Primary objective:To determine the effect of obesity (BMI > 40kg/m2) on the pharmacokinetics of micafungin and develop a dosing regimen for obese patients. Secondary objective:* To describe the pharmacokinetics of the approved dose of 200mg in…
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Source
Brief title
Condition
- Fungal infectious disorders
Synonym
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
A farmacokinetic model using Non Linear Mixed Effects Modelling (NONMEM). Model
validation using bootstrap method.
Een farmacokinetisch model met de hulp van non-lineaire mixed effect modelleren
zal de data beschrijven. Met behulp van bootstrap zullen we dit model
valideren. The final model will be used for Monte Carlo simulation for
multiple-dosing regimens and higher dosages.
Secondary outcome
NA
Background summary
The prevalence of obesity in adults and children is rapidly increasing across
the world. Several general (patho)
physiological alterations associated with obesity have been described, but the
specific impact of these alterations on drug
metabolism and elimination and its consequences for drug dosing remains largely
unknown.
Although micafugin is a well studied drug, little is known about the
farmacokinetic profile in morbidly obese. In a study with 12 obese patients it
was found that patients with an increased body mass had a significant lower
exposure of micafungin. Using Monte Carlo simulations these researchers found
that a higher dose is justified. However, a large portion of unexplained
variation in the calculated AUC was found and these investigators also
neglected to include sever significant covariates like gender, in their models.
We intend to investigate the exposure of micafungin and compare 2 obese groups
(1 group will receive 100mg and 1 group will receive 200mg) with a group of
non-obese subjects receiving 100mg micafungin. We expect to see a linear
relation between 100 mg and 200 mg micafungin en this allows us to extrapolate
to higher dosages. Using Monte Carlo simulations we will simulate a multiple
dosing regimen en investigate an optimal strategy in an obese population.
Study objective
Primary objective:
To determine the effect of obesity (BMI > 40kg/m2) on the pharmacokinetics of
micafungin and develop a dosing regimen for obese patients.
Secondary objective:
* To describe the pharmacokinetics of the approved dose of 200mg in obese
patients;
* To determine optimal dosing strategy (multiple dose) in obese patients trough
Monte Carlo simulations based on the developed PK model.
Study design
Prospective, open-label, non-randomized, multi-center, single-dose dose
escalation trial (using 100 mg and 200 mg micafungin).
Intervention
Placing a venous cathether for blood sampling.
Single dose of micafungin, adminstered according to SPC.
Sampling of a total of 75ml blood (including, PK curve, lab and hematology)
Study burden and risks
The safety of micafungin has been well established for repeated dosages (up to
896mg) and was well tolerated. In addition we expect a lower exposure in obese
patient due to a (possible) increased volume of distribution and an increased
clearance. With the combination of a single dose and an decreased exposure we
don*t expect to find significant adverse events.
Geert Grooteplein-Zuid 10
Nijmegen 6500HB
NL
Geert Grooteplein-Zuid 10
Nijmegen 6500HB
NL
Listed location countries
Age
Inclusion criteria
1. Subjects BMI:;o obese groups: subject must have a BMI > 40 kg/m2 at the time of inclusion, ;o non-obese group: subject must have a BMI *18.5 and < 25kg/m2 at the time of inclusion.;2. Subject is at least 18 of age on the day of screening and not older than 65 years of age on the day of dosing;;3. If a woman, is neither pregnant nor able to become pregnant and is not nursing an infant;;4. Subject is able and willing to sign the Informed Consent before screening evaluations.;For the non-obese subjects the following additional exclusion criteria apply:;5. Subject is in good age-appropriate health condition as established by medical history, physical examination, electrocardiography, results of biochemistry, hematology and urinalysis testing within 4 weeks prior to study drug administration. Results of biochemistry, hematology and urinalysis testing should be within the laboratory's reference ranges (see Appendix A). If laboratory results are not within the reference ranges, the subject is included based on the investigator*s judgment that the observed deviations are not clinically relevant. This should be clearly recorded;;6. Subject has a normal blood pressure and pulse rate, determined by the investigator;;7. Subject does not smoke more than 10 cigarettes, 2 cigars, or 2 pipes per day for at least 3 months prior to study drug administration.
Exclusion criteria
1. Documented history of sensitivity to medicinal products or excipients similar to those found in the micafungin preparation;;2. History of, or known abuse of drugs, alcohol or solvents (up until a maximum of three months before study drug administration);;3. Inability to understand the nature of the trial and the procedures required;;4. Use of medication that has known interaction with study drug as determined by the investigator up to 4 weeks prior to study drug administration.;For the non-obese subjects the following additional exclusion criteria apply:;5. Evidence of organ dysfunction or any clinically significant deviation from normal in physical examination, vital signs or clinical laboratory determinations;;6. Clinical relevant liver enzymes (alkaline phosphatase, ALT, AST) abnormalities at screening;;7. Donation of blood or plasma to a blood bank or in a clinical study (except a screening visit) within 4 weeks prior to study drug administration;;8. Blood transfusion within 8 weeks prior to study drug administration;;9. Inability to be venipunctured and/or tolerate venous access;;10. Relevant history or presence of pulmonary disorders (especially COPD), cardiovascular disorders, neurological disorders (especially seizures and migraine), psychiatric disorders, gastro-intestinal disorders, renal disorders, hepatic disorders (Child-Pugh B or C), hormonal disorders (especially diabetes mellitus), coagulation disorders;;11. Any other sound medical, psychiatric and/or social reason as determined by the investigator.
Design
Recruitment
Medical products/devices used
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In other registers
Register | ID |
---|---|
EudraCT | EUCTR2016-000611-32-NL |
CCMO | NL56834.091.16 |