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| ID | Type | Description | Link |
|---|---|---|---|
| 20200157 | Other Identifier | Amgen Study ID |
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The purpose of this study is to assess how much of apremilast is found in the blood unchanged when administered as an oral suspension compared to when it is administered as a tablet formulation. The effect of food on apremilast oral suspension will also be evaluated. In addition, information on the safety and tolerability of apremilast will be obtained.
This is a phase 1, open-label, randomized, three-period, six-sequence crossover study in healthy subjects. The study will consist of a screening phase, baseline (Day -1), three study periods, and a follow-up phone call. Each study period will be four days in duration (Day 1 through Day 4) followed by a five-day washout between doses.
Eligible participants will be admitted into the study center on Day -1 of study Period 1 for baseline measurements. During each study period, participants will receive a single 30 mg oral dose of apremilast on Day 1 according to the assigned treatment sequence. Participants will be confined at the study center from Day 1 of study Period 1 through Day 4 of study Period 3, including the 5 day washout between doses. All participants will be discharged from the study center on Day 4 of study Period 3 following completion of required study procedures. A follow-up phone call will occur approximately four days after the discharge from the study center.
The study will be conducted in compliance with International Conference on Harmonisation (ICH) Good Clinical Practices (GCPs).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment A: Apremilast 30 mg Tablet - Fasted | Experimental | A single oral dose of 30 mg apremilast tablet after an overnight fast. |
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| Treatment B: Apremilast 30 mg Oral Suspension - Fasted | Experimental | A single oral dose of 30 mg apremilast oral suspension formulation (6 mL) after an overnight fast. |
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| Treatment C - Apremilast 30 mg Oral Suspension - Fed | Experimental | A single oral dose of 30 mg apremilast oral suspension formulation (6 mL) after a high-fat meal. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Apremilast Tablet | Drug | 30 mg tablet |
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| Measure | Description | Time Frame |
|---|---|---|
| Maximum Observed Plasma Concentration (Cmax) of Apremilast | Concentrations of apremilast in plasma were measured using a validated liquid chromatography tandem mass spectrometry assay. | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
| Area Under the Concentration-time Curve From Time Zero to the Last Measured Time Point (AUC0-t) for Apremilast | Concentrations of apremilast in plasma were measured using a validated liquid chromatography tandem mass spectrometry assay. AUC from time zero to the last measured time point was calculated by the linear trapezoidal method. | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
| Area Under the Concentration-time Curve From Time Zero to Infinity (AUC0-∞) for Apremilast | Concentrations of apremilast in plasma were measured using a validated liquid chromatography tandem mass spectrometry assay. AUC from time zero to infinity was calculated as (AUC0-t + Ct/λz), where Ct is the last quantifiable concentration, and λz is the apparent terminal rate constant. | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
| Time to Maximum Observed Plasma Concentration (Tmax) of Apremilast | Concentrations of apremilast in plasma were measured using a validated liquid chromatography tandem mass spectrometry assay. | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
| Terminal Elimination Half-life (T1/2) of Apremilast | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Treatment-emergent Adverse Events | An adverse event (AE) is any noxious, unintended, or untoward medical occurrence that may appear or worsen in a participant during the course of a study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the participant's health, including laboratory test values, regardless of etiology. A treatment-emergent AE (TEAE) was defined as any AE that occurred after dosing of the study drug. A serious adverse event (SAE) is any AE occurring at any dose that:
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Inclusion Criteria:
Subjects must satisfy ALL of the following criteria to be eligible for enrollment into the study:
Must understand and voluntarily sign a written Informed Consent (ICF) prior to any study-related procedures being performed.
Must be able to communicate with the investigator, understand and comply with the requirements of the study, and agree to adhere to restrictions and examination schedules.
Male and female subjects of any race between 18 to 55 years of age (inclusive), and in good health as determined by the Investigator at the time of signing the informed consent document.
Have a Body Mass Index (BMI) between 18 and 33 kg/m^2 (inclusive).
No clinically significant laboratory test results as determined by the investigator.
At the screening visit, must be afebrile, with supine systolic blood pressure (BP): 90 to 140 mmHg, supine diastolic BP: 50 to 90 mmHg, and pulse rate: 40 to 110 bpm. Eligibility criteria for vital signs performed during check-in and/or predose on Day 1 will be at the discretion of the Investigator.
Must have a normal or clinically acceptable 12-lead electrocardiogram (ECG). Subjects must have a QTcF value ≤ 450 msec.
Contraception Requirements:
All FCBP must have a negative pregnancy test at Visits 1 and 2. All FCBP subjects who engage in activity in which conception is possible must use one of the approved contraceptive options described below:
Option 1: Any one of the following highly effective methods: hormonal contraception (oral, injection, implant, transdermal patch, vaginal ring); intrauterine device (IUD); tubal ligation; or partner's vasectomy; OR Option 2: Male or female condom (latex condom or non-latex condom NOT made out of natural [animal] membrane [for example, polyurethane]); PLUS one of the following additional barrier methods: (a) diaphragm with spermicide; (b) cervical cap with spermicide; or (c) contraceptive sponge with spermicide.
Male subjects (including those who have had a vasectomy) who engage in activity in which conception is possible must use barrier contraception (latex or non-latex condoms NOT made out of natural [animal] membrane [for example, polyurethane]) while on investigational product (IP) and for at least 28 days after the last dose of IP.
Must agree to refrain from donating sperm, blood or plasma (other than for this study) while participating in this study and for at least 28 days after the last dose of investigational product.
Subject is willing and able to adhere to the study visit schedule and other protocol requirements
Exclusion Criteria:
The presence of ANY of the following will exclude any healthy subject from enrollment into the study:
History of any clinically significant and relevant neurological, psychiatric, gastrointestinal, renal, hepatic, cardiovascular, psychological, pulmonary, metabolic, endocrine, hematological, allergic disease, drug allergies, or other major disorders.
Any condition which places the subject at unacceptable risk if he were to participate in the study, or confounds the ability to interpret data from the study.
Use of any prescribed systemic or topical medication within 30 days of the first dose administration.
Use of any non-prescribed systemic or topical medication (including vitamin/mineral supplements, and herbal medicines) within 14 days of the first dose administration, Any surgical or medical condition possibly affecting drug absorption, distribution, metabolism and excretion, eg, bariatric procedure, colon resection, irritable bowel syndrome, Crohn's disease, etc. Subjects with cholecystectomy and appendectomy may be included.
Exposure to an investigational drug (new chemical entity) within 30 days prior to the first dose administration or 5 half-lives of that investigational drug, if known (whichever is longer).
Donated blood or plasma within 8 weeks before the first dose administration to a blood bank or blood donation center.
History of drug abuse (as defined by the current version of the Diagnostic and Statistical Manual [DSM]) within 2 years before dosing, or a positive drug screen reflecting consumption of illicit drugs.
History of alcohol abuse (as defined by the current version of the DSM) within 2 years before dosing, or a positive alcohol screen.
Known to have hepatitis, or known to be a carrier of the hepatitis B surface antigen (HBsAg), or hepatitis C antibody (HCV Ab), or have a positive result to the test for HBsAg, HCV Ab, or human immunodeficiency virus (HIV) antibodies at Screening.
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| Name | Affiliation | Role |
|---|---|---|
| MD | Amgen | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Covance Clinical Research Unit Inc | Madison | Wisconsin | 53704 | United States |
De-identified individual patient data for variables necessary to address the specific research question in an approved data sharing request
Data sharing requests relating to this study will be considered beginning 18 months after the study has ended and either 1) the product and indication have been granted marketing authorization in both the US and Europe or 2) clinical development for the product and/or indication discontinues and the data will not be submitted to regulatory authorities. There is no end date for eligibility to submit a data sharing request for this study.
Qualified researchers may submit a request containing the research objectives, the Amgen product(s) and Amgen study/studies in scope, endpoints/outcomes of interest, statistical analysis plan, data requirements, publication plan, and qualifications of the researcher(s). In general, Amgen does not grant external requests for individual patient data for the purpose of re-evaluating safety and efficacy issues already addressed in the product labelling. Requests are reviewed by a committee of internal advisors. If not approved, a Data Sharing Independent Review Panel will arbitrate and make the final decision. Upon approval, information necessary to address the research question will be provided under the terms of a data sharing agreement. This may include anonymized individual patient data and/or available supporting documents, containing fragments of analysis code where provided in analysis specifications. Further details are available at the URL below.
Participants were randomly assigned to one of six treatment sequences. On day 1 of each treatment sequence participants received one of the following according to their assigned treatment sequence:
Participants were enrolled at a single site in the United States. The study consisted of three treatment periods separated by a 5-day washout period.
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| ID | Title | Description |
|---|---|---|
| FG000 | Sequence 1: Treatments ACB | Participants received 30 mg apremilast oral tablet after an overnight fast on day 1 of treatment period 1, 30 mg apremilast oral suspension after a high-fat meal on day 1 of treatment period 2, and 30 mg apremilast oral suspension after an overnight fast on day 1 of treatment period 3. |
| FG001 |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Apremilast Oral Suspension | Drug | 30 mg oral suspension |
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| Apparent Clearance of Apremilast From Plasma After Extravascular Administration (CL/F) | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
| Apparent Volume of Distribution of Apremilast During the Terminal Phase (Vz/F) | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
| Lag Time (Tlag) of Apremilast | Lag time is the delay between the time of administration and start of absorption. | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
| Relative Bioavailability (F) of Apremilast Oral Suspension Formulation | Relative bioavailability of the oral suspension formulation compared to the tablet formulation, calculated as (AUC0-∞/Dose[oral suspension]) / (AUC0-∞/Dose[tablet]) * 100%. | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
| From first dose of study drug in treatment period 1 to 8 days after the last dose; up to 18 days. |
| Sequence 2: Treatments CBA |
Participants received 30 mg apremilast oral suspension after a high-fat meal on day 1 of treatment period 1, 30 mg apremilast oral suspension after an overnight fast on day 1 of treatment period 2, and 30 mg apremilast oral tablet after an overnight fast on day 1 of treatment period 3. |
| FG002 | Sequence 3: Treatments BAC | Participants received 30 mg apremilast oral suspension after an overnight fast on day 1 of treatment period 1, 30 mg apremilast oral tablet after an overnight fast on day 1 of treatment period 2, and 30 mg apremilast oral suspension after a high-fat meal on day 1 of treatment period 3. |
| FG003 | Sequence 4: Treatments ABC | Participants received 30 mg apremilast oral tablet after an overnight fast on day 1 of treatment period 1, 30 mg apremilast oral suspension after an overnight fast on day 1 of treatment period 2, and 30 mg apremilast oral suspension after a high-fat meal on day 1 of treatment period 3. |
| FG004 | Sequence 5: Treatments CAB | Participants received 30 mg apremilast oral suspension after a high-fat meal on day 1 of treatment period 1, 30 mg apremilast oral tablet after an overnight fast on day 1 of treatment period 2, and 30 mg apremilast oral suspension after an overnight fast on day 1 of treatment period 3. |
| FG005 | Sequence 6: Treatments BCA | Participants received 30 mg apremilast oral suspension after an overnight fast on day 1 of treatment period 1, 30 mg apremilast oral suspension after a high-fat meal on day 1 of treatment period 2, and 30 mg apremilast oral tablet after an overnight fast on day 1 of treatment period 3. |
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All randomized participants
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| ID | Title | Description |
|---|---|---|
| BG000 | Total | Participants received a single dose of the following three treatments in one of six treatment sequences:
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
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| Age, Continuous | Mean | Full Range | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Race/Ethnicity, Customized | Count of Participants | Participants |
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| 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 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Primary | Maximum Observed Plasma Concentration (Cmax) of Apremilast | Concentrations of apremilast in plasma were measured using a validated liquid chromatography tandem mass spectrometry assay. | The pharmacokinetic (PK) population included all participants who received at least one dose of apremilast and had at least one measurable concentration datum. | Posted | Geometric Mean | Geometric Coefficient of Variation | ng/mL | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
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| Primary | Area Under the Concentration-time Curve From Time Zero to the Last Measured Time Point (AUC0-t) for Apremilast | Concentrations of apremilast in plasma were measured using a validated liquid chromatography tandem mass spectrometry assay. AUC from time zero to the last measured time point was calculated by the linear trapezoidal method. | The pharmacokinetic population | Posted | Geometric Mean | Geometric Coefficient of Variation | ng*h/mL | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
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| Primary | Area Under the Concentration-time Curve From Time Zero to Infinity (AUC0-∞) for Apremilast | Concentrations of apremilast in plasma were measured using a validated liquid chromatography tandem mass spectrometry assay. AUC from time zero to infinity was calculated as (AUC0-t + Ct/λz), where Ct is the last quantifiable concentration, and λz is the apparent terminal rate constant. | The pharmacokinetic population | Posted | Geometric Mean | Geometric Coefficient of Variation | ng*h/mL | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
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| Primary | Time to Maximum Observed Plasma Concentration (Tmax) of Apremilast | Concentrations of apremilast in plasma were measured using a validated liquid chromatography tandem mass spectrometry assay. | The PK population | Posted | Median | Full Range | hours | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
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| Primary | Terminal Elimination Half-life (T1/2) of Apremilast | PK population | Posted | Geometric Mean | Geometric Coefficient of Variation | hours | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
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| Primary | Apparent Clearance of Apremilast From Plasma After Extravascular Administration (CL/F) | PK population | Posted | Geometric Mean | Geometric Coefficient of Variation | L/h | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
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| Primary | Apparent Volume of Distribution of Apremilast During the Terminal Phase (Vz/F) | PK population | Posted | Geometric Mean | Geometric Coefficient of Variation | L | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
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| Primary | Lag Time (Tlag) of Apremilast | Lag time is the delay between the time of administration and start of absorption. | PK population | Posted | Median | Full Range | hours | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
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| Primary | Relative Bioavailability (F) of Apremilast Oral Suspension Formulation | Relative bioavailability of the oral suspension formulation compared to the tablet formulation, calculated as (AUC0-∞/Dose[oral suspension]) / (AUC0-∞/Dose[tablet]) * 100%. | PK population. Relative bioavailability calculated for each of the oral suspension treatments as pre-specified in the Protocol. | Posted | Geometric Mean | Geometric Coefficient of Variation | percent availability | Predose and at 0.5, 1, 1.5, 2, 3, 5, 8, 12, 24, 36, 48, 60 and 72 hours after dosing on day 1 of each treatment period. |
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| Secondary | Number of Participants With Treatment-emergent Adverse Events | An adverse event (AE) is any noxious, unintended, or untoward medical occurrence that may appear or worsen in a participant during the course of a study. It may be a new intercurrent illness, a worsening concomitant illness, an injury, or any concomitant impairment of the participant's health, including laboratory test values, regardless of etiology. A treatment-emergent AE (TEAE) was defined as any AE that occurred after dosing of the study drug. A serious adverse event (SAE) is any AE occurring at any dose that:
| The safety population included all participants who received at least one dose of apremilast. | Posted | Count of Participants | Participants | From first dose of study drug in treatment period 1 to 8 days after the last dose; up to 18 days. |
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From first dose of study drug in treatment period 1 to 8 days after the last dose; up to 18 days.
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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 | Treatment A: Apremilast 30 mg Tablet - Fasted | A single oral dose of 30 mg apremilast tablet after an overnight fast. | 0 | 34 | 5 | 34 | ||
| EG001 | Treatment B: Apremilast 30 mg Oral Suspension - Fasted | A single oral dose of 30 mg apremilast oral suspension formulation (6 mL) after an overnight fast. | 0 | 34 | 10 | 34 | ||
| EG002 | Treatment C: Apremilast 30 mg Oral Suspension - Fed | A single oral dose of 30 mg apremilast oral suspension formulation (6 mL) after a high-fat meal. | 0 | 34 | 3 | 34 | ||
| EG003 | Total | Participants received a single dose of the following three treatments in one of six treatment sequences:
| 0 | 34 | 15 | 34 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Constipation | Gastrointestinal disorders | MedDRA 18.0 | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA 18.0 | Systematic Assessment |
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| Dyspepsia | Gastrointestinal disorders | MedDRA 18.0 | Systematic Assessment |
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| Flatulence | Gastrointestinal disorders | MedDRA 18.0 | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA 18.0 | Systematic Assessment |
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| Feeling hot | General disorders | MedDRA 18.0 | Systematic Assessment |
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| Musculoskeletal pain | Musculoskeletal and connective tissue disorders | MedDRA 18.0 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA 18.0 | Systematic Assessment |
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The Clinical Trial Agreement generally does not restrict an investigator's discussion of trial results after completion. The Agreement permits Amgen a limited period of time to review material discussing trial results (typically up to 45 days and possible extension). Amgen may remove confidential information, but authors have final control and approval of publication content. For multicenter studies, the investigator agrees not to publish any results before the first multi-center publication.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Study Director | Amgen Inc. | 866-572-6436 | medinfo@amgen.com |
| ID | Term |
|---|---|
| C505730 | apremilast |
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| Unknown or Not Reported |
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| Black or African American |
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| White |
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| Other |
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| To assess the effect of food on the PK of apremilast oral suspension formulation, an ANOVA model, with treatment, sequence, and period as fixed effects and subject nested within sequence as a random effect, was performed on the natural log-transformed Cmax. | Geometric Mean Ratio | 78.2 | 2-Sided | 90 | 71.2 | 86.0 | Ratio of adjusted geometric means (Treatment C / Treatment B) expressed as a percentage. | Other |
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| OG002 | Treatment C: Apremilast 30 mg Oral Suspension - Fed | A single oral dose of 30 mg apremilast oral suspension formulation (6 mL) after a high-fat meal. |
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