, WBC:\<0.6\*LLN, \>1.5\*ULN;total bilirubin\>1.5\*ULN, aspartate aminotransferase,alanine aminotransferase,alkaline phosphatase:\>3.0\*ULN,total protein,albumin:\<0.8\*LLN,\>1.2\*ULN;blood urea nitrogen,creatinine:\>1.3\*ULN, uric acid\>1.2\*ULN;sodium\<0.95\*LLN,\>1.05\*ULN,potassium,chloride,calcium,bicarbonate:\<0.9\*LLN,\>1.1\*ULN;glucose\<0.6\*LLN,\>1.5\*ULN,urine pH:\<4.5, \>8; urine: WBC, RBC greater than or equal to (\>=)20/high performance field, bacteria: \>20; urobilinogen, urine: glucose, ketone, protein, Hgb, nitrite, leukocyte esterase, bilirubin: \>=1.

Number of Participants With Vital Sign Abnormalities
Baseline up to Day 30

Criteria for vital sign abnormality included supine pulse rate of \<40 beats per minute (bpm) or \>120 bpm, standing pulse rate of \<40 bpm or \>140 bpm, supine and standing systolic blood pressure (SBP) \<90 millimeter of mercury (mmHg), supine and standing diastolic blood pressure (DBP) \<50 mmHg, supine and standing SBP of \>=30 mmHg maximum (max.) increase from baseline (IFB) and and decrease from baseline (DFB) in same posture, supine and Standing DBP of \>=20 mmHg max. increase and decrease from baseline in same posture. Categories in which there was atleast 1 abnormality are reported in this outcome measure.

Number of Participants With Electrocardiogram (ECG) Abnormalities
Baseline up to Day 30

Criteria for ECG abnormalities: maximum PR interval \>=300 milliseconds (msec) and maximum increase PR interval increase from baseline (IFB): percent change (Pctchg) \>=25 percent (%) for baseline value of \>200 msec and Pctchg\>=50% for baseline value of \<=200 msec for PR interval, maximum QRS interval \>=140 msec and a maximum IFB: Pctchg\>=50%, maximum QTCF interval (Fridericia's Correction) of 450 msec to \<480 msec, 480 msec to \<500 msec or \>=500 msec and a maximum change of \<=30change\<60 or \>=60 msec from baseline.

Number of Participants With Clinically Significant Change From Baseline in Physical Examination Findings
Baseline up to Day 30

Physical examination included examination of the head, ears, eyes, nose, mouth, skin, heart and lung examinations, lymph nodes, gastrointestinal, musculoskeletal, and neurological systems. The examination assessed the participants for any potential changes in general appearance, the respiratory and cardiovascular systems, as well as towards participant reported symptoms. Findings were considered to be clinically significant based on investigator's decision.

Number of Participants With Clinically Significant Neurological Examination Abnormality
Baseline up to Day 30

The complete or full neurological examination included assessment of the cranial nerves; muscle strength, tone, cortical drift, abnormal movements; deep tendon reflexes; sensory exam, coordination, gait and station. Higher cortical and motor function was considered part of the complete neurological exam. Findings were considered abnormal as confirmed by a certified neurologist.

Number of Participants With Categorical Scores on The Columbia Suicide Severity Rating Scale (C-SSRS)
Baseline up to Day 30

The C-SSRS was an interview-based rating scale to systematically assess suicidal ideation and suicidal behavior. C-SSRS assessed whether participant experienced any of the following 1: completed suicide, 2: suicide attempt (response of "yes" on "actual attempt"), 3: preparatory acts toward imminent suicidal behavior ("yes" on "aborted attempt", "interrupted attempt", "preparatory acts or behavior"), 4: any suicidal behavior or ideation, suicidal ideation ("yes" on "wish to be dead", "non-specific active suicidal thoughts", "active suicidal ideation with methods without intent to act or some intent to act, without specific plan or with specific plan and intent"), 7: self-injurious behavior, no suicidal intent ("yes" on "has participant engaged in non-suicidal self-injurious behavior").

Change From Baseline in Parkinson's Disease Diary For Participants With Motor Fluctuations at Day 13
Baseline, Day 13

According to Parkinson's disease diaries of participants "OFF" time was a time period when the medication no longer providing benefit with regard to mobility, slowness, and stiffness and participants experienced relatively poor overall function with worsening of tremor, rigidity, balance, or bradykinesia. "ON" time was a time period when medication was providing benefit with regard to mobility, slowness, and stiffness. "ON" time was classified as associated with or without troublesome dyskinesia (TD) that interfere with activities of daily living and with or without dyskinesia. "OFF" time and "ON" time with TD were generally considered to be "bad time" with regard to motor function, whereas "ON" time without dyskinesia (WD) and with non- troublesome dyskinesia (NTD) were generally considered to be "good time".

Change From Baseline in Parkinson's Disease Diary For Participants With Motor Fluctuations at Day 20
Baseline, Day 20

According to Parkinson's disease diaries of participants "OFF" time was a time period when the medication no longer providing benefit with regard to mobility, slowness, and stiffness and participants experienced relatively poor overall function with worsening of tremor, rigidity, balance, or bradykinesia. "ON" time was a time period when medication was providing benefit with regard to mobility, slowness, and stiffness. "ON" time was classified as associated with or without troublesome dyskinesia (TD) that interfere with activities of daily living and with or without dyskinesia. "OFF" time and "ON" time with TD were generally considered to be "bad time" with regard to motor function, whereas "ON" time without dyskinesia (WD) and with non- troublesome dyskinesia (NTD) were generally considered to be "good time".

Amount of unchanged drug excreted in urine relative to dose (Ae%)
Day 14 (Cohorts 1 - 4, 9), Day 21 (Cohort 5), Day 28 (Cohorts 6 - 8)
Renal Clearance (CLR)
Day 14 (Cohort 1 - 4, 9), Day 21 (Cohort 5) and Day 28 (Cohorts 6 - 8)
Area Under the Curve from Time Zero to end of dosing interval (AUCtau)
Day 1, Day 14 (Cohorts 1 - 4, 9), Day 1 and Day 21 (Cohort 5), Day 1 and Day 28 (Cohorts 6 - 8)
Maximum Observed Plasma Concentration (Cmax)
Day 1, Day 7, Day 14 (Cohorts 1 - 4, 9), Day 1 and 21 (Cohort 5), Day 1 and 28 (Cohorts 6 - 8)

Maximum plasma concentration

Time to Reach Maximum Observed Plasma Concentration (Tmax)
Day 1, Day 7, Day 14 (Cohorts 1 - 4, 9), Day 1 and 21 (Cohort 5), Day 1 and 28 (Cohorts 6 - 8)

Time for Cmax

Plasma Decay Half-Life (t1/2)
Days 14 - 18 (Cohorts 1 - 4, 9), Days 21 - 25 (Cohort 5), Days 28 - 32 (Cohorts 6 - 8)

Plasma decay half-life is the time measured for the plasma concentration to decrease by one half.

Apparent Oral Clearance (CL/F)
Days 14 - 18 (Cohorts 1 - 4, 9), Days 21 - 25 (Cohort 5), Days 28 - 32 (Cohorts 6 - 8)

Clearance of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes. Clearance obtained after oral dose (apparent oral clearance) is influenced by the fraction of the dose absorbed. Drug clearance is a quantitative measure of the rate at which a drug substance is removed from the blood.

Apparent Volume of Distribution (Vz/F)
Days 14 - 18 (Cohorts 1 - 4, 9), Days 21 - 25 (Cohort 5), Days 28 - 32 (Cohorts 6 - 8)

Volume of distribution is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired plasma concentration of a drug. Apparent volume of distribution after oral dose (Vz/F) is influenced by the fraction absorbed.

Trough Concentration (Ctrough)
Day 1 to 14 (Cohorts 1 - 4, 9), Day 1 to 21 (Cohort 5), Day 1 to 28 (Cohorts 6 - 8)

Minimum concentration pre-dose

Ratio of accumulation for AUCtau (Rac AUCtau)
Day 1 and 14 (Cohorts 1 - 4, 9), Day 1 and 21 (Cohort 5), Day 1 and 28 (Cohorts 6 - 8)

Ratio of accumulation for AUCtau. Corrected for titrated doses.

Ratio of accumulation for Cmax (Rac Cmax)
Day 1, Day 7 and Day 14 (Cohorts 1 - 4, 9), Day 1 and 21 (Cohort 5), Day 1 and 28 (Cohorts 6 - 8)

Ratio of accumulation for Cmax. Corrected for titrated doses.

Peak-to-trough ratio (PTR)
Day 7 and Day 14 (Cohorts 1 - 4, 9), Day 21 (Cohort 5), Day 28 (Cohorts 6 - 8)

Peak-to-trough ratio at steady state

Changes from baseline in total cholesterol, High Density Lipoprotein (HDL) cholesterol, Low Density Lipoprotein (LDL) cholesterol, triglycerides
Day 1 and Day 14 (Cohorts 1 - 4, 9), Day 1 and 21 (Cohort 5), Day 1 and 28 (Cohorts 6 - 8)
Amount of unchanged drug excreted in urine relative to dose (Ae)
Day 14 (Cohorts 1 - 4, 9), Day 21 (Cohort 5), Day 28 (Cohorts 6 - 8)

Calculated from urinary volumes and concentration

Area Under the Curve From Time Zero to Last Quantifiable Concentration (AUClast)
0, 0.5, 1, 1.5, 2, 4, 6, 8, 10, 12, 16, 24, 32, 48, 72 hours post-dose

Area under the plasma concentration time-curve from zero to the last measured concentration (AUClast)

Area Under the Curve From Time Zero to Extrapolated Infinite Time [AUC (0 - 8)]
0, 0.5, 1, 1.5, 2, 4, 6, 8, 10, 12, 16, 24, 32, 48, 72 hours post-dose

AUC (0 - 8)= Area under the plasma concentration versus time curve (AUC) from time zero (pre-dose) to extrapolated infinite time (0 - 8). It is obtained from AUC (0 - t) plus AUC (t - 8).

Eye Blink Rate
0, 0.5, 1, 1.5, 2, 4, 6, 8, 10, 12, 16, 24 hours post-dose

Measurement of eye blink rate for a given dose at time of predicted maximum blood concentration of the compound

Secondary Endpoints

Number of Participants with categorical scores on the Columbia Suicide Severity Rating Scale (C-SSRS)
Day 0
Number of Participants With Treatment Emergent Treatment-Related Adverse Events (AEs)
Day 1 to Day 26
MDS-UPDRS part III
Day 1, Periods 1-3
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Study Design & Arms

MaskingNONE
ModelCROSSOVER
PurposeBASIC_SCIENCE

Treatment Arms

ArmTypeDescription
Cohort 1EXPERIMENTAL -
Cohort 2EXPERIMENTALThree single doses over three periods. For each of the three periods, subjects will be crossed-over from placebo or PF-06649751. Each PF-06649751 dose is separated by at least one week.
Single Ascending Doses Cohort 1EXPERIMENTALSingle doses, given by oral solution, starting at 0.75 mg up to a possible maximum of 3.0 mg. The subject will have been fasted for 10 hours prior to the single dose. For each dosing period, 3 subjects will be given a placebo as a comparator while 6 are given active dose. The subjects will be given concomitant trimethobenzamide hydrochloride for the 3 weeks that the subject is in the CRU. For each of the three periods, subjects will be crossed-over from placebo or PF-06649751. Each PF-06649751 dose is separated by one week.
Single Ascending Doses Cohort 2EXPERIMENTALSingle doses, given by oral solution, starting at 4.5 mg up to a possible maximum of 9.0 mg. The subject will have been fasted for 10 hours prior to the single dose. For each dosing period, 3 subjects will be given a placebo as a comparator while 6 are given active dose. The subjects will be given concomitant trimethobenzamide hydrochloride for the 3 weeks that the subject is in the CRU. For each of the three periods, subjects will be crossed-over from placebo or PF-06649751. Each PF-06649751 dose is separated by one week.
Cohort 3EXPERIMENTALTitration of PF-06649751 up to 5 mg QD
Cohort 4EXPERIMENTALTitration of PF-06649751 up to 15 mg QD
Cohort 5EXPERIMENTALTitration of PF-06649751 up to 15 mg QDi n subjects with Levodopa-induced dyskinesias (LID)
Cohort 6EXPERIMENTALTitration of PF-0649751 up to 25 mg QD
Cohort 7EXPERIMENTALDosing in healthy Western subjects.
Optional Cohort 8EXPERIMENTALDosing in healthy Western subjects. Cohort may not be conducted.
Cohort 9EXPERIMENTALDosing in healthy Japanese subjects.
Single ascending dosesEXPERIMENTAL -
Measurement of eye blink rateEXPERIMENTAL -

Interventions

NameTypeDescription
PF06649751, ItraconazoleDRUGPF-06649751 0.25 mg on Days 1,2,3 PF-06649751 0.5 mg on Days 4,5,6 PF-06649751 1 mg on Days 7 to Day 25 Itracoanzole 200 mg on Days 12 to Day 25
PF-06649751DRUGSubjects completing all three treatment periods will be administered two doses. Doses: 0.75mg, 1.5mg, 3mg, 6mg, 9mg. Tablets in the form of 0.25mg or 1 mg.
Trimethobenzamide HydrochlorideDRUG300mg TID, Capsules. Optional in both Cohorts.
PlaceboDRUGSubjects completing all three treatment periods will be receiving placebo once.
0.15 mg PF-06649751DRUGOral dosing of 0.15 mg PF-06649751 extemporaneously-prepared solution given once-daily for 14 days.
0.5 mg PF-06649751DRUGOral dosing of 0.5 mg PF-06649751 extemporaneously-prepared solution given once-daily for 14 days.
1.5 mg PF-06649751DRUGOral dosing of tablets up to 1.5 mg PF-06649751 given once-daily for 14 days.
1.5 mg PF-06649751 21 DaysDRUGOral dosing of tablets up to 1.5 mg PF-06649751 given once-daily for 21 days.
3.0 mg PF-06649751DRUGOral dosing of tablets up to 3.0 mg PF-06649751 given once-daily for 28 days.
5.0 mg PF-06649751DRUGOral dosing of tablets up to 5.0 mg PF-06649751 given once-daily for 28 days.
8.0 mg PF-06649751DRUGOral dosing of tablets up to 8.0 mg PF-06649751 given once-daily for 28 days.
1.5 mg PF-06649751 in healthy Japanese subjectsDRUGOral dosing of tablets up to 1.5 mg PF-06649751 given once-daily for 14 days given in healthy Japanese subjects.
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Eligibility Criteria

Age Range18 Years to 55 Years
SexALL
Healthy VolunteersYes
Study Sites1

Inclusion Criteria: Subjects must meet all of the following inclusion criteria to be eligible for enrollment in the study: * Healthy female subjects of nonchildbearing potential and/or male subjects who, at the time of screening, are between the ages of 18 and 55 years, inclusive. * Female subject...

Countries:BelgiumUnited States
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Frequently asked questions about PF06649751, Itraconazole

What is PF-06649751?

PF-06649751 is an investigational small molecule developed by Pfizer, Inc. (NYSE: PFE) for Parkinson's disease. It has been studied in Phase 1 clinical trials involving healthy volunteers and patients with idiopathic Parkinson's disease. The drug is not approved for any indication and remains in clinical development.

What is PF-06649751 used for?

PF-06649751 is being developed for the treatment of Parkinson's disease, including idiopathic Parkinson's disease. It has been evaluated in Phase 1 trials in both healthy adult subjects and patients with Parkinson's disease. The drug is investigational and has not been approved for any use.

Who is developing PF-06649751?

PF-06649751 is being developed by Pfizer, Inc., which trades on the New York Stock Exchange under the ticker PFE. Pfizer has sponsored all four Phase 1 clinical trials of the drug, which have been completed.

What phase is PF-06649751 in?

PF-06649751 is in Phase 1 clinical development. All four of its clinical trials are Phase 1 studies and have been completed. The drug is investigational and has not received FDA approval for any indication.

What clinical trials is PF-06649751 in?

PF-06649751 has been studied in four completed Phase 1 trials: NCT03121664 in healthy adults, NCT02373072 in idiopathic Parkinson's disease, NCT02262767 in healthy subjects with trimethobenzamide, and NCT02224664 in Parkinson's disease. Total enrollment across these trials was 115 participants.

Is PF-06649751 the same as itraconazole?

No, PF-06649751 and itraconazole are different compounds. PF-06649751 is an investigational small molecule developed by Pfizer for Parkinson's disease. Itraconazole is an antifungal drug used in a separate study to assess its effects on the pharmacokinetics of PF-06649751. PF-06649751 is also known as PF-06649751 and 0.15 mg PF-06649751.