Phase 1
N=16
Pharmacokinetics (PK) Study of Gepotidacin (GSK2140944) in Adult Subjects With Varying Degrees of Hepatic Impairment and in Matched Control Subjects With Normal Hepatic Function
Infections, Bacterial
Bottom Line
View on ClinicalTrials.gov: NCT03562117 ↗Enrolled (actual)
16
Serious AEs
4.0%
Results posted
Dec 2019
Primary outcome: Primary: Area Under the Plasma Concentration-time Curve (AUC) From Time Zero (Pre-dose) Extrapolated to Infinity (AUC[0-inf]) for Plasma Gepotidacin — 15894.7; 19505.7; 25415.5 Hours*nanograms per milliliter
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 1
- Interventions
- Gepotidacin (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- GlaxoSmithKline
- Primary completion
- Dec 2018
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Area Under the Plasma Concentration-time Curve (AUC) From Time Zero (Pre-dose) Extrapolated to Infinity (AUC[0-inf]) for Plasma Gepotidacin |
15894.7; 19505.7; 25415.5 | — |
| PRIMARY Maximum Observed Concentration (Cmax) for Plasma Gepotidacin |
3196.8; 3913.7; 5541.8 | — |
| SECONDARY AUC From Time 0 to the Time of the Last Quantifiable Concentration (AUC [0-t]) for Plasma Gepotidacin |
15512.9; 19151.6; 25066.8 | — |
| SECONDARY Time to First Occurrence (Tmax) of Cmax for Plasma Gepotidacin |
3.000; 2.750; 2.250 | — |
| SECONDARY Lag Time Before Observation of Drug Concentrations in Sampled Matrix (Tlag) for Plasma Gepotidacin |
0.50; 0.00; 0.00 | — |
| SECONDARY Apparent Oral Clearance (CL/F) for Plasma Gepotidacin |
94.37; 76.90; 59.02 | — |
| SECONDARY Apparent Volume of Distribution of the Terminal Phase (Vz/F) for Plasma Gepotidacin |
1235.3; 944.7; 699.1 | — |
| SECONDARY Terminal-phase Rate Constant (Lambda_z) for Plasma Gepotidacin |
0.07639; 0.08140; 0.08443 | — |
| SECONDARY Terminal Phase Half Life (t1/2) for Plasma Gepotidacin |
9.073; 8.515; 8.210 | — |
| SECONDARY Number of Participants With Abnormal Electrocardiogram (ECG) Findings |
1; 6; 3; 0; 0; 0 | — |
| SECONDARY Change From Baseline Values in Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) |
-10.4; -6.1; -3.8; -10.3; -7.5; -0.1 | — |
| SECONDARY Change From Baseline Values in Heart Rate |
0.3; 0.6; -0.6; -0.8; -0.1; 0.8 | — |
| SECONDARY Number of Participants With Serious Adverse Events (SAEs) and Non-SAEs |
3; 2; 4; 1; 0; 0 | — |
| SECONDARY Number of Participants With Toxicity Grading 3 or Higher for Clinical Chemistry Parameters |
0; 1; 6 | — |
| SECONDARY Change From Baseline Values for Clinical Chemistry Parameters: ALT, ALP, AST and CK |
-2.1; -0.1; -3.7; -1.3; -4.4; -5.2 | — |
| SECONDARY Change From Baseline Values for Clinical Chemistry Parameters: Albumin and Protein |
-1.3; -0.4; -1.7; -0.9; 0.8; -3.5 | — |
| SECONDARY Change From Baseline Values for Clinical Chemistry Parameters: Bilirubin, Direct Bilirubin and Creatinine |
-2.470; -1.924; -7.695; -3.2413; 7.6245; -0.4420 | — |
| SECONDARY Change From Baseline Values for Clinical Chemistry Parameters: Calcium, Glucose, Potassium, Sodium and Urea |
-0.00831; -0.01623; -0.05488; -0.08016; 0.04855; -0.79563 | — |
| SECONDARY Number of Participants With Toxicity Grading 3 or Higher for Hematology Parameters |
0; 0; 2 | — |
| SECONDARY Number of Participants With Toxicity Grading 3 or Higher for Urinalysis Parameters |
0; 0; 0 | — |
| SECONDARY Number of Participants With Abnormal Findings During Physical Examinations |
— | — |
| SECONDARY Total Unchanged Drug (Ae_total) and Amount of Drug Excreted in Urine in a Time Intervals (Ae (t1-t2) for Gepotidacin |
127.67; 191.39; 325.31; 5.82; 55.53; 28.79 | — |
| SECONDARY Percentage of the Given Dose of Drug Excreted in Urine (Fe%) |
8.51; 12.76; 21.69 | — |
| SECONDARY Renal Clearance (CLr) of Gepotidacin |
8.18; 9.45; 12.46 | — |
| SECONDARY AUC(0-12) of Gepotidacin |
1201; 3030; 4771 | — |
| SECONDARY AUC(0-24) of Gepotidacin |
1269; 2925; 5807 | — |
| SECONDARY AUC(0-48) of Gepotidacin |
1394; 3547; 5035 | — |
Summary
This is a two-part study which will evaluate the PK, safety, and tolerability of a single 1500 milligram (mg) oral dose of gepotidacin in subjects with normal hepatic function and in subjects with mild, moderate, and severe hepatic impairment. In Part 1, subjects with moderate hepatic impairment and subjects with normal hepatic function will be enrolled. Matching subjects with normal hepatic function in Part 1 (Group D), will be enrolled following the completion of all Day 3 assessments of the respective matched, hepatically impaired subject. In Part 2, subjects with mild (optional) and severe hepatic impairment and subjects with normal hepatic function will be enrolled concurrently based on the PK, safety, and tolerability data of Part 1. Subjects with mild hepatic impairment, may be studied if there is a significant difference in PK between subjects with moderate hepatic impairment and subjects with normal hepatic function. Subjects with severe hepatic impairment, will be studied in Part 2, provided that, the PK objectives are achieved in Part 1. A totals of 48 subjects, are planned to be enrolled in the study. The study duration is approximately of 44 days from Screening to Follow-up visit. The results from this study will enable the development of appropriate dosing recommendations in subjects with impaired hepatic function.
Eligibility Criteria
Inclusion Criteria
- Subjects must be 18 to 80 years of age inclusive, at the time of signing the informed consent.
- Healthy subjects must be in clinically stable health as determined by the investigator based on medical history, clinical laboratory results (serum chemistry, hematology, urinalysis, and serology), vital sign measurements, 12-lead ECG results, and physical examination findings.
- Hepatically impaired subjects must have chronic (>6 months), stable (no acute episodes of illness within the previous 1 month prior to screening due to deterioration in hepatic function) hepatic insufficiency with features of cirrhosis due to any etiology. Subjects must also remain stable throughout the Screening period.
- Hepatically impaired subjects, will be classified, using the Child-Pugh classification system. Subjects must have, a Child-Pugh score, of 5 to 6 (mild hepatic impairment), 7 to 9 (moderate hepatic impairment), or 10 to 15 (severe hepatic impairment), with known medical history of liver disease (with or without a known history of alcohol abuse), and previous confirmation of liver cirrhosis by liver biopsy or other medical imaging technique (including laparoscopy, computed tomography scan, magnetic resonance imaging, or ultrasonography) associated with unambiguous medical history. If imaging study, or biopsy is not available, then the subject should have one of the following: Physical findings such as hepatomegaly, ascites, palmar erythema, spider angiomata, abdominal venous collaterals, gynecomastia, or other physical manifestations of hepatic disease Or Laboratory findings: ALT or AST elevation (> upper limit of normal [ULN]), alkaline phosphatase, or total bilirubin, or international normalized ratio (INR) elevation (>ULN) or an albumin value that is below the lower limit of normal laboratory reference range.
- Subjects with hepatic impairment may be taking medications, which in the opinion of the investigator, are believed to be therapeutic, and these medications should not interfere with the conduct of the study. Subjects with hepatic impairment should be on stable regimen of chronic medications for at least 7 days prior to dosing until completion of the Follow-Up Visit.
- Subjects with hepatic impairment must have platelet counts of 30,000 × 109/Liter of blood and have not had any major bleeding episodes within the past 6 months.
- Body weight >=45 kilogram (kg) and body mass index (BMI) within the range 18.5 to 40 kg/meter^2 (inclusive).
- Male subjects must agree to use contraception, as protocol from Day -1 until completion of the Follow-up Visit or, female subject will be eligible to participate if she is not pregnant not breastfeeding, and at least one of the following conditions applied Not a woman of childbearing potential (WOCBP) or A WOCBP who agrees to follow the contraceptive guidance from 30 days prior to study drug administration and until completion of the Follow-up Visit.
- Capable of giving signed informed consent.
Exclusion Criteria
- Subject has a clinically significant abnormality in past medical history or at the Screening physical examination (excluding hepatic insufficiency and other related medical conditions within the hepatically impaired populations, which should be stable for at least 1 month before study drug administration), that in the investigator's opinion, may place the subject at risk or interfere with outcome variables of the study. This includes, but is not limited to, history or current significant cardiac, renal, neurologic, gastrointestinal, respiratory, hematologic, or immunologic disease.
- Subject has any surgical or medical condition (active or chronic) that may interfere with drug absorption, distribution, metabolism, or excretion of the study drug, or any other condition that may place the subject at risk, in the opinion of the investigator.
- Female subject, has a positive pregnancy test result or is lactating at Screening or upon admission to the clinic.
- Subje
Data sourced from ClinicalTrials.gov (NCT03562117). 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.