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The Effect of Various Amounts of Fat on PK of Oral Testosterone Undecanoate

Primary Purpose

Hypogonadism

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Oral Testosterone Undecanoate
Sponsored by
Clarus Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Hypogonadism

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Man 18 to 65 years of age, inclusive, with a clinical diagnosis of hypogonadism (signs/symptoms consistent with hypogonadism for testosterone naïve subjects and history of signs/symptoms for subjects who have received prior treatment) as well as testosterone levels consistent with hypogonadism as defined by 2 morning total T values of <300 ng/dL (between 6:00 and 10:00 AM drawn on 2 separate days [approximately 7 (±2) days apart].
  2. Adequate venous access in the left or right arm to allow collection of a number of blood samples via a venous cannula.
  3. Must be naïve to androgen-replacement therapy or washed out of prior androgen replacement therapies; that is, be willing to cease current T treatment or currently not be taking T treatment, (washout durations specified in exclusion criterion #1). Subjects must remain off all forms of T, except for dispensed study drug, throughout the entire study.
  4. Subjects on replacement therapy for hypopituitarism or multiple endocrine deficiencies must be on stable doses of thyroid hormone and adrenal replacement hormones for at least 14 days before Screen 1.
  5. Has voluntarily given written informed consent to participate in this study.

Exclusion Criteria:

  1. Received oral topical (eg, gel or patch), intranasal, or buccal T therapy within the previous 2 weeks, intramuscular T injection of short-acting duration (eg, T enanthate, T cypionate) within the previous 4 weeks, intramuscular T injection of long-acting duration (eg, AVEED) within the previous 20 weeks, or T implantable pellets (Testopel®) within the previous 6 months.
  2. Has an intercurrent disease deemed clinically significant in the opinion of the investigator of any type; in particular, liver, kidney, uncontrolled or poorly controlled heart disease, including hypertension, congestive heart failure or coronary heart disease, or psychiatric-illness, including severe depression.
  3. Has had a recent (within 2 years) history of stroke, transient ischemic attack, or acute coronary event.
  4. Has a mean of the triplicate assessment of sBP > 150 mm Hg and/or dBP > 90 mm Hg at screening (if prescribed antihypertensives, subject should be taking medications on the day of the screening visit with a sip of water). Subjects < 60 years of age and prescribed antihypertensives will be excluded if the mean of the triplicate assessment of sBP > 140 mm Hg and/or dBP > 90 mm Hg at screening.
  5. Has had recent (within 2 years) history of angina or stent (coronary or carotid) placement.
  6. Has untreated, severe obstructive sleep apnea.
  7. Has clinically significant abnormal laboratory values, including serum transaminases > 2 × upper limits of normal (ULN), serum bilirubin > 1.5 × ULN and serum creatinine > 1.5 × ULN.
  8. Has a hematocrit (HCT) value of < 35% or > 48%.
  9. Has a history of polycythemia, either idiopathic or associated with TRT treatment.
  10. Is a diabetic subject with a glycosylated hemoglobin > 8.5%.
  11. Has a body mass index (BMI) ≥ 38 kg/m2.
  12. Has been on stable doses of antihypertensive medication for < 3 months.
  13. Has an abnormal prostate digital rectal examination [(DRE); palpable nodules], elevated PSA (serum PSA > 4.0 ng/mL), I-PSS > 19 points at screening, and/or history of, or current or suspected, prostate cancer.
  14. Has a history of, or current or suspected, breast cancer.
  15. Has a history of abnormal bleeding tendencies or thrombophlebitis unrelated to venipuncture or intravenous cannulation within the previous 2 years.
  16. Use of dietary supplements such as saw palmetto or phytoestrogens and any dietary supplements that may increase total T, such as androstenedione or dehydroepiandrosterone within the previous 4 weeks.
  17. Has known malabsorption syndrome and/or current treatment with oral lipase inhibitors (eg, orlistat [Xenical®]) and/or bile acid-binding resins (eg, cholestyramine [Questran®], colestipol [Colestid®]) or treatments that promote gastric emptying (eg, metoclopramide [Reglan®]).
  18. Inability to observe all rules and smoking restrictions in place at the clinical facility during confinement.
  19. Has history of abuse of alcohol or any drug substance within the previous 2 years.
  20. Poor compliance or unlikely to keep clinic appointments and remain for entire confinement period.
  21. Has received any drug as part of another research study within 30 days of initial dose administration in this study.
  22. Donated blood (≥ 500 mL) within the 12-week period before the initial study dose.
  23. Current use of the following groups of drugs that effect T levels, T metabolism or levels of T metabolites, namely antiandrogens, 5-alpha-reductase inhibitors (eg, dutasteride, finasteride), estrogens, long-acting opioid analgesics (eg, methadone hydrochloride, buprenorphine hydrochloride) or human growth hormone (HGH).
  24. Unwilling or unable to follow the dietary requirements for this study.

Sites / Locations

  • Harbor-UCLA Medical Center
  • Orlando Clinical Research Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Other

Other

Other

Other

Other

Arm Label

Breakfast A - Fasting

Breakfast B - 15 g fat

Breakfast C - 30 g fat

Breakfast D - 45 g fat

Breakfast E - High Fat

Arm Description

Oral Testosterone Undecanoate 237 mg administered twice daily immediately prior to Fasting at breakfast and immediately prior to dinner.

Oral Testosterone Undecanoate 237 mg administered twice daily immediately prior to 15 g fat breakfast and immediately prior to dinner.

Oral Testosterone Undecanoate 237 mg administered twice daily immediately prior to 30 g fat breakfast and immediately prior to dinner.

Oral Testosterone Undecanoate 237 mg administered twice daily immediately prior to 45 g fat breakfast and immediately prior to dinner.

Oral Testosterone Undecanoate 237 mg administered twice daily immediately prior to high fat breakfast and immediately prior to dinner.

Outcomes

Primary Outcome Measures

Cmax-am for Oral TU Across Breakfast With Varying Fat Content
Peak Concentration after morning dose (Cmax) for oral testosterone undecanoate taken after a fasting breakfast of varying fat content.
Time of Peak Concentration (Tmax-am)
The time of peak concentration (Tmax-am) will be assessed within each relevant dosing interval.
Area Under the Curve (AUC-am)
The 12 hours following morning dose area under the curve (AUC) will assessed for each sequence of breakfasts with varying fat content.
Time Weighted Average Total Testosterone Concentration (Cavg-am)
The time weighted average of total testosterone concentration will be assessed for each dosing interval.

Secondary Outcome Measures

Full Information

First Posted
September 29, 2016
Last Updated
April 18, 2018
Sponsor
Clarus Therapeutics, Inc.
Collaborators
Celerion
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1. Study Identification

Unique Protocol Identification Number
NCT02921386
Brief Title
The Effect of Various Amounts of Fat on PK of Oral Testosterone Undecanoate
Official Title
A Phase 2 Study of the Effect of Meals With Various Amounts of Fat Given Immediately After Dosing on the Pharmacokinetics of an Oral Testosterone Undecanoate
Study Type
Interventional

2. Study Status

Record Verification Date
April 2018
Overall Recruitment Status
Completed
Study Start Date
October 2016 (undefined)
Primary Completion Date
January 21, 2017 (Actual)
Study Completion Date
January 21, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Clarus Therapeutics, Inc.
Collaborators
Celerion

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
A Phase 2, open-label, randomized, cross-over, pharmacokinetic study designed to determine the effect of meals of various amounts of fat given immediately prior to dosing on the pharmacokinetics of oral testosterone undecanoate. Approximately 20 hypogonadal subjects will be dosed for a 14 day run-in period. This will be followed by a randomized sequence of five periods over a 6 day confinement period. Subjects will receive a randomly ordered sequence of breakfast meals containing various amounts of fat, fasting, 15 g, 30 g, 45 g and a high fat breakfast consistent Guidance for Industry on Food-Effect Bioavailability and Fed Bioequivalence Studies.
Detailed Description
This is a Phase 2, open-label, randomized, cross over, pharmacokinetic study. Subjects will initially be dosed for 2 weeks (Run-In Phase) to allow suppression of endogenous testosterone production, while allowing the oral TU to reach steady state. The subjects will then be confined to a clinical unit in which they undergo the PK Phase of the study. During the PK Phase of the study, subjects will undergo a five-period cross-over in which oral TU is dosed twice daily. Subjects will dose in the morning and in the evening immediately prior to protocol-defined meals. The protocol-defined breakfasts will contain various levels of fat including 15 g, 30 g, 45 g, a breakfast consistent with the fat and calorie content of the high-fat breakfast consistent with recommendations in the Guidance for Industry on Food-Effect Bioavailability and Fed Bioequivalence Studies (December 2002), or while fasting (with no meal until 4 hours post-dose). Subjects will be randomized to a designated sequence of the protocol-defined breakfasts, or the fasted state. The subjects will be required to consume the entire breakfast within 20 minutes during the PK Phase. The protocol-defined evening meal will be required to be consumed within 20 minutes. The 5 meal periods will occur on sequential days. Approximately twenty (20) subjects will be enrolled in order to ensure completion of 16 subjects.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Model Description
Open-label, randomized, 5-period crossover food effect study
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
18 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Breakfast A - Fasting
Arm Type
Other
Arm Description
Oral Testosterone Undecanoate 237 mg administered twice daily immediately prior to Fasting at breakfast and immediately prior to dinner.
Arm Title
Breakfast B - 15 g fat
Arm Type
Other
Arm Description
Oral Testosterone Undecanoate 237 mg administered twice daily immediately prior to 15 g fat breakfast and immediately prior to dinner.
Arm Title
Breakfast C - 30 g fat
Arm Type
Other
Arm Description
Oral Testosterone Undecanoate 237 mg administered twice daily immediately prior to 30 g fat breakfast and immediately prior to dinner.
Arm Title
Breakfast D - 45 g fat
Arm Type
Other
Arm Description
Oral Testosterone Undecanoate 237 mg administered twice daily immediately prior to 45 g fat breakfast and immediately prior to dinner.
Arm Title
Breakfast E - High Fat
Arm Type
Other
Arm Description
Oral Testosterone Undecanoate 237 mg administered twice daily immediately prior to high fat breakfast and immediately prior to dinner.
Intervention Type
Drug
Intervention Name(s)
Oral Testosterone Undecanoate
Intervention Description
All study participants received Oral TU dose of 237 mg TU twice daily before breakfast and dinner for 14 days and throughout 5 crossover periods
Primary Outcome Measure Information:
Title
Cmax-am for Oral TU Across Breakfast With Varying Fat Content
Description
Peak Concentration after morning dose (Cmax) for oral testosterone undecanoate taken after a fasting breakfast of varying fat content.
Time Frame
0, 1, 2, 3, 4, 6, 8, 12 hours post-dose
Title
Time of Peak Concentration (Tmax-am)
Description
The time of peak concentration (Tmax-am) will be assessed within each relevant dosing interval.
Time Frame
12 hours
Title
Area Under the Curve (AUC-am)
Description
The 12 hours following morning dose area under the curve (AUC) will assessed for each sequence of breakfasts with varying fat content.
Time Frame
0, 1, 2, 3, 4, 6, 8, 12 hours post-dose
Title
Time Weighted Average Total Testosterone Concentration (Cavg-am)
Description
The time weighted average of total testosterone concentration will be assessed for each dosing interval.
Time Frame
12 hours

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Man 18 to 65 years of age, inclusive, with a clinical diagnosis of hypogonadism (signs/symptoms consistent with hypogonadism for testosterone naïve subjects and history of signs/symptoms for subjects who have received prior treatment) as well as testosterone levels consistent with hypogonadism as defined by 2 morning total T values of <300 ng/dL (between 6:00 and 10:00 AM drawn on 2 separate days [approximately 7 (±2) days apart]. Adequate venous access in the left or right arm to allow collection of a number of blood samples via a venous cannula. Must be naïve to androgen-replacement therapy or washed out of prior androgen replacement therapies; that is, be willing to cease current T treatment or currently not be taking T treatment, (washout durations specified in exclusion criterion #1). Subjects must remain off all forms of T, except for dispensed study drug, throughout the entire study. Subjects on replacement therapy for hypopituitarism or multiple endocrine deficiencies must be on stable doses of thyroid hormone and adrenal replacement hormones for at least 14 days before Screen 1. Has voluntarily given written informed consent to participate in this study. Exclusion Criteria: Received oral topical (eg, gel or patch), intranasal, or buccal T therapy within the previous 2 weeks, intramuscular T injection of short-acting duration (eg, T enanthate, T cypionate) within the previous 4 weeks, intramuscular T injection of long-acting duration (eg, AVEED) within the previous 20 weeks, or T implantable pellets (Testopel®) within the previous 6 months. Has an intercurrent disease deemed clinically significant in the opinion of the investigator of any type; in particular, liver, kidney, uncontrolled or poorly controlled heart disease, including hypertension, congestive heart failure or coronary heart disease, or psychiatric-illness, including severe depression. Has had a recent (within 2 years) history of stroke, transient ischemic attack, or acute coronary event. Has a mean of the triplicate assessment of sBP > 150 mm Hg and/or dBP > 90 mm Hg at screening (if prescribed antihypertensives, subject should be taking medications on the day of the screening visit with a sip of water). Subjects < 60 years of age and prescribed antihypertensives will be excluded if the mean of the triplicate assessment of sBP > 140 mm Hg and/or dBP > 90 mm Hg at screening. Has had recent (within 2 years) history of angina or stent (coronary or carotid) placement. Has untreated, severe obstructive sleep apnea. Has clinically significant abnormal laboratory values, including serum transaminases > 2 × upper limits of normal (ULN), serum bilirubin > 1.5 × ULN and serum creatinine > 1.5 × ULN. Has a hematocrit (HCT) value of < 35% or > 48%. Has a history of polycythemia, either idiopathic or associated with TRT treatment. Is a diabetic subject with a glycosylated hemoglobin > 8.5%. Has a body mass index (BMI) ≥ 38 kg/m2. Has been on stable doses of antihypertensive medication for < 3 months. Has an abnormal prostate digital rectal examination [(DRE); palpable nodules], elevated PSA (serum PSA > 4.0 ng/mL), I-PSS > 19 points at screening, and/or history of, or current or suspected, prostate cancer. Has a history of, or current or suspected, breast cancer. Has a history of abnormal bleeding tendencies or thrombophlebitis unrelated to venipuncture or intravenous cannulation within the previous 2 years. Use of dietary supplements such as saw palmetto or phytoestrogens and any dietary supplements that may increase total T, such as androstenedione or dehydroepiandrosterone within the previous 4 weeks. Has known malabsorption syndrome and/or current treatment with oral lipase inhibitors (eg, orlistat [Xenical®]) and/or bile acid-binding resins (eg, cholestyramine [Questran®], colestipol [Colestid®]) or treatments that promote gastric emptying (eg, metoclopramide [Reglan®]). Inability to observe all rules and smoking restrictions in place at the clinical facility during confinement. Has history of abuse of alcohol or any drug substance within the previous 2 years. Poor compliance or unlikely to keep clinic appointments and remain for entire confinement period. Has received any drug as part of another research study within 30 days of initial dose administration in this study. Donated blood (≥ 500 mL) within the 12-week period before the initial study dose. Current use of the following groups of drugs that effect T levels, T metabolism or levels of T metabolites, namely antiandrogens, 5-alpha-reductase inhibitors (eg, dutasteride, finasteride), estrogens, long-acting opioid analgesics (eg, methadone hydrochloride, buprenorphine hydrochloride) or human growth hormone (HGH). Unwilling or unable to follow the dietary requirements for this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ronald Swerdloff
Organizational Affiliation
Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Harbor-UCLA Medical Center
City
Torrance
State/Province
California
ZIP/Postal Code
90502
Country
United States
Facility Name
Orlando Clinical Research Center
City
Orlando
State/Province
Florida
ZIP/Postal Code
32809-3017
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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The Effect of Various Amounts of Fat on PK of Oral Testosterone Undecanoate

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