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This is an open-label, single-sequence, 3-period crossover study conducted in healthy subjects. Eligible subjects will participate in a single treatment period, in which they will receive the following treatments: Day 1, single doses of midazolam and metoprolol; Day 2, single doses of pioglitazone, tolbutamide, and omeprazole; Days 5 to 17, daily doses of relacorilant; Day 14, single doses of midazolam and metoprolol (with relacorilant); and, Day 15, single doses of pioglitazone, tolbutamide, and omeprazole (with relacorilant).
This is an open-label, single-sequence, 3-period crossover study conducted in healthy subjects. Subjects will be screened for eligibility for the study within 21 days before the first dose of study drug based on entrance criteria specified in Section 4. Eligible subjects will participate in a single treatment period, in which they will receive the following treatments:
Safety and tolerability will be monitored using AEs, clinical laboratory evaluations, 12-lead ECG recordings, vital sign and pulse oximetry measurements, and physical examinations.
Subjects will be admitted to the Clinical Research Unit (CRU) on the morning of Day -1 following an 8-hour fast for baseline assessments and will remain confined until completion of procedures, 72 hours after the last dose of probe substrate and 24 hours after the last dose of relacorilant. Subjects may leave the CRU after safety review on the morning of Day 18. Each subject will have a follow-up (FU) visit 14 ± 2 days after the last dose of study drug.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Period 1 | Experimental | Period 1 (Study Days 1 to 4): Midazolam hydrochloride and metoprolol tartrate will be given once on Day 1. Pioglitazone hydrochloride, tolbutamide and omeprazole will be given once on Day 2 |
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| Period 2 | Experimental | Period 2 (Study Days 5 to 13): Relacorilant will be given daily from Day 5 to Day 13. |
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| Period 3 | Experimental | Period 3 (Study Days 14 to 17): Midazolam hydrochloride and metoprolol tartrate will be given once on Day 14. Pioglitazone hydrochloride, tolbutamide and omeprazole will be given once on Day 15. Relacorilant will be given daily from Day 14 to Day 17. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Midazolam hydrochloride | Drug | Midazolam hydrochloride 2.5 mg |
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| Measure | Description | Time Frame |
|---|---|---|
| Area under plasma concentration-time curve up to the last quantifiable sample (AUC0-tz) | Ratio of population geometric means (GMR) for Reference Day (following a single dose with each probe substrate given within a cocktail of probe substrates) and Test Day (following the same dose given to subjects after 10 or 11 days of daily dosing with relacorilant) areas under plasma concentration-time curve up to the last quantifiable sample (AUC0-tz) | predose to 96 hrs postdose |
| Measure | Description | Time Frame |
|---|---|---|
| Area under plasma concentration-time curve extrapolated to infinity (AUCinf) | Ratio of population geometric means (GMR) for Reference Day (following a single dose with each probe substrate given within a cocktail of probe substrates) and Test Day (following the same dose given to subjects after 10 days of daily dosing with relacorilant) areas under plasma concentration-time curve extrapolated to infinity (AUCinf) |
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Inclusion Criteria:
Able to understand the purpose and risks of the study; willing and able to adhere to scheduled visits, treatment plans, laboratory tests, and other study evaluations and procedures.
Give written informed consent.
Be males or nonpregnant, nonlactating females judged to be in good health, based on the results of medical history, physical examination, vital signs, 12-lead ECG, and clinical laboratory findings.
Have a body mass index (BMI) between 18 and 32 kg/m2, inclusive, and a body weight more than 50 kg (110 pounds).
Be a nonsmoker. Use of nicotine or nicotine-containing products must be discontinued at least 90 days prior to the first dose of study drug.
Be willing to comply with study restrictions
Have suitable veins for multiple venipuncture/cannulation.
Female subjects must be either of nonchildbearing potential (ie, postmenopausal or permanently sterilized) or use highly effective contraception with low user-dependency.
Exclusion Criteria:
Be an employee or immediate family member of the Clinical Research Unit or Corcept.
Have been previously enrolled in any study of relacorilant.
Have multiple drug allergies, or be allergic to any of the components of relacorilant.
Have a condition that could be aggravated by glucocorticoid blockade (eg, asthma, any chronic inflammatory condition).
Have a history of gastric bypass surgery.
Have a history of malabsorption syndrome or previous gastrointestinal surgery, with the exception of appendectomy and cholecystectomy, which could affect drug absorption or metabolism.
Current alcohol or substance abuse.
In the 2 calendar months before first study drug administration, have donated/lost blood or plasma in excess of 400 mL.
In the 30 days before first study drug administration, have participated in another clinical trial of a new chemical entity or a prescription medicine.
Have a positive test for alcohol or drugs of abuse at screening or first admission.
Have a positive test for exogenous glucocorticoids at screening.
Have clinically relevant abnormal findings on vital signs, physical examination, laboratory screening tests, or 12-lead ECG, at screening and/or before first study drug administration, including but not limited to**:
Have any medical or social reasons for not participating in the study raised by their primary care physician.
Have any other condition that might increase the risk to the individual or decrease the chance of obtaining satisfactory data, as assessed by the Investigator.
Taken any prohibited prior medication within protocol designated timeframes, such as or including any glucocorticoid, strong inducers, inhibitors or substrates of CYP enzymes involved in drug-drug-interactions, hormonal contraception or hormone replacement therapy.
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| Name | Affiliation | Role |
|---|---|---|
| Kirsteen Donaldson, FFPM,DM,FRCP | Corcept Therapeutics | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Celerion | Tempe | Arizona | 85283 | United States |
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| Metoprolol tartrate | Drug | Metoprolol tartrate 100 mg |
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| Pioglitazone hydrochloride | Drug | Pioglitazone hydrochloride 15 mg |
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| Tolbutamide | Drug | Tolbutamide 500 mg |
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| Omeprazole | Drug | Omeprazole 20 mg |
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| Relacorilant | Drug | Relacorilant 350mg |
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| predose to 96 hrs postdose |
| Maximum plasma concentration (Cmax) | Ratio of population geometric means (GMR) for Reference Day (following a single dose with each probe substrate given within a cocktail of probe substrates) and Test Day (following the same dose given to subjects after 10 days of daily dosing with relacorilant) maximum plasma concentration (Cmax). | predose to 96 hrs postdose |
| Adverse Events | Safety and tolerability measure by number of subjects who experience adverse events | up to 8 weeks |
| Safety Labs | Safety and tolerability measure by number of subjects who experience potential clinically significant changes in safety labs | up to 8 weeks |
| ECGs | Safety and tolerability measure by number of subjects who experience potential clinically significant changes in ECGs | up to 8 weeks |
| Vital Signs | Safety and tolerability measure by number of subjects who experience potential clinically significant changes in vital signs | up to 8 weeks |
| Physical Examinations | Safety and tolerability measure by number of subjects who experience potential clinically significant changes in physical exams | up to 8 weeks |
| ID | Term |
|---|---|
| D008874 | Midazolam |
| D008790 | Metoprolol |
| D000077205 | Pioglitazone |
| D014044 | Tolbutamide |
| D009853 | Omeprazole |
| C000633444 | relacorilant |
| ID | Term |
|---|---|
| D001569 | Benzodiazepines |
| D001552 | Benzazepines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D050198 | Phenoxypropanolamines |
| D011412 | Propanolamines |
| D000605 | Amino Alcohols |
| D000438 | Alcohols |
| D009930 | Organic Chemicals |
| D020005 | Propanols |
| D000588 | Amines |
| D045162 | Thiazolidinediones |
| D013844 | Thiazoles |
| D013457 | Sulfur Compounds |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D000096926 | Benzenesulfonamides |
| D013449 | Sulfonamides |
| D000577 | Amides |
| D013453 | Sulfonylurea Compounds |
| D014508 | Urea |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D013450 | Sulfones |
| D053799 | 2-Pyridinylmethylsulfinylbenzimidazoles |
| D013454 | Sulfoxides |
| D011725 | Pyridines |
| D001562 | Benzimidazoles |
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