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Dosing Obese With Noxafil® Under a Trial (DONUT) (DONUT)

Primary Purpose

Morbid Obesity

Status
Completed
Phase
Phase 4
Locations
Netherlands
Study Type
Interventional
Intervention
Posaconazole Injection [Noxafil] 300mg
Posaconazole Injection [Noxafil] 400mg
Sponsored by
Radboud University Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Morbid Obesity

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Subjects BMI:

    • obese groups: subject must have a BMI ≥35 kg/m2 at the time of inclusion,
    • non-obese group: subject must have a BMI ≥18.5 and < 25kg/m2 at the time of inclusion.
  2. Subject is at least 18 of age on the day of screening and not older than 65 years of age on the day of dosing;
  3. If a woman, is neither pregnant nor able to become pregnant and is not nursing an infant;
  4. Subject is able and willing to sign the Informed Consent before screening evaluations.

    For the non-obese subjects the following additional inclusion criteria applies:

  5. Subject is in good age-appropriate health condition as established by medical history, physical examination, electrocardiography, results of biochemistry, hematology and urinalysis testing within 6 weeks prior to study drug administration. Results of biochemistry, hematology and urinalysis testing should be within the laboratory's reference ranges (see Appendix A). If laboratory results are not within the reference ranges, the subject is included based on the investigator's judgment that the observed deviations are not clinically relevant. This should be clearly recorded;

Exclusion Criteria:

  1. Documented history of sensitivity to medicinal products or excipients similar to those found in the posaconazole preparation;
  2. History of, or known abuse of drugs, alcohol or solvents (up until a maximum of three months before study drug administration);
  3. Use of medication that has known relevant interaction with study drug as determined by the investigator up to 1 weeks prior to study drug administration.
  4. Donation of blood or plasma to a blood bank or in a clinical study (except a screening visit) within 4 weeks prior to study drug administration;
  5. Blood transfusion within 8 weeks prior to study drug administration;

Sites / Locations

  • St. Antonius hospital
  • Radboudumc

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Obese subjects

Non-obese subjects

Arm Description

Subjects with a BMI>35 kg/m2

Subjects with a BMI>18.5 and <25 kg/m2

Outcomes

Primary Outcome Measures

Posaconazole exposure
The concentration-time curve of posaconazole in obese will be compared with that in non-obese subjects. Exposure is assessed by Area-Under-the-Curve from zero to 48 hours (AUC0-48h).

Secondary Outcome Measures

Exposure with augemented posaconazol dose
The concentration-time curve of posaconazole in obese receiving 400mg will be compared with that in non-obese subjects. Exposure is assessed by Area-Under-the-Curve from zero to 48 hours (AUC0-48h).

Full Information

First Posted
August 2, 2017
Last Updated
October 16, 2020
Sponsor
Radboud University Medical Center
Collaborators
St. Antonius Hospital, Merck Sharp & Dohme LLC
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1. Study Identification

Unique Protocol Identification Number
NCT03246386
Brief Title
Dosing Obese With Noxafil® Under a Trial (DONUT)
Acronym
DONUT
Official Title
Pharmacokinetics of Posaconazole Given as a Single Intravenous Dose to Obese Subjects: Dosing Obese With Noxafil® Under a Trial (DONUT)
Study Type
Interventional

2. Study Status

Record Verification Date
December 2019
Overall Recruitment Status
Completed
Study Start Date
November 5, 2017 (Actual)
Primary Completion Date
September 1, 2018 (Actual)
Study Completion Date
September 1, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Radboud University Medical Center
Collaborators
St. Antonius Hospital, Merck Sharp & Dohme LLC

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
Although posaconazole is approved for the prophylaxes and treatment of invasive fungal infections, specific dosing guidelines for posaconazole in (morbidly) obese patients are not specified. There is clear evidence indicating that heavier patients are receiving a sub-optimal dose if the current guidelines are used. Specifically in the setting of augmented prevalence of species with intermediate susceptible to posaconazole, adequate dosing is needed at start of treatment. Therefore it seems prudent to conduct a trial in a cohort of obese patients who receive posaconazole (300mg or 400mg) and define the pharmacokinetics. These will then be compared to the pharmacokinetics in a normal-weight group receiving 300mg posaconazole.
Detailed Description
Obese patients with a BMI ≥ 35 kg/m2 undergoing endoscopic gastric bypass surgery will receive a 300 mg or 400mg dose of posaconazole. A PK curve will be determined after administration at t=0.45, 0.75, 1, 1.5, 2, 4, 8, 12, 24, and (if feasible) 48 hours post infusion. Blood samples (4 mL) on PK days will be taken to obtain at least 2.0 mL of plasma.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Morbid Obesity

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Model Description
Comparing a 2 groups of obese subjects vs 1 group of non-obese subjects.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Obese subjects
Arm Type
Experimental
Arm Description
Subjects with a BMI>35 kg/m2
Arm Title
Non-obese subjects
Arm Type
Active Comparator
Arm Description
Subjects with a BMI>18.5 and <25 kg/m2
Intervention Type
Drug
Intervention Name(s)
Posaconazole Injection [Noxafil] 300mg
Intervention Description
Single dose by intravenous infusion 300mg
Intervention Type
Drug
Intervention Name(s)
Posaconazole Injection [Noxafil] 400mg
Intervention Description
Single dose by intravenous infusion 400mg
Primary Outcome Measure Information:
Title
Posaconazole exposure
Description
The concentration-time curve of posaconazole in obese will be compared with that in non-obese subjects. Exposure is assessed by Area-Under-the-Curve from zero to 48 hours (AUC0-48h).
Time Frame
Through study completion (usually after 24 or 48 hours)
Secondary Outcome Measure Information:
Title
Exposure with augemented posaconazol dose
Description
The concentration-time curve of posaconazole in obese receiving 400mg will be compared with that in non-obese subjects. Exposure is assessed by Area-Under-the-Curve from zero to 48 hours (AUC0-48h).
Time Frame
Through study completion (usually after 24 or 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: Subjects BMI: obese groups: subject must have a BMI ≥35 kg/m2 at the time of inclusion, non-obese group: subject must have a BMI ≥18.5 and < 25kg/m2 at the time of inclusion. Subject is at least 18 of age on the day of screening and not older than 65 years of age on the day of dosing; If a woman, is neither pregnant nor able to become pregnant and is not nursing an infant; Subject is able and willing to sign the Informed Consent before screening evaluations. For the non-obese subjects the following additional inclusion criteria applies: Subject is in good age-appropriate health condition as established by medical history, physical examination, electrocardiography, results of biochemistry, hematology and urinalysis testing within 6 weeks prior to study drug administration. Results of biochemistry, hematology and urinalysis testing should be within the laboratory's reference ranges (see Appendix A). If laboratory results are not within the reference ranges, the subject is included based on the investigator's judgment that the observed deviations are not clinically relevant. This should be clearly recorded; Exclusion Criteria: Documented history of sensitivity to medicinal products or excipients similar to those found in the posaconazole preparation; History of, or known abuse of drugs, alcohol or solvents (up until a maximum of three months before study drug administration); Use of medication that has known relevant interaction with study drug as determined by the investigator up to 1 weeks prior to study drug administration. Donation of blood or plasma to a blood bank or in a clinical study (except a screening visit) within 4 weeks prior to study drug administration; Blood transfusion within 8 weeks prior to study drug administration;
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Roger Brüggemann, PhD-PharmD
Organizational Affiliation
Radboud University Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
St. Antonius hospital
City
Nieuwegein
Country
Netherlands
Facility Name
Radboudumc
City
Nijmegen
Country
Netherlands

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
31971567
Citation
Wasmann RE, Smit C, van Donselaar MH, van Dongen EPA, Wiezer RMJ, Verweij PE, Burger DM, Knibbe CAJ, Bruggemann RJM. Implications for IV posaconazole dosing in the era of obesity. J Antimicrob Chemother. 2020 Apr 1;75(4):1006-1013. doi: 10.1093/jac/dkz546.
Results Reference
result
Links:
URL
https://pubmed.ncbi.nlm.nih.gov/31971567/
Description
paper

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Dosing Obese With Noxafil® Under a Trial (DONUT)

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