The Effect of Hepatic Impairment on the Pharmacokinetics of Balovaptan
Primary Purpose
Autism Spectrum Disorder
Status
Withdrawn
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
Balovaptan
Sponsored by
About this trial
This is an interventional treatment trial for Autism Spectrum Disorder
Eligibility Criteria
Inclusion Criteria for All Participants:
- BMI between 18 and 40 kg/m2, inclusive.
- Women of childbearing potential must either: agree to use one highly effective contraceptive method combined with a barrier method from Screening until 90 days after the last dose of study drug or practice true abstinence because of the subject's lifestyle choice; be in an exclusively same-sex relationship.
- For men: agreement to use contraceptive measures
- Females of child-bearing potential must refrain from donating ova from Day -1 until 90 days after the safety Follow-up visit. Males must refrain from donating sperm from Day -1 until 90 days after the safety Follow-up visit.
Inclusion Criteria for Participants with Hepatic Impairment:
- Stable, documented moderate liver disease diagnosed >6 months and stable for at least 3 months prior to Screening.
- Participants with moderate hepatic impairment may have medical findings consistent with their hepatic dysfunction. Participants with abnormal findings considered in line with underlying hepatic disease by the Investigator will be eligible.
Inclusion Criteria for Healthy Participants:
- Healthy status is defined by no clinically significant findings from medical and surgical history, a complete physical examination including vital signs, 12-lead ECG, hematology, chemistry, and urinalysis at Screening and/or Day -1 as assessed by the Investigator (or designee). Gilbert's syndrome is acceptable.
Exclusion Criteria for All Participants:
- History of significant hypersensitivity, intolerance, or allergy to any drug compound, constituents or excipients of the study drug, food, or other substance, unless approved by the Investigator (or designee).
- History of stomach or intestinal surgery or resection that would potentially alter absorption and/or excretion of orally administered drugs.
- Evidence of hepatorenal syndrome and estimated creatinine clearance range <60 mL/min or abnormal and clinically significant sodium and potassium levels, as determined by the Investigator (or designee).
- Female subjects of childbearing potential with a positive serum pregnancy test at Screening and/or at admission (Day -1), or who are lactating.
- History of drug/chemical abuse within 2 years prior to Screening; current active substance abuse will not be permitted.
- Known personal or family history of congenital long QT syndrome or sudden unexplained death.
Exclusion Criteria for Participants with Hepatic Impairment:
- History within 3 months prior to Screening, or current symptoms of, hepatic encephalopathy Grade 2 and above.
- Evidence of severe ascites.
- Recent history of, or the treatment of, esophageal bleeding within 3 months of first dose, unless banded.
- Participants who have had a porto-systemic shunt.
- Participants who have a history of paracentesis within 3 months prior to Day -1.
- Participants who have a history of unstable diabetes mellitus as evidenced by hemoglobin A1c ≥ 9% at Screening.
- History of alcoholism within 3 months prior to Screening.
- Use of any prescription drugs within 30 days (or within 5 times the elimination half-life, if known, of the medication, whichever is longer) of first dose, with the exception of therapies for hepatic-associated disorders that have been stable for at least 60 days prior to first dose.
- Biliary liver cirrhosis or other causes of hepatic impairment not related to parenchymal disorder and/or disease of the liver.
- Positive result on human immunodeficiency virus (HIV) 1, HIV2, Hepatitis B Surface Antigen (HBsAg).
Exclusion Criteria for Healthy Participants:
- History of presence of liver disease, injury, or dysfunction as indicated by any clinically significant deviations from normal reference ranges in liver function tests, unless approved by the Investigator of designee.
- Participants likely to need prescription medication during the study. Participants who have received any prescribed systemic or topical medication within 30 days (or within 5 times the elimination half-life, if known, of the medication, whichever is longer) of the first dose administration, unless in the opinion of the Investigator the medication will not interfere with the study procedures or compromise safety.
- Any slow-release medicinal formulations considered to still be active within 4 weeks (or within 5 times the elimination half-life of the medication, whichever is longer) prior to the first study drug administration are prohibited, unless in the opinion of the Investigator or designee the medication will not interfere with the study procedures or compromise safety.
- History of alcoholism within 2 years prior to Screening.
- Positive result on HIV 1, HIV2, HBsAg, Hepatitis B core antibody (HBcAb), and/or HCV antibody.
- Signs and symptoms potentially indicative of peripheral neuropathy.
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Test group
Reference group
Arm Description
Participants with moderate hepatic impairment.
Healthy pariticipants with normal hepatic function.
Outcomes
Primary Outcome Measures
Plasma concentration of balovaptan
Plasma concentration of M2 metabolite, as applicable
Plasma concentration of M3 metabolite
AUC during the dosing interval on Day 1 of balovaptan
AUC during the dosing interval on Day 1 of M2 metabolite
AUC during the dosing interval on Day 1 of M3 metabolite
AUC during the dosing interval at steady state on Day 14 of balovaptan
AUC during the dosing interval at steady state on Day 14 of M2 metabolite
AUC during the dosing interval at steady state on Day 14 of M3 metabolite
Maximum observed plasma concentration (Cmax) of balovaptan
Maximum observed plasma concentration (Cmax) of M2 metabolite
Maximum observed plasma concentration (Cmax) of M3 metabolite
Time of maximum observed plasma concentration (Tmax) of balovaptan
Time of maximum observed plasma concentration (Tmax) of M2 metabolite
Time of maximum observed plasma concentration (Tmax) of M3 metabolite
Metabolite:Parent ratio of area under the plasma (MRauc) of M2 metabolite
Metabolite:Parent ratio of area under the plasma (MRauc) of M3 metabolite
Metabolite:Parent ratio of maximum observed plasma (MRcmax) of M2 metabolite
Metabolite:Parent ratio of maximum observed plasma (MRcmax) of M3 metabolite
Apparent volume of distribution (V/F) of balovaptan
Apparent volume of distribution (V/F) of M2 metabolite
Apparent volume of distribution (V/F) of M3 metabolite
Terminal phase rate constant (λZ) of balovaptan, when possible
Terminal phase rate constant (λZ) of M2 metabolite, when possible
Terminal phase rate constant (λZ) of M3 metabolite, when possible
Apparent terminal elimination half-life (t½) of balovaptan, when possible
Apparent terminal elimination half-life (t½) of M2 metabolite, when possible
Apparent terminal elimination half-life (t½) of M3 metabolite, when possible
Apparent plasma clearance after oral administration (CLss/F) of balovaptan, when possible
Apparent plasma clearance after oral administration (CLss/F) of M2 metabolite, when possible
Apparent plasma clearance after oral administration (CLss/F) of M3 metabolite, when possible
Apparent volume of distribution based on the terminal phase after oral administration (Vz/F) of balovaptan, when possible
Apparent volume of distribution based on the terminal phase after oral administration (Vz/F) of M2 metabolite, when possible
Apparent volume of distribution based on the terminal phase after oral administration (Vz/F) of M3 metabolite, when possible
Secondary Outcome Measures
Percentage of participants with adverse events
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03912350
Brief Title
The Effect of Hepatic Impairment on the Pharmacokinetics of Balovaptan
Official Title
The Effect of Hepatic Impairment on the Pharmacokinetics of Balovaptan: A Phase I, Multiple-Center, Open-Label Study Following Multiple Daily Oral Doses of Balovaptan in Subjects With Moderate Hepatic Impairment and Healthy Subjects With Normal Hepatic Function
Study Type
Interventional
2. Study Status
Record Verification Date
February 2022
Overall Recruitment Status
Withdrawn
Why Stopped
The study is on hold due to stopping of the Autism Spectrum Disorder program with balovatpan, the study drug.
Study Start Date
June 26, 2022 (Anticipated)
Primary Completion Date
September 24, 2022 (Anticipated)
Study Completion Date
October 13, 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Hoffmann-La Roche
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is a multi-center, non-randomized, open-label, parallel group, multiple-dose study to assess the pharmacokinetic, safety, and tolerability of balovaptan in male and female subjects with moderate hepatic impairment compared to healthy subjects with normal hepatic function matched by age (±10 years), sex, and body mass index (BMI; ±20%).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Autism Spectrum Disorder
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Test group
Arm Type
Experimental
Arm Description
Participants with moderate hepatic impairment.
Arm Title
Reference group
Arm Type
Active Comparator
Arm Description
Healthy pariticipants with normal hepatic function.
Intervention Type
Drug
Intervention Name(s)
Balovaptan
Intervention Description
Participants will receive 1 tablet of balovaptan once daily (QD) on Days 1 through 14.
Primary Outcome Measure Information:
Title
Plasma concentration of balovaptan
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16 hours post-dose on Day 1; pre-dose on Day 2 to Day 13; pre-dose and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Plasma concentration of M2 metabolite, as applicable
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16 hours post-dose on Day 1; pre-dose on Day 2 to Day 13; pre-dose and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Plasma concentration of M3 metabolite
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16 hours post-dose on Day 1; pre-dose on Day 2 to Day 13; pre-dose and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
AUC during the dosing interval on Day 1 of balovaptan
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1
Title
AUC during the dosing interval on Day 1 of M2 metabolite
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1
Title
AUC during the dosing interval on Day 1 of M3 metabolite
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1
Title
AUC during the dosing interval at steady state on Day 14 of balovaptan
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
AUC during the dosing interval at steady state on Day 14 of M2 metabolite
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
AUC during the dosing interval at steady state on Day 14 of M3 metabolite
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Maximum observed plasma concentration (Cmax) of balovaptan
Time Frame
1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Maximum observed plasma concentration (Cmax) of M2 metabolite
Time Frame
1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Maximum observed plasma concentration (Cmax) of M3 metabolite
Time Frame
1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Time of maximum observed plasma concentration (Tmax) of balovaptan
Time Frame
1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Time of maximum observed plasma concentration (Tmax) of M2 metabolite
Time Frame
1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Time of maximum observed plasma concentration (Tmax) of M3 metabolite
Time Frame
1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Metabolite:Parent ratio of area under the plasma (MRauc) of M2 metabolite
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Metabolite:Parent ratio of area under the plasma (MRauc) of M3 metabolite
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Metabolite:Parent ratio of maximum observed plasma (MRcmax) of M2 metabolite
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Metabolite:Parent ratio of maximum observed plasma (MRcmax) of M3 metabolite
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Apparent volume of distribution (V/F) of balovaptan
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Apparent volume of distribution (V/F) of M2 metabolite
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Apparent volume of distribution (V/F) of M3 metabolite
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Terminal phase rate constant (λZ) of balovaptan, when possible
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Terminal phase rate constant (λZ) of M2 metabolite, when possible
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Terminal phase rate constant (λZ) of M3 metabolite, when possible
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Apparent terminal elimination half-life (t½) of balovaptan, when possible
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Apparent terminal elimination half-life (t½) of M2 metabolite, when possible
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Apparent terminal elimination half-life (t½) of M3 metabolite, when possible
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Apparent plasma clearance after oral administration (CLss/F) of balovaptan, when possible
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Apparent plasma clearance after oral administration (CLss/F) of M2 metabolite, when possible
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Apparent plasma clearance after oral administration (CLss/F) of M3 metabolite, when possible
Time Frame
Pre-dose, and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Apparent volume of distribution based on the terminal phase after oral administration (Vz/F) of balovaptan, when possible
Time Frame
1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Apparent volume of distribution based on the terminal phase after oral administration (Vz/F) of M2 metabolite, when possible
Time Frame
1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Title
Apparent volume of distribution based on the terminal phase after oral administration (Vz/F) of M3 metabolite, when possible
Time Frame
1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 1; pre-dose and 1, 2, 3, 4, 5, 6, 9, 12, 16, and 24 hours post-dose on Day 14
Secondary Outcome Measure Information:
Title
Percentage of participants with adverse events
Time Frame
Up to approximately 18 weeks from screening (screening is up to 28 days prior to admission to the clinical research unit).
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 for All Participants:
BMI between 18 and 40 kg/m2, inclusive.
Women of childbearing potential must either: agree to use one highly effective contraceptive method combined with a barrier method from Screening until 90 days after the last dose of study drug or practice true abstinence because of the subject's lifestyle choice; be in an exclusively same-sex relationship.
For men: agreement to use contraceptive measures
Females of child-bearing potential must refrain from donating ova from Day -1 until 90 days after the safety Follow-up visit. Males must refrain from donating sperm from Day -1 until 90 days after the safety Follow-up visit.
Inclusion Criteria for Participants with Hepatic Impairment:
Stable, documented moderate liver disease diagnosed >6 months and stable for at least 3 months prior to Screening.
Participants with moderate hepatic impairment may have medical findings consistent with their hepatic dysfunction. Participants with abnormal findings considered in line with underlying hepatic disease by the Investigator will be eligible.
Inclusion Criteria for Healthy Participants:
Healthy status is defined by no clinically significant findings from medical and surgical history, a complete physical examination including vital signs, 12-lead ECG, hematology, chemistry, and urinalysis at Screening and/or Day -1 as assessed by the Investigator (or designee). Gilbert's syndrome is acceptable.
Exclusion Criteria for All Participants:
History of significant hypersensitivity, intolerance, or allergy to any drug compound, constituents or excipients of the study drug, food, or other substance, unless approved by the Investigator (or designee).
History of stomach or intestinal surgery or resection that would potentially alter absorption and/or excretion of orally administered drugs.
Evidence of hepatorenal syndrome and estimated creatinine clearance range <60 mL/min or abnormal and clinically significant sodium and potassium levels, as determined by the Investigator (or designee).
Female subjects of childbearing potential with a positive serum pregnancy test at Screening and/or at admission (Day -1), or who are lactating.
History of drug/chemical abuse within 2 years prior to Screening; current active substance abuse will not be permitted.
Known personal or family history of congenital long QT syndrome or sudden unexplained death.
Exclusion Criteria for Participants with Hepatic Impairment:
History within 3 months prior to Screening, or current symptoms of, hepatic encephalopathy Grade 2 and above.
Evidence of severe ascites.
Recent history of, or the treatment of, esophageal bleeding within 3 months of first dose, unless banded.
Participants who have had a porto-systemic shunt.
Participants who have a history of paracentesis within 3 months prior to Day -1.
Participants who have a history of unstable diabetes mellitus as evidenced by hemoglobin A1c ≥ 9% at Screening.
History of alcoholism within 3 months prior to Screening.
Use of any prescription drugs within 30 days (or within 5 times the elimination half-life, if known, of the medication, whichever is longer) of first dose, with the exception of therapies for hepatic-associated disorders that have been stable for at least 60 days prior to first dose.
Biliary liver cirrhosis or other causes of hepatic impairment not related to parenchymal disorder and/or disease of the liver.
Positive result on human immunodeficiency virus (HIV) 1, HIV2, Hepatitis B Surface Antigen (HBsAg).
Exclusion Criteria for Healthy Participants:
History of presence of liver disease, injury, or dysfunction as indicated by any clinically significant deviations from normal reference ranges in liver function tests, unless approved by the Investigator of designee.
Participants likely to need prescription medication during the study. Participants who have received any prescribed systemic or topical medication within 30 days (or within 5 times the elimination half-life, if known, of the medication, whichever is longer) of the first dose administration, unless in the opinion of the Investigator the medication will not interfere with the study procedures or compromise safety.
Any slow-release medicinal formulations considered to still be active within 4 weeks (or within 5 times the elimination half-life of the medication, whichever is longer) prior to the first study drug administration are prohibited, unless in the opinion of the Investigator or designee the medication will not interfere with the study procedures or compromise safety.
History of alcoholism within 2 years prior to Screening.
Positive result on HIV 1, HIV2, HBsAg, Hepatitis B core antibody (HBcAb), and/or HCV antibody.
Signs and symptoms potentially indicative of peripheral neuropathy.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Trials
Organizational Affiliation
Hoffmann-La Roche
Official's Role
Study Director
12. IPD Sharing Statement
Plan to Share IPD
No
IPD Sharing Plan Description
Qualified researchers may request access to individual patient level data through the clinical study data request platform (www.clinicalstudydatarequest.com). Further details on Roche's criteria for eligible studies are available here (https://clinicalstudydatarequest.com/Study-Sponsors/Study-Sponsors-Roche.aspx). For further details on Roche's Global Policy on the Sharing of Clinical Information and how to request access to related clinical study documents, see here (https://www.roche.com/research_and_development/who_we_are_how_we_work/clinical_trials/our_commitment_to_data_sharing.htm).
Learn more about this trial
The Effect of Hepatic Impairment on the Pharmacokinetics of Balovaptan
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