Renal ImpairmentPhase 1NCT03896750
Single-Dose Study to Evaluate the PKs of Pretomanid in Participants With Renal Impairment Compared to Participants With Normal Renal Function
A Phase 1 study testing PA-824 in people with Renal Impairment and Tuberculosis, run by National Institute of Allergy and Infectious Diseases (NIAID) at 3 sites in United States.
Trial summary
This is a Phase 1, open-label, single-dose, sequential group study to compare the safety and pharmacokinetics (PK) of pretomanid in the following groups of participants: 1) participants with severe renal impairment including those with end stage renal disease (ESRD) not on dialysis, and participants with mild or… Read more about this study
- Who is it for?
- Ages 18 to 85 yearsHealthy volunteers can take part
- Conditions the study is for
- Renal Impairment, Tuberculosis
- What is being tested?
- PA-824
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 12 participants
- Where
- 3 sitesUnited States
- Study dates
- 17 Apr 2024to 28 Oct 2024
- Phase
- Phase 1
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 85 years
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Who may be able to join
- Participant Inclusion Criteria for Patients with Renal Impairment (Groups 2-4)
- Have the ability to understand the requirements of the study and have provided written informed consent* before any study-related procedure is performed.
- As evidence by signature on an informed consent document approved by the Institutional Review Board
- Agree to abide by the study restrictions.
- Are between the ages of 18 and 85 years, inclusive, at the time of enrollment.
- Must have mild, moderate, or severe renal impairment or end stage renal disease (ESRD), but are not on dialysis.
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- Have no history of chronic tobacco/nicotine usage (i.e., >10 cigarettes per day for 3 months minimum prior to admission).
- Have corrected QT interval by Fridericia (QTcF) <460 msec on Electrocardiogram (ECG).
- Have a Body Mass Index (BMI) of 18 to 40 kg/m^2 at enrollment.
- Women of childbearing potential must use an acceptable contraception method* for the duration of the study.
- Not sterilized via tubal ligation, bilateral oophorectomy, bilateral salpingectomy, hysterectomy, implanted contraceptive device placement (permanent, non-surgical, non-hormonal sterilization) with documented radiological confirmation test at least 90 days after the procedure, and still menstruating or <1 year has passed since the last menses if menopausal.
- Includes, non-male sexual relationships, abstinence from sexual intercourse with a male partner, monogamous relationship with vasectomized partner who has been vasectomized for 180 days or more prior to the participant receiving study product, barrier methods such as condoms with spermicide or diaphragms/cervical caps with spermicide, effective intrauterine devices, NuvaRing(R), and licensed hormonal methods such as implants, injectables, or oral contraceptives ("the pill").
- If participant is male and capable of reproduction, agrees to avoid fathering a child for the duration of the study by using an acceptable method of birth control****.
- In addition to the use of a barrier method (condom) unless vasectomized, acceptable methods of birth control are restricted to a monogamous relationship with a woman who agrees to use acceptable contraception as outlined in inclusion criterion #8, and/or abstinence from sexual intercourse with women.
- Women of childbearing potential must have a negative urine pregnancy test within 24 hours prior to receipt of study product.
- Participant Inclusion Criteria for Healthy Participants (Groups 1A-1C)
- Have the ability to understand the requirements of the study and have provided written informed consent* before any study-related procedure is performed.
- As evidence by signature on an informed consent document approved by the Institutional Review Board (IRB).
- Agree to abide by the study restrictions.
- Are healthy male or non-pregnant female, between the ages of 18 and 85 years, inclusive, with normal GFR >90 at screening.
- Have no history of chronic tobacco/nicotine usage (i.e., >10 cigarettes per day for 3 months minimum prior to admission).
- Have a normal corrected QT interval by Fridericia (QTcF) <460 msec on ECG.
- Have a Body Mass Index of 18 to 40 kg/m^2 at enrollment.
- Women of childbearing potential must use an acceptable contraception method* for the duration of the study.
- Not sterilized via tubal ligation, bilateral oophorectomy, bilateral salpingectomy, hysterectomy, implanted contraceptive device placement (permanent, non-surgical, non-hormonal sterilization) with documented radiological confirmation test at least 90 days after the procedure, and still menstruating or <1 year has passed since the last menses if menopausal.
- Includes non-male sexual relationships, abstinence from sexual intercourse with a male partner, monogamous relationship with vasectomized partner who has been vasectomized for 180 days or more prior to the participant receiving study product, barrier methods such as condoms with spermicide or diaphragms/cervical caps with spermicide, effective intrauterine devices, NuvaRing(R), and licensed hormonal methods such as implants, injectables, or oral contraceptives ("the pill").
- If participant is male and capable of reproduction, agrees to avoid fathering a child for the duration of the study by using an acceptable method of birth control****.
- In addition to the use of a barrier method (condom) unless vasectomized, acceptable methods of birth control are restricted to a monogamous relationship with a woman who agrees to use acceptable contraception as outlined in inclusion criterion #7, and/or abstinence from sexual intercourse with women.
- Women of childbearing potential must have a negative urine pregnancy test within 24 hours prior to receipt of study product.
Who cannot join
- Participant Exclusion Criteria for Patients with Renal Impairment (Groups 2-4)
- History of known active TB.
- History of peptic ulcer disease.
- Known hypersensitivity to pretomanid or any of the excipients.
- History of any clinically significant uncontrolled cardiac abnormality (as deemed by the Principal Investigator (PI)).
- Any clinically significant electrocardiogram (ECG) abnormality at screening*.
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- Note: the following can be considered not clinically significant:
- Heart rate </= 50 beats per minute (bpm) (sinus bradycardia with heart rate between 45 and 49, inclusive, is acceptable only in younger athletic participants, as determined by the Principal Investigator ))
- Mild first-degree atrioventricular (A-V) block (P-R interval >0.23 seconds)
- Right or left axis deviation
- Incomplete right bundle branch block
- Isolated left anterior fascicular block (left anterior hemiblock) in younger athletic participants
- History of, or screening results show a corrected QT interval by Fridericia (QTcF) >/= 460 msec.
- Family history of Long-QT Syndrome or sudden death when a cause of death is unknown.
- Inability to swallow tablets.
- History of fever or documented fever (oral temperature >/= 100.4 degrees F) in the 48 hours prior to admission to the hospital.
- Resting pulse rate <50 or >110 bpm at Screening.
- At Screening, blood pressure >/= 20 mm Hg systolic or >10 mm Hg diastolic above baseline** (sitting).
- Baseline is most recent blood pressure in the last 3 months.
- Current hyperkalemia or hypomagnesemia.
- Positive result of urine drug screen or blood alcohol screen prior to hospital admission except for approved prescriptions that are not opiates and benzodiazepines.
- Significant history of drug and/or food allergies (as deemed by the Principal Investigator (PI)).
- For women, participant is pregnant (positive test for urine Human Chorionic Gonadotropin [HCG]) at screening or Admission, breastfeeding, or planning to conceive for the duration of the study.
- Any contraindication to the use of nitroimidazoles, or prior treatment with pretomanid or delamanid.
- Treatment with strong or moderate CYP3A4 inducers or inhibitors* within 14 days before admission and during the study**.
- Except hormonal contraceptives
- In the opinion of the site investigator
- Use of St. John's Wort within 7 days prior to admission and during the entire study.
- Consumption of products containing grapefruit within 5 days prior to dosing until Visit 01N.
- Donation of whole blood or blood products >500 mL within 30 days from screening and/or plans to donate during the study or up to 14 days after dosing.
- Participation in another interventional clinical trial within 30 days prior to dosing until after the last study visit.
- Hemoglobin (Hgb) <8.0 g/dL in both men and women at the screening visit.
- Positive Screening test for Hepatitis C Virus (HCV), Hepatitis B Virus (HBV), or Human Immunodeficiency Virus (HIV).
- Renal transplant.
- Scheduled for hemodialysis or peritoneal dialysis.
- Presence of any condition or finding* which would jeopardize participant safety, impact study result validity, or diminish the participant's ability to undergo all study procedures and assessments.
- In the opinion of the investigator
- For men, semen donation for the duration of the study.
- Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) > 2.5 x Upper Limit of Normal (ULN).
- Hyperbilirubinemia >1.5 x Upper Limits of Normal (ULN).
- Participant Exclusion Criteria for Healthy Participants (Groups 1A-1C)
- History of known active TB.
- History of peptic ulcer disease.
- Known hypersensitivity to pretomanid or any of the excipients.
- History of any clinically significant uncontrolled cardiac abnormality (as deemed by the Principal Investigator (PI)).
- Any clinically significant ECG abnormality at screening.*
- Note: the following can be considered not clinically significant:
- Heart rate </= 50 bpm (sinus bradycardia with heart rate between 45 and 49, inclusive, is acceptable only in younger athletic participants)
- Mild first-degree A-V block (P-R interval >0.23 seconds)
- Right or left axis deviation
- Incomplete right bundle branch block
- Isolated left anterior fascicular block (left anterior hemiblock) in younger athletic participants
- Family history of Long-QT Syndrome or sudden death when a cause of death is unknown.
- Inability to swallow tablets.
- History of fever or documented fever (oral temperature >/= 100.4 degrees F) in the 48 hours prior to admission to the hospital.
- At Screening blood pressure >140/90 mm Hg or <90/65 mm Hg (sitting).
- History of, or screening results show a corrected QT interval by Fridericia (QTcF) >460 msec.
- Positive result of urine drug screen or blood alcohol screen prior to hospital admission except for approved prescriptions that are not opiates and benzodiazepines.
- Significant history of drug and/or food allergies (as deemed by the Principal Investigator (PI)).
- Women of childbearing potential with a positive urine pregnancy test within 24 hours prior to receipt of study product.
- Any contraindication to the use of nitroimidazoles, or prior treatment with pretomanid or delamanid.
- Treatment with strong or moderate CYP3A4 inducers or inhibitors within 14 days before admission and during the study*.
- Except hormonal contraceptives
- In the opinion of the site Principal Investigator (PI)
- Use of St. John's Wort within 7 days prior to admission and during the entire study.
- Consumption of products containing grapefruit within 5 days prior to dosing until Visit 01N.
- Donation of whole blood or blood products >500 mL within 30 days from screening and/or plans to donate during the study or up to 14 days after dosing.
- Participation in another interventional clinical trial within 30 days prior to dosing until after the last study visit.
- Hgb <10.0 g/dL in both men and women at the screening visit.
- Positive Screening test for Hepatitis C virus (HCV), Hepatitis B virus (HBV), or Human Immunodeficiency Virus (HIV).
- Renal transplant.
- Presence of any condition or finding**** which would jeopardize participant safety, impact study result validity, or diminish the participant's ability to undergo all study procedures and assessments.
- In the opinion of the investigator
- For men, semen donation for the duration of the study.
- Aspartate Aminotransferase (AST) and Alanine Aminotransferase (ALT) > Upper Limits of Normal (ULN).
- Bilirubin > Upper Limits of Normal (ULN)
Trial locations and contacts
3 sites in 1 country.
United States3 sites
Alliance for Multispecialty Research, LLC - Knoxville
Knoxville, Tennessee, 37920
Advanced Pharma - Miami
Miami, Florida, 33147
Saint Louis University Center for Vaccine Development
St Louis, Missouri, 63104-1015
About this study
Official title: A Phase 1, Open-Label, Single-Dose Study to Evaluate the Pharmacokinetics and Safety of Pretomanid in Participants With Renal Impairment Compared to Participants With Normal Renal Function
This is a Phase 1, open-label, single-dose, sequential group study to compare the safety and pharmacokinetics (PK) of pretomanid in the following groups of participants: 1) participants with severe renal impairment including those with end stage renal disease (ESRD) not on dialysis, and participants with mild or moderate renal impairment, designated as Groups 2, 3, and 4, respectively; and 2) participants with normal renal function matched to the above renal impairment groups, designated as Groups 1A, 1B, and 1C, respectively.
The study will be conducted following a reduced PK study design in Part A. Part A will enroll participants from Group 1A (i.e., 6 healthy matched controls) and Group 2 (i.e., 6 participants with severe renal impairment and ESRD, not on dialysis). A decision to proceed to Part B will be made after the PK of pretomanid, and safety in participants enrolled in Part A have been reviewed. If Part A demonstrates at least a 50% increase in pretomanid area under the plasma concentration-time curve (AUC) in Group 2 (severe renal impairments and ESRD, not on dialysis) relative to the exposures in Group 1A (matched participants with normal renal function), then the reduced PK study will extend to the full PK study to enroll participants into Part B (i.e., to investigate mild and moderate renal impairment). All Part B groups (1B, 1C, 3, and 4) will be enrolled concurrently.
Read more
If the reduced PK study shows at least a 50% increase in AUC in patients with severe renal impairment and patients with ESRD not yet on dialysis relative to the matched healthy controls, a "full PK" renal impairment study in patients with all intermediate levels of renal function impairment should be conducted. Otherwise, no further study is recommended.
The approximate patient involvement will be 3 months. The primary objective is to evaluate the PK profiles of pretomanid in plasma and urine after a single oral dose of 200 mg in participants with renal impairment compared to matched healthy controls.
Read the detailed description
This is a Phase 1, open-label, single-dose, sequential group study to compare the safety and pharmacokinetics (PK) of pretomanid in the following groups of participants: 1) participants with severe renal impairment including those with end stage renal disease (ESRD) not on dialysis, and participants with mild or moderate renal impairment, designated as Groups 2, 3, and 4, respectively; and 2) participants with normal renal function matched to the above renal impairment groups, designated as Groups 1A, 1B, and 1C, respectively.
The study will be conducted following a reduced PK study design in Part A. Part A will enroll participants from Group 1A (i.e., 6 healthy matched controls) and Group 2 (i.e., 6 participants with severe renal impairment and ESRD, not on dialysis). A decision to proceed to Part B will be made after the PK of pretomanid, and safety in participants enrolled in Part A have been reviewed. If Part A demonstrates at least a 50% increase in pretomanid area under the plasma concentration-time curve (AUC) in Group 2 (severe renal impairments and ESRD, not on dialysis) relative to the exposures in Group 1A (matched participants with normal renal function), then the reduced PK study will extend to the full PK study to enroll participants into Part B (i.e., to investigate mild and moderate renal impairment). All Part B groups (1B, 1C, 3, and 4) will be enrolled concurrently.
If the reduced PK study shows at least a 50% increase in AUC in patients with severe renal impairment and patients with ESRD not yet on dialysis relative to the matched healthy controls, a "full PK" renal impairment study in patients with all intermediate levels of renal function impairment should be conducted. Otherwise, no further study is recommended.
The approximate patient involvement will be 3 months. The primary objective is to evaluate the PK profiles of pretomanid in plasma and urine after a single oral dose of 200 mg in participants with renal impairment compared to matched healthy controls. The secondary objectives are 1) to assess the safety profile of a single oral dose of 200 mg pretomanid in renally impaired participants to matched healthy controls; and 2) to evaluate the PK profiles or representative pretomanid metabolites (M19 and M50) in plasma and urine.
- Conditions
- Renal Impairment, Tuberculosis
- Being tested
- PA-824
- Keywords
- Open-Label, Pretomanid, Renal Pharmacokinetic, Single-Dose
- Medical subject headings
- Renal Insufficiency, Tuberculosis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PA-824Drug
PA-824, a nitroimidazooxazine, used in prior studies of pretomanid is a novel TB treatment that is being investigated for use with other TB drugs to shorten and/or simplify regimens to treat either drug susceptible or resistant disease. Pretomanid will be administered in the fed state (high-fat and high-calorie meal) in this study following an overnight fast of at least 8 hours. Pretomanid should be administered 30 + or - 10 minutes after start of the meal.
| Study group | Role | What they receive |
|---|---|---|
| Part A Group 1A | Active comparator | 6 healthy participants with normal renal function: Modification of Diet in Renal Disease (MDRD) estimated Glomerular Filtration Rate (eGFR > / = 90 mL/min) matched to Group 2 by race, gender, age (+/- 10 years, but between 18 to 85 years of age) and body mass index (BMI) (18 to 40 kg/m^2) will receive a single oral dose of 200 mg pretomanid Receives: Drug: PA-824 |
| Part A Group 2 | Experimental | 6 participants with severe renal impairment: Stage 4, Modification of Diet in Renal Disease (MDRD) estimated Glomerular Filtration Rate (eGFR 15-29 mL/min), and End Stage Renal Disease (ESRD) not on dialysis: Stage 5, Modification of Diet in Renal Disease (MDRD) with estimated Glomerular Filtration Rate (eGFR < 15 mL/min) matched to Group 1A will receive a single oral dose of 200 mg pretomanid Receives: Drug: PA-824 |
| Part B Group 1B | Active comparator | 6 healthy participants with Modification of Diet in Renal Disease (MDRD) estimated Glomerular Filtration Rate (eGFR of > / = 90 mL/min) matched to Group 3 by race, gender, age (+/- 10 years, but between 18 to 85 years of age) and body mass index (BMI) (18 to 40 kg/m^2) will receive a single oral dose of 200 mg pretomanid after the PK and safety of subjects enrolled in Part A have been reviewed Receives: Drug: PA-824 |
| Part B Group 1C | Active comparator | 6 healthy participants: with Modification of Diet in Renal Disease (MDRD) estimated Glomerular Filtration Rate (eGFR > / = 90 mL/min) matched to Group 4 by race, gender, age (+/- 10 years, but between 18 to 85 years of age) and body mass index (BMI) (18 to 40 kg/m^2) will receive a single oral dose of 200 mg pretomanid after the PK and safety of subjects enrolled in Part A have been reviewed Receives: Drug: PA-824 |
| Part B Group 3 | Experimental | 6 participants with mild renal impairment: Stage 2, Modification of Diet in Renal Disease (MDRD) estimated Glomerular Filtration Rate (eGFR 60-89 mL/min) matched to Group 1B will receive a single oral dose of 200 mg pretomanid after the PK and safety of subjects enrolled in Part A have been reviewed Receives: Drug: PA-824 |
| Part B Group 4 | Experimental | 6 participants with moderate renal impairment: Stage 3, Modification of Diet in Renal Disease (MDRD) estimated Glomerular Filtration Rate (eGFR = 30-59 mL/min) matched to Group 1C will receive a single oral dose of 200 mg pretomanid after the PK and safety of subjects enrolled in Part A have been reviewed Receives: Drug: PA-824 |
What is being measured
The primary outcome is the main question the study is designed to answer.
Fold Change in Pretomanid AUC(0-last) in Participants With Renal Impairment as Compared to Matched Healthy Controls
The mean fold change of AUC(0-last) Area under the concentration time-curve to the last concentration above the lower limit of quantitation at specified pre-dose and post-dose time points was calculated by noncompartmental analysis using the linear up log down method. The mean fold change of each enrolled renal impairment arm as compared to the Healthy Matched Control arm was calculated by a linear regression model controlling for site.
Measured: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Fold Change in Pretomanid AUC(0-infinity) in Participants With Renal Impairment as Compared to Matched Healthy Controls
The mean fold change of AUC(0-infinity) was calculated by noncompartmental analysis using the linear up log down method with the area extrapolated to infinity as Clast/Lambda_z where Clast was the last observed concentration and Lambda_z is the elimination rate constant. The mean fold change of each enrolled renal impairment arm as compared to the Healthy Matched Control arm was calculated by a linear regression model controlling for site.
Measured: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Secondary outcomes (24)
Area Under the M19 and M50 Concentration Time-curve Extrapolated to Infinity at Specified Pre-dose and Post-dose Time Points
AUC(0-infinity) was calculated by noncompartmental analysis using the linear up log down method with the area extrapolated to infinity as Clast/Lambda_z where Clast was the last observed concentration and Lambda_z is the elimination rate constant. M19 and M50 are the two primary representative metabolites of pretomanid.
Measured: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Area Under the M19 and M50 Concentration Time-curve to the Last Concentration Above the Lower Limit of Quantitation at Specified Pre-dose and Post-dose Time Points
AUC(0-last) Area under the concentration time-curve to the last concentration above the lower limit of quantitation at specified pre-dose and post-dose time points was calculated by noncompartmental analysis using the linear up log down method. M19 and M50 are the two primary representative metabolites of pretomanid.
Measured: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Maximum M19 and M50 Concentrations at Specified Pre-dose and Post-dose Time Points
Maximum M19 and M50 concentrations is the maximum observed drug concentration in blood plasma at specified pre-dose and post-dose timepoints. M19 and M50 are the two primary representative metabolites of pretomanid.
Measured: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Apparent Terminal Elimination Half-life of M19 and M50 at Specified Pre-dose and Post-dose Time Points
Apparent terminal half-life of M19 and M50 at specified pre-dose and post-dose timepoints was estimated by ln(2)/Lambda_z, where Lambda_z is the elimination rate constant. M19 and M50 are the two primary representative metabolites of pretomanid.
Measured: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Renal Clearance of M19 and M50 at Specified Pre-dose and Post-dose Time Points
Renal clearance (CLr) of M19 and M50 calculated as the amount excreted in urine to time t in urine divided by the plasma AUC from 0 to time t. M19 and M50 are the two primary representative metabolites of pretomanid.
Measured: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Amount of M19 and M50 Excreted in Urine at Specified Pre-dose and Post-dose Time Points
Amount of M19 and M50 excreted in Urine [Ae(0-t)] is the sum of the amount of M19 and M50 recovered in urine during the collection window. M19 and M50 are the two primary representative metabolites of pretomanid.
Measured: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Apparent Volume of Distribution of M19 and M50 at Specified Pre-dose and Post-dose Time Points
Apparent Volume of Distribution at specified pre-dose and post-dose timepoints is the volume that the total amount of administered drug would occupy to provide the same concentration as it currently is in blood plasma divided by the bioavailability. It is calculated by Dose/[Lambda_z x AUC(0-infinity)]. M19 and M50 are the two primary representative metabolites of pretomanid.
Measured: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Time of Maximum M19 and M50 Concentration at Specified Pre-dose and Post-dose Time Points
Time of maximum M19 and M50 concentration (Tmax) at specified pre-dose and post-dose timepoints. M19 and M50 are the two primary representative metabolites of pretomanid.
Measured: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Apparent Oral Clearance of M19 and M50 From Dose/AUC(0-infinity) at Specified Pre-dose and Post-dose Time Points
Apparent oral clearance was calculated by noncompartmental analysis using the formula Dose/AUC(0-infinity). M19 and M50 are the two primary representative metabolites of pretomanid.
Measured: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Number of Participants With and Severity of Adverse Events
An Adverse Event (AE) was defined as any unfavorable or unintended medical occurrence temporally associated with the use of a study drug, device, other medical product, or procedure whether or not it is considered related to the product itself.
Measured: Day 1 to Day 85
Mean Change From Baseline in Alanine Aminotransferase (ALT)
The mean change from baseline was calculated by taking the mean of each participant value at the specified day minus the value last recorded prior to drug administration.
Measured: Day 5 and Day 12
Mean Change From Baseline in Aspartate Aminotransferase (AST)
The mean change from baseline was calculated by taking the mean of each participant value at the specified day minus the value last recorded prior to drug administration.
Measured: Day 5 and Day 12
Mean Change From Baseline in Blood Urea Nitrogen (BUN)
The mean change from baseline was calculated by taking the mean of each participant value at the specified day minus the value last recorded prior to drug administration.
Measured: Day 5 and Day 12
Mean Change From Baseline in Creatinine
The mean change from baseline was calculated by taking the mean of each participant value at the specified day minus the value last recorded prior to drug administration.
Measured: Day 5 and Day 12
Mean Change From Baseline in Hemoglobin (Hgb)
The mean change from baseline was calculated by taking the mean of each participant value at the specified day minus the value last recorded prior to drug administration.
Measured: Day 5 and Day 12
Mean Change From Baseline in Estimated Glomerular Filtration Rate (eGFR)
The mean change from baseline was calculated by taking the mean of each participant value at the specified day minus the value last recorded prior to drug administration.
Measured: Day 5 and Day 12
Mean Change From Baseline in Magnesium
The mean change from baseline was calculated by taking the mean of each participant value at the specified day minus the value last recorded prior to drug administration.
Measured: Day 5 and Day 12
Mean Change From Baseline in Serum Potassium
The mean change from baseline was calculated by taking the mean of each participant value at the specified day minus the value last recorded prior to drug administration.
Measured: Day 5 and Day 12
Mean Change From Baseline in Total Bilirubin
The mean change from baseline was calculated by taking the mean of each participant value at the specified day minus the value last recorded prior to drug administration.
Measured: Day 5 and Day 12
Mean Change in Oral Temperature From Baseline
The mean change from baseline was calculated by taking the mean of each participant value at the specified day minus the value last recorded prior to drug administration.
Measured: Days 1, 2, 3, 4, 5, and 12
Mean Change in Pulse From Baseline
The mean change from baseline was calculated by taking the mean of each participant value at the specified day minus the value last recorded prior to drug administration.
Measured: Days 1, 2, 3, 4, 5, and 12
Mean Change in Sitting Systolic Blood Pressure From Baseline
The mean change from baseline was calculated by taking the mean of each participant value at the specified day minus the value last recorded prior to drug administration.
Measured: Days 1, 2, 3, 4, 5, and 12
Mean Change in Sitting Diastolic Blood Pressure From Baseline
The mean change from baseline was calculated by taking the mean of each participant value at the specified day minus the value last recorded prior to drug administration.
Measured: Days 1, 2, 3, 4, 5, and 12
Mean Change in the Electrocardiogram (ECG) Corrected QT Interval by Fridericia (QTcF) Interval From Baseline
The mean change from baseline was calculated by taking the mean of each participant value at the specified day minus the value last recorded prior to drug administration.
Measured: Day 5
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Apr 2019
- Study start17 Apr 2024
- Primary completion10 Aug 2024
- Study completion28 Oct 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Other trials for Renal ImpairmentStudies of the same condition, open and under way.
- More trials run by National Institute of Allergy and Infectious Diseases (NIAID)The sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 1
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Enrolment
- 12 participants (actual)
Sponsor and investigators
- Sponsor type
- US National Institutes of Health
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03896750
- Sponsor's protocol ID
- 15-0037
- Other IDs
- 75N93022D00018
- Status last verified
- 19 Feb 2025
- First submitted
- 28 Mar 2019
- Last updated
- 16 Jul 2026
- Results posted
- Yes, on ClinicalTrials.gov
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 16 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 1, Open-Label, Single-Dose Study to Evaluate the Pharmacokinetics and Safety of Pretomanid in Participants With Renal Impairment Compared to Participants With Normal Renal Function
- ClinicalTrials.gov ID
- NCT03896750
- Acronym / sponsor ID
- 15-0037
- Conditions
- Renal Impairment, Tuberculosis
- Keywords
- Open-Label, Pretomanid, Renal Pharmacokinetic, Single-Dose
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 12 participants (actual)
- Lead sponsor
- National Institute of Allergy and Infectious Diseases (NIAID)US National Institutes of Health
- Study start
- 17 Apr 2024 (actual)
- Primary completion
- 10 Aug 2024 (actual)
- Study completion
- 28 Oct 2024 (actual)
- First posted
- 1 Apr 2019 (actual)
- Results
- Posted 15 Oct 2025
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a Phase 1, open-label, single-dose, sequential group study to compare the safety and pharmacokinetics (PK) of pretomanid in the following groups of participants: 1) participants with severe renal impairment including those with end stage renal disease (ESRD) not on dialysis, and participants with mild or moderate renal impairment, designated as Groups 2, 3, and 4, respectively; and 2) participants with normal renal function matched to the above renal impairment groups, designated as Groups 1A, 1B, and 1C, respectively.
The study will be conducted following a reduced PK study design in Part A. Part A will enroll participants from Group 1A (i.e., 6 healthy matched controls) and Group 2 (i.e., 6 participants with severe renal impairment and ESRD, not on dialysis). A decision to proceed to Part B will be made after the PK of pretomanid, and safety in participants enrolled in Part A have been reviewed. If Part A demonstrates at least a 50% increase in pretomanid area under the plasma concentration-time curve (AUC) in Group 2 (severe renal impairments and ESRD, not on dialysis) relative to the exposures in Group 1A (matched participants with normal renal function), then the reduced PK study will extend to the full PK study to enroll participants into Part B (i.e., to investigate mild and moderate renal impairment). All Part B groups (1B, 1C, 3, and 4) will be enrolled concurrently.
If the reduced PK study shows at least a 50% increase in AUC in patients with severe renal impairment and patients with ESRD not yet on dialysis relative to the matched healthy controls, a "full PK" renal impairment study in patients with all intermediate levels of renal function impairment should be conducted. Otherwise, no further study is recommended.
The approximate patient involvement will be 3 months. The primary objective is to evaluate the PK profiles of pretomanid in plasma and urine after a single oral dose of 200 mg in participants with renal impairment compared to matched healthy controls.
Detailed description
This is a Phase 1, open-label, single-dose, sequential group study to compare the safety and pharmacokinetics (PK) of pretomanid in the following groups of participants: 1) participants with severe renal impairment including those with end stage renal disease (ESRD) not on dialysis, and participants with mild or moderate renal impairment, designated as Groups 2, 3, and 4, respectively; and 2) participants with normal renal function matched to the above renal impairment groups, designated as Groups 1A, 1B, and 1C, respectively.
The study will be conducted following a reduced PK study design in Part A. Part A will enroll participants from Group 1A (i.e., 6 healthy matched controls) and Group 2 (i.e., 6 participants with severe renal impairment and ESRD, not on dialysis). A decision to proceed to Part B will be made after the PK of pretomanid, and safety in participants enrolled in Part A have been reviewed. If Part A demonstrates at least a 50% increase in pretomanid area under the plasma concentration-time curve (AUC) in Group 2 (severe renal impairments and ESRD, not on dialysis) relative to the exposures in Group 1A (matched participants with normal renal function), then the reduced PK study will extend to the full PK study to enroll participants into Part B (i.e., to investigate mild and moderate renal impairment). All Part B groups (1B, 1C, 3, and 4) will be enrolled concurrently.
If the reduced PK study shows at least a 50% increase in AUC in patients with severe renal impairment and patients with ESRD not yet on dialysis relative to the matched healthy controls, a "full PK" renal impairment study in patients with all intermediate levels of renal function impairment should be conducted. Otherwise, no further study is recommended.
The approximate patient involvement will be 3 months. The primary objective is to evaluate the PK profiles of pretomanid in plasma and urine after a single oral dose of 200 mg in participants with renal impairment compared to matched healthy controls. The secondary objectives are 1) to assess the safety profile of a single oral dose of 200 mg pretomanid in renally impaired participants to matched healthy controls; and 2) to evaluate the PK profiles or representative pretomanid metabolites (M19 and M50) in plasma and urine.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Sequential
- Masking
- None (open label)
- Number of arms
- 6
| Arm | Type | Receives |
|---|---|---|
| Part A Group 1A | Active comparator | Drug: PA-8246 healthy participants with normal renal function: Modification of Diet in Renal Disease (MDRD) estimated Glomerular Filtration Rate (eGFR > / = 90 mL/min) matched to Group 2 by race, gender, age (+/- 10 years, but between 18 to 85 years of age) and body mass index (BMI) (18 to 40 kg/m^2) will receive a single oral dose of 200 mg pretomanid |
| Part A Group 2 | Experimental | Drug: PA-8246 participants with severe renal impairment: Stage 4, Modification of Diet in Renal Disease (MDRD) estimated Glomerular Filtration Rate (eGFR 15-29 mL/min), and End Stage Renal Disease (ESRD) not on dialysis: Stage 5, Modification of Diet in Renal Disease (MDRD) with estimated Glomerular Filtration Rate (eGFR < 15 mL/min) matched to Group 1A will receive a single oral dose of 200 mg pretomanid |
| Part B Group 1B | Active comparator | Drug: PA-8246 healthy participants with Modification of Diet in Renal Disease (MDRD) estimated Glomerular Filtration Rate (eGFR of > / = 90 mL/min) matched to Group 3 by race, gender, age (+/- 10 years, but between 18 to 85 years of age) and body mass index (BMI) (18 to 40 kg/m^2) will receive a single oral dose of 200 mg pretomanid after the PK and safety of subjects enrolled in Part A have been reviewed |
| Part B Group 1C | Active comparator | Drug: PA-8246 healthy participants: with Modification of Diet in Renal Disease (MDRD) estimated Glomerular Filtration Rate (eGFR > / = 90 mL/min) matched to Group 4 by race, gender, age (+/- 10 years, but between 18 to 85 years of age) and body mass index (BMI) (18 to 40 kg/m^2) will receive a single oral dose of 200 mg pretomanid after the PK and safety of subjects enrolled in Part A have been reviewed |
| Part B Group 3 | Experimental | Drug: PA-8246 participants with mild renal impairment: Stage 2, Modification of Diet in Renal Disease (MDRD) estimated Glomerular Filtration Rate (eGFR 60-89 mL/min) matched to Group 1B will receive a single oral dose of 200 mg pretomanid after the PK and safety of subjects enrolled in Part A have been reviewed |
| Part B Group 4 | Experimental | Drug: PA-8246 participants with moderate renal impairment: Stage 3, Modification of Diet in Renal Disease (MDRD) estimated Glomerular Filtration Rate (eGFR = 30-59 mL/min) matched to Group 1C will receive a single oral dose of 200 mg pretomanid after the PK and safety of subjects enrolled in Part A have been reviewed |
Who may qualify
- Ages
- 18 to 85 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (29 listed)
- Participant Inclusion Criteria for Patients with Renal Impairment (Groups 2-4)
- Have the ability to understand the requirements of the study and have provided written informed consent* before any study-related procedure is performed.
- As evidence by signature on an informed consent document approved by the Institutional Review Board
- Agree to abide by the study restrictions.
- Are between the ages of 18 and 85 years, inclusive, at the time of enrollment.
Key exclusion criteria (76 listed)
- Participant Exclusion Criteria for Patients with Renal Impairment (Groups 2-4)
- History of known active TB.
- History of peptic ulcer disease.
- Known hypersensitivity to pretomanid or any of the excipients.
- History of any clinically significant uncontrolled cardiac abnormality (as deemed by the Principal Investigator (PI)).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PA-824PA-824, a nitroimidazooxazine, used in prior studies of pretomanid is a novel TB treatment that is being investigated for use with other TB drugs to shorten and/or simplify regimens to treat either drug susceptible or resistant disease. Pretomanid will be administered in the fed state (high-fat and high-calorie meal) in this study following an overnight fast of at least 8 hours. Pretomanid should be administered 30 + or - 10 minutes after start of the meal. | Drug | Part A Group 1A, Part A Group 2, Part B Group 1B, Part B Group 1C, Part B Group 3, Part B Group 4 |
Primary outcome
Fold Change in Pretomanid AUC(0-last) in Participants With Renal Impairment as Compared to Matched Healthy Controls
Time frame: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
The mean fold change of AUC(0-last) Area under the concentration time-curve to the last concentration above the lower limit of quantitation at specified pre-dose and post-dose time points was calculated by noncompartmental analysis using the linear up log down method. The mean fold change of each enrolled renal impairment arm as compared to the Healthy Matched Control arm was calculated by a linear regression model controlling for site.
Fold Change in Pretomanid AUC(0-infinity) in Participants With Renal Impairment as Compared to Matched Healthy Controls
Time frame: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
The mean fold change of AUC(0-infinity) was calculated by noncompartmental analysis using the linear up log down method with the area extrapolated to infinity as Clast/Lambda_z where Clast was the last observed concentration and Lambda_z is the elimination rate constant. The mean fold change of each enrolled renal impairment arm as compared to the Healthy Matched Control arm was calculated by a linear regression model controlling for site.
24 secondary outcomes
Area Under the M19 and M50 Concentration Time-curve Extrapolated to Infinity at Specified Pre-dose and Post-dose Time Points
Time frame: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Area Under the M19 and M50 Concentration Time-curve to the Last Concentration Above the Lower Limit of Quantitation at Specified Pre-dose and Post-dose Time Points
Time frame: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Maximum M19 and M50 Concentrations at Specified Pre-dose and Post-dose Time Points
Time frame: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Apparent Terminal Elimination Half-life of M19 and M50 at Specified Pre-dose and Post-dose Time Points
Time frame: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Renal Clearance of M19 and M50 at Specified Pre-dose and Post-dose Time Points
Time frame: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Amount of M19 and M50 Excreted in Urine at Specified Pre-dose and Post-dose Time Points
Time frame: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Apparent Volume of Distribution of M19 and M50 at Specified Pre-dose and Post-dose Time Points
Time frame: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Time of Maximum M19 and M50 Concentration at Specified Pre-dose and Post-dose Time Points
Time frame: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Apparent Oral Clearance of M19 and M50 From Dose/AUC(0-infinity) at Specified Pre-dose and Post-dose Time Points
Time frame: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.
Number of Participants With and Severity of Adverse Events
Time frame: Day 1 to Day 85
Mean Change From Baseline in Alanine Aminotransferase (ALT)
Time frame: Day 5 and Day 12
Mean Change From Baseline in Aspartate Aminotransferase (AST)
Time frame: Day 5 and Day 12
Mean Change From Baseline in Blood Urea Nitrogen (BUN)
Time frame: Day 5 and Day 12
Mean Change From Baseline in Creatinine
Time frame: Day 5 and Day 12
Mean Change From Baseline in Hemoglobin (Hgb)
Time frame: Day 5 and Day 12
Mean Change From Baseline in Estimated Glomerular Filtration Rate (eGFR)
Time frame: Day 5 and Day 12
Mean Change From Baseline in Magnesium
Time frame: Day 5 and Day 12
Mean Change From Baseline in Serum Potassium
Time frame: Day 5 and Day 12
Mean Change From Baseline in Total Bilirubin
Time frame: Day 5 and Day 12
Mean Change in Oral Temperature From Baseline
Time frame: Days 1, 2, 3, 4, 5, and 12
Mean Change in Pulse From Baseline
Time frame: Days 1, 2, 3, 4, 5, and 12
Mean Change in Sitting Systolic Blood Pressure From Baseline
Time frame: Days 1, 2, 3, 4, 5, and 12
Mean Change in Sitting Diastolic Blood Pressure From Baseline
Time frame: Days 1, 2, 3, 4, 5, and 12
Mean Change in the Electrocardiogram (ECG) Corrected QT Interval by Fridericia (QTcF) Interval From Baseline
Time frame: Day 5
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Jul 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing PA-824 in people with Renal Impairment and Tuberculosis, run by National Institute of Allergy and Infectious Diseases (NIAID) at 3 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 29 inclusion and 76 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 16 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 15 Oct 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Fold Change in Pretomanid AUC(0-last) in Participants With Renal Impairment as Compared to Matched Healthy Controls (time frame: Day 1 at 1, 2, 4, 5, 6, 8, 12, 16 hours post dose; Day 2 at 24 and 36 hours post dose; Day 3 at 48 hours post dose; Day 4 at 72 hours post dose; and Day 5 at 96 hours post dose.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Jul 2026.