Abstract

PT150, a novel competitive glucocorticoid receptor (GR) antagonist, has proven safe in animal models, healthy volunteers, and people with depression. Our study is the first to investigate PT150’s safety with alcohol use. The primary objective of this study was to evaluate pharmacodynamic interactions between ethanol and PT150 in healthy subjects. This single-site, Phase I pilot trial consisted of community-recruited, healthy, alcohol-experienced participants aged 21–64 years. Of 32 participants screened, 11 were enrolled and randomized, one of which withdrew before intervention. PT150 (900 mg/day) was administered orally to all participants for five days. All participants received two beverage challenges on Day 1 (before PT150 administration) and Day 5 (after PT150 administration). On challenge days, they received both alcohol (16% ethanol) and placebo (1% ethanol) beverages in random order. Primary outcomes included breath alcohol level, blood pressure, heart rate, adverse events, and electrocardiogram changes. There were no statistically significant differences in vital signs or estimated blood alcohol concentrations between PT150 non-exposed and exposed groups during the ethanol challenge. There were no clinically significant abnormal electrocardiograms or serious adverse events. These data show that administration of PT150 with concurrent alcohol use is safe and well-tolerated. This study supports a future pharmacokinetic interaction study between PT150 and alcohol.Trial Registration ClinicalTrials.gov Identifier: NCT03548714.

Highlights

  • PT150, a novel competitive glucocorticoid receptor (GR) antagonist, has proven safe in animal models, healthy volunteers, and people with depression

  • PT150 is highly selective for GR, 100-fold more so than the non-selective GR and progesterone receptor antagonist mifepristone (RU486)[12], a specificity that may allow PT150 to be a more effective treatment option with a more favorable side effect profile

  • An aggregate of the Phase I studies in healthy volunteers (n = 244) showed that PT150 was well tolerated in doses up to 900 mg daily over 14 days

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Summary

Introduction

PT150, a novel competitive glucocorticoid receptor (GR) antagonist, has proven safe in animal models, healthy volunteers, and people with depression. The primary objective of this study was to evaluate pharmacodynamic interactions between ethanol and PT150 in healthy subjects This single-site, Phase I pilot trial consisted of community-recruited, healthy, alcohol-experienced participants aged 21–64 years. The five Phase II trials conducted (protocol # 28104, 28105, 28106, 28130, and 28133) included a total of 704 patients with major depressive disorder (MDD) treated for 14 or 28 days. Of these patients, 428 received PT150 (118 on 150–300 mg/day, 212 on 300–600 mg/day, and 98 on 900 mg/day), 107 received paroxetine (10–40 mg/day), 9 received clomipramine (50–200 mg/day), and 160 received placebo. Three SAEs were deemed probably related to PT150: two hospitalizations for major depression and one for a rash

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