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PREA, PK And Safety PASS Study Of IV Pantoprazole In Pediatric Subjects

Phase 4
Terminated
Conditions
Gastroesophageal Reflux Disease
Interventions
Registration Number
NCT02401035
Lead Sponsor
Pfizer
Brief Summary

The purpose of this study is to characterize the pharmacokinetics (PK) and safety of intravenous (IV) pantoprazole in patients 1 to 16 years old who are candidates for acid suppression therapy.

Detailed Description

In hospitalized pediatric subjects, age 1 to 16 years who in the judgment of the investigator are candidates for acid suppression therapy, the following are the objectives of this trial:

Primary Objectives To characterize the PK of single and multiple IV doses of pantoprazole in pediatric subjects aged 1 to less than 2 years old.

To characterize the PK of single and multiple IV doses of pantoprazole in pediatric subjects aged 2 to 16 years old.

Secondary Objectives To determine the safety, tolerability, and PK of single and multiple IV doses of pantoprazole in each of the independent age cohorts.

To assess the CYP2C19 genotype in pediatric subjects receiving IV pantoprazole, to determine the presence of the gene for the major enzyme responsible for metabolism of pantoprazole.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
19
Inclusion Criteria
  • Subjects aged 1 to 16 years who in the judgment of the investigator are candidates for gastric acid suppression therapy (ie, those with a presumptive diagnosis of GERD, a clinical diagnosis of suspected GERD, symptomatic GERD, or endoscopically proven GERD) and whom the investigator judges would need to receive IV PPI therapy for at least 4 days.
  • Body weight > 5th percentile for age.
  • Y-site or dedicated IV line for administration of pantoprazole sodium.
  • Expected survival for at least 30 days.
  • Fertile male and female subjects of childbearing potential at risk for pregnancy must agree to use a highly effective method of contraception throughout the study and for at least 28 days after the last dose of assigned treatment. Female subjects of non-childbearing potential must be premenarchal, have undergone hysterectomy with bilateral oophorectomy, have medically confirmed ovarian failure, or achieved post-menopausal status.
Exclusion Criteria
  • Participation in other studies involving investigational drug(s) or treatment with an investigational drug within 30 days or 5 half lives prior to study entry and/or during study participation.
  • Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the subject inappropriate for entry into this study.
  • Pregnant females; breastfeeding females; fertile male subjects, and female subjects of childbearing potential who are unwilling or unable to use a highly effective method of contraception for the duration of the study and for at least 28 days after last dose of investigational product.
  • Serum CK levels >3x ULN.
  • Known history of HIV or clinical manifestations of AIDS.
  • Known hypersensitivity to PPIs or to any substituted benzimidazole or to any of the excipients.
  • History of treatment with any PPI within 2 days (48 hours) before investigational product dosing on Day 1.
  • Use of H2RAs, sucralfate, misoprostol, or prokinetic agents, and bismuth preparations within 1 day (24 hours) before investigational product dosing on Day 1.
  • Any disorder requiring chronic (every day) use of warfarin, carbamazepine, or phenytoin, methotrexate, atazanavir or nelfinavir, clopidogrel, and potent inhibitors and inducers of CYP2C19.
  • Chronic (daily) use of glucocorticoids. Steroid inhalers and topical steroids may be used.
  • Active malignancy of any type, or history of a malignancy (Subject with a history of malignancies that have been surgically removed or eradicated by irradiation or chemotherapy and who have no evidence of recurrence for at least 5 years before Screening are acceptable).
  • ALT or BUN >2.0 ULN or estimated creatinine >1.5 X ULN for age or any other laboratory abnormality considered by the Investigator to be clinically significant within 14 days before Screening.
  • In the Investigator's opinion, a chronic condition (eg, diabetes, epilepsy), which is either not stable or well controlled and may interfere with the conduct of the study.
  • History of sensitivity to heparin or heparin induced thrombocytopenia.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
IV pantoprazoleIV pantoprazolePatients will receive 10 mg, 20 mg, or 40 mg IV pantoprazole determined by weight.
Primary Outcome Measures
NameTimeMethod
Clearance (CL) of Pantoprazole0.25, 1 to 2, 3 to 4, and 5 to 6 hours post-dose on Day 1; 0.25, 0.5, 1 to 2, 3 to 4, and 5 to 6, 8, and 12 hours post-dose on Day 2; 0.25, 0.5, 1, 2, 4, 8, and 12 hours post-dose on Day 7

Data reported below is combined for Days 1, 2 and 7.

Volume of Distribution (Vd) of Pantoprazole0.25, 1 to 2, 3 to 4, and 5 to 6 hours post-dose on Day 1; 0.25, 0.5, 1 to 2, 3 to 4, and 5 to 6, 8, and 12 hours post-dose on Day 2; 0.25, 0.5, 1, 2, 4, 8, and 12 hours post-dose on Day 7

Data reported below is combined for Days 1, 2 and 7.

Secondary Outcome Measures
NameTimeMethod
Area Under the Plasma Concentration-time Profile From Time Zero Extrapolated to Infinite Time (AUCinf) of Pantoprazole: Multiple Dose0.25, 0.5, 1 to 2, 3 to 4, and 5 to 6, 8, and 12 hours post-dose on Day 2; 0.25, 0.5, 1, 2, 4, 8, and 12 hours post dose on Day 7

Data reported below is combined for Days 2 and 7.

Area Under the Plasma Concentration-time Profile From Time Zero to 24 Hour (AUC24) of Pantoprazole: Multiple Dose0.25, 0.5, 1 to 2, 3 to 4, and 5 to 6, 8, and 12 hours post-dose on Day 2; 0.25, 0.5, 1, 2, 4, 8, and 12 hours post dose on Day 7

Data reported below is combined for Days 2 and 7.

Maximum Plasma Concentration (Cmax) of Pantoprazole: Single Dose0.25, 1, 2, 3 to 4, and 5 to 6 hours post-dose on Day 1

The results for Cmax were presented separately for single dose and multiple doses.

Area Under the Plasma Concentration-time Profile From Time Zero to 24 Hour (AUC24) of Pantoprazole: Single Dose0.25, 1, 2, 3 to 4, and 5 to 6 hours post-dose on Day 1; 24 hours post dose on Day 1 (pre dose on Day 2)

The results for AUC24 were presented separately for single dose and multiple doses.

Terminal Half-Life (t1/2) of Pantoprazole0.25, 1 to 2, 3 to 4, and 5 to 6 hours post-dose on Day 1; 0.25, 0.5, 1 to 2, 3 to 4, and 5 to 6, 8, and 12 hours post-dose on Day 2; 0.25, 0.5, 1, 2, 4, 8, and 12 hours post-dose on Day 7

Data reported below is combined for Days 1, 2 and 7.

Number of Participants With Adverse Events (AEs)From Day 1 up to 34 days after the last dose (maximum up to 41 days)

An AE was defined as any untoward medical occurrence in a clinical investigation participant who was administered a product; the event need not necessarily had a causal relationship with the treatment or usage.

Number of Participants With Physical Examination Abnormalities of Potential Clinical ConcernAt screening (Day 0)

Number of participants with abnormalities in physical examination of potential concern were reported in this outcome measure. The criteria to determine the abnormalities was determined by the investigator.

Number of Participants With Pulse Rate Abnormalities of Potential Clinical ConcernUp to Day 9

Number of participants with abnormalities in pulse rate of potential clinical concern were reported in this outcome measure. The criteria to determine the abnormalities was determined by the investigator.

Cmax of Pantoprazole: Multiple Dose0.25, 0.5, 1 to 2, 3 to 4, and 5 to 6, 8, and 12 hours post-dose on Day 2; 0.25, 0.5, 1, 2, 4, 8, and 12 hours post dose on Day 7

Data reported below is combined for Days 2 and 7.

Area Under the Plasma Concentration-time Profile From Time Zero Extrapolated to Infinite Time (AUCinf) of Pantoprazole: Single Dose0.25, 1, 2, 3 to 4, and 5 to 6 hours post-dose on Day 1

The results for AUCinf were presented separately for single dose and multiple doses.

Number of Participants According to CYP2C19 GenotypingDay 1

CYP2C19 genotype was assessed in pediatric participants who received intravenous pantoprazole sodium and determined the presence of the gene for the major enzyme responsible for metabolism of pantoprazole.

Number of Participants With Laboratory Abnormalities of Potential Clinical ConcernUp to Day 9

Number of participants with abnormalities in laboratory parameters of potential clinical concern were reported in this outcome measure. The criteria to determine the abnormalities was determined by the investigator.

Number of Participants With Blood Pressure Abnormalities of Potential Clinical ConcernUp to Day 9

Number of participants with abnormalities in blood pressure of potential clinical concern were reported in this outcome measure. The criteria to determine the abnormalities was determined by the investigator.

Trial Locations

Locations (19)

Children's Health Specialty Center Dallas Campus

🇺🇸

Dallas, Texas, United States

Children's Medical Center Dallas

🇺🇸

Dallas, Texas, United States

Primary Children's Hospital

🇺🇸

Salt Lake City, Utah, United States

Centro Trials - Dipartimento Pediatrico Universitario Ospedaliero Padiglione Salviati

🇮🇹

Roma, Italy

Hospital Militar Central "Cirujano Mayor Dr. Cosme Argerich"

🇦🇷

Caba, Buenos Aires, Argentina

University Children's Clinic

🇷🇸

Belgrade, Serbia

Komunalne nekomertsiine pidpryiemstvo Ivano-Frankivska oblasna dytiacha klinichna likarnia

🇺🇦

Ivano-Frankivsk, Ukraine

Institute for Child and Youth Health Care of Vojvodina

🇷🇸

Novi Sad, Serbia

Komunalne pidpryiemstvo Dnipropetrovskyi spetsializovanyi klinichnyi medychnyi tsentr materi

🇺🇦

Dnipro, Ukraine

University clinical center of the Republic of Srpska

🇧🇦

Banja Luka, Bosnia and Herzegovina

JSC Evex Medical Corporation

🇬🇪

Tbilisi, Georgia

LTD Imedi Clinic

🇬🇪

Tbilisi, Georgia

Narodny ustav detskych chorob

🇸🇰

Bratislava, Slovakia

Komunalne nekomertsiine pidpryiemstvo "Khersonska dytiacha oblasna klinichna likarnia"

🇺🇦

M. Kherson, Ukraine

Univerzitna nemocnica Martin

🇸🇰

Martin, Slovakia

Katholisches Klinikum Bochum

🇩🇪

Bochum, Germany

IRCCS Ospedale Pediatrico Bambino Gesù

🇮🇹

Roma, Italy

IRCCS-Ospedale Pediatrico Bambino Gesù Farmacia Ospedaliera

🇮🇹

Roma, Italy

Zentralapotheke St. Josef-Hospital

🇩🇪

Bochum, Germany

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