Healthy
Conditions
Keywords
Comparative, Bioavailability, lomitapide
Brief summary
To compare the relative bioavailability of lomitapide when administered by sprinkling the contents of a 20 mg capsule of lomitapide in applesauce or in mashed banana to a single oral intact capsule dose of 20 mg lomitapide in healthy subjects.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
1. Subject is a non-smoking healthy male or female, aged between 18 and 40 years of age. 2. Subject has a BMI of 18.5 - 25 kg/m2. 3. Subject has total body weight between \> 50 kg to ≤ 100 kg. 4. Subjects must agree to use acceptable methods of contraception. 5. All females, regardless of childbearing potential, must have a negative serum beta human chorionic gonadotropin pregnancy test at Screening and on admission. 6. In good health, determined by no clinically significant or relevant abnormalities identified by a detailed medical history & full physical examination. 7. No known history of hypersensitivity or previous intolerance to lomitapide, applesauce, and/or banana. 8. Subjects must be capable of understanding and complying with the requirements of the protocol and must have signed the informed consent form prior to undergoing any study-related procedures.
Exclusion criteria
1. Subject has a clinically significant disease or any condition or disease that might affect drug absorption, distribution or excretion. 2. History of stomach or intestinal surgery or resection that would potentially alter absorption and/or excretion of orally administered drugs. 3. Any clinically significant abnormal laboratory, vital signs or other safety findings as determined by medical history, physical examination or other evaluations. 4. History of significant hypersensitivity, intolerance, or allergy to any drug compound, food, or other substance, unless approved by the Investigator; 5. Electrocardiogram (ECG) abnormalities in the standard 12-lead ECG (at screening) such as a QTcF interval of \>450 msec, a history of a prolonged QTc interval or Brugada syndrome. 6. History or current evidence of any clinically relevant cardiovascular, pulmonary, hepatic, renal, gastrointestinal, haematological, endocrinological, allergic, dermatological, metabolic, neurological, psychiatric or other disease. 7. History or laboratory evidence of Gilbert's syndrome. 8. Positive results in any of the serology tests for Hepatitis B Surface Antigen (HbsAg), anti-Hepatitis core antibody (anti-HBc Ig G \[and anti-HBc IgM if IgG is positive\], Hepatitis C antibodies (anti-HCV), and HIV 1 and 2 antibodies, (anti-HIV 1/2). 9. Use of any drugs of abuse within 6 months prior to admission. 10. Confirmed positive results from urine drug screen (amphetamines, benzodiazepines, cocaine, cannabinoids, opiates, barbiturates and methadone) or from the alcohol breath test at screening and on admission (Day -1). 11. History or clinical evidence of alcohol or drug abuse within one year prior to admission. 12. Mentally handicapped. 13. Participation in a drug trial within 90 days prior to first drug administration. 14. Use of any prescription medication within 2 weeks prior to admission (Day -1), with the exception of the oral contraceptive pill. 15. Use of any substance inducing or inhibiting CYP3A4 enzymes within 30 days prior to admission (Day -1). 16. Use of any over-the-counter (OTC) medication (including vitamins, minerals, and phytotherapeutic/herbal/plant-derived preparations) within 7 days prior to admission (Day -1), unless deemed acceptable by the Investigator and Sponsor. 17. Use of alcohol-, grapefruit-, starfruit-, or caffeine-containing foods or beverages within 72 hours prior to admission and through Study Completion. 18. Donation of more than 500 mL of blood within 90 days prior to drug administration. 19. Receipt of blood products within 2 months prior to admission. 20. Poor peripheral venous access. 21. Use of any tobacco- or nicotine-containing products within 6 months prior to admission (Day -1). 22. Any acute or chronic condition, scheduled hospitalisation (inclusive of elective surgery during study), or scheduled travel prior to completion of all study procedures. 23. Any circumstances or conditions, which, in the opinion of the PI, may affect full participation in the trial or compliance with the protocol. 24. Legal incapacity or limited legal capacity at screening. 25. Subjects who are vegetarians, vegans or have any dietary restrictions conflicting with the study standardised menus.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| AUC0-t | predose and 1, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 48, 72, 96, 120, 144, and 168 hours post-dose | Area under the concentration-time curve from hour 0 to the last measurable concentration of lomitapide and its metabolites (M1& M3). |
| Cmax | predose and 1, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 48, 72, 96, 120, 144, and 168 hours post-dose | Maximum observed concentration of lomitapide and its metabolites (M1& M3). |
| Tmax | predose and 1, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 48, 72, 96, 120, 144, and 168 hours post-dose | Time to reach maximum plasma concentration of lomitapide and its metabolites (M1& M3). |
| t1/2 | predose and 1, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 48, 72, 96, 120, 144, and 168 hours post-dose | Terminal elimination half-life of lomitapide and its metabolites (M1& M3). |
| AUC0-∞ | predose and 1, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 48, 72, 96, 120, 144, and 168 hours post-dose | Area under the plasma concentration vs time curve from zero to infinity of lomitapide and its metabolites (M1& M3). |
| λz | predose and 1, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 48, 72, 96, 120, 144, and 168 hours post-dose | Elimination rate constant estimated from individual linear regression of the terminal part of the log concentration vs time curve of lomitapide and its metabolites (M1& M3). |
Countries
United Kingdom
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Applesauce, Mashed Banana, Intact Capsule (ABC) Contents of single 20 mg capsule of lomitapide sprinkled in applesauce, mashed banana
Capsule taken intact
lomitapide | 11 |
| Mashed Banana, Intact Capsule, Applesauce (BCA) Contents of single 20 mg capsule of lomitapide sprinkled in applesauce& mashed banana
Capsule taken intact
lomitapide | 10 |
| Intact Capsule, Applesauce, Mashed Banana (CAB) Contents of single 20 mg capsule of lomitapide sprinkled in applesauce& mashed banana
Capsule taken intact
lomitapide | 11 |
| Total | 32 |
Baseline characteristics
| Characteristic | Applesauce, Mashed Banana, Intact Capsule (ABC) | Mashed Banana, Intact Capsule, Applesauce (BCA) | Intact Capsule, Applesauce, Mashed Banana (CAB) | Total |
|---|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 11 Participants | 10 Participants | 11 Participants | 32 Participants |
| Age, Continuous | 28.45 years STANDARD_DEVIATION 5.837 | 25.90 years STANDARD_DEVIATION 5.131 | 27.91 years STANDARD_DEVIATION 3.27 | 27.42 years STANDARD_DEVIATION 4.746 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 0 Participants | 0 Participants | 1 Participants | 1 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 11 Participants | 10 Participants | 10 Participants | 31 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 1 Participants | 1 Participants | 1 Participants | 3 Participants |
| Race (NIH/OMB) Black or African American | 3 Participants | 2 Participants | 4 Participants | 9 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 1 Participants | 1 Participants | 2 Participants |
| Race (NIH/OMB) White | 7 Participants | 6 Participants | 5 Participants | 18 Participants |
| Region of Enrollment United Kingdom | 11 participants | 10 participants | 11 participants | 32 participants |
| Sex: Female, Male Female | 3 Participants | 6 Participants | 6 Participants | 15 Participants |
| Sex: Female, Male Male | 8 Participants | 4 Participants | 5 Participants | 17 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 30 | 0 / 31 | 0 / 31 |
| other Total, other adverse events | 5 / 30 | 6 / 31 | 6 / 31 |
| serious Total, serious adverse events | 0 / 30 | 0 / 31 | 0 / 31 |
Outcome results
AUC0-∞
Area under the plasma concentration vs time curve from zero to infinity of lomitapide and its metabolites (M1& M3).
Time frame: predose and 1, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 48, 72, 96, 120, 144, and 168 hours post-dose
Population: Pharmacokinetic Analysis Set included all subjects who received at least one single dose of lomitapide and who had evaluable PK data
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Lomitapide Sprinkled in Applesauce (Treatment A) | AUC0-∞ | M1 | 72.8 ng*h/mL | Standard Deviation 20.8 |
| Lomitapide Sprinkled in Applesauce (Treatment A) | AUC0-∞ | Lomitapide | 42.5 ng*h/mL | Standard Deviation 17.7 |
| Lomitapide Sprinkled in Applesauce (Treatment A) | AUC0-∞ | M3 | 457 ng*h/mL | Standard Deviation 317 |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | AUC0-∞ | M1 | 75.2 ng*h/mL | Standard Deviation 23.7 |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | AUC0-∞ | Lomitapide | 43.8 ng*h/mL | Standard Deviation 15.3 |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | AUC0-∞ | M3 | 464 ng*h/mL | Standard Deviation 300 |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | AUC0-∞ | Lomitapide | 47.7 ng*h/mL | Standard Deviation 20.6 |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | AUC0-∞ | M3 | 474 ng*h/mL | Standard Deviation 333 |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | AUC0-∞ | M1 | 77.8 ng*h/mL | Standard Deviation 23.9 |
AUC0-t
Area under the concentration-time curve from hour 0 to the last measurable concentration of lomitapide and its metabolites (M1& M3).
Time frame: predose and 1, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 48, 72, 96, 120, 144, and 168 hours post-dose
Population: Pharmacokinetic Analysis Set included all subjects who received at least one single dose of lomitapide and who had evaluable PK data
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Lomitapide Sprinkled in Applesauce (Treatment A) | AUC0-t | M1 | 70.4 ng*h/mL | Standard Deviation 20.2 |
| Lomitapide Sprinkled in Applesauce (Treatment A) | AUC0-t | Lomitapide | 38.3 ng*h/mL | Standard Deviation 15.2 |
| Lomitapide Sprinkled in Applesauce (Treatment A) | AUC0-t | M3 | 443 ng*h/mL | Standard Deviation 308 |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | AUC0-t | M1 | 72.9 ng*h/mL | Standard Deviation 23.1 |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | AUC0-t | Lomitapide | 40.2 ng*h/mL | Standard Deviation 13.4 |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | AUC0-t | M3 | 450 ng*h/mL | Standard Deviation 292 |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | AUC0-t | Lomitapide | 43.6 ng*h/mL | Standard Deviation 17.7 |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | AUC0-t | M3 | 460 ng*h/mL | Standard Deviation 325 |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | AUC0-t | M1 | 75.2 ng*h/mL | Standard Deviation 22.8 |
Cmax
Maximum observed concentration of lomitapide and its metabolites (M1& M3).
Time frame: predose and 1, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 48, 72, 96, 120, 144, and 168 hours post-dose
Population: Pharmacokinetic Analysis Set included all subjects who received at least one single dose of lomitapide and who had evaluable PK data
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Lomitapide Sprinkled in Applesauce (Treatment A) | Cmax | M1 | 2.52 ng/mL | Standard Deviation 0.748 |
| Lomitapide Sprinkled in Applesauce (Treatment A) | Cmax | Lomitapide | 0.986 ng/mL | Standard Deviation 0.536 |
| Lomitapide Sprinkled in Applesauce (Treatment A) | Cmax | M3 | 30.2 ng/mL | Standard Deviation 15.6 |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | Cmax | M1 | 2.65 ng/mL | Standard Deviation 0.813 |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | Cmax | Lomitapide | 1.03 ng/mL | Standard Deviation 0.463 |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | Cmax | M3 | 31.0 ng/mL | Standard Deviation 13.3 |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | Cmax | Lomitapide | 1.13 ng/mL | Standard Deviation 0.591 |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | Cmax | M3 | 28.6 ng/mL | Standard Deviation 13.7 |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | Cmax | M1 | 2.74 ng/mL | Standard Deviation 0.796 |
t1/2
Terminal elimination half-life of lomitapide and its metabolites (M1& M3).
Time frame: predose and 1, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 48, 72, 96, 120, 144, and 168 hours post-dose
Population: Pharmacokinetic Analysis Set included all subjects who received at least one single dose of lomitapide and who had evaluable PK data
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Lomitapide Sprinkled in Applesauce (Treatment A) | t1/2 | M1 | 38.7 h | Standard Deviation 7.56 |
| Lomitapide Sprinkled in Applesauce (Treatment A) | t1/2 | Lomitapide | 52.4 h | Standard Deviation 13.3 |
| Lomitapide Sprinkled in Applesauce (Treatment A) | t1/2 | M3 | 46.0 h | Standard Deviation 13.1 |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | t1/2 | M1 | 37.0 h | Standard Deviation 6.78 |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | t1/2 | Lomitapide | 47.7 h | Standard Deviation 12.2 |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | t1/2 | M3 | 45.7 h | Standard Deviation 11.5 |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | t1/2 | Lomitapide | 48.8 h | Standard Deviation 10.7 |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | t1/2 | M3 | 44.0 h | Standard Deviation 11.6 |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | t1/2 | M1 | 39.1 h | Standard Deviation 6.32 |
Tmax
Time to reach maximum plasma concentration of lomitapide and its metabolites (M1& M3).
Time frame: predose and 1, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 48, 72, 96, 120, 144, and 168 hours post-dose
Population: Pharmacokinetic Analysis Set included all subjects who received at least one single dose of lomitapide and who had evaluable PK data
| Arm | Measure | Group | Value (MEDIAN) |
|---|---|---|---|
| Lomitapide Sprinkled in Applesauce (Treatment A) | Tmax | M1 | 5.00 hours |
| Lomitapide Sprinkled in Applesauce (Treatment A) | Tmax | Lomitapide | 4.00 hours |
| Lomitapide Sprinkled in Applesauce (Treatment A) | Tmax | M3 | 2.03 hours |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | Tmax | M1 | 5.00 hours |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | Tmax | Lomitapide | 5.00 hours |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | Tmax | M3 | 3.00 hours |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | Tmax | Lomitapide | 5.00 hours |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | Tmax | M3 | 3.00 hours |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | Tmax | M1 | 5.00 hours |
λz
Elimination rate constant estimated from individual linear regression of the terminal part of the log concentration vs time curve of lomitapide and its metabolites (M1& M3).
Time frame: predose and 1, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 48, 72, 96, 120, 144, and 168 hours post-dose
Population: Pharmacokinetic Analysis Set included all subjects who received at least one single dose of lomitapide and who had evaluable PK data
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Lomitapide Sprinkled in Applesauce (Treatment A) | λz | M1 | 0.0185 1/h | Standard Deviation 0.00344 |
| Lomitapide Sprinkled in Applesauce (Treatment A) | λz | Lomitapide | 0.0140 1/h | Standard Deviation 0.00341 |
| Lomitapide Sprinkled in Applesauce (Treatment A) | λz | M3 | 0.0161 1/h | Standard Deviation 0.00408 |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | λz | M1 | 0.0195 1/h | Standard Deviation 0.00457 |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | λz | Lomitapide | 0.0153 1/h | Standard Deviation 0.00343 |
| Lomitapide Sprinkled in Mashed Banana (Treatment B) | λz | M3 | 0.0162 1/h | Standard Deviation 0.00428 |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | λz | Lomitapide | 0.0149 1/h | Standard Deviation 0.0032 |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | λz | M3 | 0.0167 1/h | Standard Deviation 0.00405 |
| Intact Capsule of 20 mg Lomitapide (Treatment C) | λz | M1 | 0.0182 1/h | Standard Deviation 0.00309 |