Trial Outcomes & Findings for Bioequivalence Study of Two Nitisinone Formulations Compared to Orfadin (NCT NCT02750709)

NCT ID: NCT02750709

Last Updated: 2017-03-15

Results Overview

Recruitment status

COMPLETED

Study phase

PHASE1

Target enrollment

24 participants

Primary outcome timeframe

0, 0.25, 0.50, 1, 2, 2.5, 3, 3.5, 4, 5, 6, 7, 8, 10, 12, 24, 36, 48, 72, 96 and 120 hours

Results posted on

2017-03-15

Participant Flow

Participant milestones

Participant milestones
Measure
Treatment Sequence A (TP 1) - B (TP 2) - C (Reference)
Subjects will receive a single 10 mg tablet of Nitisinone 10 mg Tablet (Test Product 1) in treatment period 1, 10 mg tablet of Nitisinone 10 mg Tablet High Compritol (Test Product 2) in treatment period 2, and 10 mg hard capsule of Orfadin (Reference) in treatment period 3 under fasting conditions. Each treatment period will be separated by at least 23 calendar days of washout period. Nitisinone: A single oral dose of Nitisinone 10 mg tablet will be administered in fasted state. Nitisinone 10 mg Tablet High Compritol: A single oral dose of Nitisinone 10 mg High Compritol tablet will be administered in fasted state. Orfadin: A single oral dose of Orfadin 10 mg hard capsule will be administered in fasted state.
Treatment Sequence A (TP 1) - C (Reference) - B (TP 2)
Subjects will receive a single 10 mg tablet of Nitisinone 10 mg Tablet (Test Product 2) in treatment period 1, 10 mg hard capsule of Orfadin (Reference) in treatment period 2, and 10 mg tablet of Nitisinone 10 mg Tablet High Compritol (Test Product 2) in treatment period 3 under fasting conditions. Each treatment period will be separated by at least 23 calendar days of washout period. Nitisinone: A single oral dose of Nitisinone 10 mg tablet will be administered in fasted state. Nitisinone 10 mg Tablet High Compritol: A single oral dose of Nitisinone 10 mg High Compritol tablet will be administered in fasted state. Orfadin: A single oral dose of Orfadin 10 mg hard capsule will be administered in fasted state.
Treatment Sequence B (TP 2) - A (TP 1) - C (Reference)
Subjects will receive a single 10 mg tablet of Nitisinone 10 mg Tablet High Compritol (Test Product 2) in treatment period 1, 10 mg tablet of Nitisinone 10 mg Tablet (Test Product 1) in treatment period 2, and 10 mg hard capsule of Orfadin (Reference) in treatment period 3 under fasting conditions. Each treatment period will be separated by at least 23 calendar days of washout period. Nitisinone: A single oral dose of Nitisinone 10 mg tablet will be administered in fasted state. Nitisinone 10 mg Tablet High Compritol: A single oral dose of Nitisinone 10 mg High Compritol tablet will be administered in fasted state. Orfadin: A single oral dose of Orfadin 10 mg hard capsule will be administered in fasted state.
Treatment Sequence B (TP 2) - C (Reference) - A (TP 1)
Subjects will receive a single 10 mg tablet of Nitisinone 10 mg Tablet High Compritol (Test Product 2) in treatment period 1, 10 mg hard capsule of Orfadin (Reference) in treatment period 2, and 10 mg tablet of Nitisinone 10 mg Tablet (Test Product 1) in treatment period 3, and under fasting conditions. Each treatment period will be separated by at least 23 calendar days of washout period. Nitisinone: A single oral dose of Nitisinone 10 mg tablet will be administered in fasted state. Nitisinone 10 mg Tablet High Compritol: A single oral dose of Nitisinone 10 mg High Compritol tablet will be administered in fasted state. Orfadin: A single oral dose of Orfadin 10 mg hard capsule will be administered in fasted state.
Treatment Sequence C (Reference) - A (TP 1) - B (TP 2)
Subjects will receive a single 10 mg hard capsule of Orfadin (Reference) in treatment period 1, 10 mg tablet of Nitisinone 10 mg Tablet (Test Product 1) in treatment period 2, and 10 mg tablet of Nitisinone 10 mg Tablet High Compritol (Test Product 2) in treatment period 3 under fasting conditions. Each treatment period will be separated by at least 23 calendar days of washout period. Nitisinone: A single oral dose of Nitisinone 10 mg tablet will be administered in fasted state. Nitisinone 10 mg Tablet High Compritol: A single oral dose of Nitisinone 10 mg High Compritol tablet will be administered in fasted state. Orfadin: A single oral dose of Orfadin 10 mg hard capsule will be administered in fasted state.
Treatment Sequence C (Reference) - B (TP 2) - A (TP 1)
Subjects will receive a single 10 mg hard capsule of Orfadin (Reference) in treatment period 1, 10 mg tablet of Nitisinone 10 mg Tablet High Compritol (Test Product 2) in treatment period 2, 10 mg tablet of Nitisinone 10 mg Tablet (Test Product 1) in treatment period 3 under fasting conditions. Each treatment period will be separated by at least 23 calendar days of washout period. Nitisinone: A single oral dose of Nitisinone 10 mg tablet will be administered in fasted state. Nitisinone 10 mg Tablet High Compritol: A single oral dose of Nitisinone 10 mg High Compritol tablet will be administered in fasted state. Orfadin: A single oral dose of Orfadin 10 mg hard capsule will be administered in fasted state.
Treatment Period 1
STARTED
4
4
4
4
4
4
Treatment Period 1
COMPLETED
4
4
4
4
4
3
Treatment Period 1
NOT COMPLETED
0
0
0
0
0
1
Treatment Period 2
STARTED
4
4
4
4
4
3
Treatment Period 2
COMPLETED
4
4
4
4
4
3
Treatment Period 2
NOT COMPLETED
0
0
0
0
0
0
Treatment Period 3
STARTED
4
4
4
4
4
3
Treatment Period 3
COMPLETED
4
4
4
4
4
3
Treatment Period 3
NOT COMPLETED
0
0
0
0
0
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Treatment Sequence A (TP 1) - B (TP 2) - C (Reference)
Subjects will receive a single 10 mg tablet of Nitisinone 10 mg Tablet (Test Product 1) in treatment period 1, 10 mg tablet of Nitisinone 10 mg Tablet High Compritol (Test Product 2) in treatment period 2, and 10 mg hard capsule of Orfadin (Reference) in treatment period 3 under fasting conditions. Each treatment period will be separated by at least 23 calendar days of washout period. Nitisinone: A single oral dose of Nitisinone 10 mg tablet will be administered in fasted state. Nitisinone 10 mg Tablet High Compritol: A single oral dose of Nitisinone 10 mg High Compritol tablet will be administered in fasted state. Orfadin: A single oral dose of Orfadin 10 mg hard capsule will be administered in fasted state.
Treatment Sequence A (TP 1) - C (Reference) - B (TP 2)
Subjects will receive a single 10 mg tablet of Nitisinone 10 mg Tablet (Test Product 2) in treatment period 1, 10 mg hard capsule of Orfadin (Reference) in treatment period 2, and 10 mg tablet of Nitisinone 10 mg Tablet High Compritol (Test Product 2) in treatment period 3 under fasting conditions. Each treatment period will be separated by at least 23 calendar days of washout period. Nitisinone: A single oral dose of Nitisinone 10 mg tablet will be administered in fasted state. Nitisinone 10 mg Tablet High Compritol: A single oral dose of Nitisinone 10 mg High Compritol tablet will be administered in fasted state. Orfadin: A single oral dose of Orfadin 10 mg hard capsule will be administered in fasted state.
Treatment Sequence B (TP 2) - A (TP 1) - C (Reference)
Subjects will receive a single 10 mg tablet of Nitisinone 10 mg Tablet High Compritol (Test Product 2) in treatment period 1, 10 mg tablet of Nitisinone 10 mg Tablet (Test Product 1) in treatment period 2, and 10 mg hard capsule of Orfadin (Reference) in treatment period 3 under fasting conditions. Each treatment period will be separated by at least 23 calendar days of washout period. Nitisinone: A single oral dose of Nitisinone 10 mg tablet will be administered in fasted state. Nitisinone 10 mg Tablet High Compritol: A single oral dose of Nitisinone 10 mg High Compritol tablet will be administered in fasted state. Orfadin: A single oral dose of Orfadin 10 mg hard capsule will be administered in fasted state.
Treatment Sequence B (TP 2) - C (Reference) - A (TP 1)
Subjects will receive a single 10 mg tablet of Nitisinone 10 mg Tablet High Compritol (Test Product 2) in treatment period 1, 10 mg hard capsule of Orfadin (Reference) in treatment period 2, and 10 mg tablet of Nitisinone 10 mg Tablet (Test Product 1) in treatment period 3, and under fasting conditions. Each treatment period will be separated by at least 23 calendar days of washout period. Nitisinone: A single oral dose of Nitisinone 10 mg tablet will be administered in fasted state. Nitisinone 10 mg Tablet High Compritol: A single oral dose of Nitisinone 10 mg High Compritol tablet will be administered in fasted state. Orfadin: A single oral dose of Orfadin 10 mg hard capsule will be administered in fasted state.
Treatment Sequence C (Reference) - A (TP 1) - B (TP 2)
Subjects will receive a single 10 mg hard capsule of Orfadin (Reference) in treatment period 1, 10 mg tablet of Nitisinone 10 mg Tablet (Test Product 1) in treatment period 2, and 10 mg tablet of Nitisinone 10 mg Tablet High Compritol (Test Product 2) in treatment period 3 under fasting conditions. Each treatment period will be separated by at least 23 calendar days of washout period. Nitisinone: A single oral dose of Nitisinone 10 mg tablet will be administered in fasted state. Nitisinone 10 mg Tablet High Compritol: A single oral dose of Nitisinone 10 mg High Compritol tablet will be administered in fasted state. Orfadin: A single oral dose of Orfadin 10 mg hard capsule will be administered in fasted state.
Treatment Sequence C (Reference) - B (TP 2) - A (TP 1)
Subjects will receive a single 10 mg hard capsule of Orfadin (Reference) in treatment period 1, 10 mg tablet of Nitisinone 10 mg Tablet High Compritol (Test Product 2) in treatment period 2, 10 mg tablet of Nitisinone 10 mg Tablet (Test Product 1) in treatment period 3 under fasting conditions. Each treatment period will be separated by at least 23 calendar days of washout period. Nitisinone: A single oral dose of Nitisinone 10 mg tablet will be administered in fasted state. Nitisinone 10 mg Tablet High Compritol: A single oral dose of Nitisinone 10 mg High Compritol tablet will be administered in fasted state. Orfadin: A single oral dose of Orfadin 10 mg hard capsule will be administered in fasted state.
Treatment Period 1
Adverse Event
0
0
0
0
0
1

Baseline Characteristics

Bioequivalence Study of Two Nitisinone Formulations Compared to Orfadin

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
All Study Participants
n=24 Participants
Age, Categorical
<=18 years
0 Participants
n=99 Participants
Age, Categorical
Between 18 and 65 years
24 Participants
n=99 Participants
Age, Categorical
>=65 years
0 Participants
n=99 Participants
Sex: Female, Male
Female
5 Participants
n=99 Participants
Sex: Female, Male
Male
19 Participants
n=99 Participants
Race/Ethnicity, Customized
Black
15 Participants
n=99 Participants
Race/Ethnicity, Customized
Caucasian
7 Participants
n=99 Participants
Race/Ethnicity, Customized
Coloured
1 Participants
n=99 Participants
Race/Ethnicity, Customized
Mixed Race
1 Participants
n=99 Participants
Region of Enrollment
South Africa
24 participants
n=99 Participants

PRIMARY outcome

Timeframe: 0, 0.25, 0.50, 1, 2, 2.5, 3, 3.5, 4, 5, 6, 7, 8, 10, 12, 24, 36, 48, 72, 96 and 120 hours

Population: All subjects for whom the primary PK parameters Cmax and AUC(0-120) could be calculated for at least 2 treatment periods (where one of the treatment periods is the Reference product), and who had no major protocol deviations thought to impact on the analysis of the PK data were included in the statistical PK analysis for the study.

Outcome measures

Outcome measures
Measure
Treatment Period 1
n=23 Participants
Nitisinone Tablet, 10 mg
Treatment Period 2
n=23 Participants
Nitisinone Tablet (High Compritol), 10 mg
Reference Product
n=23 Participants
ORFADIN® hard capsule, 10 mg
Maximum Observed Plasma Concentration (Cmax)
1137.40 ng/mL
Geometric Coefficient of Variation 17.9
1080.69 ng/mL
Geometric Coefficient of Variation 24.2
1168.71 ng/mL
Geometric Coefficient of Variation 22.6

PRIMARY outcome

Timeframe: 0, 0.25, 0.50, 1, 2, 2.5, 3, 3.5, 4, 5, 6, 7, 8, 10, 12, 24, 36, 48, 72, 96 and 120 hours

Population: All subjects for whom the primary PK parameters Cmax and AUC(0-120) could be calculated for at least 2 treatment periods (where one of the treatment periods is the Reference product), and who had no major protocol deviations thought to impact on the analysis of the PK data were included in the statistical PK analysis for the study.

Outcome measures

Outcome measures
Measure
Treatment Period 1
n=23 Participants
Nitisinone Tablet, 10 mg
Treatment Period 2
n=23 Participants
Nitisinone Tablet (High Compritol), 10 mg
Reference Product
n=23 Participants
ORFADIN® hard capsule, 10 mg
Area Under the Plasma Concentration Versus Time Curve, From Time Zero to 120 Hours Post-dose (AUC(0-120))
66220.91 hr*ng/mL
Geometric Coefficient of Variation 19.0
61883.52 hr*ng/mL
Geometric Coefficient of Variation 23.1
66199.76 hr*ng/mL
Geometric Coefficient of Variation 18.7

SECONDARY outcome

Timeframe: 0, 0.25, 0.50, 1, 2, 2.5, 3, 3.5, 4, 5, 6, 7, 8, 10, 12, 24, 36, 48, 72 hours post-dose

Population: All subjects for whom the primary PK parameters Cmax and AUC(0-120) could be calculated for at least 2 treatment periods (where one of the treatment periods is the Reference product), and who had no major protocol deviations thought to impact on the analysis of the PK data were included in the statistical PK analysis for the study.

Outcome measures

Outcome measures
Measure
Treatment Period 1
n=23 Participants
Nitisinone Tablet, 10 mg
Treatment Period 2
n=23 Participants
Nitisinone Tablet (High Compritol), 10 mg
Reference Product
n=23 Participants
ORFADIN® hard capsule, 10 mg
Area Under the Plasma Concentration Versus Time Curve, From Time Zero to 72 Hours Post-dose (AUC(0-72))
49448.49 hr*ng/mL
Geometric Coefficient of Variation 19.8
46401.12 hr*ng/mL
Geometric Coefficient of Variation 37.6
49582.69 hr*ng/mL
Geometric Coefficient of Variation 19.2

SECONDARY outcome

Timeframe: 0, 0.25, 0.50, 1, 2, 2.5, 3, 3.5, 4, 5, 6, 7, 8, 10, 12, 24, 36, 48, 72, 96 and 120 hours

Population: All subjects for whom the primary PK parameters Cmax and AUC(0-120) could be calculated for at least 2 treatment periods (where one of the treatment periods is the Reference product), and who had no major protocol deviations thought to impact on the analysis of the PK data were included in the statistical PK analysis for the study.

Outcome measures

Outcome measures
Measure
Treatment Period 1
n=23 Participants
Nitisinone Tablet, 10 mg
Treatment Period 2
n=23 Participants
Nitisinone Tablet (High Compritol), 10 mg
Reference Product
n=23 Participants
ORFADIN® hard capsule, 10 mg
Area Under the Plasma Concentration Versus Time Curve, With Extrapolation to Infinity (AUC(0-∞)
91226.27 hr*ng/mL
Geometric Coefficient of Variation 26.6
83245.33 hr*ng/mL
Geometric Coefficient of Variation 37.0
89394.35 hr*ng/mL
Geometric Coefficient of Variation 23.7

SECONDARY outcome

Timeframe: 0, 0.25, 0.50, 1, 2, 2.5, 3, 3.5, 4, 5, 6, 7, 8, 10, 12, 24, 36, 48, 72, 96 and 120 hours

Population: All subjects for whom the primary PK parameters Cmax and AUC(0-120) could be calculated for at least 2 treatment periods (where one of the treatment periods is the Reference product), and who had no major protocol deviations thought to impact on the analysis of the PK data were included in the statistical PK analysis for the study.

Outcome measures

Outcome measures
Measure
Treatment Period 1
n=23 Participants
Nitisinone Tablet, 10 mg
Treatment Period 2
n=23 Participants
Nitisinone Tablet (High Compritol), 10 mg
Reference Product
n=23 Participants
ORFADIN® hard capsule, 10 mg
Time to Maximum Observed Plasma Concentration (Tmax)
3.00 hr
Interval 2.0 to 5.0
3.00 hr
Interval 1.0 to 7.0
2.50 hr
Interval 0.5 to 8.0

SECONDARY outcome

Timeframe: 0, 0.25, 0.50, 1, 2, 2.5, 3, 3.5, 4, 5, 6, 7, 8, 10, 12, 24, 36, 48, 72, 96 and 120 hours

Population: All subjects for whom the primary PK parameters Cmax and AUC(0-120) could be calculated for at least 2 treatment periods (where one of the treatment periods is the Reference product), and who had no major protocol deviations thought to impact on the analysis of the PK data were included in the statistical PK analysis for the study.

Outcome measures

Outcome measures
Measure
Treatment Period 1
n=23 Participants
Nitisinone Tablet, 10 mg
Treatment Period 2
n=23 Participants
Nitisinone Tablet (High Compritol), 10 mg
Reference Product
n=23 Participants
ORFADIN® hard capsule, 10 mg
Terminal Elimination Rate Constant (λz)
0.011 1/hr
Geometric Coefficient of Variation 29.1
0.012 1/hr
Geometric Coefficient of Variation 20.6
0.012 1/hr
Geometric Coefficient of Variation 25.2

SECONDARY outcome

Timeframe: 0, 0.25, 0.50, 1, 2, 2.5, 3, 3.5, 4, 5, 6, 7, 8, 10, 12, 24, 36, 48, 72, 96 and 120 hours

Population: All subjects for whom the primary PK parameters Cmax and AUC(0-120) could be calculated for at least 2 treatment periods (where one of the treatment periods is the Reference product), and who had no major protocol deviations thought to impact on the analysis of the PK data were included in the statistical PK analysis for the study.

Outcome measures

Outcome measures
Measure
Treatment Period 1
n=23 Participants
Nitisinone Tablet, 10 mg
Treatment Period 2
n=23 Participants
Nitisinone Tablet (High Compritol), 10 mg
Reference Product
n=23 Participants
ORFADIN® hard capsule, 10 mg
Apparent Terminal Half-life (t1/2)
61.42 hr
Geometric Coefficient of Variation 29.1
58.41 hr
Geometric Coefficient of Variation 20.6
59.43 hr
Geometric Coefficient of Variation 25.2

Adverse Events

Test Product 1

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Test Product 2

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Reference Product

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Test Product 1
n=23 participants at risk
Nitisinone Tablet, 10 mg
Test Product 2
n=23 participants at risk
Nitisinone Tablet (High Compritol), 10 mg
Reference Product
n=24 participants at risk
ORFADIN® hard capsule, 10 mg
Nervous system disorders
Headache
4.3%
1/23 • Number of events 1 • Adverse event data were collected over the period of the study (December 2015 - January 2016).
24 subjects were entered in to the study and randomly assigned to treatment sequence according to randomization schedule before first administration of the Investigational Medicinal Product (IMP). One subject was withdrawn from the study after Treatment Period 1 (Reference Product) because they vomited within 2 times median Tmax. As a result, 24 subjects completed dosing of Reference Product and 23 subjects completed the study.
0.00%
0/23 • Adverse event data were collected over the period of the study (December 2015 - January 2016).
24 subjects were entered in to the study and randomly assigned to treatment sequence according to randomization schedule before first administration of the Investigational Medicinal Product (IMP). One subject was withdrawn from the study after Treatment Period 1 (Reference Product) because they vomited within 2 times median Tmax. As a result, 24 subjects completed dosing of Reference Product and 23 subjects completed the study.
4.2%
1/24 • Number of events 1 • Adverse event data were collected over the period of the study (December 2015 - January 2016).
24 subjects were entered in to the study and randomly assigned to treatment sequence according to randomization schedule before first administration of the Investigational Medicinal Product (IMP). One subject was withdrawn from the study after Treatment Period 1 (Reference Product) because they vomited within 2 times median Tmax. As a result, 24 subjects completed dosing of Reference Product and 23 subjects completed the study.
Skin and subcutaneous tissue disorders
Itching Fingers
0.00%
0/23 • Adverse event data were collected over the period of the study (December 2015 - January 2016).
24 subjects were entered in to the study and randomly assigned to treatment sequence according to randomization schedule before first administration of the Investigational Medicinal Product (IMP). One subject was withdrawn from the study after Treatment Period 1 (Reference Product) because they vomited within 2 times median Tmax. As a result, 24 subjects completed dosing of Reference Product and 23 subjects completed the study.
4.3%
1/23 • Number of events 1 • Adverse event data were collected over the period of the study (December 2015 - January 2016).
24 subjects were entered in to the study and randomly assigned to treatment sequence according to randomization schedule before first administration of the Investigational Medicinal Product (IMP). One subject was withdrawn from the study after Treatment Period 1 (Reference Product) because they vomited within 2 times median Tmax. As a result, 24 subjects completed dosing of Reference Product and 23 subjects completed the study.
0.00%
0/24 • Adverse event data were collected over the period of the study (December 2015 - January 2016).
24 subjects were entered in to the study and randomly assigned to treatment sequence according to randomization schedule before first administration of the Investigational Medicinal Product (IMP). One subject was withdrawn from the study after Treatment Period 1 (Reference Product) because they vomited within 2 times median Tmax. As a result, 24 subjects completed dosing of Reference Product and 23 subjects completed the study.
Nervous system disorders
Vaso Vagal Attack
0.00%
0/23 • Adverse event data were collected over the period of the study (December 2015 - January 2016).
24 subjects were entered in to the study and randomly assigned to treatment sequence according to randomization schedule before first administration of the Investigational Medicinal Product (IMP). One subject was withdrawn from the study after Treatment Period 1 (Reference Product) because they vomited within 2 times median Tmax. As a result, 24 subjects completed dosing of Reference Product and 23 subjects completed the study.
0.00%
0/23 • Adverse event data were collected over the period of the study (December 2015 - January 2016).
24 subjects were entered in to the study and randomly assigned to treatment sequence according to randomization schedule before first administration of the Investigational Medicinal Product (IMP). One subject was withdrawn from the study after Treatment Period 1 (Reference Product) because they vomited within 2 times median Tmax. As a result, 24 subjects completed dosing of Reference Product and 23 subjects completed the study.
4.2%
1/24 • Number of events 1 • Adverse event data were collected over the period of the study (December 2015 - January 2016).
24 subjects were entered in to the study and randomly assigned to treatment sequence according to randomization schedule before first administration of the Investigational Medicinal Product (IMP). One subject was withdrawn from the study after Treatment Period 1 (Reference Product) because they vomited within 2 times median Tmax. As a result, 24 subjects completed dosing of Reference Product and 23 subjects completed the study.

Additional Information

James Price

Cycle Pharmaceuticals Ltd

Phone: +44 1223 803638

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place