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Pharmacokinetics of TNO155 in Participants With Mild, Moderate, or Severe Hepatic Impairment Compared to Matched Healthy Participants

Primary Purpose

Hepatic Impairment

Status
Not yet recruiting
Phase
Phase 1
Locations
Study Type
Interventional
Intervention
TNO155
Sponsored by
Novartis Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Hepatic Impairment focused on measuring Hepatic, Impairment, TNO155, Phase 1, pharmacokinetics, safety, Tolerability, Child-Pug

Eligibility Criteria

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

Inclusion Criteria:

All participants Participants must weigh at least 50 kg and no more than 120 kg and must have a body mass index (BMI) within the range of 18.0 to 38.0 kg/m2, inclusive, for healthy participants. For participants with hepatic impairment without overt ascites, the BMI should be within the range of 18.0 to 40.0 kg/m2. For participants with hepatic impairment with overt ascites, the BMI should be within the range of 18.0 to 45.0 kg/m2.

Group 1

•Each healthy control participant must match in age (± 10 years), sex, body weight (± 20%), and smoking status to at least 1 hepatic impairment participant in Groups 2, 3 and/or 4.

Groups 2 to 4 •Participants with mild, moderate or severe hepatic impairment must have a Child-Pugh score clinically determined at screening and confirmed unchanged at baseline calculated as per the Child-Pugh classification in line with the hepatic impairment status of each Group

Exclusion Criteria:

All Participants

  • Use of drugs (prescription, non-prescription and herbal remedies such as St John's wort) known to affect CYP3A or UGT1A3, including UGT1A3 inhibitors and inducers and strong and moderate CYP3A inhibitors and inducers, within 4 weeks prior to dosing until completion of the End of Study Visit.
  • Acute or chronic hepatitis B or C infection or active infection requiring therapy that will not be completed before screening.

Left ventricular ejection fraction (LVEF) < 50% or below the institutional standard lower limit, whichever is higher, as determined by multiple gated acquisition (MUGA) scan or Trans-thoracic echocardiography (TTE) at screening or baseline.

•At screening, history of retinal vein occlusion (RVO) or presence of predisposing factors to RVO or central serous retinopathy, or any other clinically significant ophthalmologic abnormalities determined by an ophthalmologist.

Group 1

  • Any single parameter of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), or alkaline phosphatase (ALP) exceeding 2.5 × upper limit of normal (ULN) or total bilirubin ≥ 1.5 ULN OR any elevation above ULN of more than 1 parameter of ALT, AST, GGT, ALP, or serum bilirubin at screening or baseline.
  • Impaired renal function as indicated by clinically significantly abnormal creatinine or blood urea nitrogen and/or other urea values outside local laboratory ranges or abnormal urinary constituents at screening or baseline.

Groups 2 and 3

  • Severe complications of liver disease within the preceding 3 months prior to dosing.
  • Hospitalization due to liver disease within the preceding 1 month prior to dosing.
  • Participant has received liver transplant at any time in the past and is on immunosuppressant therapy.
  • Participants requiring paracentesis more than every 3 weeks for the management of ascites are excluded.

Other protocol-defined inclusion/exclusion criteria may apply.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm Type

    Experimental

    Experimental

    Experimental

    Experimental

    Arm Label

    Group 1 (control)

    Group 2 (score 5-6)

    Group 3 (score 7-9)

    Group 4 (score 10-15)

    Arm Description

    Healthy control participants with normal hepatic function

    Mild hepatic impairment: Child-Pugh A

    Moderate hepatic impairment: Child-Pugh B

    Severe hepatic impairment: Child-Pugh C. This group may be opened if allowed by the results of the interim analysis of the Groups 1 to 3.

    Outcomes

    Primary Outcome Measures

    Area under the concentration-versus-time curve (AUC) from time zero to the last measurable plasma concentration (AUClast) of TNO155
    AUClast will be calculated based on TNO155 plasma concentrations and non-compartmental methods.
    AUC from time zero to time "t" (AUC0-t) of TNO155
    AUC0-t will be calculated as needed based on TNO155 plasma concentrations and non-compartmental methods. The definition of time "t" may be data-driven post-hoc to mitigate treatment bias due to within participant differences in Tlast between the treatments, or may be selected to allow between-study exposure comparisons that use a common time window.
    AUC from time zero to infinity (AUCinf) of TNO155
    AUCinf will be calculated based on TNO155 plasma concentrations and non-compartmental methods.
    Maximum (peak) observed plasma concentration (Cmax) of TNO155
    Cmax will be calculated based on TNO155 plasma concentrations and non-compartmental methods.
    Time to reach maximum observed plasma concentration (Tmax) of TNO155
    Tmax will be calculated based on TNO155 plasma concentrations and non-compartmental methods
    Elimination half-life (T1/2) of TNO155
    T1/2 will be calculated based on TNO155 plasma concentrations and non-compartmental methods.
    Sampling time of the last measurable plasma concentration (Tlast) of TNO155
    Tlast will be calculated based on TNO155 plasma concentrations and non-compartmental methods.
    Apparent plasma clearance (CL/F) of TNO155
    CL/F will be calculated based on TNO155 plasma concentrations and non-compartmental methods.
    Apparent volume of distribution during terminal phase (Vz/F) of TNO155
    Vz/F will be calculated based on TNO155 plasma concentrations and non-compartmental methods.

    Secondary Outcome Measures

    Incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs)
    Incidence of AEs and SAEs, including changes in vital signs, electrocardiograms (ECGs) and laboratory results qualifying and reported as AEs.
    Unbound Cmax (Cmax,u) of TNO155
    Cmax,u will be calculated based on the unbound fraction of TNO155 in plasma.
    Unbound AUClast (AUClast,u) of TNO155
    AUClast,u will be calculated based on the unbound fraction of TNO155 in plasma.
    Unbound AUCinf (AUCinf,u) of TNO155
    AUCinf,u will be calculated based on the unbound fraction of TNO155 in plasma
    Unbound CL/F (CL/F,u) of TNO155
    CL/F,u will be calculated based on the unbound fraction of TNO155 in plasma.
    Renal clearance (CLr) of TNO155
    CLr will be calculated based on urinary excretion data of TNO155.
    Apparent non-renal clearance (CLNR/F) of TNO155
    CLNR/F will be calculated based on urinary excretion data of TNO155.
    Fraction of dose excreted in urine (fe) of TNO155
    Fe will be calculated based on urinary excretion data of TNO155.

    Full Information

    First Posted
    August 4, 2022
    Last Updated
    July 27, 2023
    Sponsor
    Novartis Pharmaceuticals
    Collaborators
    Pharmaceutical Research Associates
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    1. Study Identification

    Unique Protocol Identification Number
    NCT05490030
    Brief Title
    Pharmacokinetics of TNO155 in Participants With Mild, Moderate, or Severe Hepatic Impairment Compared to Matched Healthy Participants
    Official Title
    A Phase 1, Open-label, Single-dose, Multi-center, Parallel Group Study to Evaluate the Pharmacokinetics of TNO155 in Participants With Mild, Moderate, or Severe Hepatic Impairment Compared to Matched Healthy Control Participants
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    July 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    February 19, 2024 (Anticipated)
    Primary Completion Date
    June 10, 2024 (Anticipated)
    Study Completion Date
    June 10, 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Novartis Pharmaceuticals
    Collaborators
    Pharmaceutical Research Associates

    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 purpose of this study is to evaluate the effect of various degrees of hepatic impairment on plasma pharmacokinetics (PK), safety and tolerability of TNO155. The results of this study will guide the Novartis recommendation regarding whether or not a dose adjustment may be needed when treating patients with hepatic impairment.
    Detailed Description
    This is a study to evaluate the PK of TNO155 in participants with mild, moderate or severe hepatic impairment compared to matched healthy control participants with normal hepatic function. The study will be divided into 2 parts. Participants in the hepatic impairment groups will be staged by their respective degree of hepatic impairment (mild, moderate, or severe) according to a classification score determined at the screening visit and confirmed unchanged at the baseline visit. Each participant in the healthy control group may be matched to 1 or more evaluable participants with hepatic impairment with respect to age (± 10 years), body weight (± 20%), sex and smoking status (smoker vs. non smoker). Each participant in the control group can be matched to participants from any hepatic impairment group but cannot be matched to more than 1 participant from the same hepatic impairment group. All participants will be domiciled from Day -1 until Day 11. All participants should have a poststudy safety follow-up contact conducted approximately 30 days after administration of study treatment. The study will be considered complete once all the participants have finished the required assessments, dropped out, or been lost to follow-up before completing the required assessments.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Hepatic Impairment
    Keywords
    Hepatic, Impairment, TNO155, Phase 1, pharmacokinetics, safety, Tolerability, Child-Pug

    7. Study Design

    Primary Purpose
    Diagnostic
    Study Phase
    Phase 1
    Interventional Study Model
    Parallel Assignment
    Model Description
    The study will be divided into 2 parts. Participants in the hepatic impairment groups will be staged by their respective degree of hepatic impairment according to the Child Pugh classification score determined at the screening visit and confirmed unchanged at the baseline visit. Healthy participants who were identified and enrolled as matching partners for a hepatic impairment group in Part I can serve as matching partners for participants in hepatic impairment group in Part II if they fulfilled the matching criteria. Otherwise, additional matched healthy participants will be enrolled. Part I: will include participants with mild and moderate levels of hepatic impairment as well as healthy control participants assigned to the groups Part II: will include participants with severe hepatic impairment.
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    48 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Group 1 (control)
    Arm Type
    Experimental
    Arm Description
    Healthy control participants with normal hepatic function
    Arm Title
    Group 2 (score 5-6)
    Arm Type
    Experimental
    Arm Description
    Mild hepatic impairment: Child-Pugh A
    Arm Title
    Group 3 (score 7-9)
    Arm Type
    Experimental
    Arm Description
    Moderate hepatic impairment: Child-Pugh B
    Arm Title
    Group 4 (score 10-15)
    Arm Type
    Experimental
    Arm Description
    Severe hepatic impairment: Child-Pugh C. This group may be opened if allowed by the results of the interim analysis of the Groups 1 to 3.
    Intervention Type
    Drug
    Intervention Name(s)
    TNO155
    Intervention Description
    Single oral dose of TNO155 on Day 1
    Primary Outcome Measure Information:
    Title
    Area under the concentration-versus-time curve (AUC) from time zero to the last measurable plasma concentration (AUClast) of TNO155
    Description
    AUClast will be calculated based on TNO155 plasma concentrations and non-compartmental methods.
    Time Frame
    Up to 240 hours post single dose
    Title
    AUC from time zero to time "t" (AUC0-t) of TNO155
    Description
    AUC0-t will be calculated as needed based on TNO155 plasma concentrations and non-compartmental methods. The definition of time "t" may be data-driven post-hoc to mitigate treatment bias due to within participant differences in Tlast between the treatments, or may be selected to allow between-study exposure comparisons that use a common time window.
    Time Frame
    Up to 240 hours post single dose
    Title
    AUC from time zero to infinity (AUCinf) of TNO155
    Description
    AUCinf will be calculated based on TNO155 plasma concentrations and non-compartmental methods.
    Time Frame
    Up to 240 hours post single dose
    Title
    Maximum (peak) observed plasma concentration (Cmax) of TNO155
    Description
    Cmax will be calculated based on TNO155 plasma concentrations and non-compartmental methods.
    Time Frame
    Up to 240 hours post single dose
    Title
    Time to reach maximum observed plasma concentration (Tmax) of TNO155
    Description
    Tmax will be calculated based on TNO155 plasma concentrations and non-compartmental methods
    Time Frame
    Up to 240 hours post single dose
    Title
    Elimination half-life (T1/2) of TNO155
    Description
    T1/2 will be calculated based on TNO155 plasma concentrations and non-compartmental methods.
    Time Frame
    Up to 240 hours post single dose
    Title
    Sampling time of the last measurable plasma concentration (Tlast) of TNO155
    Description
    Tlast will be calculated based on TNO155 plasma concentrations and non-compartmental methods.
    Time Frame
    Up to 240 hours post single dose
    Title
    Apparent plasma clearance (CL/F) of TNO155
    Description
    CL/F will be calculated based on TNO155 plasma concentrations and non-compartmental methods.
    Time Frame
    Up to 240 hours post single dose
    Title
    Apparent volume of distribution during terminal phase (Vz/F) of TNO155
    Description
    Vz/F will be calculated based on TNO155 plasma concentrations and non-compartmental methods.
    Time Frame
    Up to 240 hours post single dose
    Secondary Outcome Measure Information:
    Title
    Incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs)
    Description
    Incidence of AEs and SAEs, including changes in vital signs, electrocardiograms (ECGs) and laboratory results qualifying and reported as AEs.
    Time Frame
    Up to 30 days post single dose
    Title
    Unbound Cmax (Cmax,u) of TNO155
    Description
    Cmax,u will be calculated based on the unbound fraction of TNO155 in plasma.
    Time Frame
    Up to 240 hours post single dose
    Title
    Unbound AUClast (AUClast,u) of TNO155
    Description
    AUClast,u will be calculated based on the unbound fraction of TNO155 in plasma.
    Time Frame
    Up to 240 hours post single dose
    Title
    Unbound AUCinf (AUCinf,u) of TNO155
    Description
    AUCinf,u will be calculated based on the unbound fraction of TNO155 in plasma
    Time Frame
    Up to 240 hours post single dose
    Title
    Unbound CL/F (CL/F,u) of TNO155
    Description
    CL/F,u will be calculated based on the unbound fraction of TNO155 in plasma.
    Time Frame
    Up to 240 hours post single dose
    Title
    Renal clearance (CLr) of TNO155
    Description
    CLr will be calculated based on urinary excretion data of TNO155.
    Time Frame
    Up to 240 hours post single dose
    Title
    Apparent non-renal clearance (CLNR/F) of TNO155
    Description
    CLNR/F will be calculated based on urinary excretion data of TNO155.
    Time Frame
    Up to 240 hours post single dose
    Title
    Fraction of dose excreted in urine (fe) of TNO155
    Description
    Fe will be calculated based on urinary excretion data of TNO155.
    Time Frame
    Up to 240 hours post single dose

    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: All participants Participants must weigh at least 50 kg and no more than 120 kg and must have a body mass index (BMI) within the range of 18.0 to 38.0 kg/m2, inclusive, for healthy participants. For participants with hepatic impairment without overt ascites, the BMI should be within the range of 18.0 to 40.0 kg/m2. For participants with hepatic impairment with overt ascites, the BMI should be within the range of 18.0 to 45.0 kg/m2. Group 1 •Each healthy control participant must match in age (± 10 years), sex, body weight (± 20%), and smoking status to at least 1 hepatic impairment participant in Groups 2, 3 and/or 4. Groups 2 to 4 •Participants with mild, moderate or severe hepatic impairment must have a Child-Pugh score clinically determined at screening and confirmed unchanged at baseline calculated as per the Child-Pugh classification in line with the hepatic impairment status of each Group Exclusion Criteria: All Participants Use of drugs (prescription, non-prescription and herbal remedies such as St John's wort) known to affect CYP3A or UGT1A3, including UGT1A3 inhibitors and inducers and strong and moderate CYP3A inhibitors and inducers, within 4 weeks prior to dosing until completion of the End of Study Visit. Acute or chronic hepatitis B or C infection or active infection requiring therapy that will not be completed before screening. Left ventricular ejection fraction (LVEF) < 50% or below the institutional standard lower limit, whichever is higher, as determined by multiple gated acquisition (MUGA) scan or Trans-thoracic echocardiography (TTE) at screening or baseline. •At screening, history of retinal vein occlusion (RVO) or presence of predisposing factors to RVO or central serous retinopathy, or any other clinically significant ophthalmologic abnormalities determined by an ophthalmologist. Group 1 Any single parameter of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), or alkaline phosphatase (ALP) exceeding 2.5 × upper limit of normal (ULN) or total bilirubin ≥ 1.5 ULN OR any elevation above ULN of more than 1 parameter of ALT, AST, GGT, ALP, or serum bilirubin at screening or baseline. Impaired renal function as indicated by clinically significantly abnormal creatinine or blood urea nitrogen and/or other urea values outside local laboratory ranges or abnormal urinary constituents at screening or baseline. Groups 2 and 3 Severe complications of liver disease within the preceding 3 months prior to dosing. Hospitalization due to liver disease within the preceding 1 month prior to dosing. Participant has received liver transplant at any time in the past and is on immunosuppressant therapy. Participants requiring paracentesis more than every 3 weeks for the management of ascites are excluded. Other protocol-defined inclusion/exclusion criteria may apply.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Novartis Pharmaceuticals
    Phone
    1-888-669-6682
    Email
    novartis.email@novartis.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Novartis Pharmaceuticals

    12. IPD Sharing Statement

    Plan to Share IPD
    No

    Learn more about this trial

    Pharmacokinetics of TNO155 in Participants With Mild, Moderate, or Severe Hepatic Impairment Compared to Matched Healthy Participants

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