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An Open-label, Non-randomized, Parallel Group Study in Subjects With Mild and Moderate Hepatic Insufficiency and Healthy Volunteers

NCT01767103 — Phase 4, Completed, 21 participants, ApoPharma

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An Open-Label Study to Compare the Pharmacokinetic Profiles of a Single Dose of Ferriprox® in Subjects With Impaired Hepatic Function and Healthy Volunteers

RegistryNCT01767103
StatusCompleted
PhasePhase 4
Study typeInterventional; non randomized, parallel, masking: none
Enrollment21 (Actual)
SponsorApoPharma (Industry)
ConditionsHepatic Impairment
InterventionsFerriprox® (Drug)
Datesstart 2013-01-01, primary completion 2014-04-01, completion 2014-04-01, first posted 2013-01-14, last updated 2014-09-10
Locations2 sites in United States

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-Summary

Multi-center, non-randomized, open-label, single-dose, parallel group study to determine the effect of impaired hepatic function on the PK of deferiprone and its 3-O-glucuronide metabolite following a single oral dose of 33mg/kg Ferriprox®.

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+Detailed description

Post-marketing study to evaluate the effect of impaired hepatic function on the pharmacokinetics (PK) of deferiprone and its 3-O-glucuronide metabolite and on the safety of Ferriprox® in subjects with mild and moderate hepatic impairment as compared to healthy volunteers.

+Arms and interventions

ArmTypeInterventionsDescription
Normal Hepatic Function (healthy volunteers)ExperimentalDrug: Ferriprox®Healthy volunteers with normal hepatic function received a single 33 mg/kg dose of Ferriprox®.
Mild Hepatic FailureExperimentalDrug: Ferriprox®Subjects with mild hepatic failure as defined by the Child-Pugh Class C: 5-6 points received a single 33 mg/kg dose of Ferriprox®.
Moderate Hepatic FailureExperimentalDrug: Ferriprox®Subjects with moderate hepatic failure as defined by the Child-Pugh Class B: 7-9 points received a single 33 mg/kg dose of Ferriprox®.
  • Ferriprox® (Drug), also known as DFP, Deferiprone, L1

+Outcome measures

Primary outcomes

  • Cmax for Serum Deferiprone and Deferiprone 3-O-glucuronide [24-hour interval]: Cmax was assessed over a 24-hour interval for analyses of deferiprone and its 3-O-glucuronide metabolite in subjects with normal hepatic function, mild hepatic impairment, or moderate hepatic impairment. Blood samples were obtained prior to dosing and at 0.25, 0.50, 0.75, 1, 1.33, 1.66, 2, 2.5, 3, 4, 6, 9, 12, 16, and 24 hours post-dose.
  • Tmax for Serum Deferiprone and Deferiprone 3-O-glucuronide [24-hour interval]: Tmax was assessed over a 24-hour interval for analyses of deferiprone and its 3-O-glucuronide metabolite in subjects with normal hepatic function, mild hepatic impairment, or moderate hepatic impairment. Blood samples were obtained prior to dosing and at 0.25, 0.50, 0.75, 1, 1.33, 1.66, 2, 2.5, 3, 4, 6, 9, 12, 16, and 24 hours post-dose.
  • AUC0-∞ for Serum Deferiprone and Deferiprone 3-O-glucuronide [24-hour interval]: AUC (area under the curve) from zero to infinity was assessed over a 24-hour interval for analyses of deferiprone and its 3-O-glucuronide metabolite in subjects with normal hepatic function, mild hepatic impairment, or moderate hepatic impairment. Blood samples were obtained prior to dosing and at 0.25, 0.50, 0.75, 1, 1.33, 1.66, 2, 2.5, 3, 4, 6, 9, 12, 16, and 24 hours post-dose.
  • T1/2 for Serum Deferiprone and Deferiprone 3-O-glucuronide [24-hour interval]: T1/2 was assessed over a 24-hour interval for analyses of deferiprone and its 3-O-glucuronide metabolite in subjects with normal hepatic function, mild hepatic impairment, or moderate hepatic impairment. Blood samples were obtained prior to dosing and at 0.25, 0.50, 0.75, 1, 1.33, 1.66, 2, 2.5, 3, 4, 6, 9, 12, 16, and 24 hours post-dose.
  • CumAe for Urine Deferiprone and Deferiprone 3-O-glucuronide [24-hour interval]: Cumulative amount of deferiprone and deferiprone 3-O-glucuronide excreted in the urine. Urine samples were collected at the intervals of -2 to 0 hours pre-dose, and 0-2, 2-4, 4-8, 8-12 ,and 12- 24 hours post-dose. Note: For unknown reasons, the urine samples for one subject in the moderate hepatic failure group had low or zero volume and there were no measurable levels of deferiprone or its metabolite in any of the samples. Accordingly, the urine PK results were derived both with and without this subject's data, and are here presented without them (i.e., N=6 rather than 7).
  • Fe% for Urine Deferiprone and Deferiprone 3-O-glucuronide [24-hour interval]: Cumulative fraction of Ferriprox dose excreted in urine as deferiprone or deferiprone 3-O-glucuronide. Urine samples were collected at the intervals of -2 to 0 hours pre-dose, and 0-2, 2-4, 4-8, 8-12 ,and 12- 24 hours post-dose. Note: For unknown reasons, the urine samples for one subject in the moderate hepatic failure group had low or zero volume and there were no measurable levels of deferiprone or its metabolite in any of the samples. Accordingly, the urine PK results were derived both with and without this subject's data, and are here presented without them (i.e., N=6 rather than 7).

Secondary outcomes

  • Safety and Tolerability of Ferriprox in Subjects With or Without Hepatic Impairment. [Time of dosing until 48 hours post-dose]: The number of participants who experienced adverse events following a single dose of Ferriprox, between the time of dosing and the follow-up visit (including any changes of clinical significance in physical examinations, vital signs, 12-lead ECG, and clinical laboratory tests).

+Eligibility

Sex: All, ages: 18 Years to 75 Years, accepts healthy volunteers

Main Inclusion Criteria:

All subjects:

1. Adult males or females, 18 - 75 years of age (inclusive);
2. Body weight ≥ 50 kg;
3. Body mass index (BMI) between 19 and 32 kg/mE2 (inclusive);
4. Absolute neutrophil count (ANC) of >1.5x10E9/L ;

Healthy volunteers:

1. Medically healthy with clinically insignificant screening results (e.g., laboratory profiles, medical history, vital signs, physical examination);
2. Matched to hepatically impaired subjects in the study by age (+/- 10 years), sex and weight (+/- 15% BMI).

Hepatically impaired subjects:

1. Considered clinically stable in the opinion of the Investigator;
2. Subjects with different degrees of impaired hepatic function as assessed by a Child-Pugh classification score: mild (Class A: 5-6 points) and moderate (Class B: 7-9 points) impaired hepatic function.

Main Exclusion Criteria:

1. For subjects with hepatic impairment, fluctuating or rapidly deteriorating hepatic function as indicated by clinical and/or laboratory signs of hepatic impairment (e.g. advanced ascites, infection of ascites, fever, or active gastrointestinal bleeding).
2. Evidence of liver impairment in healthy volunteers: hepatitis B and C; or aspartate aminotransferase (AST), alanine aminotransferase (ALT), bilirubin, clotting factors, serum protein that is considered clinically significant by the Investigator;
3. History or presence of significant clinically unstable respiratory, cardiovascular, pulmonary, hepatic (except for subjects assigned to one of the hepatically impaired groups), renal, hematologic, gastrointestinal, endocrine (except for subjects with hepatic impairment with clinically stable and treated diabetes, hypertension and thyroid disorders), immunologic, dermatologic, neurologic, or psychiatric disease;
4. Disorders or surgery of the gastrointestinal tract which may interfere with drug absorption or may otherwise influence the PK of the investigational medicinal product (e.g. resections of the small or large intestine, febrile conditions, chronic diarrhea, chronic vomiting, clinically unstable endocrine disease, severe infections, acute inflammations, etc.);
5. Received a pharmacological agent in another clinical trial within 28 days prior to the first dose of the study;

+Posted results

Participant flow

MilestoneNormal Hepatic Function (Healthy Volunteers)Mild Hepatic FailureModerate Hepatic Failure
Started777
Completed777
Not completed000

Outcome results

  • Cmax for Serum Deferiprone and Deferiprone 3-O-glucuronide (Primary), Mean, ug/mL: Normal Hepatic Function (Healthy Volunteers) 49.00 +/- 24.081; Mild Hepatic Failure 36.26 +/- 8.4799; Moderate Hepatic Failure 35.94 +/- 7.8407
  • Safety and Tolerability of Ferriprox in Subjects With or Without Hepatic Impairment. (Secondary), Number, participants: Normal Hepatic Function (Healthy Volunteers) 0; Mild Hepatic Failure 1; Moderate Hepatic Failure 3
  • Tmax for Serum Deferiprone and Deferiprone 3-O-glucuronide (Primary), Median, hour: Normal Hepatic Function (Healthy Volunteers) 0.7500 (0.500 to 2.00); Mild Hepatic Failure 0.7500 (0.500 to 1.00); Moderate Hepatic Failure 0.7500 (0.500 to 1.33)
  • AUC0-∞ for Serum Deferiprone and Deferiprone 3-O-glucuronide (Primary), Mean, ug*hr/mL: Normal Hepatic Function (Healthy Volunteers) 92.64 +/- 19.221; Mild Hepatic Failure 82.02 +/- 28.213; Moderate Hepatic Failure 105.5 +/- 41.684
  • T1/2 for Serum Deferiprone and Deferiprone 3-O-glucuronide (Primary), Mean, hour: Normal Hepatic Function (Healthy Volunteers) 1.994 +/- 0.26971; Mild Hepatic Failure 1.855 +/- 0.45370; Moderate Hepatic Failure 2.180 +/- 0.83153
  • CumAe for Urine Deferiprone and Deferiprone 3-O-glucuronide (Primary), Mean, mg: Normal Hepatic Function (Healthy Volunteers) 69.0 +/- 25.9; Mild Hepatic Failure 59.5 +/- 19.4; Moderate Hepatic Failure 62.9 +/- 31.1
  • Fe% for Urine Deferiprone and Deferiprone 3-O-glucuronide (Primary), Mean, percentage of dose excreted in urine: Normal Hepatic Function (Healthy Volunteers) 2.56 +/- 0.773; Mild Hepatic Failure 2.18 +/- 0.669; Moderate Hepatic Failure 2.36 +/- 1.20

Adverse events

Time frame: 2 days

ArmDeathsSerious adverse eventsOther adverse events
Normal Hepatic Function (Healthy Volunteers)00/7 (0.0%)0/7 (0.0%)
Mild Hepatic Failure00/7 (0.0%)1/7 (14.3%)
Moderate Hepatic Failure01/7 (14.3%)3/7 (42.9%)

Serious adverse events by term

TermOrgan systemNormal Hepatic Function (Healthy Volunteers)Mild Hepatic FailureModerate Hepatic Failure
Liver injuryHepatobiliary disorders0/70/71/7
Renal failureRenal and urinary disorders0/70/71/7

Other adverse events by term

TermOrgan systemNormal Hepatic Function (Healthy Volunteers)Mild Hepatic FailureModerate Hepatic Failure
NauseaGastrointestinal disorders0/70/71/7
VomitingGastrointestinal disorders0/70/71/7
Hepatic enzyme increasedInvestigations0/70/71/7
GoutMetabolism and nutrition disorders0/71/70/7
HeadacheNervous system disorders0/70/71/7

+Locations (2)

FacilityCityCountryStatus
University of MiamiMiami, FloridaUnited States
Orlando Clinical Research CenterOrlando, FloridaUnited States

+Investigators

My Notes