The Effects of Denosumab on the Pharmacokinetics (PK) of Midazolam
Primary Purpose
Postmenopausal Osteoporosis
Status
Completed
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Denosumab
Midazolam
Sponsored by
About this trial
This is an interventional treatment trial for Postmenopausal Osteoporosis focused on measuring Amgen, Phase 1, Postmenopausal, Osteoporosis
Eligibility Criteria
Inclusion Criteria:
- Between 45 to 75 years of age
- Postmenopausal women
- Osteoporosis
Exclusion Criteria:
- Use of any known inhibitors of cytochrome P450 3A4/P-gp (CYP3A4) within 14 days or 5 half lives, whichever is longer; or grapefruit juice or grapefruit containing products within 7 days prior to investigational product administration
- Use of any known CYP3A4 inducers within 30 days or 5 half-lives, whichever is longer, prior to investigational product administration
- Use of any herbal medicine with a known impact on CYP3A4 (eg, St. John's wort) within 30 days prior to investigational product administration
- Current use of medications prescribed for osteoporosis treatment
- Use of midazolam within 14 days prior to investigational product administration
- Influenza or other vaccination within 28 days of screening
- Previous exposure to denosumab
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Other
Active Comparator
Arm Label
Midazolam
Denosumab
Arm Description
All 27 subjects will receive midazolam.
Eighteen (18) subjects will receive denosumab.
Outcomes
Primary Outcome Measures
Ratio of Pharmcokinetic (PK) Area Under the Concentration Time Curve (AUC) Parameter Estimates Between Day 16 (Midazolam With the Presence of Denosumab) and Day 1 (Midazolam Only)
The ratio and confidence interval are calculated based on natural log scale data and converted back to the original scale.
Estimates of Inter- and Intra-subject Variability for the PK AUC Parameters for Midazolam With Denosumab Group
AUC Subject denotes the inter-subject variability, while AUC Residual denotes the intra-subject variability
Estimates of Inter- and Intra-subject Variability for PK Maximum Observed Plasma Concentration (Cmax) Parameter for Midazolam With Denosumab Group
Cmax Subject denotes the inter-subject variability, while Cmax Residual denotes the intra-subject variability
Ratio of PK Cmax Parameter Estimates Between Day 16 (Midazolam With the Presence of Denosumab) and Day 1 (Midazolam Only)
The ratio and confidence interval are calculated based on natural log scale data and converted back to the original scale.
Secondary Outcome Measures
Ratio of PK AUC Parameter Estimates Between Day 16 (Midazolam Only) and Day 1(Midazolam Only)
The ratio and confidence interval are calculated based on natural log scale data and converted back to the original scale.
Estimates of Inter- and Intra-subject Variability for the PK AUC Parameters for Midazolam Only Group
AUC Subject denotes the inter-subject variability, while AUC Residual denotes the intra-subject variability.
Estimates of Inter- and Intra-subject Variability for PK Cmax Parameter for Midazolam Only Group
Cmax Subject denotes the inter-subject variability, while Cmax Residual denotes the intra-subject variability.
Summary of Serum Denosumab Concentration
This table summarizes serum Denosumab for Midazolam with Denosumab group. The Lower Limit Of Quantification (LLOQ) is 20 ng/mL. On Day 2 (pre-dose), the true value is below LLOQ, and is treated as 0 in the analysis.
Summary of Serum C-Telopeptide Concentration
This table summarizes serum C-Telopeptide (sCTX) concentration raw values for Midazolam with Denosumab group.
Summary of Percent Change From Baseline to Day 16 for Serum C-Telopeptide Concentration
This table summarizes percent change from baseline to day 16 for serum C-Telopeptide (sCTX) concentration raw values for Midazolam with Denosumab group.
Ratio of PK Cmax Parameter Estimates Between Day 16 (Midazolam Only) and Day 1(Midazolam Only)
The ratio and confidence interval are calculated based on natural log scale data and converted back to the original scale.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01221727
Brief Title
The Effects of Denosumab on the Pharmacokinetics (PK) of Midazolam
Official Title
The Effects of Denosumab on the Pharmacokinetics (PK) of Midazolam, a Cytochrome P450 3A4/P-gp (CYP3A4) Substrate, in Postmenopausal Osteoporotic Women
Study Type
Interventional
2. Study Status
Record Verification Date
September 2015
Overall Recruitment Status
Completed
Study Start Date
November 2010 (undefined)
Primary Completion Date
July 2011 (Actual)
Study Completion Date
July 2011 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Amgen
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is a multi-center, open-label, drug-drug interaction study in postmenopausal women with osteoporosis.
Detailed Description
Approximately 27 subjects (Group A: 18; Group B: 9) will receive a 2 mg oral dose of midazolam on day 1 followed by a 24 hour PK collection. Subjects randomized to Group A will receive a single 60 mg subcutaneous (SC) dose of denosumab on day 2 administered in the abdomen. On study day 16, another 2 mg oral dose of midazolam will be administered to all subjects (Groups A and B) followed by a 24 hour PK collection. The primary analysis to determine the effect of denosumab on the PK of midazolam will be based on data from subjects in Group A only.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Postmenopausal Osteoporosis
Keywords
Amgen, Phase 1, Postmenopausal, Osteoporosis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
30 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Midazolam
Arm Type
Other
Arm Description
All 27 subjects will receive midazolam.
Arm Title
Denosumab
Arm Type
Active Comparator
Arm Description
Eighteen (18) subjects will receive denosumab.
Intervention Type
Drug
Intervention Name(s)
Denosumab
Other Intervention Name(s)
AMG 162
Intervention Description
Eighteen (18) subjects will receive 1 fixed dose administration of denosumab.
Intervention Type
Drug
Intervention Name(s)
Midazolam
Intervention Description
All subjects will receive two oral dose administrations of midazolam.
Primary Outcome Measure Information:
Title
Ratio of Pharmcokinetic (PK) Area Under the Concentration Time Curve (AUC) Parameter Estimates Between Day 16 (Midazolam With the Presence of Denosumab) and Day 1 (Midazolam Only)
Description
The ratio and confidence interval are calculated based on natural log scale data and converted back to the original scale.
Time Frame
From day 1 pre-dose to 24 hours post-dose and from day 16 pre-dose to 24 hours post-dose
Title
Estimates of Inter- and Intra-subject Variability for the PK AUC Parameters for Midazolam With Denosumab Group
Description
AUC Subject denotes the inter-subject variability, while AUC Residual denotes the intra-subject variability
Time Frame
From day 1 pre-dose to 24 hours post-dose and from day 16 pre-dose to 24 hours post-dose
Title
Estimates of Inter- and Intra-subject Variability for PK Maximum Observed Plasma Concentration (Cmax) Parameter for Midazolam With Denosumab Group
Description
Cmax Subject denotes the inter-subject variability, while Cmax Residual denotes the intra-subject variability
Time Frame
From day 1 pre-dose to 24 hours post-dose and from day 16 pre-dose to 24 hours post-dose
Title
Ratio of PK Cmax Parameter Estimates Between Day 16 (Midazolam With the Presence of Denosumab) and Day 1 (Midazolam Only)
Description
The ratio and confidence interval are calculated based on natural log scale data and converted back to the original scale.
Time Frame
From day 1 pre-dose to 24 hours post-dose and from day 16 pre-dose to 24 hours post-dose
Secondary Outcome Measure Information:
Title
Ratio of PK AUC Parameter Estimates Between Day 16 (Midazolam Only) and Day 1(Midazolam Only)
Description
The ratio and confidence interval are calculated based on natural log scale data and converted back to the original scale.
Time Frame
From day 1 pre-dose to 24 hours post-dose and from day 16 pre-dose to 24 hours post-dose
Title
Estimates of Inter- and Intra-subject Variability for the PK AUC Parameters for Midazolam Only Group
Description
AUC Subject denotes the inter-subject variability, while AUC Residual denotes the intra-subject variability.
Time Frame
From day 1 pre-dose to 24 hours post-dose and from day 16 pre-dose to 24 hours post-dose
Title
Estimates of Inter- and Intra-subject Variability for PK Cmax Parameter for Midazolam Only Group
Description
Cmax Subject denotes the inter-subject variability, while Cmax Residual denotes the intra-subject variability.
Time Frame
From day 1 pre-dose to 24 hours post-dose and from day 16 pre-dose to 24 hours post-dose
Title
Summary of Serum Denosumab Concentration
Description
This table summarizes serum Denosumab for Midazolam with Denosumab group. The Lower Limit Of Quantification (LLOQ) is 20 ng/mL. On Day 2 (pre-dose), the true value is below LLOQ, and is treated as 0 in the analysis.
Time Frame
Baseline (day 2 pre-dose) to day 16
Title
Summary of Serum C-Telopeptide Concentration
Description
This table summarizes serum C-Telopeptide (sCTX) concentration raw values for Midazolam with Denosumab group.
Time Frame
Baseline (day 2 pre-dose) to day 16
Title
Summary of Percent Change From Baseline to Day 16 for Serum C-Telopeptide Concentration
Description
This table summarizes percent change from baseline to day 16 for serum C-Telopeptide (sCTX) concentration raw values for Midazolam with Denosumab group.
Time Frame
Baseline (day 2 pre-dose) to day 16
Title
Ratio of PK Cmax Parameter Estimates Between Day 16 (Midazolam Only) and Day 1(Midazolam Only)
Description
The ratio and confidence interval are calculated based on natural log scale data and converted back to the original scale.
Time Frame
From day 1 pre-dose to 24 hours post-dose and from day 16 pre-dose to 24 hours post-dose
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
45 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Between 45 to 75 years of age
Postmenopausal women
Osteoporosis
Exclusion Criteria:
Use of any known inhibitors of cytochrome P450 3A4/P-gp (CYP3A4) within 14 days or 5 half lives, whichever is longer; or grapefruit juice or grapefruit containing products within 7 days prior to investigational product administration
Use of any known CYP3A4 inducers within 30 days or 5 half-lives, whichever is longer, prior to investigational product administration
Use of any herbal medicine with a known impact on CYP3A4 (eg, St. John's wort) within 30 days prior to investigational product administration
Current use of medications prescribed for osteoporosis treatment
Use of midazolam within 14 days prior to investigational product administration
Influenza or other vaccination within 28 days of screening
Previous exposure to denosumab
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
MD
Organizational Affiliation
Amgen
Official's Role
Study Director
12. IPD Sharing Statement
Citations:
PubMed Identifier
25505582
Citation
Jang G, Kaufman A, Lee E, Hamilton L, Hutton S, Egbuna O, Padhi D. A clinical therapeutic protein drug-drug interaction study: coadministration of denosumab and midazolam in postmenopausal women with osteoporosis. Pharmacol Res Perspect. 2014 Apr;2(2):e00033. doi: 10.1002/prp2.33. Epub 2014 Mar 13.
Results Reference
background
Links:
URL
http://www.amgentrials.com
Description
AmgenTrials clinical trials website
Learn more about this trial
The Effects of Denosumab on the Pharmacokinetics (PK) of Midazolam
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