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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT02294448
Other study ID # PopPK profile of Qishe Pill
Secondary ID
Status Recruiting
Phase Phase 1
First received September 11, 2014
Last updated November 15, 2014
Start date November 2014
Est. completion date July 2016

Study information

Verified date November 2014
Source Shanghai University of Traditional Chinese Medicine
Contact Xue-Jun Cui, Dr.
Email 13917715524@139.com
Is FDA regulated No
Health authority China: Food and Drug Administration
Study type Interventional

Clinical Trial Summary

Qishe Pill (Shanghai Sundise Traditional Chinese Medicine Co., Ltd, China), composed of processed Radix Astragali, Muscone, Szechuan Lovage Rhizome, Radix Stephaniae Tetrandrae, Ovientvine, and Calculus Bovis Artifactus, has been developed and spread in use into clinical settings in 2009. As individualization has become the trend of modern medicine, a personalized medicine of Qishe Pill should be documented and practiced with various patients according to the ancient TCM system, a classification of personalized constitution type, which has been established to determine predisposition and prognosis to diseases as well as therapy and life-style administration. Therefore, we describe the population pharmacokinetic profile of Qishe Pill and compare its extent of metabolism in the 3 major Constitution Type (Qi-Deficiency, Yin-Deficiency and Blood-Stasis) to address major challenges of individualized and standardized Traditional Chinese Medicine into clinical practice.


Description:

With the greatly increased morbidity of neck pain, it brought a large challenge to some optimal therapies for various situations in population at a given time based on their demographic, physiological and pathological characteristics. Chinese proprietary herbal medicines, as a kind of Complementary and Alternative Medicine (CAM), are usually developed from some well-established and long-standing recipes and formulated as tablets or capsules for commerce, convenience or palatability. Although these advantage mentioned, a good quantification and a strict standardization in detail are still need to be improved for individualized implementation in therapeutic strategies. Based on the YQHY decoction (Yi-Qi Hua-Yu Decoction, tonify Qi and promoting circulation and removing stasis), Qishe Pill (Shanghai Sundise Traditional Chinese Medicine Co., Ltd, China) has been developed and spread in use into clinical settings in 2009. As individualization has become the trend of modern medicine, a personalized medicine of Qishe Pill should be documented and practiced with various patients according to the ancient TCM system, a classification of personalized constitution type, which has been established to determine predisposition and prognosis to diseases as well as therapy and life-style administration. Therefore, we describe the population pharmacokinetic profile of Qishe Pill and compare its extent of metabolism in the 3 major Constitution Type (Qi-Deficiency, Yin-Deficiency and Blood-Stasis) to address major challenges of individualized and standardized Traditional Chinese Medicine into clinical practice.


Recruitment information / eligibility

Status Recruiting
Enrollment 36
Est. completion date July 2016
Est. primary completion date December 2015
Accepts healthy volunteers Accepts Healthy Volunteers
Gender Both
Age group 20 Years to 35 Years
Eligibility Inclusion

- Aged 20-35

- 18.5 kg/m2 =Body mass index (BMI) <23 kg/m2

- TCM-constitutionally typed as either the 3 major type

Exclusion

- History of impaired fasting glucose or diabetes mellitus (past history of diabetes or fasting blood glucose at screening =100 mg/dl)

- History of liver disease (hepatitis, hepatic cirrhosis) or hepatic dysfunction (AST or ALT at screening =40 U/L)

- History of renal dysfunction (creatinine at screening =1.2 mg/dl)

- History of heart disease (heart failure, angina pectoris, myocardial infarction, arrhythmia)

- History of malignant tumor

- Having digestive disorders that can interfere with normal absorption of standard diet (gastritis, gastric ulcer, duodenitis, duodenal ulcer, etc.)

- Smoking during the recent 3 months

- Alcohol consumption 3 or more times a week during the recent 3 months

- Women who were pregnant, intended to become pregnant, or breast- feeding

- Medicated during the recent month for therapeutic or prophylactic purposes

- Participating in another clinical trial

Study Design

Allocation: Randomized, Endpoint Classification: Pharmacokinetics Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment


Related Conditions & MeSH terms


Intervention

Drug:
Qishe Pill
Qishe Pill is a thin 0.15 g film-coated pill, composed of processed Radix Astragali, Muscone, Szechuan Lovage Rhizome, Radix Stephaniae Tetrandrae, Ovientvine, and Calculus Bovis Artifactus, which should be taken orally with water (240mL) after a minimum 10-hour fast

Locations

Country Name City State
China Longhua Hospital, Shanghai University of TCM Shanghai, Shanghai

Sponsors (1)

Lead Sponsor Collaborator
Shanghai University of Traditional Chinese Medicine

Country where clinical trial is conducted

China, 

References & Publications (21)

Aker PD, Gross AR, Goldsmith CH, Peloso P. Conservative management of mechanical neck pain: systematic overview and meta-analysis. BMJ. 1996 Nov 23;313(7068):1291-6. — View Citation

Bovim G, Schrader H, Sand T. Neck pain in the general population. Spine (Phila Pa 1976). 1994 Jun 15;19(12):1307-9. — View Citation

Choo V. WHO reassesses appropriate body-mass index for Asian populations. Lancet. 2002 Jul 20;360(9328):235. — View Citation

Cui X, Trinh K, Wang YJ. Chinese herbal medicine for chronic neck pain due to cervical degenerative disc disease. Cochrane Database Syst Rev. 2010 Jan 20;(1):CD006556. doi: 10.1002/14651858.CD006556.pub2. Review. — View Citation

EMEA. Strategies to identify and mitigate risks for first-in-human clinical trialswith investigational medicinal products; 2009, http:// www.ema.europa.eu/docs/en_GB/document_library/Scientific_ guideline/2009/09/WC500002988.pdf.

FDA/CDER. Guidance for industry estimating the maximum safe starting dose in initial clinical trials for therapeutics in adult healthy volunteers; 2005, http://www.fda.gov/downloads/drugs/guidance-complianceregulatoryinformation/guidances/ucm078932.pdf.

Feng Y, Pollock BG, Coley K, Marder S, Miller D, Kirshner M, Aravagiri M, Schneider L, Bies RR. Population pharmacokinetic analysis for risperidone using highly sparse sampling measurements from the CATIE study. Br J Clin Pharmacol. 2008 Nov;66(5):629-39. doi: 10.1111/j.1365-2125.2008.03276.x. Epub 2008 Jul 31. — View Citation

Ge JR, Wang HM, Meng CX, Tong PJ. Effects of Qishe Pill, a compound traditional Chinese herbal medicine, on cervical radiculopathy: a randomized controlled trial for Phase III. Chinese Journal of New Drugs and Clinical. 2014(7):56-58.

Hsu H-Y: 1986 Oriental MateriaMedica. Long Beach, CA: Oriental Healing Arts Institute; 1986.

Johnson CL, Fulwood R, Abraham S, Bryner JD. Basic data on anthropometric measurements and angular measurements of the hip and knee joints for selected age groups 1-74 years of age. Vital Health Stat 11. 1981 Apr;(219):1-68. — View Citation

Liu M, Zhang N, Wang YJ, Zhang YQ, Zhou CJ. Technology research of Qishe Pill, a new medicine for cervical spondylosis. Lishizhen Med Mater Med Res. 2010(21):176-179.

Liu Mei, Zhang N, Wang YJ, Shi Q. Purification process research of major compound in Qishe Pill as Astragalus. Acta Chinese Medicine and Pharmacology. 2006(34):14-16.

Mäkelä M, Heliövaara M, Sievers K, Impivaara O, Knekt P, Aromaa A. Prevalence, determinants, and consequences of chronic neck pain in Finland. Am J Epidemiol. 1991 Dec 1;134(11):1356-67. — View Citation

Sheiner LB, Beal SL. Evaluation of methods for estimating population pharmacokinetic parameters. II. Biexponential model and experimental pharmacokinetic data. J Pharmacokinet Biopharm. 1981 Oct;9(5):635-51. — View Citation

Sheiner LB, Beal SL. Evaluation of methods for estimating population pharmacokinetic parameters. III. Monoexponential model: routine clinical pharmacokinetic data. J Pharmacokinet Biopharm. 1983 Jun;11(3):303-19. — View Citation

Sheiner LB, Beal SL. Evaluation of methods for estimating population pharmacokinetics parameters. I. Michaelis-Menten model: routine clinical pharmacokinetic data. J Pharmacokinet Biopharm. 1980 Dec;8(6):553-71. — View Citation

van der Donk J, Schouten JS, Passchier J, van Romunde LK, Valkenburg HA. The associations of neck pain with radiological abnormalities of the cervical spine and personality traits in a general population. J Rheumatol. 1991 Dec;18(12):1884-9. — View Citation

Wang Q. Classification of the nine basic TCM constitutional type and based expression and diagnosis. Journal of Beijing University of Traditional Chinese medicine. 2005.1-8

Zhang WJ, Hufnagl P, Binder BR, Wojta J. Antiinflammatory activity of astragaloside IV is mediated by inhibition of NF-kappaB activation and adhesion molecule expression. Thromb Haemost. 2003 Nov;90(5):904-14. — View Citation

Zhang YQ, Liu XH, Zhang N, Liu M. Quality standard research of Qishe Pill. Lishizhen Med Mater Med Res. 2008(19): 977-979.

Zhu YB, Wang Q, Xue HS, Origasa H. Preliminary assessment on performance of constitution in Chinese medicine questionnaire. ZhongGuo Lin Chuang Kang Fu 2006; 10 (3): 15-17.

* Note: There are 21 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Other The Constitution in Chinese Medicine Questionnaire (CCMQ) Two qualified traditional Chinese medical doctors licensed by the Chinese government determine the constitution according to CCMQ During screening in the recuitment No
Other The Constitution in Chinese Medicine Questionnaire (CCMQ) Two qualified traditional Chinese medical doctors licensed by the Chinese government determine the constitution according to CCMQ 2880 min after dosing No
Other Laboratory measures and clinical assessment These parameters including blood count, electrolytes, renal and liver function parameters, blood lipids, age, gender, history of smoking, blood pressure, weight (kg), and height (meters) will be obtained for all subjects. During screening in the recuitment No
Primary Plasma concentration of Qishe Pill 5 ml blood samples for pharmacokinetic analysis Dosing(0 hour) No
Primary Plasma concentration of Qishe Pill 5 ml blood samples for pharmacokinetic analysis 15 min after dosing No
Primary Plasma concentration of Qishe Pill 5 ml blood samples for pharmacokinetic analysis 30 min after dosing No
Primary Plasma concentration of Qishe Pill 5 ml blood samples for pharmacokinetic analysis 45 min after dosing No
Primary Plasma concentration of Qishe Pill 5 ml blood samples for pharmacokinetic analysis 60 min after dosing No
Primary Plasma concentration of Qishe Pill 5 ml blood samples for pharmacokinetic analysis 90 min after dosing No
Primary Plasma concentration of Qishe Pill 5 ml blood samples for pharmacokinetic analysis 120 min after dosing No
Primary Plasma concentration of Qishe Pill 5 ml blood samples for pharmacokinetic analysis 150 min after dosing No
Primary Plasma concentration of Qishe Pill 5 ml blood samples for pharmacokinetic analysis 180 min after dosing No
Primary Plasma concentration of Qishe Pill 5 ml blood samples for pharmacokinetic analysis 240 min after dosing No
Primary Plasma concentration of Qishe Pill 5 ml blood samples for pharmacokinetic analysis 360 min after dosing No
Primary Plasma concentration of Qishe Pill 5 ml blood samples for pharmacokinetic analysis 480 min after dosing No
Primary Plasma concentration of Qishe Pill 5 ml blood samples for pharmacokinetic analysis 600 min after dosing No
Primary Plasma concentration of Qishe Pill 5 ml blood samples for pharmacokinetic analysis 720 min after dosing No
Primary Plasma concentrations of Qishe Pill 5 ml blood samples for pharmacokinetic analysis 1440 min after dosing No
Primary Plasma concentration of Qishe Pill 5 ml blood samples for pharmacokinetic analysis 2160 min after dosing No
Primary Plasma sampling of Qishe Pill for pharmacokinetic analysis 5 ml blood samples for pharmacokinetic analysis 2880 min after dosing No
Primary Vital signs body temperature, heart rate and blood pressure Dosing(0 hour) Yes
Primary Vital signs body temperature, heart rate and blood pressure 180 min after dosing Yes
Primary Vital signs body temperature, heart rate and blood pressure 720 min after dosing Yes
Primary Vital signs body temperature, heart rate and blood pressure 1440 min after dosing Yes
Primary Vital signs body temperature, heart rate and blood pressure 2160 min after dosing Yes
Primary Vital signs body temperature, heart rate and blood pressure 2880 min after dosing Yes
Primary ECG monitoring Electrocardiograms (ECGs) Dosing(0 hour) Yes
Primary ECG monitoring Electrocardiograms (ECGs) 180 min after dosing Yes
Primary ECG monitoring Electrocardiograms (ECGs) 720 min after dosing Yes
Primary ECG monitoring Electrocardiograms (ECGs) 1440 min after dosing Yes
Primary ECG monitoring Electrocardiograms (ECGs) 2160 min after dosing Yes
Primary ECG monitoring Electrocardiograms (ECGs) 2880 min after dosing Yes
Primary Number of Participants with Adverse Events The investigators will assess all clinical AEs according to the Medical Dictionary for Regular Activities criteria, in terms of intensity (mild, moderate, or severe), duration, outcome and relationship to the study drug. Day 1 of drug administration and blood sampling Yes
Primary Number of Participants with Adverse Events The investigators will assess all clinical AEs according to the Medical Dictionary for Regular Activities criteria, in terms of intensity (mild, moderate, or severe), duration, outcome and relationship to the study drug. Day 2 of drug administration and blood sampling Yes
Primary Number of Participants with Adverse Events The investigators will assess all clinical AEs according to the Medical Dictionary for Regular Activities criteria, in terms of intensity (mild, moderate, or severe), duration, outcome and relationship to the study drug. Day 3 of drug administration and blood sampling Yes
Primary Number of Participants with Adverse Events Subjects will be requested to return to the study unit 4 d after drug administration and blood sampling for a follow-up visit. 4 days after drug administration and blood sampling Yes
Primary Peak Plasma Concentration (Cmax) of Qishe Pill in low dosage The maximum plasma concentration 4 days after drug administration and blood sampling No
Primary Peak Plasma Concentration (Cmax) of Qishe Pill in medial dosage The maximum plasma concentration 4 days after drug administration and blood sampling No
Primary Peak Plasma Concentration (Cmax) of Qishe Pill in high dosage The maximum plasma concentration 4 days after drug administration and blood sampling No
Primary The Time to Peak Plasma Concentration (Tmax) of Qishe Pill in low dosage The time to maximum concentration 4 days after drug administration and blood sampling No
Primary The Time to Peak Plasma Concentration (Tmax) of Qishe Pill in medial dosage The time to maximum concentration 4 days after drug administration and blood sampling No
Primary The Time to Peak Plasma Concentration (Tmax) of Qishe Pill in high dosage The time to maximum concentration 4 days after drug administration and blood sampling No
Primary Area under the Plasma Concentration versus Time Curve (AUC) of Qishe Pill in low dosage The area under the plasma concentration-time curve (AUC) will be calculated using the linear trapezoidal rule. 4 days after drug administration and blood sampling No
Primary Area under the Plasma Concentration versus Time Curve (AUC) of Qishe Pill in medial dosage The area under the plasma concentration-time curve (AUC) will be calculated using the linear trapezoidal rule. 4 days after drug administration and blood sampling No
Primary Area under the Plasma Concentration versus Time Curve (AUC) of Qishe Pill in high dosage The area under the plasma concentration-time curve (AUC) will be calculated using the linear trapezoidal rule. 4 days after drug administration and blood sampling No
Primary The distribution volume (DF) of Qishe Pill in low dosage The distribution volume (DF) will be calculated by Dose/AUC/ke. ke is the elimination rate constant. 4 days after drug administration and blood sampling No
Primary The distribution volume (DF) of Qishe Pill in medial dosage The distribution volume (DF) will be calculated by Dose/AUC/ke. ke is the elimination rate constant. 4 days after drug administration and blood sampling No
Primary The distribution volume (DF) of Qishe Pill in high dosage The distribution volume (DF) will be calculated by Dose/AUC/ke. ke is the elimination rate constant. 4 days after drug administration and blood sampling No
Secondary Deep phenotyping with genomics and functional genomics approaches 3 ml blood samples for genomic variants analysis. The cytochrome P450 gene family, such as CYP1A1, CYP1A2, CYP2D6, CYP2C9, CYP2C19, CYP2E1, CYP3A4 and CYP3A5 , etc, will be chosen as the target objective. Dosing(0 hour) No
Secondary Deep phenotyping with genomics and functional genomics approaches 3 ml blood samples for genomic variants analysis. The cytochrome P450 gene family, such as CYP1A1, CYP1A2, CYP2D6, CYP2C9, CYP2C19, CYP2E1, CYP3A4 and CYP3A5 , etc, will be chosen as the target objective. 2880 min after dosing No
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