BE Study of Metformin GSK 850mg
Condition: Diabetic Foot
MeSH terms: Diabetic Foot
Study type: Interventional
Phase: Phase 2

Summary: 
      A randomized, balanced, open label, crossover, two period, two treatment, two sequence,
      single dose, oral bioequivalence study under fasting condition. It is a pivotal study to
      demonstrate the bioequivalence of Metformin 850 mg tablets manufactured by Savipharm J.S.C,
      Vietnam and Glucophage® 850 mg tablets of Merck Sante, France, in healthy adult human male
      subjects under fasting condition.
    

Detailed description: 
      Sample Size Estimation Assuming the formulation ratio (T/R) 95-105% and with the maximum
      observable intra subject variability for Metformin is 22% (based on literature), a sample
      size of 29 subjects would be sufficient to prove bioequivalence between the two formulations
      with power of at least 90%. Hence, total 32 subjects will be enrolled in the study
      considering withdrawal and dropouts.

      Screening procedures: Demographic data, medical and medication histories, complete physical
      examination, height, weight and BMI as well as 12 lead ECG, chest X-ray [PA view], vital
      signs [blood pressure, pulse rate, respiratory rate and oral temperature], hematology,
      biochemistry, HIV 1 & 2, Hepatitis B and C, RPR test for Syphilis and urine analysis will be
      done at screening.

      Urine drug screen, Liver chemistry test and breath alcohol test to be done prior to each
      check-in.

      Breath alcohol test to be done prior to each ambulatory visit blood collection. Liver
      chemistry test to be done at the end of each period. Housing: The study subjects will be
      housed at least 11 h prior to drug administration until after the 24 h blood sampling in each
      study period. The housing will be followed by one ambulatory visits [36.0 hr post dose] for
      each period.

      Washout: At least 7 days, but not exceeding 14 days between two dosing days. Treatment arms:
      Test: A single dose of Metformin 500 mg tablet manufactured by Savipharm J.S.C, Vietnam.

      Reference: A single dose of Glucophage® 500 mg tablet of Merck Sante, France Drug
      administration: As per the randomization schedule, one tablet of either test or reference
      product will be orally administered to each subject in each period in sitting posture, after
      an overnight fast of at least 10 h.

      To avoid hypoglycemic episodes, the investigational products will be administered with 240 mL
      of a 20% glucose solution in water, followed by 60 mL of the glucose solution administered
      every 15 min for up to 4 h after dosing.

      Subjects will be instructed not to chew or crush the tablet but should be swallowed.
      Compliance for dosing will be assessed by identification of subjects with subject ID card,
      identification of label on investigational product to confirm correct allocation of treatment
      and checking the oral cavity immediately after dosing.

      Restrictions: Subjects will remain in upright position [sitting or ambulatory] for two hours
      after dosing in each period except when clinically indicated to change the posture. The
      subjects will fast for at least 10 h prior to dosing and 4 h post-dose. Water will be
      permitted ad libitum except for 1 h before and until 1 h after post dose. During 1 hr post
      dose water restriction a, 60 mL of 20% glucose solution will be administered every 15 min to
      the study subjects.

      In each period of the study, 18 blood samples of 6 mL each will be collected in K2EDTA
      vacutainers via an indwelling catheter placed in one of the forearm veins. Heparin-lock
      technique will be used to prevent clotting of blood in the indwelling catheter. Before each
      in-house blood sample is drawn through catheter, 0.5 mL of blood will be discarded so as to
      purge the heparin containing blood sample in the catheter. Blood can also be collected by
      direct venipuncture in case of cannula blockage, during ambulatory visits or for any other
      practical reasons. The two pre-dose blood samples will be collected within a period of 1 h
      before the drug administration. The post-dose blood samples will be collected at 0.5, 1.0,
      1.5, 2.0, 2.5, 3.0, 3.5, 4.0, 5.0, 6.0, 8.0, 10.0, 12.0, 16.0, 24.0 and 36.0 h. The 36.0 h
      post dose blood samples will be collected during ambulatory visits by direct venipuncture.
      Immediately after collection of blood, the sample will be kept in ice bath. After collecting
      the blood samples from all the subjects at each sampling time point, samples will be
      centrifuged at 4oC with 3500 rpm for 10 minutes. The plasma samples will be separated and
      stored in pre-labeled polypropylene tubes at -70 ± 10°C pending assay. The time interval
      between sample collection and the start of centrifugation should not exceed more than 45
      minutes. The blood sample collection, processing and analysis will be done under sodium
      monochromatic light.

      The total volume of blood drawn including the volume necessary for the laboratory tests, PK
      sample analysis and the volume of blood discarded before each in house blood draw will be
      about 250 mL per subject for the entire study.

      Subjects monitoring: Brief physical examination and vital signs [blood pressure, pulse rate
      and oral temperature] will be carried out and recorded at each check-in and at check-out.
      Vital signs [blood pressure and pulse rate] will also be recorded before dosing of
      investigational products, between 2 - 3, 9 - 10 and 36.0 h post dose. Vital signs should be
      done in sitting position after rest of at least 5 minutes. Physical examination and
      measurement of vital signs can also be carried out at any time during the conduct of the
      study if the Investigator/Doctor feels it necessary. In case of abnormality in pre-dose vital
      signs, Investigator based on his medical judgement will take the decision whether to dose the
      subject or not. During vitals recording each subject will be asked about his well-being. Also
      subject well-being questionnaire will be performed at 1.0 and 5.0 h post dose.

      Post-study Procedures: Safety evaluation [complete physical examination, vital signs,
      hematology [except blood grouping & Rh typing] and biochemistry] will be done at the end of
      the clinical part of the study. In case of any withdrawals during the study safety assessment
      will be done at the time of withdrawal. In case of dropouts subjects will be asked to visit
      the facility to undergo safety assessments.

      Pharmacokinetic Parameters: Cmax, Tmax, AUC0-t, AUC0-∞, AUC%_Extrap, Kel and t1/2 Analytical
      Methods: Metformin in plasma will be estimated using validated LC-MS/MS method.

      Statistical Methods: Statistical analyses will be done using SAS® version 9.2 or higher.
      Analysis of variance [ANOVA] for log-transformed pharmacokinetic parameters [Cmax, AUC0-t and
      AUC0-∞], two one-sided tests [Schuirmann] for bioequivalence, power, ratio and 90% confidence
      interval for log-transformed pharmacokinetic parameters - Cmax, AUC0-t and AUC0-∞ will be
      performed.

      Standards for Bioequivalence: The calculated 90% Confidence Interval for the test to
      reference ratio of Metformin should fall within the range of 80%-125% for log transformed
      Cmax, AUC0-t and AUC0-∞ for the conclusion of bioequivalence.

      Adverse Events The investigator or site staff is responsible for detecting, documenting and
      reporting events that meet the definition of an AE or SAE.

      AEs will be collected from the start of Study Treatment and until the follow-up contact.
      Medical occurrences that begin prior to the start of study treatment but after obtaining
      informed consent may be recorded on the Medical History/Current Medical Conditions CRF.

      SAEs will be collected over the same time period as stated above for AEs. However, any SAEs
      assessed as related to study participation (e.g. study treatment, protocol-mandated
      procedures, invasive tests, or change in existing therapy) or related to a GSK concomitant
      medication will be recorded from the time a subject consents to participate in the study up
      to and including any follow-up contact. All SAEs will be recorded and reported to the sponsor
      within 24 hours.

      Investigators are not obligated to actively seek AEs or SAEs in former study participants.
      However, if the investigator learns of any SAE, including a death, at any time after a
      subject has been discharged from the study, and he considers the event reasonably related to
      the study treatment or study participation, the investigator would promptly notify the
      sponsor.

      All serious adverse events will be informed to the sponsor within 24 hrs and to the IEC
      within 7 working days. Any unexpected serious adverse event (SAE) occurring during a clinical
      trial should be communicated promptly (within 14 calendar days) by the Sponsor/CRO to the
      Licensing Authority.

      Any follow-up information on a previously reported SAE will also be reported to the sponsor
      within 24 hours.

      If the investigator does not have all information regarding an SAE, he/she will not wait to
      receive additional information before notifying the sponsor of the event and completing the
      appropriate data collection tool. The investigator will always provide an assessment of
      causality at the time of the initial report.
    

Intervention name(s): Metformin GSK 850mg; Gluocophage 850mg
Intervention type(s): Other; Other
Intervention description(s): EVALUATE BIOEQUIVALENCE BETWEEN METFORMIN 850 MG TABLETS MANUFACTURED BY SAVIPHARM J.S.C, VIETNAM AND GLUCOPHAGE® 850 MG TABLETS MANUFACTURED BY MERCK SANTE S.A.S.2, RUE DU PRESSOIR VERT-45400 SEMOY-FRANCE AND BE REGISTERED IN VIETNAM IN HEALTHY, ADULT, HUMAN MALE SUBJECTS UNDER FASTING CONDITION; EVALUATE BIOEQUIVALENCE BETWEEN METFORMIN 850 MG TABLETS MANUFACTURED BY SAVIPHARM J.S.C, VIETNAM AND GLUCOPHAGE® 850 MG TABLETS MANUFACTURED BY MERCK SANTE S.A.S.2, RUE DU PRESSOIR VERT-45400 SEMOY-FRANCE AND BE REGISTERED IN VIETNAM IN HEALTHY, ADULT, HUMAN MALE SUBJECTS UNDER FASTING CONDITION
Intervention MeSH terms: Metformin
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Basic Science