The Effect Of NS-0200 and NS-0300 Versus Placebo on Weight In Obesity

Inclusion Criteria

• Age ≥18 and ≤65 at study entry.
• Is male, or female and, if female, meets all of the following criteria:
• Not breastfeeding
• Post-menopausal or negative serum pregnancy test result (human chorionic gonadotropin, beta subunit [β-hCG]) at Screening/Visit 1 (Day-7/Week-1) (not required for hysterectomized females)
• If of childbearing potential (including peri-menopausal women who have had a menstrual period within one year) must practice and be willing to continue to practice appropriate birth control (defined as a method which results in a low failure rate, i.e., less than 1% per year, when used consistently and correctly, such as double barrier methods [male condom with spermicide, with or without cervical cap or diaphragm], implants, injectables, oral contraceptives [must have been using for at least the last 3 months], some intrauterine contraceptive devices, tubal ligation, or in an established relationship with a vasectomized or same sex partner) during the entire duration of the study
• Stable body weight (±5%) and health over the last 3 months.
• Has a BMI between 30 kg/m2 and 45 kg/m2
• Stable diet within the last three months
• Subjects on antidepressants, excluding those listed in the exclusion criteria, must have been on a stable dose regiment for at least 3 months prior to study enrollment and maintain stable dose during the study
• Clinical laboratory tests (hematology, clinical chemistry, and urinalysis) either normal, not clinically significant or with abnormalities consistent with obesity
• Is able to read, understand, and sign the informed consent forms (ICF) and, when applicable, an authorization to use and disclose protected health information form (consistent with Health Insurance Portability and Accountability Act of 1996 [HIPAA] legislation), communicate with the investigator, and understand and comply with protocol requirements.

Exclusion Criteria

• Diagnosis of diabetes or on a diabetes medication
• HbA1c ≥6.5% at Screening/Visit 1 (Day-7/Week-1)
• Severe renal impairment (eGFR 25mmol/L computed without K.

Normal is 8- 16, but acidosis is >25

• Use of any of the following medications in the eight weeks prior to entering screening for study participation and during the study:
• Use of any anti-diabetes medication including metformin and any combination drug that contains metformin
• Sildenafil
• Tadalafil
• Vardenafil
• OCT2/MATE inhibitors (e.g. cimetidine, quinidine, and pyrimethamine)
• Riociguat (guanylate cyclase stimulant)
• Alpha blockers
• Nitrates (e.g. oral nitrates, sublingual nitroglycerine and nitroglycerine patches)
• Potent CYP3A4 inhibitors (e.g. clarithromycin, telithromycin, nefazodone, itraconazole, ketoconazole, atazanavir, darunavir, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir, tipranavir)
• All antihypertensive medications
• Medications associated with weight changes
• Drugs approved for the treatment of obesity
• Cypropheptadine or medroxyprogesterone
• Atypical anti-psychotic drugs
• Tricyclic antidepressants
• Lithium, MAO's, glucocorticoids
• SSRI's or SNRI's
• Antiepileptic drugs
• Systemic corticosteroids
• Stimulants e.g. amphetamines
• Any dietary supplement that is labeled for weight management or maintenance of healthy weight
• Diagnosis or evidence of eating disorders
• ≥ 5% weight change in the last 3 months
• Subjects who have had bariatric surgery
• An infection requiring antibiotic treatment within the last 30 days
• Any chronic inflammatory disease, e.g. inflammatory bowel disease rheumatoid arthritis, vasculitis, systemic lupus erythematosus
• Diseases interfering with metabolism (including metabolism of branched chain amino acids) and/or ingestive behavior (myxedema, Cushing's disease, diabetes, schizophrenia, major psychoses, maple syrup urine disease, unmanaged depression etc.)
• History of alcohol abuse (defined ≥ 21 drinks per week for males and > 14 drinks per week for females),