Phase I Open-label Study to Evaluate Pharmacokinetics of TAK-272 in Participants With Renal or Hepatic Impairment
Condition: Renal Impairment; Hepatic Impairment
MeSH terms: Liver Diseases; Renal Insufficiency
Intervention: TAK-272
Intervention description: TAK-272 tablet
Intervention MeSH terms: Imarikiren hydrochloride
Phase: Phase 1
Study type: Interventional
Primary purpose: Treatment
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Enrollment: 48.0
Sex: All
Minimum age: 20 Years
Maximum age: 85 Years
Healthy volunteers: No
Keywords: Drug therapy

Summary:

      The purpose of this study is to examine the effects of renal and hepatic impairment on
      TAK-272 pharmacokinetics with a single oral administration of TAK-272 in participants with
      renal or hepatic impairment.
    

Eligibility criteria:

        Inclusion Criteria:

        All participants

          1. In the opinion of the investigator or subinvestigator, the participant is capable of
             understanding and complying with protocol requirements.

          2. Signs and dates a written, informed consent form prior to the initiation of any study
             procedures.

          3. Is either male or female and aged 20 to 85 years, inclusive, at the time of informed
             consent.

          4. Weighs at least 45 kilogram (kg) for males and 40 kg for females and have a body mass
             index (BMI) of less than (<) 35.0 kilogram per square meter (kg/m^2) at screening and
             Day 1.

          5. A male participant who is nonsterilized and sexually active with a female partner of
             childbearing potential agrees to use adequate contraception from signing of informed
             consent until 12 weeks after study drug administration.

          6. A female participant of childbearing potential who is sexually active with a
             nonsterilized male partner agrees to routinely use adequate contraception from signing
             of informed consent until 1 month after the completion of the study.

             Participants with normal renal or hepatic function (Cohorts 1R and 1H)

          7. Estimated glomerular filtration rate (eGFR) is greater than or equal to (>=) 90
             milliliter per minute per 1.73 square meter (mL/min/1.73 m^2) at screening.

          8. Based on the participant's medical history, clinical laboratory values, and physical
             examination findings, the investigator or subinvestigator judges the participant to be
             in good health (hypertension, type 2 diabetes, and hypercholesteremia or dyslipidemia
             are controlled, if present).

          9. Is within +/-10 years of the mean age and +/-20 percent (%) of the mean weight for the
             24 participants with renal impairment and 12 participants with hepatic impairment
             administered the study drug.

             Participants with renal impairment (Cohorts 2R, 3R, 4R, 5R)

         10. Falls into any of the following categories:

               -  With mild renal impairment (Cohort 2R): eGFR >=60 mL/min/1.73 m^2 and <90
                  mL/min/1.73 m^2 at screening.

               -  With moderate renal impairment (Cohort 3R): eGFR >=30 mL/min/1.73 m^2 and <60
                  mL/min/1.73 m^2 at screening.

               -  With severe renal impairment or end-stage renal failure (non-hemodialysis
                  participants) (Cohort 4R): eGFR <30 mL/min/1.73 m^2 at screening.

               -  Hemodialysis participants (Cohort 5R): with end-stage renal failure and little or
                  no urine output who are undergoing hemodialysis 3 times weekly.

         11. For non-hemodialysis participants, difference in eGFR obtained between 3 months and 7
             days before screening from eGFR at screening is less than or equal to (<=) 30%.

             Participants with hepatic impairment (Cohorts 2H, 3H)

         12. In observations during the screening period, those diagnosed with hepatic impairment
             corresponding to any of the following Child-Pugh classes:

               -  With mild hepatic impairment (Cohort 2H): Child-Pugh class A.

               -  With moderate hepatic impairment (Cohort 3H): Child-Pugh class B.

         13. Is diagnosed by the investigator or subinvestigator with hepatic impairment that has
             remained stable during the 3 months before screening.

        Exclusion Criteria:

        All participants

          1. Has received any investigational product within 16 weeks (112 days) prior to the start
             of study drug administration.

          2. Has received TAK-272 in a previous clinical study.

          3. Is an immediate family member, study site employee, or in a dependent relationship
             with a study site employee who is involved in the conduct of this study (example,
             spouse, parent, child, sibling) or may consent under duress.

          4. Has a history of cancer. This does not include individuals who have been in remission
             for at least 1 year prior to the start of screening and who are judged by the
             investigator or subinvestigator to have had no recurrence during the study.

          5. Has a known hypersensitivity or allergy to any component of the TAK-272 formulation or
             renin inhibitors.

          6. Has a history of drug abuse (defined as any illicit drug use) or a history of alcohol
             abuse within 1 year prior to the screening visit or is unwilling to agree to abstain
             from alcohol and drugs throughout the study.

          7. Has any positive urine drug test result at screening (including test for alcohol) if a
             non-hemodialysis participant.

          8. Has taken any excluded medication or food product listed in the Excluded Medications
             and Dietary Products section during the period in which excluded medication use is
             prohibited, or needs to take any excluded medication or food product during the study.

          9. Previously has undergone kidney or liver transplantation.

         10. Has poor peripheral venous access.

         11. Has undergone whole blood collection of 800 milliliter (mL) or more within 52 weeks
             (364 days) prior to the start of study drug administration.

         12. Has undergone whole blood collection of 200 mL or more within 4 weeks (28 days) or 400
             mL or more within 12 weeks (84 days) for males and 16 weeks (112 days) for females
             prior to the start of study drug administration.

         13. Has undergone blood component collection within 2 weeks (14 days) prior to the start
             of study drug administration.

         14. Has onset of myocardial infarction or coronary revascularization within 6 months
             before screening.

         15. Has a history of abdominal surgery (excluding laparoscopic cholecystectomy or
             appendectomy without complications) or chest or non-peripheral vascular surgery within
             6 months before screening.

         16. Has onset of acute disease (example, renal and urinary tract disease) within 30 days
             before screening.

         17. Has clinically significant abnormal electrocardiogram (ECG) in the screening period or
             the pretreatment examination.

         18. Has clinically significant hyperkalemia.

         19. If female, the participant is pregnant or lactating or intending to become pregnant
             before, during or within 1 month after participating in this study, or intending to
             donate ova during such time period.

         20. If male, the participant intends to donate sperm during the course of this study or
             for 12 weeks thereafter.

         21. In the opinion of the investigator or subinvestigator, is unlikely to comply with
             protocol or is unsuitable for any other reason.

             Participants with normal renal and hepatic function (Cohorts 1R and 1H)

         22. Has uncontrolled, clinically significant hepatic, renal, neurologic, cardiovascular,
             blood, pulmonary, metabolic, gastrointestinal, urologic or endocrine disease, immune
             disease, infection or other abnormality, which may impact the ability of the
             participant to participate or potentially confound the study results.

         23. Has clinical laboratory results at screening suggestive of a clinically significant
             underlying disease other than controlled hypertension, type 2 diabetes,
             hypercholesteremia, or dyslipidemia.

         24. Systolic blood pressure is <80 millimeter of mercury (mmHg) at screening, in the
             pretreatment examination, or in the examination prior to the start of study drug
             administration and has repeated instances of the findings listed below, suggesting the
             presence of hypotension:

             - Dizziness postural, facial pallor, cold sweats.

         25. Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) is >2.0 times
             higher than the upper limit of normal at screening.

         26. Has a positive test result for hepatitis B surface antigen (HBsAg), hepatitis C virus
             (HCV) antibody, human immunodeficiency virus (HIV) antigen/antibody, or serological
             reactions for syphilis at screening.

             Participants with renal impairment (Cohorts 2R, 3R, 4R, 5R)

         27. Has uncontrolled, clinically significant hepatic, neurologic, cardiovascular, blood,
             pulmonary, metabolic, gastrointestinal, urologic or endocrine disease, immune disease,
             infection or other abnormality, which may impact the ability of the participant to
             participate or potentially confound the study results.

         28. Sitting systolic blood pressure is <110 mmHg at screening, in the pretreatment
             examination, or in the examination before administration on Day 1.

         29. ALT or AST is >2.0 times higher than the upper limit of normal at screening.

         30. Has a positive test result for HBsAg, HCV antibody, HIV antigen/antibody, or
             serological reactions for syphilis at screening.

             Participants with hepatic impairment (Cohorts 2H, 3H)

         31. Has uncontrolled, clinically significant renal, neurologic, cardiovascular, blood,
             pulmonary, metabolic, gastrointestinal, urologic or endocrine disease, immune disease,
             infection or other abnormality, which may impact the ability of the participant to
             participate or potentially confound the study results.

         32. Has ascites requiring invasive treatment.

         33. Systolic blood pressure is <80 mmHg at screening, in the pretreatment examination, or
             in the examination prior to the start of study drug administration and has repeated
             instances of the findings listed below, suggesting the presence of hypotension:

             - Dizziness postural, facial pallor, cold sweats.

         34. eGFR is <60 mL/min/1.73 m^2 at screening.

         35. Has a positive test result for HIV antigen/antibody or the participant has a positive
             test result for serological reactions for syphilis and syphilis is judged not to have
             been cured at screening.