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Bile Salt Export Pump (BSEP) TransporterPhase 4NCT04640571

Impact of Metformin and Polysorbate 80 on Drug Absorption and Disposition

A Phase 4 study of Bile Salt Export Pump (BSEP) Transporter and Polysorbate 80, run by University of Maryland, Baltimore at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The study employs two-sub-studies that share a common placebo arm. The objective of one sub-study is to assess the impact of metformin on pravastatin and chenodeoxycholic acid pharmacokinetics. Read more about this study

Who is it for?
Ages 18 to 65 yearsHealthy volunteers can take part
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
18 participants
Where
1 siteUnited States
Study dates
1 Apr 2021to 1 Nov 2021
Phase
Phase 4
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 65 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Subject is healthy, as determined by screening evaluation that is not greater than 60 days before the first study visit.
  • Subject is male or female between 18 and 65 years of age, inclusive.
  • Subject is an acceptable candidate for venipuncture.
  • Subject is willing to stop all non-routine OTC medications, as well as vitamins, dietary supplements, and herbals, for 24 hours prior to study drug administration and during pharmacokinetic study visits.

Who cannot join

  • Subject has a significant medical disease (including cardiovascular, pulmonary, hematologic, endocrine, immunologic, neurologic, renal, gastrointestinal, metabolic, or psychiatric).
  • Subject has a clinically significant history or presence of any clinically significant gastrointestinal pathology (e.g. chronic diarrhea, inflammatory bowel diseases), unresolved gastrointestinal symptoms (e.g. diarrhea, vomiting), liver or kidney disease, or other conditions known to interfere with the absorption, distribution, metabolism or excretion of study drugs.
  • Subject has a history of liver or gallbladder disease, or history of myopathy
  • Subject has a history of angioedema either with or without previous treatment with an angiotensin converting enzyme inhibitor.
  • Subject was previously diagnosed with diabetes, or treated with antidiabetic agents
  • Subject has a history of alcohol or drug abuse, which in the opinion of the PI or medical physician, could jeopardize the subject's health or would compromise the subject's ability to participate in this trial.
Show all 16Show fewer
  • Subject is pregnant, breast feeding, or trying to become pregnant.
  • Female subject of childbearing potential is unwilling or unable to use a medically acceptable method of contraception throughout the entire study period and for one week after the study is completed. Medically acceptable methods of contraception that may be used by the subject and/or her partner are: oral birth control pill, condom with spermicide, diaphragm with spermicide, IUD, vaginal spermicidal suppository, surgical sterilization of patient or their partner(s), abstinence, or hormonal-based patches, ring, injections, and implants.
  • Subject routinely uses (i.e. daily or weekly) prescription medication except hormonal birth control medication, routinely uses (i.e. daily or weekly) OTC medication, or routinely uses niacin to treat hypercholesterolemia. OTC medications do not include vitamins, dietary supplements, or herbals.
  • Subject routinely uses (i.e. daily or weekly) acid blockers, antacids, anti-diarrhea, stimulants, appetite suppressants, or anti-nausea medication or other drugs that modulate GI function.
  • Subject is currently taking metformin, valacyclovir, acyclovir, chenodiol, pravastatin, enalapril, enalaprilat, or medications known to interact with any of these medications.
  • Subject has a history or allergy or sensitivity to metformin, valacyclovir, acyclovir, chenodiol, pravastatin, polysorbate 80, enalapril, enalaprilat, or history of any drug hypersensitivity or intolerance which, in the opinion of the PI or medical physician, would compromise the safety of the subject or the study.
  • Subject has liver impairment as assessed by alanine aminotransferase (ALT), aspartate aminotransferase (AST), or total bilirubin levels greater than the upper limit of normal (ULN).
  • Subject has renal impairment as assessed by creatinine clearance lower than 60mL/min/1.73m2, using the CKDEPI formula.
  • Subject is not willing or able to be adherent to study protocol (e.g., study visits).
  • Subject has a condition in which in the opinion of the PI or medical physician would increase risk to the subject or interfere with the integrity of the study.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of Maryland

    Baltimore, Maryland, 21201

Other trials in United States

About this study

The study employs two-sub-studies that share a common placebo arm.

The objective of one sub-study is to assess the impact of metformin on pravastatin and chenodeoxycholic acid pharmacokinetics. We hypothesize that metformin represses the bile salt export pump (BSEP) in the liver, which excretes pravastatin and chenodeoxycholic acid from the liver into the bile.

The objective of the other sub-study is to assess the impact of polysorbate 80 on valacyclovir, chenodeoxycholic acid, and enalaprilat pharmacokinetics. We hypothesize that polysorbate 80 inhibits uptake transporters in the intestine, which absorb valacyclovir and chenodeoxycholic acid in the gut via the peptide transporter 1 (PepT1) and apical sodium-bile acid transporter (ASBT), respectively. Enalaprilat is passively absorbed but with low permeability, and thus serves as a passive absorption reference.

Being tested
pravastatin and chenodeoxycholic acid, after metformin and placebo, valacyclovir, chenodeoxycholic acid, and enalaprilat, after polysorbate 80 and placebo
Keywords
healthy volunteer, pharmacokinetics, excipient, transporter
Medical subject headings
Cholestasis, progressive familial intrahepatic 2

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • pravastatin and chenodeoxycholic acid, after metformin and placeboDrug

    single oral dose of pravastatin 80 mg and chenodeoxycholic acid 250 mg

  • valacyclovir, chenodeoxycholic acid, and enalaprilat, after polysorbate 80 and placeboDrug

    single oral dose of valacyclovir 500 mg, chenodeoxycholic acid 250 mg, and enalaprilat 20 mg

Study groups in NCT04640571
Study groupRoleWhat they receive
placebo, then metformin, then polysorbate 80ExperimentalPlacebo is one twice a day, metformin is 500mg twice a day, and polysorbate 80 is 400mg twice a day
Receives: Drug: pravastatin and chenodeoxycholic acid, after metformin and placebo; Drug: valacyclovir, chenodeoxycholic acid, and enalaprilat, after polysorbate 80 and placebo
metformin, then polysorbate 80, then placeboExperimentalPlacebo is one twice a day, metformin is 500mg twice a day, and polysorbate 80 is 400mg twice a day
Receives: Drug: pravastatin and chenodeoxycholic acid, after metformin and placebo; Drug: valacyclovir, chenodeoxycholic acid, and enalaprilat, after polysorbate 80 and placebo
polysorbate 80, then placebo, then metforminExperimentalPlacebo is one twice a day, metformin is 500mg twice a day, and polysorbate 80 is 400mg twice a day
Receives: Drug: pravastatin and chenodeoxycholic acid, after metformin and placebo; Drug: valacyclovir, chenodeoxycholic acid, and enalaprilat, after polysorbate 80 and placebo
polysorbate 80, then metformin, then placeboExperimentalPlacebo is one twice a day, metformin is 500mg twice a day, and polysorbate 80 is 400mg twice a day
Receives: Drug: pravastatin and chenodeoxycholic acid, after metformin and placebo; Drug: valacyclovir, chenodeoxycholic acid, and enalaprilat, after polysorbate 80 and placebo
placebo, then polysorbate 80, then metforminExperimentalPlacebo is one twice a day, metformin is 500mg twice a day, and polysorbate 80 is 400mg twice a day
Receives: Drug: pravastatin and chenodeoxycholic acid, after metformin and placebo; Drug: valacyclovir, chenodeoxycholic acid, and enalaprilat, after polysorbate 80 and placebo
metformin, then placebo, then polysorbate 80ExperimentalPlacebo is one twice a day, metformin is 500mg twice a day, and polysorbate 80 is 400mg twice a day
Receives: Drug: pravastatin and chenodeoxycholic acid, after metformin and placebo; Drug: valacyclovir, chenodeoxycholic acid, and enalaprilat, after polysorbate 80 and placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Area-Under-the-Curve (AUC) of Pravastatin After Metformin

    Pravastatin AUC after metformin, compared to pravastatin AUC after placebo. AUC units are concentration x time (i.e. ng/ml x h).

    Measured: 0-10 hours

  2. Peak Plasma Concentration (Cmax) of Pravastatin After Metformin

    Pravastatin Cmax after metformin, compared to pravastatin Cmax after placebo. Cmax units are concentration (i.e. ng/ml).

    Measured: 0-10 hours

  3. Area-Under-the-Curve (AUC) of Chenodeoxycholic Acid After Metformin

    Baseline-corrected chenodeoxycholic acid AUC after metformin. AUC Units are concentration x time (i.e. ng/ml x h). Baseline-corrected chenodeoxycholic acid is chenodeoxycholic acid concentration minus chenodeoxycholic acid concentration value at time zero (i.e. t=0).

    Measured: 0-10 hours

  4. Peak Plasma Concentration (Cmax) of Chenodeoxycholic Acid After Metformin

    Baseline-corrected chenodeoxycholic acid Cmax after metformin. Cmax units are concentration (i.e. ng/ml). Baseline-corrected chenodeoxycholic acid is chenodeoxycholic acid concentration minus chenodeoxycholic acid concentration value at time zero (i.e. t=0).

    Measured: 0-10 hours

  5. Area-Under-the-Curve (AUC) of Acyclovir After Polysorbate 80

    Acyclovir AUC after polysorbate 80. AUC units are concentration x time (i.e. ng/ml x h).

    Measured: 0-10 hours

  6. Peak Plasma Concentration (Cmax) of Acyclovir After Polysorbate 80

    Acyclovir Cmax after polysorbate 80. Cmax units are concentration (i.e. ng/ml).

    Measured: 0-10 hours

  7. Area-Under-the-Curve (AUC) of Chenodeoxycholic Acid (CDCA) After Polysorbate 80

    Baseline-corrected Chenodeoxycholic acid AUC after polysorbate 80. AUC units are concentration x time (i.e. ng/ml x h). Baseline-corrected chenodeoxycholic acid is chenodeoxycholic acid concentration minus chenodeoxycholic acid concentration value at time zero (i.e. t=0).

    Measured: 0-10 hours

  8. Peak Plasma Concentration (Cmax) of Chenodeoxycholic Acid (CDCA) After Polysorbate 80

    Baseline-corrected Chenodeoxycholic acid Cmax after polysorbate 80. Cmax units are concentration (i.e. ng/ml). Baseline-corrected chenodeoxycholic acid is chenodeoxycholic acid concentration minus chenodeoxycholic acid concentration value at time zero (i.e. t=0).

    Measured: 0-10 hours

  9. Area-Under-the-Curve (AUC) of Enalaprilat After Polysorbate 80

    Enalaprilat AUC after polysorbate 80. AUC units are concentration x time (i.e. ng/ml x h).

    Measured: 0-10 hours

  10. Peak Plasma Concentration (Cmax) of Enalaprilat After Polysorbate 80

    Enalaprilat Cmax after polysorbate 80. Cmax units are concentration (i.e. ng/ml).

    Measured: 0-10 hours

Secondary outcomes (4)
  1. Area-Under-the-Curve (AUC) of Endogenous Bile Acids After Polysorbate 80

    For each of 15 endogenous bile acid, endogenous bile acid AUC after polysorbate 80, compared to endogenous bile acid AUC after placebo. AUC units are concentration x time (i.e. ng/ml x h).

    Measured: 0-10 hours

  2. Peak Plasma Concentration (Cmax) of Endogenous Bile Acids After Metformin

    For each of 15 endogenous bile acid, endogenous bile acid Cmax after metformin, compared to endogenous bile acid Cmax after placebo. Cmax units are concentration (i.e. ng/ml).

    Measured: 0-10 hours

  3. Area-Under-the-Curve (AUC) of Endogenous Bile Acids After Metformin

    For each of 15 endogenous bile acid, endogenous bile acid AUC after metformin, compared to endogenous bile acid AUC after placebo. AUC units are concentration x time (i.e. ng/ml x h).

    Measured: 0-10 hours

  4. Peak Plasma Concentration (Cmax) of Endogenous Bile Acids After Polysorbate 80

    For each of 15 endogenous bile acid, endogenous bile acid Cmax after polysorbate 80, compared to endogenous bile acid Cmax after placebo. Cmax units are concentration (i.e. ng/ml).

    Measured: 0-10 hours

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Nov 2020
  2. Study start1 Apr 2021
  3. Primary completion1 Nov 2021
  4. Study completion1 Nov 2021

Resources

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 4
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
18 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04640571
Sponsor's protocol ID
HP-00090086
Status last verified
Jul 2024
First submitted
9 Nov 2020
Last updated
16 Jul 2024
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study of Bile Salt Export Pump (BSEP) Transporter and Polysorbate 80, run by University of Maryland, Baltimore at 1 site 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 4 inclusion and 16 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 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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 16 Jul 2024). 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?

Area-Under-the-Curve (AUC) of Pravastatin After Metformin (time frame: 0-10 hours). The study lists 10 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 2024.

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