An Investigational Study of Hydrocortisone

Adrenal Insufficiency Clinical Trial

Official title:

An Open Label, Partially Randomised, Single Dose, Crossover Study to Evaluate the PK, Oral Bioavailability and Relationship to Metabolic Parameters of Hydrocortisone and Infacort® in Healthy Adult Male Volunteers.

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01960530
• Other study ID #: Infacort 002
• Status: Completed
• Phase: Phase 1
• Start date: October 2013
• Est. completion date: November 2014

Study information

• Verified date: April 2022
• Source: Diurnal Limited
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This study will investigate a new drug called Infacort®; a newly-developed immediate release formulation of a well-established drug called hydrocortisone. Hydrocortisone is used as a replacement treatment for people whose adrenal glands are not producing enough natural cortisol - a condition known as adrenal insufficiency. The study will assess how Infacort® acts once inside the body, by measuring cortisol and other hormone levels in the body, compared to already marketed hydrocortisone tablet and hydrocortisone intravenous (through the vein) injection. The population who are eligible to take part in the study are healthy male volunteers, aged between 18 and 60 years of age.

Description:

The study will evaluate the normal physiology, PK and metabolism of cortisol, investigate the PK and bioavailability of cortisol from the test Infacort® Granules (hydrocortisone) and the reference hydrocortisone tablets and i.v injection in healthy adult male volunteers and explore the role of cortisol in the regulation of metabolic pathways.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 14
• Est. completion date: November 2014
• Est. primary completion date: November 2014
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Male
• Age group: 18 Years to 60 Years

Eligibility

Inclusion Criteria:

• Healthy male volunteers between 18 and 60 years of age, inclusive (at screening).
• Subjects with a Body Mass Index (BMI) of 21-28. Body Mass Index = Body weight (kg) / (Height (m))*2.
• Subjects with no clinically significant abnormal serum biochemistry, haematology and urinalysis values within 14 days prior to Day 1 of Study Period 1.
• Subjects with a negative urinary drugs of abuse screen, determined within 14 days prior to Day 1 of Study Period 1. A positive alcohol test may be repeated at the discretion of the Investigator.
• Subjects with negative HIV and Hepatitis B and C results.
• Subjects with no clinically significant abnormalities in 12-lead electrocardiogram (ECG) determined within 14 days prior to Day 1 of Study Period 1.
• Subjects with no clinically-significant deviation outside the normal ranges for blood pressure and pulse measurements.
• Subjects (unless anatomically sterile or where abstaining from sexual intercourse is in line with the preferred and usual lifestyle of the subject) and sexual partners must use effective contraception methods during the trial and for 3 months after the

last dose, for example:

• Oral contraceptive + condom
• Intra-uterine device (IUD) + condom
• Diaphragm with spermicide + condom
• Subjects must be available to complete the study.
• Subjects must satisfy a medical examiner about their fitness to participate in the study.
• Subjects must provide written informed consent to participate in the study.

Exclusion Criteria:

• A clinically significant history of gastrointestinal disorder likely to influence drug absorption.
• Receipt of regular medication within 14 days prior to Day 1 of Study Period 1 (including high dose vitamins, dietary supplements or herbal remedies).
• Receipt of any vaccination within 14 days prior to Day 1 of Study Period 1.
• Evidence of renal, hepatic, central nervous system, respiratory, cardiovascular or metabolic dysfunction.
• Presence of clinically significant infections (systemic fungal and viral infections, acute bacterial infections).
• Current or previous history of tuberculosis.
• A clinically significant history of previous allergy / sensitivity to Hydrocortisone and/or Dexamethasone.
• A clinically significant history or family history of psychiatric disorders/illnesses.
• A clinically significant history of drug or alcohol abuse.
• Inability to communicate well with the Investigator (i.e., language problem, poor mental development or impaired cerebral function).
• Participation in a New Chemical Entity clinical study within the previous 4 months or a marketed drug clinical study within the previous 3 months. (N.B. The washout period between trials is defined as the period of time elapsed between the last dose of the previous study and the first dose of the next study)
• Subjects who have consumed more than 2 units of alcohol per day within seven (7) days prior to Day 1 of Study Period 1or have consumed any alcohol within the 48 hour period prior to Day 1 of Study Period 1.
• Donation of 450ml or more of blood within the previous 3 months.
• Subjects who smoke (or ex-smokers who have smoked within 6 months prior to Day 1 of Study Period 1).
• Subjects who work shifts (i.e. regularly alternate between days, afternoons and nights).

Related Conditions & MeSH terms

• Adrenal Insufficiency

Intervention

Drug:
• Hydrocortisone granules
Multi-particulate granules
• Hydrocortisone Tablet
Standard hydrocortisone tablets
• i.v. Hydrocortisone Injection
Standard hydrocortisone solution for intravenous injection

Other:
• Dexamethasone
Challenge agent

Locations

Country	Name	City	State
United Kingdom	Simbec Research Limited	Merthyr Tydfil

Sponsors (2)

Lead Sponsor	Collaborator
Diurnal Limited	Simbec Research

Country where clinical trial is conducted

United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Maximum Serum Concentration (Cmax)	Derived PK for Serum Cortisol: Maximum serum concentration (Cmax)	Hourly from 0 to 24 hours
Primary	AUC0-t	Derived PK for Serum Cortisol: Area under the curve from 0-24 hours	Hourly from 0 to 24 hours
Secondary	Adverse Events (AEs)	Number of subjects with adverse events throughout the study.	Days 1-2 during each Study Period
Secondary	Concentrations of Cortisol Binding Protein	Cortisol protein binding under physiological conditions and after the administration of dexamethasone and hydrocortisone.	Blood samples on Day 1 and/or Day 2 of each Study Period
Secondary	Insulin Sensitivity Under Physiological Conditions and After Administration of Dexamethasone and Infacort®, Hydrocortisone Tablets and i.v Hydrocortisone.	A standardised mixed meal elevates blood glucose and provides a reproducible stimulation of insulin release. Lower levels of insulin secretion, whilst maintaining normoglycaemia would indicate enhanced insulin sensitivity and glucose disposal; higher insulin levels will reflect insulin resistance.	Blood samples on Day 1 and/or Day 2 of each Study Period
Secondary	PK and Metabolism of Cortisol	Blood: Serum cortisol under physiological conditions and after administration of dexamethasone and Infacort® Granules, Hydrocortisone Tablets and i.v Hydrocortisone Injection.	Blood, urine & saliva samples on Day 1 and/or Day 2 of each Study Period