Clinical trial NCT04199598: Relative Bioavailability Study With Abediterol Administered Via Three Different Inhalation Devices in Healthy Volunteers.
Official title: An Open-label, Single-center, Randomized, 4-period, Single Dose, Crossover Study to Assess the Relative Bioavailability of Abediterol Inhaled Via Two Different Nebulizers and Via Dry Powder Inhaler in Healthy Subjects.
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE1
Conditions: Chronic Obstructive Pulmonary Disease
Keywords: Open-label
Long-acting beta-2 agonist
COPD
Bioavailability
Phase 1
Abediterol
Healthy subjects
Crossover
Lead sponsor: AstraZeneca
Sponsor class: INDUSTRY
Collaborators: name: Parexel
First posted: 2019-12-16
Enrollment: 25
Sex: MALE
Minimum age (years): 18
Maximum age (years): 45
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: CROSSOVER
Primary purpose: BASIC_SCIENCE

Brief summary: The study is intended to assess the relative bioavailability of 2 different abediterol nebulised formulations (test) and the dry powder formulation (reference). The study results will provide information on the pharmacokinetic (PK) profile following use of the 3 devices to be used in further clinical development.

Detailed description: This study will be an open-label, randomized, 4-period, single-dose, single-center, crossover study with a William's design in healthy subjects (males).

The study will comprise:

1. A screening period of maximum 28 days;
2. Four treatment periods during which subjects will be resident prior to the evening meal the night before dosing with abediterol (Day -1) until at least 48 hours following dosing for collection of PK samples; discharged on the morning of Day 3; and
3. A final safety post-treatment visit within 14 days after the last administration of abediterol.

There will be a minimum washout period of 14 days between each treatment period.

Each subject will be involved in the study for approximately 12 weeks.

Eligibility criteria: Inclusion Criteria:

1. Provision of signed and dated, written informed consent prior to any study-specific procedures.
2. Healthy male subjects aged 18 - 45 years, inclusive, with suitable veins for cannulation or repeated venipuncture.
3. Have a body mass index (BMI) between 18 and 29.9 kg/m2 inclusive and weigh at least 50 kg and no more than 100 kg inclusive.
4. Subject is able to understand and communicate in German.
5. Willing and able to comply with all required study procedures.

Exclusion Criteria:

1. History of any clinically significant disease or disorder which, in the opinion of the 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. History or presence of gastrointestinal (GI), hepatic or renal disease, or any other conditions (e.g., including Gilbert's syndrome, gallstone and cholecystectomy) known to interfere with absorption, distribution, metabolism, or excretion of drugs.
3. History of tuberculosis, any other significant lung diseases like surgeries, asthma, COPD.
4. Upper respiratory tract infections within 14 days of the first study day, or lower respiratory tract infection within 3 months prior to screening.
5. Any clinically significant illness, medical/surgical procedure, or trauma within

4 weeks of the first administration of IMP. 6 Any clinically significant abnormalities in clinical chemistry, hematology, or urinalysis results, at screening and first admission to the study unit (first treatment period) as judged by the PI. 7 Any clinically significant abnormal findings in vital signs at screening and first admission to the study unit (first treatment period), as judged by the PI, and defined as:

1. Systolic BP \<90 mmHg or ≥140 mmHg and diastolic BP \<50 mmHg or

   ≥90 mmHg
2. Heart rate \<50 beats per minute \[bpm\] or \>90 bpm Note: Assessments may be repeated once to confirm values. 8 Any clinically significant abnormalities on 12-lead ECG at screening and first admission to the study unit (first treatment period), as judged by the PI, and defined as:

(1) Sick sinus syndrome (2) Arrhythmia (3) Prolonged QT interval corrected using Fridericia's formula (QTcF) \> 450 ms (4) Family history of long QT syndrome, persistent or intermittent bundle branch block (BBB), AV block grade II or III 9 Any positive result on screening for serum hepatitis B surface antigen (HBsAg) OR anti-hepatitis B core antigen (HBc) antibody, hepatitis C antibody, and human immunodeficiency virus (HIV) antibody. 10 Has received another new chemical and biologic entity (defined as a compound which has not been approved for marketing) within 3 months of the first administration of IMP in this study. The period of exclusion begins 3 months after the final dose or one month after the last visit whichever is the longest. Note: subjects consented and screened, but not randomized in this study or a previous phase I study, are not excluded. 11 Plasma donation within 1 month of screening or any blood donation/loss more than 500 mL during the 3 months prior to screening. 12 History of severe allergy/hypersensitivity or ongoing allergy/hypersensitivity, as judged by the PI or history of hypersensitivity to drugs with a similar chemical structure or class to abediterol. 13 Current smokers or those who have smoked or used nicotine products (including e- cigarettes; \> 10 pack-year) within the 3 months prior to screening. 14 Use of drugs with enzyme-inducing properties such as St John's Wort within 3 weeks prior to the first administration of IMP. 15 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 IMP or longer if the medication has a long half-life.

16 Known or suspected history of alcohol or drug abuse or excessive intake of alcohol as judged by the PI or positive screen for drugs of abuse, cotinine, and/or alcohol at screening or on each admission to the Clinical Unit. 17 Subjects with a pregnant partner. 18 Involvement of any AstraZeneca, Parexel or study site employee or their close relatives. 19 Subjects who have previously received abediterol. 20 Judgement by the PI that the subject 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. 21 Vulnerable subjects, e.g., kept in detention, protected adults under guardianship, trusteeship, or committed to an institution by governmental or juridical order.

Primary outcomes:
measure: Geometric mean ratios and 90% confidence intervals for area under plasma (AUC) for test versus abediterol reference treatments
timeFrame: On Day 1: pre-dose, 5 min [only for DPI], 12, 30, and 45 min, and 1, 2, 4, 6, 8, 12 hours post-dose, on Day 2: 24 and 36 hours post-dose, on Day 3: 48 hours post-dose, on Day 4-7: 72, 96, 120 and 144 hours post-dose.
measure: Geometric mean ratios and 90% confidence intervals for area under the plasma concentration-time curve from time zero to time of last quantifiable concentration (AUC[0-t]) for test versus reference abediterol treatments
timeFrame: On Day 1: pre-dose, 5 min [only for DPI], 12, 30, and 45 min, and 1, 2, 4, 6, 8, 12 hours post-dose, on Day 2: 24 and 36 hours post-dose, on Day 3: 48 hours post-dose, on Day 4-7: 72, 96, 120 and 144 hours post-dose.
measure: Geometric mean ratios and 90% confidence intervals for maximum observed plasma concentration (Cmax) the for test versus reference abediterol treatments
timeFrame: On Day 1: pre-dose, 5 min [only for DPI], 12, 30, and 45 min, and 1, 2, 4, 6, 8, 12 hours post-dose, on Day 2: 24 and 36 hours post-dose, on Day 3: 48 hours post-dose, on Day 4-7: 72, 96, 120 and 144 hours post-dose.
Secondary outcomes:
measure: AUC for each abediterol treatment
timeFrame: On Day 1: pre-dose, 5 min [only for DPI], 12, 30, and 45 min, and 1, 2, 4, 6, 8, 12 hours post-dose, on Day 2: 24 and 36 hours post-dose, on Day 3: 48 hours post-dose, on Day 4-7: 72, 96, 120 and 144 hours post-dose.
measure: AUC (0-t) for each abediterol treatment
timeFrame: On Day 1: pre-dose, 5 min [only for DPI], 12, 30, and 45 min, and 1, 2, 4, 6, 8, 12 hours post-dose, on Day 2: 24 and 36 hours post-dose, on Day 3: 48 hours post-dose, on Day 4-7: 72, 96, 120 and 144 hours post-dose.
measure: Cmax for each abediterol treatment
timeFrame: On Day 1: pre-dose, 5 min [only for DPI], 12, 30, and 45 min, and 1, 2, 4, 6, 8, 12 hours post-dose, on Day 2: 24 and 36 hours post-dose, on Day 3: 48 hours post-dose, on Day 4-7: 72, 96, 120 and 144 hours post-dose.
measure: Area under the plasma concentration-time curve from time zero to 24 hours [AUC (0-24)] for each abediterol treatment
timeFrame: On Day 1: pre-dose, 5 min [only for DPI], 12, 30, and 45 min, and 1, 2, 4, 6, 8, 12 hours post-dose, on Day 2: 24 and 36 hours post-dose, on Day 3: 48 hours post-dose, on Day 4-7: 72, 96, 120 and 144 hours post-dose.
measure: Maximum concentration (tmax) for each abediterol treatment
timeFrame: On Day 1: pre-dose, 5 min [only for DPI], 12, 30, and 45 min, and 1, 2, 4, 6, 8, 12 hours post-dose, on Day 2: 24 and 36 hours post-dose, on Day 3: 48 hours post-dose, on Day 4-7: 72, 96, 120 and 144 hours post-dose.
measure: Terminal slope (λz) of a semi-logarithmic concentration-time curve (t1/2λz) for each abediterol treatment
timeFrame: On Day 1: pre-dose, 5 min [only for DPI], 12, 30, and 45 min, and 1, 2, 4, 6, 8, 12 hours post-dose, on Day 2: 24 and 36 hours post-dose, on Day 3: 48 hours post-dose, on Day 4-7: 72, 96, 120 and 144 hours post-dose.
measure: Terminal elimination rate constant (λz) for each abediterol treatment
timeFrame: On Day 1: pre-dose, 5 min [only for DPI], 12, 30, and 45 min, and 1, 2, 4, 6, 8, 12 hours post-dose, on Day 2: 24 and 36 hours post-dose, on Day 3: 48 hours post-dose, on Day 4-7: 72, 96, 120 and 144 hours post-dose.
measure: Time of last quantifiable plasma concentration (tlast) for each abediterol treatment
timeFrame: On Day 1: pre-dose, 5 min [only for DPI], 12, 30, and 45 min, and 1, 2, 4, 6, 8, 12 hours post-dose, on Day 2: 24 and 36 hours post-dose, on Day 3: 48 hours post-dose, on Day 4-7: 72, 96, 120 and 144 hours post-dose.
measure: Apparent total body clearance of drug from plasma after extravascular administration (CL/F) for each abediterol treatment
timeFrame: On Day 1: pre-dose, 5 min [only for DPI], 12, 30, and 45 min, and 1, 2, 4, 6, 8, 12 hours post-dose, on Day 2: 24 and 36 hours post-dose, on Day 3: 48 hours post-dose, on Day 4-7: 72, 96, 120 and 144 hours post-dose.
measure: Mean residence time of the unchanged drug in the systemic circulation from zero to infinity (MRT) for each abediterol treatment
timeFrame: On Day 1: pre-dose, 5 min [only for DPI], 12, 30, and 45 min, and 1, 2, 4, 6, 8, 12 hours post-dose, on Day 2: 24 and 36 hours post-dose, on Day 3: 48 hours post-dose, on Day 4-7: 72, 96, 120 and 144 hours post-dose.
measure: Apparent volume of distribution during the terminal phase after extravascular administration (Vz/F) for each abediterol treatment
timeFrame: On Day 1: pre-dose, 5 min [only for DPI], 12, 30, and 45 min, and 1, 2, 4, 6, 8, 12 hours post-dose, on Day 2: 24 and 36 hours post-dose, on Day 3: 48 hours post-dose, on Day 4-7: 72, 96, 120 and 144 hours post-dose.
measure: Number of subjects with adverse events
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal electrocardiogram (ECG)
timeFrame: From Screening (Day -28), Day -1 until Day 3
measure: Number of subjects with abnormal telemetry
timeFrame: Day -1, 1 (pre-dose to 12 hours from the start of study drug administration)
measure: Number of subjects with abnormal vital signs
timeFrame: From Screening (Day -28) until Day 3
measure: Number of subjects with abnormal physical examination
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal spirometry
timeFrame: At Screening (Day -28) and Day 1
measure: Number of subjects with abnormal taste questionnaire
timeFrame: Day 1
measure: Number of subjects with abnormal White blood cell (WBC) count
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Red blood cell (RBC) count
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Hemoglobin (Hb)
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Hematocrit (HCT)
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Mean corpuscular volume (MCV)
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Mean corpuscular hemoglobin (MCH)
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Mean corpuscular hemoglobin concentration (MCHC)
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Neutrophils absolute count
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Lymphocytes absolute count
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Monocytes absolute count
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Eosinophils absolute count
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Basophils absolute count
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Reticulocytes absolute count
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal sodium
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal pottasium
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal urea
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal creatinine
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal albumin
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal calcium
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal phosphate
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal glucose (fasting)
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal C-reactive protein (CRP)
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Alkaline phosphatase (ALP)
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Alanine aminotransferase (ALT)
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Aspartate aminotransferase (AST)
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Total Bilirubin
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal Unconjugated bilirubin
timeFrame: Screening (Day -28), Day -1, 1 and 14 days after last dose
measure: Number of subjects with abnormal Thyroid-stimulating hormone (TSH)
timeFrame: Screening (Day -28)
measure: Number of subjects with abnormal urinalysis (glucose, blood and protein)
timeFrame: Screening (Day -28) and Day -1
measure: Number of subjects with abnormal Gamma glutamyl transpeptidase (GGT)
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
measure: Number of subjects with abnormal platelet
timeFrame: From Screening (Day -28) until follow-up (14 days after last dose)
Other outcomes:
Locations:
city: Berlin
country: Germany
facility: Research Site
Study officials:
affiliation: Parexel
name: Dr. med. Rainard Fuhr
role: PRINCIPAL_INVESTIGATOR
References: