A Phase 1, 2-Part, Open-Label, Randomized, Crossover Pilot Trial to Assess the Relative Bioavailability of Quetiapine Versus Seroquel® 300-mg Oral Tablets in Subjects With Schizophrenia or Bipolar Disorder and 25-mg Oral Tablets in Healthy Subjects
试验速览
- 阶段
- 1 期
- 状态
- 已完成
- 入组人数
- 58
- 试验地点
- 1
- 主要终点
- Part B: Area Under the Concentration-Time Curve from Time Zero to Infinity (AUC∞) for Quetiapine
研究概览
简要总结
This is a two-part trial.
The primary objective of Part A is to estimate the ratio of geometric means of pharmacokinetic (PK) parameters and their within-subject variability for the 300mg quetiapine tablet formulation A and the 300mg quetiapine tablet formulation B compared to 300mg Seroquel.
The primary objective of Part B is to estimate the ratio of geometric means of PK parameters and their within-subject variability for the selected tablet formulation from Part A of 25mg quetiapine compared to 25mg Seroquel.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Basic Science
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 45 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Must have a current diagnosis of schizophrenia or bipolar disorder, as determined by the Diagnostic and Statistical Manual of Mental Disorders Version 5 (DSM-5) criteria.
- •Must have a Body Mass Index between 18 and 35 kg/m^
- •Good physical health as determined by no clinically significant deviation from normal, in the opinion of the investigator, in medical history, clinical laboratory determination, ECGs, or physical examinations.
- •Participants must be considered stable, per the investigator's judgment, on one of the following atypical oral antipsychotic medications at an adequate dose (eg, low- to mid-range of the recommended dose range for the treatment of schizophrenia or bipolar disorder, according to the manufacturer labeling) and for an adequate duration (30 days) prior to the administration of IMP: aripiprazole, brexpiprazole, risperidone, olanzapine, quetiapine, ziprasidone, paliperidone, cariprazine, lurasidone, and asenapine. Other oral antipsychotic medications may be allowed if approved by the medical monitor and sponsor; however, clozapine will not be allowed. Per the investigator's judgment, they should be comfortable with the participant discontinuing background antipsychotic therapy during the trial period and then restarting the antipsychotic therapy once trial participation has been completed.
- •Male or female participants between 18 and 45 years of age, inclusive.
- •Must have a Body Mass Index between 18 and 32 kg/m^
- •Good physical health as determined by no clinically significant deviation from normal, in the opinion of the investigator, in medical history, clinical laboratory determination, ECGs, or physical examinations.
- •Able to provide informed consent prior to the initiation of any protocol-related procedures.
- •Male and female participants who are surgically sterile, female participants who have been postmenopausal for at least 12 consecutive months prior to the screening visit, or male participants/female participants (of childbearing potential) who agree to practice 2 of the approved birth control methods from the screening visit and for at least 30 days after the last dose of IMP for a female participant or 80 days after the last dose of IMP for a male participant.
排除标准
- •Participants who are unable to stop receiving varenicline beyond the screening visit. If a participant is receiving varenicline at the screening visit, attempts should be made to discontinue the medication, if clinically feasible, to allow potential participants to enter the trial.
- •Participants who have a significant risk of committing suicide based on history, routine psychiatric status examination, investigator's judgment, or who have an answer of "yes" on questions 4 or 5 (current or over the last 3 months) on the Baseline/Screening Version of the C-SSRS or participants with any suicidal behavior during the 6 months prior to the screening visit.
- •Participants currently in an acute relapse of schizophrenia as assessed by the investigator. Bipolar participants who currently have an unstable mood (manic, mixed, or depressed) as assessed by the investigator.
- •Participants with a current DSM-5 diagnosis other than schizophrenia or bipolar disorder, including schizoaffective disorder, major depressive disorder, delirium, dementia, amnestic, or other cognitive disorders. Also, participants with borderline, paranoid, histrionic, schizotypal, schizoid, or antisocial personality disorder.
- •Use of any moderate-strong CYP3A4 inhibitor or inducer within 14 days or 5 plasma half-lives (whichever is longer) prior to the administration of IMP and for the duration of the trial. Weak CYP3A4 inhibitors, including valproic acid, may be allowed based on the investigator's judgment, provided the participant has been on a stable dose for at least 30 days prior to IMP administration and throughout the duration of the trial.
- •Participants with a history of neuroleptic malignant syndrome, seizure disorder, or clinically significant tardive dyskinesia as assessed by the investigator.
- •Subjects with a history of any significant drug allergy or known or suspected hypersensitivity to antipsychotics, in particular to quetiapine.
- •Participants who are maintained on long-acting insulin.
- •Any participant who does not successfully tolerate a quetiapine dose of 300 mg BID during the titration period of this trial.
- •History of any significant drug allergy to quetiapine, prescription drugs, non-prescription drugs, or food.
- •Any history of significant bleeding or hemorrhagic tendencies.
- •Exposure to any substances known to stimulate hepatic microsomal enzymes within 30 days prior to screening through the end of the trial (eg, occupational exposure to pesticides, organic solvents, etc).
- •Participants who have supine blood pressure after resting for ≥ 5 minutes, higher than 130/80 mmHg or lower than 100/50 mmHg (systolic/diastolic). The sponsor may allow exceptions if they are not deemed clinically significant.
- •Participants who have a supine pulse rate, after resting for ≥ 5 minutes, outside the range of 60 to 90 beats per minute. The sponsor may allow exceptions if they are not deemed clinically significant (eg, bradycardia attributable to superior physical fitness).
- •History of serious mental disorders that, in the opinion of the investigator, would exclude the participant from participating in this trial.
- •Use of any CYP3A4 inhibitors or CYP3A4 inducers within 14 days or 5 plasma half-lives (whichever is longer) prior to the administration of IMP and for the duration of the trial.
研究组 & 干预措施
Part A: Sequence 1
Titration Period:
All participants will complete the titration period to establish tolerability. Depending on exposure prior to the trial, participants will titrate up to and including a dose of 300mg twice a day (BID) prior to randomization.
Treatment Period:
Participants will receive Seroquel IR (tablet, orally, 300mg, BID) on Days 1-5, Quetiapine Formulation A (tablet, orally, 300mg, BID) on Days 6-10 and Quetiapine Formulation B (tablet, orally, 300mg, BID) on Days 11-15.
干预措施: Seroquel IR 300mg (Drug)
Part A: Sequence 1
Titration Period:
All participants will complete the titration period to establish tolerability. Depending on exposure prior to the trial, participants will titrate up to and including a dose of 300mg twice a day (BID) prior to randomization.
Treatment Period:
Participants will receive Seroquel IR (tablet, orally, 300mg, BID) on Days 1-5, Quetiapine Formulation A (tablet, orally, 300mg, BID) on Days 6-10 and Quetiapine Formulation B (tablet, orally, 300mg, BID) on Days 11-15.
干预措施: Quetiapine Formulation A 300mg (Drug)
Part A: Sequence 1
Titration Period:
All participants will complete the titration period to establish tolerability. Depending on exposure prior to the trial, participants will titrate up to and including a dose of 300mg twice a day (BID) prior to randomization.
Treatment Period:
Participants will receive Seroquel IR (tablet, orally, 300mg, BID) on Days 1-5, Quetiapine Formulation A (tablet, orally, 300mg, BID) on Days 6-10 and Quetiapine Formulation B (tablet, orally, 300mg, BID) on Days 11-15.
干预措施: Quetiapine Formulation B 300mg (Drug)
Part A: Sequence 2
Titration Period:
All participants will complete the titration period to establish tolerability. Depending on exposure prior to the trial, participants will titrate up to and including a dose of 300mg BID prior to randomization.
Treatment Period:
Participants will receive Quetiapine Formulation A (tablet, orally, 300mg, BID) on Days 1-5, Quetiapine Formulation B (tablet, orally, 300mg, BID) on Days 6-10 and Seroquel IR (tablet, orally, 300mg, BID) on Days 11-15.
干预措施: Seroquel IR 300mg (Drug)
Part A: Sequence 2
Titration Period:
All participants will complete the titration period to establish tolerability. Depending on exposure prior to the trial, participants will titrate up to and including a dose of 300mg BID prior to randomization.
Treatment Period:
Participants will receive Quetiapine Formulation A (tablet, orally, 300mg, BID) on Days 1-5, Quetiapine Formulation B (tablet, orally, 300mg, BID) on Days 6-10 and Seroquel IR (tablet, orally, 300mg, BID) on Days 11-15.
干预措施: Quetiapine Formulation A 300mg (Drug)
Part A: Sequence 2
Titration Period:
All participants will complete the titration period to establish tolerability. Depending on exposure prior to the trial, participants will titrate up to and including a dose of 300mg BID prior to randomization.
Treatment Period:
Participants will receive Quetiapine Formulation A (tablet, orally, 300mg, BID) on Days 1-5, Quetiapine Formulation B (tablet, orally, 300mg, BID) on Days 6-10 and Seroquel IR (tablet, orally, 300mg, BID) on Days 11-15.
干预措施: Quetiapine Formulation B 300mg (Drug)
Part A: Sequence 3
Titration Period:
All participants will complete the titration period to establish tolerability. Depending on exposure prior to the trial, participants will titrate up to and including a dose of 300mg BID prior to randomization.
Treatment Period:
Participants will receive Quetiapine Formulation B (tablet, orally, 300mg, BID) on Days 1-5, Seroquel IR (tablet, orally, 300mg, BID) on Days 6-10 and Quetiapine Formulation A (tablet, orally, 300mg, BID) on Days 11-15.
干预措施: Seroquel IR 300mg (Drug)
Part A: Sequence 3
Titration Period:
All participants will complete the titration period to establish tolerability. Depending on exposure prior to the trial, participants will titrate up to and including a dose of 300mg BID prior to randomization.
Treatment Period:
Participants will receive Quetiapine Formulation B (tablet, orally, 300mg, BID) on Days 1-5, Seroquel IR (tablet, orally, 300mg, BID) on Days 6-10 and Quetiapine Formulation A (tablet, orally, 300mg, BID) on Days 11-15.
干预措施: Quetiapine Formulation A 300mg (Drug)
Part A: Sequence 3
Titration Period:
All participants will complete the titration period to establish tolerability. Depending on exposure prior to the trial, participants will titrate up to and including a dose of 300mg BID prior to randomization.
Treatment Period:
Participants will receive Quetiapine Formulation B (tablet, orally, 300mg, BID) on Days 1-5, Seroquel IR (tablet, orally, 300mg, BID) on Days 6-10 and Quetiapine Formulation A (tablet, orally, 300mg, BID) on Days 11-15.
干预措施: Quetiapine Formulation B 300mg (Drug)
Part B: Sequence 1
Participants will receive Seroquel IR (tablet, orally, 25mg) on Day 1 and Quetiapine formulation established in Part A (tablet, orally, 25mg) on Day 4.
干预措施: Seroquel IR 25mg (Drug)
Part B: Sequence 1
Participants will receive Seroquel IR (tablet, orally, 25mg) on Day 1 and Quetiapine formulation established in Part A (tablet, orally, 25mg) on Day 4.
干预措施: Quetiapine Formulation 25mg (Drug)
Part B: Sequence 2
Participants will receive Quetiapine formulation established in Part A (tablet, orally, 25mg) on Day 1 and Seroquel IR (tablet, orally, 25mg) on Day 4.
干预措施: Seroquel IR 25mg (Drug)
Part B: Sequence 2
Participants will receive Quetiapine formulation established in Part A (tablet, orally, 25mg) on Day 1 and Seroquel IR (tablet, orally, 25mg) on Day 4.
干预措施: Quetiapine Formulation 25mg (Drug)
结局指标
主要结局
Part B: Area Under the Concentration-Time Curve from Time Zero to Infinity (AUC∞) for Quetiapine
时间窗: Predose (within 30 minutes prior to dosing), 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 4, 6, 8, 10, 12 (Days 1 to 4), 24, 36 (Days 2 and 5), and 48 (Days 3 and 6) hours post dose
Part A: Area Under the Concentration-Time Curve Calculated to the Last Observable Concentration at Time t (AUCt) for Quetiapine
时间窗: Pre-dose on days 4, 9 and 14, 12 hours post morning dose on Days 4, 9 and 14 and pre-dose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.25, 3, 4, 6, 8, 10 and 12 hours post morning dose on days 5, 10 and 15
Pharmacokinetic endpoint analysis will be done separately for formulation A and formulation B.
Part B: Area Under the Concentration-Time Curve Calculated to the Last Observable Concentration at Time t (AUCt) for Quetiapine
时间窗: Predose (within 30 minutes prior to dosing), 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 4, 6, 8, 10, 12 (Days 1 to 4), 24, 36 (Days 2 and 5), and 48 (Days 3 and 6) hours post dose
Part A: Maximum Observed Plasma Concentration (Cmax) for Quetiapine
时间窗: Pre-dose on days 4, 9 and 14, 12 hours post morning dose on Days 4, 9 and 14 and pre-dose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.25, 3, 4, 6, 8, 10 and 12 hours post morning dose on days 5, 10 and 15
Pharmacokinetic endpoint analysis will be done separately for formulation A and formulation B.
Part B: Maximum Observed Plasma Concentration (Cmax) for Quetiapine
时间窗: Predose (within 30 minutes prior to dosing), 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 4, 6, 8, 10, 12 (Days 1 to 4), 24, 36 (Days 2 and 5), and 48 (Days 3 and 6) hours post dose
次要结局
- Part A: Percentage of Participants who Experience a Clinically Significant Change from Baseline in Vital Signs(Baseline (Day -1) to Day 11)
- Part B: Terminal-Phase Elimination Half-Life (t1/2,z) for Quetiapine(Predose (within 30 minutes prior to dosing), 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 4, 6, 8, 10, 12 (Days 1 to 4), 24, 36 (Days 2 and 5), and 48 (Days 3 and 6) hours post dose)
- Part A: Terminal-Phase Elimination Half-Life (t1/2,z) for Quetiapine(Pre-dose on days 4, 9 and 14, 12 hours post morning dose on Days 4, 9 and 14 and pre-dose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.25, 3, 4, 6, 8, 10 and 12 hours post morning dose on days 5, 10 and 15)
- Part A: Apparent Clearance of Drug from Plasma After Extravascular Administration (CL/F) for Quetiapine(Pre-dose on days 4, 9 and 14, 12 hours post morning dose on Days 4, 9 and 14 and pre-dose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.25, 3, 4, 6, 8, 10 and 12 hours post morning dose on days 5, 10 and 15)
- Part B: Time to Maximum (Peak) Plasma Concentration (tmax) for Quetiapine(Predose (within 30 minutes prior to dosing), 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 4, 6, 8, 10, 12 (Days 1 to 4), 24, 36 (Days 2 and 5), and 48 (Days 3 and 6) hours post dose)
- Part B: Percentage of Participants who Experience a Significant Change from Baseline in ECGs(Baseline (Day -1) to Day 6)
- Part B: Percentage of Participants who Experience a Significant Change from Baseline in Clinical Laboratory Tests(Baseline (Day -1) to Day 6)
- Part A: Percentage of Participants who Experience at Least One Treatment-Emergent Adverse Event(Day 1 to End of Follow-Up (Day 45[+/- 2 days]))
- Part A: Percentage of Participants who Experience a Significant Change from Baseline in ECGs(Baseline (Day -1) to Day 11)
- Part A: Change from Baseline in Columbia-Suicide Severity Rating Scale Score(Baseline (Day -1) and Day 15)
- Part B: Apparent Clearance of Drug from Plasma After Extravascular Administration (CL/F) for Quetiapine(Predose (within 30 minutes prior to dosing), 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.5, 3, 4, 6, 8, 10, 12 (Days 1 to 4), 24, 36 (Days 2 and 5), and 48 (Days 3 and 6) hours post dose)
- Part B: Percentage of Participants who Experience a Clinically Significant Change from Baseline in Vital Signs(Baseline (Day -1) to Day 6)
- Part A: Time to Maximum (Peak) Plasma Concentration (tmax) for Quetiapine(Pre-dose on days 4, 9 and 14, 12 hours post morning dose on Days 4, 9 and 14 and pre-dose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 1.75, 2, 2.25, 3, 4, 6, 8, 10 and 12 hours post morning dose on days 5, 10 and 15)
- Part B: Percentage of Participants who Experience at Least One Treatment-Emergent Adverse Event(Day 1 to End of Follow-Up (Day 34 [+ 2 Days]))
- Part A: Percentage of Participants who Experience a Significant Change from Baseline in Clinical Laboratory Tests(Baseline (Day -1) to Day 15)
- Part B: Change from Baseline in Columbia-Suicide Severity Rating Scale Score(Baseline (Day -1) and Day 6)