Oedema Clinical Trial
Official title:
Characterisation of Gastric Residence of a Furosemide-containing New Gastric Retention System by Means of MMM Measurement and Determination of Pharmacokinetics, Pharmacodynamics and Safety
Furosemide is a diuretic drug, used in the treatment of oedematous states associated with
cardiac, renal, and hepatic disorder, and may be effective in patients unresponsive to
thiazide diuretics. Furosemide is also used in the treatment of hypertension.
Absorption of furosemide from the gastrointestinal tract is fairly rapid; bioavailability is
60-70%, but variable and not predictable, with large intra- and inter-individual
variability, and are influenced by dosage form, underlying diseases, and by the presence of
food after oral administration. Data from animal model show that furosemide administered
into the stomach is more rapidly absorbed than if is administered into the small intestine.
To increase the residency of furosemide in the stomach after oral administration, a
gastroretentive dosage form (GRDF) of furosemide has been developed. In the current study,
the new formulation (30mg furosemide coated tablet) will be tested in healthy male subjects.
Absorption will be characterised by an effective and safe imaging technique - Magnetic
Marker Monitoring (MMM), based on Fe3O4 added to the drug product to generate magnetic
signal that can be used for up to 12 h after furosemide administration to localize the
medication in the gastrointestinal tract. Fe3O4 is frequently used as colouring pigment in
medicinal products. It does not exhibit own pharmacodynamic activity and is considered as an
inactive ingredient.
In the current study, GRDF formulation of furosemide will be evaluated for: gastric
residence as well as pharmacokinetic and pharmacodynamic characteristics under fasting and
fed conditions. As part of the study, the subjects will be hospitalized for 1 day during
each drug administration. The duration of the stay will depend on the intestinal behaviour
of the investigational product.
Status | Completed |
Enrollment | 10 |
Est. completion date | August 2013 |
Est. primary completion date | August 2013 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Male |
Age group | 18 Years to 55 Years |
Eligibility |
Inclusion Criteria: 1. sex: male 2. ethnic origin: Caucasian 3. age: 18 years to 55 years 4. body-mass index (BMI): > or = 19 kg/m² and < or = 27 kg/m² 5. good state of health 6. non-smoker or ex-smoker for at least 1 month 7. written informed consent, after having been informed about benefits and potential risks of the clinical trial, as well as details of the insurance taken out to cover the subjects participating in the clinical trial Exclusion Criteria: 1. existing cardiac and/or haematological diseases or pathological findings, which might interfere with the safety or tolerability of the active ingredient 2. existing hepatic and/or renal diseases or pathological findings, which might interfere with the safety or tolerability of the active ingredient 3. existing gastrointestinal diseases or pathological findings, which might interfere with the safety and tolerability or with gastric emptying and the gastrointestinal transport (e.g. inflammatory bowel diseases, ileus) 4. history of relevant central nervous system (CNS) and/or psychiatric disorders and/or currently treated CNS and/or psychiatric disorders 5. any surgery at the gastrointestinal tract, which might interfere with the safety of the test product or any stomach reduction like Bioenterics Intragastric Balloon (BIB) or gastric banding 6. known allergic reactions to the active ingredients used or to constituents of the pharmaceutical preparations 7. known allergic reactions to sulphonamide 8. subjects with severe allergies or multiple drug allergies unless it is judged as not relevant for the clinical trial by the investigator 9. heart rate < 50 bpm or > 90 bpm 10. systolic blood pressure of < 100 mmHg and > 140 mmHg, diastolic blood pressure of < 60 mmHg and >90 mmHg 11. laboratory values, especially for sodium, potassium, calcium, creatinine, urea, uric acid, and blood glucose out of normal range unless the deviation from normal is judged as not relevant for the clinical trial by the investigator 12. positive anti-human immunodeficiency virus-test (if positive to be verified by western blot), surface antigen of the hepatitis B virus (HBs-AG)test [if positive to be verified by test for hepatitis B Core (HBc-IgM)] or anti-hepatitis C virus-test 13. renal failure with anuria 14. coma and praecoma hepatica 15. severe hypokalemia and/or hyponatremia 16. hypovolemia or dehydration 17. subjects with manifest or latent diabetes mellitus or gout 18. subjects with cerebrovascular insufficiency or coronary heart disease 19. subjects with bladder outlet obstruction (BOO) e.g. prostatic hypertrophy, hydronephrosis or ureteral stenosis 20. hypoproteinemia 21. liver cirrhosis and simultaneous limitation of kidney function 22. acute or chronic diseases which could affect gastric emptying and the gastrointestinal transport 23. history of or current drug or alcohol dependence 24. positive alcohol or drug test at screening examination 25. regular intake of alcoholic food or beverages of = 40 g pure ethanol for male per day 26. subjects who are on a diet which could affect gastric emptying and the gastro-intestinal transport 27. regular intake of caffeine containing food or beverages of = 500 mg caffeine per day 28. subjects with claustrophobia 29. ferromagnetic implants or any other magnetic disturbance, which can affect the Magnetic Marker Monitoring measurement 30. blood donation or other blood loss of more than 400 ml within the last two months prior to individual enrolment of the subject 31. participation in a clinical trial during the last two months prior to individual enrolment of the subject 32. regular treatment with any systemically available medication including all ototoxic medication like aminoglycosides and medication which could affect gastric emptying and the gastrointestinal transport (e.g. laxatives, metoclopramide, loperamide, antacids, H2-receptor antagonists) or antibiotics 33. subjects, who report a frequent occurrence of migraine attacks 34. subjects suspected or known not to follow instructions 35. subjects who are unable to understand the written and verbal instructions, in particular regarding the risks and inconveniences they will be exposed to during their participation in the clinical trial 36. subjects who have forfeited their own freedom by administrative or legal award, or who are under guardianship or have been admitted in a sanitary or social institution |
Allocation: Randomized, Endpoint Classification: Pharmacokinetics/Dynamics Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
Germany | SocraTec R&D GmbH Clinical Pharmacology Unit | Berlin |
Lead Sponsor | Collaborator |
---|---|
LTS Lohmann Therapie-Systeme AG |
Germany,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Residency time of GRDF furosemide in the gastrointestinal tract, evaluated with MMM technique, under fasted and fed conditions. | Residency time of GRDF furosemide in the gastrointestinal track will be monitored using the non-invasive MMM technique under fasted and fed conditions. Measurements will start after each administration and last until 2 hours after gastric emptying indicated by the MMM measurement, but not longer than 12 h post administration. Each observation interval for each subject will last for a minimum of 10 min followed by a break of maximum 20 min. For meal intake, a break of the MMM measuring of 30 minutes will be performed. Anatomical localisation within the measuring sequences will be listed for each subject and treatment Statistical evaluation of gastric emptying time will include: arithmetic means, medians, minimum , maximum, standard deviation. GRDF=Gastro retentive dosage formulation |
every 30 min for up to 12 h after drug administration; maximal observation time 12 h | No |
Secondary | Cmax of GRDF furosemide under fasted conditions | Characterization of the pharmacokinetic (PK) properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. Cmax = maximum concentration in plasma; GRDF=Gastro retentive dosage formulation |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | Cmax of GRDF furosemide under fed conditions | Characterization of the pharmacokinetic (PK) properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. Cmax = maximum concentration in plasma; GRDF=Gastro retentive dosage formulation |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | tmax of GRDF furosemide under fasted conditions | Characterization of the pharmacokinetic (PK) properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. tmax = time to reach maximum concentration in plasma; GRDF=Gastro retentive dosage formulation |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | tmax of GRDF furosemide under fed conditions | Characterization of the pharmacokinetic (PK) properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. tmax = time to reach maximum concentration in plasma; GRDF=Gastro retentive dosage formulation |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | t1/2 of GRDF furosemide under fasted conditions | Characterization of the pharmacokinetic (PK) properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. t1/2 = apparent terminal elimination half-life; GRDF=Gastro retentive dosage formulation |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | t1/2 of GRDF furosemide under fed conditions | Characterization of the pharmacokinetic (PK) properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. t1/2 = apparent terminal elimination half-life; GRDF=Gastro retentive dosage formulation |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | AUC0-tlast of GRDF furosemide under fasted conditions | Characterization of the pharmacokinetic (PK) properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. AUC0 = area under the plasma concentration vs. time curve from dosing time to the last measurement time point with a concentration value above the lower limit of quantitation, calculated by means of the linear up/log down method (linear trapezoidal rule for increases in concentration/logarithmic trapezoidal rule for decreases in concentrations; GRDF=Gastro retentive dosage formulation |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | AUC0-tlast of GRDF furosemide under fed conditions | Characterization of the pharmacokinetic (PK) properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. AUC0-tlast = area under the plasma concentration vs. time curve from dosing time to the last measurement time point with a concentration value above the lower limit of quantitation, calculated by means of the linear up/log down method (linear trapezoidal rule for increases in concentration/logarithmic trapezoidal rule for decreases in concentrations; GRDF=Gastro retentive dosage formulation |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | AUC 0-infinity of GRDF furosemide under fasted conditions | Characterization of the pharmacokinetic (PK) properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. AUC0-infinity = AUC0-tlast + AUCexpol; GRDF=Gastro retentive dosage formulation |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | AUC 0-infinity of GRDF furosemide under fed conditions | Characterization of the pharmacokinetic (PK) properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. AUC0-infinity = AUC0-tlast + AUCexpol; GRDF=Gastro retentive dosage formulation |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | AUCextrapol of GRDF furosemide under fasted conditions | Characterization of the pharmacokinetic (PK) properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. AUCextrapol = AUCextrapolated = Clast/lamda; lamda = apparent terminal elimination rate constant determined by log-linear regression; GRDF=Gastro retentive dosage formulation |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | AUCextrapol of GRDF furosemide under fed conditions | Characterization of the pharmacokinetic (PK) properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. AUCextrapol = AUCextrapolated = Clast/lamda; lamda = apparent terminal elimination rate constant determined by log-linear regression; GRDF=Gastro retentive dosage formulation |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | CL_f of GRDF furosemide under fasted conditions | Characterization of the pharmacodynamic properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. CL_f = apparent total body clearance of furosemide: dose / AUC0-8; GRDF=Gastro retentive dosage formulation |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | CL_f of GRDF furosemide under fed conditions | Characterization of the pharmacodynamic properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. CL_f = apparent total body clearance of furosemide: dose / AUC0-8; GRDF=Gastro retentive dosage formulation |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | Vdz of GRDF furosemide under fasted conditions | Characterization of the pharmacodynamic properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. Vdz = apparent volume of distribution of furosemide: dose / (AUC0-8 x ?); GRDF=Gastro retentive dosage formulation; ?=apparent terminal elimination rate constant determined by log-linear regression |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | Vdz of GRDF furosemide under fed conditions | Characterization of the pharmacodynamic properties of GRDF furosemide, with special focus on the absorption phase of furosemide. Compare results during fasted and fed state. Blood samples for the determination of furosemide concentration will be taken at pre-dose (within 1 h prior to administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after administration. LC-MS/MS will be used to analyze furosemide in plasma. Vdz = apparent volume of distribution of furosemide: dose / (AUC0-8 x ?); GRDF=Gastro retentive dosage formulation; ?=apparent terminal elimination rate constant determined by log-linear regression |
pre-dose (within 1 h prior to drug administration) and 0.5, 1, 1.5, 2, 2.5, 3, 4, 5, 6, 8, 10, 12, and 24 h after drug administration. | No |
Secondary | Sodium excretion over time under fasted conditions | Sodium in urine will be measured for each time interval and total sampling time. Urine will be collected and sampled during the following sample intervals: pre-dose (within 1 hour prior to administration), 0-2h, 2-4h, 4-8h, and 8-12h after administration. | pre-dose (within 1 hour prior to administration), 0-2h, 2-4h, 4-8h, and 8-12h after administration. | No |
Secondary | Sodium excretion over time under fed conditions | Sodium in urine will be measured for each time interval and total sampling time. Urine will be collected and sampled during the following sample intervals: pre-dose (within 1 hour prior to administration), 0-2h, 2-4h, 4-8h, and 8-12h after administration. | pre-dose (within 1 hour prior to administration), 0-2h, 2-4h, 4-8h, and 8-12h after administration. | No |
Secondary | Urine excretion over time under fasted conditions | Urine volume will be measured for each time interval and total sampling time. Urine will be collected and sampled during the following sample intervals: pre-dose (within 1 hour prior to administration), 0-2h, 2-4h, 4-8h, and 8-12h after administration. | pre-dose (within 1 hour prior to administration), 0-2h, 2-4h, 4-8h, and 8-12h after administration. | No |
Secondary | Urine excretion over time under fed conditions | Urine volume will be measured for each time interval and total sampling time. Urine will be collected and sampled during the following sample intervals: pre-dose (within 1 hour prior to administration), 0-2h, 2-4h, 4-8h, and 8-12h after administration. | pre-dose (within 1 hour prior to administration), 0-2h, 2-4h, 4-8h, and 8-12h after administration. | No |
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