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Study Conducted to Further Understand the Elimination Pathways, Metabolite Profile and PK Profile of 14C-estetrol

An Open-Label, Single Dose Study Designed to Assess the Mass Balance Recovery, Metabolite Profiles and Metabolite Identification of [14C]-Estetrol in Healthy Female Volunteers

Status
Completed
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02720224
Enrollment
6
Registered
2016-03-25
Start date
2016-02-29
Completion date
2016-04-30
Last updated
2019-02-15

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Contraception, Menopause

Brief summary

This study is being conducted to further understand the elimination pathways, metabolite profile and pharmacokinetic (PK) profile of carbon 14 labelled estetrol (\[14C\] estetrol).

Detailed description

This will be an open-label, non-randomised, single dose study in healthy female volunteers of non-child bearing potential. Subjects will be screened for eligibility to participate in the study up to 28 days before dosing. The study will be executed in a single group, 6 subjects will be enrolled and dosed with a single oral dose of carbon 14 labelled estetrol. Subjects will be admitted to the clinical unit on the morning prior to study drug administration (Day -1). Dosing will take place on the morning of Day 1 after an overnight fast (approximately 10 h). Subjects will be resident in the clinic up to 240 h after dosing during which plasma, blood, urine and faeces samples will be collected. It is planned that subjects will be released as a group when all subjects have achieved a mass balance cumulative recovery of \>90% or if a mean of \<1% of the dose administered has been collected in urine and faeces within 2 separate, consecutive 24 h periods. In this case, collection of all samples (blood, urine and faeces) will be stopped and the subjects will undergo discharge assessments. If this criterion has not been met by all subjects on Day 11, home collections of urine and faeces may be requested at the discretion of the investigator for individual subjects.

Interventions

15 mg \[14C\]-estetrol containing approximately 2.8 MBq (76 μCi) 14C

Sponsors

Quotient Clinical
CollaboratorOTHER
Estetra
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
OTHER
Masking
NONE

Eligibility

Sex/Gender
FEMALE
Age
30 Years to 65 Years
Healthy volunteers
No

Inclusion criteria

1. Healthy females of non-child bearing potential, i.e. surgically sterilised or post menopausal subjects. Postmenopausal status will be defined by an absence of menses for a minimum of 12 months and confirmed by a FSH result ≥30 IU/ml 2. Negative pregnancy test at screening and Day -1 3. 30 to 65 years of age inclusive 4. Body mass index between ≥18.0 and ≤30.0 kg/m2 5. Must be willing and able to communicate and participate in the whole study 6. Must provide written informed consent 7. Must have regular bowel movements (i.e. average stool production of ≥1 and ≤3 stools per day)Must agree to use an adequate method of contraception

Exclusion criteria

1. Participation in a clinical research study within the previous 3 months 2. Subjects who are study site employees, or immediate family members of a study site or sponsor employee 3. Subjects who have previously been enrolled in this study 4. History of any drug or alcohol abuse in the past 2 years 5. Regular alcohol consumption i.e. \>14 units per week (1 unit = ½ pint beer, 25 ml of 40% spirit or a 125 ml glass of wine) 6. Current smokers and those who have smoked within the last 12 months. A breath carbon monoxide reading of greater than 10 ppm at screening 7. Females who are pregnant or lactating 8. Radiation exposure, including that from the present study, excluding background radiation but including diagnostic x-rays and other medical exposures, exceeding 5 mSv in the last 12 months or 10 mSv in the last 5 years. No occupationally exposed worker, as defined in the Ionising Radiation Regulations 1999, shall participate in the study 9. Subjects who do not have suitable veins for multiple venepunctures/cannulation as assessed at screening 10. Clinically significant abnormal biochemistry, haematology or urinalysis as judged by the investigator 11. Positive drugs of abuse test result 12. Positive hepatitis B surface antigen (HBsAg), hepatitis C virus antibody (HCV Ab) or human immunodeficiency virus (HIV) results 13. History or presence of clinically significant cardiovascular, renal, hepatic, chronic respiratory or gastrointestinal disease as judged by the investigator 14. Serious adverse reaction or serious hypersensitivity to any drug or the formulation excipients 15. Presence or history of clinically significant allergy requiring treatment, as judged by the investigator. Hayfever is allowed unless it is active 16. Donation or loss of greater than 400 ml of blood within the previous 3 months 17. Subjects who are taking, or have taken, any prescribed medications in the 28 days before IMP administration (exceptions may apply on a case by case basis provided they are considered not to interfere with the objectives of the study as agreed by the PI or delegate and sponsor's medical monitor), or over-the-counter drug or herbal remedies in the 14 days before IMP administration. If needed (i.e. an incidental and limited need) ibuprofen is acceptable as analgesic treatment, but must be documented in the (Case Report Form) CRF. Use of paracetamol is forbidden during the entire study 18. Subjects who are not in euthyroid condition (thyroid-stimulating hormone \[TSH\] and free thyroxine \[fT4\] within the normal reference range) 19. Any history of suspected malignancy with the exception of basal cell (excluded if within the prior 2 years) or squamous cell (excluded if within the prior one year) carcinoma of the skin 20. History or presence of prolonged QT interval corrected by Bazett's formula or any other clinically significant ECG abnormalities as judged by the investigator based on 12-lead ECG readings at screening 21. Subjects with abnormal supine blood pressure at screening: at least 2 readings of systolic blood pressure greater than 140 mmHg or lower than 90 mmHg, and/or diastolic blood pressure of more than 90 mmHg or lower than 50 mmHg after minimum intervals of 5 min 22. Any surgical or medical condition which might significantly alter the absorption, distribution, metabolism, or excretion of drugs, or which may jeopardize the subject in case of participation in the study. The investigator should make this determination in consideration of the subject's medical history and/or clinical or laboratory evidence of any of the following: * History or symptoms of inflammatory bowel disease, gastritis, ulcers, gastrointestinal or rectal bleeding, * History of major gastrointestinal tract surgery (subjects who have had an appendectomy are acceptable for inclusion), * History or presence of pancreatic injury or pancreatitis, * History or presence of impaired hepatic function, * History or presence of liver disease or liver injury as indicated by abnormal liver function tests such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), or total serum bilirubin. Any single parameter elevated ≥1.5 fold upper limit of normal should be re-checked once prior to enrolment/randomisation (subject who have had a cholecystectomy are acceptable for inclusion if all liver/gallbladder parameters are in the normal range), * History or presence of impaired renal function if considered as clinically significant, * Abnormal urinary constituents (e.g. albumin if considered as clinically significant). 23. Suspected or current history of gynaecological or breast pathology, including any abnormal Pap smear within the 3 previous years (ASCUS , ASC-H , LGSIL or worse) or history of abnormal mammogram within the 2 previous years 24. Failure to satisfy the investigator of fitness to participate for any other reason

Design outcomes

Primary

MeasureTime frameDescription
Mass Balance of Total Radioactivity in UrineFrom Day -1 prior study treatment intake to 312 hours post-doseAmount excreted in urine (Ae\[urine\])
Mass Balance of Total Radioactivity in Faeces:From Day -1 prior study treatment intake to 312 hours post-doseAmount excreted in faeces (Ae\[faeces\])

Secondary

MeasureTime frame
Area Under the Curve From 0 Time to Last Measurable Concentration [AUC(0-last)] of Total Radioactivity in PlasmaPredose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose
The Elapsed Time (Tlag) of Total Radioactivity in PlasmaPredose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose
Cmax of Estetrol in PlasmaPredose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose
Tmax of Estetrol in PlasmaPredose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose
AUC(0-last) of Estetrol in PlasmaPredose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose
AUC(0-infinity) of Estetrol in PlasmaPredose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose
Tlag of Estetrol in PlasmaPredose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose
Maximum Concentration (Cmax) of Total Radioactivity in PlasmaPredose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose
The Mean Residence Time (MRT) of Estetrol in PlasmaPredose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose
Cmax of Total Radioactivity in Whole BloodPredose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose
The Terminal Elimination Rate Constant (Lambda-z) of Estetrol in PlasmaPredose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose
AUC(0-last) of Total Radioactivity in Whole BloodPredose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose
Renal Clearance (CLr) for EstetrolFrom Day-1 prior study treatment intake to 240 hours post-dose
Renal Clearance (CLr) for Total RadioactivityFrom Day-1 prior study treatment intake to 240 hours post-dose
Number of Subjects With Adverse Events as a Measure of Safety and TolerabilityFrom maximum 28 days prior study treatment intake to 240 hours post-dose
Half-life (t1/2) of Estetrol in PlasmaPredose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose
Time to Maximum Concentration (Tmax) of Total Radioactivity in PlasmaPredose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose

Countries

United Kingdom

Participant flow

Participants by arm

ArmCount
Estetrol
A single oral dose of 15 mg carbon 14 labelled estetrol (\[14C\]-estetrol), containing approximately 2.8 MBq (76 µCi) 14C Estetrol: 15 mg \[14C\]-estetrol containing approximately 2.8 MBq (76 μCi) 14C
6
Total6

Baseline characteristics

CharacteristicEstetrol
Age, Categorical
<=18 years
0 Participants
Age, Categorical
>=65 years
0 Participants
Age, Categorical
Between 18 and 65 years
6 Participants
Age, Continuous57.8 years
STANDARD_DEVIATION 3.5
Region of Enrollment
United Kingdom
6 participants
Sex: Female, Male
Female
6 Participants
Sex: Female, Male
Male
0 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 6
other
Total, other adverse events
2 / 6
serious
Total, serious adverse events
0 / 6

Outcome results

Primary

Mass Balance of Total Radioactivity in Faeces:

Amount excreted in faeces (Ae\[faeces\])

Time frame: From Day -1 prior study treatment intake to 312 hours post-dose

Population: Mass balance population - n = all subjects who took one dose of study treatment and had evaluable total radioactivity concentration (urinary and faecal) data.

ArmMeasureValue (MEAN)Dispersion
EstetrolMass Balance of Total Radioactivity in Faeces:21.88 Cumulative percent excreted (%)Standard Deviation 8.29
Primary

Mass Balance of Total Radioactivity in Urine

Amount excreted in urine (Ae\[urine\])

Time frame: From Day -1 prior study treatment intake to 312 hours post-dose

Population: Mass balance population - n = all subjects who took one dose of study treatment and had evaluable total radioactivity concentration (urinary and faecal) data.

ArmMeasureValue (MEAN)Dispersion
EstetrolMass Balance of Total Radioactivity in Urine68.97 Cumulative percent excreted (%)Standard Deviation 7.3
Secondary

Area Under the Curve From 0 Time to Last Measurable Concentration [AUC(0-last)] of Total Radioactivity in Plasma

Time frame: Predose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose

Population: PK population - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose plasma concentration for PK parameter estimation.~One subject was excluded from the AUC0-last calculation due to undetectable samples from 4 to 24 hours post E4 dose.

ArmMeasureValue (MEDIAN)
EstetrolArea Under the Curve From 0 Time to Last Measurable Concentration [AUC(0-last)] of Total Radioactivity in Plasma561 ng*h/mL
Secondary

AUC(0-infinity) of Estetrol in Plasma

Time frame: Predose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose

Population: PK population - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose plasma concentration for PK parameter estimation.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
EstetrolAUC(0-infinity) of Estetrol in Plasma92.6 ng*h/mLGeometric Coefficient of Variation 15.2
Secondary

AUC(0-last) of Estetrol in Plasma

Time frame: Predose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose

Population: PK population - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose plasma concentration for PK parameter estimation.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
EstetrolAUC(0-last) of Estetrol in Plasma90.4 ng*h/mLGeometric Coefficient of Variation 15.4
Secondary

AUC(0-last) of Total Radioactivity in Whole Blood

Time frame: Predose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose

Population: PK population - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose plasma concentration for PK parameter estimation.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
EstetrolAUC(0-last) of Total Radioactivity in Whole Blood125 ng eq*h/mLGeometric Coefficient of Variation 51.7
Secondary

Cmax of Estetrol in Plasma

Time frame: Predose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose

Population: PK population - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose plasma concentration for PK parameter estimation.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
EstetrolCmax of Estetrol in Plasma16.6 ng/mLGeometric Coefficient of Variation 18.7
Secondary

Cmax of Total Radioactivity in Whole Blood

Time frame: Predose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose

Population: PK population - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose plasma concentration for PK parameter estimation.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
EstetrolCmax of Total Radioactivity in Whole Blood122 ng eq/mLGeometric Coefficient of Variation 27.6
Secondary

Half-life (t1/2) of Estetrol in Plasma

Time frame: Predose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose

Population: PK population - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose plasma concentration for PK parameter estimation.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
EstetrolHalf-life (t1/2) of Estetrol in Plasma31.7 hourGeometric Coefficient of Variation 31.8
Secondary

Maximum Concentration (Cmax) of Total Radioactivity in Plasma

Time frame: Predose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose

Population: Pharmacokinetic (PK) population - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose plasma concentration for PK parameter estimation.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
EstetrolMaximum Concentration (Cmax) of Total Radioactivity in Plasma231 ng/mLGeometric Coefficient of Variation 29.2
Secondary

Number of Subjects With Adverse Events as a Measure of Safety and Tolerability

Time frame: From maximum 28 days prior study treatment intake to 240 hours post-dose

Population: Safety population - all subjects who took one dose of study treatment

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
EstetrolNumber of Subjects With Adverse Events as a Measure of Safety and Tolerability2 Participants
Secondary

Renal Clearance (CLr) for Estetrol

Time frame: From Day-1 prior study treatment intake to 240 hours post-dose

Population: PK and mass balance populations - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose samples (plasma, urinary and faecal) for PK and mass balance parameter estimation.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
EstetrolRenal Clearance (CLr) for Estetrol8.1 mL/minGeometric Coefficient of Variation 41.6
Secondary

Renal Clearance (CLr) for Total Radioactivity

Time frame: From Day-1 prior study treatment intake to 240 hours post-dose

Population: PK and mass balance populations - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose samples (plasma, urinary and faecal) for PK and mass balance parameter estimation.~One subject was excluded from the CLr analysis due to undetectable PK samples from 4 to 24 hours post E4 dose.

ArmMeasureValue (GEOMETRIC_LEAST_SQUARES_MEAN)Dispersion
EstetrolRenal Clearance (CLr) for Total Radioactivity273 mL/minGeometric Coefficient of Variation 27
Secondary

The Elapsed Time (Tlag) of Total Radioactivity in Plasma

Time frame: Predose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose

Population: PK population - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose plasma concentration for PK parameter estimation.

ArmMeasureValue (MEDIAN)
EstetrolThe Elapsed Time (Tlag) of Total Radioactivity in Plasma0.0 hour
Secondary

The Mean Residence Time (MRT) of Estetrol in Plasma

Time frame: Predose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose

Population: PK population - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose plasma concentration for PK parameter estimation.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
EstetrolThe Mean Residence Time (MRT) of Estetrol in Plasma42.78 hourGeometric Coefficient of Variation 31
Secondary

The Terminal Elimination Rate Constant (Lambda-z) of Estetrol in Plasma

Time frame: Predose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose

Population: PK population - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose plasma concentration for PK parameter estimation.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
EstetrolThe Terminal Elimination Rate Constant (Lambda-z) of Estetrol in Plasma0.0218 1/hourGeometric Coefficient of Variation 31.8
Secondary

Time to Maximum Concentration (Tmax) of Total Radioactivity in Plasma

Time frame: Predose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose

Population: PK population - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose plasma concentration for PK parameter estimation.

ArmMeasureValue (MEDIAN)
EstetrolTime to Maximum Concentration (Tmax) of Total Radioactivity in Plasma0.25 hour
Secondary

Tlag of Estetrol in Plasma

Time frame: Predose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose

Population: PK population - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose plasma concentration for PK parameter estimation.

ArmMeasureValue (MEDIAN)
EstetrolTlag of Estetrol in Plasma0.0 hour
Secondary

Tmax of Estetrol in Plasma

Time frame: Predose, 0.25, 0.5, 0.75, 1, 1.25, 1.5, 2, 3, 4, 5, 6, 8, 12, 16, 24, 36, 48, 72, 96, 120, 144, 168, 192, 216, 240 hours post-dose

Population: PK population - n = all subjects who took one dose of study treatment and had sufficient quantifiable post-dose plasma concentration for PK parameter estimation.

ArmMeasureValue (MEDIAN)
EstetrolTmax of Estetrol in Plasma0.25 hour

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026