Safety, pharmacokinetics and pharmacodynamics of selgantolimod, an oral Toll-like receptor 8 agonist: a Phase Ia study in healthy subjects

Antivir Ther. 2020;25(3):171-180. doi: 10.3851/IMP3363.

Abstract

Background: Selgantolimod is a novel oral, selective Toll-like receptor 8 (TLR8) agonist in development for the treatment of chronic hepatitis B (CHB). TLR8 is an endosomal innate immune receptor and a target for treatment of viral infections. This first-in-human study investigated the safety, tolerability, pharmacokinetics (PK) and pharmacodynamics (PD) of selgantolimod in healthy volunteers.

Methods: Of 71 subjects enrolled, 59 received a single dose of selgantolimod (0.5, 1.5, 3 or 5 mg) or placebo, and 12 were evaluated for food effect. Safety, PK and PD activity by induction of cytokines, chemokines and acute phase proteins were assessed. PK/PD analyses were conducted.

Results: Single doses of 0.5-5 mg were generally safe. No serious adverse events (AEs) or AEs leading to discontinuation were reported, and most were Grade 1 in severity. Selgantolimod displayed rapid absorption and dose-proportional PK and PD activity. Food had minimal effect on PK but resulted in diminished PD activity. In PK/PD analyses, near-saturation of induction for most evaluated biomarkers occurred at the 5-mg dose.

Conclusions: Single doses of up to 5 mg selgantolimod were safe and induced dose-dependent PD responses. These data support evaluation of selgantolimod in combination with other agents in future clinical studies of CHB. Australian New Zealand Clinical Trials Registration: ACTRN12616001646437.

Publication types

  • Clinical Trial, Phase I
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adult
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / adverse effects
  • Antiviral Agents / pharmacokinetics
  • Antiviral Agents / pharmacology*
  • Chemokines / blood
  • Dose-Response Relationship, Drug
  • Female
  • Hepatitis B, Chronic / drug therapy
  • Hexanols / administration & dosage
  • Hexanols / adverse effects
  • Hexanols / pharmacokinetics
  • Hexanols / pharmacology*
  • Humans
  • Interleukin 1 Receptor Antagonist Protein / blood
  • Interleukin-12 / blood
  • Male
  • Pyrimidines / administration & dosage
  • Pyrimidines / adverse effects
  • Pyrimidines / pharmacokinetics
  • Pyrimidines / pharmacology*
  • Toll-Like Receptor 8 / agonists*
  • Young Adult

Substances

  • Antiviral Agents
  • Chemokines
  • Hexanols
  • Interleukin 1 Receptor Antagonist Protein
  • Pyrimidines
  • TLR8 protein, human
  • Toll-Like Receptor 8
  • Interleukin-12
  • selgantolimod