Renal Insufficiency
Conditions
Keywords
renal insufficency, low molecular weight heparin, pharmacokinetics, elderly
Brief summary
Open pharmacokinetic study with 5 parallel groups and two treatment phases (bemiparin 3,500 IU multiple dose and bemiparin 115 IU/kg single dose). The bemiparin pharmacokinetic profile will be assessed by measuring its effects on the coagulation cascade. Plasma anti-Xa activity (measured using chromogenic amidolytic assay) in IU per milliliter will be the primary endpoint to assess the pharmacokinetic profile of bemiparin.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
Non-elderly healthy volunteers (Group I): * Male or female subjects aged between 18 and 65 years * body weight, clinical history, physical examination, vital signs (systolic and diastolic blood pressure, heart beat rate and body temperature), ECG and laboratory tests (hemogram and biochemistry) within normal range * without evidence of significant organic or psychiatric illness * who have accepted to participate in the study and have signed the written informed consent. Patients with renal insufficiency (Groups II, III and IV): * Male or female subjects aged between 18 and 65 years, who will be assigned to one of the following groups according to renal function: * Group II: mild renal insufficiency (creatinine clearance \> 50 to 80 ml/min); * Group III: Moderate renal insufficiency (creatinine clearance: 30 to 50 ml/min); * Group IV: Severe renal insufficiency (creatinine clearance \< 30 ml/min). The degree of renal insufficiency will be calculated on the basis of determination of creatinine clearance measuring total urinary output over a 24-h period and serum creatinine levels. Urine samples will be collected no more than 2 weeks before the first experimental period. * Patients with renal insufficiency must have a stable renal function during the 3 months before their inclusion in the study. * They must have a body weight between 45 and 110 Kg. * They have to accept to participate in the study and have signed the written informed consent. Elderly healthy volunteers (Group V): * Male or female subjects aged \> 65 years old who fulfill with the remaining inclusion criteria specified for non-elderly healthy volunteers.
Exclusion criteria
Non-elderly healthy volunteers (Group I): * Previous history of alcoholism or drugs consumption * Important consumer of exciting drinks * Hypersensitivity, allergy, idiosyncrasy to medicines * Taking another medication four weeks before the initiation of the trial including medication without prescription and medicinal plants * Positive serology of hepatitis B, C or HIV virus * History or clinic evidence of concomitant disease * Familiar history of coagulation's disorders * surgery within the previous 6 months * Women who are pregnant or who are not using effective contra conceptive methods * Ethanol, cannabis, cocaine, amphetamine, benzodiazepin or opiate in urine * Current platelet count \< 100.000/mm3 or serum K \> 5,5 mEq/L * Any contraindication to bemiparin administration in order to authorized summary product characteristics * Healthy volunteers who are not participating in another clinical trial or have not done so in the past 2 months * To give blood in the four weeks before beginning of the trial Patients with renal insufficiency or elderly healthy volunteers (Groups II, III, IV, V): * Previous history of alcoholism or drugs consumption * Important consumer of exciting drinks * Hypersensitivity, allergy, idiosyncrasy to medicines * Treatment with enzymatic inhibitors or inductors medicines * Administration with ASA of dosis \> 125 mg/day and/or NDAIs with half-life \> 20 hours or with high antiagregant effect during the previous ten days to the inclusion * Chronic hepatopatology * bilirubin levels \> 1,5 mg/dl and/or increment of AST/ALT levels twice higher than maximum limit of normality * prothrombin time 20% higher than maximun limit of normality and haemoglobine \< 8gr/dl or albumim levels \<3gr/dl * Previous history of acute infarction of myocardium, cardiac ischemic or arrhythmia * Acute illness in the previous week to the participation * Familiar history of coagulation's disorders * surgery within the previous 6 months * Women who are pregnant or who are not using effective contra conceptive methods * Ethanol, cannabis, cocaine, amphetamine, benzodiazepin or opiate in urine * Current platelet count \< 75.000/mm3 or serum K \> 6 mEq/L * Any contraindication to bemiparin administration in order to authorized summary product characteristics * Healthy volunteers who are not participating in another clinical trial or have not done so in the past 2 months * To give blood in the four weeks before beginning of the trial * Subjects in haemodialysis or peritoneal dialysis
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To assess the pharmacokinetics of bemiparin administered subcutaneously once daily for 4 days at prophylactic doses (3500 IU) and at a single therapeutic dose (115 IU/kg), in renal insufficiency and in the elderly. | — |
Secondary
| Measure | Time frame |
|---|---|
| To assess the safety and tolerability of bemiparin in all volunteers and patients. | — |
Countries
Spain