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The purpose of this study is to examine the drug-drug interaction when given the study drug, bexagliflozin, with three commonly prescribed medications, probenecid, verapamil or rifampin. The study is to evaluate how safe the study drug is and how well the study drug is tolerated when taken with probenecid, verapamil or rifampin.
In this study, a total of 48 healthy subjects were enrolled and assigned to one of three groups of 16 subjects. Each group participated in an open-label, non-randomized, fixed-sequence studies to assess potential interaction of bexagliflozin tablets, 20 mg with probenecid, rifampin or verapamil.
Sequence 1: Bexagliflozin/probenecid Sixteen healthy subjects were dosed with bexagliflozin, qd and/or probenecid tablets, 500 mg, bid, in sequential order as follows: on Day 1 subjects took bexagliflozin; on Days 3 and 4 subjects took probenecid, bid; on Day 5 subjects took one bexagliflozin, and probenecid, bid; and on Day 6 subjects took probenecid tablets, 500 mg, bid.
Sequence 2: Bexagliflozin/rifampin Sixteen healthy subjects were dosed with bexagliflozin, qd and/or 600 mg of rifampin daily in sequential order as follows: on Day 1 subjects took one bexagliflozin tablet; on Days 3 to 5, subjects took rifampin once daily; on Day 6 subjects took one bexagliflozin tablet and rifampin; and on Day 7 subjects took rifampin.
Sequence 3: Bexagliflozin/verapamil Sixteen healthy subjects were dosed with bexagliflozin, and/or verapamil tablets, 120 mg in sequential order as follows: on Day 1 subjects took one bexagliflozin tablet, on Day 4 subjects took one verapamil tablet, 1 hour before taking a bexagliflozin tablet.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Bexagliflozin/probenecid | Experimental | Sixteen healthy subjects were dosed with bexagliflozin, qd and/or probenecid tablets, 500 mg, bid, in sequential order as follows: on Day 1 subjects took bexagliflozin; on Days 3 and 4 subjects took probenecid, bid; on Day 5 subjects took one bexagliflozin, and probenecid, bid; and on Day 6 subjects took probenecid tablets, 500 mg, bid. |
|
| Bexagliflozin/rifampin | Experimental | Sixteen healthy subjects were dosed with bexagliflozin, qd and/or 600 mg of rifampin daily in sequential order as follows: on Day 1 subjects took one bexagliflozin tablet; on Days 3 to 5, subjects took rifampin once daily; on Day 6 subjects took one bexagliflozin tablet and rifampin; and on Day 7 subjects took rifampin. |
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| Bexagliflozin/verapamil | Experimental | Sixteen healthy subjects were dosed with bexagliflozin, and/or verapamil tablets, 120 mg in sequential order as follows: on Day 1 subjects took one bexagliflozin tablet, on Day 4 subjects took one verapamil tablet, 1 hour before taking a bexagliflozin tablet. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bexagliflozin | Drug | Bexagliflozin 20 mg, tablet; qd |
|
| Measure | Description | Time Frame |
|---|---|---|
| Cmax (Maximum Observed Plasma Concentration) | Whole venous blood samples of 3 mL were collected from a peripheral vein prior to dosing and at 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36, and 48 h after administration of bexagliflozin; On Day 1 and Day 5 for Study 1, Day 1 and Day 6 for Study 2, Day 1 and Day 4 for Study 3. The pharmacokinetic parameters were estimated from the bexagliflozin plasma concentration data for each subject by non-compartmental analysis (NCA). | Up to 48 hours |
| Tmax (Time of Maximum Observed Plasma Concentration) | Whole venous blood samples of 3 mL were collected from a peripheral vein prior to dosing and at 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36, and 48 h after administration of bexagliflozin; On Day 1 and Day 5 for Study 1, Day 1 and Day 6 for Study 2, Day 1 and Day 4 for Study 3. The pharmacokinetic parameters were estimated from the bexagliflozin plasma concentration data for each subject by non-compartmental analysis (NCA). | Up to 48 hours |
| T1/2 (Apparent Terminal Elimination Half-life) | Whole venous blood samples of 3 mL were collected from a peripheral vein prior to dosing and at 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36, and 48 h after administration of bexagliflozin; On Day 1 and Day 5 for Study 1, Day 1 and Day 6 for Study 2, Day 1 and Day 4 for Study 3. The pharmacokinetic parameters were estimated from the bexagliflozin plasma concentration data for each subject by non-compartmental analysis (NCA). | Up to 48 hours |
| AUC0-inf (Area Under the Plasma Concentration-time Curve From Time 0 to Infinity) | Whole venous blood samples of 3 mL were collected from a peripheral vein prior to dosing and at 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36, and 48 h after administration of bexagliflozin; On Day 1 and Day 5 for Study 1, Day 1 and Day 6 for Study 2, Day 1 and Day 4 for Study 3. The pharmacokinetic parameters were estimated from the bexagliflozin plasma concentration data for each subject by non-compartmental analysis (NCA). |
| Measure | Description | Time Frame |
|---|---|---|
| Urinary Glucose Excretion 0-48 hr | Pre-dose urine samples were collected from -12 to 0 h for baseline measurement of pharmacodynamic parameters. Post-dose urine samples were collected without preservative in four batches: 0 to 12 h, 12 to 24 h, 24 to 36h, and 36 to 48 h after dosing. Urine aliquots were prepared from well mixed collections for the assessment of pharmacodynamics. | 0 to 48 hours |
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Subjects meeting the following Criteria were included::
Subjects who met any of the following criteria were excluded from the study:
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| Name | Affiliation | Role |
|---|---|---|
| Mason Freeman, M.D. | Massachusetts General Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Covance Clinical Research Unit | Daytona Beach | Florida | 32117 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Bexagliflozin, Then Probenecid, Then Bexagliflozin and Probenecid | Subjects were dosed with bexagliflozin tablets, 20 mg, qd and/or probenecid tablets, 500 mg, bid, in sequential order as follows: on Day 1 subjects took bexagliflozin; on Days 3 and 4 subjects took probenecid, bid; on Day 5 subjects took one bexagliflozin, and probenecid, bid; and on Day 6 subjects took probenecid tablets, 500 mg, bid. |
| FG001 | Bexagliflozin, Then Rifampin, Then Bexagliflozin and Refampin | Subjects were dosed with bexagliflozin tablets, 20 mg, qd and/or 600 mg of rifampin daily in sequential order as follows: on Day 1 subjects took one bexagliflozin tablet; on Days 3 to 5, subjects took rifampin once daily; on Day 6 subjects took one bexagliflozin tablet and rifampin; and on Day 7 subjects took rifampin. |
| FG002 | Bexagliflozin, Then Verapamil and Bexagliflozin | Subjects were dosed with bexagliflozin tablets, 20 mg, and/or verapamil tablets, 120 mg in sequential order as follows: on Day 1 subjects took one bexagliflozin tablet, on Day 4 subjects took one verapamil tablet, 1 hour before taking a bexagliflozin tablet. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | Bexagliflozin, Then Probenecid, Then Bexagliflozin and Probenecid | Bexagliflozin: Bexagliflozin tablets, 20 mg; qd Probenecid: Probenecid tablets, 500 mg; bid |
| BG001 | Bexagliflozin, Then Rifampin, Then Bexagliflozin and Refampin |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| 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 | Cmax (Maximum Observed Plasma Concentration) | Whole venous blood samples of 3 mL were collected from a peripheral vein prior to dosing and at 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36, and 48 h after administration of bexagliflozin; On Day 1 and Day 5 for Study 1, Day 1 and Day 6 for Study 2, Day 1 and Day 4 for Study 3. The pharmacokinetic parameters were estimated from the bexagliflozin plasma concentration data for each subject by non-compartmental analysis (NCA). | Posted | Geometric Mean | Geometric Coefficient of Variation | ng/mL | Up to 48 hours |
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The adverse event data were collected from Day 0 up to Day 7 for study 1, Day 0 up to Day 8 for study 2 and Day 0 up to Day 6 for study 3 after drug administration
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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 | Study 1: Bexagliflozin Alone | Bexagliflozin: Bexagliflozin tablets, 20 mg; qd |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Diarrhea | Gastrointestinal disorders | MedDRA 20.1 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Albert Collinson | Theracos Sub, LLC | (508) 688-4221 | acollinson@theracos.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Aug 28, 2017 | Feb 19, 2020 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Nov 30, 2017 | Feb 19, 2020 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D003924 | Diabetes Mellitus, Type 2 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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| ID | Term |
|---|---|
| C000705992 | bexagliflozin |
| D011339 | Probenecid |
| D012293 | Rifampin |
| D014700 | Verapamil |
| ID | Term |
|---|---|
| D013449 | Sulfonamides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D013450 | Sulfones |
| D013457 |
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| Probenecid | Drug | Probenecid tablets, 500 mg; bid |
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| Rifampin | Drug | Rifampin, 600 mg (2 x 300 mg capsules); qd |
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| Verapamil | Drug | Verapamil hydrochloride tablet, 120 mg; qd |
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| Up to 48 hours |
Bexagliflozin: Bexagliflozin tablets, 20 mg; qd
Rifampin: Rifampin 600 mg (2 x 300 mg capsules); qd
| BG002 | Bexagliflozin, Then Verapamil and Bexagliflozin | Bexagliflozin: Bexagliflozin tablets, 20 mg; qd Verapamil: Verapamil hydrochloride tablets, 120 mg; qd |
| BG003 | Total | Total of all reporting groups |
| 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 (NIH/OMB) | Count of Participants | Participants |
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| Weight | Mean | Standard Deviation | kg |
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| Height | Mean | Standard Deviation | cm |
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| BMI | Mean | Standard Deviation | kg/m^2 |
|
| OG002 | Study 2: Bexagliflozin Alone | Bexagliflozin tablets, 20 mg; qd |
| OG003 | Study 2: Bexagliflozin and Rifampin | Bexagliflozin: Bexagliflozin tablets, 20 mg; qd Rifampin: Rifampin 600 mg (2 x 300 mg capsules); qd |
| OG004 | Study 3: Bexagliflozin Alone | Bexagliflozin tablets, 20 mg; qd |
| OG005 | Study 3: Bexagliflozin and Verapamil | Bexagliflozin: Bexagliflozin tablets, 20 mg; qd Verapamil: Verapamil hydrochloride tablets, 120 mg; qd |
|
|
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| Primary | Tmax (Time of Maximum Observed Plasma Concentration) | Whole venous blood samples of 3 mL were collected from a peripheral vein prior to dosing and at 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36, and 48 h after administration of bexagliflozin; On Day 1 and Day 5 for Study 1, Day 1 and Day 6 for Study 2, Day 1 and Day 4 for Study 3. The pharmacokinetic parameters were estimated from the bexagliflozin plasma concentration data for each subject by non-compartmental analysis (NCA). | Posted | Median | Full Range | hours | Up to 48 hours |
|
|
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| Primary | T1/2 (Apparent Terminal Elimination Half-life) | Whole venous blood samples of 3 mL were collected from a peripheral vein prior to dosing and at 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36, and 48 h after administration of bexagliflozin; On Day 1 and Day 5 for Study 1, Day 1 and Day 6 for Study 2, Day 1 and Day 4 for Study 3. The pharmacokinetic parameters were estimated from the bexagliflozin plasma concentration data for each subject by non-compartmental analysis (NCA). | Posted | Geometric Mean | Geometric Coefficient of Variation | hours | Up to 48 hours |
|
|
|
| Primary | AUC0-inf (Area Under the Plasma Concentration-time Curve From Time 0 to Infinity) | Whole venous blood samples of 3 mL were collected from a peripheral vein prior to dosing and at 1, 2, 3, 4, 5, 6, 8, 10, 12, 16, 24, 36, and 48 h after administration of bexagliflozin; On Day 1 and Day 5 for Study 1, Day 1 and Day 6 for Study 2, Day 1 and Day 4 for Study 3. The pharmacokinetic parameters were estimated from the bexagliflozin plasma concentration data for each subject by non-compartmental analysis (NCA). | AUC0-t (from time 0 to time T) was used instead of AUC0-inf for Study 2 since AUC0-inf was not reported | Posted | Geometric Mean | Geometric Coefficient of Variation | hr*ng/mL | Up to 48 hours |
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|
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| Secondary | Urinary Glucose Excretion 0-48 hr | Pre-dose urine samples were collected from -12 to 0 h for baseline measurement of pharmacodynamic parameters. Post-dose urine samples were collected without preservative in four batches: 0 to 12 h, 12 to 24 h, 24 to 36h, and 36 to 48 h after dosing. Urine aliquots were prepared from well mixed collections for the assessment of pharmacodynamics. | Only subjects with data in the specific category is included | Posted | Mean | Standard Deviation | g | 0 to 48 hours |
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| 0 |
| 16 |
| 0 |
| 16 |
| 0 |
| 16 |
| EG001 | Study 1: Bexagliflozin and Probenecid | Bexagliflozin: Bexagliflozin tablets, 20 mg; qd Probenecid: Probenecid tablets, 500 mg; bid | 0 | 16 | 0 | 16 | 1 | 16 |
| EG002 | Study 2: Bexagliflozin Alone | Bexagliflozin: Bexagliflozin tablets, 20 mg; qd | 0 | 16 | 0 | 16 | 0 | 16 |
| EG003 | Study 2: Bexagliflozin and Rrifampin | Bexagliflozin: Bexagliflozin tablets, 20 mg; qd Rifampin: Rifampin 600 mg (2 x 300 mg capsules); qd | 0 | 16 | 0 | 16 | 0 | 16 |
| EG004 | Study 3: Bexagliflozin Alone | Bexagliflozin: Bexagliflozin tablets, 20 mg; qd | 0 | 16 | 0 | 16 | 2 | 16 |
| EG005 | Study 3: Bexagliflozin and Verapamil | Bexagliflozin: Bexagliflozin tablets, 20 mg; qd Verapamil: Verapamil hydrochloride tablets, 120 mg; qd | 0 | 16 | 0 | 16 | 0 | 16 |
| Gastrointestinal sounds abnormal | Gastrointestinal disorders | MedDRA 20.1 | Systematic Assessment |
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| Laceration | Injury, poisoning and procedural complications | MedDRA 20.1 | Systematic Assessment |
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| Presyncope | Nervous system disorders | MedDRA 20.1 | Systematic Assessment |
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The Investigator has no right to publish the trial results.
| D004700 | Endocrine System Diseases |
| Sulfur Compounds |
| D012294 | Rifamycins |
| D006576 | Heterocyclic Compounds, 4 or More Rings |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D047029 | Lactams, Macrocyclic |
| D047028 | Macrocyclic Compounds |
| D011083 | Polycyclic Compounds |
| D010627 | Phenethylamines |
| D005021 | Ethylamines |
| D000588 | Amines |
|
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| Geometric LS Mean was used as PK parameters | Point Estimate (%) | 86.12 | 2-Sided | 90 | 70.24 | 105.59 | Point Estimate is the estimated ratio of exponentiated mean difference of log-transformed PK parameter from ANOVA. Confidence interval is obtained from ANOVA with treatment as a fixed effect, and subject as a random effect. | Equivalence | The acceptance range for bioequivalence is 80.0 - 125.00%. |
| Geometric LS Mean was used as PK parameters | Point Estimate (%) | 97.93 | 2-Sided | 90 | 90.26 | 106.26 | Point Estimate is the estimated ratio of exponentiated mean difference of log-transformed PK parameter from ANOVA. Confidence interval is obtained from ANOVA with treatment as a fixed effect, and subject as a random effect. | Equivalence | The acceptance range for bioequivalence is 80.0 - 125.00%. |
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| 0 - 12 hours post-dose |
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| 12 - 24 hours post-dose |
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| 24 - 36 hours post-dose |
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| 36 - 48 hours post-dose |
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| 0 - 24 hours post-dose |
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| 0 - 48 hours post-dose |
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