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Nitazoxanide Pharmacokinetic Parameters in Hepatic Impaired Patients

Primary Purpose

Moderate Hepatic Impairment, Severe Hepatic Impairment, Liver Diseases

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Nitazoxanide
Sponsored by
Genfit
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Moderate Hepatic Impairment focused on measuring Pharmacokinetics, Healthy Volunteer, Liver Disease, Hepatic Impairment, Antiparasitic, Antiprotozoal

Eligibility Criteria

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

Inclusion Criteria:

  1. Males or females, between 18 and 75 years of age, inclusive;
  2. With a minimum body weight of 50 kg and within a BMI range of 18.0 to 40.0 kg/m^2, inclusive;
  3. Females participating in this study must be of non-childbearing potential or must be using highly effective contraception for the full duration of the study;
  4. Negative human immunodeficiency virus antibody screens at Screening;
  5. Matched to participants with moderate and/or severe hepatic impairment in age (± 10 years), BMI (± 20 percentage) and sex;
  6. Participants who have chronic (≥ 6 months) moderate or severe hepatic insufficiency (of any etiology) that has been clinically stable (no acute episodes of illness due to deterioration in hepatic function) for at least 1 month prior to Screening and must also remain stable throughout the Screening period.

Other protocol-defined inclusion criteria may apply

Exclusion Criteria:

  1. A positive alcohol test result at Check-In Visit;
  2. A history of alcohol abuse in the prior 2 years;
  3. Positive urine screen for drugs of abuse at Screening or Check-In;
  4. Strenuous exercise within 72 hours prior to Check-In Visit;
  5. Blood 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;
  6. History of a major surgical procedure within 30 days prior to Screening;
  7. History of stomach or intestinal surgery or resection that would potentially alter absorption and/or excretion of orally administered drugs except that appendectomy and hernia repair will be allowed. Bariatric surgery will not be allowed;
  8. Presence or history of malignancy within the prior 3 years, with the exception of treated basal cell or squamous cell carcinoma;
  9. Poor peripheral venous access;
  10. Receipt of blood products within 2 months prior to Check-In Visit;
  11. Significant history or clinical manifestation of any metabolic (including thyroid), allergic, dermatological, hepatic, renal, hematological, pulmonary, cardiovascular (including any prior history of cardiomyopathy or cardiac failure), gastrointestinal (GI), neurological, or psychiatric disorder;
  12. Positive serologic test for hepatitis B surface antigen or for hepatitis C virus antibody at Screening;
  13. Frequent headaches (> twice a month) and/or migraines, recurrent nausea and/or vomiting, diarrhea;
  14. Participants with symptomatic hypotension at Screening, whatever the decrease of blood pressure, or asymptomatic postural hypotension;
  15. History of unstable diabetes mellitus;
  16. Participants who have a transjugular intrahepatic portosystemic shunt and/or have undergone portacaval shunting;
  17. Participant has shown evidence of hepatorenal syndrome or has creatinine clearance ≤ 60 mL/min;
  18. Participants has required treatment for GI bleeding within the 6 months prior to Check-In Visit;
  19. Recent history of paracentesis (< 1 months prior to Check-In Visit);
  20. Participants with Wilson's disease, alpha-1 antitrypsin deficiency, glycogen storage diseases, or galactosemia;
  21. Participants with anemia secondary to hepatic disease, unless hemoglobin is ≥ 8.5 g/dL and anemia symptoms are not clinically significant. Participants must have ≥ 30,000 platelets at screening and at Check-In Visit.

Other protocol-defined exclusion criteria may apply

Sites / Locations

  • Panax Clinical Research
  • Orlando Clinical Research Center

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Healthy Control Match (Normal hepatic function)

Moderate Child-Pugh B (Moderate hepatic impairment)

Severe Child-Pugh C (Severe hepatic impairment)

Arm Description

NTZ 500 mg twice a day for 7 days

NTZ 500 mg twice a day for 7 days

NTZ 500 mg twice a day for 7 days

Outcomes

Primary Outcome Measures

Area under the plasma concentration time curve (AUC) from time zero to 12h (AUC0-12)
In participants with moderate and severe hepatic impairment compared to healthy volunteers
AUC from time zero to the time of the last quantifiable concentration (AUC0-t)
In participants with moderate and severe hepatic impairment compared to healthy volunteers
Maximum observed plasma concentration (Cmax),
In participants with moderate and severe hepatic impairment compared to healthy volunteers

Secondary Outcome Measures

Plasma pharmacokinetics: time of the maximum observed plasma concentration (Tmax), apparent plasma terminal elimination half life (t1/2), AUC from time zero to infinity (AUC0-∞), trough concentration (Ctrough) and percentage of extrapolated (%AUCextrap)
For NTZ and its major active metabolite
Plasma pharmacokinetics: Tmax, AUC0-12, AUC0-t, AUC0-∞, Cmax, t1/2, %AUCextrap and Ctrough.
For the NTZ major active metabolite
Urine pharmacokinetics: amount of drug excreted (Ae), cumulative amount of drug excreted (Ae0-t), and renal clearance (CLR)
For the NTZ major active metabolites
Plasma and urine pharmacokinetics: After the single oral administration of NTZ 500 mg: Cmax, AUC0-12, AUC0-t, AUC0-∞ , Tmax, t1/2, %AUCextrap, Ae0-∞, Ae0-t and CLR.
For the NTZ major active metabolites

Full Information

First Posted
November 1, 2021
Last Updated
October 12, 2022
Sponsor
Genfit
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1. Study Identification

Unique Protocol Identification Number
NCT05116826
Brief Title
Nitazoxanide Pharmacokinetic Parameters in Hepatic Impaired Patients
Official Title
An Open-label, Phase 1, Multiple-dose Study to Evaluate the Pharmacokinetics of Nitazoxanide 500 mg Twice Daily for 7 Days in Adult Subjects With Moderate and Severe Hepatic Impairment and Adult Healthy Control Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Completed
Study Start Date
November 5, 2021 (Actual)
Primary Completion Date
April 8, 2022 (Actual)
Study Completion Date
April 13, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Genfit

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
This study is being conducted to evaluate the major Nitazoxanide (NTZ) active metabolite in adult participants with hepatic impairment and healthy adults.
Detailed Description
This study is being conducted to assess the effect of hepatic impairment on the pharmacokinetics of the major Nitazoxanide active metabolite in hepatic impaired (moderate and severe according to Child-Pugh categories) and healthy control adults following repeated oral dose administration of NTZ 500 mg twice a day for 7 days.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Moderate Hepatic Impairment, Severe Hepatic Impairment, Liver Diseases
Keywords
Pharmacokinetics, Healthy Volunteer, Liver Disease, Hepatic Impairment, Antiparasitic, Antiprotozoal

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
25 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Healthy Control Match (Normal hepatic function)
Arm Type
Experimental
Arm Description
NTZ 500 mg twice a day for 7 days
Arm Title
Moderate Child-Pugh B (Moderate hepatic impairment)
Arm Type
Experimental
Arm Description
NTZ 500 mg twice a day for 7 days
Arm Title
Severe Child-Pugh C (Severe hepatic impairment)
Arm Type
Experimental
Arm Description
NTZ 500 mg twice a day for 7 days
Intervention Type
Drug
Intervention Name(s)
Nitazoxanide
Other Intervention Name(s)
NTZ
Intervention Description
500 mg Twice Daily for 7 days
Primary Outcome Measure Information:
Title
Area under the plasma concentration time curve (AUC) from time zero to 12h (AUC0-12)
Description
In participants with moderate and severe hepatic impairment compared to healthy volunteers
Time Frame
Day 1: pre-dose; 1; 2; 3; 4; 5; 6; 7; 8; 10 and 12 hours post dose Day 7: pre-dose; 1; 2; 3; 4; 5; 6; 7; 8; 10; 12; 14; 16; 18; 24; and 48 hours post dose
Title
AUC from time zero to the time of the last quantifiable concentration (AUC0-t)
Description
In participants with moderate and severe hepatic impairment compared to healthy volunteers
Time Frame
Day 1: pre-dose; 1; 2; 3; 4; 5; 6; 7; 8; 10 and 12 hours post dose Day 7: pre-dose; 1; 2; 3; 4; 5; 6; 7; 8; 10; 12; 14; 16; 18; 24; and 48 hours post dose
Title
Maximum observed plasma concentration (Cmax),
Description
In participants with moderate and severe hepatic impairment compared to healthy volunteers
Time Frame
Day 1: pre-dose; 1; 2; 3; 4; 5; 6; 7; 8; 10 and 12 hours post dose Day 7: pre-dose; 1; 2; 3; 4; 5; 6; 7; 8; 10; 12; 14; 16; 18; 24; and 48 hours post dose
Secondary Outcome Measure Information:
Title
Plasma pharmacokinetics: time of the maximum observed plasma concentration (Tmax), apparent plasma terminal elimination half life (t1/2), AUC from time zero to infinity (AUC0-∞), trough concentration (Ctrough) and percentage of extrapolated (%AUCextrap)
Description
For NTZ and its major active metabolite
Time Frame
Day 1: pre-dose; 1; 2; 3; 4; 5; 6; 7; 8; 10 and 12 hours post dose Day 7: pre-dose; 1; 2; 3; 4; 5; 6; 7; 8; 10; 12; 14; 16; 18; 24; and 48 hours post dose
Title
Plasma pharmacokinetics: Tmax, AUC0-12, AUC0-t, AUC0-∞, Cmax, t1/2, %AUCextrap and Ctrough.
Description
For the NTZ major active metabolite
Time Frame
Day 1: pre-dose; 1; 2; 3; 4; 5; 6; 7; 8; 10 and 12 hours post dose Day 7: pre-dose; 1; 2; 3; 4; 5; 6; 7; 8; 10; 12; 14; 16; 18; 24; and 48 hours post dose
Title
Urine pharmacokinetics: amount of drug excreted (Ae), cumulative amount of drug excreted (Ae0-t), and renal clearance (CLR)
Description
For the NTZ major active metabolites
Time Frame
Day-1: pre-dose, Day 1: 0-4 h, 4-8 h, 8-12, 12-24 h post-dose; Day 7: 0-4 h, 4-8 h, 8-12 h, 12-24 h, 24-48 h post-dose
Title
Plasma and urine pharmacokinetics: After the single oral administration of NTZ 500 mg: Cmax, AUC0-12, AUC0-t, AUC0-∞ , Tmax, t1/2, %AUCextrap, Ae0-∞, Ae0-t and CLR.
Description
For the NTZ major active metabolites
Time Frame
Plasma:Day 1: pre-dose; 1; 2; 3; 4; 5; 6; 7; 8; 10, 12 h post dose Day 7: pre-dose; 1; 2; 3; 4; 5; 6; 7; 8; 10; 12; 14; 16; 18; 24; and 48 h post dose Urine:Day-1: pre-dose, Day 1: 24 hours urine collection post-dose; Day 7: 48 hours urine collection

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: Males or females, between 18 and 75 years of age, inclusive; With a minimum body weight of 50 kg and within a BMI range of 18.0 to 40.0 kg/m^2, inclusive; Females participating in this study must be of non-childbearing potential or must be using highly effective contraception for the full duration of the study; Negative human immunodeficiency virus antibody screens at Screening; Matched to participants with moderate and/or severe hepatic impairment in age (± 10 years), BMI (± 20 percentage) and sex; Participants who have chronic (≥ 6 months) moderate or severe hepatic insufficiency (of any etiology) that has been clinically stable (no acute episodes of illness due to deterioration in hepatic function) for at least 1 month prior to Screening and must also remain stable throughout the Screening period. Other protocol-defined inclusion criteria may apply Exclusion Criteria: A positive alcohol test result at Check-In Visit; A history of alcohol abuse in the prior 2 years; Positive urine screen for drugs of abuse at Screening or Check-In; Strenuous exercise within 72 hours prior to Check-In Visit; Blood 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; History of a major surgical procedure within 30 days prior to Screening; History of stomach or intestinal surgery or resection that would potentially alter absorption and/or excretion of orally administered drugs except that appendectomy and hernia repair will be allowed. Bariatric surgery will not be allowed; Presence or history of malignancy within the prior 3 years, with the exception of treated basal cell or squamous cell carcinoma; Poor peripheral venous access; Receipt of blood products within 2 months prior to Check-In Visit; Significant history or clinical manifestation of any metabolic (including thyroid), allergic, dermatological, hepatic, renal, hematological, pulmonary, cardiovascular (including any prior history of cardiomyopathy or cardiac failure), gastrointestinal (GI), neurological, or psychiatric disorder; Positive serologic test for hepatitis B surface antigen or for hepatitis C virus antibody at Screening; Frequent headaches (> twice a month) and/or migraines, recurrent nausea and/or vomiting, diarrhea; Participants with symptomatic hypotension at Screening, whatever the decrease of blood pressure, or asymptomatic postural hypotension; History of unstable diabetes mellitus; Participants who have a transjugular intrahepatic portosystemic shunt and/or have undergone portacaval shunting; Participant has shown evidence of hepatorenal syndrome or has creatinine clearance ≤ 60 mL/min; Participants has required treatment for GI bleeding within the 6 months prior to Check-In Visit; Recent history of paracentesis (< 1 months prior to Check-In Visit); Participants with Wilson's disease, alpha-1 antitrypsin deficiency, glycogen storage diseases, or galactosemia; Participants with anemia secondary to hepatic disease, unless hemoglobin is ≥ 8.5 g/dL and anemia symptoms are not clinically significant. Participants must have ≥ 30,000 platelets at screening and at Check-In Visit. Other protocol-defined exclusion criteria may apply
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Carol Addy, MD
Organizational Affiliation
Genfit
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
Facility Name
Orlando Clinical Research Center
City
Orlando
State/Province
Florida
ZIP/Postal Code
32802
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Nitazoxanide Pharmacokinetic Parameters in Hepatic Impaired Patients

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