Healthy Volunteers
Conditions
Brief summary
All study participants will receive both warfarin and a study drug called evacetrapib. The main purpose of this study is to look at how much warfarin gets into the blood stream and how long it takes the body to get rid of warfarin when given both with and without evacetrapib. Another purpose is to evaluate the effectiveness of warfarin therapy to prevent blood clots when given with evacetrapib by measuring the time it takes for blood to clot and comparing it to an average of the international normalized ratio (INR). INR measures the time it takes for blood to clot and compares it to an average. The study will last approximately 5 weeks, not including screening.
Interventions
Oral administration
Oral administration
Sponsors
Study design
Eligibility
Inclusion criteria
* Participants have given written informed consent approved by Lilly and the ethical review board (ERB) governing the site * A medical history and physical examination consistent with a being a healthy individual * Male participants will use a reliable method of birth control (as deemed by the investigator) and not donate sperm during the study and for 3 months following the last dose of the investigational product * Female participants are not of child-bearing potential due to surgical sterilization (at least 6 weeks after surgical hysterectomy, bilateral oophorectomy, or tubal ligation) confirmed by medical history, or post-menopausal * Have a body mass index (BMI) of 18 to 32 kilograms per square meter (kg/m\^2) * Participants are predicted to be cytochrome P450 2C9 (CYP2C9) extensive metabolizers as determined by genotyping assessment
Exclusion criteria
* Have an abnormality in the 12-lead electrocardiogram (ECG) that increases the risks associated with participating in the study * Have an abnormal supine blood pressure * Have a history or presence of cardiovascular, respiratory, hepatic, renal, gastrointestinal, endocrine, hematological, or neurological disorders capable of significantly altering the absorption, metabolism, or elimination of drugs; of constituting a risk when taking the study medication; or of interfering with the interpretation of data * Show evidence of human immunodeficiency virus (HIV) infection and/or positive human HIV antibodies * Show evidence of hepatitis C and/or positive hepatitis C antibody or evidence of hepatitis B and/or positive hepatitis B surface antigen * Women who are pregnant or are lactating * Have used or intend to use over-the-counter or prescription medications (including vitamins/mineral supplements, herbal medicine) 14 days prior to enrollment and during the study * Have consumed grapefruit, cranberries, or grapefruit- or cranberry-containing products within 7 days prior to the first dose of warfarin * Have a history or presence of significant bleeding disorders that is, hematemesis, melanena, severe or recurrent epistaxis, hemoptysis, clinically overt hematuria or intracranial hemorrhage, gastrointestinal ulcers with hemorrhage * Have a personal or family history of coagulation or bleeding disorders or reasonable suspicion of vascular malformations, for example, cerebral hemorrhage, aneurysm or premature stroke (cerebrovascular accident at \<65 years of age) * Have a history of major head trauma (with loss of consciousness) within the past year or minor head trauma (without loss of consciousness) within the last 3 months prior to screening or history of major surgery within 3 months of screening * Have planned surgery within 14 days after the last day of dosing * Have an international normalized ratio/prothrombin time (INR/PT), or activated partial thromboplastin time (aPTT) above the normal reference range or abnormal Protein S antigen and/or Protein C activity at screening
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Pharmacokinetics (PK): Area Under the Concentration Versus Time Curve From Time Zero to Infinity (AUC0-∞) of S-Warfarin | Days 1 and 17: 0, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48, 72, 96, 120, and 144 hours following warfarin dose |
| PK: Maximum Observed Concentration (Cmax) of S-Warfarin | Days 1 and 17: 0, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48, 72, 96, 120, and 144 hours following warfarin dose |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| PK: AUC0-∞ of R-Warfarin | Days 1 and 17: 0, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48, 72, 96, 120, and 144 hours following warfarin dose | — |
| PK: Cmax of R-Warfarin | Days 1 and 17: 0, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48, 72, 96, 120, and 144 hours following warfarin dose | — |
| Pharmacodynamics (PD): Area Under the International Normalized Ratio Curve (AUCINR) of Warfarin | Days 1 and 17: 0, 6, 12, 24, 36, 48, 72, 96, 120, and 144 hours following warfarin dose | The INR is a standardized ratio of the prothrombin time (PT), time it takes for blood to clot. AUCINR is the time curve used to measure change in INR over time. |
| PD: Maximum Observed INR Response (INRmax) of Warfarin | 0, 6, 12, 24, 36, 48, 72, 96, 120, and 144 hours following warfarin dose on Days 1 and 17 | The INR is a standardized ratio of the PT, time it takes for blood to clot. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Overall Study Participants were administered 15 mg warfarin as a single oral dose on Days 1 and 17; 130 mg evacetrapib was administered QD, orally, on Days 7 to 22. | 17 |
| Total | 17 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Period 2 | Withdrawal by Subject | 0 | 1 |
Baseline characteristics
| Characteristic | Overall Study |
|---|---|
| Age, Continuous | 38.2 years STANDARD_DEVIATION 9.4 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 4 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 13 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 4 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 13 Participants |
| Region of Enrollment United States | 17 Participants |
| Sex: Female, Male Female | 1 Participants |
| Sex: Female, Male Male | 16 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — |
| other Total, other adverse events | 5 / 17 | 2 / 17 | 4 / 16 |
| serious Total, serious adverse events | 0 / 17 | 0 / 17 | 0 / 16 |
Outcome results
Pharmacokinetics (PK): Area Under the Concentration Versus Time Curve From Time Zero to Infinity (AUC0-∞) of S-Warfarin
Time frame: Days 1 and 17: 0, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48, 72, 96, 120, and 144 hours following warfarin dose
Population: All participants who received a dose of study drug and had evaluable data for AUC(0-∞).
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Warfarin | Pharmacokinetics (PK): Area Under the Concentration Versus Time Curve From Time Zero to Infinity (AUC0-∞) of S-Warfarin | 132 nanograms*hour/milliliter (ng*h/mL) | Geometric Coefficient of Variation 35 |
| Evacetrapib + Warfarin | Pharmacokinetics (PK): Area Under the Concentration Versus Time Curve From Time Zero to Infinity (AUC0-∞) of S-Warfarin | 126 nanograms*hour/milliliter (ng*h/mL) | Geometric Coefficient of Variation 39 |
PK: Maximum Observed Concentration (Cmax) of S-Warfarin
Time frame: Days 1 and 17: 0, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48, 72, 96, 120, and 144 hours following warfarin dose
Population: All participants who received a dose of study drug and had evaluable data for Cmax.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Warfarin | PK: Maximum Observed Concentration (Cmax) of S-Warfarin | 4.69 nanograms/milliliter (ng/mL) | Geometric Coefficient of Variation 20 |
| Evacetrapib + Warfarin | PK: Maximum Observed Concentration (Cmax) of S-Warfarin | 4.72 nanograms/milliliter (ng/mL) | Geometric Coefficient of Variation 15 |
PD: Maximum Observed INR Response (INRmax) of Warfarin
The INR is a standardized ratio of the PT, time it takes for blood to clot.
Time frame: 0, 6, 12, 24, 36, 48, 72, 96, 120, and 144 hours following warfarin dose on Days 1 and 17
Population: All participants who received a dose of study drug and had evaluable data for INRmax.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Warfarin | PD: Maximum Observed INR Response (INRmax) of Warfarin | 1.36 ratio | Geometric Coefficient of Variation 17.4 |
| Evacetrapib + Warfarin | PD: Maximum Observed INR Response (INRmax) of Warfarin | 1.25 ratio | Geometric Coefficient of Variation 12.9 |
Pharmacodynamics (PD): Area Under the International Normalized Ratio Curve (AUCINR) of Warfarin
The INR is a standardized ratio of the prothrombin time (PT), time it takes for blood to clot. AUCINR is the time curve used to measure change in INR over time.
Time frame: Days 1 and 17: 0, 6, 12, 24, 36, 48, 72, 96, 120, and 144 hours following warfarin dose
Population: All participants who received a dose of study drug and had evaluable data for AUCINR.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Warfarin | Pharmacodynamics (PD): Area Under the International Normalized Ratio Curve (AUCINR) of Warfarin | 167 ratio*h | Geometric Coefficient of Variation 7.9 |
| Evacetrapib + Warfarin | Pharmacodynamics (PD): Area Under the International Normalized Ratio Curve (AUCINR) of Warfarin | 162 ratio*h | Geometric Coefficient of Variation 5.2 |
PK: AUC0-∞ of R-Warfarin
Time frame: Days 1 and 17: 0, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48, 72, 96, 120, and 144 hours following warfarin dose
Population: All participants who received a dose of study drug and had evaluable data for AUC(0-∞).
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Warfarin | PK: AUC0-∞ of R-Warfarin | 321 ng*h/mL | Geometric Coefficient of Variation 25 |
| Evacetrapib + Warfarin | PK: AUC0-∞ of R-Warfarin | 314 ng*h/mL | Geometric Coefficient of Variation 25 |
PK: Cmax of R-Warfarin
Time frame: Days 1 and 17: 0, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48, 72, 96, 120, and 144 hours following warfarin dose
Population: All participants who received a dose of study drug and had evaluable data for Cmax.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Warfarin | PK: Cmax of R-Warfarin | 6.02 ng/mL | Geometric Coefficient of Variation 19 |
| Evacetrapib + Warfarin | PK: Cmax of R-Warfarin | 6.22 ng/mL | Geometric Coefficient of Variation 15 |