A Study in Healthy Adult Male Participants to Learn the Way Vericiguat is Absorbed With and Without Food When Taken as a Single Dose in Liquid Form Suitable for Children Compared to a 10 Milligram (mg) Tablet That Releases the Active Substance Immediately

Study Overview
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Brief Summary
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Researchers are looking for a better way to treat heart failure, a condition in which the heart does not pump blood as well as it should. Heart failure can happen in both adults and children. The study treatment, vericiguat, is already available for doctors to give to adults who have heart failure. It works by increasing the activity of an enzyme called soluble guanylate cyclase (sGC). The sGC enzyme helps regulate the heart and blood circulation. The current form of vericiguat is a tablet that releases the active substance immediately. The active substance is the part of the drug that works in the body to treat the condition. Vericiguat is currently only available as a treatment for adults. Researchers think vericiguat could help treat children with heart failure, but think it will be easiest for them to take a liquid treatment. Another study is planned to find out how well vericiguat works in children who have a specific type of heart failure. Before researchers can give vericiguat to children, they must first study different doses and ways of taking vericiguat in adults. In this study, the researchers will study a new liquid form of vericiguat in adults. This form is also known as the pediatric formulation. In this study, the researchers want to find out how the new pediatric formulation of vericiguat moves into, through, and out of the body compared to the currently approved tablet form for adults. The researchers also want to find out if eating food affects the new pediatric formulation differently than the current tablet form of vericiguat. The study will include about 36 healthy white male participants aged between 18 and 45 years old. During this study, the participants will all take 4 different treatments in different orders. They will take: a high dose of vericiguat in the new pediatric formulation, with food a high dose of vericiguat in the new pediatric formulation, without food a low dose of vericiguat in the new pediatric formulation, with food a dose of the currently available tablet form, with food While taking each study treatment, the participants will stay at the study site for 4 days. There will be a break of at least 10 days between each treatment. Overall, the participants will be in this study for about 11 weeks. During the study, the participants will: have blood and urine samples taken have their overall health and heart health checked answer questions about how the new pediatric formulation tastes answer questions about any adverse events they are having An adverse event is any medical problem that a participant has during a study. Doctors keep track of all adverse events that happen in studies, even if they do not think the adverse events might be related to the study treatments.

Official Title
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Pivotal Relative Bioavailability Study to Investigate the Pharmacokinetics and Food Effect of Single Oral Doses of Vericiguat Given as Pediatric Oral Suspension Formulations in Comparison to the 10 mg IR Tablet in Healthy Male Participants in a Randomized, Open-label, 4-fold Crossover Design

Conditions
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Heart Failure, Children

Intervention / Treatment
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* Drug: Vericiguat (BAY1021189) - Intervention A
* Drug: Vericiguat (BAY1021189) - Intervention B
* Drug: Vericiguat (BAY1021189) - Intervention C
* Drug: Vericiguat (Verquvo, BAY1021189) - Intervention D


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Healthy male subjects Age 18 -45 years Body Mass Index (BMI): above or equal 18.5 and below or equal 29.9 kg / m² Exclusion Criteria: Incompletely cured pre-existing diseases for which it can be assumed that the absorption, distribution, metabolism, elimination and effects of the study drugs will not be normal Febrile illness (temperature ≥38.0 oC) within 4 weeks prior to admission to the ward A history of relevant diseases of vital organs, of the central nervous system or other organs A history of relevant smell and / or taste disorders Relevant diseases within the last 4 weeks prior to the first study intervention administration Known gastro-intestinal disorders (e.g. stomach ulcers, duodenal ulcers, gastro-intestinal bleeding) or inflammatory bowel disease (e.g. Crohn's disease, ulcerative colitis) Regular use of medicines in the 4 weeks prior to first dosing Regular use of therapeutic or recreational drugs (e.g. carnitine products, anabolics, high-dose vitamins) Use of medication (prescription or over the counter) or herbal products within 2 weeks before first study intervention administration which could oppose the study objectives or which might influence them Criteria which in the opinion of the investigator preclude participation for scientific reasons, for reasons of compliance, or for reasons of the participant's safety

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 45 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: B-A-D-C<br>4-fold crossover design with 4 interventions, 4 intervention periods, and 4 intervention sequences. (according to Williams design [balanced for 1-period-carry-over]). | Drug: Vericiguat (BAY1021189) - Intervention A<br>* Single dose of 10 mg vericiguat high-concentration pediatric formulation (oral liquid formulation) in fed state.<br>Drug: Vericiguat (BAY1021189) - Intervention B<br>* Single dose of 10 mg vericiguat high-concentration pediatric formulation (oral liquid formulation) in fasted state.<br>Drug: Vericiguat (BAY1021189) - Intervention C<br>* Single dose of 2.5 mg vericiguat low-concentration pediatric formulation (oral liquid formulation) in fed state.<br>Drug: Vericiguat (Verquvo, BAY1021189) - Intervention D<br>* Single dose of 10 mg vericiguat immediate release (IR) intact tablet in fed state.<br>|
| Experimental: C-D-A-B<br>4-fold crossover design with 4 interventions, 4 intervention periods, and 4 intervention sequences. (according to Williams design [balanced for 1-period-carry-over]). | Drug: Vericiguat (BAY1021189) - Intervention A<br>* Single dose of 10 mg vericiguat high-concentration pediatric formulation (oral liquid formulation) in fed state.<br>Drug: Vericiguat (BAY1021189) - Intervention B<br>* Single dose of 10 mg vericiguat high-concentration pediatric formulation (oral liquid formulation) in fasted state.<br>Drug: Vericiguat (BAY1021189) - Intervention C<br>* Single dose of 2.5 mg vericiguat low-concentration pediatric formulation (oral liquid formulation) in fed state.<br>Drug: Vericiguat (Verquvo, BAY1021189) - Intervention D<br>* Single dose of 10 mg vericiguat immediate release (IR) intact tablet in fed state.<br>|
| Experimental: D-B-C-A<br>4-fold crossover design with 4 interventions, 4 intervention periods, and 4 intervention sequences. (according to Williams design [balanced for 1-period-carry-over]). | Drug: Vericiguat (BAY1021189) - Intervention A<br>* Single dose of 10 mg vericiguat high-concentration pediatric formulation (oral liquid formulation) in fed state.<br>Drug: Vericiguat (BAY1021189) - Intervention B<br>* Single dose of 10 mg vericiguat high-concentration pediatric formulation (oral liquid formulation) in fasted state.<br>Drug: Vericiguat (BAY1021189) - Intervention C<br>* Single dose of 2.5 mg vericiguat low-concentration pediatric formulation (oral liquid formulation) in fed state.<br>Drug: Vericiguat (Verquvo, BAY1021189) - Intervention D<br>* Single dose of 10 mg vericiguat immediate release (IR) intact tablet in fed state.<br>|
| Experimental: A-C-B-D<br>4-fold crossover design with 4 interventions, 4 intervention periods, and 4 intervention sequences. (according to Williams design [balanced for 1-period-carry-over]). | Drug: Vericiguat (BAY1021189) - Intervention A<br>* Single dose of 10 mg vericiguat high-concentration pediatric formulation (oral liquid formulation) in fed state.<br>Drug: Vericiguat (BAY1021189) - Intervention B<br>* Single dose of 10 mg vericiguat high-concentration pediatric formulation (oral liquid formulation) in fasted state.<br>Drug: Vericiguat (BAY1021189) - Intervention C<br>* Single dose of 2.5 mg vericiguat low-concentration pediatric formulation (oral liquid formulation) in fed state.<br>Drug: Vericiguat (Verquvo, BAY1021189) - Intervention D<br>* Single dose of 10 mg vericiguat immediate release (IR) intact tablet in fed state.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| AUC of vericiguat (a single oral dose of the pediatric high concentration formulation in comparison to vericiguat intact tablet in fed condition) | AUC: area under the concentration vs. time curve from zero to infinity after single (first) dose, calculated up by linear trapezoidal rule, down by logarithmic trapezoidal rule | From pre-dose until 72 hours after dosing in each intervention period | 
| AUC(0-tlast) of vericiguat (a single oral dose of the pediatric high concentration formulation in comparison to vericiguat intact tablet in fed condition) | AUC(0-tlast): AUC from time 0 to the last data point > lower limit of quantitation (LLOQ) | From pre-dose until 72 hours after dosing in each intervention period | 
| Cmax of vericiguat (a single oral dose of the pediatric high concentration formulation in comparison to vericiguat intact tablet in fed condition) | Cmax: maximum observed drug concentration in measured matrix after single dose administration | From pre-dose until 72 hours after dosing in each intervention period | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| AUC/D of vericiguat ( a single oral dose of 2.5 mg of the pediatric low-concentration formulation in comparison to 10 mg vericiguat intact tablet in fed condition) | AUC/D: AUC divided by dose | From pre-dose until 72 hours after dosing in each intervention period | 
| AUC(0-tlast)/D of vericiguat ( a single oral dose of 2.5 mg of the pediatric low-concentration formulation in comparison to 10 mg vericiguat intact tablet in fed condition) | AUC(0-tlast)/D: AUC from time 0 to the last data point divided by dose | From pre-dose until 72 hours after dosing in each intervention period | 
| Cmax/D of vericiguat ( a single oral dose of 2.5 mg of the pediatric low-concentration formulation in comparison to 10 mg vericiguat intact tablet in fed condition) | Cmax/D: Cmax divided by dose | From pre-dose until 72 hours after dosing in each intervention period | 
| AUC/D of vericiguat (a single oral dose of 10 mg of the pediatric high-concentration formulation in comparison to a single oral dose of 2.5 mg of the pediatric low-concentration formulation in fed condition) |  | From pre-dose until 72 hours after dosing in each intervention period | 
| AUC(0-tlast)/D of vericiguat (a single oral dose of 10 mg of the pediatric high-concentration formulation in comparison to a single oral dose of 2.5 mg of the pediatric low-concentration formulation in fed condition) |  | From pre-dose until 72 hours after dosing in each intervention period | 
| Cmax/D of vericiguat (a single oral dose of 10 mg of the pediatric high-concentration formulation in comparison to a single oral dose of 2.5 mg of the pediatric low-concentration formulation in fed condition) |  | From pre-dose until 72 hours after dosing in each intervention period | 
| Number of participants with treatment emergent adverse events (TEAEs) |  | From dosing to 5 days after each dose per period (estimate duration is 20 days) | 
| Questionnaire by means of descriptive statistics | Questionnaire to assess the taste, smell, and appearance of the newly developed pediatric formulation of vericiguat. | 0 - 30 minutes | 
| AUC of vericiguat (a high fat, high calorie meal on the PK of vericiguat after a single oral dose of high-concentration pediatric formulation in comparison to the fasted state) |  | From pre-dose until 72 hours after dosing in each intervention period | 
| AUC(0-tlast) of vericiguat (a high fat, high calorie meal on the PK of vericiguat after a single oral dose of high-concentration pediatric formulation in comparison to the fasted state) |  | From pre-dose until 72 hours after dosing in each intervention period | 
| Cmax of vericiguat (a high fat, high calorie meal on the PK of vericiguat after a single oral dose of high-concentration pediatric formulation in comparison to the fasted state) |  | From pre-dose until 72 hours after dosing in each intervention period |