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
About this trial
This is an interventional treatment trial for Hepatic Insufficiency
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.)
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
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
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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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