Phase 2
N=22
Pharmacokinetic Study of Oral Gepotidacin (GSK2140944) in Subjects With Uncomplicated Urinary Tract Infection (Acute Cystitis)
Infections, Bacterial
Bottom Line
View on ClinicalTrials.gov: NCT03568942 ↗Enrolled (actual)
22
Serious AEs
4.6%
Results posted
Jan 2020
Primary outcome: Primary: Area Under the Plasma Concentration-time Curve (AUC) From Zero (Pre-dose) Over the Dosing Interval (AUC[0-tau]) of Gepotidacin — 20236.2; 29313.8 Hours* nanogram per milliliter (h*ng/mL)
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Gepotidacin (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- Female
- Sponsor
- GlaxoSmithKline
- Primary completion
- Jan 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Area Under the Plasma Concentration-time Curve (AUC) From Zero (Pre-dose) Over the Dosing Interval (AUC[0-tau]) of Gepotidacin |
20236.2; 29313.8 | — |
| PRIMARY Maximum Plasma Concentration (Cmax) of Gepotidacin |
5891; 8437 | — |
| PRIMARY Time of Occurrence of Cmax (Tmax) of Gepotidacin |
1.500; 1.917 | — |
| PRIMARY Apparent Steady State Clearance (CLss/F) of Gepotidacin |
51.17 | — |
| PRIMARY Accumulation Ratio (Ro) of Gepotidacin |
1.402 | — |
| PRIMARY Plasma Pre-dose Concentration (Ctau) of Gepotidacin |
NA; 620.5; 789.3; 851.4; 818.9 | — |
| SECONDARY Amount of Drug Excreted Over 12 Hours (Ae12hours) of Gepotidacin |
298.7; 460.0 | — |
| SECONDARY Amount of Drug Excreted in Urine in a Time Interval (Ae[t1-t2]) of Gepotidacin |
NA; 63.05; 131.9; 168.1; 87.01; 128.6 | — |
| SECONDARY Percentage of the Given Dose of Drug Excreted in Urine (fe%) of Gepotidacin |
19.91; 30.67 | — |
| SECONDARY Renal Clearance (CLr) of Gepotidacin |
14.76; 15.69 | — |
| SECONDARY Urine Pre-dose Concentration (Ctau) of Gepotidacin |
NA; 279.1; 322.2; 326.7; 351.7 | — |
| SECONDARY Number of Participants With Non-serious Adverse Events (Non-SAEs) and Serious AEs (SAEs) |
21; 1 | — |
| SECONDARY Change From Baseline in Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) |
-3.1; -0.3; -1.5; 0.9; 1.5; -2.3 | — |
| SECONDARY Change From Baseline in Pulse Rate |
2.2; 2.4; 2.9; 7.2; 0.8 | — |
| SECONDARY Change From Baseline in Body Temperature |
-0.05; -0.06; 0.02; -0.05; -0.10 | — |
| SECONDARY Change From Baseline in Electrocardiogram (ECG) Parameters: PR Interval, QRS Duration, QT Interval, Corrected QT Interval Using Bazett's Formula (QTcB) and Corrected QT Interval Using Fridericia's Formula (QTcF) |
-1.9; 0.1; -3.5; -0.7; -0.9; 2.1 | — |
| SECONDARY Change From Baseline in Hematology Parameters: Basophils, Eosinophils, Lymphocytes, Monocytes, Neutrophils and Platelet Counts |
0.013; -0.003; 0.000; 0.013; -0.003; 0.051 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Hemoglobin |
-3.4; -0.6; -8.2 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Hematocrit |
0.75; -0.54; -2.30 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Erythrocyte Mean Corpuscular Hemoglobin |
0.13; 0.03; 0.16 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Erythrocyte Mean Corpuscular Volume |
4.53; -0.72; 1.14 | — |
| SECONDARY Change From Baseline in Hematology Parameter: Red Blood Cell Count |
-0.135; -0.031; -0.298 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: Albumin and Protein |
-2.0; -1.4; -1.3; -3.0; -2.6; -2.4 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: Creatinine and Bilirubin |
2.411; 1.684; 0.442; -1.8932; -1.6986; -1.6856 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST) and Alkaline Phosphatase (ALP) |
-1.5; 1.7; 1.7; -1.3; 1.3; 2.1 | — |
| SECONDARY Change From Baseline in Clinical Chemistry Parameters: Glucose, Calcium, Chloride, Potassium, Sodium and Urea |
0.13121; 0.87495; -0.05274; -0.05330; -0.05228; -0.07110 | — |
| SECONDARY Number of Participants With Urinalysis Dipstick Results: Glucose and Nitrites |
22; 22; 21; 20; 13; 9 | — |
| SECONDARY Number of Participants With Urinalysis Dipstick Results: Ketones |
21; 1; 22; 21; 18; 2 | — |
| SECONDARY Number of Participants With Urinalysis Dipstick Results: Leukocyte Esterase |
4; 2; 4; 1; 11; 19 | — |
| SECONDARY Number of Participants With Urinalysis Dipstick Results: Occult Blood |
6; 10; 3; 3; 19; 1 | — |
| SECONDARY Number of Participants With Urinalysis Dipstick Results: Protein |
11; 10; 1; 18; 4; 16 | — |
| SECONDARY Number of Participants With Abnormal Physical Examination Findings |
— | — |
Summary
Gepotidacin (GSK2140944) is a novel triazaacenaphthylene bacterial type II topoisomerase inhibitor that is being developed for the treatment of uncomplicated urinary tract infections (UTIs; acute cystitis). This Phase IIa study will evaluate plasma and urine pharmacokinetics of gepotidacin in female subjects with acute cystitis. Eligible female subjects will receive twice daily (BID) dose of gepotidacin 1500 milligram (mg) for 5 days via oral route. Pre-treatment and post-treatment samples for pharmacokinetic (PK) assessments will be collected throughout the study. The total duration of the study is approximately 28 days.
Eligibility Criteria
Inclusion Criteria
- Subject must be >=18 to =10 white blood cells per cubic millimeters [WBC/mm^3] or the presence of leukocyte esterase) and/or nitrite from a pretreatment clean-catch midstream urine sample based on local laboratory procedures.
- The subject is female. A female subject is eligible to participate if she is not pregnant, not breastfeeding, and at least 1 of the following conditions applies: a) Not a woman of childbearing potential (WOCBP) OR b) A WOCBP who agrees to follow the contraceptive guidance from the Baseline Visit through completion of the Test of Cure (TOC) Visit.
- Capable of giving signed informed consent, which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and protocol.
Exclusion Criteria
- The subject resides in a nursing home or dependent care-type facility.
- The subject has a body mass index >=40.0 kilogram per square meter (kg/m^2) or a body mass index >=35.0 kg/m^2 with obesity-related health conditions such as high blood pressure or uncontrolled diabetes.
- The subject has a history of sensitivity to the study treatment, or components thereof, or a history of a drug or other allergy that, in the opinion of the investigator or medical monitor, contraindicates her participation.
- The subject is immunocompromised or has altered immune defenses that may predispose the subject to a higher risk of treatment failure and/or complications (e.g., renal transplant recipients, subjects with clinically significant persistent granulocytopenia [absolute neutrophil count 40 mg/day prednisolone or equivalent for >1 week or >=20 milligrams per day (mg/day) prednisolone or equivalent for >6 weeks; or prednisolone or equivalent >=10 mg/day for >6 weeks]). Subjects with a known cluster of differentiation 4 (CD4) count of 300 milligrams per deciliter (mg/dL) or based on investigator judgment.
- The subject has any of the following: A medical condition that requires medication that may be aggravated by inhibition of acetylcholinesterase, such as: a) Poorly controlled asthma or chronic obstructive pulmonary disease at Baseline and, in the opinion of the investigator, not stable on current therapy; b) Acute severe pain, uncontrolled with conventional medical management; c) Active peptic ulcer disease; d) Parkinson disease; e) Myasthenia gravis; f) A history of seizure disorder requiring medications for control (this does not include a history of childhood febrile seizures) OR Any surgical or medical condition (active or chronic) that may interfere with drug absorption, distribution, metabolism, or excretion of the study drug (e.g., ileostomy or malabsorption syndrome). Subjects who have had a gastric bypass or a cholecystectomy are excluded from the study OR Hemoglobin value =96 hours before the Screening assessment, or a temperature >=101 degree Fahrenheit, flank pain, chills, or any other manifestations suggestive of upper UTI.
- The subject has anuria, oliguria, or significant impairment of renal function (creatinine clearance =III.
- The subject has severe left ventricular hypertrophy.
- The subject has a family history of QT prolongation or sudden death.
- The subject has a recent history of vasovagal syncope or episodes of symptomatic bradycardia or bradyarrhythmia within the last 12 months.
- The subject is taking QT-prolonging drugs or drugs known to increase the risk of torsades de points (TdP) per the www.crediblemeds.org "Known Risk of TdP" category at the time of her Baseline Visit, which cannot be safely discontinued from the Baseline Visit to the TOC Visit; or the subject is taking a strong cytochrome P450 enzyme 3A4 (CYP3A4) inhibitor or a strong P-glycoprotein (P-gp) inhibitor.
- The subject has a QT interval corrected for heart rate (QTc) >450 milliseconds (msec) or a QTc >480 msec for subjects with bundle-branch block.
- The subject has a known ALT value >2 times upper limit of normal (ULN).
- The subject has a known bilirubin value >1.5
Data sourced from ClinicalTrials.gov (NCT03568942). 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.