Assessment and Evaluation of Pharmacokinetic Profile of E004 in Healthy Adults
Information source: Amphastar Pharmaceuticals, Inc.
ClinicalTrials.gov processed this data on August 20, 2015 Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Asthma
Intervention: Arm T Epinephrine Inhalation Aerosol HFA, 125 mcg, 1 inhalation (Drug); Arm C-Epinephrine Inhalation Aerosol CFC (Drug)
Phase: Phase 1/Phase 2
Status: Terminated
Sponsored by: Amphastar Pharmaceuticals, Inc. Official(s) and/or principal investigator(s): Vladimir Evilevitch, M.D., Study Director, Affiliation: Amphastar Pharmaceuticals, Inc.
Summary
This study examines the pharmacokinetic profile of Armstrong's proposed Epinephrine
Inhalation Aerosol USP, an HFA-MDI (E004), using a stable isotope deuterium-labeled
epinephrine (epinephrine-d3) to differentiate the administered drug from the endogenous
epinephrine, in healthy male and female adult volunteers. The current study is designed to
complement an earlier PK study, API-E004-CL-B, for a more thorough evaluation of the E004
PK. Safety of E004 will also be evaluated.
Clinical Details
Official title: Assessment and Evaluation of Pharmacokinetic Profile of E004 in Healthy Adults (A Randomized, Evaluator-Blind, Single-Dose, Two Arm, Crossover, PK Study in Healthy Volunteers)
Study design: Allocation: Randomized, Endpoint Classification: Pharmacokinetics Study, Intervention Model: Crossover Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
Primary outcome: Calculation and Comparison of relative Bioavailability of Epinephrine
Secondary outcome: Vital Signs12-lead ECG (Routine and QT/QTc analysis) Physical Examinations Lab tests
Detailed description:
This study is a randomized, evaluator-blind, single dose, two-arm, crossover, PK study, to
be conducted in ~18 healthy, male and female, adult volunteers. PK will be studied using
E004-d3 at 125 mcg per inhalation (Arm T). A previously marketed Epinephrine CFC-MDI,
labeled "For Investigational Use Only" will be used as a Reference Control (Arm C).
The main features of the study design are:
(1) All candidates must be screened and must satisfy all enrollment criteria. All enrolled
subjects will participate in two Study Visits, corresponding to two randomized treatments.
Each Study Visit consists of a pre-dose baseline assessment and a post-dose evaluation for 6
hours.
(2) It is important to minimize physical and psychological disturbances to the endogenous
epinephrine concentrations in the study subjects, before and during the study visits. All
subjects must maintain a reclining or recumbent resting position during the entire Study
Visit, with physical activities restricted to a minimum necessity for bathroom trips and
study activities. Caffeine-containing (including de-caffeinated) foods or beverages are
prohibited. Physical exercise, unnecessary physical activities, and video games are
prohibited throughout the study visit.
(3)At the Screening Visit and the beginning of each Study Visit, each subject will be
trained on the correct self-administration of MDI, using a simulation MDI unit that contains
no active drug. The following two randomized treatments will be self-administered at two
Study Visits:
Treatment T: Two (2) inhalations of E004-d3 (125 mcg/inhalation), totaling 250 mcg of
epinephrine-d3;
Treatment C: Two (2) inhalations of Epinephrine CFC-MDI (220 mcg/inhalation, totaling 440
mcg of epinephrine base equivalent).
(4) PK blood samples will be taken from a vein in a hand or arm via an indwelling
anticoagulated IV catheter, or by venipunctures, at scheduled time points of predose
baseline (within 30 minutes of dosing), and at 2±1, 5±1, 7. 5±1, 10±1, 12. 5, 15, 20, 25, 30,
45, 60, 90, 120, 240 and 360 minutes postdose. The total volume of blood taken per subject
shall not exceed 500 mL in any 30-day period. Study visit schedule may be adjusted to avoid
overdrawing blood in any 30-day period.
(5) At each PK sampling point, blood samples (~ 5mL), will be collected in ice-chilled
potassium-EDTA sample tubes, each containing pre-added 1% (V: V) of a 1. 0 M sodium
metabisulfite solution as an antioxidant. Sample tubes will be labeled with a sample ID#
(consisting of subject ID#, Study Visit#, and sample#). The sample tubes will be kept on ice
or refrigerated, and will be centrifuged within 60 minutes of collection. The harvested
plasma from each sample tube will be transferred to, and stored in, 2 storage tubes,
respectively, and frozen at NMT - 20 degrees C until analysis.
(6) PK samples will be analyzed with an established LC/MS/MS method, with a quantitative
detection limit of 5 pg/mL, for both epinephrine-d3 (MW=186) and epinephrine (MW=183).
(7) Safety parameters and adverse drug events, if any, will be monitored and documented at
each study visit. An End-of-Study (EOS) safety evaluation will be conducted at the end of,
or within 7 days after, Study Visit-2.
Eligibility
Minimum age: 18 Years.
Maximum age: 30 Years.
Gender(s): Both.
Criteria:
Inclusion Criteria:
- Generally healthy, male and female adults, 18-30 yrs of age at Screening
- Having no clinically significant respiratory, cardiovascular and other systemic or
organic illnesses, per investigator discretion;
- Body weight greater than or equal to 50 kg for men and greater than or equal to 45 kg
for women, and BMI within the range of 18. 5 - 30. 0 kg/m2 inclusive
- Sitting blood pressure less than or equal to 135/90 mmHg;
- Demonstrating negative alcohol/drug screen tests;
- Demonstrating negative HIV, HBsAg and HCV-Ab screen tests;
- Women of child-bearing potential must be non-pregnant, non-lactating, and practicing
a clinically acceptable form of birth control;
- Having properly consented and satisfied all other inclusion/exclusion criteria as
required for this protocol.
Exclusion Criteria:
- A smoking history of more than or equal to 10 pack-years, or having smoked within 6
months prior to Screening;
- Upper respiratory tract infections within 2 weeks, or lower respiratory tract
infection within 4 weeks, prior to Screening
- Any current or recent respiratory conditions that, per investigator discretion, might
significantly affect pharmacodynamic response to the study drugs, including but not
limited to: asthma, COPD, cystic fibrosis, bronchiectasis, tuberculosis, emphysema,
etc.
- Concurrent clinically significant cardiovascular, hematological, renal, neurologic,
hepatic, endocrine (including diabetes), psychiatric, neoplastic or other illnesses
that in the opinion of the investigator could impact on the conduct, safety and
evaluation of the study
- Known intolerance or hypersensitivity to any of the study MDI ingredients (i. e.,
epinephrine, HFA-134a, CFC-12, CFC-114, polysorbate-80, ethanol, thymol, nitric acid
and ascorbic acid)
- Use of prohibited drugs or failure to observe the drug washout restrictions
- Having been on other investigational drug/device studies, or donated blood, in the
last 30 days prior to Screening.
Locations and Contacts
West Coast Clinical Trials, LLC, Cypress, California 90630, United States
Additional Information
Related publications: Pinnas JL, Schachtel BP, Chen TM, Roseberry HR, Thoden WR. Inhaled epinephrine and oral theophylline-ephedrine in the treatment of asthma. J Clin Pharmacol. 1991 Mar;31(3):243-7. Hendeles L, Marshik PL, Ahrens R, Kifle Y, Shuster J. Response to nonprescription epinephrine inhaler during nocturnal asthma. Ann Allergy Asthma Immunol. 2005 Dec;95(6):530-4. Warren JB, Doble N, Dalton N, Ewan PW. Systemic absorption of inhaled epinephrine. Clin Pharmacol Ther. 1986 Dec;40(6):673-8. Cripps A, Riebe M, Schulze M, Woodhouse R. Pharmaceutical transition to non-CFC pressurized metered dose inhalers. Respir Med. 2000 Jun;94 Suppl B:S3-9. Dickinson BD, Altman RD, Deitchman SD, Champion HC. Safety of over-the-counter inhalers for asthma: report of the council on scientific affairs. Chest. 2000 Aug;118(2):522-6. Kushner DJ, Baker A, Dunstall TG. Pharmacological uses and perspectives of heavy water and deuterated compounds. Can J Physiol Pharmacol. 1999 Feb;77(2):79-88. Review.
Starting date: November 2012
Last updated: July 12, 2013
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