Clinical trial NCT01796938: Study to Evaluate the Pharmacokinetics, Safety, Tolerability of Single Dose Lacosamide in Subjects With Renal Impairment Compared to Healthy Subjects
Official title: Open, Non-randomized, Sequential Group Comparison to Investigate the Pharmacokinetics, Safety, and Tolerability of 100 mg SPM 927 in Male and Female Subjects With Renal Impairment Including Subjects Requiring Dialysis Compared With Male and Female Healthy Subjects Following Single-dose Administration
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
Conditions: Healthy
Renal Impairment
Keywords: Lacosamide
Vimpat
Single Dose
Pharmacokinetics
Renal Impairment
Lead sponsor: UCB Pharma
Sponsor class: INDUSTRY
First posted: 2013-02-22
Enrollment: 40
Sex: ALL
Minimum age (years): 18
Maximum age (years): 70
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Allocation: NON_RANDOMIZED
Intervention model: PARALLEL

Brief summary: To investigate the Pharmacokinetics (PK) of oral administered Lacosamide in renal impaired subjects and healthy subjects.


Eligibility criteria: Inclusion Criteria:

* Subject was informed and given ample time and opportunity to think about his/her participation and had given his/her written informed consent
* Subject was willing and able to comply with all trial requirements
* Subject was a male or female Caucasian, between 18 and 70 years of age (inclusive)
* If female, subject was of non-childbearing potential (post-menopausal or hysterectomized) or was using medically adequate contraception
* If female of childbearing potential, subject had a negative pregnancy test
* Subject had a Body Mass Index (BMI) between 20 and 34 kg/m2 (inclusive)
* Subject was healthy without clinically relevant cardiovascular, renal, gastrointestinal, hepatic, metabolic, endocrine, neurological, or psychiatric abnormalities detected during Eligibility Assessment (EA)

Subjects with renal impairment also had to fulfill the following inclusion criteria:

* Subject had no clinically relevant cardiovascular or endocrine findings during EA
* Subject had a renal impairment. The subjects were assigned to 1 of the following treatment groups according to Creatinine Clearance (CLCr) values determined 2 to 7 days prior to dosing:
* Group 2: 80 mL/min \> CLCr ≥ 50 mL/min (subjects with mild renal impairment)
* Group 3: 50 mL/min \> CLCr ≥ 30 mL/min (subjects with moderate renal impairment)
* Group 4: CLCr \< 30 mL/min (subjects with severe renal impairment, not on dialysis between 2 weeks before EA and end of the trial)

Inclusion criteria for Group 5:

* Subject was informed and given ample time and opportunity to think about his/her participation and had given his/her written informed consent
* Subject was willing and able to comply with all trial requirements
* Subject was a male or female Caucasian, between 18 and 70 years of age (inclusive)
* If female, subject was of non-childbearing potential (post-menopausal or hysterectomized) or was using medically adequate contraception
* If female of childbearing potential, subject had a negative pregnancy test
* Subject had a BMI between 20 and 34 kg/m2 (inclusive)
* Subject had no clinically relevant cardiovascular or endocrine findings during EA
* Subject had an endstage renal disease (CLCr \< 15 mL/min, determined approximately 2 to 7 days before first dosing) treated with extracorporal hemodialysis for at least 4 months

Exclusion Criteria:

Healthy subjects:

* Subject had previously participated in this trial
* Subject had participated in another trial of an investigational product within the last 3 months or was currently participating in another trial of an investigational product
* Subject had donated blood or had a comparable blood loss (\> 500 mL) within the last 3 months prior to EA
* Subject smoked more than 5 cigarettes per day or had done so within the 6 months prior to commencement of this trial
* Subject had a history of chronic alcohol or drug abuse within the last 6 months prior to commencement of this trial
* Subject consumed more than 40 g of alcohol/day (amount corresponds to 1 L beer/day or 0.5 L wine/day or 120 mL liquor/day)
* Subject had positive tests for alcohol (urine or breath test) or drugs (urine test)
* Subject had clinically relevant changes in the electrocardiogram (ECG), such as second- or third-degree atrioventricular (AV) block, prolongation of the QRS complex over 120 ms or of the corrected QT (QTc) interval \> 430 ms (male subjects) or \> 450 ms (female subjects)
* Subject had a history or present condition of clinically relevant respiratory or cardiovascular disorders, eg, cardiac insufficiency, coronary heart disease, hypertension, arrhythmia, tachyarrhythmia, or status after myocardial infarction
* Subject had a history or present condition of psychic abnormality, psychiatric or neurologic illness, or autonomic neuropathy that, in the opinion of the Investigator, could have jeopardized or would have compromised the subject's ability to participate in the trial
* Subject had a history or present condition of seizure disorder
* Subject had a history or present condition of malignancy
* Subject had a history or present condition of renal disorders (albuminuria, chronic infections) or renal impairment
* Subject had a history or present condition of Diabetes Mellitus or thyroid dysfunction, especially Hyperthyreosis, or other endocrine disorders
* Subject had a clinically relevant allergy
* Subject had a known or suspected drug hypersensitivity, in particular to the trial medication
* Subject was taking any concomitant medication currently or within 2 weeks prior to the first day of dosing (with the exception of oral contraceptives and Paracetamol \[maximum allowed dose: 1000 mg/dose\], which were allowed up to 48 hours prior to dosing); further exceptions could be made if the Investigator and the sponsor jointly considered the medication as acceptable
* Subject was tested positive for human immunodeficiency virus 1/2 antibodies (HIV-1/2-Ab), hepatitis B surface antigen (HBs-Ag), or hepatitis C virus antibody (HCV-Ab)
* Subject had any clinically relevant abnormality in the physical examination or in vital sign measurements (systolic blood pressure \> 150 mmHg or \< 100 mmHg, diastolic blood pressure \> 95 mmHg or \< 60 mmHg, pulse rate \> 100 beats per minute (bpm) or \< 50 bpm)
* Subject had a clinically relevant deviation from the norm in the clinical chemistry, hematology, or urinalysis evaluations

Exclusion criteria for Groups 2-4:

* Exclusion criteria 1 to 12 for healthy subjects also applied to subjects with renal impairment
* Subject had a clinically relevant allergy
* Subject had a known or suspected drug hypersensitivity, in particular to the trial medication
* Subject was taking any concomitant medication currently or within 2 weeks prior to dosing that could have interfered with the investigational product
* Subject was tested positive for HIV-1/2-Ab, HBs-Ag, or HCV-Ab
* Subject had any clinically relevant abnormality in the physical examination or in vital sign measurements (systolic blood pressure \> 180 mmHg or \< 100 mmHg, diastolic blood pressure \> 110 mmHg, pulse rate \> 100 bpm or \< 60 bpm)
* Subject had a clinically relevant deviation from the norm in the clinical chemistry, hematology or urinalysis evaluations other than expected for a subject with renal impairment, eg, hemoglobin \< 8.0 g/dL

Exclusion criteria for Group 5:

* Exclusion criteria 1 to 12 for healthy subjects also applied to subjects in Group 5
* Subject had a clinically relevant allergy
* Subject had a known or suspected drug hypersensitivity, in particular to the trial medication
* Subject was tested positive for HIV-1/2-Ab, HBs-Ag, or HCV-Ab
* Subject was taking any concomitant medication that might interfere with the investigational product currently or within 2 weeks prior to dosing
* Subject had any clinically relevant abnormality in the physical examination or in vital sign measurements (systolic blood pressure \> 200 mmHg \[predialysis value\] or \< 100 mmHg, diastolic blood pressure \> 110 mmHg, pulse rate \> 100 bpm or \< 60 bpm)
* Subject had a clinically relevant deviation from the norm in the clinical chemistry, hematology, or urinalysis evaluations other than expected for a patient with renal impairment, eg, hemoglobin \< 8.0 g/dL

Primary outcomes:
measure: Area under the Lacosamide plasma concentration time curve from 0 to the last quantifiable data point (AUC(0-tz))
timeFrame: Day 1 to Day 5 of study
measure: Measured maximal concentration (Cmax) of Lacosamide
timeFrame: Day 1 to Day 5 of study
measure: Area under the Lacosamide plasma concentration-time curve from 0 to the last quantifiable data point (AUC (0-tz)), normalized by body weight
timeFrame: Day 1 to Day 5 of study
measure: Measured maximal concentration (Cmax, norm) of Lacosamide normalized by body weight
timeFrame: Day 1 to Day 5 of study
Secondary outcomes:
measure: Time of observed maximum (tmax) of Lacosamide concentration
timeFrame: Day 1 to Day 5 of study
measure: Time of observed maximum (tmax) of Lacosamide metabolite (SPM12809) concentration
timeFrame: Day 1 to Day 5 of study
measure: Terminal half-life (t1/2) of Lacosamide
timeFrame: Day 1 to Day 5 of study
measure: Terminal half-life (t1/2) of Lacosamide metabolite (SPM12809)
timeFrame: Day 1 to Day 5 of study
measure: Apparent total clearance (CL/f) of Lacosamide from plasma
timeFrame: Day 1 to Day 5 of study
measure: Area under the lacosamide metabolite (SPM12809) plasma concentration-time curve from 0 to the last quantifiable data point (AUC(0-tz))
timeFrame: Day 1 to Day 5 of study
measure: Amount of Lacosamide excreted in urine from 0 to defined time point (Ae(0-48)) (t=48 hours)
timeFrame: Day 1 to Day 3 of study
measure: Amount of Lacosamide metabolite (SPM12809) excreted in urine from 0 to defined time point (Ae(0-48)) (t=48 hours)
timeFrame: Day 1 to Day 3 of study
measure: Measured maximal concentration (Cmax) of Lacosamide metabolite (SPM12809)
timeFrame: Day 1 to Day 5 of study
measure: Area under the Lacosamide metabolite (SPM12809) plasma concentration time curve from 0 to the last quantifiable data point (AUC(0-tz)), normalized by body weight
timeFrame: Day 1 to Day 5 of study
measure: Measured maximal Lacosamide metabolite (SPM12809) concentration (Cmax,norm), normalized by body weight
timeFrame: Day 1 to Day 5 of study
measure: Terminal half-life (t1/2) of Lacosamide in urine
timeFrame: Day 1 to Day 3 of study
measure: Lacosamide concentration in dialysis inlet line (Cin)
timeFrame: From 4 hours up to 6 hours postdose
measure: Lacosamide metabolite (SPM12809) concentration in dialysis inlet line (Cin)
timeFrame: From 4 hours up to 6 hours postdose
measure: Lacosamide concentration in dialysis outlet line (Cout)
timeFrame: From 4 hours up to 6 hours postdose
measure: Lacosamide metabolite (SPM12809) concentration in dialysis outlet line (Cout)
timeFrame: From 4 hours up to 6 hours postdose
measure: Extraction rate (E) of Lacosamide
timeFrame: From 4 hours up to 6 hours postdose
measure: Extraction rate (E) of Lacosamide metabolite (SPM12809)
timeFrame: From 4 hours up to 6 hours postdose
measure: Dialysis clearance (CLdial) of Lacosamide
timeFrame: From 4 hours up to 6 hours postdose
measure: Dialysis clearance (CLdial) of Lacosamide metabolite (SPM12809)
timeFrame: From 4 hours up to 6 hours postdose
measure: Rate constant of Lacosamide elimination
timeFrame: Day 1 to Day 5 of study
measure: Rate constant of Lacosamide metabolite (SPM12809) elimination
timeFrame: Day 1 to Day 5 of study
Other outcomes:
Locations:
city: Cologne
country: Germany
facility: 1
city: Rendsburg
country: Germany
facility: 2
Study officials:
affiliation: +1 877 822 9493 (UCB)
name: UCB Clinical Trial Call Center
role: STUDY_DIRECTOR
References:
citation: Cawello W, Fuhr U, Hering U, Maatouk H, Halabi A. Impact of impaired renal function on the pharmacokinetics of the antiepileptic drug lacosamide. Clin Pharmacokinet. 2013 Oct;52(10):897-906. doi: 10.1007/s40262-013-0080-7.