Phase 1
N=8
Study to Assess the Pharmacokinetics of GSK1278863 in Subjects With End Stage Renal Disease Undergoing Peritoneal Dialysis
Anaemia
Bottom Line
View on ClinicalTrials.gov: NCT02243306 ↗Enrolled (actual)
8
Serious AEs
0.0%
Results posted
Mar 2019
Primary outcome: Primary: Area Under the Concentration-time Curve (AUC) Over the Dosing Interval (AUC[0-tau]) of GSK1278863 and Its Metabolites — 184.9863; 138.6511; 162.9366; 131.2826 Hour into nanograms per milliliter
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 1
- Interventions
- GSK1278863 (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- GlaxoSmithKline
- Primary completion
- May 2017
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Area Under the Concentration-time Curve (AUC) Over the Dosing Interval (AUC[0-tau]) of GSK1278863 and Its Metabolites |
184.9863; 138.6511; 162.9366; 131.2826; 245.8999; 147.8039 | — |
| PRIMARY AUC From Time Zero (Pre-dose) Extrapolated to Infinite Time (AUC [0-inf]) of GSK1278863 and Its Metabolites |
184.9888; 138.6860; 117.2111; 68.5089; 104.5268; 73.9865 | — |
| PRIMARY Maximum Observed Concentration (Cmax) of GSK1278863 and Its Metabolites |
90.400; 58.771; 57.800; 30.303; 19.900; 11.360 | — |
| SECONDARY Number of Participants With Non-serious Adverse Events (AEs) and Serious AEs (SAEs) |
1; 5; 0; 0 | — |
| SECONDARY Change From Baseline in Glucose, Calcium, Chloride, Carbon-dioxide (CO2), Potassium, Sodium and Urea Levels |
-0.10; 0.27; 0.360; 0.040; -2.0; -1.3 | — |
| SECONDARY Change From Baseline in Albumin and Protein Levels |
3.0; -1.3; 5.0; -2.0 | — |
| SECONDARY Change From Baseline in Direct Bilirubin, Bilirubin, Creatinine and Urate Levels |
0.0; -0.5; -2.0; 0.5; 13.30; -119.12 | — |
| SECONDARY Change From Baseline in Alkaline Phosphatase (ALP), Aspartate Aminotransferase (AST) and Gamma Glutamyl Aminotransferase (GGT) Levels |
5.0; -0.5; -1.0; -3.3; 0.0; -6.3 | — |
| SECONDARY Change From Baseline in Alanine Aminotransferase (ALT) and Creatinine Kinase Levels |
-3.0; -0.7; -7.0; -2.5; -9.0; -3.5 | — |
| SECONDARY Change From Baseline in Basophils, Eosinophils, Lymphocytes, Monocytes, Neutrophils, Platelets and Leukocytes Levels |
-0.020; 0.010; -0.010; 0.060; 0.260; -0.138 | — |
| SECONDARY Change From Baseline in Erythrocyte and Reticulocyte Levels |
0.00; -0.05; 0.02840; -0.00165 | — |
| SECONDARY Change From Baseline in Hematocrit Levels |
0.0070; -0.0100 | — |
| SECONDARY Change From Baseline in Hemoglobin Levels |
7.0; 3.1; 4.0; -2.2; 0.0; -3.2 | — |
| SECONDARY Change From Baseline in Mean Corpuscular Hemoglobin Concentration (MCHC) |
8.0; 6.3 | — |
| SECONDARY Change From Baseline in Mean Corpuscular Volume (MCV) |
1.0; -1.5 | — |
| SECONDARY Change From Baseline in Mean Corpuscular Hemoglobin (MCH) Levels |
1.00; -0.02 | — |
| SECONDARY Number of Participants With Abnormal Electrocardiogram (ECG) Findings |
0; 3 | — |
| SECONDARY Change From Baseline in Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) |
12.0; -10.4; 24.0; -10.0; 10.0; -3.4 | — |
| SECONDARY Change From Baseline in Pulse Rate |
-9.0; -5.6; -6.0; -7.0 | — |
| SECONDARY Change From Baseline in Body Temperature |
-0.10; -0.20; -0.90; -0.30 | — |
| SECONDARY Number of Participants With Abnormal Physical Examination Findings |
— | — |
| SECONDARY Peritoneal Dialysis Clearance of GSK1278863 and Metabolites |
12.07; 154.68; 31.68; 124.40; 13.08; 167.89 | — |
| SECONDARY Terminal Phase Half-life (t 1/2) of GSK1278863 and Metabolites |
1.6256; 1.9870; 1.8088; 2.5312; 9.2225; 10.2882 | — |
| SECONDARY Time of Occurrence of Cmax (Tmax) of GSK1278863 and Metabolites |
0.50; 1.00; 2.00; 2.00; 3.00; 4.00 | — |
| SECONDARY Accumulation Ratio of GSK1278863 and Metabolites |
0.896; 1.176; 1.019; 1.581; 1.116; 1.415 | — |
| SECONDARY Time Invariance Ratio of GSK1278863 and Metabolites |
0.896; 1.007; 0.986 | — |
| SECONDARY Plasma Concentration of Erythropoietin |
13.860; 11.363; 11.590; 14.494; 23.540; 36.257 | — |
| SECONDARY Plasma Concentration of Hepcidin |
1143.00; 863.21; 1286.00; 922.86; 1427.10; 760.14 | — |
Summary
GSK1278863 is an orally-active, novel small molecule agent which inhibits hypoxia-inducible factor (HIF) prolyl -4- hydroxylases (PHDs) and is in development for the treatment of anaemia associated with chronic kidney disease (CKD). As the kidney represents a major site of elimination for many drugs and their metabolites, and GSK1278863 will be administered to subjects with various stages of renal disease, it is important to characterize the pharmacokinetics in this target patient population. The purpose of this study is to characterize the pharmacokinetics of GSK1278863 and its metabolites in subjects with end stage renal disease (ESRD) undergoing peritoneal dialysis. This will be a repeat-dose, open-label, parallel-group study. Approximately 30 subjects with ESRD will be enrolled in two cohorts (15 subjects in each cohort) to ensure that 6 subjects on continuous ambulatory peritoneal dialysis (CAPD) (cohort 1) and 6 subjects on automated peritoneal dialysis APD (cohort 2) complete dosing and critical assessments. GSK1278863 will be administered once daily for 14 days. Primary pharmacokinetic assessments will be made on Days 1 and 14.
Eligibility Criteria
Inclusion Criteria
SAFETY:
- Satisfactory medical evaluation based upon medical history, medication history, physical examination, and clinical laboratory data obtained at the Screening visit. The determination of clinical significance will be made by the Investigator and the GlaxoSmithKline (GSK) Medical Monitor and will require that the finding is unlikely to introduce additional risk factors or interfere with the study procedures, or the integrity of the study.
- Corrected QT interval (QTc) 1.5xULN is acceptable if bilirubin is fractionated and direct bilirubin 1.7 measured at any time within last 3 months.
- No history of peritoneal dialysis-associated peritonitis, peritoneal catheter tunnel (exit site) infection or leakage for at least 3 months before study.
- Meets the following erythropoiesis stimulating agent (ESA) criteria: Is ESA naive (i.e., no ESA use within the previous 12 weeks of screening) OR agrees to discontinue ESA (if currently using ESA) for at least 7 days prior to first dose of GSK1278863 until completion of Follow-up visit (If the subject has a scheduled ESA interval which is 7 days, ESA treatment must be discontinued for at least the scheduled interval length [e.g., if ESA interval is 14 days, then ESA must be discontinued for >=14 days] prior to the first dose of GSK1278863)
- Has a haemoglobin value: For ESA naïve subjects: =18 years of age at the time of Screening.
- A female subject is eligible to participate if she is of: (a) Childbearing potential, and agrees to use one of the contraception methods described in the protocol. This criterion must be followed from the time of Screening until completion of the Follow-up Visit; (b) Non-childbearing potential, defined as pre-menopausal females with a documented tubal ligation or hysterectomy; or postmenopausal defined as 12 months of spontaneous amenorrhea (In questionable cases, a blood sample with simultaneous follicle stimulating hormone (FSH) 23.0-116.3 international units (IU)/litre (L) and estradiol 45 kilograms (kg) and 100 millimetres of mercury [mmHg] or systolic BP >170 mmHg) at Screening.
- History of drug abuse or dependence within 6 months of the study.
- History of sensitivity to GSK1278863, or its components thereof or a history of drug or other allergy that, in the opinion of the Investigator or GSK Medical Monitor, contraindicates their participation.
- History of sensitivity to heparin or heparin-induced thrombocytopenia (if the clinical research unit uses heparin to maintain intravenous cannula patency).
- History of thrombosis defined as deep vein thrombosis, stroke, pulmonary embolism or other thrombosis related condition within 3 months prior to Screening.
- History of myocardial infarction or acute coronary syndrome within 3 months prior to Screening.
- History of stroke or transient ischaemic attack within 3 months prior to Screening.
- Subjects with a pre-existing condition interfering with normal gastrointestinal anatomy or motility, and/or hepatic function that could interfere with the absorption, metabolism, and/or excretion of GSK1278863. Examples of conditions that could interfere with normal gastrointestinal anatomy or motility include gastrointestinal bypass surgery, partial or total gastrectomy, small bowel resection, vagotomy, malabsorption, Crohn's disease, ulcerative colitis, or celiac sprue. Examples of conditions that could interfere with hepatic function include Gilbert's syndrome.
- Evidence of active peptic, duodenal or esophageal ulcer disease at Screening OR history of clinically significant gastro-intestinal (GI) bleeding within 3 months prior to Screening.
- Subjects with chronic inflammatory disease that could impact erythropoiesis (e.g. scleroderma, systemic lupus erythematosis, rheumatoid arthritis, celiac disease).
- Subjects with a history of symptomatic right heart failure.
- Subjects with Class III or Class IV heart failure, as defined by the New York Heart Association (NYHA) functional classificat
Data sourced from ClinicalTrials.gov (NCT02243306). 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.