Effects of BI 201335 NA on Cytochrome P450 and P-glycoprotein Activity Using a Probe Drug Cocktail in Healthy Volunteers
- Registration Number
- NCT02182336
- Lead Sponsor
- Boehringer Ingelheim
- Brief Summary
The objective of this trial was to quantify the effect of oral single-dose (480 mg) and steady-state BI 201335 NA (240 mg BID) on intestinal and hepatic cytochrome P450 (CYP) and P-glycoprotein (P-gp) probe drugs as a means of predicting drug interactions. The AUCs for the probe drugs caffeine, warfarin, omeprazole, dextromethorphan, midazolam, and digoxin were assessed.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 23
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Signed and dated written informed consent prior to admission to the study in accordance with GCP (Good Clinical Practice) and the local legislation
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Healthy males and female subjects age ≥18 to ≤55 years and according to the following criteria:
- Complete medical history, including the physical examination, vital signs (Blood Pressure (BP), Pulse Rate (PR)), 12-lead EKG (electrocardiogram)(including determination of QTcB, and QtcF intervals), and clinical laboratory tests; all with acceptable findings
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Weighing at least 50 kg, and BMI ≥18.5 and BMI ≤29.9 kg/m2 (Body Mass Index)
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Volunteers must not leave the research unit, during the days of over-night stays, which include the periods from evening of Day-1 to morning of Day 5, and evening of Day 9 to morning of Day 24
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Volunteers must be willing to complete all study-related activities
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Any finding of the medical examination (including blood pressure, pulse rate and EKG) deviating from normal and of clinical relevance, as assessed by the investigator
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Active diseases of the gastrointestinal, hepatic, renal, respiratory, cardiovascular, metabolic, musculoskeletal, immunologic, rheumatologic, hormonal, neurological system, cancer, or bleeding disorders that require current medical treatment, may be unstable, or may be exacerbated by participation in the study
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Any evidence of a clinically relevant concomitant disease, which is not defined in the exclusion criteria 2 above, including but not limited to relevant chronic or acute infection
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Surgery of the gastrointestinal tract (except appendectomy and endoscopic removal of colon polyps)
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History or presence of allergy to any of the study drugs (e.g., BI 201335 NA, caffeine, warfarin, vitamin K, omeprazole, dextromethorphan, digoxin, midazolam, omeprazole) or their components or drugs of their class, or a history of drug or other allergy that, in the opinion of the physician responsible, contraindicates their participation
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Concomitant drugs, nutraceuticals, and herbal remedies that in the opinion of the investigator (in consultation with the BI medical monitor or pharmacokineticist), would interfere with either the absorption, distribution or metabolism of BI 201335 NA, or other study drugs
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Use of drugs, which might reasonably influence the results of the trial or that prolong the QT/QTc interval within 30 days prior to screening until trial completion
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Use of any investigational drug within 30 days prior to enrollment; or the planned usage of any investigational drug during the course of the current study
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Smoking (>10 cigarettes or >3 cigars or >3 pipes/day)
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Inability to abstain from alcohol from day of screening to 7 days after last study drug administration.
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Drug abuse
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Blood donation (more than 100 mL within four weeks prior to administration or during the trial)
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Excessive physical activities (within one week prior to administration or during the trial
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Any laboratory value outside the reference range that is of clinical relevance at screening, according to the judgment of the investigator, and in consultation with the clinical monitor
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Known elevated liver enzymes in past with any compound (experimental or marketed)
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Concomitant administration of any food product known to alter P450 enzyme or P-gp activity such as grapefruit juice, Seville oranges, St. John's Wort
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Concomitant administration of any drug that could affect bleeding (e.g., aspirin, clopidogrel, ticlopidine, warfarin in addition to the studied warfarin dose, heparin, low-molecular weight heparin)
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Concomitant administration of oral contraceptives (may be included with 7-day washout period)
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Inadequate venous access
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Renal or hepatic insufficiency
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A marked baseline prolongation of QT/QTc interval e.g., repeated demonstration of a QTcF, or QTcB interval >450 ms)
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Infection with hepatitis B (HBV), or hepatitis C virus (HCV), defined as either being hepatitis B surface antigen and /or hepatitis B core antibody positive, or hepatitis C antibody positive)
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Positive Enzyme-linked immunosorbent assay (ELISA) for Human Immunodeficiency Virus (HIV)-1 or HIV-2
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Fasting screening laboratory testing with direct bilirubin within the normal range and elevated total bilirubin, defined as 30% above the upper limit of normal
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For female subjects:
- Pregnancy or planning to become pregnant within 2 months of study completion
- Positive pregnancy test at screening visit
- No adequate contraception, e.g., sterilisation, IUD (intrauterine device), have not been using a barrier method of contraception for at least 3 months prior to participation in the study
- Are not willing or are unable to use a reliable method of barrier contraception (such as diaphragm with spermicidal cream/jelly or condoms with spermicidal foam), during and up to 2 months after completion/termination of the trial
- Lactation period with active breastfeeding from time of screening to 30 days after end of trial visit
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- SINGLE_GROUP
- Arm && Interventions
Group Intervention Description BI 201335 NA Midazolam HCl oral syrup - BI 201335 NA BI 201335 NA - BI 201335 NA Omeprazole - BI 201335 NA Midazolam HCl solution - BI 201335 NA Vitamin K - BI 201335 NA Warfarin sodium - BI 201335 NA Caffeine - BI 201335 NA Dextromethorphan hydrobromide - BI 201335 NA Digoxin -
- Primary Outcome Measures
Name Time Method Area under the curve (AUC) 0-24h of caffeine Pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 16, 24 hours after treatment on days 1, 10 and 19 AUC0-24h of Midazolam IV Pre-dose and 0.08, 0.5, 1, 2, 3, 4, 6, 8, 12, 24 hours after treatment on days 3 and 21 AUC0-120h of Warfarin Pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 16, 24, 48 hours after treatment on days 1, 10 and 19 AUC0-24h of Omeprazole Pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 16, 24 hours after treatment on days 1, 10 and 19 AUC0-24h of Midazolam oral Pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 16, 24 hours after treatment on days 1, 10 and 19 AUC0-96h of Digoxin Pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48, 72, 96 hours after treatment on days 2 and 20 AUC0-24h of Dextromethorphan Pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 16, 24 hours after treatment on days 1, 10 and 19
- Secondary Outcome Measures
Name Time Method Urinary metabolic ratios of the analyte of first-day and steady state up to day 19 Ct of Omeprazole Baseline and day 1, day 1 and day 19 tmax of Omeprazole Baseline and day 1, day 1 and day 19 CL/F of Omeprazole Baseline and day 1, day 1 and day 19 Cmin,ss,N of BI 201335 NA Day 19 tmax,N of BI 201335 NA Day 10 tmax,ss,N of BI 201335 NA Day 19 AUC of Midazolam oral Baseline and day 1, baseline and day 19 Ct of Midazolam oral Baseline and day 1, baseline and day 19 tmax (Time of Maximum Concentration after a single dose) of caffeine Baseline and day 1, baseline and day 19 t1/2 (Apparent Terminal Half-Life) of caffeine Baseline and day 1, baseline and day 19 AUC of caffeine Baseline and day 1, day 1 and day 19 Cmax of Warfarin Baseline and day 1, day 1 and day 19 CL/F of Warfarin Baseline and day 1, day 1 and day 19 CL/F of Midazolam IV Baseline and day 1, day 1 and day 19 Cmax (Maximum Plasma Concentration after a single dose) of caffeine Baseline and day 1, baseline and day 19 AUC of Warfarin Baseline and day 1, day 1 and day 19 t1/2 of Warfarin Baseline and day 1, day 1 and day 19 Cmax of Omeprazole Baseline and day 1, day 1 and day 19 Ct (Plasma concentration at a given time t after a single dose) of caffeine Baseline and day 1, baseline and day 19 CL/F (Oral Clearance after a single dose) of caffeine Baseline and day1, baseline and day 19 Ct of Warfarin Baseline and day 1, day 1 and day 19 tmax of Warfarin Baseline and day 1, day 1 and day 19 AUC of Omeprazole Baseline and day 1, day 1 and day 19 t1/2 of Omeprazole Baseline and day 1, day 1 and day 19 AUC of Dextromethorphan Baseline and day 1, day 1 and day 19 Cmax,N of BI 201335 NA Day 10 Cmin,N of BI 201335 NA Day 10 t1/2 of Midazolam IV Baseline and day 1, day 1 and day 19 Cmax of Dextromethorphan Baseline and day 1, day 1 and day 19 Ct of Dextromethorphan Baseline and day 1, day 1 and day 19 Ct of Midazolam IV Baseline and day 1, day 1 and day 19 tmax of Digoxin Baseline and day 1, baseline and day 19 t1/2 of Digoxin Baseline and day 1, baseline and day 19 tmax of Midazolam IV Baseline and day 1, day 1 and day 19 Ct of Digoxin Baseline and day 1, baseline and day 19 CL/F of Digoxin Baseline and day 1, baseline and day 19 AUCτ,ss,N of BI201335 NA Day 19 tmax of Dextromethorphan Baseline and day 1, day 1 and day 19 AUC of Midazolam IV Baseline and day 1, day 1 and day 19 CL/F of Midazolam oral Baseline and day 1, baseline and day 19 t1/2 of Midazolam oral Baseline and day 1, baseline and day 19 Cmax of Digoxin Baseline and day 1, baseline and day 19 AUCτ,N (Uniform Dosing Interval τ Following the Nth Dose) of BI201335 NA Day 10 CL/F of Dextromethorphan Baseline and day 1, day 1 and day 19 t1/2 of Dextromethorphan Baseline and day 1, day 1 and day 19 Cmax of Midazolam IV Baseline and day 1, day 1 and day 19 Cmax of Midazolam oral Baseline and day 1, baseline and day 19 tmax of Midazolam oral Baseline and day 1, baseline and day 19 AUC of Digoxin Baseline and day 1, baseline and day 19 Cmax,ss,N of BI 201335 NA Day 19 CL/F,ss,N of BI 201335 NA Day 19