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An Assessment of Pharmacokinetic Gemigliptin and Metformin Interactions in Healthy Mexican Volunteers

Primary Purpose

Diabetes Mellitus, Type 2

Status
Completed
Phase
Phase 1
Locations
Mexico
Study Type
Interventional
Intervention
Gemigliptin
Gemigliptin 50 mg q.d. + metformin 1000 mg twice a day
Metformin
Sponsored by
Stendhal Americas, S.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetes Mellitus, Type 2 focused on measuring Type 2 Diabetes Mellitus, DPP-IV inhibitor, Drug-Drug Interactions, Ethnicity

Eligibility Criteria

20 Years - 45 Years (Adult)MaleAccepts Healthy Volunteers

Inclusion Criteria:

  • Healthy male subjects at age between 20 and 45 at the screening test
  • Subjects with a body weight of 55kg or more but less than 90kg and a Body Mass Index (BMI) of between 18.0 or more but less than 27.0

    • BMI (kg/m2) = Weight (kg) / {Height (m)}2
  • Subjects who show the blood glucose level within the range of 70-125 mg/dL at the fasting plasma glucose (FPG) test conducted at screening
  • Subjects who fully understand this clinical trial after hearing a detailed explanation about it, make a decision to participate in it by his/her own free will, and sign an informed consent form to comply with the precautions

Exclusion Criteria:

  • Subjects who have a present condition or past history of any disease involving liver, kidney, nervous system, immune system, respiratory system, or endocrine system, hematologic and oncologic disease, cardiovascular disease, or psychiatric disorder (mood disorder, obsessive-compulsive disorder, etc.) (including subjects carrying hepatitis virus in case of liver disease)
  • Subjects with a past history of a gastrointestinal system disease (Crohn's disease, ulcer, acute or chronic pancreatitis, etc.) or a gastrointestinal system surgery (however, subjects with a history of appendectomy or hernioplasty are not excluded)
  • Subjects with a medical history of allergic reaction to drugs (aspirin, antibiotics, etc.) or clinically significant hypersensitivity reaction
  • Subjects who show one of the following results at screening test:

    • Exceeds 1.5 times the upper limit of the normal range of blood AST (SGOT) and ALT (SGPT)
    • The creatinine clearance calculated by Cockcroft-Gault equation is below 80 mL/min.
    • QTc > 450 ms in ECG or clinically significant abnormal rhythm
  • In the vital signs measured in sitting position after a rest for 3 minutes or longer, subjects who showed a systolic blood pressure of ≤ 100 mmHg or ≥ 150 mmHg, or a diastolic blood pressure of ≤ 60 mmHg or ≥ 95 mmHg)
  • Subjects who have a past history of drug abuse or have shown a positive reaction to drugs that are used in abusive manner or cotinine at a urine drug screening
  • Subjects who have taken any ethical drug or an herbal medication within 2 weeks before the date of first administration or have taken any over-the-counter (OTC) drug or vitamin preparation within 1 week (however, they can be included as subjects if considered appropriate at the investigator's discretion judgment)
  • Subject who have already participated in other clinical trials within 2 months before the date of first drug administration
  • Subject who have had whole blood donation within 2 months or component blood donation within 1 month before the date of first drug administration, or transfusion in 1 month before the date of first drug administration
  • Subjects who have been drinking alcohol continuously (more than 21 units/week, 1 unit = 10 g of pure alcohol) or can't refrain from drinking alcohol during the clinical trial period
  • Smokers (however, if the subject stopped smoking more than 3 months before the date of the first drug administration, he/she can be selected as a subject)
  • 12) Subjects who have had grapefruit/ any food containing caffeine within 3 days before the date of the first drug administration

Sites / Locations

  • Unidad de Farmacología Clínica de la Facultad de Medicina de la Universidad Nacional Autónoma de México

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Other

Other

Other

Arm Label

Treatment sequence A

Treatment sequence B

Treatment sequence C

Arm Description

Gemigliptin 50 mg q.d. during 7 days, metformin 1000 mg twice a day during 7 days and gemigliptin 50 mg q.d + metformin 1000 mg twice a day during 7 days.

Gemigliptin 50 mg q.d + metformin 1000 mg twice a day during 7 days, gemigliptin 50 mg q.d. during 7 days, metformin 1000 mg twice a day during 7 days

Metformin 1000 mg twice a day during 7 days, gemigliptin 50 mg q.d + metformin 1000 mg twice a day during 7 days, gemigliptin 50 mg q.d. during 7 days

Outcomes

Primary Outcome Measures

Gemigliptin AUCτ,ss Geometric Mean Ratio (and 90%CI)
AUCτ,ss Geometric Mean Ratio for gemigliptin when administered concomitanty with metformin (test) to its administration alone (reference)

Secondary Outcome Measures

Gemigliptin Cmax,ss Geometric Mean Ratio (and 90%CI)
Cmax,ss Geometric Mean Ratio for gemigliptin when administered concomitanty with metformin (test) to its administration alone (reference)
Metformin AUCτ,ss Geometric Mean Ratio (and 90%CI)
AUCτ,ss Geometric Mean Ratio for metformin when administered concomitanty with metformin (test) to its administration alone (reference)
Metformin Cmax,ss Geometric Mean Ratio (and 90%CI)
Cmax,ss Geometric Mean Ratio for metformin when administered concomitanty with metformin (test) to its administration alone (reference)
Ctrough,ss
Lowest plasma concentration prior to the next dose administration at steady state
Aeτ,ss
cumulative amount of drug excreted in the urine during a dosing interval
CLss/F
Apparent drug clearance
CLR,ss
Renal drug clearance
MR
Metabolic ratio
Tmax
Time to maximum plasma concentration at steady state

Full Information

First Posted
September 13, 2017
Last Updated
October 13, 2017
Sponsor
Stendhal Americas, S.A.
Collaborators
Universidad Nacional Autonoma de Mexico, LG Chem
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1. Study Identification

Unique Protocol Identification Number
NCT03310749
Brief Title
An Assessment of Pharmacokinetic Gemigliptin and Metformin Interactions in Healthy Mexican Volunteers
Official Title
A Randomized, Open-label, Multiple Dosing, Three-way Crossover Clinical Trial to Investigate the Pharmacokinetic Drug-drug Interaction of Gemigliptin and Metformin After Oral Administration in Healthy Mexican Male Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
October 2017
Overall Recruitment Status
Completed
Study Start Date
January 15, 2016 (Actual)
Primary Completion Date
May 3, 2016 (Actual)
Study Completion Date
May 3, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Stendhal Americas, S.A.
Collaborators
Universidad Nacional Autonoma de Mexico, LG Chem

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
This is an open, randomized (randomization ratio: 1:1), multiple dose, three way, three period cross over study to assess the potential for drug drug interactions between gemigliptin (a DPP-IV inhibitor mainly metabolized by CYP3A4) and metformin in a sample of healthy Mexican volunteers, aimed to determine whether the observed lack of drug-drug interactions between gemigliptin and metformin in the Korean population is reproducible in an ethnically different population characterized by a significant difference in the frequency of CYP3A4 polymorphisms associated with decreased enzymatic activity, such as CYP3A4*1b, in comparison with Asian populations.
Detailed Description
Consenting, eligible healthy adult subjects sequentially received either gemigliptin 50 mg q.d., metformin 1000 mg twice a day or gemigliptin 50 mg q.d. plus metformin 1000 mg twice a day during 3 consecutive 7 day treatment periods separated by two 5-day washout intervals, in accordance with a randomly assigned treatment sequence. Starting on the sixth treatment period day, participating subjects underwent safety assessments and repeated (24 hour) blood and urine sampling for pharmacokinetic analysis. All subjects attended to a post-study visit for final safety assessments within 8 days of study completion or early withdrawal. Urine and plasma samples where processed to determine gemigliptin and metformin concentrations using validated analytical methods and pharmacokinetic profiles of both gemigliptin and metformin were obtained using a non-compartmental method; both the rate and degree of gemigliptin and metformin absorption resulting from their concomitant administration relative to the administration of each drug alone were assessed in search of potential pharmacokinetic interactions, Finally, a post hoc assessment of the degree and rate of the absorption of gemigliptin in the study population relative to those of a group of Korean subjects participating in phase I, repeated dose gemigliptin studies was conducted.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetes Mellitus, Type 2
Keywords
Type 2 Diabetes Mellitus, DPP-IV inhibitor, Drug-Drug Interactions, Ethnicity

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Model Description
Open, randomized, multiple dose, three way, three period, cross over, drug-drug interaction, safety and tolerability study
Masking
None (Open Label)
Allocation
Randomized
Enrollment
34 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment sequence A
Arm Type
Other
Arm Description
Gemigliptin 50 mg q.d. during 7 days, metformin 1000 mg twice a day during 7 days and gemigliptin 50 mg q.d + metformin 1000 mg twice a day during 7 days.
Arm Title
Treatment sequence B
Arm Type
Other
Arm Description
Gemigliptin 50 mg q.d + metformin 1000 mg twice a day during 7 days, gemigliptin 50 mg q.d. during 7 days, metformin 1000 mg twice a day during 7 days
Arm Title
Treatment sequence C
Arm Type
Other
Arm Description
Metformin 1000 mg twice a day during 7 days, gemigliptin 50 mg q.d + metformin 1000 mg twice a day during 7 days, gemigliptin 50 mg q.d. during 7 days
Intervention Type
Drug
Intervention Name(s)
Gemigliptin
Other Intervention Name(s)
Metformin, Gemigliptin 50 mg q.d. + metformin 1000 mg twice a day
Intervention Description
A 7-day treatment period with gemigliptin 50 mg q.d., followed by a 5-day washout period; a 7 day treatment period with metformin 1000 mg twice a day followed by a 5-day washout period and a final 7-day treatment period with gemigliptin 50 mg q.d. + metformin 1000 mg twice a day
Intervention Type
Drug
Intervention Name(s)
Gemigliptin 50 mg q.d. + metformin 1000 mg twice a day
Other Intervention Name(s)
Gemigliptin, Metformin
Intervention Description
A 7-day treatment period with gemigliptin 50 mg q.d. + metformin 1000 mg twice a day followed by a 5-day washout period; a 7-day treatment period with gemigliptin 50 mg q.d. followed by a 5-day washout period and a final 7-day treatment period with metformin 1000 mg twice a day
Intervention Type
Drug
Intervention Name(s)
Metformin
Other Intervention Name(s)
Gemigliptin 50 mg q.d. + metformin 1000 mg twice a day, Gemigliptin
Intervention Description
A 7-day treatment period with 1000 mg metformin twice a day followed by a 5-day washout period; a 7-day treatment period with gemigliptin 50 mg q.d.+ metformin 1000 mg twice a day followed by a 5-day washout period and a final 7-day treatment period with gemigliptin 50 mg q.d.
Primary Outcome Measure Information:
Title
Gemigliptin AUCτ,ss Geometric Mean Ratio (and 90%CI)
Description
AUCτ,ss Geometric Mean Ratio for gemigliptin when administered concomitanty with metformin (test) to its administration alone (reference)
Time Frame
At steady state, on the sixth planned treatment day
Secondary Outcome Measure Information:
Title
Gemigliptin Cmax,ss Geometric Mean Ratio (and 90%CI)
Description
Cmax,ss Geometric Mean Ratio for gemigliptin when administered concomitanty with metformin (test) to its administration alone (reference)
Time Frame
At steady state, on the sixth planned treatment day
Title
Metformin AUCτ,ss Geometric Mean Ratio (and 90%CI)
Description
AUCτ,ss Geometric Mean Ratio for metformin when administered concomitanty with metformin (test) to its administration alone (reference)
Time Frame
At steady state, on the sixth planned treatment day
Title
Metformin Cmax,ss Geometric Mean Ratio (and 90%CI)
Description
Cmax,ss Geometric Mean Ratio for metformin when administered concomitanty with metformin (test) to its administration alone (reference)
Time Frame
At steady state, on the sixth planned treatment day
Title
Ctrough,ss
Description
Lowest plasma concentration prior to the next dose administration at steady state
Time Frame
At steady state, on the sixth planned treatment day
Title
Aeτ,ss
Description
cumulative amount of drug excreted in the urine during a dosing interval
Time Frame
At steady state, on the sixth planned treatment day
Title
CLss/F
Description
Apparent drug clearance
Time Frame
At steady state, on the sixth planned treatment day
Title
CLR,ss
Description
Renal drug clearance
Time Frame
At steady state, on the sixth planned treatment day
Title
MR
Description
Metabolic ratio
Time Frame
At steady state, on the sixth planned treatment day
Title
Tmax
Description
Time to maximum plasma concentration at steady state
Time Frame
At steady state, on the sixth planned treatment day
Other Pre-specified Outcome Measures:
Title
Incidence of treatment-emergent adverse events
Description
Incidence of adverse events occuring during the exposure to the study medications
Time Frame
From the first pre-treatment admission date, trough the 39 days required for completion of the planned treatment/sampling and washout periods up to and including the post-study safety visit, conducted at study day 44

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy male subjects at age between 20 and 45 at the screening test Subjects with a body weight of 55kg or more but less than 90kg and a Body Mass Index (BMI) of between 18.0 or more but less than 27.0 BMI (kg/m2) = Weight (kg) / {Height (m)}2 Subjects who show the blood glucose level within the range of 70-125 mg/dL at the fasting plasma glucose (FPG) test conducted at screening Subjects who fully understand this clinical trial after hearing a detailed explanation about it, make a decision to participate in it by his/her own free will, and sign an informed consent form to comply with the precautions Exclusion Criteria: Subjects who have a present condition or past history of any disease involving liver, kidney, nervous system, immune system, respiratory system, or endocrine system, hematologic and oncologic disease, cardiovascular disease, or psychiatric disorder (mood disorder, obsessive-compulsive disorder, etc.) (including subjects carrying hepatitis virus in case of liver disease) Subjects with a past history of a gastrointestinal system disease (Crohn's disease, ulcer, acute or chronic pancreatitis, etc.) or a gastrointestinal system surgery (however, subjects with a history of appendectomy or hernioplasty are not excluded) Subjects with a medical history of allergic reaction to drugs (aspirin, antibiotics, etc.) or clinically significant hypersensitivity reaction Subjects who show one of the following results at screening test: Exceeds 1.5 times the upper limit of the normal range of blood AST (SGOT) and ALT (SGPT) The creatinine clearance calculated by Cockcroft-Gault equation is below 80 mL/min. QTc > 450 ms in ECG or clinically significant abnormal rhythm In the vital signs measured in sitting position after a rest for 3 minutes or longer, subjects who showed a systolic blood pressure of ≤ 100 mmHg or ≥ 150 mmHg, or a diastolic blood pressure of ≤ 60 mmHg or ≥ 95 mmHg) Subjects who have a past history of drug abuse or have shown a positive reaction to drugs that are used in abusive manner or cotinine at a urine drug screening Subjects who have taken any ethical drug or an herbal medication within 2 weeks before the date of first administration or have taken any over-the-counter (OTC) drug or vitamin preparation within 1 week (however, they can be included as subjects if considered appropriate at the investigator's discretion judgment) Subject who have already participated in other clinical trials within 2 months before the date of first drug administration Subject who have had whole blood donation within 2 months or component blood donation within 1 month before the date of first drug administration, or transfusion in 1 month before the date of first drug administration Subjects who have been drinking alcohol continuously (more than 21 units/week, 1 unit = 10 g of pure alcohol) or can't refrain from drinking alcohol during the clinical trial period Smokers (however, if the subject stopped smoking more than 3 months before the date of the first drug administration, he/she can be selected as a subject) 12) Subjects who have had grapefruit/ any food containing caffeine within 3 days before the date of the first drug administration
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ignacio Conde-Carmona, MD
Organizational Affiliation
Específicos Stendhal S.A. de C.V.
Official's Role
Study Chair
Facility Information:
Facility Name
Unidad de Farmacología Clínica de la Facultad de Medicina de la Universidad Nacional Autónoma de México
City
Nezahualcóyotl
State/Province
Estado de México
ZIP/Postal Code
57740
Country
Mexico

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
No formal plan has been established since at the time the study was conducted no consent was obtained from the subjects to share their individual data for research purposes different from those specifically defined in the study protocol
Citations:
PubMed Identifier
27298192
Citation
Kim SH, Jung E, Yoon MK, Kwon OH, Hwang DM, Kim DW, Kim J, Lee SM, Yim HJ. Pharmacological profiles of gemigliptin (LC15-0444), a novel dipeptidyl peptidase-4 inhibitor, in vitro and in vivo. Eur J Pharmacol. 2016 Oct 5;788:54-64. doi: 10.1016/j.ejphar.2016.06.016. Epub 2016 Jun 11.
Results Reference
background
PubMed Identifier
19014837
Citation
Lim KS, Kim JR, Choi YJ, Shin KH, Kim KP, Hong JH, Cho JY, Shin HS, Yu KS, Shin SG, Kwon OH, Hwang DM, Kim JA, Jang IJ. Pharmacokinetics, pharmacodynamics, and tolerability of the dipeptidyl peptidase IV inhibitor LC15-0444 in healthy Korean men: a dose-block-randomized, double-blind, placebo-controlled, ascending single-dose, Phase I study. Clin Ther. 2008 Oct;30(10):1817-30. doi: 10.1016/j.clinthera.2008.10.013.
Results Reference
background
PubMed Identifier
20002082
Citation
Lim KS, Cho JY, Kim BH, Kim JR, Kim HS, Kim DK, Kim SH, Yim HJ, Lee SH, Shin SG, Jang IJ, Yu KS. Pharmacokinetics and pharmacodynamics of LC15-0444, a novel dipeptidyl peptidase IV inhibitor, after multiple dosing in healthy volunteers. Br J Clin Pharmacol. 2009 Dec;68(6):883-90. doi: 10.1111/j.1365-2125.2009.03376.x.
Results Reference
background
PubMed Identifier
24304170
Citation
Kim N, Patrick L, Mair S, Stevens L, Ford G, Birks V, Lee SH. Absorption, metabolism and excretion of [14C]gemigliptin, a novel dipeptidyl peptidase 4 inhibitor, in humans. Xenobiotica. 2014 Jun;44(6):522-30. doi: 10.3109/00498254.2013.865856. Epub 2013 Dec 4.
Results Reference
background
PubMed Identifier
18001838
Citation
Ingelman-Sundberg M, Sim SC, Gomez A, Rodriguez-Antona C. Influence of cytochrome P450 polymorphisms on drug therapies: pharmacogenetic, pharmacoepigenetic and clinical aspects. Pharmacol Ther. 2007 Dec;116(3):496-526. doi: 10.1016/j.pharmthera.2007.09.004. Epub 2007 Oct 9.
Results Reference
background
PubMed Identifier
23333322
Citation
Zanger UM, Schwab M. Cytochrome P450 enzymes in drug metabolism: regulation of gene expression, enzyme activities, and impact of genetic variation. Pharmacol Ther. 2013 Apr;138(1):103-41. doi: 10.1016/j.pharmthera.2012.12.007. Epub 2013 Jan 16.
Results Reference
background
PubMed Identifier
17952011
Citation
Reyes-Hernandez OD, Lares-Asseff I, Sosa-Macias M, Vega L, Albores A, Elizondo G. A comparative study of CYP3A4 polymorphisms in Mexican Amerindian and Mestizo populations. Pharmacology. 2008;81(2):97-103. doi: 10.1159/000109983. Epub 2007 Oct 19.
Results Reference
background
PubMed Identifier
24627290
Citation
Shin D, Cho YM, Lee S, Lim KS, Kim JA, Ahn JY, Cho JY, Lee H, Jang IJ, Yu KS. Pharmacokinetic and pharmacodynamic interaction between gemigliptin and metformin in healthy subjects. Clin Drug Investig. 2014 Jun;34(6):383-93. doi: 10.1007/s40261-014-0184-3.
Results Reference
background
PubMed Identifier
30249366
Citation
Conde-Carmona I, Garcia-Medina S, Jimenez-Vargas JM, Martinez-Munoz A, Lee SH. Pharmacokinetic Interactions Between Gemigliptin and Metformin, and Potential Differences in the Pharmacokinetic Profile of Gemigliptin Between the Mexican and Korean Populations: A Randomized, Open-label Study in Healthy Mexican Volunteers. Clin Ther. 2018 Oct;40(10):1729-1740. doi: 10.1016/j.clinthera.2018.08.015. Epub 2018 Sep 22.
Results Reference
derived

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An Assessment of Pharmacokinetic Gemigliptin and Metformin Interactions in Healthy Mexican Volunteers

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