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A Pharmacokinetics, Pharmacodynamics and Safety Study of Single Dose of Rivaroxaban in Participants With End-Stage Renal Disease (ESRD) on Maintenance Hemodialysis

Primary Purpose

End-Stage Renal Disease

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Rivaroxaban 15 mg
Sponsored by
Janssen Research & Development, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for End-Stage Renal Disease focused on measuring End-Stage Renal Disease, Healthy, Rivaroxaban, BAY 59-7939, JNJ-39039039, Xarelto, Hemodialysis, Blood Coagulation, Pharmacokinetics

Eligibility Criteria

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

Inclusion Criteria:

A. All Participants:

- Body mass index (BMI = weight in kilogram [kg] divided by the square of height in meter [m]) between 18 and 38 kg/m^2, extremes included, and body weight not less than 50 kg

B. Additional Inclusion Criteria for ESRD Participants (Group A):

  • Participants with end-stage renal disease (ESRD) requiring maintenance hemodialysis 2 or 3 times a week for at least 3 months prior to Screening
  • Participants with clinically stable medical condition, consistent with ESRD, as judged by the investigator on the basis of the Screening physical examination, medical history, vital signs, 12-lead electrocardiogram (ECG), and results of clinical laboratory tests performed within 3 weeks of the first administration of study drug (unless judged to be clinically unimportant by the investigator or sponsor)
  • Participants with diastolic blood pressure less than (<) 110 millimeter of mercury (mmHg) and/or systolic blood pressure <180 mmHg (at Screening only) recorded after 5 minutes rest in sitting position

C. Additional Inclusion Criteria for Healthy Matched Control Participants (Group B):

  • Healthy Participants on the basis of Screening physical examination, medical history, vital signs, 12-lead ECG, and results of clinical laboratory tests performed within 3 weeks prior to the administration of study drug
  • Participants with diastolic blood pressure <95 mmHg and/or systolic blood pressure <150 mmHg recorded after 5 minutes rest in sitting position
  • Participants with normal renal function characterized as having creatinine clearance (CLcr) >80 mL/min by Cockcroft-Gault estimate

Exclusion Criteria:

  • Participants with history of clinically significant medical illness prior to Screening including (but not limited to) chronic atrial fibrillation, hemodynamically significant valvular heart disease, heart failure (New York Heart Association Class >=II) within 6 months prior to the Screening visit, cardiac revascularization within 6 months including percutaneous transluminal coronary angioplasty or coronary artery bypass graft surgery, ischemic stroke within 6 months, previous intracranial hemorrhage at any time, anemia with a hemoglobin concentration <9 gram per deciliter (g/dL), or any other illness that the investigator considers should exclude the participant or that could interfere with the interpretation of the study results
  • Participants diagnosed with current malignancy/active disease; (however, participants with clinically stable prostate cancer, basal cell carcinoma of the skin or who have not required antineoplastic treatment of previous cancers for at least one year are eligible)
  • Participants with psychiatric disorders that would impair the participant's ability to participate or complete this study in the opinion of the investigator or the sponsor
  • Participants with history of gastrointestinal disease (for example, Crohn's disease) which could result in impaired absorption of the study drugs
  • Participants with any other disease or condition which could influence the physiological metabolic turnover of study drug (for example, endocrine diseases, febrile conditions, severe infections)
  • Participants with history of significant hemorrhage and gastrointestinal ulceration within 6 months prior to the screening visit
  • Participants with known primary coagulation disorders (for example, von Willebrand's disease, hemophilias)
  • Participants with history of recurrent dialysis membrane thrombosis
  • Participants with sensitivity to heparin
  • Participants with dialysis for acute renal failure

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Group A

Group B

Arm Description

Participants with end-stage renal disease (ESRD), will receive a single 15-milligram (mg) oral dose of rivaroxaban in Treatment Period 1 on Day 1, administered 2 hours before the start of a 4-hour hemodialysis session followed 7 to 14 days later by Treatment Period 2 wherein a single 15-mg oral dose of rivaroxaban will be given 3 hours after the completion of a 4-hour hemodialysis session on Day 1.

Healthy control participants matching to 'Group A' participants, will receive a single 15-mg oral dose of rivaroxaban on Day 1.

Outcomes

Primary Outcome Measures

Maximum Observed Plasma Concentration (Cmax) of Rivaroxaban
The Cmax is the maximum observed plasma concentration.
Area Under the Plasma Concentration-time Curve From Time Zero to Last Quantifiable Time (AUClast) of Rivaroxaban
The AUClast is the area under the plasma concentration-time curve from time zero to time of last quantifiable concentration.
Area Under the Plasma Concentration-time Curve From Time Zero to Extrapolated Infinite Time (AUCinfinity) of Rivaroxaban
The AUCinfinity is the area under the plasma concentration-time curve from time zero to extrapolated infinite time, calculated as the sum of AUClast and Clast/lambda(z), where AUClast is area under the plasma concentration-time curve from time zero to time of last quantifiable plasma concentration; Clast is the last observed quantifiable concentration; and lambda(z) is first-order rate constant associated with the terminal portion of the semilogarithmic drug concentration-time curve.

Secondary Outcome Measures

Maximum Observed Effect (Emax) for Prothrombin Time (PT), Factor Xa (FXa) Inhibition and Anti-FXa
Maximum observed effect (Emax) for parameters: prothrombin time (PT), factor Xa (FXa) inhibition and anti-FXa, will be assessed.
Area Under the Dose-Response Curve for Prothrombin Time (PT), Factor Xa (FXa) Inhibition and Anti-FXa
The area under the dose-response curve for parameters: prothrombin time, FXa inhibition and anti-FXa, will be assessed.
Number of Participants With Adverse Events (AEs) or Serious Adverse Events (SAEs)
An AE is any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. An SAE is an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly.

Full Information

First Posted
November 10, 2014
Last Updated
January 23, 2017
Sponsor
Janssen Research & Development, LLC
Collaborators
Bayer
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1. Study Identification

Unique Protocol Identification Number
NCT02289703
Brief Title
A Pharmacokinetics, Pharmacodynamics and Safety Study of Single Dose of Rivaroxaban in Participants With End-Stage Renal Disease (ESRD) on Maintenance Hemodialysis
Official Title
An Open-label Study to Evaluate the Pharmacokinetics, Pharmacodynamics and Safety of a Single Dose of Rivaroxaban in Subjects With End-Stage Renal Disease (ESRD) on Maintenance Hemodialysis
Study Type
Interventional

2. Study Status

Record Verification Date
January 2017
Overall Recruitment Status
Completed
Study Start Date
January 2015 (undefined)
Primary Completion Date
March 2015 (Actual)
Study Completion Date
March 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Janssen Research & Development, LLC
Collaborators
Bayer

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to assess the pharmacokinetics (the study of the way a drug enters and leaves the blood and tissues over time) and pharmacodynamics (the way a drug may change body function) of a single 15-milligram (mg) dose of rivaroxaban in both healthy participants with a creatinine clearance (CLcr) greater than equal to (>=) 80 milliliter per minute (mL/min) and clinically stable participants with end-stage renal disease (ESRD) on maintenance hemodialysis (a method used to remove waste material from the blood when the kidneys are unable to do so).
Detailed Description
This is an open-label (participants and researchers are aware about the treatment, participants are receiving), single-dose, single-center, parallel group (a medical research study comparing the response in 2 or more groups of participants receiving different interventions) study. This study consists of a Screening Period (within 21 days prior to admission into the study center on Day -1), followed by 2 treatment periods for ESRD participants (Group A) (Treatment Period 1: rivaroxaban will be administered 2 hours before the start of a 4-hour hemodialysis session on Day 1; Treatment Period 2: rivaroxaban will be administered 3 hours after the completion of a 4-hour hemodialysis session on Day 1), or 1 treatment period for healthy participants (Group B) (single oral dose of rivaroxaban will be administered on Day 1). Each treatment period will have duration of 4 days. For ESRD participants, the 2 treatments periods will be separated by a washout period of at least 7 days and a maximum of 14 days. The total study duration for ESRD participants is approximately 43 days. The total study duration for healthy participants is approximately 25 days. Blood samples will be collected to assess pharmacokinetic and pharmacodynamic parameters. Participants' safety will be monitored throughout the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
End-Stage Renal Disease
Keywords
End-Stage Renal Disease, Healthy, Rivaroxaban, BAY 59-7939, JNJ-39039039, Xarelto, Hemodialysis, Blood Coagulation, Pharmacokinetics

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Group A
Arm Type
Experimental
Arm Description
Participants with end-stage renal disease (ESRD), will receive a single 15-milligram (mg) oral dose of rivaroxaban in Treatment Period 1 on Day 1, administered 2 hours before the start of a 4-hour hemodialysis session followed 7 to 14 days later by Treatment Period 2 wherein a single 15-mg oral dose of rivaroxaban will be given 3 hours after the completion of a 4-hour hemodialysis session on Day 1.
Arm Title
Group B
Arm Type
Experimental
Arm Description
Healthy control participants matching to 'Group A' participants, will receive a single 15-mg oral dose of rivaroxaban on Day 1.
Intervention Type
Drug
Intervention Name(s)
Rivaroxaban 15 mg
Other Intervention Name(s)
JNJ-39039039, BAY 59-7939, Xarelto
Intervention Description
Single oral dose of rivaroxaban 15-mg tablet on Day 1 of each of the treatment periods.
Primary Outcome Measure Information:
Title
Maximum Observed Plasma Concentration (Cmax) of Rivaroxaban
Description
The Cmax is the maximum observed plasma concentration.
Time Frame
Pre-dose up to 72 hrs post-dose
Title
Area Under the Plasma Concentration-time Curve From Time Zero to Last Quantifiable Time (AUClast) of Rivaroxaban
Description
The AUClast is the area under the plasma concentration-time curve from time zero to time of last quantifiable concentration.
Time Frame
Pre-dose up to 72 hrs post-dose
Title
Area Under the Plasma Concentration-time Curve From Time Zero to Extrapolated Infinite Time (AUCinfinity) of Rivaroxaban
Description
The AUCinfinity is the area under the plasma concentration-time curve from time zero to extrapolated infinite time, calculated as the sum of AUClast and Clast/lambda(z), where AUClast is area under the plasma concentration-time curve from time zero to time of last quantifiable plasma concentration; Clast is the last observed quantifiable concentration; and lambda(z) is first-order rate constant associated with the terminal portion of the semilogarithmic drug concentration-time curve.
Time Frame
Pre-dose up to 72 hrs post-dose
Secondary Outcome Measure Information:
Title
Maximum Observed Effect (Emax) for Prothrombin Time (PT), Factor Xa (FXa) Inhibition and Anti-FXa
Description
Maximum observed effect (Emax) for parameters: prothrombin time (PT), factor Xa (FXa) inhibition and anti-FXa, will be assessed.
Time Frame
Pre-dose up to 72 hrs post-dose
Title
Area Under the Dose-Response Curve for Prothrombin Time (PT), Factor Xa (FXa) Inhibition and Anti-FXa
Description
The area under the dose-response curve for parameters: prothrombin time, FXa inhibition and anti-FXa, will be assessed.
Time Frame
Pre-dose up to 72 hrs post-dose
Title
Number of Participants With Adverse Events (AEs) or Serious Adverse Events (SAEs)
Description
An AE is any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. An SAE is an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly.
Time Frame
Screening up to end of study (Group A: maximum up to 43 days, Group B: maximum up to 25 days) or up to early withdrawal

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: A. All Participants: - Body mass index (BMI = weight in kilogram [kg] divided by the square of height in meter [m]) between 18 and 38 kg/m^2, extremes included, and body weight not less than 50 kg B. Additional Inclusion Criteria for ESRD Participants (Group A): Participants with end-stage renal disease (ESRD) requiring maintenance hemodialysis 2 or 3 times a week for at least 3 months prior to Screening Participants with clinically stable medical condition, consistent with ESRD, as judged by the investigator on the basis of the Screening physical examination, medical history, vital signs, 12-lead electrocardiogram (ECG), and results of clinical laboratory tests performed within 3 weeks of the first administration of study drug (unless judged to be clinically unimportant by the investigator or sponsor) Participants with diastolic blood pressure less than (<) 110 millimeter of mercury (mmHg) and/or systolic blood pressure <180 mmHg (at Screening only) recorded after 5 minutes rest in sitting position C. Additional Inclusion Criteria for Healthy Matched Control Participants (Group B): Healthy Participants on the basis of Screening physical examination, medical history, vital signs, 12-lead ECG, and results of clinical laboratory tests performed within 3 weeks prior to the administration of study drug Participants with diastolic blood pressure <95 mmHg and/or systolic blood pressure <150 mmHg recorded after 5 minutes rest in sitting position Participants with normal renal function characterized as having creatinine clearance (CLcr) >80 mL/min by Cockcroft-Gault estimate Exclusion Criteria: Participants with history of clinically significant medical illness prior to Screening including (but not limited to) chronic atrial fibrillation, hemodynamically significant valvular heart disease, heart failure (New York Heart Association Class >=II) within 6 months prior to the Screening visit, cardiac revascularization within 6 months including percutaneous transluminal coronary angioplasty or coronary artery bypass graft surgery, ischemic stroke within 6 months, previous intracranial hemorrhage at any time, anemia with a hemoglobin concentration <9 gram per deciliter (g/dL), or any other illness that the investigator considers should exclude the participant or that could interfere with the interpretation of the study results Participants diagnosed with current malignancy/active disease; (however, participants with clinically stable prostate cancer, basal cell carcinoma of the skin or who have not required antineoplastic treatment of previous cancers for at least one year are eligible) Participants with psychiatric disorders that would impair the participant's ability to participate or complete this study in the opinion of the investigator or the sponsor Participants with history of gastrointestinal disease (for example, Crohn's disease) which could result in impaired absorption of the study drugs Participants with any other disease or condition which could influence the physiological metabolic turnover of study drug (for example, endocrine diseases, febrile conditions, severe infections) Participants with history of significant hemorrhage and gastrointestinal ulceration within 6 months prior to the screening visit Participants with known primary coagulation disorders (for example, von Willebrand's disease, hemophilias) Participants with history of recurrent dialysis membrane thrombosis Participants with sensitivity to heparin Participants with dialysis for acute renal failure
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Janssen Research & Development, LLC Clinical Trial
Organizational Affiliation
Janssen Research & Development, LLC
Official's Role
Study Director
Facility Information:
City
Knoxville
State/Province
Tennessee
Country
United States

12. IPD Sharing Statement

Links:
URL
http://filehosting.pharmacm.com/DownloadService.ashx?client=CTR_JNJ_7051&studyid=8598&filename=CR105711_CSR%20Synopsis.pdf
Description
An Open-label Study to Evaluate the Pharmacokinetics, Pharmacodynamics and Safety of a Single Dose of Rivaroxaban in Subjects with End-Stage Renal Disease (ESRD) on Maintenance Hemodialysis

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A Pharmacokinetics, Pharmacodynamics and Safety Study of Single Dose of Rivaroxaban in Participants With End-Stage Renal Disease (ESRD) on Maintenance Hemodialysis

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