Pharmacokinetics (PK) Study of Epinephrine Inhalation Aerosol in Healthy Volunteers

Phase 1

Completed

Conditions: Asthma

Interventions: Drug: epinephrine inhalation aerosol

Registration Number: NCT01143051

Lead Sponsor: Amphastar Pharmaceuticals, Inc.

Brief Summary: This study examines the pharmacokinetic profile of Armstrong's proposed Epinephrine Inhalation Aerosol USP, an HFA-MDI (E004), in healthy male and female adult volunteers. Safety of E004 will also be evaluated, under augmented dose conditions.

Detailed Description: This study is a randomized, evaluator-blind, single dose, three-arm, crossover, PK study, to be conducted in \~18 healthy, male and female, adult volunteers. PK will be studied at two dose strengths (Arm T1 and Arm T2). A currently marketed, non-labeled, Epinephrine CFC-MDI will be used as a Reference Control (Arm C).

* At the Screening Visit and the beginning of each Study Visit, each subject will be trained on the correct self-administration of MDI. The following three randomized treatments will be self-administered, at three Study Visits:

* Treatment T1: Ten (10) inhalations of the low dose E004(125 mcg/inhalation), totaling 1.25 mg of epinephrine;

* Treatment T2: Ten (10) inhalations of the high dose E004 (160 mcg/inhalation), totaling 1.60 mg of epinephrine;

* Treatment C: Ten (10) inhalations of Epinephrine CFC-MDI (220 mcg/inhalation, totaling 2.2 mg of epinephrine base equivalent).

* PK blood samples will be taken from a vein at scheduled time points.

* Safety parameters and adverse drug events, if any, will be monitored and documented at each study visit. An End-of-Study (EOS) safety evaluation will be conducted.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 24

Inclusion Criteria

Generally healthy, male and female adults, 18-30 yrs of age at Screening;
Having no clinically significant respiratory, cardiovascular and other systemic or organic illnesses, per investigator discretion;
Women of child-bearing potential must be non-pregnant, non-lactating, and practicing a clinically acceptable form of birth control;
Having properly consented and satisfied all other inclusion/exclusion criteria as required for this protocol.
Other criteria apply.

Exclusion Criteria

A recent or significant smoking history;
Use of prohibited drugs or failure to observe the drug washout restrictions;
Having been on other investigational drug/device studies in the last 30 days prior to Screening.
Other criteria apply

Study & Design

Study Type: INTERVENTIONAL

Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Treatment C	epinephrine inhalation aerosol	Active comparator arm utilizing marketed Primatene Mist with CFC propellant at the labeled dose.
Treatment 1	epinephrine inhalation aerosol	T1 is HFA propelled epinephrine inhalation aerosol 125 mcg/inhalation
Treatment 2	epinephrine inhalation aerosol	HFA propelled epinephrine inhalation aerosol, 160 mcg/inhalation

Primary Outcome Measures

Name	Time	Method
Baseline Concentration (C0) of Labeled Epinephrine Total Epinephrine	0 to 30 minutes prior to dosing	Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at Baseline (prior to dosing) in each treatment period following a specified washout period (3-14 days), and were analyzed using an established analysis method. Baseline concentration (C0) is the concentration of epinephrine measured in the plasma at this time point.
Area Under the Curve From Time Zero to 6 Hours Post-dose (AUC[0-6])	Pre-dose to 6 hours post-dose	Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at 0 (baseline), 5, 15, 30, 45, 60, 90, 120, 180, 240, and 360 minutes post-dose in each treatment period and were analyzed using an established analysis method. Area under the curve from time zero to 6 hours post-dose (AUC\[0-6\]) was calculated using the trapezoidal rule.
Peak Concentration (Cmax) for Total Epinephrine From Time Zero to 6 Hours Post-dose	Pre-dose to 6 hours post-dose	Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at 0 (baseline), 5, 15, 30, 45, 60, 90, 120, 180, 240, and 360 minutes post-dose in each treatment period and were analyzed using an established analysis method. Peak (maximum) concentration (Cmax) is the highest concentration of epinephrine measured in plasma during the treatment period.
Time to Reach Peak Concentration (Tmax) for Total Epinephrine	Pre-dose to 6 hours post-dose	Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at 0 (baseline), 5, 15, 30, 45, 60, 90, 120, 180, 240, and 360 minutes post-dose in each treatment period and were analyzed using an established analysis method. tmax is the amount of time it takes for epinephrine to reach peak concentration in plasma during the treatment period.
Half-life (t1/2) for Total Epinephrine	Pre-dose to 6 hours post-dose	Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at 0 (baseline), 5, 15, 30, 45, 60, 90, 120, 180, 240, and 360 minutes post-dose in each treatment period and were analyzed using an established analysis method. Half-life (t1/2) is the amount of time it takes for epinephrine decrease to half the peak concentration in plasma during the treatment period.
Concentration vs. Time for Total Epinephrine From Time Zero to 6 Hours Post-dose	Pre-dose to 6 hours post-dose	Patient PK blood samples were taken from a vein in a hand or arm via indwelling heparin-anticoagulated IV catheters, or by venipunctures at 0 (baseline), 5, 15, 30, 45, 60, 90, 120, 180, 240, and 360 minutes post-dose in each treatment period and were analyzed using an established analysis method.

Secondary Outcome Measures

Name	Time	Method
Vital Signs: Systolic Blood Pressure (SBP)	Pre-dose (baseline) to 360 minutes post-dose	Subject vital signs, i.e., blood pressure and heart rate, were measured prior to study drug dosing (baseline) and up to 360 minutes after dosing during the study visit.
Vital Signs: Diastolic Blood Pressure (DBP)	Pre-dose (baseline) to 360 minutes post-dose	Subject vital signs, i.e., blood pressure and heart rate, were measured prior to study drug dosing (baseline) and up to 360 minutes after dosing during the study visit.
Vital Signs: Heart Rate (HR)	Pre-dose (baseline) to 360 minutes post-dose	Subject vital signs, i.e., blood pressure and heart rate, were measured prior to study drug dosing (baseline) and up to 360 minutes after dosing during the study visit.
ECG: QT Interval	Pre-dose (baseline) to 360 minutes post-dose	Subject QT and QTc Intervals were recorded using a 12-Lead ECG prior to study drug dosing (baseline) and up to 360 minutes after dosing during the study visit.
ECG: QTc Interval	Pre-dose (baseline) to 360 minutes post-dose	Subject QT and QTc Intervals were recorded using a 12-Lead ECG prior to study drug dosing (baseline) and up to 360 minutes after dosing during the study visit.
Hand Tremor Scores	Pre-dose (baseline) to 360 minutes post-dose	Subjects evaluated hand tremor experiences using a scale from 0 to 3 (0: No tremor; 1: Mild, perceivable; 2: Moderate, observable; and 3: Severe, interfering with hand activities). Hand tremors were evaluated prior to study drug dosing (baseline) and up to 360 minutes post-dose.
Number of Subjects With Significant Changes in Physical Examination	Approximately 6 weeks	Physical examinations were performed as a part of Screening and End-of-Study (EOS) procedures. This outcome is a count of the number of subjects that showed a clinically significant change in the EOS physical examination compared to the Screening Visit.
Number of Subjects With Significant Changes in Laboratory Tests	Approximately 6 weeks	Laboratory tests (CBC, serum comprehensive metabolic panel, urinalysis, and urinary pregnancy test for women of childbearing potential) were performed as a part of Screening and End-of-Study (EOS) procedures. This outcome is a count of the number of subjects that showed a clinically significant change in the EOS laboratory tests compared to the Screening Visit.
Serum Glucose Levels	Pre-dose (baseline) to 360 minutes post-dose	Blood samples used to measure subject serum glucose and potassium levels were collected prior to study drug dosing (baseline) and up to 360 minutes post-dose.
Serum Potassium Levels	Pre-dose (baseline) to 360 minutes post-dose	Blood samples used to measure subject serum glucose and potassium levels were collected prior to study drug dosing (baseline) and up to 360 minutes post-dose.