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Phase 2 N=32 Randomized Triple-blind Treatment

Phase IIa Study of Fomepizole for Acetaldehyde Toxicity After Ethanol Exposure in Subjects With Altered Ethanol Metabolism

Aldehyde Dehydrogenase-2 (ALDH2) Deficiency

Enrolled (actual)
32
Serious AEs
0.0%
Results posted
Sep 2017
Primary outcome: Primary: Number of Participants With Adverse Events (AEs), Serious AEs, and AEs Leading to Study Discontinuation — 13; 6; 8; 21 Participants

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Antizol (Drug); Placebo (Drug); Ethanol (Other)
Age
Adult · 21+ yrs
Sex
All
Sponsor
Amgen
Primary completion
Jun 2008

Outcome Measures

OutcomeResultp-value
PRIMARY
Number of Participants With Adverse Events (AEs), Serious AEs, and AEs Leading to Study Discontinuation
13; 6; 8; 21; 28; 13
SECONDARY
Pharmacokinetics (PK) of 4-MP: Maximum Plasma Concentration (Cmax)
2386; 1358; 5605; 4680; 8623
SECONDARY
PK of 4-MP: Dose-Normalized (DN) Cmax
38.3; 18.9; 27.6; 28.0; 30.2 0.8727
SECONDARY
PK of 4-MP: Time to Cmax (Tmax)
1.00; 2.50; 0.667; 1.48; 1.00
SECONDARY
PK of 4-MP: Area Under the Plasma Concentration-Time Curve (AUC), Calculated to the Last Measured Concentration (AUC[0-t])
13804; 7409; 44942; 34310; 109298
SECONDARY
PK of 4-MP: DN AUC(0-t)
223; 103; 231; 204; 378 0.0023 sig
SECONDARY
PK of 4-MP: AUC, From Time 0 Extrapolated to Infinite Time (AUC[0-∞])
11035; 7627; 55452; 57028; 136871
SECONDARY
PK of 4-MP: DN AUC(0-∞)
149; 122; 317; 334; 460
SECONDARY
PK of 4-MP: Percentage of AUC0-∞ Obtained by Extrapolation (AUC%Extrap)
16.8; 13.0; 3.31; 4.37; 13.2
SECONDARY
PK of 4-MP: Half-Life (T1/2)
2.72; 3.11; 5.37; 5.76; 9.26
SECONDARY
PK of 4-MP: Apparent Clearance (CL/F)
6.70; 8.23; 3.15; 2.99; 2.35
SECONDARY
PK of 4-MP: Apparent Volume of Distribution During Terminal Phase (Vz/F)
26.3; 24.7; 24.4; 24.9; 24.7
SECONDARY
PK of Ethanol: Cmax
62.7; 70.3; 80.5; 43.3; 74.9; 59.3
SECONDARY
PK of Ethanol: DN Cmax
0.00195; 0.00198; 0.00243; 0.00155; 0.00261; 0.00193
SECONDARY
PK of Ethanol: Tmax
1.50; 0.833; 0.500; 1.42; 0.500; 0.500
SECONDARY
PK of Ethanol: AUC(0-t)
209; 209; 205; 135; 231; 157
SECONDARY
PK of Ethanol: DN AUC(0-t)
0.00648; 0.00585; 0.00613; 0.00483; 0.00791; 0.00508
SECONDARY
PK of Ethanol: AUC(0-∞)
245; 263; 237; 215; 271; 214
SECONDARY
PK of Ethanol: DN AUC(0-∞)
0.00760; 0.00731; 0.00705; 0.00768; 0.00917; 0.00681
SECONDARY
PK of Ethanol: AUC%Extrap
14.7; 20.5; 13.2; 20.0; 12.1; 13.4
SECONDARY
PK of Ethanol: T1/2
1.51; 1.95; 1.43; 1.78; 1.67; 1.45
SECONDARY
PK of Ethanol: CL/F
140; 138; 142; 131; 112; 159
SECONDARY
PK of Ethanol: Vz/F
297; 387; 295; 330; 242; 287
SECONDARY
PK of Acetaldehyde: Cmax
59.6; 37.6; 50.9; 55.9; 40.0; 60.3
SECONDARY
PK of Acetaldehyde: DN Cmax
0.00181; 0.00104; 0.00157; 0.00201; 0.00138; 0.00193
SECONDARY
PK of Acetaldehyde: Tmax
0.500; 0.650; 1.00; 1.33; 0.500; 0.500
SECONDARY
PK of Acetaldehyde: AUC(0-t)
178; 118; 155; 167; 128; 163
SECONDARY
PK of Acetaldehyde: DN AUC(0-t)
0.00547; 0.00329; 0.00470; 0.00597; 0.00439; 0.00521
SECONDARY
PK of Acetaldehyde: AUC(0-∞)
234; 154; 297; 302; 188; 205
SECONDARY
PK of Acetaldehyde: DN AUC(0-∞)
0.00682; 0.00432; 0.00929; 0.0105; 0.00626; 0.00616
SECONDARY
PK of Acetaldehyde: AUC%Extrap
19.0; 18.8; 13.1; 9.78; 24.7; 13.7
SECONDARY
PK of Acetaldehyde: T1/2
3.14; 3.08; 2.48; 1.72; 3.45; 2.39

Summary

This trial will evaluate if fomepizole (4-methylpyrazole) can treat symptoms associated with alcohol intolerance due to aldehyde dehydrogenase 2 (ALDH2) deficiency, an inherited metabolic disorder. These symptoms include flushing, nausea, headache, shortness of breath and dizziness, resulting from exposure to acetaldehyde, the primary metabolite of ethanol. Long-term, serious health risks have been associated with repeated exposure to acetaldehyde, a carcinogen, among ALDH2-deficient individuals.

Eligibility Criteria

Inclusion Criteria

  • Signed informed consent
  • Age 21 to 50 years
  • Subject of Japanese descent
  • History of flushing, with or without palpitations, or nausea (Alcohol Sensitivity Screening Test ≥ 3.1) following occasional or inadvertent ethanol consumption either currently or in the past
  • Subjects must be healthy volunteers with no other clinically relevant abnormalities as determined by medical history, blood chemistry, complete blood count (CBC), urinalysis,and 12-lead electrocardiogram (ECG)
  • Positive skin ethanol patch test (100 μL of 70% ethanol on a lint pad applied to skin for 7 minutes results in an area of erythema)
  • For Cohort 4, enrolled subjects were either homozygous or heterozygous for the ALDH2*2 genotype as assessed by genotyping at Screening

Exclusion Criteria

  • Vaccination within 2 weeks of Day 1
  • Current respiratory disease or a past history of chronic respiratory disease, or current smoker within last six months
  • Any one of the following Screening ECG findings:
  • QTc (Bazett) interval duration greater than 450 msec (male) or 470 msec (female), or
  • QRS interval greater than 120 msec, or
  • PR interval greater than 220 msec
  • History or evidence of drug or alcohol abuse or regular consumption of more than 8 units of alcohol daily (1 unit = 300 mL beer, 1 glass wine, 1 measure spirit) or those who may have difficulty abstaining from non study alcohol during the 36 hours prior to dose administration and until completion of blood sampling on Day 7
  • Subjects who have donated blood totalling more than 550 mL within the 3 months prior to Day 1
  • Use of any prescription medication other than oral contraceptives during the 14 days prior to Day 1, unless approved by both the Principal Investigator (PI) and the Sponsor
  • Inability to abstain from smoking any tobacco product from within prior to 2 hours of blood sampling to after 2 hours of blood sampling during the study period.
  • Use of any over-the-counter product, herbal product, diet aid, hormone supplement, etc., within 14 days prior to Day 1 unless approved by both the PI and the Sponsor
  • Chronic use of pain medications
  • Administration of an investigational agent within the last 30 days (or within a period of less than 5 times the agent's half-life, whichever is longer) prior to Day 1
  • Major surgery within 60 days prior to Day 1, or any planned surgery or medical procedure during the study period (through Day 7)
  • Positive alcohol breath-test or Positive drug screen (e.g., opiates, barbiturates, cannabinoids, benzodiazepines, cocaine, amphetamines) during screening or at Day 0 Check-In
  • Known hypersensitivity reaction to Antizol® or other pyrazoles, tomato juice
  • Abnormal laboratory results, including:
  • WBC ≤3.5 × 109/L or neutrophil count ≤2.0 × 10^9/L
  • Hemoglobin 16.0 gm/dL
  • Creatinine ≥2 mg/dL
  • Total bilirubin ≥2 mg/dL
  • Alanine aminotransferase and/or aspartate aminotransferase ≥2 times the upper limit of normal
  • PaO2 ≤95% on room air by pulse oximetry
  • Urine dipstick positive for protein, blood, ketones, glucose or leukocyte esterase
  • Any other clinically significant abnormal result for hematology, clinical chemistry, or urinalysis at screening or check-In
  • Positive serum pregnancy test for females of childbearing potential
  • Subject and/or partner unable or unwilling to use an effective form of barrier contraceptives during the course of the study and for 7 days after study drug administration.
  • Cancer (excluding adequately treated basal cell carcinoma) within the last 5 years
  • Significant past medical history of hepatic, renal, cardiovascular (including family history of prolonged QT syndrome), pulmonary, gastrointestinal, hematological, locomotor, immunologic, ophthalmologic, metabolic endocrine or other diseases; or any condition that in the opinion of the Investigator would complicate or compromise the study, or the well-being of the subject
  • Any other reason, which in the opinion of the Principal Investigator, would preven
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT00661141). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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