Aardvark Therapeutics has paused enrollment and dosing in its Phase III HERO trial and open-label extension study of ARD-101 in Prader-Willi syndrome (PWS) after observing cardiac signals in a separate healthy volunteer study. The company said the findings—reversible increases in QRS duration—prompted a comprehensive data review and discussions with the US FDA, with further guidance expected in Q2 2026.
The signal emerged in a cardiac safety study conducted in healthy volunteers at doses up to 1,600 mg twice daily, above the 800 mg twice daily target dose used in HERO. At the higher dose, two of eight participants showed QRS increases greater than 25% from baseline. At 800 mg twice daily, one of 23 participants exceeded this threshold. All events were non-serious, asymptomatic, and resolved after discontinuation. Aardvark said exposure-response analysis indicates higher plasma concentrations are associated with increased QRS risk, while lower doses appear to remain below this threshold.
The HERO trial uses a stepwise dose-escalation regimen beginning at 200 mg twice daily before reaching the 800 mg target dose, though no data have been disclosed on whether this mitigates cardiac risk. No efficacy data from the Phase III study have been reported.
ARD-101 is a bitter taste receptor (TAS2R) agonist designed to modulate gut-brain signaling pathways involved in appetite regulation. In previously reported Phase II obesity data, the drug reduced self-reported hunger and increased satiety hormones including peptide YY and GLP-1.
Aardvark also paused studies of ARD-201, a combination of ARD-101 with a DPP-4 inhibitor, in obesity. The company said it will provide updates on both programs following its ongoing review.
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