Skip to content

Safety and Pharmacokinetics of Sustained-release Depot Tacrolimus: A First-in-human Study

An Open-Label, First-in-human, Safety and Pharmacokinetic Study of 1-Month Sustained-Release Injectable Tacrolimus in Healthy Subjects

Status
Completed
Phases
Early Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03626714
Enrollment
8
Registered
2018-08-13
Start date
2018-10-16
Completion date
2019-01-05
Last updated
2019-08-13

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

Conditions

Organ Transplant Rejection, Psoriasis

Keywords

Tacrolimus, Immunosuppressant, Sustained-release, Plexis

Brief summary

This first-in-human study is designed to assess the safety and pharmacokinetic (PK) profile of sustained-release (SR) depot tacrolimus, which will be administered as a single dose of 0.1 mg/kg by subcutaneous (SC) injection in healthy subjects.

Detailed description

This is a first-in-human study to assess the safety and pharmacokinetic (PK) profile of sustained-release (SR) tacrolimus, which will be administered as a single dose of 0.1 mg/kg by subcutaneous (SC) injection in healthy subjects. The short-term general investigational plan is to evaluate sustained release tacrolimus in healthy volunteers for up to 30 days in an exploratory trial to determine safety and drug concentrations in blood. The results from this study will inform the long-term goal of this program, which is to provide an improved treatment modality for prophylaxis of organ (kidney, liver and heart) transplant rejection with the additional benefit of enhancing medication compliance. These improvements have the potential to mitigate both the personal and economic burden of this disease.

Interventions

DRUGSustained Release Injectable Tacrolimus

Long-acting formulation of tacrolimus developed using Auritec's proprietary Plexis drug delivery technology.

Sponsors

National Institute of Allergy and Infectious Diseases (NIAID)
CollaboratorNIH
Auritec Pharmaceuticals
Lead SponsorINDUSTRY

Study design

Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
Yes

Inclusion criteria

* Subjects must be able to understand and provide informed consent. A signed informed consent form must be provided before any study assessments are done; * Males or females, between 18 and 45 years of age, inclusive; * Body mass index must be within the range 18.5 to 32.0 kg/m2, inclusive; * Must be in good health, as determined by no clinically significant findings from medical history, vital signs, and 12-lead electrocardiogram (ECG), inclusive of documented absence of QT prolongation; * Clinical laboratory evaluations (including clinical chemistry panel \[fasted at least 10 hours\], complete blood count \[CBC\], and urinalysis \[UA\]) must be within the reference range for the test laboratory, unless deemed not clinically significant by the Investigator; * Must be negative for autoimmune disorders in the past 3 months and at Screening - participant's medical history will be used for this evaluation; * Must not use any immunosuppressant calcineurin inhibitor product other than SR Injectable tacrolimus throughout the dosing period and until after the final visit; * Must agree to blood draws throughout the course of the study and venous access sufficient to allow for blood sampling as per the protocol; * Must be negative for selected drugs of abuse at Screening and at Check-in (Day -1); * Must have a negative hepatitis panel (including hepatitis B surface antigen \[HBsAg\] and hepatitis C virus antibody \[HCV\]) and negative human immunodeficiency virus \[HIV\] antibody screens; * Females will be nonpregnant, nonlactating, and either postmenopausal, defined as amenorrhea for at least 1 year and follicle-stimulating hormone levels of 40 mIU/mL or higher; surgically sterile (eg, tubal ligation, hysterectomy, oophorectomy) for at least 90 days prior to Screening; or agree to use, from the time of signing the informed consent or 10 days prior to Check-in on Day -1 of the Inpatient Period until 30 days after Study Discharge, one of the following forms of contraception: nonhormonal intrauterine device (IUD) with spermicide; female condom with spermicide; contraceptive sponge with spermicide; diaphragm with spermicide; cervical cap with spermicide; male sexual partner who agrees to use a male condom with spermicide; or sterile sexual partner; alternatively, women must agree to maintain abstinence (must agree to use a double barrier method if they become sexually active during the study. For all females of childbearing potential, the pregnancy test result must be negative at Screening and Check-in on Day -1 of the Inpatient Period (see Appendix 1). Women must also agree not to douche throughout the dosing period and until after the final visit; * Males will either be sterile or agree to use, from Check-in on Day -1 of the Inpatient Period until 90 days following Study Discharge, one of the following approved methods of contraception: male condom with spermicide; sterile sexual partner; or use by female sexual partner of an IUD with spermicide; a female condom with spermicide; a contraceptive sponge with spermicide; an intravaginal system (eg, NuvaRing®); a diaphragm with spermicide; a cervical cap with spermicide; or oral, implantable, transdermal, or injectable contraceptives. Subjects will refrain from sperm donation from Check-in on Day -1 of the Inpatient Period until 90 days following Study Discharge.

Exclusion criteria

* Inability or unwillingness of a participant to give written informed consent or comply with study protocol; * Prisoners or patients who are compulsorily detained (involuntarily incarcerated) for treatment of either a psychiatric or physical (eg, infectious disease) illness must not be enrolled into this trial; * Presence of an uncontrolled, unstable clinically significant medical condition that in the opinion of the Investigator may increase the risk to the subject or may interfere with the interpretation of safety and PK evaluations, or could impair the subject's ability to complete the trial, or could impair the decisional capacity of the subject; * Presence of clinically significant vital signs or a physical examination finding that, in the opinion of the Investigator, could increase the risk to the subject or may potentially interfere with the ability to evaluate safety and tolerability in the trial; * History of tacrolimus use, or hypersensitivity and/or adverse reaction to calcineurin inhibitor drugs; * History of toxic shock syndrome; * Currently receiving chemotherapy or immunosuppressive agents; * Use of investigative drugs within 30 days or 5 half-lives of study participation; * Currently using sirolimus; * Currently using live vaccines; * Currently on concomitant substrates and/or inhibitors of CYP3A4; * Requires the use of any concomitant medication, except for treatment of an adverse event (AE) during the study; * Any abnormality on clinical laboratory tests, or ECG finding that is considered to be clinically significant by the Investigator. * Known or suspected (nonfebrile) seizure disorder; * Use of any other depot medications within the last three months. * Unwilling to commit to avoid eating grapefruit or drinking grapefruit juice during the first 30 days of this exploratory study. * Grade ≥ 1 finding as described in the Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Vaccine Clinical Trials

Design outcomes

Primary

MeasureTime frameDescription
Mean Blood Concentration-time Curve - Cmax60 daysMaximum observed tacrolimus whole blood concentration
Number of Subjects That Experienced Treatment-related Adverse Events [Safety and Tolerability]60 daysAdverse events were documented at each study visit according to the criteria set forth in the Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Vaccine Clinical Trials as follows: Grade 1 (mild); Grade 2 (moderate); Grade 3 (severe); Grade 4 (potentially life-threatening).
Drug Concentrations in Blood Samples at Individual Time-points60 daysThe concentrations of tacrolimus in blood samples were measured at baseline, day 1 (1 hr, 3 hrs, 6 hrs, 12 hrs, and 24 hrs), followed by days 3, 7, 14, 21, 30, 37, 44, 51 and 60.
Mean Blood Concentration-time Curve - Tmax60 daysTime to maximum observed tacrolimus whole blood concentration
Blood Concentration-time Curve [AUC]60 daysArea under the concentration-time curve
Terminal Elimination Half-life [t1/2]60 daysThe apparent terminal elimination half-life was calculated.

Countries

United States

Participant flow

Participants by arm

ArmCount
Experimental: Sustained Release Injectable Tacrolimus
All subjects will be treated with a single dose injection of sustained-release Tacrolimus.
8
Total8

Baseline characteristics

CharacteristicExperimental: Sustained Release Injectable Tacrolimus
Age, Continuous34.37 years
Ethnicity (NIH/OMB)
Hispanic or Latino
6 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
2 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
3 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
5 Participants
Region of Enrollment
United States
8 participants
Sex: Female, Male
Female
4 Participants
Sex: Female, Male
Male
4 Participants

Adverse events

Event typeEG000
affected / at risk
deaths
Total, all-cause mortality
0 / 8
other
Total, other adverse events
8 / 8
serious
Total, serious adverse events
0 / 8

Outcome results

Primary

Blood Concentration-time Curve [AUC]

Area under the concentration-time curve

Time frame: 60 days

ArmMeasureValue (MEAN)Dispersion
Experimental: Sustained Release Injectable TacrolimusBlood Concentration-time Curve [AUC]568 hour*ng/mLStandard Deviation 171
Primary

Drug Concentrations in Blood Samples at Individual Time-points

The concentrations of tacrolimus in blood samples were measured at baseline, day 1 (1 hr, 3 hrs, 6 hrs, 12 hrs, and 24 hrs), followed by days 3, 7, 14, 21, 30, 37, 44, 51 and 60.

Time frame: 60 days

ArmMeasureGroupValue (MEAN)Dispersion
Experimental: Sustained Release Injectable TacrolimusDrug Concentrations in Blood Samples at Individual Time-pointsDay 140.341 ng/mLStandard Deviation 0.158
Experimental: Sustained Release Injectable TacrolimusDrug Concentrations in Blood Samples at Individual Time-pointsDay 210.320 ng/mLStandard Deviation 0.127
Experimental: Sustained Release Injectable TacrolimusDrug Concentrations in Blood Samples at Individual Time-pointsDay 300.302 ng/mLStandard Deviation 0.091
Experimental: Sustained Release Injectable TacrolimusDrug Concentrations in Blood Samples at Individual Time-pointsDay 370.282 ng/mLStandard Deviation 0.074
Experimental: Sustained Release Injectable TacrolimusDrug Concentrations in Blood Samples at Individual Time-pointsDay 440.260 ng/mLStandard Deviation 0.082
Experimental: Sustained Release Injectable TacrolimusDrug Concentrations in Blood Samples at Individual Time-pointsDay 510.269 ng/mLStandard Deviation 0.091
Experimental: Sustained Release Injectable TacrolimusDrug Concentrations in Blood Samples at Individual Time-pointsDay 600.260 ng/mLStandard Deviation 0.072
Experimental: Sustained Release Injectable TacrolimusDrug Concentrations in Blood Samples at Individual Time-pointsBaseline0 ng/mLStandard Deviation 0
Experimental: Sustained Release Injectable TacrolimusDrug Concentrations in Blood Samples at Individual Time-pointsDay 1, hour 10.667 ng/mLStandard Deviation 0.505
Experimental: Sustained Release Injectable TacrolimusDrug Concentrations in Blood Samples at Individual Time-pointsDay 1, hour 30.956 ng/mLStandard Deviation 0.556
Experimental: Sustained Release Injectable TacrolimusDrug Concentrations in Blood Samples at Individual Time-pointsDay 1 hour 61.30 ng/mLStandard Deviation 0.623
Experimental: Sustained Release Injectable TacrolimusDrug Concentrations in Blood Samples at Individual Time-pointsDay 1, hour 121.84 ng/mLStandard Deviation 0.548
Experimental: Sustained Release Injectable TacrolimusDrug Concentrations in Blood Samples at Individual Time-pointsDay 1, hour 241.54 ng/mLStandard Deviation 0.484
Experimental: Sustained Release Injectable TacrolimusDrug Concentrations in Blood Samples at Individual Time-pointsDay 31.24 ng/mLStandard Deviation 0.397
Experimental: Sustained Release Injectable TacrolimusDrug Concentrations in Blood Samples at Individual Time-pointsDay 70.775 ng/mLStandard Deviation 0.365
Primary

Mean Blood Concentration-time Curve - Cmax

Maximum observed tacrolimus whole blood concentration

Time frame: 60 days

ArmMeasureValue (MEAN)Dispersion
Experimental: Sustained Release Injectable TacrolimusMean Blood Concentration-time Curve - Cmax1.92 ng/mLStandard Deviation 0.527
Primary

Mean Blood Concentration-time Curve - Tmax

Time to maximum observed tacrolimus whole blood concentration

Time frame: 60 days

ArmMeasureValue (MEAN)Dispersion
Experimental: Sustained Release Injectable TacrolimusMean Blood Concentration-time Curve - Tmax14.3 HourStandard Deviation 6.36
Primary

Number of Subjects That Experienced Treatment-related Adverse Events [Safety and Tolerability]

Adverse events were documented at each study visit according to the criteria set forth in the Toxicity Grading Scale for Healthy Adult and Adolescent Volunteers Enrolled in Preventive Vaccine Clinical Trials as follows: Grade 1 (mild); Grade 2 (moderate); Grade 3 (severe); Grade 4 (potentially life-threatening).

Time frame: 60 days

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Experimental: Sustained Release Injectable TacrolimusNumber of Subjects That Experienced Treatment-related Adverse Events [Safety and Tolerability]Tenderness at Injection Site - Grade 16 Participants
Experimental: Sustained Release Injectable TacrolimusNumber of Subjects That Experienced Treatment-related Adverse Events [Safety and Tolerability]Burning Pain at Injection Site - Grade 16 Participants
Experimental: Sustained Release Injectable TacrolimusNumber of Subjects That Experienced Treatment-related Adverse Events [Safety and Tolerability]Induration/Swelling at Injection Site - Grade 12 Participants
Experimental: Sustained Release Injectable TacrolimusNumber of Subjects That Experienced Treatment-related Adverse Events [Safety and Tolerability]Tenderness at Injection Site - Grade 21 Participants
Experimental: Sustained Release Injectable TacrolimusNumber of Subjects That Experienced Treatment-related Adverse Events [Safety and Tolerability]Erythema/Redness at Injection Site - Grade 13 Participants
Primary

Terminal Elimination Half-life [t1/2]

The apparent terminal elimination half-life was calculated.

Time frame: 60 days

ArmMeasureValue (MEAN)Dispersion
Experimental: Sustained Release Injectable TacrolimusTerminal Elimination Half-life [t1/2]1100 hoursStandard Deviation 803

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