Bexagliflozin Drug/Drug Interaction Study With Exenatide Injection
Primary Purpose
Type2 Diabetes Mellitus
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Bexagliflozin
Exenatide Injection
Sponsored by

About this trial
This is an interventional treatment trial for Type2 Diabetes Mellitus
Eligibility Criteria
Inclusion Criteria:
- Male and female subjects who were between the ages of 18 and 65 years, inclusive, in good health based on medical history, physical examination, electrocardiogram and routine laboratory tests.
- Subjects with body-mass index (BMI) between 18.0 kg/m2 and 32.0 kg/m2, inclusive.
- Subjects who were non-smokers for at least 3 months prior to screening.
- Subjects with adequate venous access at multiple sites in both arms.
- Subjects who were willing and able to be confined to the clinical research facility as required by the protocol.
- Subjects who had the ability to comprehend and who were willing to provide written informed consent in accordance with institutional and regulatory guidelines.
Exclusion Criteria:
- Subjects who were determined by the investigator or sub-investigator to be unsuitable for participation in the study based on medical conditions or factors that would have influenced adherence to study activities.
- Subjects with a clinically significant history of allergy to drugs or latex.
- Subjects with a history of hypoglycemia.
- Subjects with a history of alcohol or drug dependence in the last 12 months.
- Subjects who donated 400 mL of whole blood within 56 days, 200 mL of whole blood within one month, or donated blood components within 14 days of screening.
- Subjects who used prescription or over-the-counter (OTC) drugs within 14 days prior to the first dose.
- Subjects who used vitamin preparations or supplements (including St. John's Wort and ginseng) within 14 days prior to the first dose .
- Subjects who were not willing to refrain from smoking, alcohol, grapefruit, grapefruit juice or related products, caffeine consumption (including chocolate), and strenuous exercise within 72 h prior to Day 1 and through the end of the PK study.
- Male subjects who did not agree to refrain from donating sperm and use appropriate birth control methods including condoms with spermicide, female partner's use of diaphragm with spermicide, or stable oral, implanted, or injected contraceptive hormones, or with an intrauterine device, or female partner is surgically sterile (i.e. have undergone partial or full hysterectomy, or bilateral oophorectomy) or postmenopausal (absence of menses greater than 12 months and age >45 years), for a period of 30 days after discharge from the clinic.
- Female subjects of childbearing potential who were not willing to use an adequate method of contraception including bilateral tubal ligation, intrauterine device, diaphragm with spermicide and male partner's use of male condom with spermicide, and to not become pregnant for the duration of the study. Female subjects who were surgically sterile (partial or full hysterectomy, or bilateral oophorectomy) or postmenopausal (absence of menses greater than 12 months and age >45 years) were eligible if they tested negative on the pregnancy test.
- Subjects who had been treated with an investigational drug within 30 days or 7 half-lives of the investigational drug, whichever is longer, prior to the first dose of study drug in this trial.
- Subjects who had previously received exenatide, or any other GLP-1 RAs within three months from the screening or subjects who had had any GLP-1 RA and suffered an adverse reaction due to the medication.
- Subjects who had previously received bexagliflozin, or any other SGLT2 inhibitors within 3 months from the screening.
- Subjects whose screening ECG demonstrates any one of the following: heart rate >100 bpm, QRS >120 msec, QTc >470 msec (corrected by Fridericia's formula), PR >220 msec (a subject with PR >220 msec was generally to be excluded but exceptions may have been allowed at the discretion of the investigator), or any clinically significant arrhythmia.
- Subjects whose sitting blood pressure was above 140/90 mmHg at screening. If the sitting blood pressure at screening was above 140/90 mmHg, one repeat measurement was allowed and the subject may have been randomized if the blood pressure was 140/90 +/-5 mm Hg at the discretion of the Investigator.
- Subjects who had a positive result of hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibody, urinary drug or urinary cotinine test.
- Subjects with human immunodeficiency virus (HIV) infection.
- Subjects who had had a febrile illness within 5 days prior to the first dose of study medication.
- Subjects vaccinated within 30 days (with the exception of the flu vaccine) prior to the first dose of investigational drug.
- Subjects with a history of acute or chronic pancreatitis or gall stones.
- Positive urine glucose at screening.
- Subjects with estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m2 or a history of kidney transplant.
- Subjects with digestion problems, including gastroesophageal reflux disease, irritable bowel syndrome, gastroparesis, and any other disorder deemed by the investigator to be clinically significant.
Sites / Locations
- Clinical Research Site
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Bexagliflozin alone
Bexagliflozin with exenatide injection
Arm Description
Outcomes
Primary Outcome Measures
Cmax (Maximum Observed Plasma Concentration)
Whole venous blood samples of 3 mL was collected from peripheral vein at each period at pre-dose and at 0.5, 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36 and 48 h post-dose of bexagliflozin. A non-compartmental pharmacokinetic analysis was used to calculate the PK parameters. Cmax was obtained directly from experimental observations.
Tmax (Time of Maximum Observed Plasma Concentration)
Whole venous blood samples of 3 mL was collected from peripheral vein at each period at pre-dose and at 0.5, 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36 and 48 h post-dose of bexagliflozin. A non-compartmental pharmacokinetic analysis was used to calculate the PK parameters. Tmax was obtained directly from experimental observations.
T1/2 (Apparent Terminal Elimination Half-life)
Whole venous blood samples of 3 mL was collected from peripheral vein at each period at pre-dose and at 0.5, 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36 and 48 h post-dose of bexagliflozin. A non-compartmental pharmacokinetic analysis was used to calculate the PK parameters. T1/2 was calculated as the natural log of 2 divided by the terminal phase rate constant.
AUC0-inf (Area Under the Plasma Concentration-time Curve From Time 0 to Infinity)
Whole venous blood samples of 3 mL was collected from peripheral vein at each period at pre-dose and at 0.5, 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36 and 48 h post-dose of bexagliflozin. A non-compartmental pharmacokinetic analysis was used to calculate the PK parameters. AUC0-inf was calculated using the linear trapezoidal rule, using actual elapsed time values. If the actual time of sample collection was not available, the nominal time was used for the purpose of parameter estimation.
Secondary Outcome Measures
Urinary Glucose Excretion (UGE)
Post-dose urine was collected without preservative in four batches: 0 to 12 h, 12 to 24 h, 24 to 36 h, and 36 to 48 h collections. After collection, the total volume of each batch and collection time was recorded. UGE, including UGE(t1-t2) and total 0-24 h and 0-48 h UGE were calculated. UGE(t1-t2) was derived from urine volume (Vt1-t2) multiplied by glucose concentration divided by 100.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03167411
Brief Title
Bexagliflozin Drug/Drug Interaction Study With Exenatide Injection
Official Title
A Phase 1, Open-label, Randomized, Two-period, Two-treatment, Crossover Study to Evaluate the Effect of Exenatide on the Pharmacokinetics and Pharmacodynamics of Bexagliflozin in Healthy Subjects
Study Type
Interventional
2. Study Status
Record Verification Date
March 2021
Overall Recruitment Status
Completed
Study Start Date
May 24, 2017 (Actual)
Primary Completion Date
June 29, 2017 (Actual)
Study Completion Date
June 29, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Theracos
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to examine the drug-drug interaction when given the study drug, bexagliflozin, with one of the most commonly prescribed glucagon-like peptide 1 receptor agonist (GLP-1 RA) exenatide. The study will also evaluate how safe the study drug is and how well the study drug is tolerated when administered with exenatide injection.
Detailed Description
This was a phase 1, single center, open-label, 2 × 2 crossover study designed to assess the effects of exenatide injection on the PK and PD of orally administered bexagliflozin tablets. Healthy subjects were randomly assigned to one of two groups with 10 subjects per group. Each group received both the treatments, alternately, in a crossover fashion with the two treatment periods separated by a 7-day washout period.
In Treatment Period 1, subjects were admitted to the clinic on day 0, the day before dosing, and stayed in the clinic until 48 h post-dose. After an overnight fast of at least 10 h, subjects in Group 1 received a single oral dose of bexagliflozin tablets, 20 mg, alone 30 min before breakfast, and subjects in Group 2 received a subcutaneous (SC) injection of exenatide at 10 µg twice a day (bid) with an initial dose 30 min prior to a single oral dose of bexagliflozin tablets, 20 mg, and 1 hr before breakfast, followed by the second dose of exenatide alone 1 hr prior to the evening meal.
In Treatment Period 2, subjects were admitted to the clinic on day 7, the day before dosing, and stayed in the clinic until 48 hr post-dose. After an overnight fast of at least 10 h, subjects in Group 1 received a SC injection exenatide at 10 µg bid with an initial dose 30 min prior to a single oral dose of bexagliflozin tablets, 20 mg, and 1 hr before breakfast and followed by the second dose of exenatide alone 1 hr prior to the evening meal. Subjects in Group 2 received a single oral dose of bexagliflozin tablets, 20 mg, alone 30 minutes before breakfast.
Blood samples for bexagliflozin plasma concentration were collected during each period at pre-dose and at 0.5, 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36, and 48 hr post-dose. Pre-dose urine samples were collected from -12 to 0 hr for baseline measurement of PD parameters. Post-dose urine samples were collected in four batches: 0 to 12 hr, 12 to 24 hr, 24 to 36 hr, and 36 to 48 hr.
Clinical laboratory tests and safety monitoring were conducted during both treatment periods for each group.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Type2 Diabetes Mellitus
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
20 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Bexagliflozin alone
Arm Type
Experimental
Arm Title
Bexagliflozin with exenatide injection
Arm Type
Active Comparator
Intervention Type
Drug
Intervention Name(s)
Bexagliflozin
Intervention Description
Bexagliflozin tablets, 20 mg
Intervention Type
Drug
Intervention Name(s)
Exenatide Injection
Other Intervention Name(s)
Byetta®
Intervention Description
Byetta® (Exenatide), 10 ug, bid, subcutaneous injection
Primary Outcome Measure Information:
Title
Cmax (Maximum Observed Plasma Concentration)
Description
Whole venous blood samples of 3 mL was collected from peripheral vein at each period at pre-dose and at 0.5, 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36 and 48 h post-dose of bexagliflozin. A non-compartmental pharmacokinetic analysis was used to calculate the PK parameters. Cmax was obtained directly from experimental observations.
Time Frame
Up to 48 hrs
Title
Tmax (Time of Maximum Observed Plasma Concentration)
Description
Whole venous blood samples of 3 mL was collected from peripheral vein at each period at pre-dose and at 0.5, 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36 and 48 h post-dose of bexagliflozin. A non-compartmental pharmacokinetic analysis was used to calculate the PK parameters. Tmax was obtained directly from experimental observations.
Time Frame
Up to 48 hrs
Title
T1/2 (Apparent Terminal Elimination Half-life)
Description
Whole venous blood samples of 3 mL was collected from peripheral vein at each period at pre-dose and at 0.5, 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36 and 48 h post-dose of bexagliflozin. A non-compartmental pharmacokinetic analysis was used to calculate the PK parameters. T1/2 was calculated as the natural log of 2 divided by the terminal phase rate constant.
Time Frame
Up to 48 hrs
Title
AUC0-inf (Area Under the Plasma Concentration-time Curve From Time 0 to Infinity)
Description
Whole venous blood samples of 3 mL was collected from peripheral vein at each period at pre-dose and at 0.5, 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36 and 48 h post-dose of bexagliflozin. A non-compartmental pharmacokinetic analysis was used to calculate the PK parameters. AUC0-inf was calculated using the linear trapezoidal rule, using actual elapsed time values. If the actual time of sample collection was not available, the nominal time was used for the purpose of parameter estimation.
Time Frame
Up to 48 hrs
Secondary Outcome Measure Information:
Title
Urinary Glucose Excretion (UGE)
Description
Post-dose urine was collected without preservative in four batches: 0 to 12 h, 12 to 24 h, 24 to 36 h, and 36 to 48 h collections. After collection, the total volume of each batch and collection time was recorded. UGE, including UGE(t1-t2) and total 0-24 h and 0-48 h UGE were calculated. UGE(t1-t2) was derived from urine volume (Vt1-t2) multiplied by glucose concentration divided by 100.
Time Frame
0-48 hours
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:
Male and female subjects who were between the ages of 18 and 65 years, inclusive, in good health based on medical history, physical examination, electrocardiogram and routine laboratory tests.
Subjects with body-mass index (BMI) between 18.0 kg/m2 and 32.0 kg/m2, inclusive.
Subjects who were non-smokers for at least 3 months prior to screening.
Subjects with adequate venous access at multiple sites in both arms.
Subjects who were willing and able to be confined to the clinical research facility as required by the protocol.
Subjects who had the ability to comprehend and who were willing to provide written informed consent in accordance with institutional and regulatory guidelines.
Exclusion Criteria:
Subjects who were determined by the investigator or sub-investigator to be unsuitable for participation in the study based on medical conditions or factors that would have influenced adherence to study activities.
Subjects with a clinically significant history of allergy to drugs or latex.
Subjects with a history of hypoglycemia.
Subjects with a history of alcohol or drug dependence in the last 12 months.
Subjects who donated 400 mL of whole blood within 56 days, 200 mL of whole blood within one month, or donated blood components within 14 days of screening.
Subjects who used prescription or over-the-counter (OTC) drugs within 14 days prior to the first dose.
Subjects who used vitamin preparations or supplements (including St. John's Wort and ginseng) within 14 days prior to the first dose .
Subjects who were not willing to refrain from smoking, alcohol, grapefruit, grapefruit juice or related products, caffeine consumption (including chocolate), and strenuous exercise within 72 h prior to Day 1 and through the end of the PK study.
Male subjects who did not agree to refrain from donating sperm and use appropriate birth control methods including condoms with spermicide, female partner's use of diaphragm with spermicide, or stable oral, implanted, or injected contraceptive hormones, or with an intrauterine device, or female partner is surgically sterile (i.e. have undergone partial or full hysterectomy, or bilateral oophorectomy) or postmenopausal (absence of menses greater than 12 months and age >45 years), for a period of 30 days after discharge from the clinic.
Female subjects of childbearing potential who were not willing to use an adequate method of contraception including bilateral tubal ligation, intrauterine device, diaphragm with spermicide and male partner's use of male condom with spermicide, and to not become pregnant for the duration of the study. Female subjects who were surgically sterile (partial or full hysterectomy, or bilateral oophorectomy) or postmenopausal (absence of menses greater than 12 months and age >45 years) were eligible if they tested negative on the pregnancy test.
Subjects who had been treated with an investigational drug within 30 days or 7 half-lives of the investigational drug, whichever is longer, prior to the first dose of study drug in this trial.
Subjects who had previously received exenatide, or any other GLP-1 RAs within three months from the screening or subjects who had had any GLP-1 RA and suffered an adverse reaction due to the medication.
Subjects who had previously received bexagliflozin, or any other SGLT2 inhibitors within 3 months from the screening.
Subjects whose screening ECG demonstrates any one of the following: heart rate >100 bpm, QRS >120 msec, QTc >470 msec (corrected by Fridericia's formula), PR >220 msec (a subject with PR >220 msec was generally to be excluded but exceptions may have been allowed at the discretion of the investigator), or any clinically significant arrhythmia.
Subjects whose sitting blood pressure was above 140/90 mmHg at screening. If the sitting blood pressure at screening was above 140/90 mmHg, one repeat measurement was allowed and the subject may have been randomized if the blood pressure was 140/90 +/-5 mm Hg at the discretion of the Investigator.
Subjects who had a positive result of hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibody, urinary drug or urinary cotinine test.
Subjects with human immunodeficiency virus (HIV) infection.
Subjects who had had a febrile illness within 5 days prior to the first dose of study medication.
Subjects vaccinated within 30 days (with the exception of the flu vaccine) prior to the first dose of investigational drug.
Subjects with a history of acute or chronic pancreatitis or gall stones.
Positive urine glucose at screening.
Subjects with estimated glomerular filtration rate (eGFR) <90 mL/min/1.73 m2 or a history of kidney transplant.
Subjects with digestion problems, including gastroesophageal reflux disease, irritable bowel syndrome, gastroparesis, and any other disorder deemed by the investigator to be clinically significant.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mason Freeman, M.D.
Organizational Affiliation
Massachusetts General Hospital
Official's Role
Study Chair
Facility Information:
Facility Name
Clinical Research Site
City
Evansville
State/Province
Indiana
ZIP/Postal Code
47710
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Bexagliflozin Drug/Drug Interaction Study With Exenatide Injection
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