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Plazomicin Study in ESRD Patients Receiving IHD

Primary Purpose

End Stage Renal Disease

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Plazomicin Injection
Sponsored by
Cipla USA Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for End Stage Renal Disease

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Male and female subjects between 18 and 75 years of age with a BMI ≥19 to ≤42 kg/m2 and weight of ≥40 kg
  • Pre-existing ESRD requiring in-center IHD for a minimum of 3 months on a schedule of three IHD sessions per week with the third weekly IHD session occurring at least 72 hours before the first weekly IHD session of the subsequent week (e.g. Monday/Wednesday/Friday or Tuesday/Thursday/Saturday)
  • Females of childbearing potential must not be breast-feeding, must have a negative serum pregnancy test at screening, and must use a highly effective method of contraception (includes hormonal implants, intrauterine devices, injectable hormones, oral hormonal contraceptives, prior hysterectomy, prior bilateral oophorectomy, or a vasectomized partner whose vasectomy was performed 4 months or more prior to dosing on Day 1) or be abstinent from sexual activity for at least 1 month prior to dosing on Day 1, during the study and through 30 days following the last dose of study drug. Females of non-childbearing potential, defined as women who have not had a period for 12 consecutive months prior to dosing on Day 1, may be enrolled.
  • Willing to comply with all study activities and procedures and have provided written informed consent prior to any study procedures and have signed and dated a Health Insurance Portability and Accountability Act (HIPAA) authorization form.

Exclusion Criteria:

  • Subjects with any medical, psychological, or social condition which, in the opinion of the Investigator, would prevent the subject from fully participating in the study, would represent a concern for study compliance or would constitute a safety concern to the subject.
  • Unstable cardiovascular disease per the Investigator, including:

    1. Heart rate <40 or >110 beats per minute (bpm) or QT interval corrected using Fridericia's formula (QTcF) >500 msec.
    2. Uncontrolled hypertension, asthma, diabetes (type I or type II), thyroid disease, or seizure disorder
  • Myasthenia gravis or any other neuromuscular disorder.
  • Known infection with hepatitis B (antigen positive), hepatitis C (antibody positive), or human immunodeficiency virus (HIV). Subjects with clinically insignificant or adequately treated hepatitis C may be allowed at the discretion of the Investigator.
  • Active malignancy; carcinoma in situ of the prostate or cervix or basal cell or squamous cell carcinoma of the skin are permitted.
  • Presence of functioning transplant organ or blood procedure.
  • Significant change in either over-the-counter or prescription medications or supplements within 3 months prior to dosing, defined as any new medication or any dosage adjustment that is significant in the judgment of the Investigator.
  • History of significant hearing loss or a family history of hearing loss, excluding age-related (≥65 years) hearing loss. A prior diagnosis of sensorineural hearing loss or Ménière's disease or receipt of any potentially ototoxic agent within 30 prior to the start of screening.
  • Subjects who received a systemic aminoglycoside within 90 days of the start of screening.
  • Clinically significant illness, including viral syndromes within three weeks of dosing.
  • Current participation in a clinical study of an investigational product.
  • Subjects who took any investigational medication/therapy within 30 days or 5 half-lives, whichever is longer, before dosing of plazomicin.
  • Subjects with active alcoholism and/or drug/chemical abuse in the opinion of the Investigator. Also, consumption of any amount of ethanol within 48 hours of plazomicin dosing.
  • Subjects who donated more than 500 mL of blood within 60 days prior to start of screening.
  • Previous participation in this or any other plazomicin study.
  • Known hypersensitivity to aminoglycosides or any component of plazomicin injection.
  • The subject is an employee of the Investigator or study center with direct involvement in the proposed study or other studies under the direction of that Investigator or study center, as well as a family member of the employee or Investigator.

Sites / Locations

  • Orlando Clinical Research Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Plazomicin Injection

Arm Description

plazomicin (30-minute IV infusion at 2.5 mg/kg) single dose given before IHD and single dose given after IHD

Outcomes

Primary Outcome Measures

o Maximum observed plasma drug concentration (Cmax)
Plasma PK parameter for plazomicin before and after IHD
o Time to maximum observed plasma concentration (Tmax)
Plasma PK parameter for plazomicin before and after IHD
o Area under the plasma concentration time curve from time 0 to the last measurable concentration (AUC0-t)
Plasma PK parameter for plazomicin before and after IHD
o Area under the plasma concentration time curve extrapolated to infinity (AUCinf)
Plasma PK parameter for plazomicin before and after IHD
o Terminal elimination half-life (t1/2)
Plasma PK parameter for plazomicin before and after IHD
o Total plasma clearance (CL)
Plasma PK parameter for plazomicin before and after IHD
o Volume of distribution during the terminal elimination phase (Vz)
Plasma PK parameter for plazomicin before and after IHD
o Terminal elimination rate constant (λz)
Plasma PK parameter for plazomicin before and after IHD

Secondary Outcome Measures

• Adverse events (AEs)
Safety assessment; An overall summary will be generated presenting the frequency and percentage of subjects and the number of treatment-emergent adverse events (TEAEs).

Full Information

First Posted
December 28, 2020
Last Updated
March 8, 2022
Sponsor
Cipla USA Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04699656
Brief Title
Plazomicin Study in ESRD Patients Receiving IHD
Official Title
A Phase 1 Open-Label Study to Assess the Pharmacokinetics, Safety, and Tolerability of Intravenous Administration of Plazomicin in Subjects With End Stage Renal Disease (ESRD) Receiving Intermittent Hemodialysis (IHD)
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Completed
Study Start Date
January 5, 2021 (Actual)
Primary Completion Date
March 8, 2021 (Actual)
Study Completion Date
June 9, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cipla USA Inc.

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 study is being conducted to directly characterize the pharmacokinetic (PK) profile of plazomicin following administration of a single oral dose before and after IHD in subjects with ESRD. This PK assessment will be used to provide appropriate plazomicin dosing recommendations for patients with ESRD receiving IHD.
Detailed Description
This is a Phase 1, single-center, open-label, single-dose study to evaluate the PK of a single dose of plazomicin (30-minute IV infusion at 2.5 mg/kg) when administered prior to and after IHD in subjects with ESRD. The study will consist of a screening period of up to 28 days and two treatment periods, with at least a 7-day washout between dosing in each treatment period. The start of the study is defined as the date that the first subject is screened following signing of an informed consent form (ICF). In Period 1 (Week 1), the dosing day will be concomitant with the 3rd weekly IHD session, which must be at least 72 hours before the 1st weekly IHD session of the subsequent Week. All subjects will receive a single dose of plazomicin (30 minute IV infusion at 2.5 mg/kg) within 1 hour after IHD is completed. PK samples will be collected at specified time points from 0.6 hours to 72 hours after completion of the plazomicin infusion. Collection of all PK samples must be completed prior to the next scheduled IHD. In Period 2 (Week 2), the dosing day will occur on the day of the 3rd weekly IHD session, which must be at least 7 days after the first dose and at least 72 hours before the 1st weekly IHD session of the subsequent Week. All subjects will receive a single dose of plazomicin (30 minute IV infusion at 2.5 mg/kg) before IHD is started. The plazomicin infusion should be completed within 30 minutes of IHD initiation. During IHD, the total dialysate will be collected in a large collection container and pooled at 1-hour intervals (0-1, 1-2, 2-3, etc. for the duration of the IHD session). From each hourly interval (including any partial interval at end of dialysis), an aliquot sample of dialysate will be collected for PK analysis. PK samples will be collected at specified time points from 0.6 hours to 72 hours after completion of the plazomicin infusion. Collection of all PK samples must be completed prior to the next scheduled IHD. Safety assessments will include physical examination findings, vital signs (blood pressure, pulse rate, respiration rate, and oral temperature), clinical laboratory evaluations, and monitoring of adverse events (AEs). Adverse events will be assessed from the time the subject signs the ICF until exit from the study. The site will attempt to contact all subjects (including subjects who terminate the study early) via phone call approximately 14 days after the last dose of study drug to determine if any AE has occurred since the last study visit. Subjects reporting AEs may be asked to return to the site for further assessment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
End Stage Renal Disease

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Plazomicin Injection
Arm Type
Experimental
Arm Description
plazomicin (30-minute IV infusion at 2.5 mg/kg) single dose given before IHD and single dose given after IHD
Intervention Type
Drug
Intervention Name(s)
Plazomicin Injection
Other Intervention Name(s)
Zemdri
Intervention Description
single dose of plazomicin
Primary Outcome Measure Information:
Title
o Maximum observed plasma drug concentration (Cmax)
Description
Plasma PK parameter for plazomicin before and after IHD
Time Frame
30 days
Title
o Time to maximum observed plasma concentration (Tmax)
Description
Plasma PK parameter for plazomicin before and after IHD
Time Frame
30 days
Title
o Area under the plasma concentration time curve from time 0 to the last measurable concentration (AUC0-t)
Description
Plasma PK parameter for plazomicin before and after IHD
Time Frame
30 days
Title
o Area under the plasma concentration time curve extrapolated to infinity (AUCinf)
Description
Plasma PK parameter for plazomicin before and after IHD
Time Frame
30 days
Title
o Terminal elimination half-life (t1/2)
Description
Plasma PK parameter for plazomicin before and after IHD
Time Frame
30 days
Title
o Total plasma clearance (CL)
Description
Plasma PK parameter for plazomicin before and after IHD
Time Frame
30 days
Title
o Volume of distribution during the terminal elimination phase (Vz)
Description
Plasma PK parameter for plazomicin before and after IHD
Time Frame
30 days
Title
o Terminal elimination rate constant (λz)
Description
Plasma PK parameter for plazomicin before and after IHD
Time Frame
30 days
Secondary Outcome Measure Information:
Title
• Adverse events (AEs)
Description
Safety assessment; An overall summary will be generated presenting the frequency and percentage of subjects and the number of treatment-emergent adverse events (TEAEs).
Time Frame
30 days
Other Pre-specified Outcome Measures:
Title
o Cumulative amount of drug excreted in dialysate (Ae)
Description
Dialysate PK parameter for plazomicin after IHD
Time Frame
30 days
Title
o Percent of plazomicin recovered in dialysate (Ae%)
Description
Dialysate PK parameter for plazomicin after IHD
Time Frame
30 days
Title
o Dialysate clearance (CLD)
Description
Dialysate PK parameter for plazomicin after IHD
Time Frame
30 days

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: Male and female subjects between 18 and 75 years of age with a BMI ≥19 to ≤42 kg/m2 and weight of ≥40 kg Pre-existing ESRD requiring in-center IHD for a minimum of 3 months on a schedule of three IHD sessions per week with the third weekly IHD session occurring at least 72 hours before the first weekly IHD session of the subsequent week (e.g. Monday/Wednesday/Friday or Tuesday/Thursday/Saturday) Females of childbearing potential must not be breast-feeding, must have a negative serum pregnancy test at screening, and must use a highly effective method of contraception (includes hormonal implants, intrauterine devices, injectable hormones, oral hormonal contraceptives, prior hysterectomy, prior bilateral oophorectomy, or a vasectomized partner whose vasectomy was performed 4 months or more prior to dosing on Day 1) or be abstinent from sexual activity for at least 1 month prior to dosing on Day 1, during the study and through 30 days following the last dose of study drug. Females of non-childbearing potential, defined as women who have not had a period for 12 consecutive months prior to dosing on Day 1, may be enrolled. Willing to comply with all study activities and procedures and have provided written informed consent prior to any study procedures and have signed and dated a Health Insurance Portability and Accountability Act (HIPAA) authorization form. Exclusion Criteria: Subjects with any medical, psychological, or social condition which, in the opinion of the Investigator, would prevent the subject from fully participating in the study, would represent a concern for study compliance or would constitute a safety concern to the subject. Unstable cardiovascular disease per the Investigator, including: Heart rate <40 or >110 beats per minute (bpm) or QT interval corrected using Fridericia's formula (QTcF) >500 msec. Uncontrolled hypertension, asthma, diabetes (type I or type II), thyroid disease, or seizure disorder Myasthenia gravis or any other neuromuscular disorder. Known infection with hepatitis B (antigen positive), hepatitis C (antibody positive), or human immunodeficiency virus (HIV). Subjects with clinically insignificant or adequately treated hepatitis C may be allowed at the discretion of the Investigator. Active malignancy; carcinoma in situ of the prostate or cervix or basal cell or squamous cell carcinoma of the skin are permitted. Presence of functioning transplant organ or blood procedure. Significant change in either over-the-counter or prescription medications or supplements within 3 months prior to dosing, defined as any new medication or any dosage adjustment that is significant in the judgment of the Investigator. History of significant hearing loss or a family history of hearing loss, excluding age-related (≥65 years) hearing loss. A prior diagnosis of sensorineural hearing loss or Ménière's disease or receipt of any potentially ototoxic agent within 30 prior to the start of screening. Subjects who received a systemic aminoglycoside within 90 days of the start of screening. Clinically significant illness, including viral syndromes within three weeks of dosing. Current participation in a clinical study of an investigational product. Subjects who took any investigational medication/therapy within 30 days or 5 half-lives, whichever is longer, before dosing of plazomicin. Subjects with active alcoholism and/or drug/chemical abuse in the opinion of the Investigator. Also, consumption of any amount of ethanol within 48 hours of plazomicin dosing. Subjects who donated more than 500 mL of blood within 60 days prior to start of screening. Previous participation in this or any other plazomicin study. Known hypersensitivity to aminoglycosides or any component of plazomicin injection. The subject is an employee of the Investigator or study center with direct involvement in the proposed study or other studies under the direction of that Investigator or study center, as well as a family member of the employee or Investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Patrice P Rioux, MD, PhD
Organizational Affiliation
Cipla USA Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Orlando Clinical Research Center
City
Orlando
State/Province
Florida
ZIP/Postal Code
32809
Country
United States

12. IPD Sharing Statement

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Plazomicin Study in ESRD Patients Receiving IHD

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