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Pharmacokinetics, Pharmacodynamics, Safety and Tolerability of Dabigatran Etexilate in Patients With Moderate Hepatic Impairment Compared to Subjects With Normal Hepatic Function

Primary Purpose

Hepatic Insufficiency

Status
Completed
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Dabigatran etexilate
Sponsored by
Boehringer Ingelheim
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hepatic Insufficiency

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Healthy age-, weight-, and sex-matched subjects determined by results of screening with normal hepatic function (group 1)
  • Hepatically impaired subjects determined by results of screening classified as Child-Pugh B (group 2)
  • Signed written informed consent in accordance with Good Clinical Practice (GCP) and local legislation
  • Age >=18 and <=75 years
  • BMI >=18.0 and <=32 kg/m2, at least 45 kg for females
  • Creatinine clearance >80 mL/min according to Cockcroft & Gault

Exclusion Criteria:

  • Healthy subjects (Group 1) who met any of the following criteria should not be entered into this trial:

    • Any finding of the medical examination (including blood pressure, pulse rate, and electrocardiogram) deviating from normal and of clinical relevance
    • Clinically relevant gastrointestinal, hepatic, renal, respiratory, cardiovascular, metabolic, immunologic or hormonal disorders
    • Surgery of gastrointestinal tract (except appendectomy, cholecystectomy, herniotomy)
    • Clinically relevant diseases of the central nervous system
    • Relevant history of orthostatic hypotension, fainting spells or blackouts
    • Evidence of blood dyscrasia, haemorrhagic diathesis, severe thrombocytopenia, cerebrovascular haemorrhage, bleeding tendencies associated with active ulceration or overt bleeding of gastrointestinal, respiratory or genitourinary tract or any disease or condition with haemorrhagic tendencies (e.g. cerebral aneurysm, dissecting aorta, central nervous system (CNS) trauma, retinopathy, nephrolithiasis)
    • Recent or contemplated diagnostic or therapeutic procedures with potential for uncontrollable bleeding (e.g. spinal puncture, lumbar block anaesthesia, surgery of CNS or eye or surgery resulting in large open surfaces) within 14 days before or after drug administration of this clinical trial
    • Chronic or relevant acute infections
    • History of allergy/hypersensitivity (including drug allergy), which is deemed relevant to the trial as judged by the investigator
    • For women with childbearing potential: no reliable contraception (accepted methods are intra-uterine device, hormonal contraceptives, bilateral tubal ligation, hysterectomy, condoms) or pregnancy (known or detected by a positive pregnancy test) or breast feeding period
    • Intake of drugs with a long half-life (> 24 hours) (< 1 month prior to administration or during the trial)
    • Use of any drugs, within 14 days prior to administration or during the trial
    • Participation in another trial with an investigational drug (< 2 months prior to administration or during trial)
    • Drug abuse
    • Blood donation or loss > 400 ml, < 1 month prior to administration or during the trial
    • Excessive physical activities < 5 days prior to administration of study drug or during the trial
    • Clinically relevant laboratory abnormalities
    • Veins unsuited for i.v. puncture and administration of prolonged infusions on either arm (e.g. veins which are difficult to locate, access or puncture, veins with a tendency to rupture during or after puncture, etc.)
  • Hepatically impaired subjects (Group 2) who met any of the following criteria should not be entered into this trial:

    • Moderate and severe concurrent renal function impairment (e.g., due to hepato-renal syndrome)
    • Clinically relevant gastrointestinal, respiratory, cardiovascular, metabolic, immunologic or hormonal disorders
    • Surgery of gastrointestinal tract (except appendectomy, cholecystectomy, herniotomy)
    • Clinically relevant diseases of the central nervous system
    • Relevant history of orthostatic hypotension, fainting spells or blackouts
    • Evidence of blood dyscrasia, haemorrhagic diathesis, severe thrombocytopenia, cerebrovascular haemorrhage, bleeding tendencies associated with active ulceration or overt bleeding of gastrointestinal, respiratory or genitourinary tract or any disease or condition with haemorrhagic tendencies (e.g. cerebral aneurysm, dissecting aorta, CNS trauma, retinopathy, nephrolithiasis) considered by the investigator or one of the coinvestigators to be clinically relevant
    • Recent or contemplated diagnostic or therapeutic procedures with potential for uncontrollable bleeding (e.g. spinal puncture, lumbar block anaesthesia, surgery of CNS or eye or surgery resulting in large open surfaces) within 14 days before or after drug administration of this clinical trial
    • History of allergy/hypersensitivity (including drug allergy) which is deemed relevant to the trial as judged by the investigator
    • For women with childbearing potential: no reliable contraception (accepted methods are intra-uterine device, hormonal contraceptives, bilateral tubal ligation, hysterectomy, condoms) or pregnancy (known or detected by a positive pregnancy test) or breast feeding period
    • Use of any drugs which have an influence on the blood clotting within 14 days prior to administration or during the trial
    • Participation in another trial with an investigational drug (< 2 months prior to administration or during trial)
    • Blood donation or loss > 400 ml, < 1 month prior to administration or during the trial
    • Excessive physical activities < 5 days prior to administration of study drug or during the trial
    • Clinically relevant laboratory abnormalities (except for liver function tests according to Child-Pugh classification), constellation of blood clotting parameters according to the judgment of the investigator
    • Veins unsuited for i.v. puncture and administration of prolonged infusions on either arm (e.g. veins which are difficult to locate, access or puncture, veins with a tendency to rupture during or after puncture, etc.)

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Dabigatran etexilate

    Arm Description

    Outcomes

    Primary Outcome Measures

    AUC0-infinity (area under the concentration time curve of the analyte in plasma over the time interval from 0 extrapolated to infinity)
    Cmax (maximum concentration of the analyte in plasma)
    CL/F (apparent clearance of the analyte in the plasma after extravascular administration)
    concentration-response relationship of dabigatran assessed by analysis of activated partial thromboplastin time (aPTT), ecarin clotting time (ECT) , prothrombin time (PT) expressed as international normalised ratio (INR), and thrombin time (TT)

    Secondary Outcome Measures

    AUC0-tz (area under the concentration-time curve of the analyte in plasma over the time interval from 0 to the time of the last quantifiable data point)
    AUCt1-t2 (Area under the concentration time curve of the analyte in plasma over the time interval t1 to t2)
    tmax (time from dosing to the maximum concentration of the analyte in plasma)
    λz ( terminal rate constant in plasma)
    t1/2 ( terminal half-life of the analyte in plasma)
    MRTpo (mean residence time of the analyte in the body after oral administration)
    Vz/F (apparent volume of distribution during the terminal phase λz following an extravascular dose)
    Ae0-72 (amount of analyte that is eliminated in urine from the time interval 0 to 72 h)
    fe0-72 (fraction of administered drug excreted unchanged in urine from time point 0 to 72 h)
    CLR,0-72 (renal clearance of the analyte in plasma from the time point 0 h until the time point 72 h)
    Plasma protein binding of dabigatran
    Change in pulse rate
    Change in systolic and diastolic blood pressure
    Change in ECG
    Occurrence of adverse events
    Assessment of tolerability by investigator on a four-point scale

    Full Information

    First Posted
    June 20, 2014
    Last Updated
    June 20, 2014
    Sponsor
    Boehringer Ingelheim
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    1. Study Identification

    Unique Protocol Identification Number
    NCT02170571
    Brief Title
    Pharmacokinetics, Pharmacodynamics, Safety and Tolerability of Dabigatran Etexilate in Patients With Moderate Hepatic Impairment Compared to Subjects With Normal Hepatic Function
    Official Title
    Pharmacokinetics, Pharmacodynamics, Safety and Tolerability of 150 mg Dabigatran Etexilate p.o. in Patients With Moderate Hepatic Impairment Compared to Subjects With Normal Hepatic Function in a Monocentric, Open, Parallel-group Design
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2014
    Overall Recruitment Status
    Completed
    Study Start Date
    July 2005 (undefined)
    Primary Completion Date
    December 2005 (Actual)
    Study Completion Date
    undefined (undefined)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Boehringer Ingelheim

    4. Oversight

    5. Study Description

    Brief Summary
    Assessment of the effect of moderate liver impairment (Child-Pugh classification B) on the pharmacokinetics and pharmacodynamics of dabigatran after oral administration of dabigatran etexilate. Determination of safety and tolerability of dabigatran upon administration to hepatically impaired patients and healthy subjects (matched pairs)

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Hepatic Insufficiency

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 1
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    24 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Dabigatran etexilate
    Arm Type
    Experimental
    Intervention Type
    Drug
    Intervention Name(s)
    Dabigatran etexilate
    Primary Outcome Measure Information:
    Title
    AUC0-infinity (area under the concentration time curve of the analyte in plasma over the time interval from 0 extrapolated to infinity)
    Time Frame
    pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48 and 72 hours
    Title
    Cmax (maximum concentration of the analyte in plasma)
    Time Frame
    pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48 and 72 hours
    Title
    CL/F (apparent clearance of the analyte in the plasma after extravascular administration)
    Time Frame
    pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48 and 72 h
    Title
    concentration-response relationship of dabigatran assessed by analysis of activated partial thromboplastin time (aPTT), ecarin clotting time (ECT) , prothrombin time (PT) expressed as international normalised ratio (INR), and thrombin time (TT)
    Time Frame
    pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48 and 72 h
    Secondary Outcome Measure Information:
    Title
    AUC0-tz (area under the concentration-time curve of the analyte in plasma over the time interval from 0 to the time of the last quantifiable data point)
    Time Frame
    pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48 and 72 h
    Title
    AUCt1-t2 (Area under the concentration time curve of the analyte in plasma over the time interval t1 to t2)
    Time Frame
    pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48 and 72 h
    Title
    tmax (time from dosing to the maximum concentration of the analyte in plasma)
    Time Frame
    pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48 and 72 h
    Title
    λz ( terminal rate constant in plasma)
    Time Frame
    pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48 and 72 h
    Title
    t1/2 ( terminal half-life of the analyte in plasma)
    Time Frame
    pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48 and 72 h
    Title
    MRTpo (mean residence time of the analyte in the body after oral administration)
    Time Frame
    pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48 and 72 h
    Title
    Vz/F (apparent volume of distribution during the terminal phase λz following an extravascular dose)
    Time Frame
    pre-dose and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 48 and 72 h
    Title
    Ae0-72 (amount of analyte that is eliminated in urine from the time interval 0 to 72 h)
    Time Frame
    pre-dose over 12 h from day -1 till day 1 and post-dose from day 1 till day 4 in fractions of 0 - 12, 12 - 24, 24 - 48 and 48 - 72 h
    Title
    fe0-72 (fraction of administered drug excreted unchanged in urine from time point 0 to 72 h)
    Time Frame
    pre-dose over 12 h from day -1 till day 1 and post-dose from day 1 till day 4 in fractions of 0 - 12, 12 - 24, 24 - 48 and 48 - 72 h
    Title
    CLR,0-72 (renal clearance of the analyte in plasma from the time point 0 h until the time point 72 h)
    Time Frame
    pre-dose over 12 h from day -1 till day 1 and post-dose from day 1 till day 4 in fractions of 0 - 12, 12 - 24, 24 - 48 and 48 - 72 h
    Title
    Plasma protein binding of dabigatran
    Time Frame
    before drug administration
    Title
    Change in pulse rate
    Time Frame
    up to day 4
    Title
    Change in systolic and diastolic blood pressure
    Time Frame
    up to day 4
    Title
    Change in ECG
    Time Frame
    up to day 4
    Title
    Occurrence of adverse events
    Time Frame
    up to Day 4
    Title
    Assessment of tolerability by investigator on a four-point scale
    Time Frame
    up to day 4

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    75 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Healthy age-, weight-, and sex-matched subjects determined by results of screening with normal hepatic function (group 1) Hepatically impaired subjects determined by results of screening classified as Child-Pugh B (group 2) Signed written informed consent in accordance with Good Clinical Practice (GCP) and local legislation Age >=18 and <=75 years BMI >=18.0 and <=32 kg/m2, at least 45 kg for females Creatinine clearance >80 mL/min according to Cockcroft & Gault Exclusion Criteria: Healthy subjects (Group 1) who met any of the following criteria should not be entered into this trial: Any finding of the medical examination (including blood pressure, pulse rate, and electrocardiogram) deviating from normal and of clinical relevance Clinically relevant gastrointestinal, hepatic, renal, respiratory, cardiovascular, metabolic, immunologic or hormonal disorders Surgery of gastrointestinal tract (except appendectomy, cholecystectomy, herniotomy) Clinically relevant diseases of the central nervous system Relevant history of orthostatic hypotension, fainting spells or blackouts Evidence of blood dyscrasia, haemorrhagic diathesis, severe thrombocytopenia, cerebrovascular haemorrhage, bleeding tendencies associated with active ulceration or overt bleeding of gastrointestinal, respiratory or genitourinary tract or any disease or condition with haemorrhagic tendencies (e.g. cerebral aneurysm, dissecting aorta, central nervous system (CNS) trauma, retinopathy, nephrolithiasis) Recent or contemplated diagnostic or therapeutic procedures with potential for uncontrollable bleeding (e.g. spinal puncture, lumbar block anaesthesia, surgery of CNS or eye or surgery resulting in large open surfaces) within 14 days before or after drug administration of this clinical trial Chronic or relevant acute infections History of allergy/hypersensitivity (including drug allergy), which is deemed relevant to the trial as judged by the investigator For women with childbearing potential: no reliable contraception (accepted methods are intra-uterine device, hormonal contraceptives, bilateral tubal ligation, hysterectomy, condoms) or pregnancy (known or detected by a positive pregnancy test) or breast feeding period Intake of drugs with a long half-life (> 24 hours) (< 1 month prior to administration or during the trial) Use of any drugs, within 14 days prior to administration or during the trial Participation in another trial with an investigational drug (< 2 months prior to administration or during trial) Drug abuse Blood donation or loss > 400 ml, < 1 month prior to administration or during the trial Excessive physical activities < 5 days prior to administration of study drug or during the trial Clinically relevant laboratory abnormalities Veins unsuited for i.v. puncture and administration of prolonged infusions on either arm (e.g. veins which are difficult to locate, access or puncture, veins with a tendency to rupture during or after puncture, etc.) Hepatically impaired subjects (Group 2) who met any of the following criteria should not be entered into this trial: Moderate and severe concurrent renal function impairment (e.g., due to hepato-renal syndrome) Clinically relevant gastrointestinal, respiratory, cardiovascular, metabolic, immunologic or hormonal disorders Surgery of gastrointestinal tract (except appendectomy, cholecystectomy, herniotomy) Clinically relevant diseases of the central nervous system Relevant history of orthostatic hypotension, fainting spells or blackouts Evidence of blood dyscrasia, haemorrhagic diathesis, severe thrombocytopenia, cerebrovascular haemorrhage, bleeding tendencies associated with active ulceration or overt bleeding of gastrointestinal, respiratory or genitourinary tract or any disease or condition with haemorrhagic tendencies (e.g. cerebral aneurysm, dissecting aorta, CNS trauma, retinopathy, nephrolithiasis) considered by the investigator or one of the coinvestigators to be clinically relevant Recent or contemplated diagnostic or therapeutic procedures with potential for uncontrollable bleeding (e.g. spinal puncture, lumbar block anaesthesia, surgery of CNS or eye or surgery resulting in large open surfaces) within 14 days before or after drug administration of this clinical trial History of allergy/hypersensitivity (including drug allergy) which is deemed relevant to the trial as judged by the investigator For women with childbearing potential: no reliable contraception (accepted methods are intra-uterine device, hormonal contraceptives, bilateral tubal ligation, hysterectomy, condoms) or pregnancy (known or detected by a positive pregnancy test) or breast feeding period Use of any drugs which have an influence on the blood clotting within 14 days prior to administration or during the trial Participation in another trial with an investigational drug (< 2 months prior to administration or during trial) Blood donation or loss > 400 ml, < 1 month prior to administration or during the trial Excessive physical activities < 5 days prior to administration of study drug or during the trial Clinically relevant laboratory abnormalities (except for liver function tests according to Child-Pugh classification), constellation of blood clotting parameters according to the judgment of the investigator Veins unsuited for i.v. puncture and administration of prolonged infusions on either arm (e.g. veins which are difficult to locate, access or puncture, veins with a tendency to rupture during or after puncture, etc.)

    12. IPD Sharing Statement

    Links:
    URL
    http://trials.boehringer-ingelheim.com/content/dam/internet/opu/clinicaltrial/com_EN/results/1160/1160.51_U06-1705-01.pdf
    Description
    Related Info

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    Pharmacokinetics, Pharmacodynamics, Safety and Tolerability of Dabigatran Etexilate in Patients With Moderate Hepatic Impairment Compared to Subjects With Normal Hepatic Function

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