- Conference Article
- 10.1183/13993003.congress-2025.pa4085
Late Breaking Abstract - Results from a phase 1, randomized, double-blind, single and multiple ascending oral dose study characterizing the PK, safety, and target engagement of the Rho kinase 1 and 2 inhibitor ROC-101 in healthy volunteers
- Sep 27, 2025
- Marc Humbert + 7 more +7
Rho kinase (ROCK) dysfunction in pulmonary artery hypertension (PAH) and Interstitial lung disease-pulmonary hypertension (ILD-PH) contributes to the pathogenesis of these highly morbid and ultimately fatal diseases. ROC-101 is the first orally administered ROCK1&2 inhibitor to be considered for treatment of PAH and ILD-PH. In this 2-part, first-in-human study, ROC-101 (up to 40 mg QD) was administered to healthy volunteers in single (Part A, N=62) and multiple (Part B, N=30) ascending doses to assess safety, tolerability, PK, PD, and biomarkers. PK was characterized by dose-proportional increases in C<sub>max</sub> and AUC. Target exposures were achieved due to rapid absorption (T<sub>max</sub>, 1-3 h) and a t<sub>1/2</sub> of 12-14 hours. PD data demonstrated clinically meaningful ROCK1&2 inhibition and suppression of inflammatory cytokines (IL-17α, IFN-γ). ROC-101 was safe and well tolerated, as evidenced by absence of hypotension at any dose and the absence of SAEs or discontinuations. The most common TEAEs were headache and constipation (4%-5%). Clinically significant QTcF increases were not observed for single doses. The ROCK1&2 inhibitor fasudil has been approved for >30 years in Japan and China for the treatment of cerebral vasospasm and has been evaluated in several studies for the treatment of PH. The top dose of ROC-101 yielded exposures up to 25-fold higher than fasudil exposures in a historically successful investigator-initiated PH trial. Together, these data support initiation of a phase 2, proof-of-concept study in patients who have PAH or ILD-PH.
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