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Study of the Fed-Fast Pharmocokinetics and Bioequivalance of 300mg Capsules of Droxidopa

Primary Purpose

Symptomatic Neurogenic Orthostatic Hypotension

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Droxidopa
Droxidopa
Droxidopa
Sponsored by
Chelsea Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Symptomatic Neurogenic Orthostatic Hypotension focused on measuring Droxidopa, Randomized, Crossover, Open Label, Bioequivalence, Fed Fast, TID

Eligibility Criteria

65 Years - undefined (Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Provide written consent on an IRB-approved Informed Consent Form (ICF), prior to any study-specific evaluation. Subjects should have the ability to read and understand the ICF, ask for any clarifications from the study staff, and be able to comply with all planned study procedures.
  2. Male or female ≥65 years of age.
  3. Body mass index (BMI) between 18 and 35 kg/m2, inclusive.
  4. If female, not pregnant (or lactating), as evidenced by a negative serum pregnancy test, and is surgically sterile (hysterectomy, bilateral ovariectomy, or bilateral tubal ligation), or at least 2 years postmenopausal.
  5. Ability and willingness to abstain from alcohol from 48 h prior to the first dose until the completion of the study.
  6. No clinically significant abnormalities on the basis of medical history, physical examination, and vital signs unless currently controlled with medical treatment (e.g., a stable medication dosing regimen).
  7. Computerized, 12-lead ECG recording without signs of clinically relevant pathology or showing no clinically relevant deviations, as judged by the investigator.
  8. All values for hematology, clinical chemistry, and urinalysis are normal or if abnormal-are deemed not clinically significant as judged by a physician investigator with documented agreement from the Medical Monitor.
  9. Nonsmoking or have quit smoking at least 6 months prior to dosing.

Exclusion Criteria:

  1. Presence of active or recurring clinically significant cardiovascular, pulmonary, renal, endocrine, hepatic, neurologic, psychiatric, immunologic, hematologic, gastrointestinal, or metabolic disease not currently controlled with medical treatment (e.g., a stable medication dosing regimen).
  2. Presence of an active malignancy of any type other than nonmelanomatous skin malignancies.
  3. History of relevant drug and/or food allergies.
  4. Recent history (past 5 years) of alcohol abuse or drug addiction.
  5. Required use of concomitant medications that could confound the PK or safety evaluation, such as medications that affect GI function (including proton pump inhibitors or metoclopramide) or vasoconstricting agents (e.g., ephedrine, dihydroergotamine, or midodrine), -triptans (e.g., sumatriptan, naratriptan, zolmitriptan, rizatriptan), halogen-containing anesthetics (e.g., cyclopropane, or halothane), catecholaminecontaining preparations (e.g., isoprenaline), non-selective MAOIs, ergotamine derivatives (except for anti-Parkinson medications), or any drugs with anti-hypertensive properties that in the investigator's opinion, could significantly contribute to the subject's orthostatic hypotension.
  6. Participation in an investigational drug study within 30 days prior to study drug administration.
  7. Donated a unit of blood (500 mL) or plasma within the 30-day period prior to the initial dose of study medication or who intend to donate blood or plasma within a 30-day period following the final dose of study medication.
  8. Positive screen for drugs of abuse (opiates, methadone, cocaine, amphetamines, cannabinoids, barbiturates, benzodiazepines) or alcohol.
  9. Positive screen for urine cotinine.
  10. Positive screen for hepatitis B surface antigen.
  11. Positive screen for antibodies to hepatitis C virus.
  12. Positive screen for antibodies to human immunodeficiency virus (HIV-1/HIV-2).
  13. Acute illness within 5 days prior to drug administration.
  14. History of coagulation disorder, thrombocytopenia, bleeding tendency, or gastrointestinal bleeding.
  15. Professional or ancillary personnel involved in the study.
  16. In the opinion of the investigator, not suitable for entry into the study.

Sites / Locations

  • Cetero Research

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Arm Label

Fed Dosing

Fasted Dosing

Bioequivalence

TID Dosing

Arm Description

Subjects fed a high calorie, high fat meal prior to receiving 3 x 100mg capsules

Subjects fasted prior to receiving 3 x 100mg capsules

Subjects fasted prior to receiving 1x 300mg capsule

Droxidopa 300 mg given TID

Outcomes

Primary Outcome Measures

Droxidopa Pharmacokinetics
Blood samples will be collected at the time from 0 to 24 hours. Cmax, Tmax, AUC(0-∞), AUC(0-t), t1/2, and CL/F, will be determined for plasma concentrations of droxidopa in Parts I and II and will also be determined for two of its metabolites (3-OM-droxidopa and norepinephrine) in Part II only.

Secondary Outcome Measures

Full Information

First Posted
June 22, 2010
Last Updated
March 18, 2013
Sponsor
Chelsea Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT01149629
Brief Title
Study of the Fed-Fast Pharmocokinetics and Bioequivalance of 300mg Capsules of Droxidopa
Official Title
A Randomized, Open-Label, Three-Period, Three-Sequence, Single-Dose Crossover and Separate Three-Daily-Dose Treatment Period Study Comparing the Pharmacokinetic Profiles Following Oral Dosing of 300 mg of Droxidopa in the Fed Versus Fasted State, the Bioequivalence of Three 100 mg Capsules of Droxidopa Versus a Single 300 mg Capsule of Droxidopa, and 300 mg of Droxidopa Given Three Times at Four Hour Intervals in Healthy, Elderly Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
March 2013
Overall Recruitment Status
Completed
Study Start Date
July 2010 (undefined)
Primary Completion Date
August 2010 (Actual)
Study Completion Date
August 2010 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Chelsea Therapeutics

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
One purpose of this study is to determine if taking droxidopa after eating will have an effect on how the body processes (absorbs and eliminates) the drug in healthy elderly subjects. Another purpose of this study is to see how the body processes (absorbs and eliminates) one 300mg capsule compared to three 100mg capsules. This study will also evaluate how well the body processes (absorbs and eliminates) and tolerates droxidopa when a 300 mg capsule is given 3 times a day for a total dose of 900 mg over the course of one day. Droxidopa is used to treat low blood pressure upon standing in patients with diseases of the nervous system, to prevent low blood pressure in patients with kidney disease during hemodialysis (removal of waste products of the blood), and to treat frozen gait (walking, stepping or running) and dizziness upon standing in patients with Parkinson's disease.
Detailed Description
This is a two-part study. Part I is a randomized, open-label, three-period crossover study in 24 healthy, elderly, male or female subjects. Subjects will be allocated to one of three treatment sequences according to a randomization schedule prepared prior to the start of the study. Each subject will receive a single, oral dose of three 100 mg capsules of droxidopa with 240 mL of water either in the fasted state (Treatment A) or immediately following the consumption of a standardized high-fat meal (Treatment B) and a single, oral dose of one 300 mg capsule of droxidopa with 240 mL of water in the fasted state (Treatment C) on Days 1, 4, and 7. Subjects will be discharged from the research clinic on Day 8 after completing all posttreatment follow-up assessments and will return to the research clinic approximately 1 week later for Part II of the study. Part II of the study is an open-label design where all subjects will receive three doses of 300 mg droxidopa (three 100 mg capsules/dose) at 4 hour intervals and will be followed for a concurrent 24 h period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Symptomatic Neurogenic Orthostatic Hypotension
Keywords
Droxidopa, Randomized, Crossover, Open Label, Bioequivalence, Fed Fast, TID

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
24 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Fed Dosing
Arm Type
Active Comparator
Arm Description
Subjects fed a high calorie, high fat meal prior to receiving 3 x 100mg capsules
Arm Title
Fasted Dosing
Arm Type
Active Comparator
Arm Description
Subjects fasted prior to receiving 3 x 100mg capsules
Arm Title
Bioequivalence
Arm Type
Active Comparator
Arm Description
Subjects fasted prior to receiving 1x 300mg capsule
Arm Title
TID Dosing
Arm Type
Active Comparator
Arm Description
Droxidopa 300 mg given TID
Intervention Type
Drug
Intervention Name(s)
Droxidopa
Intervention Description
One capsule containing 300 mg droxidopa, given once
Intervention Type
Drug
Intervention Name(s)
Droxidopa
Intervention Description
3 capsules each containing 100 mg droxidopa, give 3 times at 4 hour intervals
Intervention Type
Drug
Intervention Name(s)
Droxidopa
Intervention Description
3 capsules each containing 100 mg droxidopa, given once
Primary Outcome Measure Information:
Title
Droxidopa Pharmacokinetics
Description
Blood samples will be collected at the time from 0 to 24 hours. Cmax, Tmax, AUC(0-∞), AUC(0-t), t1/2, and CL/F, will be determined for plasma concentrations of droxidopa in Parts I and II and will also be determined for two of its metabolites (3-OM-droxidopa and norepinephrine) in Part II only.
Time Frame
24 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Provide written consent on an IRB-approved Informed Consent Form (ICF), prior to any study-specific evaluation. Subjects should have the ability to read and understand the ICF, ask for any clarifications from the study staff, and be able to comply with all planned study procedures. Male or female ≥65 years of age. Body mass index (BMI) between 18 and 35 kg/m2, inclusive. If female, not pregnant (or lactating), as evidenced by a negative serum pregnancy test, and is surgically sterile (hysterectomy, bilateral ovariectomy, or bilateral tubal ligation), or at least 2 years postmenopausal. Ability and willingness to abstain from alcohol from 48 h prior to the first dose until the completion of the study. No clinically significant abnormalities on the basis of medical history, physical examination, and vital signs unless currently controlled with medical treatment (e.g., a stable medication dosing regimen). Computerized, 12-lead ECG recording without signs of clinically relevant pathology or showing no clinically relevant deviations, as judged by the investigator. All values for hematology, clinical chemistry, and urinalysis are normal or if abnormal-are deemed not clinically significant as judged by a physician investigator with documented agreement from the Medical Monitor. Nonsmoking or have quit smoking at least 6 months prior to dosing. Exclusion Criteria: Presence of active or recurring clinically significant cardiovascular, pulmonary, renal, endocrine, hepatic, neurologic, psychiatric, immunologic, hematologic, gastrointestinal, or metabolic disease not currently controlled with medical treatment (e.g., a stable medication dosing regimen). Presence of an active malignancy of any type other than nonmelanomatous skin malignancies. History of relevant drug and/or food allergies. Recent history (past 5 years) of alcohol abuse or drug addiction. Required use of concomitant medications that could confound the PK or safety evaluation, such as medications that affect GI function (including proton pump inhibitors or metoclopramide) or vasoconstricting agents (e.g., ephedrine, dihydroergotamine, or midodrine), -triptans (e.g., sumatriptan, naratriptan, zolmitriptan, rizatriptan), halogen-containing anesthetics (e.g., cyclopropane, or halothane), catecholaminecontaining preparations (e.g., isoprenaline), non-selective MAOIs, ergotamine derivatives (except for anti-Parkinson medications), or any drugs with anti-hypertensive properties that in the investigator's opinion, could significantly contribute to the subject's orthostatic hypotension. Participation in an investigational drug study within 30 days prior to study drug administration. Donated a unit of blood (500 mL) or plasma within the 30-day period prior to the initial dose of study medication or who intend to donate blood or plasma within a 30-day period following the final dose of study medication. Positive screen for drugs of abuse (opiates, methadone, cocaine, amphetamines, cannabinoids, barbiturates, benzodiazepines) or alcohol. Positive screen for urine cotinine. Positive screen for hepatitis B surface antigen. Positive screen for antibodies to hepatitis C virus. Positive screen for antibodies to human immunodeficiency virus (HIV-1/HIV-2). Acute illness within 5 days prior to drug administration. History of coagulation disorder, thrombocytopenia, bleeding tendency, or gastrointestinal bleeding. Professional or ancillary personnel involved in the study. In the opinion of the investigator, not suitable for entry into the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gregory M Haugen, M.D.
Organizational Affiliation
Cetero Research, San Antonio
Official's Role
Principal Investigator
Facility Information:
Facility Name
Cetero Research
City
Fargo
State/Province
North Dakota
ZIP/Postal Code
58104
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
29392574
Citation
Chen JJ, Hewitt LA. Comparison of the Pharmacokinetics of Droxidopa After Dosing in the Fed Versus Fasted State and with 3-Times-Daily Dosing in Healthy Elderly Subjects. Drugs R D. 2018 Mar;18(1):77-86. doi: 10.1007/s40268-018-0226-z.
Results Reference
derived

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Study of the Fed-Fast Pharmocokinetics and Bioequivalance of 300mg Capsules of Droxidopa

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