Healthy Volunteers
Conditions
Brief summary
The purpose of this study is to evaluate the ability of PRT064445 to reverse the effects of several blood thinner drugs on laboratory tests. The study also is evaluating the blood levels of PRT064445 given at different doses.
Detailed description
A randomized, double-blind, vehicle-controlled study to assess the safety, tolerability, pharmacokinetics (PK), and pharmacodynamics (PD) of intravenously administered PRT064445 after dosing to steady state with one of four direct/indirect factor Xa (fXa) inhibitors in healthy volunteers.
Interventions
Sponsors
Study design
Intervention model description
This study has four modules with a total of 21 cohorts, each module was reported and submitted separately. Module 1, NCT01758432 (54 subjects with 7 cohorts including placebo); Module 2, NCT03578146 (48 subjects with 6 cohorts including placebo); Module 3, NCT03551730 (27 subjects with 4 cohorts including placebo); Module 4, NCT03551743 (28 subjects with 4 cohorts including placebo)
Eligibility
Inclusion criteria
* Healthy men or women between the ages of 18 and 45 years old
Exclusion criteria
* History (including family history) or symptoms of, or risk factors for bleeding * History (including family history) of or risk factors for a hypercoagulable or thrombotic condition * Absolute/relative contraindication to anticoagulation or treatment with specific anticoagulants * History of major surgery, severe trauma or bone fracture within 3 months prior to dosing; or planned surgery within 1 month after dosing.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Efficacy:Percent Change From Baseline in Anti-fXa Activity at 2 Mins Following Andexanet/Placebo Administration Activity | Baseline to 2 minutes following the end of andexanet/placebo administration | Anti-fXa activity was measured immediately prior to (Baseline) and at 2 mins following andexanet/placebo administration. Anti-fXa activity was measured using a commercial kit (Coamatic Heparin-82 33 9363, DiaPharma) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Andexanet Maximum Observed Plasma Concentration (Cmax) | Blood was collected at predose, 0.033, 0.2, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4.5, 5.5, 6.5, 7.5, 8.5 and 14.5 hours postdose. | Plasma concentrations of andexanet was determined using a validated method that involved analysis of citrated human plasma by an electrochemiluminescent assay. Cmax was taken directly from the raw data. |
| Andexanet Area Under the Drug Concentration-time Curve From Time 0 Extrapolated to Infinity (AUC0-inf ) | Blood was collected at predose, 0.033, 0.2, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4.5, 5.5, 6.5, 7.5, 8.5 and 14.5 hours postdose. | Plasma concentrations of andexanet was determined using a validated method that involved analysis of citrated human plasma by an electrochemiluminescent assay. AUC0-inf was calculated using a non-compartmental approach |
| Andexanet Time of Maximum Observed Plasma Concentration (Tmax) | Blood was collected at predose, 0.033, 0.2, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4.5, 5.5, 6.5, 7.5, 8.5 and 14.5 hours postdose. | Plasma concentrations of andexanet was determined using a validated method that involved analysis of citrated human plasma by an electrochemiluminescent assay. Tmax was taken directly from the raw data. |
| Efficacy: Percent Change From Baseline in Thrombin Generation at 2 Mins Following Andexanet/Placebo Administration | Baseline to 2 minutes following the end of andexanet/placebo administration | Thrombin generation was measured immediately prior to (Baseline) and at 2 mins following andexanet/placebo administration. Thrombin generation was measured using a TF-initiated thrombin generation assay. |
| Andexanet Total Systemic Clearance (CL) | Blood was collected at predose, 0.033, 0.2, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4.5, 5.5, 6.5, 7.5, 8.5 and 14.5 hours postdose. | Plasma concentrations of andexanet was determined using a validated method that involved analysis of citrated human plasma by an electrochemiluminescent assay. CL was calculated using a non-compartmental approach. |
| Andexanet Total Volume of Distribution (Vss) | Blood was collected at predose, 0.033, 0.2, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4.5, 5.5, 6.5, 7.5, 8.5 and 14.5 hours postdose. | Plasma concentrations of andexanet was determined using a validated method that involved analysis of citrated human plasma by an electrochemiluminescent assay. Vss was calculated using a non-compartmental approach. |
| Andexanet Apparent Terminal Elimination Half-life (t1/2) | Blood was collected at predose, 0.033, 0.2, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4.5, 5.5, 6.5, 7.5, 8.5 and 14.5 hours postdose. | Plasma concentrations of andexanet was determined using a validated method that involved analysis of citrated human plasma by an electrochemiluminescent assay.t1/2 was determined by linear regression of the log concentration on the terminal portion of the plasma concentration-time curve. |
Countries
United States
Participant flow
Recruitment details
Subject recruitment occurred at investigative site in the US between August 2013 through November 2013
Pre-assignment details
Enoxaparin was administered subcutaneously at 40 mg once daily for 6 days to steady-state in an open label fashion. Subjects were then randomized to receive study treatment intravenously on Day 6; such that they ended at 3 hours after the last dose of enoxaparin.
Participants by arm
| Arm | Count |
|---|---|
| Placebo Placebo administered intravenously (IV) as a bolus. | 9 |
| Module 3 (210 mg Bolus) Original 210 mg andexanet IV bolus over 7 minutes (\
30 mg/min) | 6 |
| Module 3 (420 mg Bolus) Original 420 mg andexanet IV bolus over 14 minutes (\
30 mg/min) | 6 |
| Module 3 (210 mg) Lyophilized 210 mg andexanet IV bolus over 7 minutes (\
30 mg/min) | 6 |
| Total | 27 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 |
|---|---|---|---|---|---|
| Overall Study | Adverse Event | 1 | 0 | 0 | 0 |
Baseline characteristics
| Characteristic | Placebo | Module 3 (210 mg Bolus) Original | Module 3 (420 mg Bolus) Original | Module 3 (210 mg) Lyophilized | Total |
|---|---|---|---|---|---|
| Age, Continuous | 33.7 years STANDARD_DEVIATION 5.59 | 33.2 years STANDARD_DEVIATION 8.3 | 32.5 years STANDARD_DEVIATION 5.09 | 35.7 years STANDARD_DEVIATION 8.66 | 33.7 years STANDARD_DEVIATION 6.6 |
| Sex: Female, Male Female | 5 Participants | 2 Participants | 0 Participants | 3 Participants | 10 Participants |
| Sex: Female, Male Male | 4 Participants | 4 Participants | 6 Participants | 3 Participants | 17 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — | — / — |
| other Total, other adverse events | 5 / 8 | 4 / 6 | 4 / 6 | 5 / 6 |
| serious Total, serious adverse events | 0 / 8 | 0 / 6 | 0 / 6 | 0 / 6 |
Outcome results
Efficacy:Percent Change From Baseline in Anti-fXa Activity at 2 Mins Following Andexanet/Placebo Administration Activity
Anti-fXa activity was measured immediately prior to (Baseline) and at 2 mins following andexanet/placebo administration. Anti-fXa activity was measured using a commercial kit (Coamatic Heparin-82 33 9363, DiaPharma)
Time frame: Baseline to 2 minutes following the end of andexanet/placebo administration
Population: 26 subjects who received andexanet or placebo were included in the pharmacodynamics (PD) analysis
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Efficacy:Percent Change From Baseline in Anti-fXa Activity at 2 Mins Following Andexanet/Placebo Administration Activity | -3.57 Percent change in anti-fXa activity | Standard Deviation 12.8 |
| Module 3 (210 mg Bolus) Original | Efficacy:Percent Change From Baseline in Anti-fXa Activity at 2 Mins Following Andexanet/Placebo Administration Activity | -70.80 Percent change in anti-fXa activity | Standard Deviation 6.98 |
| Module 3 (420 mg Bolus) Original | Efficacy:Percent Change From Baseline in Anti-fXa Activity at 2 Mins Following Andexanet/Placebo Administration Activity | -60.83 Percent change in anti-fXa activity | Standard Deviation 8.39 |
| Module 3 (210 mg) Lyophilized | Efficacy:Percent Change From Baseline in Anti-fXa Activity at 2 Mins Following Andexanet/Placebo Administration Activity | -69.85 Percent change in anti-fXa activity | Standard Deviation 7.46 |
Andexanet Apparent Terminal Elimination Half-life (t1/2)
Plasma concentrations of andexanet was determined using a validated method that involved analysis of citrated human plasma by an electrochemiluminescent assay.t1/2 was determined by linear regression of the log concentration on the terminal portion of the plasma concentration-time curve.
Time frame: Blood was collected at predose, 0.033, 0.2, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4.5, 5.5, 6.5, 7.5, 8.5 and 14.5 hours postdose.
Population: 18 subjects who received andexanet were included in the andexanet PK analysis
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Module 3 (210 mg Bolus) Original | Andexanet Apparent Terminal Elimination Half-life (t1/2) | 5.28 hr | Standard Deviation 1.99 |
| Module 3 (420 mg Bolus) Original | Andexanet Apparent Terminal Elimination Half-life (t1/2) | 6.11 hr | Standard Deviation 2.34 |
| Module 3 (210 mg) Lyophilized | Andexanet Apparent Terminal Elimination Half-life (t1/2) | 8.36 hr | Standard Deviation 7.46 |
Andexanet Area Under the Drug Concentration-time Curve From Time 0 Extrapolated to Infinity (AUC0-inf )
Plasma concentrations of andexanet was determined using a validated method that involved analysis of citrated human plasma by an electrochemiluminescent assay. AUC0-inf was calculated using a non-compartmental approach
Time frame: Blood was collected at predose, 0.033, 0.2, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4.5, 5.5, 6.5, 7.5, 8.5 and 14.5 hours postdose.
Population: 18 subjects who received andexanet were included in the andexanet PK analysis
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Module 3 (210 mg Bolus) Original | Andexanet Area Under the Drug Concentration-time Curve From Time 0 Extrapolated to Infinity (AUC0-inf ) | 33600 ng*hr/mL | Standard Deviation 4280 |
| Module 3 (420 mg Bolus) Original | Andexanet Area Under the Drug Concentration-time Curve From Time 0 Extrapolated to Infinity (AUC0-inf ) | 63900 ng*hr/mL | Standard Deviation 8880 |
| Module 3 (210 mg) Lyophilized | Andexanet Area Under the Drug Concentration-time Curve From Time 0 Extrapolated to Infinity (AUC0-inf ) | 40900 ng*hr/mL | Standard Deviation 12300 |
Andexanet Maximum Observed Plasma Concentration (Cmax)
Plasma concentrations of andexanet was determined using a validated method that involved analysis of citrated human plasma by an electrochemiluminescent assay. Cmax was taken directly from the raw data.
Time frame: Blood was collected at predose, 0.033, 0.2, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4.5, 5.5, 6.5, 7.5, 8.5 and 14.5 hours postdose.
Population: 18 subjects who received andexanet were included in the andexanet pharmacokinetics (PK) analysis
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Module 3 (210 mg Bolus) Original | Andexanet Maximum Observed Plasma Concentration (Cmax) | 32000 ng/mL | Standard Deviation 7320 |
| Module 3 (420 mg Bolus) Original | Andexanet Maximum Observed Plasma Concentration (Cmax) | 55800 ng/mL | Standard Deviation 6050 |
| Module 3 (210 mg) Lyophilized | Andexanet Maximum Observed Plasma Concentration (Cmax) | 42700 ng/mL | Standard Deviation 14400 |
Andexanet Time of Maximum Observed Plasma Concentration (Tmax)
Plasma concentrations of andexanet was determined using a validated method that involved analysis of citrated human plasma by an electrochemiluminescent assay. Tmax was taken directly from the raw data.
Time frame: Blood was collected at predose, 0.033, 0.2, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4.5, 5.5, 6.5, 7.5, 8.5 and 14.5 hours postdose.
Population: 18 subjects who received andexanet were included in the andexanet PK analysis
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Module 3 (210 mg Bolus) Original | Andexanet Time of Maximum Observed Plasma Concentration (Tmax) | 0.18 hr |
| Module 3 (420 mg Bolus) Original | Andexanet Time of Maximum Observed Plasma Concentration (Tmax) | 0.29 hr |
| Module 3 (210 mg) Lyophilized | Andexanet Time of Maximum Observed Plasma Concentration (Tmax) | 0.17 hr |
Andexanet Total Systemic Clearance (CL)
Plasma concentrations of andexanet was determined using a validated method that involved analysis of citrated human plasma by an electrochemiluminescent assay. CL was calculated using a non-compartmental approach.
Time frame: Blood was collected at predose, 0.033, 0.2, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4.5, 5.5, 6.5, 7.5, 8.5 and 14.5 hours postdose.
Population: 18 subjects who received andexanet were included in the andexanet PK analysis
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Module 3 (210 mg Bolus) Original | Andexanet Total Systemic Clearance (CL) | 6.34 L/hr | Standard Deviation 0.87 |
| Module 3 (420 mg Bolus) Original | Andexanet Total Systemic Clearance (CL) | 6.69 L/hr | Standard Deviation 0.991 |
| Module 3 (210 mg) Lyophilized | Andexanet Total Systemic Clearance (CL) | 5.56 L/hr | Standard Deviation 1.76 |
Andexanet Total Volume of Distribution (Vss)
Plasma concentrations of andexanet was determined using a validated method that involved analysis of citrated human plasma by an electrochemiluminescent assay. Vss was calculated using a non-compartmental approach.
Time frame: Blood was collected at predose, 0.033, 0.2, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4.5, 5.5, 6.5, 7.5, 8.5 and 14.5 hours postdose.
Population: 18 subjects who received andexanet were included in the andexanet PK analysis
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Module 3 (210 mg Bolus) Original | Andexanet Total Volume of Distribution (Vss) | 9.86 L | Standard Deviation 2.61 |
| Module 3 (420 mg Bolus) Original | Andexanet Total Volume of Distribution (Vss) | 9.62 L | Standard Deviation 1.13 |
| Module 3 (210 mg) Lyophilized | Andexanet Total Volume of Distribution (Vss) | 9.69 L | Standard Deviation 4.16 |
Efficacy: Percent Change From Baseline in Thrombin Generation at 2 Mins Following Andexanet/Placebo Administration
Thrombin generation was measured immediately prior to (Baseline) and at 2 mins following andexanet/placebo administration. Thrombin generation was measured using a TF-initiated thrombin generation assay.
Time frame: Baseline to 2 minutes following the end of andexanet/placebo administration
Population: 26 subjects who received andexanet or placebo were included in the PD analysis
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo | Efficacy: Percent Change From Baseline in Thrombin Generation at 2 Mins Following Andexanet/Placebo Administration | 3.48 Percent change in thrombin generation | Standard Deviation 15.162 |
| Module 3 (210 mg Bolus) Original | Efficacy: Percent Change From Baseline in Thrombin Generation at 2 Mins Following Andexanet/Placebo Administration | 36.34 Percent change in thrombin generation | Standard Deviation 15.127 |
| Module 3 (420 mg Bolus) Original | Efficacy: Percent Change From Baseline in Thrombin Generation at 2 Mins Following Andexanet/Placebo Administration | 107.48 Percent change in thrombin generation | Standard Deviation 73.301 |
| Module 3 (210 mg) Lyophilized | Efficacy: Percent Change From Baseline in Thrombin Generation at 2 Mins Following Andexanet/Placebo Administration | 72.7 Percent change in thrombin generation | Standard Deviation 74.301 |