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Drug Drug InteractionPhase 1NCT05845567

The Potential of Givinostat as DDI Victim in Co-administration P-gp Inhibitor (Part 2)

A Phase 1 study testing Givinostat and Clarithromycin in people with Drug Drug Interaction, run by Italfarmaco at 1 site in Portugal.

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

Primary objective: To assess the potential effect of oral Clarithromycin on the single-dose pharmacokinetics of Givinostat. Secondary objective: To assess the safety and tolerability of concomitant administration of Givinostat plus Clarithromycin. Read more about this study

Who is it for?
Ages 18 to 55 yearsHealthy volunteers can take part
Conditions the study is for
Drug Drug Interaction
What is being tested?
Givinostat and Clarithromycin
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 sitePortugal
Study dates
21 Mar 2022to 24 May 2022
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 55 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • A subject was considered eligible for the study if he/she fulfilled all the inclusion criteria:
  • Subject's written informed consent obtained prior to any study-related procedure.
  • Male or female subject, ≥18 and ≤55 years of age, at the time of signing the informed consent.
  • Body mass index (BMI) of 18.5 to 32.0 kg/m2 inclusive, and body weight ≥55 kg and ≤100 kg for females and body weight ≥60 kg and ≤110 kg for males.
  • Non-smoker or ex-smoker (i.e. someone who abstained from using tobacco or nicotine-containing products for at least 3 months prior to Screening).
  • No clinically relevant diseases.
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  • No major surgery within 4 weeks prior to dosing.
  • No clinically relevant abnormalities on physical examination.
  • No clinically relevant abnormalities on 12-lead ECG.
  • No clinically relevant abnormalities on clinical laboratory tests.
  • Negative test results for anti-Human Immunodeficiency virus 1 and 2 antibodies (anti-HIV-1Ab and anti-HIV-2Ab), Hepatitis B surface antigen (HBsAg) and anti-Hepatitis C virus antibodies (anti-HCVAb).
  • Female subjects are eligible if they are of non-childbearing potential or agree to use a non-hormonal highly effective contraceptive method from 28 days prior to Screening until at least 90 days after the last study drug administration. Nonchildbearing potential female is defined as:
  • Menopausal, i.e. no menses for ≥ 12 months without an alternative medical cause other than menopause, and a high FSH level.
  • Pre-menopausal female with documented hysterectomy, bilateral salpingectomy and/or bilateral oophorectomy.
  • A non-hormonal effective contraceptive method is defined as:
  • Intrauterine device.
  • Bilateral tubal occlusion.
  • Total abstinence of heterosexual intercourse, in accordance with the lifestyle of the subject.
  • Vasectomized partner, who has received medical assessment of the surgical success, or clinically diagnosed infertile partner.
  • Male subjects who are sexually active with a female partner of childbearing potential (pregnant or non-pregnant) must use contraception (condom) from investigational product administration up to at least 90 days following the last study drug administration.
  • Male subjects must ensure that his non-pregnant female partner of childbearing potential agrees to consistently and correctly use for the same period a highly effective method of contraception (see Section 8.5.3).
  • Male subjects must be willing not to donate sperm until 90 days following the last study drug administration.
  • Willingness and capability to comply with the requirements of the study and ability to understand the study procedures and the risks involved.

Who cannot join

  • A subject was excluded from the study if he/she fulfilled any of the exclusion criteria:
  • At Screening
  • Previous use of Givinostat.
  • History of anaphylaxis reaction or clinically significant drug hypersensitivity reaction (e.g., angioedema, Stevens-Johnson syndrome, acute generalized exanthematous pustulosis, drug-induced hypersensitivity syndrome, druginduced neutropenia).
  • Known history of hypersensitivity and/or allergic reactions to Givinostat, histone deacetylases (HDAC) inhibitors or to any excipient in the formulation.
  • History of sorbitol intolerance, sorbitol malabsorption or fructose intolerance.
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  • Any medical condition (e.g. gastrointestinal, renal or hepatic, including peptic ulcer, inflammatory bowel disease or pancreatitis) or surgical condition (e.g. cholecystectomy, gastrectomy) that may affect drug pharmacokinetics (absorption, distribution, metabolism or excretion) or subject safety.
  • Systolic blood pressure lower than 90 or over 140 mmHg, diastolic blood pressure lower than 60 or over 90 mmHg, or pulse rate lower than 50 or over 100 bpm.
  • QTcF ˃450 msec.
  • Subjects with history of cardiac arrhythmias (documented), family history of sudden cardiac death or history of additional risk factors for torsades-depointes (e.g. heart failure, hypokalemia, long QT syndrome).
  • Having an estimated glomerular filtration (eGFR) < 90 mL/min, based on creatinine clearance calculation by the Cockcroft-Gault formula and normalized to an average surface area of 1.73 m2.
  • Any of the following abnormal laboratory test values:
  • Platelet count below the lower limit of the normal range (LLN).
  • Total white blood cells count below the LLN.
  • Hemoglobin below the LLN.
  • Triglycerides above the upper limit of normal range (ULN).
  • Potassium or magnesium below the LLN.
  • Positive urine alcohol, drugs-of-abuse or cotinine screen tests.
  • Positive serum pregnancy test.
  • If woman, she is breast-feeding.
  • History of alcohol abuse within 1 year prior to screening or regular use of alcohol within 6 months prior to the screening visit (i.e. more than 14 units of alcohol per week for males or more than 7 units for females).
  • History of drug abuse within 1 year prior to screening or use of soft drugs (such as marijuana) within 3 months prior to the screening visit or hard drugs [such as cocaine, phencyclidine (PCP), crack, opioid derivatives including heroin, and amphetamine derivatives] within 1 year prior to screening.
  • Participation in any clinical trial within the previous 2 months.
  • Participation in more than 2 clinical trials within the previous 12 months.
  • Blood donation or significant blood loss (≥ 450 mL) due to any reason or had plasmapheresis within the previous 2 months.
  • Veins unsuitable for intravenous puncture on either arm.
  • Difficulty in swallowing capsules, tablets or suspensions.
  • Any reason which, in the opinion of the Investigator, would prevent the subject from participating in the study.
  • Known history of hypersensitivity and/or allergic reactions to clarithromycin, other macrolides or to any excipient in the formulation.
  • At Admission to Treatment Period
  • Any clinically relevant abnormalities on clinical laboratory tests.
  • Positive urine alcohol, drugs-of-abuse or cotinine screen tests.
  • Positive urine pregnancy test.
  • Positive or inconclusive SARS-CoV-2 test prior to admission.
  • Use of prescription or non-prescription medicinal products within the previous 28 days or within 5-half-lives of the medicinal product, whichever is longer.

Trial locations and contacts

1 site in 1 country.

Portugal1 site
  • Hospital da Prelada, 3rd Floor & East Wing 4th Floor Rua Sarmento de Beires

    Porto, 153

Other trials in Portugal

About this study

Official title: An Open-label, Single-center, Study in Healthy Subjects to Investigate the Effect of Oral Clarithromycin on the Pharmacokinetics of Givinostat (PART 2)

Primary objective:

To assess the potential effect of oral Clarithromycin on the single-dose pharmacokinetics of Givinostat.

Secondary objective:

To assess the safety and tolerability of concomitant administration of Givinostat plus Clarithromycin.

Read the detailed description

This study was planned as a phase I, open-label, 3-part, fixed-sequence, non-randomized study in healthy male and female subjects. The study (Part 2) aimed at assessing the potential effect of Clarythromycin on the single dose pharmacokynetics of Givinostat.

The total duration of Part 2 was divided as follows:

  • Screening: up to 21 days.
  • Treatment Period: Days 1 to 11.
  • Safety follow-up visit: 12±2 days.

Subjects were confined at site from Day -1 to Day 11. On Days 1 and 8, a single dose of 50 mg Givinostat, as oral suspension, was administered 1 hour after the planned morning time of Clarithromycin administration.

From Day 4 to Day 10, clarithromycin 500 mg film-coated tablets were administered twice a day, in the morning and in the evening.

The following assessments were performed:

  • Blood collection for pharmacokinetic analysis on Days 1 to 4 and 8 to 11.
  • Vital signs measurements on Days 1 and 4 to 10.
  • 12-lead ECG on Days 1, 3, 7 and 8.
  • Blood collection for laboratory tests (hematology and biochemistry) on Day 3.

Subjects were discharged in the morning of Day 11 after completing end of study procedures.

Being tested
Givinostat, Clarithromycin
Keywords
PK, Pharmacokinetics, Givinostat, Clarythromycin

What participants receive

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

  • GivinostatDrug

    Also called ITF2357

    ITF2357 Givinostat 10mg/mL. Dose: 10 mg/mL; Dosage form: oral suspension.

  • ClarithromycinDrug

    Also called Klacid®

    Clarithromycin 500 mg immediate-release oral film-coated tablet (Klacid®) was administered twice a day, in the morning and in the evening.

Study groups in NCT05845567
Study groupRoleWhat they receive
Givinostat + ClarithromycinExperimentalGivinostat and Clarithromycin Days 1 and 8, Givinostat 50 mg as oral suspension was administered as a single dose, 1 hour after Clarithromycin administration. From Day 4 to Day 10, Clarithromycin 500 mg film-coated tablet was administered twice a day.
Receives: Drug: Givinostat; Drug: Clarithromycin

What is being measured

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

  1. Cmax of Givinostat, Following Single Doses of the Parent Drug

    Maximum observed plasma concentration (Cmax) of givinostat.

    A total of 40 blood samples were collected as follows:

    • Twenty (20) blood samples at pre-dose and at 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 15, 24, 36, 48, 60 and 72 hours after the administration of givinostat, on Days 1 and 8, for the determination of Givinostat.

    Measured: In the turn of 72 hours after administration of Givinostat

  2. AUC0-t of Givinostat, Following Single Doses of the Parent Drug

    AUC0-t = area under the curve from time zero to last sampling time with quantifiable concentrations.

    A total of 40 blood samples were collected as follows:

    • Twenty (20) blood samples at pre-dose and at 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 15, 24, 36, 48, 60 and 72 hours after the administration of Givinostat, on Days 1 and 8, for the determination of Givinostat.

    Measured: In the turn of 72 hours after administration of Givinostat

  3. AUC0-inf of Givinostat, Following Single Doses of the Parent Drug

    AUC0-inf=Total AUC extrapolated to infinity, calculated as AUC0-t + Clast/λz, where Clast is the last measurable concentration and λz is the apparent terminal elimination rate constant.

    A total of 40 blood samples were collected as follows:

    • Twenty (20) blood samples at pre-dose and at 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 15, 24, 36, 48, 60 and 72 hours after the administration of givinostat, on Days 1 and 8, for the determination of givinostat.

    Measured: In the turn of 72 hours after administration of Givinostat

  4. %AUCextrap of Givinostat, Following Single Doses of the Parent Drug

    %AUC0extrap = Percentage of AUC0-∞ due to extrapolation from the time of the last measurable concentration (tlast) to infinity, i.e., residual area, calculated as 100 ·(AUC0-∞ - AUC0-t) / AUC0-∞.

    A total of 40 blood samples were collected as follows:

    • Twenty (20) blood samples at pre-dose and at 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 15, 24, 36, 48, 60 and 72 hours after the administration of givinostat, on Days 1 and 8, for the determination of givinostat

    Measured: In the turn of 72 hours after administration of Givinostat

  5. Tmax of Givinostat, Following Single Doses of the Parent Drug

    Tmax =The time of occurrence of maximum observed concentration of Givinostat.

    A total of 40 blood samples were collected as follows:

    • Twenty (20) blood samples at pre-dose and at 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 15, 24, 36, 48, 60 and 72 hours after the administration of givinostat, on Days 1 and 8, for the determination of Givinostat.

    Measured: In the turn of 72 hours after administration of Givinostat

  6. λz of Givinostat, Following Single Doses of the Parent Drug

    λz is the apparent first order elimination rate constant associated with the terminal (log-linear) portion of the concentration versus time curve. The parameter is estimated by linear least square regression analysis using the last three (or more) non- zero concentrations.

    A total of 40 blood samples were collected as follows:

    • Twenty (20) blood samples at pre-dose and at 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 15, 24, 36, 48, 60 and 72 hours after the administration of givinostat, on Days 1 and 8, for the determination of givinostat

    Measured: In the turn of 72 hours after administration of Givinostat

  7. t1/2 of Givinostat, Following Single Doses of the Parent Drug

    t1/2 is the apparent terminal elimination half-life, calculated as ln(2)/λz.

    A total of 40 blood samples were collected as follows:

    • Twenty (20) blood samples at pre-dose and at 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 5, 6, 8, 10, 12, 15, 24, 36, 48, 60 and 72 hours after the administration of givinostat, on Days 1 and 8, for the determination of Givinostat.

    Measured: In the turn of 72 hours after administration of Givinostat

Secondary outcomes (1)
  1. Severity of Treatment Emergent Adverse Events (TEAE)

    An AE was considered as any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily imply a causal relationship with this treatment. An AE can, therefore, be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. The period of observation for the collection of medical occurrences extended from the time when the subject gave Informed Consent until the follow-up visit.

    Measured: Throughout the study and 10-14 days after the EoS (follow-up visit), i.e. up to day 30-34

Timeline

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

  1. First posted6 May 2023
  2. Study start21 Mar 2022
  3. Primary completion8 May 2022
  4. Study completion24 May 2022

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 1
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
20 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05845567
Sponsor's protocol ID
ITF/2357/55 - PART 2
Other IDs
2021-005756-11
Status last verified
Jul 2024
First submitted
26 Apr 2023
Last updated
16 Aug 2024
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Givinostat and Clarithromycin in people with Drug Drug Interaction, run by Italfarmaco at 1 site in Portugal.

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 23 inclusion and 35 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 Aug 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 Portugal. 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 9 Feb 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?

Cmax of Givinostat, Following Single Doses of the Parent Drug (time frame: In the turn of 72 hours after administration of Givinostat). The study lists 7 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 Aug 2024.

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