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Evaluation of Safety and Pharmacokinetics of Oral Controlled-ileal-release Nicotinic Acid (CIR-NA) Compared to Immediate-release Nicotinic Acid and Placebo in Healthy Subjects and Subjects With Prediabetes

Phase 1
Completed
Conditions
Safety Issues
Pharmacokinetic
Interventions
Drug: controlled-ileal-release nicotinic acid (SAD/ MAD/MD) single- and multiple-ascending dose (SAD/MAD) or multiple dose (MD)
Drug: immediate-release nicotinic acid (SAD)
Drug: Placebo controlled-ileal-release nicotinic acid (SAD/MAD)
Drug: Placebo immediate-release nicotinic acid (SAD)
Registration Number
NCT06378125
Lead Sponsor
University Hospital Schleswig-Holstein
Brief Summary

A double-blind, randomised, placebo-controlled, single-ascending and multiple-ascending dose trial to evaluate the safety and pharmacokinetics of oral controlled-ileal-release nicotinic acid (CIR-NA) compared to immediate-release nicotinic acid and placebo in healthy subjects and subjects with prediabetes.

Detailed Description

Recently, administration of one form of vitamin B3, Nicotinamide (NAM), has been shown to improve the host-microbiome interaction in a mouse model, especially when administered in a controlled-release formulation targeting the ileocolic region. Thus, NAM and also the other form of vitamin B3, Nicotinicacid (NA), were identified as promising candidates for a gut-targeted microbiome intervention.

As the upper gastrointestinal tract efficiently absorbs amino acids and vitamins, simply increasing the NA and/or NAM content in human food would not be expected to deliver these molecules in sufficient amounts into the lower ileum and colon, where most of the microbiota are located. Moreover, adverse effects such as flushing or gastrointestinal symptoms can occur under high and immediately systemically available dosage of NA. Therefore, the novel CIR-NA formulation will be applied to deliver NA to the lower ileum and colon to tar-get the gut microbiome, while largely avoiding systemic exposure, as the terminal ileum and colon have a much lower absorptive capacity than the stomach and upper small intestine.

Both in the single- and multiple-ascending (SAD/MAD) part of the study, CIR-NA or placebo tablets will be self-administered orally, with daily doses of 100 mg (1 tablet), 200 mg (2 tablets), 500 mg (5 tablets) or 1,000 mg CIR-NA (10 tablets) or the corresponding amounts of placebo tablets. In the SAD part, an additional dose of 2,000 mg CIR-NA or placebo (20 tablets) will be self-administered.After completion of the SAD and the 200 mg MAD part in healthy subjects, an additional mul-tiple dose part (200 mg/d CIR-NA) in subjects with PreD (MD-PreD part) will start in parallel to the further dose groups of the MAD part.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
60
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SEQUENTIAL
Arm && Interventions
GroupInterventionDescription
healthy subjects healthy subjectsimmediate-release nicotinic acid (SAD)single-ascending and multipleascending doses (SAD/MAD)
healthy subjects healthy subjectsPlacebo controlled-ileal-release nicotinic acid (SAD/MAD)single-ascending and multipleascending doses (SAD/MAD)
healthy subjects healthy subjectsPlacebo immediate-release nicotinic acid (SAD)single-ascending and multipleascending doses (SAD/MAD)
subjects with prediabetescontrolled-ileal-release nicotinic acid (SAD/ MAD/MD) single- and multiple-ascending dose (SAD/MAD) or multiple dose (MD)multiple dose (MD)
healthy subjects healthy subjectscontrolled-ileal-release nicotinic acid (SAD/ MAD/MD) single- and multiple-ascending dose (SAD/MAD) or multiple dose (MD)single-ascending and multipleascending doses (SAD/MAD)
Primary Outcome Measures
NameTimeMethod
Treatment-Emergent Adverse Events [Safety and Tolerability]up to 60 days

Adverse Events (AEs) during treatment period

Treatment-Emergent Serious Adverse Events [Safety and Tolerability]up to 60 days

Serious Adverse Events (SAEs) during treatment period

Haemoglobinup to 60 days

Haemoglobin (Hb) in %

White blood cellsup to 60 days

White blood cell (WBC) count as x10\^9/l

Blood creatinineup to 60 days

Blood Creatinine in mmol/L

Blood ureaup to 60 days

Urea in mmol/L

Blood uric acidup to 60 days

Uric acid in mmol/L

Glomerular filtration rateup to 60 days

Glomerular filtration rate (GFR, automatically calculated by the laboratory based on creatinine values) GFR in ml/min/1.73m2

Blood ALTup to 60 days

Alanine transaminase (ALT) in U/l

Blood ASTup to 60 days

Aspartate transaminase (AST) in U/l

Blood GGTup to 60 days

Gamma glutamyl transferase (GGT) in U/l

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

University Medical Center Schleswig-Holstein, Campus Kiel

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Kiel, Schleswig-Holstein, Germany

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