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Genitourinary and Pharyngeal Pharmacokinetics of Solithromycin

Primary Purpose

Gonorrhoea

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Solithromycin
Sponsored by
National Institute of Allergy and Infectious Diseases (NIAID)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gonorrhoea focused on measuring genitourinary, Neisseriaceae, pharyngeal, Solithromycin

Eligibility Criteria

18 Years - 45 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

Healthy male and non-pregnant female subjects between 18 and 45 years of age (inclusive) -Body Mass Index (BMI) between 18 and 35 kg/m2 (inclusive) -Female sexually active subjects of must use one of the following acceptable birth control methods beginning 30 days prior to dosing and through 7 days post-dose: * Abstinence * Surgical sterilization * Hormonal contraceptives other than those inserted into the vagina (e.g. NuvaRing, intrauterine devices) -Male sexually active subjects must use one of the following acceptable birth control methods from 7 days prior to dosing through 7 days after dosing: * Abstinence * Surgical sterilization -Male subjects must agree not to donate sperm for 30 days after the solithromycin dose -Willingness and ability to provide written informed consent -Willingness and ability to adhere to the lifestyle guideline restrictions outlined in the protocol -Willingness and ability to participate in all study visits as required by the protocol, including optional overnight stays or returning to the unit on Days 1, 2, and 3.

Exclusion Criteria:

-Evidence or history of clinically significant disease or current infection. --oncologic, pulmonary, hepatic, gastrointestinal, cardiovascular, hematologic, metabolic, neurologic, immunologic, nephrologic, endocrine, or psychiatric disease -History of systemic (oral or parenteral) antibiotic use within two weeks prior to administration of study drug -Any condition possibly affecting drug absorption (e.g. status post gastrectomy) -History of post-antibiotic colitis within three months prior to screening -ECG with QTc > 450msec as corrected by the Fridericia formula for both males and females, or abnormal, clinically significant finding as reported by the overreading board certified cardiologist -Blood pressure readings >140 mmHg (systolic) or >90 mm/Hg (diastolic) -Participation in another research study or receipt of an investigational agent within 30 days of administration of the study drug * Investigational agent may include vaccine, drug, biologic, device, blood product, or medication. -Use of spermicide, an intrauterine device (IUD), diaphragm, and/or vaginally inserted hormonal contraceptive (e.g. NuvaRing) seven days prior to dosing -Treatment with any CYP3A4 enzyme altering drugs, except hormonal contraceptives or topical medications, within 14 days prior to treatment with study drug: --Use of systemic prescription drugs, vitamins, or herbal supplements, which in the opinion of the investigator may interfere with solithromycin metabolism via CYP3A4, within 14 days prior to administration of the study drug including, but not limited to * Concomitant use of drugs known to prolong the QT interval including class 1a (quinidine, procainamide) or Class III (amiodarone, sotalol), or antiarrythmics * Concomitant use of drugs, food, or herbal products known to be moderate to potent inhibitors of CYP3A4 isozymes: oral antifungal agents (e.g. ketoconazole, itraconazole, posaconazole, fluconazole and voriconazole); human immunodeficiency virus (HIV) protease inhibitors (e.g. ritonavir and saquinavir), hepatitis C virus (HCV) protease inhibitors (e.g. boceprevir and telaprevir), nefazodone, fluvoxamine, conivaptan, diltiazem, verapamil, aprepitant, ticlopidine, crizotinib, imatinib; grapefruit or grapefruit juice. * Any use within the prior 7 days of drugs or herbal products known to be moderate to potent inducers of CYP3A4 isozymes: St. John's Wort, rifampin, rifabutin, anti-convulsants (e.g. phenobarbital, carbamazepine, phenytoin, rufinamide), modafinil, armodafinil, etraverine, efavirenz, bosentan. * Required current use of drugs with narrow therapeutic indices that are principally metabolized by CYP3A4 or transported by P-glycoprotein (Pgp), for which a drug interaction with solithromycin could result in higher and possibly unsafe exposures to these drugs: e.g. the P-gp substrates digoxin or colchicine and the CYP3A4 substrates alfentanil, astemizole, cisapride, cyclosporine, dihydroergotamine, ergotamine, fentanyl, midazolam, pimozide, quinidine, sirolimus, tacrolimus, everolimus, and terfenadine. * Use of any non-prescription medications, vitamins, or dietary supplements , unless prior approval is granted by the investigator * Consumption of Seville oranges or products containing Seville orange components, grapefruit, or grapefruit juice within 14 days of administration of the study drug -Positive serum pregnancy test or breast feeding during the study -Positive test for human immunodeficiency virus (HIV-1), hepatitis B surface antigen (HBsAg), or anti-hepatitis C virus (HCV) antibodies -Positive urine drug screen at Screening or Enrollment (Day -1) (marijuana, cocaine metabolite, amphetamines, opiates, phencyc lidine, methadone, barbiturates, and/or benzodiazepines) -Positive breathalyzer test for alcohol -Positive STI screen * GC, CT, syphilis, or trichomoniasis, symptomatic bacterial vaginosis (assessed by Amsel criteria), or vaginal discharge consistent with candidiasis (assessed by potassium hydroxide wet preparation) -History of clinically significant intolerance or hypersensitivity to macrolide antibiotics (as determined by the investigator) or any of the excipients in the solithromycin capsules. * Clinically significant intolerance is defined as severe nausea or vomiting after a standard dose. Note that mild nausea is common after macrolide administration and a prior history would not be a contraindication. * Likelihood of requiring treatment during the study with drugs not permitted by the protocol -Blood donation or other significant blood loss (as determined by the Investigator) within 56 days of screening -Plasma donation within seven days of screening -Laboratory values outside the eligibility ranges in the protocol (See protocol page 23 and Appendix C) for serum. -Laboratory values outside the eligibility ranges in the protocol (See protocol page 23 and Appendix C) for urinalysis. -Uncontrolled intercurrent illness (i.e. active infection) or fever (oral temperature >/=100.4 degrees Fahrenheit or >/= 38 degrees Celsius). -Known or suspected significant underlying illness including but not limited to, clinically significant liver disease, diabetes mellitus, or kidney impairment.

Sites / Locations

  • Johns Hopkins Bayview Medical Center - Infectious Diseases

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Female solithromycin

Male solithromycin

Arm Description

14 females will receive a single 1000mg dose of solithromycin after a 12 hour overnight fast (water permitted) administered orally.

14 males will receive a single 1000mg dose of solithromycin after a 12 hour overnight fast (water permitted) administered orally.

Outcomes

Primary Outcome Measures

The pharmacokinetics of solithromycin will be assessed by measurement of solithromycin levels in plasma, vaginal, cervical, seminal, rectal, and pharyngeal fluid samples at multiple time points after drug administration.

Secondary Outcome Measures

The safety and tolerability of a single 1000mg oral dose of solithromycin will be assessed by comparing ECGs to baseline ECGs
The safety and tolerability of a single 1000mg oral dose of solithromycin will be assessed by laboratory analysis.
The safety and tolerability of a single 1000mg oral dose of solithromycin will be assessed by reported adverse effects
The safety and tolerability of a single 1000mg oral dose of solithromycin will be assessed by rotine vital signs
The safety and tolerability of a single 1000mg oral dose of solithromycin will be assessed by routine physical exams

Full Information

First Posted
January 22, 2015
Last Updated
January 24, 2019
Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)
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1. Study Identification

Unique Protocol Identification Number
NCT02348424
Brief Title
Genitourinary and Pharyngeal Pharmacokinetics of Solithromycin
Official Title
Phase 1 Open Label Trial of the Safety, Tolerability, and Genitourinary and Pharyngeal Pharmacokinetics of Solithromycin
Study Type
Interventional

2. Study Status

Record Verification Date
April 5, 2017
Overall Recruitment Status
Completed
Study Start Date
May 5, 2015 (Actual)
Primary Completion Date
January 13, 2017 (Actual)
Study Completion Date
January 13, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
National Institute of Allergy and Infectious Diseases (NIAID)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
This is an open-label Phase I study of plasma, genitourinary, rectal, and pharyngeal pharmacokinetics of a single 1000mg oral dose of solithromycin. Study Objectives: The primary objective is to determine the pharmacokinetics of solithromycin in plasma, vaginal, cervical, seminal, rectal, and pharyngeal fluid samples after a single 1000mg oral dose.
Detailed Description
This is an open-label Phase I study of plasma, genitourinary, rectal, and pharyngeal pharmacokinetics of a single 1000mg oral dose of solithromycin. A total of 28 subjects (14 male, 14 female) will be enrolled and will receive a single 1000mg dose of solithromycin after a 12 hour overnight fast (water permitted). Solithromycin is a fluoroketolide antibiotic under investigation for oral and parenteral use and will be administered orally. The study duration is approximately 18 months. Study Objectives: The primary objective is to determine the pharmacokinetics of solithromycin in plasma, vaginal, cervical, seminal, rectal, and pharyngeal fluid samples after a single 1000mg oral dose. The secondary objective is to determine the safety and tolerability of a single 1000 mg oral dose of solithromycin in healthy adult subjects.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gonorrhoea
Keywords
genitourinary, Neisseriaceae, pharyngeal, Solithromycin

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Female solithromycin
Arm Type
Experimental
Arm Description
14 females will receive a single 1000mg dose of solithromycin after a 12 hour overnight fast (water permitted) administered orally.
Arm Title
Male solithromycin
Arm Type
Experimental
Arm Description
14 males will receive a single 1000mg dose of solithromycin after a 12 hour overnight fast (water permitted) administered orally.
Intervention Type
Drug
Intervention Name(s)
Solithromycin
Intervention Description
Cohorts 1 and 2 will receive a single 1000mg dose of solithromycin after a 12 hour overnight fast (water permitted). Solithromycin is a fluoroketolide antibiotic under investigation for oral and parenteral use and will be administered orally.
Primary Outcome Measure Information:
Title
The pharmacokinetics of solithromycin will be assessed by measurement of solithromycin levels in plasma, vaginal, cervical, seminal, rectal, and pharyngeal fluid samples at multiple time points after drug administration.
Time Frame
Day 1 to Day 3
Secondary Outcome Measure Information:
Title
The safety and tolerability of a single 1000mg oral dose of solithromycin will be assessed by comparing ECGs to baseline ECGs
Time Frame
Day 1 to Day 7
Title
The safety and tolerability of a single 1000mg oral dose of solithromycin will be assessed by laboratory analysis.
Time Frame
Day 1 to Day 7
Title
The safety and tolerability of a single 1000mg oral dose of solithromycin will be assessed by reported adverse effects
Time Frame
Day 1 to Day 7
Title
The safety and tolerability of a single 1000mg oral dose of solithromycin will be assessed by rotine vital signs
Time Frame
Day 1 to Day 7
Title
The safety and tolerability of a single 1000mg oral dose of solithromycin will be assessed by routine physical exams
Time Frame
Day 1 to Day 7

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy male and non-pregnant female subjects between 18 and 45 years of age (inclusive) -Body Mass Index (BMI) between 18 and 35 kg/m2 (inclusive) -Female sexually active subjects of must use one of the following acceptable birth control methods beginning 30 days prior to dosing and through 7 days post-dose: * Abstinence * Surgical sterilization * Hormonal contraceptives other than those inserted into the vagina (e.g. NuvaRing, intrauterine devices) -Male sexually active subjects must use one of the following acceptable birth control methods from 7 days prior to dosing through 7 days after dosing: * Abstinence * Surgical sterilization -Male subjects must agree not to donate sperm for 30 days after the solithromycin dose -Willingness and ability to provide written informed consent -Willingness and ability to adhere to the lifestyle guideline restrictions outlined in the protocol -Willingness and ability to participate in all study visits as required by the protocol, including optional overnight stays or returning to the unit on Days 1, 2, and 3. Exclusion Criteria: -Evidence or history of clinically significant disease or current infection. --oncologic, pulmonary, hepatic, gastrointestinal, cardiovascular, hematologic, metabolic, neurologic, immunologic, nephrologic, endocrine, or psychiatric disease -History of systemic (oral or parenteral) antibiotic use within two weeks prior to administration of study drug -Any condition possibly affecting drug absorption (e.g. status post gastrectomy) -History of post-antibiotic colitis within three months prior to screening -ECG with QTc > 450msec as corrected by the Fridericia formula for both males and females, or abnormal, clinically significant finding as reported by the overreading board certified cardiologist -Blood pressure readings >140 mmHg (systolic) or >90 mm/Hg (diastolic) -Participation in another research study or receipt of an investigational agent within 30 days of administration of the study drug * Investigational agent may include vaccine, drug, biologic, device, blood product, or medication. -Use of spermicide, an intrauterine device (IUD), diaphragm, and/or vaginally inserted hormonal contraceptive (e.g. NuvaRing) seven days prior to dosing -Treatment with any CYP3A4 enzyme altering drugs, except hormonal contraceptives or topical medications, within 14 days prior to treatment with study drug: --Use of systemic prescription drugs, vitamins, or herbal supplements, which in the opinion of the investigator may interfere with solithromycin metabolism via CYP3A4, within 14 days prior to administration of the study drug including, but not limited to * Concomitant use of drugs known to prolong the QT interval including class 1a (quinidine, procainamide) or Class III (amiodarone, sotalol), or antiarrythmics * Concomitant use of drugs, food, or herbal products known to be moderate to potent inhibitors of CYP3A4 isozymes: oral antifungal agents (e.g. ketoconazole, itraconazole, posaconazole, fluconazole and voriconazole); human immunodeficiency virus (HIV) protease inhibitors (e.g. ritonavir and saquinavir), hepatitis C virus (HCV) protease inhibitors (e.g. boceprevir and telaprevir), nefazodone, fluvoxamine, conivaptan, diltiazem, verapamil, aprepitant, ticlopidine, crizotinib, imatinib; grapefruit or grapefruit juice. * Any use within the prior 7 days of drugs or herbal products known to be moderate to potent inducers of CYP3A4 isozymes: St. John's Wort, rifampin, rifabutin, anti-convulsants (e.g. phenobarbital, carbamazepine, phenytoin, rufinamide), modafinil, armodafinil, etraverine, efavirenz, bosentan. * Required current use of drugs with narrow therapeutic indices that are principally metabolized by CYP3A4 or transported by P-glycoprotein (Pgp), for which a drug interaction with solithromycin could result in higher and possibly unsafe exposures to these drugs: e.g. the P-gp substrates digoxin or colchicine and the CYP3A4 substrates alfentanil, astemizole, cisapride, cyclosporine, dihydroergotamine, ergotamine, fentanyl, midazolam, pimozide, quinidine, sirolimus, tacrolimus, everolimus, and terfenadine. * Use of any non-prescription medications, vitamins, or dietary supplements , unless prior approval is granted by the investigator * Consumption of Seville oranges or products containing Seville orange components, grapefruit, or grapefruit juice within 14 days of administration of the study drug -Positive serum pregnancy test or breast feeding during the study -Positive test for human immunodeficiency virus (HIV-1), hepatitis B surface antigen (HBsAg), or anti-hepatitis C virus (HCV) antibodies -Positive urine drug screen at Screening or Enrollment (Day -1) (marijuana, cocaine metabolite, amphetamines, opiates, phencyc lidine, methadone, barbiturates, and/or benzodiazepines) -Positive breathalyzer test for alcohol -Positive STI screen * GC, CT, syphilis, or trichomoniasis, symptomatic bacterial vaginosis (assessed by Amsel criteria), or vaginal discharge consistent with candidiasis (assessed by potassium hydroxide wet preparation) -History of clinically significant intolerance or hypersensitivity to macrolide antibiotics (as determined by the investigator) or any of the excipients in the solithromycin capsules. * Clinically significant intolerance is defined as severe nausea or vomiting after a standard dose. Note that mild nausea is common after macrolide administration and a prior history would not be a contraindication. * Likelihood of requiring treatment during the study with drugs not permitted by the protocol -Blood donation or other significant blood loss (as determined by the Investigator) within 56 days of screening -Plasma donation within seven days of screening -Laboratory values outside the eligibility ranges in the protocol (See protocol page 23 and Appendix C) for serum. -Laboratory values outside the eligibility ranges in the protocol (See protocol page 23 and Appendix C) for urinalysis. -Uncontrolled intercurrent illness (i.e. active infection) or fever (oral temperature >/=100.4 degrees Fahrenheit or >/= 38 degrees Celsius). -Known or suspected significant underlying illness including but not limited to, clinically significant liver disease, diabetes mellitus, or kidney impairment.
Facility Information:
Facility Name
Johns Hopkins Bayview Medical Center - Infectious Diseases
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21224-2735
Country
United States

12. IPD Sharing Statement

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Genitourinary and Pharyngeal Pharmacokinetics of Solithromycin

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