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PK Study of IV and Oral Amisulpride in Subjects With Severe Renal Impairment

Primary Purpose

Renal Disease, End Stage

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Amisulpride IV
Amisulpride Oral Tablet
Sponsored by
Acacia Pharma Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Renal Disease, End Stage

Eligibility Criteria

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

Inclusion Criteria: Healthy Subjects

  1. Age 18 to 75 years of age at time of signing ICF.
  2. Body mass index (BMI) between 18 and 38 kg/m2.
  3. Must be willing and able to communicate and participate in the whole study.
  4. Must provide written informed consent.
  5. Must agree to use an adequate method of contraception
  6. Healthy as defined by:

    • The absence of clinically significant illness and surgery within 4 weeks prior to dosing. Subjects vomiting within 24 hours pre-dose will be carefully evaluated for upcoming illness/disease. Inclusion pre-dosing is at the discretion of the Principal Investigator;
    • The absence of clinically significant history of neurological, endocrine, cardiovascular, pulmonary, hematological, immunologic, psychiatric, gastrointestinal, renal, hepatic (including cholecystectomy), and metabolic disease;
    • The absence of clinically significant history of lactic acidosis and severe hepatomegaly with steatosis;
    • The absence of history of suicidal tendency, disposition to seizures, state of confusion, or clinically relevant psychiatric diseases.
  7. Normal renal function, i.e., eGFR or creatinine clearance ≥ 90 mL/min/1.73 m2 as calculated using the MDRD4 or Cockcroft-Gault equation; at the Principal Investigator's discretion, 24 hour creatinine clearance may be conducted to determine renal function.
  8. Matched to subjects with severe renal impairment for gender, age (± 10 years), and BMI (± 15%) to the extent possible.

Inclusion Criteria: Renal Impaired Subjects

  1. Age 18 to 75 years of age at time of signing ICF.
  2. Body mass index (BMI) between 18 and 38 kg/m2.
  3. Must be willing and able to communicate and participate in the whole study.
  4. Must provide written informed consent.
  5. Must agree to use an adequate method of contraception
  6. A diagnosis of renal impairment that has been stable, without significant change in overall disease status in the 3 months prior to screening as determined by the Principal Investigator, with no requirement for dialysis, and an eGFR at screening < 30 mL/min/1.73 m2 calculated using the MDRD4 equation.

Exclusion Criteria: Healthy Subjects

  1. Subjects who have received any IMP in a clinical research study within the 30 days prior to IMP administration on this study.
  2. Subjects who are study site, CRO or sponsor employees, or immediate family members of a study site, CRO or sponsor employee.
  3. Subjects who have previously been enrolled in this study.
  4. Women who are pregnant or breastfeeding.
  5. Subjects who have received amisulpride for any indication within the 30 days prior to dosing.
  6. Allergy to amisulpride or any of the excipients of amisulpride.
  7. History of any drug or alcohol abuse in the 2 years prior to screening.
  8. Regular alcohol consumption >21 units per week in the 6 months prior to screening.
  9. Subjects who do not have suitable veins for multiple venepunctures/cannulation as assessed by the investigator at screening.
  10. History of epilepsy in the 5years prior toscreening.
  11. History of clinically significant syncope.
  12. Family history of sudden death.
  13. Family history of premature cardiovascular death.
  14. Clinically significant history or family history of congenital long QT syndrome (e.g.

    Romano-Ward syndrome, Jervell and Lange-Nielson syndrome) or Brugada's syndrome.

  15. History of clinically significant arrhythmias or ischaemic heart disease (especially ventricular arrhythmias, atrial fibrillation (AF), recent conversion from AF or coronary spasm).
  16. Conditions predisposing the volunteer to electrolyte imbalances (e.g. altered nutritional states, chronic vomiting, anorexia nervosa, bulimia nervosa).
  17. Clinically significant abnormal biochemistry,haematology or urinalysis at screening as judged by the investigator
  18. Positive drugs of abuse test result
  19. Positive hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (HCV Ab) or human immunodeficiency virus (HIV) results at screening.
  20. Donation of plasma within 7 days prior to dosing. Donation or loss of blood (excluding volume drawn at screening or menses) of 50 mL to 499 mL of blood within 30 days, or more than 499 mL within 56 days prior to the dosing.
  21. Subjects who are taking, or have taken, any prescribed or over-the-counter drug (other than 2,000 mg per day acetaminophen) or herbal remedies in the 14 days before IMP administration
  22. Administration of a biological product in the context of a clinical research study within 90 days prior to dosing, or concomitant participation in an investigational study involving no drug or device administration.
  23. Failure to satisfy the investigator of fitness to participate for any other reason.

Exclusion Criteria: Renal Impaired Subjects

  1. Subjects who have received any IMP in a clinical research study within the 30 days prior to IMP administration on this study.
  2. Subjects who are study site, CRO or sponsor employees, or immediate family members of a study site, CRO or sponsor employee.
  3. Subjects who have previously been enrolled in this study.
  4. Women who are pregnant or breastfeeding.
  5. Subjects who have received amisulpride for any indication within the 30 days prior to dosing.
  6. Allergy to amisulpride or any of the excipients of amisulpride.
  7. History of any drug or alcohol abuse in the 2 years prior to screening.
  8. Regular alcohol consumption >21 units per week in the 6 months prior to screening.
  9. Subjects who do not have suitable veins for multiple venepunctures/cannulation as assessed by the investigator at screening.
  10. History of epilepsy in the 5years prior to screening.
  11. History of clinically significant syncope.
  12. Family history of sudden death.
  13. Family history of premature cardiovascular death.
  14. Clinically significant history or family history of congenital long QT syndrome (e.g.

    Romano-Ward syndrome, Jervell and Lange-Nielson syndrome) or Brugada's syndrome.

  15. History of clinically significant arrhythmias or unstable ischaemic heart disease (especially ventricular arrhythmias, atrial fibrillation (AF), recent conversion from AF or coronary spasm).
  16. Positive drugs of abuse test result, unless caused by a documented prescription drug.
  17. Positive hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (HCV Ab) or human immunodeficiency virus (HIV) results at screening.
  18. Donation of plasma within 7 days prior to dosing. Donation or loss of blood (excluding volume drawn at screening or menses) of 50 mL to 499 mL of blood within 30 days, or more than 499 mL within 56 days prior to the dosing.
  19. Administration of a biological product in the context of a clinical research study within 90 days prior to dosing, or concomitant participation in an investigational study involving no drug or device administration.
  20. Failure to satisfy the investigator of fitness to participate for any other reason.

Sites / Locations

  • Panax Clinical Research

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Renal Impairment Subjects

Healthy Subjects

Arm Description

10mg dose of IV Amisulpride, followed 24 hours by a 10mg oral dose of Amisulpride

10mg dose of IV Amisulpride, followed 24 hours by a 10mg oral dose of Amisulpride

Outcomes

Primary Outcome Measures

PK: Amisulpride plasma exposure (AUC) after a single IV dose
Amisulpride plasma exposure after a single IV dose measured as the area under the concentration-time curve (AUC) between study drug administration and the time at which the following-day oral dose of Amisulpride is given

Secondary Outcome Measures

PK: Amisulpride plasma exposure (AUC) after a single oral dose
Amisulpride plasma exposure after a single oral dose measured as the area under the concentration-time curve (AUC) from study drug administration extrapolated to infinity
PK: Cmax
Peak plasma concentration (Cmax), for both a single IV and single oral dose.
PK: Tmax
Time at which peak plasma concentration achieved (Tmax) for both a single IV and single oral dose.
PK: T1/2
Half-life (T1⁄2) of both a single IV and single oral dose.
PK: Clearance
Clearance of both a single IV and single oral dose.
PK: Vd
Volume of distribution (Vd) of both a single IV and single oral dose.
Safety: AE
Frequency and severity of treatment-emergent adverse events

Full Information

First Posted
April 14, 2021
Last Updated
December 10, 2021
Sponsor
Acacia Pharma Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT04849650
Brief Title
PK Study of IV and Oral Amisulpride in Subjects With Severe Renal Impairment
Official Title
An Open Label Study of the Pharmacokinetics of Intravenous and Oral Amisulpride in Adults With Severe Renal Impairment and Healthy Control Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
December 2021
Overall Recruitment Status
Completed
Study Start Date
June 3, 2021 (Actual)
Primary Completion Date
October 30, 2021 (Actual)
Study Completion Date
October 30, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Acacia Pharma Ltd

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
The aim of the study is to understand how Amisulpride is taken up and distributed around the body and how quickly it is eliminated, when given by mouth and into a vein in adults with severe kidney disease. In addition it is important to understand how well tolerated Amisulpride is in this patient population. Healthy adults will be studied to provide a comparison.
Detailed Description
This will be an open-label, non-randomised, pharmacokinetic study in 6 adult subjects with severe renal impairment and end-stage renal disease (i.e., eGFR < 30 mL/min/1.73 m2) without dialysis. 6 matched healthy subjects (control group). Each subject will be given a single dose of 10 mg IV Amisulpride, followed by a single dose of 10 mg oral Amisulpride given 24 hours later. Subjects will be admitted to the clinic on Day -1. Dosing will start the following day (Day 1). Serial blood samples will be taken during Days 1-3 to assess the pharmacokinetics of Amisulpride. Subjects will remain in clinic over the duration of the study and will be discharged when the final blood sample is drawn on Day 3. The tolerability /safety of Amisulpride will be assessed by clinical chemistry and haematology assessments, vital signs, electrocardiograms (ECG), physical examination and adverse event reporting.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Model Description
One group of subjects with renal impairment will receive 10mg IV Amisulpride followed 24 hours later by a 10mg oral dose. One group of matched healthy subjects will receive 10mg IV Amisulpride followed 24 hours later by a 10mg oral dose.
Masking
None (Open Label)
Masking Description
All parties will have knowledge of the interventions assigned to each subject.
Allocation
Non-Randomized
Enrollment
12 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Renal Impairment Subjects
Arm Type
Experimental
Arm Description
10mg dose of IV Amisulpride, followed 24 hours by a 10mg oral dose of Amisulpride
Arm Title
Healthy Subjects
Arm Type
Experimental
Arm Description
10mg dose of IV Amisulpride, followed 24 hours by a 10mg oral dose of Amisulpride
Intervention Type
Drug
Intervention Name(s)
Amisulpride IV
Intervention Description
A single 10mg IV dose of Amisulpride given over 1 minute
Intervention Type
Drug
Intervention Name(s)
Amisulpride Oral Tablet
Intervention Description
A single 10mg dose given as an oral tablet
Primary Outcome Measure Information:
Title
PK: Amisulpride plasma exposure (AUC) after a single IV dose
Description
Amisulpride plasma exposure after a single IV dose measured as the area under the concentration-time curve (AUC) between study drug administration and the time at which the following-day oral dose of Amisulpride is given
Time Frame
24 hours
Secondary Outcome Measure Information:
Title
PK: Amisulpride plasma exposure (AUC) after a single oral dose
Description
Amisulpride plasma exposure after a single oral dose measured as the area under the concentration-time curve (AUC) from study drug administration extrapolated to infinity
Time Frame
24 hours
Title
PK: Cmax
Description
Peak plasma concentration (Cmax), for both a single IV and single oral dose.
Time Frame
24 hours
Title
PK: Tmax
Description
Time at which peak plasma concentration achieved (Tmax) for both a single IV and single oral dose.
Time Frame
24 hours
Title
PK: T1/2
Description
Half-life (T1⁄2) of both a single IV and single oral dose.
Time Frame
24 hours
Title
PK: Clearance
Description
Clearance of both a single IV and single oral dose.
Time Frame
24 hours
Title
PK: Vd
Description
Volume of distribution (Vd) of both a single IV and single oral dose.
Time Frame
24 hours
Title
Safety: AE
Description
Frequency and severity of treatment-emergent adverse events
Time Frame
From first study drug administration until discharge (4 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: Healthy Subjects Age 18 to 75 years of age at time of signing ICF. Body mass index (BMI) between 18 and 38 kg/m2. Must be willing and able to communicate and participate in the whole study. Must provide written informed consent. Must agree to use an adequate method of contraception Healthy as defined by: The absence of clinically significant illness and surgery within 4 weeks prior to dosing. Subjects vomiting within 24 hours pre-dose will be carefully evaluated for upcoming illness/disease. Inclusion pre-dosing is at the discretion of the Principal Investigator; The absence of clinically significant history of neurological, endocrine, cardiovascular, pulmonary, hematological, immunologic, psychiatric, gastrointestinal, renal, hepatic (including cholecystectomy), and metabolic disease; The absence of clinically significant history of lactic acidosis and severe hepatomegaly with steatosis; The absence of history of suicidal tendency, disposition to seizures, state of confusion, or clinically relevant psychiatric diseases. Normal renal function, i.e., eGFR or creatinine clearance ≥ 90 mL/min/1.73 m2 as calculated using the MDRD4 or Cockcroft-Gault equation; at the Principal Investigator's discretion, 24 hour creatinine clearance may be conducted to determine renal function. Matched to subjects with severe renal impairment for gender, age (± 10 years), and BMI (± 15%) to the extent possible. Inclusion Criteria: Renal Impaired Subjects Age 18 to 75 years of age at time of signing ICF. Body mass index (BMI) between 18 and 38 kg/m2. Must be willing and able to communicate and participate in the whole study. Must provide written informed consent. Must agree to use an adequate method of contraception A diagnosis of renal impairment that has been stable, without significant change in overall disease status in the 3 months prior to screening as determined by the Principal Investigator, with no requirement for dialysis, and an eGFR at screening < 30 mL/min/1.73 m2 calculated using the MDRD4 equation. Exclusion Criteria: Healthy Subjects Subjects who have received any IMP in a clinical research study within the 30 days prior to IMP administration on this study. Subjects who are study site, CRO or sponsor employees, or immediate family members of a study site, CRO or sponsor employee. Subjects who have previously been enrolled in this study. Women who are pregnant or breastfeeding. Subjects who have received amisulpride for any indication within the 30 days prior to dosing. Allergy to amisulpride or any of the excipients of amisulpride. History of any drug or alcohol abuse in the 2 years prior to screening. Regular alcohol consumption >21 units per week in the 6 months prior to screening. Subjects who do not have suitable veins for multiple venepunctures/cannulation as assessed by the investigator at screening. History of epilepsy in the 5years prior toscreening. History of clinically significant syncope. Family history of sudden death. Family history of premature cardiovascular death. Clinically significant history or family history of congenital long QT syndrome (e.g. Romano-Ward syndrome, Jervell and Lange-Nielson syndrome) or Brugada's syndrome. History of clinically significant arrhythmias or ischaemic heart disease (especially ventricular arrhythmias, atrial fibrillation (AF), recent conversion from AF or coronary spasm). Conditions predisposing the volunteer to electrolyte imbalances (e.g. altered nutritional states, chronic vomiting, anorexia nervosa, bulimia nervosa). Clinically significant abnormal biochemistry,haematology or urinalysis at screening as judged by the investigator Positive drugs of abuse test result Positive hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (HCV Ab) or human immunodeficiency virus (HIV) results at screening. Donation of plasma within 7 days prior to dosing. Donation or loss of blood (excluding volume drawn at screening or menses) of 50 mL to 499 mL of blood within 30 days, or more than 499 mL within 56 days prior to the dosing. Subjects who are taking, or have taken, any prescribed or over-the-counter drug (other than 2,000 mg per day acetaminophen) or herbal remedies in the 14 days before IMP administration Administration of a biological product in the context of a clinical research study within 90 days prior to dosing, or concomitant participation in an investigational study involving no drug or device administration. Failure to satisfy the investigator of fitness to participate for any other reason. Exclusion Criteria: Renal Impaired Subjects Subjects who have received any IMP in a clinical research study within the 30 days prior to IMP administration on this study. Subjects who are study site, CRO or sponsor employees, or immediate family members of a study site, CRO or sponsor employee. Subjects who have previously been enrolled in this study. Women who are pregnant or breastfeeding. Subjects who have received amisulpride for any indication within the 30 days prior to dosing. Allergy to amisulpride or any of the excipients of amisulpride. History of any drug or alcohol abuse in the 2 years prior to screening. Regular alcohol consumption >21 units per week in the 6 months prior to screening. Subjects who do not have suitable veins for multiple venepunctures/cannulation as assessed by the investigator at screening. History of epilepsy in the 5years prior to screening. History of clinically significant syncope. Family history of sudden death. Family history of premature cardiovascular death. Clinically significant history or family history of congenital long QT syndrome (e.g. Romano-Ward syndrome, Jervell and Lange-Nielson syndrome) or Brugada's syndrome. History of clinically significant arrhythmias or unstable ischaemic heart disease (especially ventricular arrhythmias, atrial fibrillation (AF), recent conversion from AF or coronary spasm). Positive drugs of abuse test result, unless caused by a documented prescription drug. Positive hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (HCV Ab) or human immunodeficiency virus (HIV) results at screening. Donation of plasma within 7 days prior to dosing. Donation or loss of blood (excluding volume drawn at screening or menses) of 50 mL to 499 mL of blood within 30 days, or more than 499 mL within 56 days prior to the dosing. Administration of a biological product in the context of a clinical research study within 90 days prior to dosing, or concomitant participation in an investigational study involving no drug or device administration. Failure to satisfy the investigator of fitness to participate for any other reason.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gabriel Fox, MD
Organizational Affiliation
Chief Medical Officer
Official's Role
Study Director
Facility Information:
Facility Name
Panax Clinical Research
City
Miami Lakes
State/Province
Florida
ZIP/Postal Code
33014
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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PK Study of IV and Oral Amisulpride in Subjects With Severe Renal Impairment

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