A Randomized, Single-Dose, Comparative, Positive and Placebo Controlled, Four-Way, Four Period, Cross-Over Study to Evaluate the Effect of DIC075V on QTc Intervals in Healthy Subjects

This is a randomized, single-dose, comparative, positive and placebo controlled, 4 period, 4-way crossover study evaluating the effect of DIC075V on QTc intervals in healthy subjects. Two doses of DIC075V are tested and include moxifloxicin as a positive control and normal saline as the placebo arm. On 4 separate occasions separated by at least 72 hours, subjects are given single IV or oral (moxifloxicin) treatments. ECGs are acquired from a continuous Holter monitor and selected timepoints will be evaluated. These ECGs will be 15 seconds in duration and extracted in triplicate. Monitoring will continue for 24 hours with each treatment. The primary ECG endpoint is the baseline-adjusted QTc using the Fridericia correction (QTcF). Secondary endpoints include the baseline-adjusted QTc using the Bazett correction formula (QTcB). In addition, a population-specific regression model will be constructed with QT plotted against RR (the time elapsed between 2 consecutive R-waves). Finally, QT parameters are explored graphically in relation to PK variables Cmax, Tmax and AUC.

Inclusion criteria

• Willing and able to provide signed informed consent, including Health Insurance Portability and Accountability Act (HIPAA) Authorization.
• Healthy adult male and/or female subjects, 18-50 years of age.
• Body mass index (BMI) between 18-30, inclusive.
• Medically healthy with no clinically significant screening results (laboratory profiles, medical histories, ECGs, physical exam).
• Normal blood pressure (<140 mmHg systolic and <90 mmHg diastolic).
• Normal 12-lead ECG (QTc interval <450 millisecond (ms) for males and <470 ms for females):

• Consistent sinus rhythm
• No clinically significant conduction disorders
• PR interval between 120 and 230 ms
• HR ≤100 bpm and ≥40 bpm
• QRS interval ≤110 ms
• QT intervals that can be consistently analyzed.
• No medical history of cardiac disease or a family history of QT prolongation.
• No clinically significant electrolyte abnormality.
• Subjects with a calculated creatinine clearance greater than >80 ml/min.
• Female subjects who are of childbearing potential with a negative serum pregnancy test at Screening and at Check-in who are either sexually inactive (abstinent) for 14 days prior to Screening and throughout the study or are using two of the following acceptable birth control methods:

• Intrauterine device (IUD) in place for at least 2 months prior to Study Day -2;
• Barrier method (condom or diaphragm) with spermicide for at least 14 days prior to screening through study completion;
• Hormonal contraceptive for at least 3 months prior to Study Day -2 through completion of study;
• Surgical sterilization (vasectomy) of partner at least 6 months prior to Study Day -2.
• Female subjects who are of non-childbearing potential with a negative serum pregnancy test at Screening and Check-in and meet at least one of the following criteria:

• Naturally postmenopausal for a minimum of 2 consecutive years prior to Study Day -2;
• Surgically sterile (bilateral tubal ligation with surgery at least 6 months prior to Study Day -2, hysterectomy, or bilateral oophorectomy with surgery at least 2 months prior to Study Day -2).

Exclusion criteria

• History or presence of significant cardiovascular, pulmonary, hepatic, renal, hematologic, gastrointestinal, endocrine, immunologic, dermatologic, neurologic, or psychiatric disease.
• History of invasive cancer within the past 5 years (excluding non-melanoma skin cancers).
• History of hypersensitivity or allergy to the quinolone class of antibiotics; to diclofenac or other NSAIDs; or to HPβCD or other excipients in DIC075V (monothioglycerol, sodium hydroxide, hydrochloric acid, and water for injection).
• History or presence of alcoholism or drug abuse within the past 2 years.
• Use of tobacco products within the previous 6 months.
• Donation of blood within 45 days prior to Study Day -2.
• Plasma donation within 30 days prior to Study Day -2.
• Participation in a study of an investigational drug within 90 days prior to Study Day -2.
• Participation in another clinical trial within 45 days prior to Study Day -2.
• Female subjects who are pregnant or lactating.
• Hemoglobin below the reference range for the testing laboratory.
• Clinically significant abnormal laboratory values.
• Abnormal ECG. The abnormality of the ECG could be a QRS duration of >110 ms, a first degree heart block defined as a PR duration >230 ms, second or third degree heart block, or a complete heart block.
• Male subjects with a screening QTc interval ≥450 ms and female subjects with a QTc interval ≥470 ms.
• Presence of untreated or uncontrolled blood pressure, i.e., systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg.
• Angina, uncontrolled hypertension, clinically significant bradycardia, clinically significant cardiac arrhythmias, or any other clinically significant cardiovascular abnormality.
• History of clinically significant syncope.
• History of any clinically significant arrhythmias (e.g., ventricular arrhythmias, supra-ventricular arrhythmias, or atrial fibrillation).
• History of clinically significant psychiatric illness that would prevent the subject from providing a valid Informed Consent.
• Positive laboratory test results for hepatitis B, hepatitis C, HIV, controlled Substances, cotinine, or alcohol.
• With the exception of hormonal contraceptives or hormone replacement therapy for females for at least 3 months piror to Study Day -2, any prescription or over-the-counter (OTC) medications, including topical medications, vitamins, herbal or dietary supplements/remedies (e.g., Saint John's Wort or Milk Thistle), within 14 days of Study Day -2.
• With the exception of hormonal contraceptives or hormone replacement therapy for females for at least 3 months prior to Study Day -2, any planned concomitant medication for the duration of the study (except for acetaminophen up to 2 g/day).
• History of additional risk factors for Torsade de Pointes (e.g., heart failure, hypokalemia, history of drowning survival, family history of Long QT Syndrome, family history of Short QT Syndrome, or family history of unexplainable early sudden death).
• History of asthma attack, hives, or other allergic reactions to aspirin or other NSAID medicines.
• History of a coronary bypass operation.
• History of a bleeding gastric or duodenal ulcer.
• History of skin reactions to the taking of any medications.
• History of hepatic disorders and any symptoms associated with a hepatic disorders, e.g., nausea, tiredness, itching, flu-like symptoms, vomiting of blood, blood in the subject's bowel movements, and/or melana.
• History of clinically significant seizures.