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Drug Drug Interaction Study With Gabapentin Enacarbil and Morphine

Primary Purpose

Restless Legs Syndrome

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
morphine Placebo
GEn 600 mg
Morphine
GEn Placebo
Sponsored by
XenoPort, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Restless Legs Syndrome

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)MaleAccepts Healthy Volunteers

Inclusion Criteria:

  • Subject is healthy as determined by a responsible physician, based on a medical evaluation including medical history, physical examination, clinical laboratory tests, and 12 lead ECG. A subject with a clinical abnormality or laboratory parameters outside the reference range for the population being studied may be included only if the investigator and the GSK Medical Monitor agree that the finding is unlikely to introduce additional risk factors and will not interfere with the study procedures
  • Subject is a male between 18 and 65 years of age inclusive, at the time of signing the informed consent
  • Subject has a body weight >55 kg and body mass index (BMI) within the range of 19 to 30 kg/m2 (inclusive)
  • Subject is capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form
  • Subject has a QTcB <450 ms
  • Subject has a creatinine clearance (CrCl) >80 mL/min. The CrCl is estimated using the Cockcroft and Gault equation. Details on CrCl calculations are provided in the Study Procedures Manual (SPM)
  • Subject has an aspartate aminotransferase (AST), ALT, and alkaline phosphatase within reference range at the screening visit. Isolated bilirubin >1.5 × ULN is acceptable if bilirubin is fractionated and direct bilirubin <35% of the total bilirubin

Exclusion Criteria:

  • Subject has positive prestudy drug or alcohol screen results. At minimum, the drug screen will include alcohol, cotinine, amphetamines, barbiturates, cocaine, opiates, cannabinoids, and benzodiazepines
  • Subject has positive prestudy (within 3 months of Screening) hepatitis B surface antigen or positive hepatitis C antibody results
  • Subject has a positive prestudy human immunodeficiency virus (HIV) antibody result
  • Subject has a history of regular alcohol consumption within 6 months of the study defined as: an average intake of >14 drinks/week . One drink is equivalent to (12 g of alcohol) = 5 ounces (150 mL) of wine or 12 ounces (360 mL) of beer or 1.5 ounces (45 mL) of 80 proof distilled spirits.
  • Subject has participated in a clinical trial and has received an investigational product within the following time period before the first dosing day in the current study: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer)
  • Subject has been exposed to more than 4 new chemical entities within 12 months before the first dosing day
  • Subject has used prescription or nonprescription drugs, including vitamins, herbal and dietary supplements (including St John's Wort) within 7 days (or 14 days if the drug is a potential enzyme inducer) or 5 half-lives (whichever is longer) before the first dose of study treatment, unless in the opinion of the investigator and GSK Medical Monitor the medication will not interfere with the study procedures or compromise subject safety.
  • Subject has a history of sensitivity to gabapentin, morphine, or components thereof, or a history of drug or other allergy that, in the opinion of the investigator or GSK Medical Monitor, contraindicates participation in the study
  • Subject's participation in the study would result in donation of blood or blood products in excess of 500 mL within a 56-day period
  • Subject is unwilling or unable to follow the procedures outlined in the protocol
  • Subject has a screening heart rate <45 or >100 bpm, systolic blood pressure >140 or <100 mm Hg, or diastolic blood pressure >90 or <60 mm Hg in the semi supine position and the value(s) do not return to within reference range upon retest.
  • Subject has postural hypotension demonstrated at the screening medical ( defined as a fall in systolic pressure of 30mmHg or more and/or a fall in diastolic pressure of 20mmHg or more after standing for 3 minutes) or a history of clinically significant symptomatic postural hypotension or vaso vagal episodes
  • Subject smokes more than 5 cigarettes or equivalent/day. Subjects should continue their smoking/non-smoking habits throughout the study apart from refraining from smoking on study days
  • Subject has a history or presence of clinically significant cardiovascular, pulmonary, hepatic, renal, hematologic, GI, endocrine, immunologic, dermatologic, neurologic or psychiatric disease
  • Subject has a history of seizures other than febrile seizures as a child
  • Subject has received any medications known to chronically alter drug absorption or elimination processes within 30 days of the first dose administration, in the opinion of the Sponsor or investigator
  • Subject has a creatine kinase value greater than the ULN that is not explainable by recent strenuous exercise and the value does not return to within reference range upon retest.
  • Subject has current or chronic history of liver disease, or known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones)
  • Subject is mentally or legally incapacitated
  • Subject has a history of respiratory depression, acute or severe bronchial asthma, or hypercarbia
  • Subject has or is suspected of having paralytic ileus or chronic constipation
  • Has active suicidal plan/intent or has had active suicidal thoughts in the past 6 months. Has history of suicide attempt in the last 2 years or more than 1 lifetime suicide attempt

Sites / Locations

  • GSK Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Regimen A

Regimen B

Regimen C

Arm Description

Morphine placebo + GEn 600 mg

Morphine Extended release (60 mg) + GEn placebo

Morphine Extended release (60mg) + GEn 600 mg

Outcomes

Primary Outcome Measures

Pharmacokinetics
evaluate the pharmacokinetics of morphine, morphine-6-glucuronide and of gabapentin derived from GEn following administration of single doses of morphine (60 mg) and GEn (600 mg) alone and in combination

Secondary Outcome Measures

Profile of Pharmacokinetics
Area under the curve (AUC), Concentration Max (Cmax)
Safety of Patients treated with Gen
Laboratory safety tests including blood chemistry, urine analysis, ECG testing, and liver enzyme tests

Full Information

First Posted
August 25, 2011
Last Updated
July 15, 2013
Sponsor
XenoPort, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01476124
Brief Title
Drug Drug Interaction Study With Gabapentin Enacarbil and Morphine
Official Title
A Double-Blind, 3-Part Crossover Study to Assess the Pharmacokinetics and Tolerability of Single Doses of Gabapentin Enacarbil and Morphine Administered Alone and in Combination in Healthy Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
November 2011
Overall Recruitment Status
Completed
Study Start Date
August 2011 (undefined)
Primary Completion Date
October 2011 (Actual)
Study Completion Date
October 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
XenoPort, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This double-blind study will evaluate the pharmacokinetics of a single dose of morphine or gabapentin derived from gabapentin enacarbil (GEn) after administration of morphine and GEn alone and in combination as well as the tolerability of morphine administered with GEn. The dose of GEn will be 600 mg administered with food. Morphine/morphine placebo will be administered 2 hours prior to GEn/GEn placebo in the fasted state. A 60 mg dose of a controlled release formulation of morphine will be given. Blood samples for evaluation of gabapentin, morphine and morphine-6-glucuronide will be collected. The pharmacodynamic effect of co-administering both treatments will be assessed using visual analog scales for somnolence/sedation, dizziness and nausea.
Detailed Description
This double-blind study will evaluate the pharmacokinetics of a single dose of morphine or gabapentin derived from gabapentin enacarbil (GEn) after administration of morphine and GEn alone and in combination as well as the tolerability of morphine administered with GEn. The dose of GEn will be 600 mg administered with food. Morphine/morphine placebo will be administered 2 hours prior to GEn/GEn placebo in the fasted state. A 60 mg dose of a controlled release formulation of morphine will be given. Blood samples for evaluation of gabapentin, morphine and morphine-6-glucuronide will be collected. The pharmacodynamic effect of co-administering both treatments will be assessed using visual analog scales for somnolence/sedation, dizziness and nausea.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Restless Legs Syndrome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Regimen A
Arm Type
Experimental
Arm Description
Morphine placebo + GEn 600 mg
Arm Title
Regimen B
Arm Type
Experimental
Arm Description
Morphine Extended release (60 mg) + GEn placebo
Arm Title
Regimen C
Arm Type
Experimental
Arm Description
Morphine Extended release (60mg) + GEn 600 mg
Intervention Type
Drug
Intervention Name(s)
morphine Placebo
Intervention Description
Morphine Placebo
Intervention Type
Drug
Intervention Name(s)
GEn 600 mg
Other Intervention Name(s)
XP13512, GSK1838262
Intervention Description
Gabapentin enacarbil 600 mg
Intervention Type
Drug
Intervention Name(s)
Morphine
Intervention Description
morphine extended release 60 mg
Intervention Type
Drug
Intervention Name(s)
GEn Placebo
Intervention Description
Gabapentin enacarbil placebo
Primary Outcome Measure Information:
Title
Pharmacokinetics
Description
evaluate the pharmacokinetics of morphine, morphine-6-glucuronide and of gabapentin derived from GEn following administration of single doses of morphine (60 mg) and GEn (600 mg) alone and in combination
Time Frame
7 days
Secondary Outcome Measure Information:
Title
Profile of Pharmacokinetics
Description
Area under the curve (AUC), Concentration Max (Cmax)
Time Frame
predose,1,2,3,4,5,6,7,8,9,10,11,12,14,16,18,20,24,26,and 36 hours post dose
Title
Safety of Patients treated with Gen
Description
Laboratory safety tests including blood chemistry, urine analysis, ECG testing, and liver enzyme tests
Time Frame
Screening to follow-up

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Subject is healthy as determined by a responsible physician, based on a medical evaluation including medical history, physical examination, clinical laboratory tests, and 12 lead ECG. A subject with a clinical abnormality or laboratory parameters outside the reference range for the population being studied may be included only if the investigator and the GSK Medical Monitor agree that the finding is unlikely to introduce additional risk factors and will not interfere with the study procedures Subject is a male between 18 and 65 years of age inclusive, at the time of signing the informed consent Subject has a body weight >55 kg and body mass index (BMI) within the range of 19 to 30 kg/m2 (inclusive) Subject is capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form Subject has a QTcB <450 ms Subject has a creatinine clearance (CrCl) >80 mL/min. The CrCl is estimated using the Cockcroft and Gault equation. Details on CrCl calculations are provided in the Study Procedures Manual (SPM) Subject has an aspartate aminotransferase (AST), ALT, and alkaline phosphatase within reference range at the screening visit. Isolated bilirubin >1.5 × ULN is acceptable if bilirubin is fractionated and direct bilirubin <35% of the total bilirubin Exclusion Criteria: Subject has positive prestudy drug or alcohol screen results. At minimum, the drug screen will include alcohol, cotinine, amphetamines, barbiturates, cocaine, opiates, cannabinoids, and benzodiazepines Subject has positive prestudy (within 3 months of Screening) hepatitis B surface antigen or positive hepatitis C antibody results Subject has a positive prestudy human immunodeficiency virus (HIV) antibody result Subject has a history of regular alcohol consumption within 6 months of the study defined as: an average intake of >14 drinks/week . One drink is equivalent to (12 g of alcohol) = 5 ounces (150 mL) of wine or 12 ounces (360 mL) of beer or 1.5 ounces (45 mL) of 80 proof distilled spirits. Subject has participated in a clinical trial and has received an investigational product within the following time period before the first dosing day in the current study: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer) Subject has been exposed to more than 4 new chemical entities within 12 months before the first dosing day Subject has used prescription or nonprescription drugs, including vitamins, herbal and dietary supplements (including St John's Wort) within 7 days (or 14 days if the drug is a potential enzyme inducer) or 5 half-lives (whichever is longer) before the first dose of study treatment, unless in the opinion of the investigator and GSK Medical Monitor the medication will not interfere with the study procedures or compromise subject safety. Subject has a history of sensitivity to gabapentin, morphine, or components thereof, or a history of drug or other allergy that, in the opinion of the investigator or GSK Medical Monitor, contraindicates participation in the study Subject's participation in the study would result in donation of blood or blood products in excess of 500 mL within a 56-day period Subject is unwilling or unable to follow the procedures outlined in the protocol Subject has a screening heart rate <45 or >100 bpm, systolic blood pressure >140 or <100 mm Hg, or diastolic blood pressure >90 or <60 mm Hg in the semi supine position and the value(s) do not return to within reference range upon retest. Subject has postural hypotension demonstrated at the screening medical ( defined as a fall in systolic pressure of 30mmHg or more and/or a fall in diastolic pressure of 20mmHg or more after standing for 3 minutes) or a history of clinically significant symptomatic postural hypotension or vaso vagal episodes Subject smokes more than 5 cigarettes or equivalent/day. Subjects should continue their smoking/non-smoking habits throughout the study apart from refraining from smoking on study days Subject has a history or presence of clinically significant cardiovascular, pulmonary, hepatic, renal, hematologic, GI, endocrine, immunologic, dermatologic, neurologic or psychiatric disease Subject has a history of seizures other than febrile seizures as a child Subject has received any medications known to chronically alter drug absorption or elimination processes within 30 days of the first dose administration, in the opinion of the Sponsor or investigator Subject has a creatine kinase value greater than the ULN that is not explainable by recent strenuous exercise and the value does not return to within reference range upon retest. Subject has current or chronic history of liver disease, or known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones) Subject is mentally or legally incapacitated Subject has a history of respiratory depression, acute or severe bronchial asthma, or hypercarbia Subject has or is suspected of having paralytic ileus or chronic constipation Has active suicidal plan/intent or has had active suicidal thoughts in the past 6 months. Has history of suicide attempt in the last 2 years or more than 1 lifetime suicide attempt
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
GSK Clinical Trials
Organizational Affiliation
GlaxoSmithKline
Official's Role
Study Director
Facility Information:
Facility Name
GSK Investigational Site
City
Austin
State/Province
Texas
ZIP/Postal Code
78744
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
25467190
Citation
Chen C, Upward J, Arumugham T, Stier B, Davy M. Gabapentin enacarbil and morphine administered in combination versus alone: a double-blind, randomized, pharmacokinetic, and tolerability comparison. Clin Ther. 2015 Feb 1;37(2):349-57. doi: 10.1016/j.clinthera.2014.10.015. Epub 2014 Nov 20.
Results Reference
derived

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Drug Drug Interaction Study With Gabapentin Enacarbil and Morphine

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