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This research study will determine if genetic variation in CYP2B6 affects how the body metabolizes methadone.
This investigation determined the influence of CYP2B6 genetic variation, specifically CYP2B6*6 polymorphism, on clinical methadone plasma concentrations, clearance, and metabolism. The hypothesis was that CYP2B6*6 heterozygotes or homozygotes would have reduced metabolism and clearance. A secondary objective was to evaluate other less common genotypic variants, when encountered. Healthy volunteers in genotype cohorts CYP2B6*1/*1, CYP2B6*1/*6 , and CYP2B6*6/*6, and also CYP2B6*4 and CYP2B6*5 carriers, received single doses of IV and oral methadone. Plasma and urine methadone and metabolite concentrations were determined by tandem mass spectrometry. The primary outcome measure was methadone metabolism, measured as plasma metabolite/patent area under the concentration-time curve ratio and metabolite formation clearance.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Methadone arm | Experimental |
|
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| IV racemic methadone HCl | Drug | IV racemic Methadone HC1 6 mg |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Methadone Metabolism | Plasma metabolite EDDP/methadone area under the concentration-time curve (AUC0-96) ratio | up to 96 hours |
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Inclusion Criteria:
Each subject must meet all of the following criteria:
Exclusion Criteria:
Subjects will not be enrolled if any of the following criteria exist:
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| Name | Affiliation | Role |
|---|---|---|
| Evan Kharasch, MD, PhD | Washington University School of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Washington University Schoool of Medicine | St Louis | Missouri | 63110 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26389554 | Result | Kharasch ED, Regina KJ, Blood J, Friedel C. Methadone Pharmacogenetics: CYP2B6 Polymorphisms Determine Plasma Concentrations, Clearance, and Metabolism. Anesthesiology. 2015 Nov;123(5):1142-53. doi: 10.1097/ALN.0000000000000867. |
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| ID | Type | URL | Comment |
|---|---|---|---|
| Publication | View IPD |
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11 subject withdrawals following consent due to personal reasons and/or conflicts, 3 subjects not evaluable, 64 subjects evaluable and included in analysis
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| ID | Title | Description |
|---|---|---|
| FG000 | Methadone Arm |
racemic methadone HC1: IV racemic Methadone HC1 6 mg oral d5-methadon HC1 11 mg Oral deuterated racemic methadone HCl,: 11 mg capsule once |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
3 subjects with non-evaluable PK data
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| ID | Title | Description |
|---|---|---|
| BG000 | Methadone Arm |
racemic methadone HC1: IV racemic Methadone HC1 6 mg oral d5-methadon HC1 11 mg Oral deuterated racemic methadone HCl,: 11 mg capsule once |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Methadone Metabolism | Plasma metabolite EDDP/methadone area under the concentration-time curve (AUC0-96) ratio | Plasma EDDP/methadone AUC ratio | Posted | Mean | Standard Deviation | ratio | up to 96 hours |
|
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Methadone Arm |
racemic methadone HC1: IV racemic Methadone HC1 6 mg oral d5-methadon HC1 11 mg Oral deuterated racemic methadone HCl,: 11 mg capsule once |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nausea | Gastrointestinal disorders | Systematic Assessment | Nausea and/or vomiting |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Evan D. Kharasch, MD, PhD | Washington University School of Medicine | 314-362-8796 | kharasch@wustl.edu |
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| Oral racemic methadone HCl |
| Drug |
oral d5-methadone HCl 11 mg |
|
Study results published Anesthesiology. 2015 Nov;123(5):1142-53. doi: 10.1097/ALN.0000000000000867 |
| Participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Region of Enrollment | enrollment from greater St. Louis metropolitan area | Number | participants |
|
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|
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| 0 |
| 67 |
| 0 |
| 67 |
| 56 |
| 67 |
| Headache | General disorders | Systematic Assessment | routinely related to caffeine abstinence prior to study session |
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| Itching | Skin and subcutaneous tissue disorders | Systematic Assessment |
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| Dizzyness | General disorders | Systematic Assessment |
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| syncope | General disorders | Systematic Assessment | syncopal episodes related to postural hypotension |
|
| feeling "hyperactive" | General disorders | Non-systematic Assessment | self reported by subject, no obvious s/s |
|
| light senstivity | General disorders | Non-systematic Assessment | self reported |
|
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