First‐in‐human studies of MW01‐6‐189WH, a brain‐penetrant, anti‐neuroinflammatory, small molecule drug candidate: Phase 1 safety, tolerability, pharmacokinetic, and pharmacodynamic studies in healthy adult volunteers: Human/Human trials: Inflammation

Background Acute brain injuries, such as intracerebral hemorrhage (ICH) or traumatic brain injury (TBI), are major medical problems that cause considerable mortality and morbidity in older individuals. In addition to the initial injury, secondary neuroinflammatory events can further damage the brain and lead to increased risk of neurologic complications, including Alzheimer’s disease (AD) and related dementias (ADRD). A specific aspect of neuroinflammation, injury‐induced proinflammatory cytokine overproduction from abnormally activated glia, has been linked to subsequent neurological damage and cognitive deficits in both acute and chronic CNS disorders. Despite advances in our understanding of these molecular neuroinflammatory mechanisms, approved therapeutics that target this pathological process are lacking. To address this need, we developed a CNS‐penetrant, small molecule drug candidate, MW01‐6‐189WH (=MW189), that selectively attenuates stressor‐induced proinflammatory cytokine overproduction. MW189 is efficacious at low doses in animal models of AD, TBI and ICH. Based on promising drug‐like properties, preclinical efficacy, and excellent safety profile, an intravenous formulation of MW189 was developed and tested in phase 1 human studies. Methods Phase 1 studies were done to evaluate safety, tolerability, and pharmacokinetics (PK) of single and multiple ascending doses of MW189 in healthy adults. A pilot pharmacodynamic study administering low dose endotoxin to induce a systemic inflammatory response was done to evaluate effects of a single dose of MW189 on plasma cytokine levels. Results MW189 was safe and well tolerated in single and multiple doses up to 0.25 mg/kg, with no clinically significant concerns. No clinically concerning changes were seen in vital signs, ECGs, physical or neurological examinations, or safety laboratory results. PK analysis showed dose‐proportional increases in MW189 plasma concentrations after single or multiple doses, with approximately linear kinetics and no significant drug accumulation. In the pilot pharmacodynamic study, MW189 treatment resulted in lower plasma levels of the proinflammatory cytokine TNFα and higher levels of the anti‐inflammatory cytokine IL‐10 compared to placebo treatment, suggesting engagement of pharmacological mechanism. Conclusion Overall, the safety profile, PK properties, and pharmacodynamic effect support further development of MW189 for patients with acute CNS injury, AD/ADRD, or other disorders involving dysregulated neuroinflammation as a driver of disease progression.