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Pharmacokinetics of Single-dose Dolutegravir in HIV-seronegative Subjects With Severe Hepatic Impairment Compared to Matched Controls. (POLO)

Primary Purpose

HIV-1-infection, Hepatic Impairment

Status
Withdrawn
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Dolutegravir
Sponsored by
Radboud University Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for HIV-1-infection focused on measuring pharmacokinetics, dolutegravir

Eligibility Criteria

18 Years - 90 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Subject is at least 18 and not older than 90 years at screening.
  2. Subject is able and willing to sign the Informed Consent Form prior to screening evaluations.
  3. Child-Pugh score 10 or greater (Appendix A). Expected to be in clinical stable condition for at least 4 weeks as assessed by the subject's own hepatologist. This assessment takes into account the following aspects: MELD score, fibroscan results (if available), life expectancy, recent history of decompensation events and the rate of progression of hepatic insufficiency.

For healthy volunteers

  1. Subject is at least 18 and not older than 90 years at screening.
  2. Subject is able and willing to sign the Informed Consent Form prior to screening evaluations.
  3. Subject is in good age-appropriate health condition as established by medical history, physical examination, electrocardiography, results of biochemistry, haematology and urinalysis testing within 4 weeks prior to Day 1. Results of biochemistry, haematology and urinalysis testing should be within the laboratory's reference ranges. If laboratory results are not within the reference ranges, the subject is included on condition that the Investigator judges that the deviations are not clinically relevant. This should be clearly recorded.
  4. Subject has a normal blood pressure and pulse rate, according to the Investigator's judgement.

Exclusion Criteria:

  1. Inability to understand the nature and extent of the study and the procedures required.
  2. Gilbert's syndrome or other underlying disease (other than hepatic impairment) that causes alterations in the Child-Pugh class components (bilirubin, albumin, prothrombin, encephalopathy and ascites).
  3. Therapy with strong inducers or inhibitors of UGT1A1 or drugs that are contra-indicated with concomitant use of dolutegravir (see appendix B). (NB. there are restrictions for intake of magnesium/aluminium-containing antacids, iron and calcium supplements, multivitamins and other cation-containing supplements (see appendix B and section 5.2)).
  4. Positive HIV test.
  5. Participation in a drug study within 60 days prior to Day 1.
  6. Febrile illness within 3 days before Day 1.

For healthy volunteers

  1. Documented history of sensitivity/idiosyncrasy to medicinal products or excipients.
  2. Positive HIV test.
  3. Positive hepatitis B or C test.
  4. Pregnant female (as confirmed by an hCG test performed less than 4 weeks before Day 1) or breast-feeding female. Female subjects of childbearing potential without adequate contraception.
  5. Therapy with strong inducers or inhibitors of UGT1A1 or drugs that are contra-indicated with concomitant use of dolutegravir (see appendix B). (NB. there are restrictions for intake of magnesium/aluminium-containing antacids, iron and calcium supplements, multivitamins and other cation-containing supplements (see appendix B and section 5.2)).
  6. Relevant history or presence of pulmonary disorders (especially COPD), cardiovascular disorders, neurological disorders (especially seizures and migraine), psychiatric disorders, gastro-intestinal disorders, renal and hepatic disorders, hormonal disorders (especially diabetes mellitus), coagulation disorders.
  7. Relevant history or current condition that might interfere with drug absorption, distribution, metabolism or excretion.
  8. History of or current abuse of drugs, alcohol or solvents.
  9. Inability to understand the nature and extent of the study and the procedures required.
  10. Participation in a drug study within 60 days prior to Day 1.
  11. Donation of blood within 60 days prior to Day 1.
  12. Febrile illness within 3 days before Day 1
  13. UGT1A1 polymorphism (at least one *28, *37 or *6 allele) -

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Hepatic impairment group

    Matched controls

    Arm Description

    Dolutegravir in HIV-seronegative subjects with severe hepatic impairment (child-Pugh score 10 or greater)

    Dolutegravir in control group matched for gender, age and BMI with subjects in hepatic impairment group

    Outcomes

    Primary Outcome Measures

    area under the curve
    dolutegravir area under the curve

    Secondary Outcome Measures

    adverse events
    number and severity of adverse events

    Full Information

    First Posted
    January 21, 2019
    Last Updated
    June 7, 2021
    Sponsor
    Radboud University Medical Center
    Collaborators
    Erasmus Medical Center, Leiden University Medical Center, University Medical Center Groningen
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03813979
    Brief Title
    Pharmacokinetics of Single-dose Dolutegravir in HIV-seronegative Subjects With Severe Hepatic Impairment Compared to Matched Controls.
    Acronym
    POLO
    Official Title
    Pharmacokinetics of Single-dose Dolutegravir in HIV-seronegative Subjects With Severe Hepatic Impairment Compared to Matched Controls.
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2021
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    difficult recruitment and delay due to COVID19
    Study Start Date
    November 15, 2020 (Anticipated)
    Primary Completion Date
    December 31, 2021 (Anticipated)
    Study Completion Date
    December 31, 2021 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Radboud University Medical Center
    Collaborators
    Erasmus Medical Center, Leiden University Medical Center, University Medical Center Groningen

    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
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This is an open-label, parallel-group, nonrandomized, multi-centre, phase-IV, single dose trial in 8 HIV-seronegative subjects with severe hepatic impairment and 8 matched controls to assess the pharmacokinetics of a single dose of 50mg of dolutegravir in subjects with severe hepatic impairment.
    Detailed Description
    This is an open-label, parallel-group, nonrandomized, multi-centre, phase-IV, single dose trial. The primary aim of this study is to assess the pharmacokinetics of a single dose of 50mg of dolutegravir in HIV-seronegative subjects with severe hepatic impairment (n=8) and compare these with a single dose of 50mg of dolutegravir in matched controls (n=8). In both groups a pharmacokinetic (PK) curve will be recorded for determination of dolutegravir (and dolutegravir-glucuronide).

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    HIV-1-infection, Hepatic Impairment
    Keywords
    pharmacokinetics, dolutegravir

    7. Study Design

    Primary Purpose
    Other
    Study Phase
    Phase 4
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Non-Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Hepatic impairment group
    Arm Type
    Experimental
    Arm Description
    Dolutegravir in HIV-seronegative subjects with severe hepatic impairment (child-Pugh score 10 or greater)
    Arm Title
    Matched controls
    Arm Type
    Active Comparator
    Arm Description
    Dolutegravir in control group matched for gender, age and BMI with subjects in hepatic impairment group
    Intervention Type
    Drug
    Intervention Name(s)
    Dolutegravir
    Intervention Description
    Intake of a single-dose dolutegravir 50 mg tablet on an empty stomach
    Primary Outcome Measure Information:
    Title
    area under the curve
    Description
    dolutegravir area under the curve
    Time Frame
    24 hours
    Secondary Outcome Measure Information:
    Title
    adverse events
    Description
    number and severity of adverse events
    Time Frame
    7 days

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    90 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: Subject is at least 18 and not older than 90 years at screening. Subject is able and willing to sign the Informed Consent Form prior to screening evaluations. Child-Pugh score 10 or greater (Appendix A). Expected to be in clinical stable condition for at least 4 weeks as assessed by the subject's own hepatologist. This assessment takes into account the following aspects: MELD score, fibroscan results (if available), life expectancy, recent history of decompensation events and the rate of progression of hepatic insufficiency. For healthy volunteers Subject is at least 18 and not older than 90 years at screening. Subject is able and willing to sign the Informed Consent Form prior to screening evaluations. Subject is in good age-appropriate health condition as established by medical history, physical examination, electrocardiography, results of biochemistry, haematology and urinalysis testing within 4 weeks prior to Day 1. Results of biochemistry, haematology and urinalysis testing should be within the laboratory's reference ranges. If laboratory results are not within the reference ranges, the subject is included on condition that the Investigator judges that the deviations are not clinically relevant. This should be clearly recorded. Subject has a normal blood pressure and pulse rate, according to the Investigator's judgement. Exclusion Criteria: Inability to understand the nature and extent of the study and the procedures required. Gilbert's syndrome or other underlying disease (other than hepatic impairment) that causes alterations in the Child-Pugh class components (bilirubin, albumin, prothrombin, encephalopathy and ascites). Therapy with strong inducers or inhibitors of UGT1A1 or drugs that are contra-indicated with concomitant use of dolutegravir (see appendix B). (NB. there are restrictions for intake of magnesium/aluminium-containing antacids, iron and calcium supplements, multivitamins and other cation-containing supplements (see appendix B and section 5.2)). Positive HIV test. Participation in a drug study within 60 days prior to Day 1. Febrile illness within 3 days before Day 1. For healthy volunteers Documented history of sensitivity/idiosyncrasy to medicinal products or excipients. Positive HIV test. Positive hepatitis B or C test. Pregnant female (as confirmed by an hCG test performed less than 4 weeks before Day 1) or breast-feeding female. Female subjects of childbearing potential without adequate contraception. Therapy with strong inducers or inhibitors of UGT1A1 or drugs that are contra-indicated with concomitant use of dolutegravir (see appendix B). (NB. there are restrictions for intake of magnesium/aluminium-containing antacids, iron and calcium supplements, multivitamins and other cation-containing supplements (see appendix B and section 5.2)). Relevant history or presence of pulmonary disorders (especially COPD), cardiovascular disorders, neurological disorders (especially seizures and migraine), psychiatric disorders, gastro-intestinal disorders, renal and hepatic disorders, hormonal disorders (especially diabetes mellitus), coagulation disorders. Relevant history or current condition that might interfere with drug absorption, distribution, metabolism or excretion. History of or current abuse of drugs, alcohol or solvents. Inability to understand the nature and extent of the study and the procedures required. Participation in a drug study within 60 days prior to Day 1. Donation of blood within 60 days prior to Day 1. Febrile illness within 3 days before Day 1 UGT1A1 polymorphism (at least one *28, *37 or *6 allele) -

    12. IPD Sharing Statement

    Learn more about this trial

    Pharmacokinetics of Single-dose Dolutegravir in HIV-seronegative Subjects With Severe Hepatic Impairment Compared to Matched Controls.

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