Heart Failure
Conditions
Keywords
Cardiovascular Diseases, Renal Impairment, Heart Diseases
Brief summary
A study to assess the safety, tolerability, and pharmacokinetics of AMG 986 given orally as a single dose to healthy participants and participants with severely impaired kidney function.
Interventions
tablets for oral administration
Sponsors
Study design
Masking description
The patient, investigator, investigative staff, medical monitor and care provider will not be masked for the study.
Intervention model description
This is a multisite (approximately 3 sites), open-label, non-randomized, single-dose study in participants with severely impaired kidney function and healthy participants. About 12 participants will be assigned to two groups: Group 1: 6 with severely impaired kidney function , and Group 2: 6 with normal kidney function.
Eligibility
Inclusion criteria
* Male or female subjects, who are \> or = 18 and \< or = 65 years of age at the time of screening * Subject has provided informed consent prior to initiation of any study-specific activities/procedures * Women must be of non-reproductive potential (ie, postmenopausal, history of hysterectomy, or history of bilateral oophorectomy) * Men must agree to practice an acceptable method of effective birth control while on study through 11 weeks after receiving the dose of study drug. * Men must be willing to abstain from sperm donation while on study through 11 weeks after receiving the dose of study drug * Body Mass Index \> or = 18 and \< or = 38 kg/m\^2 at screening * Physical examination and 12-lead electrocardiograms (ECGs) are clinically acceptable to the investigator * Non-hypertensive subjects or subjects with treated, stable hypertension as defined by blood pressure not exceeding 170/100 mm Hg as an average during screening and day -1; for subjects with renal impairment, no change in dosage and medication for \> or = 4 weeks prior to screening, and expected to remain on this dose and medication for the entire duration of the study * Willing to maintain current general diet and physical activity regimen * Renal function in 1 of the following 2 categories at the time of screening: Group 1 - Severe Renal Impairment (eGFR 15 to 29 mg/min/1.73 m\^2) and not anticipated to require hemodialysis or renal transplantation, and anticipated to have renal function appropriate to severe renal impairment for the duration of the study OR Group 2 - Normal renal function (eGFR \> or = 90 mg/min/1.73 m\^2)
Exclusion criteria
* Subjects whose second modification of diet in renal disease (MDRD) eGFR result on day -1 is not within 15% of the first eGFR result performed during the screening period. Healthy volunteers who have normal renal function, but show a difference greater than 15% in eGFR based on MDRD during the screening period, will be included in the trial at the discretion of the investigator and the sponsor after a 24-hour creatinine clearance has been performed that meets eligibility criteria. * Subjects who are the recipient of a renal transplant and/or are on immunosupressants. * Subjects with a history of hospitalization for heart disease or angina within 4 months of screening. * Current or prior malignancy within 5 years of enrollment with the exception of non-melanoma skin cancers, cervical or breast ductal carcinoma in situ, and adenocarcinoma of the prostate Stage I or IIa (defined as T1, T2a or T2b, N0-, M0 with documented serum prostate-specific antigen (PSA) \< 20 ng/mL and Gleason score ≤ 7) per the American Joint Committee on Cancer (AJCC) primary tumor, regional lymph nodes, and distant metastasis system. * Positive for human immunodeficiency virus (HIV) antibodies, hepatitis B surface antigen (HBsAg) or hepatitis C virus antibodies (HepCAb) at screening * History or evidence of any other clinically significant disorder, condition or disease with the exception of those outlined above that, in the opinion of the investigator or Amgen physician, if consulted, would pose a risk to subject safety or interfere with the study evaluation, procedures or completion. * Subject previously has entered this study or has been previously exposed to AMG 986. * Heart rate ≥ 100 beats per minute after 5 minutes of rest or an untreated symptomatic bradyarrhythmia within 1 month prior to enrollment. * Known history of drug or alcohol abuse within last 12 months. * Currently receiving treatment in another investigational device or drug study or less than 30 days or 5 half-lives (whichever is longer) since ending treatment on another investigational device or drug study(s) prior to receiving the dose of investigational product (AMG 986).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| AMG 986 Pharmacokinetic (PK) Parameter: Area Under the Plasma Concentration Time Curve From Time 0 to the Time of the Last Quantifiable Sample (AUClast) | Predose, 1, 2, 4, 6, 8, 12, 24, 48, 72, 96, 120 hours post-dose |
| AMG 986 PK Parameter: Maximum Observed Plasma Concentration After Dosing (Cmax) | 1, 2, 4, 6, 8, 12, 24, 48, 72, 96, 120 hours post-dose |
| AMG 986 PK Parameter: Terminal Phase Half-Life (t1/2,z) | Predose, 1, 2, 4, 6, 8, 12, 24, 48, 72, 96, 120 hours post-dose |
| AMG 986 PK Parameter: Time of Maximum Plasma Concentration (Tmax) | Predose, 1, 2, 4, 6, 8, 12, 24, 48, 72, 96, 120 hours post-dose |
| AMG 986 PK Parameter: Area Under the Plasma Concentration Time Curve From Time 0 to Infinity (AUCinf) | Predose, 1, 2, 4, 6, 8, 12, 24, 48, 72, 96, 120 hours post-dose |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | From first dose of study drug up to Day 30 | An adverse event is defined as any untoward medical occurrence in a clinical trial subject. A serious adverse event is defined as an adverse event that meets at least 1 of the following serious criteria: * fatal * life threatening (places the subject at immediate risk of death) * requires in patient hospitalization or prolongation of existing hospitalization * results in persistent or significant disability/incapacity * congenital anomaly/birth defect * other medically important serious event |
Countries
United States
Participant flow
Recruitment details
This study was conducted in 4 centers in the United States.
Participants by arm
| Arm | Count |
|---|---|
| Group 1: Severely Renal Impaired Participants Participants with severely impaired renal function (eGFR 15 to 29 mL/min/1.73 m\^2) received a single oral dose of 200 mg AMG 986. | 6 |
| Group 2: Healthy Participants Participants with normal renal function (eGFR \>= 90 mL/min/1.73 m\^2 or above) received a single oral dose of 200 mg AMG 986. | 6 |
| Total | 12 |
Baseline characteristics
| Characteristic | Group 2: Healthy Participants | Total | Group 1: Severely Renal Impaired Participants |
|---|---|---|---|
| Age, Continuous | 57.8 years STANDARD_DEVIATION 3.3 | 57.3 years STANDARD_DEVIATION 5.9 | 56.7 years STANDARD_DEVIATION 8.1 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 1 Participants | 1 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 5 Participants | 11 Participants | 6 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race/Ethnicity, Customized Asian | 1 Participants | 2 Participants | 1 Participants |
| Race/Ethnicity, Customized Black (or African American) | 3 Participants | 6 Participants | 3 Participants |
| Race/Ethnicity, Customized White | 2 Participants | 4 Participants | 2 Participants |
| Sex: Female, Male Female | 3 Participants | 6 Participants | 3 Participants |
| Sex: Female, Male Male | 3 Participants | 6 Participants | 3 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 6 | 0 / 6 |
| other Total, other adverse events | 2 / 6 | 1 / 6 |
| serious Total, serious adverse events | 0 / 6 | 0 / 6 |
Outcome results
AMG 986 Pharmacokinetic (PK) Parameter: Area Under the Plasma Concentration Time Curve From Time 0 to the Time of the Last Quantifiable Sample (AUClast)
Time frame: Predose, 1, 2, 4, 6, 8, 12, 24, 48, 72, 96, 120 hours post-dose
Population: The PK analysis set included all participants for whom at least 1 PK parameter or endpoint could be reliably estimated.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Group 1: Severely Renal Impaired Participants | AMG 986 Pharmacokinetic (PK) Parameter: Area Under the Plasma Concentration Time Curve From Time 0 to the Time of the Last Quantifiable Sample (AUClast) | 80,000 hr*ng/mL | Geometric Coefficient of Variation 33.6 |
| Group 2: Healthy Participants | AMG 986 Pharmacokinetic (PK) Parameter: Area Under the Plasma Concentration Time Curve From Time 0 to the Time of the Last Quantifiable Sample (AUClast) | 64,500 hr*ng/mL | Geometric Coefficient of Variation 70 |
AMG 986 PK Parameter: Area Under the Plasma Concentration Time Curve From Time 0 to Infinity (AUCinf)
Time frame: Predose, 1, 2, 4, 6, 8, 12, 24, 48, 72, 96, 120 hours post-dose
Population: The PK analysis set included all participants for whom at least 1 PK parameter or endpoint could be reliably estimated.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Group 1: Severely Renal Impaired Participants | AMG 986 PK Parameter: Area Under the Plasma Concentration Time Curve From Time 0 to Infinity (AUCinf) | 80,800 ng*hr/mL | Geometric Coefficient of Variation 33.6 |
| Group 2: Healthy Participants | AMG 986 PK Parameter: Area Under the Plasma Concentration Time Curve From Time 0 to Infinity (AUCinf) | 65,800 ng*hr/mL | Geometric Coefficient of Variation 68.8 |
AMG 986 PK Parameter: Maximum Observed Plasma Concentration After Dosing (Cmax)
Time frame: 1, 2, 4, 6, 8, 12, 24, 48, 72, 96, 120 hours post-dose
Population: The PK analysis set included all participants for whom at least 1 PK parameter or endpoint could be reliably estimated.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Group 1: Severely Renal Impaired Participants | AMG 986 PK Parameter: Maximum Observed Plasma Concentration After Dosing (Cmax) | 10,600 ng/mL | Geometric Coefficient of Variation 45.3 |
| Group 2: Healthy Participants | AMG 986 PK Parameter: Maximum Observed Plasma Concentration After Dosing (Cmax) | 7520 ng/mL | Geometric Coefficient of Variation 50.5 |
AMG 986 PK Parameter: Terminal Phase Half-Life (t1/2,z)
Time frame: Predose, 1, 2, 4, 6, 8, 12, 24, 48, 72, 96, 120 hours post-dose
Population: The PK analysis set included all participants for whom at least 1 PK parameter or endpoint could be reliably estimated.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Group 1: Severely Renal Impaired Participants | AMG 986 PK Parameter: Terminal Phase Half-Life (t1/2,z) | 18.4 hours | Geometric Coefficient of Variation 21.1 |
| Group 2: Healthy Participants | AMG 986 PK Parameter: Terminal Phase Half-Life (t1/2,z) | 21.1 hours | Geometric Coefficient of Variation 44.6 |
AMG 986 PK Parameter: Time of Maximum Plasma Concentration (Tmax)
Time frame: Predose, 1, 2, 4, 6, 8, 12, 24, 48, 72, 96, 120 hours post-dose
Population: The PK analysis set included all participants for whom at least 1 PK parameter or endpoint could be reliably estimated.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Group 1: Severely Renal Impaired Participants | AMG 986 PK Parameter: Time of Maximum Plasma Concentration (Tmax) | 1.1 hours |
| Group 2: Healthy Participants | AMG 986 PK Parameter: Time of Maximum Plasma Concentration (Tmax) | 1.5 hours |
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
An adverse event is defined as any untoward medical occurrence in a clinical trial subject. A serious adverse event is defined as an adverse event that meets at least 1 of the following serious criteria: * fatal * life threatening (places the subject at immediate risk of death) * requires in patient hospitalization or prolongation of existing hospitalization * results in persistent or significant disability/incapacity * congenital anomaly/birth defect * other medically important serious event
Time frame: From first dose of study drug up to Day 30
Population: The safety analysis set included all study participants who received at least 1 dose of AMG 986.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Group 1: Severely Renal Impaired Participants | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | TEAEs | 2 participants |
| Group 1: Severely Renal Impaired Participants | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Serious TEAEs | 0 participants |
| Group 2: Healthy Participants | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | TEAEs | 1 participants |
| Group 2: Healthy Participants | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Serious TEAEs | 0 participants |