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Phase 1 N=32 Treatment

Pharmacokinetics of Midazolam, Dabigatran, Pitavastatin, Atorvastatin, and Rosuvastatin in Participants With Renal Insufficiency in the Presence and Absence of Rifampin (MK-0000-386)

Renal Insufficiency

Enrolled (actual)
32
Serious AEs
1.8%
Results posted
Jan 2020
Primary outcome: Primary: Area Under the Plasma Concentration-time Curve From Time 0 to Infinity (AUC0-inf) Post-dose Period 1 — 110; 260; 364; 176 pg*hr/mL

Study Design & Population

Study type
Interventional
Phase
Phase 1
Interventions
Midazolam oral solution (Drug); Dabigatran and pitavastatin oral solution (Drug); Atorvastatin and rosuvastatin oral solution (Drug); Rifampin (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Merck Sharp & Dohme LLC
Primary completion
Aug 2018

Outcome Measures

OutcomeResultp-value
PRIMARY
Area Under the Plasma Concentration-time Curve From Time 0 to Infinity (AUC0-inf) Post-dose Period 1
110; 260; 364; 176; 273; 5370
PRIMARY
Effect of Rifampin on AUC0-inf Post-dose Period 2
244; 359; 189; 239; 10700; 7240
PRIMARY
Area Under the Plasma Concentration-time Curve From Time 0 to 24 Hours (AUC0-24) Post-dose Period 1
106; 235; 317; 168; 252; 2100
PRIMARY
Area Under the Plasma Concentration-time Curve From Time 0 to Last (AUC0-last) Post-dose Period 1
105; 248; 344; 167; 264; 3740
PRIMARY
Maximum Plasma Concentration (Cmax) Post-dose Period 1
39.9; 68.4; 77.2; 70.7; 73.2; 132
PRIMARY
Plasma Concentration at 24 Hours (C24) Post-dose Period 1
0.283; 1.83; 2.64; 0.734; 1.57; 70.2
PRIMARY
Time to Maximum Plasma Concentration (Tmax) Post-dose Period 1
0.50; 0.50; 0.50; 0.50; 1.00; 2.00
PRIMARY
Apparent Plasma Terminal Half-life (t1/2) Post-dose Period 1
4.41; 7.79; 10.3; 6.76; 7.99; 41.4
PRIMARY
Apparent Clearance After Extravascular Administration (CL/F) Post-dose Period 1
90.8; 38.5; 27.5; 56.9; 36.6; 52.5
PRIMARY
Apparent Volume of Distribution During the Terminal Phase (Vz/F) Post-dose Period 1
579; 433; 409; 555; 422; 3140
SECONDARY
Effect of Rifampin on AUC0-24 Post-dose Period 2
238; 346; 186; 234; 6540; 5480
SECONDARY
Effect of Rifampin on AUC0-last Post-dose Period 2
236; 353; 182; 231; 10400; 6830
SECONDARY
Effect of Rifampin on Cmax Post-dose Period 2
75.4; 92.5; 73.0; 81.4; 422; 443
SECONDARY
Effect of Rifampin on C24 Post-dose Period 2
0.394; 1.42; 0.00; 0.601; 174; 100
SECONDARY
Effect of Rifampin on Tmax Post-dose Period 2
0.50; 0.75; 0.50; 1.00; 3.50; 3.00
SECONDARY
Effect of Rifampin on t1/2 Post-dose Period 2
4.14; 5.49; 4.12; 4.97; 19.4; 11.3
SECONDARY
Effect of Rifampin on CL/F Post-dose Period 2
40.5; 27.8; 53.0; 41.8; 26.3; 38.9
SECONDARY
Effect of Rifampin on Vz/F Post-dose Period 2
242; 220; 315; 300; 733; 632

Summary

The purpose of this open-label, 2-period, fixed-sequence study is to characterize the plasma pharmacokinetic profiles of midazolam, dabigatran, pitavastatin, atorvastatin, and rosuvastatin following a single oral dose administration of a microdose cocktail in healthy participants, in participants with mild, moderate, severe (not on dialysis) renal impairment, and in participants with end-stage renal disease (ESRD; on dialysis).

Eligibility Criteria

Inclusion Criteria

All participants (with mild, moderate or severe renal impairment, end stage renal disease, or healthy):

  • a female must be non-pregnant, non-breast feeding and if she is of reproductive potential: must agree to use (and/or have their partner use) two acceptable methods of birth control beginning at screening, throughout the study and until 2 weeks after the last dosing of study drug
  • a female of non-childbearing potential: must have undergone a sterilization procedure at least 6 months prior to the first dose or be postmenopausal with amenorrhea for at least 1 year prior to the first dose
  • a non-vasectomized male participant must agree to use a condom with spermicide or abstain from sexual intercourse from the first dose until 90 days after the last dose of study drug
  • a male participant must agree not to donate sperm from dosing until 90 days after the last dose of study drug
  • has a body mass index (BMI) ≤ 40.0 kg/m^2
  • is a non-smoker or moderate smoker (≤ 20 cigarettes/day or the equivalent)

Participants with mild, moderate or severe renal impairment or end stage renal disease:

  • has a clinical diagnosis of renal impairment and meets the protocol-specified renal impairment function qualifications at the prestudy visit (screening)

Healthy participants:

  • has baseline creatinine clearance ≥ 90 mL/min based on Cockcroft-Gault equation
  • is judged to be in good health based on medical history, physical examination, vital signs, pulse oximetry, and laboratory safety tests

Exclusion Criteria

All participants (with mild, moderate or severe renal impairment, end stage renal disease, or healthy):

  • is mentally or legally incapacitated or has significant emotional problems at the time of the screening visit or expected during the conduct of the study.
  • history or presence of clinically significant medical or psychiatric condition or disease
  • history of stroke, chronic seizures, or major neurological disorders
  • history of malignant neoplastic disease
  • history or presence of alcoholism or drug abuse within the past 6 months
  • female participant who is pregnant or lactating

Participants with mild, moderate or severe renal impairment:

  • has had a renal transplant or has had nephrectomy
  • has uncontrolled type 2 diabetes mellitus (T2DM), a history of Type 1 diabetes, or ketoacidosis
  • history of significant endocrine, gastrointestinal, cardiovascular, hematological, immunological, respiratory, or genitourinary diseases

Participants with end stage renal disease (ESRD):

  • had a failed renal allograft within the last 2 years prior to the first dose, or a successful renal allograft
  • has uncontrolled T2DM, a history of Type 1 diabetes, or ketoacidosis
  • history of significant endocrine, gastrointestinal, cardiovascular, hematological, immunological, respiratory, or genitourinary diseases

Healthy participants:

  • history of hypoglycemia, glucose intolerance, T2DM, or ketoacidosis
  • history of clinically significant endocrine, gastrointestinal, cardiovascular, hematological, hepatic, immunological, renal, respiratory, or genitourinary abnormalities or diseases.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03311841). 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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