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Safety, Tolerability, Pharmacokinetic (PK), and Pharmacodynamic Study of GSK2881078 and Study to Evaluate the Effect of CYP3A4 Inhibition on PK of GSK2881078

Primary Purpose

Cachexia

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
GSK2881078
Placebo
Itraconazole
Sponsored by
GlaxoSmithKline
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cachexia focused on measuring Itraconazole, GSK2881078, CYP3A4, Selective Androgen Receptor Modulator, Safety, Pharmacokinetics, Tolerability

Eligibility Criteria

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

Inclusion Criteria:

  • Age: Part A: Between 50 and 75 years of age inclusive, at the time of signing the informed consent form. Part B: Between 18 and 60 years of age inclusive, at the time of signing the informed consent form.
  • Healthy as determined by the investigator. Subjects with hypertension, hyperlipidemia or hypothyroidism, well controlled and stable on a single medication, may also be included.
  • Subject values for Hemoglobin (Hgb) must be within the normal range (plus or minus 10%).
  • Estimated glomerular filtration rate (GFR) >=60 milliliter (mL)/minute (min)/1.73 square meter (m^2).
  • Body Mass Index (BMI) within the range 19 - 32 kilogram (kg)/m^2 (inclusive).
  • Sex: Part A: Male or Female; Part B: Male Males: Male subjects with female partners of child bearing potential must agree to use a condom from the time of first dose of study medication until the final follow-up visit.

Females: A female subject is eligible to participate if she is post-menopausal.

Exclusion Criteria:

  • Alanine transaminase (ALT) and bilirubin >1.1x upper limit of normal (ULN) (isolated bilirubin >1.1xULN is acceptable if bilirubin is fractionated and direct bilirubin <35%).
  • Current or chronic history of liver disease including fatty liver, or known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones).
  • Corrected QT interval (QTc) > 450 msec. Heart rate: <40 and >100 beats per minute, PR Interval: <120 and >210 millisecond (msec), QRS duration: <70 and >120 msec.
  • Subjects with a history at any time in the past of coronary artery disease, congestive heart failure, angina, myocardial infarction, any cardiac surgery, valvular heart disease, clinically significant arrhythmia, dyspnea, pulmonary edema, stroke, or transient ischemic attack.
  • Subjects with a history of clinically significant endocrine, gastrointestinal, hepatic, cardiovascular, neurological, haematological, immunological, renal, respiratory, or genitourinary abnormalities or diseases.
  • Subjects with a history of malignancy that is not in complete remission for at least 5 years or 1 year for non-melanoma skin carcinoma.
  • Male subjects with a family history of early onset (55 years of age or younger) prostate cancer or 2 or more direct family members with prostate cancer.
  • Unable to refrain from prescription or non-prescription drugs as described in protocol.
  • History of regular alcohol consumption within 6 months of the study.
  • History of drug or alcohol abuse within 5 years prior to the Screening Period.
  • Unable to refrain from consumption (whole fruit or juice) of seville oranges, grapefruit or grapefruit juice and/or pummelos, exotic citrus fruits, or grapefruit hybrids.
  • Regular, strenuous exercise or weightlifting >2 times per week for at least 2 weeks prior to screening visit or intent to start a new exercise routine during the study.
  • History of sensitivity to heparin or heparin-induced thrombocytopenia.
  • History of sensitivity to any of the study medications, or components thereof.
  • Metal implants (contraindicated for MRI and disrupt DXA imaging). These include intra-orbital metal fragments.
  • Presence of hepatitis B surface antigen (HBsAg), positive hepatitis C antibody test result at screening or within 3 months prior to first dose of study treatment. For potent immunosuppressive agents, subjects with presence of hepatitis B core antibody (HBcAb) should also be excluded.
  • A positive pre-study drug/alcohol screen.
  • A positive test for human immunodeficiency virus (HIV) antibody.
  • Where participation in the study would result in donation of blood or blood products in excess of 500 mL within a 56 day period.
  • The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the first dosing day in the current study: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer). Subjects who previously received GSK2881078 are allowed to participate in this trial, with the same timeline restrictions.
  • Exposure to more than four new chemical entities within 12 months prior to the first dosing day.
  • Prostate Specific Antigen (PSA) >4.0 nanograms (ng)/mL.
  • High-density lipoprotein cholesterol (HDL-C) <35 milligram (mg)/deciliter (dL).
  • Thyroid stimulating hormone (TSH) >10 mIU/L, test may be repeated or thyroid panel discussed with Medical Monitor.
  • Testosterone < 0.9 lower limit of normal range (LLNR) - 10%, test may be repeated, or free testosterone determined also <0.9 LLNR.

Sites / Locations

  • GSK Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Placebo Comparator

Experimental

Arm Label

Part A: GSK2881078

Part A: Placebo

Part B: GSK2881078-Itraconazole

Arm Description

The first cohort subjects will receive GSK2881078 1.5 mg (for males) or 0.75 mg (for females) twice daily for 3 days followed by once daily for 25 days. The subsequent cohort subjects will receive GSK2881078 doses selected after reviewing the unblinded data from at least 2 weeks of dosing of at least 6 subjects in the first cohort. Each cohort subjects will receive GSK2881078 dose twice daily for the first 3 days followed by 25 days of once daily.

Subjects will receive placebo twice daily for 3 days followed by once daily for 25 days.

Subjects will receive GSK2881078 (dose level will be determined based on the results from Part A) on Day 1 of Period-1 and Day 6 of Period-2. Subjects will also receive itraconazole 200 mg twice daily on Day1 of Period-2 and 200 mg once daily on Days 2-34 of Period-2.

Outcomes

Primary Outcome Measures

Part A: Blood pressure as a measure of safety and tolerability
Blood pressure will be recorded whilst the subject is in a semi -supine position, having rested in this position for at least 10 minutes.
Part A: Heart rate as a measure of safety and tolerability
Heart rate will be recorded whilst the subject is in a semi -supine position, having rested in this position for at least 10 minutes.
Part A: Cardiac telemetry as a measure of safety and tolerability
Continuous cardiac telemetry will be performed for at least 8 hours post-dose.
Part A: Electrocardiogram (ECG) as a measure of safety and tolerability
Triplicate or single 12-lead ECGs will be obtained at each timepoint and will be recorded whilst the subject is in a semi-supine position, having rested in this position for at least 10 minutes.
Part A: Composite of clinical laboratory parameters including hematology, clinical chemistry, and lipid blood panel (fasting) as a measure of safety and tolerability
Part A: Number of subjects with adverse events (AEs)
An AE is any untoward medical occurrence in a patient or clinical investigation subject, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a medicinal product.
Part A: area under the plasma drug concentration curve from time zero to the time of last quantifiable concentration (AUC0-t) for GSK2881078 after 14 and 28 days of dosing
Part A: area under the plasma drug concentration curve from time zero to end of dosing interval (AUC0-tau) for GSK2881078 after 14 and 28 days of dosing
Part A: maximum observed plasma drug concentration (Cmax) for GSK2881078 after 14 and 28 days of dosing
Part A: time to maximum observed plasma drug concentration (Tmax) for GSK2881078 after 14 and 28 days of dosing
Part A: terminal half-life (t1/2) for GSK2881078 after 14 and 28 days of dosing
Part B: area under the plasma drug concentration curve from time zero to infinity (AUC0- infinity) of GSK2881078 in absence and presence of itraconazole
Part B: Cmax of GSK2881078 in absence and presence of itraconazole

Secondary Outcome Measures

Part A: Change from baseline in appendicular mass as assessed by Dual-energy X-ray Absorptiometry (DXA)
Appendicular lean mass will be calculated from the regional lean mass measurements of the arms and legs.
Part A: Change from baseline in total lean mass as assessed by DXA
Output from DXA will be used to measure total lean mass.
Part A: Change from baseline in thigh muscle volume as assessed by MRI
MRI cross-sectional thigh scans will be performed for each cohort in Part A of the study.

Full Information

First Posted
September 3, 2015
Last Updated
March 2, 2017
Sponsor
GlaxoSmithKline
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1. Study Identification

Unique Protocol Identification Number
NCT02567773
Brief Title
Safety, Tolerability, Pharmacokinetic (PK), and Pharmacodynamic Study of GSK2881078 and Study to Evaluate the Effect of CYP3A4 Inhibition on PK of GSK2881078
Official Title
A Randomized Double-blind (Sponsor Unblind) Placebo Controlled Study in Healthy Subjects to Evaluate: Safety, Tolerability, Pharmacokinetics, and Pharmacodynamics of the Repeat Doses of GSK2881078, the Selective Androgen Receptor Modulator With an Open Label Dosing Arm to Evaluate the Effect of CYP3A4 Inhibition on Pharmacokinetics of GSK2881078
Study Type
Interventional

2. Study Status

Record Verification Date
March 2017
Overall Recruitment Status
Completed
Study Start Date
September 2015 (undefined)
Primary Completion Date
December 2016 (Actual)
Study Completion Date
December 2016 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
GSK2881078 is a selective androgen receptor modulator (SARM) that is being evaluated for effects on muscle growth and strength in subjects with muscle wasting to improve their physical function. Part A of this study will evaluate the safety, efficacy and pharmacokinetics of GSK2881078 in healthy, older men and post-menopausal women who will take daily dosing for 28 days and be followed for a total of 70 days. Part B of this study will characterize the effect of Cytochrome P450 3A4 (CYP3A4) inhibition on the GSK2881078 pharmacokinetics. Part B will only be conducted if safe and efficacious dose is identified in Part A. Part A will include healthy older males and post-menopausal females; and randomize approximately 60 subjects (about 15 per cohort [4 cohorts]) to complete approximately 48 (about 12 per cohort). Part B will enroll one cohort of approximately 15 healthy male subjects to complete approximately 12. The study duration will be approximately 115 days for Part A and 122 days for Part B.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cachexia
Keywords
Itraconazole, GSK2881078, CYP3A4, Selective Androgen Receptor Modulator, Safety, Pharmacokinetics, Tolerability

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
108 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Part A: GSK2881078
Arm Type
Experimental
Arm Description
The first cohort subjects will receive GSK2881078 1.5 mg (for males) or 0.75 mg (for females) twice daily for 3 days followed by once daily for 25 days. The subsequent cohort subjects will receive GSK2881078 doses selected after reviewing the unblinded data from at least 2 weeks of dosing of at least 6 subjects in the first cohort. Each cohort subjects will receive GSK2881078 dose twice daily for the first 3 days followed by 25 days of once daily.
Arm Title
Part A: Placebo
Arm Type
Placebo Comparator
Arm Description
Subjects will receive placebo twice daily for 3 days followed by once daily for 25 days.
Arm Title
Part B: GSK2881078-Itraconazole
Arm Type
Experimental
Arm Description
Subjects will receive GSK2881078 (dose level will be determined based on the results from Part A) on Day 1 of Period-1 and Day 6 of Period-2. Subjects will also receive itraconazole 200 mg twice daily on Day1 of Period-2 and 200 mg once daily on Days 2-34 of Period-2.
Intervention Type
Drug
Intervention Name(s)
GSK2881078
Intervention Description
GSK2881078 hot melt solutions, ranging in concentration from 0.05 mg/g to 50 mg/g, will be prepared by weighing drug substance directly into specific quantities of the hot melt vehicle solution. Subjects will be administered GSK2881078 (dose for Cohort 1: 0.75 mg for females and 1.5 mg for males) hot melt solution within capsule orally with water.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Subjects will be administered as hot melt vehicle placebo within capsule orally with water.
Intervention Type
Drug
Intervention Name(s)
Itraconazole
Intervention Description
Subjects will be administered as two capsules of itraconazole 100 mg (200 mg) orally with water.
Primary Outcome Measure Information:
Title
Part A: Blood pressure as a measure of safety and tolerability
Description
Blood pressure will be recorded whilst the subject is in a semi -supine position, having rested in this position for at least 10 minutes.
Time Frame
Up to Day 70
Title
Part A: Heart rate as a measure of safety and tolerability
Description
Heart rate will be recorded whilst the subject is in a semi -supine position, having rested in this position for at least 10 minutes.
Time Frame
Up to Day 70
Title
Part A: Cardiac telemetry as a measure of safety and tolerability
Description
Continuous cardiac telemetry will be performed for at least 8 hours post-dose.
Time Frame
Up to Day 28
Title
Part A: Electrocardiogram (ECG) as a measure of safety and tolerability
Description
Triplicate or single 12-lead ECGs will be obtained at each timepoint and will be recorded whilst the subject is in a semi-supine position, having rested in this position for at least 10 minutes.
Time Frame
Up to Day 70
Title
Part A: Composite of clinical laboratory parameters including hematology, clinical chemistry, and lipid blood panel (fasting) as a measure of safety and tolerability
Time Frame
Up to Day 70
Title
Part A: Number of subjects with adverse events (AEs)
Description
An AE is any untoward medical occurrence in a patient or clinical investigation subject, temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease (new or exacerbated) temporally associated with the use of a medicinal product.
Time Frame
Up to Day 70
Title
Part A: area under the plasma drug concentration curve from time zero to the time of last quantifiable concentration (AUC0-t) for GSK2881078 after 14 and 28 days of dosing
Time Frame
Day 14-15 (Pre-dose and 0.25, 0.5, 0.75, 1.0, 1.5, 2, 3, 4, 6, 8, 12, and 24 hours post-dose) and Day 28-30 (Pre-dose and 0.25, 0.5, 0.75, 1.0, 1.5, 2, 3, 4, 6, 8, 12, 24 36, and 48 hours post-dose)
Title
Part A: area under the plasma drug concentration curve from time zero to end of dosing interval (AUC0-tau) for GSK2881078 after 14 and 28 days of dosing
Time Frame
Day 14-15 (Pre-dose and 0.25, 0.5, 0.75, 1.0, 1.5, 2, 3, 4, 6, 8, 12, and 24 hours post-dose) and Day 28-30 (Pre-dose and 0.25, 0.5, 0.75, 1.0, 1.5, 2, 3, 4, 6, 8, 12, 24 36, and 48 hours post-dose)
Title
Part A: maximum observed plasma drug concentration (Cmax) for GSK2881078 after 14 and 28 days of dosing
Time Frame
Day 14-15 (Pre-dose and 0.25, 0.5, 0.75, 1.0, 1.5, 2, 3, 4, 6, 8, 12, and 24 hours post-dose) and Day 28-30 (Pre-dose and 0.25, 0.5, 0.75, 1.0, 1.5, 2, 3, 4, 6, 8, 12, 24 36, and 48 hours post-dose)
Title
Part A: time to maximum observed plasma drug concentration (Tmax) for GSK2881078 after 14 and 28 days of dosing
Time Frame
Day 14-15 (Pre-dose and 0.25, 0.5, 0.75, 1.0, 1.5, 2, 3, 4, 6, 8, 12, and 24 hours post-dose) and Day 28-30 (Pre-dose and 0.25, 0.5, 0.75, 1.0, 1.5, 2, 3, 4, 6, 8, 12, 24 36, and 48 hours post-dose)
Title
Part A: terminal half-life (t1/2) for GSK2881078 after 14 and 28 days of dosing
Time Frame
Day 14-15 (Pre-dose and 0.25, 0.5, 0.75, 1.0, 1.5, 2, 3, 4, 6, 8, 12, and 24 hours post-dose) and Day 28-30 (Pre-dose and 0.25, 0.5, 0.75, 1.0, 1.5, 2, 3, 4, 6, 8, 12, 24 36, and 48 hours post-dose)
Title
Part B: area under the plasma drug concentration curve from time zero to infinity (AUC0- infinity) of GSK2881078 in absence and presence of itraconazole
Time Frame
Pre-dose, 0.5, 1, 1.5, 2, 4, 6, 8, 12, 24, 48, 72, 96, 120, 144, 168, 216, 336, 504 and 672 hours post dose in both periods
Title
Part B: Cmax of GSK2881078 in absence and presence of itraconazole
Time Frame
Pre-dose, 0.5, 1, 1.5, 2, 4, 6, 8, 12, 24, 48, 72, 96, 120, 144, 168, 216, 336, 504 and 672 hours post dose in both periods
Secondary Outcome Measure Information:
Title
Part A: Change from baseline in appendicular mass as assessed by Dual-energy X-ray Absorptiometry (DXA)
Description
Appendicular lean mass will be calculated from the regional lean mass measurements of the arms and legs.
Time Frame
Baseline and up to Day 70
Title
Part A: Change from baseline in total lean mass as assessed by DXA
Description
Output from DXA will be used to measure total lean mass.
Time Frame
Baseline and up to Day 70
Title
Part A: Change from baseline in thigh muscle volume as assessed by MRI
Description
MRI cross-sectional thigh scans will be performed for each cohort in Part A of the study.
Time Frame
Baseline and up to Day 70

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: Age: Part A: Between 50 and 75 years of age inclusive, at the time of signing the informed consent form. Part B: Between 18 and 60 years of age inclusive, at the time of signing the informed consent form. Healthy as determined by the investigator. Subjects with hypertension, hyperlipidemia or hypothyroidism, well controlled and stable on a single medication, may also be included. Subject values for Hemoglobin (Hgb) must be within the normal range (plus or minus 10%). Estimated glomerular filtration rate (GFR) >=60 milliliter (mL)/minute (min)/1.73 square meter (m^2). Body Mass Index (BMI) within the range 19 - 32 kilogram (kg)/m^2 (inclusive). Sex: Part A: Male or Female; Part B: Male Males: Male subjects with female partners of child bearing potential must agree to use a condom from the time of first dose of study medication until the final follow-up visit. Females: A female subject is eligible to participate if she is post-menopausal. Exclusion Criteria: Alanine transaminase (ALT) and bilirubin >1.1x upper limit of normal (ULN) (isolated bilirubin >1.1xULN is acceptable if bilirubin is fractionated and direct bilirubin <35%). Current or chronic history of liver disease including fatty liver, or known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones). Corrected QT interval (QTc) > 450 msec. Heart rate: <40 and >100 beats per minute, PR Interval: <120 and >210 millisecond (msec), QRS duration: <70 and >120 msec. Subjects with a history at any time in the past of coronary artery disease, congestive heart failure, angina, myocardial infarction, any cardiac surgery, valvular heart disease, clinically significant arrhythmia, dyspnea, pulmonary edema, stroke, or transient ischemic attack. Subjects with a history of clinically significant endocrine, gastrointestinal, hepatic, cardiovascular, neurological, haematological, immunological, renal, respiratory, or genitourinary abnormalities or diseases. Subjects with a history of malignancy that is not in complete remission for at least 5 years or 1 year for non-melanoma skin carcinoma. Male subjects with a family history of early onset (55 years of age or younger) prostate cancer or 2 or more direct family members with prostate cancer. Unable to refrain from prescription or non-prescription drugs as described in protocol. History of regular alcohol consumption within 6 months of the study. History of drug or alcohol abuse within 5 years prior to the Screening Period. Unable to refrain from consumption (whole fruit or juice) of seville oranges, grapefruit or grapefruit juice and/or pummelos, exotic citrus fruits, or grapefruit hybrids. Regular, strenuous exercise or weightlifting >2 times per week for at least 2 weeks prior to screening visit or intent to start a new exercise routine during the study. History of sensitivity to heparin or heparin-induced thrombocytopenia. History of sensitivity to any of the study medications, or components thereof. Metal implants (contraindicated for MRI and disrupt DXA imaging). These include intra-orbital metal fragments. Presence of hepatitis B surface antigen (HBsAg), positive hepatitis C antibody test result at screening or within 3 months prior to first dose of study treatment. For potent immunosuppressive agents, subjects with presence of hepatitis B core antibody (HBcAb) should also be excluded. A positive pre-study drug/alcohol screen. A positive test for human immunodeficiency virus (HIV) antibody. Where participation in the study would result in donation of blood or blood products in excess of 500 mL within a 56 day period. The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the first dosing day in the current study: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer). Subjects who previously received GSK2881078 are allowed to participate in this trial, with the same timeline restrictions. Exposure to more than four new chemical entities within 12 months prior to the first dosing day. Prostate Specific Antigen (PSA) >4.0 nanograms (ng)/mL. High-density lipoprotein cholesterol (HDL-C) <35 milligram (mg)/deciliter (dL). Thyroid stimulating hormone (TSH) >10 mIU/L, test may be repeated or thyroid panel discussed with Medical Monitor. Testosterone < 0.9 lower limit of normal range (LLNR) - 10%, test may be repeated, or free testosterone determined also <0.9 LLNR.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
GSK Clinical Trials
Organizational Affiliation
GlaxoSmithKline
Official's Role
Study Director
Facility Information:
Facility Name
GSK Investigational Site
City
Overland Park
State/Province
Kansas
ZIP/Postal Code
66211
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Safety, Tolerability, Pharmacokinetic (PK), and Pharmacodynamic Study of GSK2881078 and Study to Evaluate the Effect of CYP3A4 Inhibition on PK of GSK2881078

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