Acetaminophen Toxicity Clinical Trial
Official title:
Protective Effects of Propylene Glycol in Daily Acetaminophen Dosing
A purpose of this protocol is to is to compare the metabolites of the toxic bioactivating pathway after acetaminophen alone or acetaminophen followed by Propylene Glycol (PG) and to determine if it prevents the formation of the toxic metabolites of acetaminophen.
The purpose of this protocol is to contribute to our overarching purpose, which is to
determine if inhibiting the bioactivation of acetaminophen (APAP) can prevent liver injury,
and to further describe the initiating mechanisms of APAP induced liver injury. APAP induced
liver injury is caused by metabolism and/or the resulting metabolites when APAP undergoes
reductive metabolism via the cytochrome P450 (CYP) system, principally via CYP 2E1.
Inhibition of CYP 2E1 activity protects against toxicity in rodents and tissue culture 1, 2.
Our prior research indicates that inhibition of CYP 2E1 by administering a pediatric
preparation of APAP containing Propylene Glycol (PG), a known CYP 2E1 inhibitor, results in
reduced production of CYP 2E1 derived metabolites via competitive inhibition.
In this proposed protocol the investigators will provide therapeutic doses of APAP and a
separately administered non toxic dose of PG over a two-week period to healthy subjects.
20-75% of healthy people who take therapeutic doses of APAP for 7-28 days will have an
asymptomatic and subclinical rise in transaminase levels that will return to baseline
without adverse effect or therapy. 3 The return to baseline occurs despite continued dosing
of APAP (heard review 9 and 17).
A primary purpose is to determine if PG is, in fact, the substance in the liquid preparation
responsible for the effect the investigators observed in the investigators initial study. A
secondary purpose is to obtain plasma samples for secondary metabolomic analysis to
elucidate the effect of CYP 2E1 inhibition.
Specific Aims
- 1 To demonstrate that co-administration of PG with APAP prevents the rise in AST/ALT
expected in approximately one third of subjects following therapeutic dosing of APAP
over days.
- 2 To show that PG administered with APAP reduces toxic P450-derived metabolite
production following therapeutic APAP administration.
- 3 To obtain plasma samples to undergo metabolomic and other analyses to determine the
effects of CYP 2E1 inhibition in the setting of APAP administration.
- 4:To undergo metabolomic analyses on the day LFT's peak to determine differences in
metabolomics parameters between subjects receiving propylene glycol plus acetaminophen
versus just acetaminophen alone.
;
Allocation: Randomized, Endpoint Classification: Pharmacokinetics Study, Intervention Model: Crossover Assignment, Masking: Single Blind (Subject), Primary Purpose: Prevention
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