A Study to Assess the Relative Bioavailability of 3 Different Formulations Under Fasted and Fed Condition
Condition: Chronic Kidney Disease
MeSH terms: Kidney Diseases; Renal Insufficiency, Chronic
Intervention: Verinurad ER8 capsule formulation (fasted); Verinurad A-capsule formulation (fasted); Verinurad A-capsule formulation (fed); Verinurad B-capsule formulation (fasted); Verinurad B-capsule formulation (fed)
Intervention description: Each participant will receive single-dose treatment of 12 mg verinurad ER8 capsule with 240 mL water, following an overnight fast of at least 10 hours.; Each participant will receive single-dose treatment of 12 mg verinurad A-capsule with 240 mL water, following an overnight fast of at least 10 hours.; Each participant will receive single dose treatment of 12 mg verinurad A-capsule with 240 mL water, following a high-fat, high-calorie breakfast (after the overnight fast).; Each participant will receive single-dose treatment of 12 mg verinurad B-capsule with 240 mL water, following an overnight fast of at least 10 hours.; Each participant will receive single dose treatment of 12 mg verinurad B-capsule with 240 mL water, following a high-fat, high-calorie breakfast (after the overnight fast).
Intervention MeSH terms: Verinurad
Phase: Phase 1
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Enrollment: 25.0
Sex: All
Minimum age: 18 Years
Maximum age: 50 Years
Healthy volunteers: Accepts Healthy Volunteers
Keywords: URAT1 inhibitor; Uric acid transporter 1; Verinurad; Crossover study; Relative bioavailability; Pharmacokinetics

Summary:

      This study is intended to assess the relative bioavailability between the (extended-release)
      ER8 capsule formulation (the formulation that is currently used for verinurad development)
      given under fasted conditions and 2 new capsule formulations of verinurad (A-capsule and
      B-capsule) given under fed or fasted conditions. All three capsules target an 8-hour release
      profile (extended-release). The highest dose (12 mg) currently tested in participants will be
      tested in this study. The study is designed to provide information to optimize the verinurad
      part of a fixed dose combination capsule to be used in future development.
    

Eligibility criteria:

        Inclusion Criteria:

          1. Provision of signed and dated, written informed consent prior to any study specific
             procedures.

          2. Healthy male and female participants aged 18 to 50 years with suitable veins for
             cannulation or repeated venepuncture.

          3. Have a body mass index (BMI) between 18 and 30 kg/m2 and weigh at least 50 kg and no
             more than 100 kg.

          4. Females must have a negative pregnancy test at screening and on admission to the unit
             and must be:

        (1) not pregnant or currently lactating or breastfeeding. (2) of non-childbearing
        potential, confirmed at screening by fulfilling one of the following criteria: (i)
        postmenopausal defined as amenorrhoea for at least 12 months or more following cessation of
        all exogenous hormonal treatments and FSH levels in the postmenopausal range (FSH levels >
        40 IU/mL).

        (ii) documentation of irreversible surgical sterilization by hysterectomy, bilateral
        oophorectomy or bilateral salpingectomy but not tubal ligation.

        (3) OR if of childbearing potential must be willing to use an acceptable method of
        contraception to avoid pregnancy for the entire study period.

        Exclusion Criteria:

          1. History of gout or any clinically significant disease or disorder which, in the
             opinion of the Principal Investigator (PI), may either put the volunteer at risk
             because of participation in the study, or influence the results or the volunteer's
             ability to participate in the study.

          2. Any clinically important illness, medical/surgical procedure or trauma within 4 weeks
             of the first administration of verinurad.

          3. History or presence of gastrointestinal (GI), hepatic or renal disease, or any other
             condition known to interfere with absorption, distribution, metabolism, or excretion
             of drugs.

          4. Any clinically important abnormalities in clinical chemistry, haematology or
             urinalysis results as judged by the Investigator at screening and first admission,
             including: (1) Alanine aminotransferase (ALT) > 1.5 x upper limit of normal (ULN), (2)
             Aspartate aminotransferase (AST) > 1.5 x ULN, (3) Bilirubin (total) > 1.5 x ULN, (4)
             Gamma glutamyl transpeptidase (GGT) > 1.5 x ULN. (5) If any of these tests are
             out-of-range, the tests can be repeated once.

          5. Any clinically significant abnormal findings in vital signs at the Screening Visit
             and/or admission to the Clinical Unit, including, but not limited to, any of the
             following:

        (1) Heart rate (resting, supine) < 50 beats per minute (bpm) or > 85 bpm, (2) Systolic BP <
        90 mmHg or > 140 mmHg and/or diastolic BP < 50 mmHg or > 90 mmHg sustained for > 10 min
        while resting in a supine position.

        6. Any clinically significant abnormalities on 12-lead Electrocardiogram (ECG) at the
        Screening Visit, including, but not limited to any of the following:

          1. ECG interval measured from the onset of the QRS complex to the end of the T wave (QT)
             interval corrected for heart rate using Fridericia's formula (QTcF) > 450 ms or < 340
             ms or family history of long QT syndrome,

          2. Any significant arrhythmia,

          3. Conduction abnormalities:

          4. Clinically significant PR (PQ) interval prolongation (> 240 ms); intermittent second
             or third degree atrioventricular (AV) block, or AV dissociation,

          5. Complete bundle branch block and/or QRS duration > 120 ms. 7. Any positive result at
             the Screening Visit for serum hepatitis B surface antigen or antiHBc antibody,
             hepatitis C antibody, and human immunodeficiency virus (HIV) antibody.

        8. Suspicion or known Gilbert's and/or Lesch-Nyhan syndrome. 9. Known or suspected history
        of alcohol or drug abuse or excessive intake of alcohol as judged by the PI. Excessive
        intake of alcohol defined as the regular consumption of more than 24 g of alcohol per day
        for men or 12 g of alcohol per day for women.

        10. Has received another new chemical entity (defined as a compound which has not been
        approved for marketing in the US) within 30 days or at least 5 half-lives (whichever is
        longer) of the first administration of verinurad in this study.

        11. Participants who have previously received verinurad. 12. Plasma donation within 1 month
        of screening or any blood donation/loss of more than 500 mL during the 3 months prior to
        the Screening Visit.

        13. Participants who are pregnant, lactating or planning to become pregnant. 14. History of
        severe allergy/hypersensitivity or ongoing clinically relevant allergy/hypersensitivity, as
        judged by the PI or history of hypersensitivity to drugs with a similar chemical structure
        or class to verinurad.

        15. Current smokers or those who have smoked or used nicotine products (including
        e-cigarettes) within the 3 months prior to screening.

        16. Excessive intake of caffeine-containing drinks or food (e.g., coffee, tea, chocolate)
        as judged by the PI. Excessive intake of caffeine defined as regular consumption of more
        than 600 mg of caffeine per day (e.g., > 5 cups of coffee) or would likely be unable to
        refrain from the use of caffeine containing beverages during confinement at the
        investigational site.

        17. Positive screen for drugs of abuse or cotinine (nicotine) at the Screening Visit or
        positive screen for alcohol, drugs of abuse and cotinine on each admission to the study
        centre.

        18. Use of drugs with enzyme-inducing properties such as St John's Wort within 3 weeks
        prior to the first administration of verinurad.

        19. Use of any prescribed or non-prescribed medication including antacids, analgesics
        (other than paracetamol/acetaminophen), herbal remedies, megadose vitamins (intake of 20 to
        600 times the recommended daily dose) and minerals during the 2 weeks prior to the first
        administration of verinurad or longer if the medication has a long half-life. The use of
        hormonal contraception therapy and hormonal replacement therapy for females are permitted.

        20. Any AstraZeneca, PAREXEL or study site employee or their close relatives. 21.
        Participants who cannot communicate reliably with the PI and/or is not able to read, speak
        and understand the German language.

        22. Judgment by the PI that the participant should not participate in the study if they
        have any ongoing or recent (i.e., during the screening period) minor medical complaints
        that may interfere with the interpretation of study data or are considered unlikely to
        comply with study procedures, restrictions, and requirements.

        23. Vulnerable participants, e.g., kept in detention, protected adults under guardianship,
        trusteeship, or committed to an institution by governmental or juridical order.

        24. Participants with any special dietary restrictions such as participants that are
        lactose intolerant or are vegetarians/vegans.