A First-In-Human Study of TAK-004 in Healthy Adults

Inclusion criteria

To be eligible for participation in this study, the participant must:

• Understand the study procedures and agree to participate by providing written informed consent.
• Be willing and able to comply with all study procedures and restrictions and follow all rules and regulations while confined in the clinical research unit.
• Be a healthy male or woman of nonchildbearing potential (WONCBP) participant aged 18 to 55 years, inclusive, at the screening visit.
• Continuous nonsmoker who has not used nicotine- and tobacco-containing products for at least 3 months before dosing.
• Has not had frequent or heavy use (i.e., near-daily) of medical or recreational cannabis for at least 3 months before screening.
• Has a body mass index greater than or equal to (>=) 18 and less than or equal to (<=) 30.0 kilogram per square meter (kg/m^2) at the screening visit.
• Be judged to be in good health (example, no evidence of psychiatric, hepatic, renal, pulmonary, or cardiovascular disease) by the investigator, based on clinical evaluations including laboratory safety tests, medical history, physical examination, ECG, and vital sign measurements performed at the screening visit and before administration of the initial dose of IP or invasive procedure.
• Meet the following birth control requirements:

• Is a male participant who is sterile or agrees to use an appropriate method of contraception, including a condom with or without spermicidal cream or jelly, from the first dose of IP until 5 half-lives after the last dose of IP. No restrictions are required for a vasectomized male participant provided the participant is at least 4 months after bilateral vasectomy procedure before the first dose of IP. A male participant whose vasectomy procedure was performed less than 4 months before the first dose of IP must follow the same restrictions as a non-vasectomized man. Appropriate documentation of surgical procedure should be provided.
• Is a male participant who agrees not to donate sperm from the first dose of IP until 5 half-lives after the last dose of IP.
• Is a WONCBP, defined by at least 1 of the following criteria:

• Postmenopausal (defined as 12 months of spontaneous amenorrhea in females aged greater than (>) 45 years or 6 months of spontaneous amenorrhea in females aged >45 years with serum follicle-stimulating hormone (FSH) levels >40 milli-international units per milliliter [mIU/mL]). Appropriate documentation of FSH levels is required.
• Surgically sterile by hysterectomy and/or bilateral oophorectomy with appropriate documentation of surgical procedure.
• Had a bilateral tubal ligation, bilateral tubal occlusion, or bilateral salpingectomy with appropriate documentation of surgical procedure.
• Has a congenital condition resulting in no uterus.

Exclusion criteria

Any participant who meets any of the following criteria will not qualify for entry into the study:

• The participant has participated in another investigational study within 4 weeks (or based on local regulations) or within 5 half-lives of the IP before the day of check-in. The 4-week or 5 half-lives window will be derived from the date of the last IP administration and/or AE related to the IP administration in the previous study to the day of check-in of the current study.
• The participant is an employee of the sponsor or study site or immediate family member (example, spouse, parent, child, sibling) of the sponsor or study site.
• The participant has a history of significant multiple and/or severe allergies (example, food, drug, latex allergy) or has had an anaphylactic reaction or significant intolerance to prescription or nonprescription drugs or food. A history of mild seasonal allergies/allergic rhinitis is allowed at the investigator's discretion.
• The participant has a known hypersensitivity or contraindication to any component of TAK-004.
• The participant has a positive pregnancy test result or is lactating or breastfeeding.
• The participant has a positive test result for hepatitis B surface antigen, hepatitis C virus antibody, or human immunodeficiency antibody/antigen, at the screening visit.
• The participant had major surgery or donated or lost 1 unit of blood (approximately 500 mL) within 4 weeks before the screening visit.
• The participant is unable to refrain from or anticipates using medications including herbal medicines beginning approximately 7 days before administration of the first dose of IP.
• The participant is unable to refrain from or anticipates using marijuana or cannabis-containing products from screening, through check-in (Day -2) or within 15 days of drug administration (whichever is longer).
• The participant has a history or presence of alcoholism or drug abuse within the past 2 years before dosing.
• The participant drinks alcohol in excess of 21 glasses/units per week for males or 14 glasses/units per week for females, with one unit = 150 mL of wine or 360 mL of beer or 45 mL of 45% alcohol.
• Positive alcohol test result at check in, or positive urine drug screen results at screening or check-in.
• The participant has a history of major psychotic disorder.
• The participant has a history or presence of:

• Cardiovascular Exclusion:

• 2 or more incidences of vasovagal syncope within the last 5 years before screening;
• A family history of unexplained sudden death or channelopathy;
• Brugada syndrome (ie, RBBB pattern with ST-elevation in leads V1-V3);
• Cardiovascular or cerebrovascular disease, such as cardiac valvulopathy, myocardial infarction, stroke, sick sinus syndrome, pulmonary congestion, any cardiac arrhythmias (including ventricular tachycardia), second-degree AV block type 2, third-degree AV block, prolonged QT interval with Fridericia correction method (QTcF) interval, hypokalemia, hypomagnesemia, or conduction abnormalities;
• Risk factors for Torsade de Pointes (eg, heart failure, cardiomyopathy, or family history of Long QT Syndrome);
• Any clinically significant ECG findings or medical history including long or short QT interval with Fridericia correction method (QTcF) (over 450 millisecond [msec] or less than 360 msec), bifascicular block, left anterior hemiblock/fascicular block or QRS >=120 msec or PR interval >210 msec from screening to Day 1 pre-dose (inclusive);
• A documented history or at screening/check-in of sinus bradycardia (<55 beats per minute [bpm]), sinoatrial block or sinus pause >=3 seconds.
• Renal Disease Exclusion:

• Any relevant personal or family history of renal disease.
• Any clinically significant elevation of blood urea nitrogen or serum creatinine and/or an abnormal glomerular filtration rate.
• Urinalysis finding suggestive of kidney injury.
• The participant has an average semi-recumbent BP less than 90/60 millimeter of mercury (mmHg) or greater than 140/90 mmHg from screening to Day 1 pre-dose, inclusive. Any assessments on Day -1, where 2 consecutive time point values do not meet this criterion, will be exclusionary.
• The participant has an average HR <55 or >100 bpm from screening to Day 1 pre-dose, inclusive. Any assessments after admission with an average HR <55 bpm or HR >100 bpm, from Day -2 to Day 1 pre-dose (inclusive), will be left to the judgment of the investigator, where 2 consecutive time point values do not meet this criterion, the participant will not be eligible.
• The participant has orthostatic hypotension defined as a decrease in SBP >=20 mm Hg or a decrease in DBP >=10 mm Hg at approximately 3 minutes of standing when compared with BP from the semi-recumbent position at screening to Day 1 pre-dose assessments, inclusive. In asymptomatic participants, any assessments that do not meet this criterion may be repeated after the participant has remained in the semi-recumbent or supine position for at least 15 minutes. If the repeat assessment is exclusionary based on the above criterion, the participant will not be eligible. If the repeat assessment is not exclusionary, the participant will be eligible.
• The participant has postural orthostatic tachycardia, defined as an increase of >30 bpm or HR >120 bpm at approximately 3 minutes of standing, at screening to Day 1 pre-dose assessments, inclusive. Any assessments that do not meet this criterion may be repeated with the participant remaining standing for up to a total of 5 minutes, provided that the participant remains asymptomatic. If the repeat assessment occurring within 5 minutes is exclusionary based on the above criterion, the participant will not be eligible.