Bioequivalence Study of Two Nitisinone Formulations Compared to Orfadin

Brief Title

Bioequivalence Study of Two Nitisinone Formulations Compared to Orfadin

Official Title

A Single Center, Single-Dose, Open-Label, Laboratory-Blind, Randomized, Three-Period Crossover Study to Determine the Bioequivalence of Two Oral Formulations Containing of Nitisinone 10 mg Compared to the Reference Formulation Orfadin 10 mg in at Least 18 Healthy Male and Female Subjects Under Fasting Conditions

Brief Summary

      The purpose of this study is to determine whether Nitisinone 10 mg Tablets (Test Product 1
      (TP1)) and Nitisinone 10 mg Tablets High Compritol (Test Product 2 (TP2)) are bioequivalent
      to the reference product Orfadin 10 mg capsules.
    

Detailed Description

      The specific aim is to conduct a randomized, single dose, three-period cross-over
      bioequivalence (BE) study in at least 18 healthy male and female subjects at a single study
      center to evaluate the in vivo performance of Nitisinone 10 mg Tablet (Test Product 1) and
      Nitisinone 10 mg Tablet High Compritol (Test Product 2) to the reference product Orfadin 10
      mg capsules.

      The pharmacokinetics (PK) of Test Product 1 and 2 compared to the reference product, will be
      determined and compared in healthy volunteers.

      The modified version of Nitisinone Tablet (Test Product 2, higher glyceryl dibehenate
      (Compritol 888)) was administered to determine the acceptance limit of the dissolution
      profile for Nitisinone tablets with a longer dissolution time (Test Product 2) since the
      dissolution time of Nitisinone tablets (Test Product 1) lengthened over time under
      accelerated study conditions. The hypothesis is that should bioequivalence between Test
      Product 1 and Test Product 2 be demonstrated then it is concluded that the prolonged
      dissolution time had no impact on the bioequivalence of Nitisinone tablets.

      A total of 24 healthy female and male volunteers (age 18 to 55 years old) will be entered
      into the study. Volunteers will be determined to be free of significant medical conditions as
      assessed by medical history, physical examination, and blood and urine tests. Volunteers will
      be randomly allocated to receive one of the three treatment sequence groups and, on each
      occasion, receive one of the following: Nitisinone 10 mg Tablet, Nitisinone 10 mg High
      Compritol Tablet and Orfadin 10 mg hard capsules (reference listed drug, (RLD)). There will
      be a minimum 23 calendar days washout between treatments. Blood samples will be collected at
      pre-dose (0 hours) and at 15 minutes, 30 minutes, 1 hour, 2 hours, 2 hours and 30 minutes, 3
      hours, 3 hours and 30 minutes, 4 hours, 5 hours, 6 hours, 7 hours, 8 hours, 10 hours, 12
      hours, 24 hours, 36 hours, 48 hours, 72 hours, 96 hours and 120 hours post-dose (total: 21
      samples per treatment period).

      The primary endpoints will be the maximum blood concentration (Cmax) and the area under the
      curve (AUC) from time zero to 120 hours post-dose.

      For the FDA, bioequivalence of the test and reference products will be assessed on the basis
      of the 90% confidence intervals for estimates of the geometric mean ratios between the
      primary PK parameters of the test and reference products using an analysis of variance
      considering the bioequivalence range of 80.00% to 125.00% for Cmax and AUC(0-120).

      For Health Canada, bioequivalence of the test and reference products will be assessed on the
      basis of the 90% confidence interval for estimate of the geometric mean ratio between the
      primary PK parameter AUC(0-120) of the test and reference products using an analysis of
      variance considering the bioequivalence range of 80.00% to 125.00% and the point estimate of
      the geometric mean ratio of the primary PK parameter Cmax considering the bioequivalence
      range of 80.00% to 125.00%.
    

Study Phase

Phase 1

Study Type

Interventional


Primary Outcome

Maximum Observed Plasma Concentration (Cmax)

Secondary Outcome

 Area Under the Plasma Concentration Versus Time Curve, From Time Zero to 72 Hours Post-dose (AUC(0-72))

Condition

Hereditary Tyrosinemia, Type I

Intervention

Nitisinone

Study Arms / Comparison Groups

 Treatment Sequence A (TP 1) - B (TP 2) - C (Reference)
Description:  Subjects will receive a single 10 mg tablet of Nitisinone 10 mg Tablet (Test Product 1) in treatment period 1, 10 mg tablet of Nitisinone 10 mg Tablet High Compritol (Test Product 2) in treatment period 2, and 10 mg hard capsule of Orfadin (Reference) in treatment period 3 under fasting conditions. Each treatment period will be separated by at least 23 calendar days of washout period.

Publications

* Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.

Recruitment Information


Recruitment Status

Drug

Estimated Enrollment

24

Start Date

October 2015

Completion Date

January 2016

Primary Completion Date

December 2015

Eligibility Criteria

        Inclusion Criteria:

          -  Body Mass Index (BMI) between 18.5 and 30 kg/m2 (inclusive).

          -  Body mass not less than 50 kg.

          -  Medical history, vital signs, physical examination, standard 12-lead electrocardiogram
             (ECG) and laboratory investigations must be clinically acceptable or within laboratory
             reference ranges for the relevant laboratory tests, unless the investigator considers
             the deviation to be irrelevant for the purpose of the study.

          -  Non-smokers.

          -  Females, if:

        Not of childbearing potential, e.g., has been surgically sterilized, undergone a
        hysterectomy, amenorrhea for ≥ 12 months and considered post-menopausal,

        Note: In postmenopausal women, the value of the serum pregnancy test may be slightly
        increased. This test will be repeated to confirm the results. If there is no increase
        indicative of pregnancy, the female will be included in the study.

        OR

        Of childbearing potential, the following conditions are to be met:

          -  Negative pregnancy test

          -  If this test is positive, the subject will be excluded from the study. In the rare
             circumstance that a pregnancy is discovered after the subject received Investigational
             Medicinal Product (IMP), every attempt must be made to follow her to term.

          -  Not lactating

          -  Abstaining from sexual activity (if this is the usual lifestyle of the subject) or
             must agree to use an accepted method of contraception, and agree to continue with the
             same method throughout the study

        Examples of reliable methods of contraception include non-hormonal intrauterine device, and
        barrier methods combined with an additional contraceptive method.

        In this study the concomitant use of hormonal contraceptives is NOT allowed.

        Other methods, if considered by the investigator as reliable, will be accepted.

          -  Written consent given for participation in the study.

        Exclusion Criteria:

          -  Evidence of psychiatric disorder, antagonistic personality, poor motivation, emotional
             or intellectual problems likely to limit the validity of consent to participate in the
             study or limit the ability to comply with protocol requirements.

          -  Current alcohol use > 21 units of alcohol per week for males and > 14 units of alcohol
             per week for females.

          -  Consumption of more than 5 cups of coffee (or equivalent amounts of caffeine) per day.

          -  Regular exposure to substances of abuse (other than alcohol) within the past year.

          -  Use of any medication, prescribed or over-the-counter or herbal remedies, within 2
             weeks before the first administration of IMP except if this will not affect the
             outcome of the study in the opinion of the investigator. In this study the concomitant
             use of hormonal contraceptives is NOT allowed.

          -  Participation in another study with an experimental drug, where the last
             administration of the previous IMP was within 8 weeks (or within 10 elimination
             half-lives for chemical entities or 2 elimination half-lives for antibodies or
             insulin), whichever is the longer) before administration of IMP in this study, at the
             discretion of the investigator.

          -  Treatment within the previous 3 months before the first administration of IMP with any
             drug with a well-defined potential for adversely affecting a major organ or system.

          -  A major illness during the 3 months before commencement of the screening period.

          -  History of hypersensitivity or allergy to the IMP or its excipients or any related
             medication.

          -  History of bronchial asthma or any other bronchospastic disease.

          -  History of convulsions.

          -  History of porphyria.

          -  Relevant history or laboratory or clinical findings indicative of acute or chronic
             disease, likely to influence study outcome.

          -  Donation or loss of blood equal to or exceeding 500 mL during the 8 weeks before the
             first administration of IMP.

          -  Diagnosis of hypotension made during the screening period.

          -  Diagnosis of hypertension made during the screening period or current diagnosis of
             hypertension.

          -  Resting pulse of > 100 beats per minute or < 40 beats per minute during the screening
             period, either supine or standing.

          -  Positive testing for human immunodeficiency virus (HIV), Hepatitis B and Hepatitis C.

          -  Positive urine screen for drugs of abuse. In case of a positive result the urine
             screen for drugs of abuse may be repeated once at the discretion of the investigator.

          -  Positive urine screen for tobacco use.

          -  Positive pregnancy test.

          -  Female subjects that are pregnant or breastfeeding.

          -  Difficulty in swallowing.

          -  Any specific investigational product safety concern.

          -  Vulnerable subjects, e.g. persons in detention.

          -  Subjects with current keratopathy, or other clinically significant abnormalities found
             by slit-lamp examination (cataracts) at the discretion of the investigator.

          -  Concomitant use of medications that are metabolized by CYP2C9 (ibuprofen, diclofenac
             and indomethacin).
      

Gender

All

Ages

18 Years - 55 Years

Accepts Healthy Volunteers

Accepts Healthy Volunteers

Contacts

André Nell, , 

Location Countries

South Africa

Location Countries

South Africa

Administrative Informations


NCT ID

NCT02750709

Organization ID

CT-001

Secondary IDs

PXL225418

Responsible Party

Sponsor

Study Sponsor

Cycle Pharmaceuticals Ltd.

Collaborators

 Parexel

Study Sponsor

André Nell, Principal Investigator, Bloemfontein Early Phase Clinical Unit, PAREXEL Internation (South Africa)


Verification Date

February 2017