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This study will assess the bioequivalence of the test product (Nicotine Prototype Mini lozenge 4 milligrams [mg]) to a commercial reference product (nicotine polacrilex mini lozenge 4mg) in healthy smokers under fasting conditions.
This study will be a single center, randomized, open label, single dose, two-way crossover in healthy smokers that smoke their first cigarette within 30 minutes of waking. This study will consist of following Visits: Visit 1 (Screening), Visit 2 (Study Period 1), followed by a Washout period and Visit 3 (Study Period 2). This will ensure approximately 29 evaluable participants per treatment arm. Each participant will be treated with a single dose of the two study treatments (test and reference) in a randomized sequence, under fasting conditions. Participants will be confined in the study facility for approximately 60 hours during each study session (for 36 hours pre-dosing and for 24 hours post dosing) during which pharmacokinetic (PK) blood samples will be obtained. Participants are to abstain from smoking during the confinement periods and be subject to random measurements of expired carbon monoxide (CO) to confirm abstinence. The CO levels must be ≤10 parts per million (ppm) throughout the study session. There will be at least 5-day and not more than 7-day clinical furlough period between treatment periods. For each treatment period, the clinical confinement period with restriction of smoking is at least 36 hours prior to dosing.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Test Product | Experimental | Participants will receive a single Nicotine Prototype Mini lozenge (4mg) by oral/buccal route of administration. |
|
| Reference Product | Active Comparator | Participants will receive a single Nicorette Mini lozenge (4 mg) by oral/buccal route of administration. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nicotine Prototype Mini lozenge | Drug | A single dose of a prototype nicotine 4mg lozenge will be placed in participants mouth, occasionally moving it side to side. Allowing it to slowly dissolve and try to minimize swallowing. Participants will be instructed not to chew lozenge. The lozenge should be completely dissolved. |
| Measure | Description | Time Frame |
|---|---|---|
| Assessment of Bioequivalence of Prototype Mini Lozenges With Nicorette Mini Lozenge by Measuring Area Under the Plasma Concentration Versus Time Curve From Time Zero to Time t (AUC [0-t]) | Bioequivalence of prototype mini lozenges with nicorette mini lozenge was assessed by measuring AUC(0-t), where t= time of the last measurable plasma concentration. AUC(0-t) was calculated using the linear trapezoidal with linear interpolation method. A linear mixed-effects model was fit to the natural log (ln)-transformed PK variable (AUC0-t), as the dependent variable, and treatment, period, and sequence as fixed effects. Participant nested within sequence was a random effect. The treatment difference and its 90% CI were exponentiated to obtain the geometric mean ratios (GMR) between the test and reference products and its 90% CI. Geometric Coefficient of variation was provided as percentage. | 0.75, 0.5, 0.25 hours predose and 0.08, 0.17, 0.33, 0.5, 0.67, 0.83, 1, 1.25, 1.5, 2, 3, 4, 6, 8 10, 14, 16, 20 and 24 hours postdose in each treatment period |
| Assessment of Bioequivalence of Prototype Mini Lozenges With Nicorette Mini Lozenge by Measuring Area Under the Plasma Concentration Versus Time Curve Calculated From Time Zero to Infinity (AUC [(0-inf]) | Bioequivalence of prototype mini lozenges with nicorette mini lozenge was assessed by measuring AUC(0-inf). AUC(0-inf) = AUC0-t + (Clast/kel), where, AUC0-t= area under the plasma concentration versus time curve from time zero to time t; Clast= last observed/measured plasma concentration and kel= elimination rate constant. A linear mixed-effects model was fit to the natural log (ln)-transformed PK variable (AUC[0-inf]), as the dependent variable, and treatment, period, and sequence as fixed effects. Participant nested within sequence was a random effect. The treatment difference and its 90% CI were exponentiated to obtain the GMR between the test and reference products and its 90% CI. Geometric Coefficient of variation was provided as percentage. | 0.75, 0.5, 0.25 hours predose and 0.08, 0.17, 0.33, 0.5, 0.67, 0.83, 1, 1.25, 1.5, 2, 3, 4, 6, 8 10, 14, 16, 20 and 24 hours postdose in each treatment period |
| Assessment of Bioequivalence of Prototype Mini Lozenges With Nicorette Mini Lozenge by Measuring Maximum Observed Plasma Nicotine Concentration (Cmax) |
| Measure | Description | Time Frame |
|---|---|---|
| Comparison of Prototype Mini Lozenges With Nicorette Mini Lozenge by Measuring Time of Maximum Plasma Nicotine Concentration (Tmax) | Tmax was defined as the time to maximum plasma nicotine concentration. If the maximum value occurred at more than one time point, Tmax was defined as the first time point with this value. | 0.75, 0.5, 0.25 hours predose and 0.08, 0.17, 0.33, 0.5, 0.67, 0.83, 1, 1.25, 1.5, 2, 3, 4, 6, 8 10, 14, 16, 20 and 24 hours postdose in each treatment period |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| GSK Clinical Trials | GlaxoSmithKline | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| GSK Investigational Site | Lincoln | Nebraska | 68502 | United States |
Participants received treatment in one of the two sequences; treatment A (Prototype Mini Lozenge: Reference drug) followed by treatment B (Nicorette Mini lozenge: Investigational drug) or vice versa in each of the study period 1 and 2.
The study was conducted at single center in United States. A total of 61 participants were screened, of whom 37 were randomized for treatment and 24 were screen failures.
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| ID | Title | Description |
|---|---|---|
| FG000 | Prototype-Washout-Nicorette | Participants randomized to this group received a single dose of Treatment A: 4 milligrams (mg) of Prototype Mini Lozenge administered orally on Day 0 in Treatment Period 1. It was followed by a washout period of at least 5 days to a maximum of 7 days, then participants received Treatment B: 4 mg of Nicorette Mini lozenge administered orally on any one day from Day 5-Day 7 (depending upon washout period) in Treatment Period 2. All these doses were administered after an overnight fast of at least 10 hours in each period. Participants were confined in the study facility for approximately 60 hours during each treatment period (for 36 hours predose and for 24 hours postdose) with abstinence from smoking during which they were subjected to random measurements of expired carbon monoxide (CO) to confirm abstinence (CO levels must have been less than or equal to(<=) 10 parts per million (ppm) throughout the treatment period). |
| FG001 | Nicorette-Washout-Prototype | Participants randomized to this group received a single dose of Treatment B: 4 mg of Nicorette Mini lozenge administered orally on Day 0 in Treatment Period 1. It was followed by a washout period of at least 5 days to a maximum of 7 days, then participants received Treatment A: 4 mg of Prototype Mini Lozenge administered orally on any one day from Day 5-Day 7 (depending upon washout period) in Treatment Period 2. All these doses were administered after an overnight fast of at least 10 hours in each period. Participants were confined in the study facility for approximately 60 hours during each treatment period (for 36 hours predose and for 24 hours postdose) with abstinence from smoking during which they were subjected to random measurements of expired CO to confirm abstinence (CO levels must have been <= 10 ppm throughout the treatment period). |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Study Period 1: Up to Day 1 |
| |||||||||||||
| Washout Period: 5 to 7 Days |
| |||||||||||||
| Study Period 2: Up to Day 8 |
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Safety population was defined as all randomized participants who received at least one dose of study medication.
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| ID | Title | Description |
|---|---|---|
| BG000 | All Treatment Combined | All randomized participants received either a single dose of TreatmentA:4mg of Prototype Mini Lozenge administered orally on Day0 in Treatment Period1 followed by TreatmentB:4mg of Nicorette Mini lozenge administered orally on any one day from Day 5-Day 7(depending upon washout period) in Treatment Period2 or vice versa. Washout period was of at least 5days to maximum of 7days between two treatment periods. All these doses were administered after an overnight fast of at least 10 hours in each period. Participants were confined in the study facility for approximately 60 hours during each treatment period (for 36 hours predose and for 24 hours postdose) with abstinence from smoking during which they were subjected to random measurements of expired CO to confirm abstinence (CO levels must have been <=10 ppm throughout the treatment period). |
| 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 | Assessment of Bioequivalence of Prototype Mini Lozenges With Nicorette Mini Lozenge by Measuring Area Under the Plasma Concentration Versus Time Curve From Time Zero to Time t (AUC [0-t]) | Bioequivalence of prototype mini lozenges with nicorette mini lozenge was assessed by measuring AUC(0-t), where t= time of the last measurable plasma concentration. AUC(0-t) was calculated using the linear trapezoidal with linear interpolation method. A linear mixed-effects model was fit to the natural log (ln)-transformed PK variable (AUC0-t), as the dependent variable, and treatment, period, and sequence as fixed effects. Participant nested within sequence was a random effect. The treatment difference and its 90% CI were exponentiated to obtain the geometric mean ratios (GMR) between the test and reference products and its 90% CI. Geometric Coefficient of variation was provided as percentage. | Pharmacokinetic analysis set1 (PKAS1) included all randomized participants who completed both periods, had no major protocol deviations concerning pharmacokinetics, excluding those with baseline nicotine concentration greater than (>) 5 percent (%) of individual highest observed plasma nicotine concentration (Cmax) for either period. | Posted | Geometric Mean | Geometric Coefficient of Variation | nanograms*hours per milliliter(ng*hr/mL) | 0.75, 0.5, 0.25 hours predose and 0.08, 0.17, 0.33, 0.5, 0.67, 0.83, 1, 1.25, 1.5, 2, 3, 4, 6, 8 10, 14, 16, 20 and 24 hours postdose in each treatment period |
From signing of the informed consent form until 5 days after last administration of study drug (up to Day 13)
Safety population: all randomized participants who received at least one dose of study medication. All adverse events (AEs) were summarized by system organ class and preferred term. All treatment emergent AEs and serious adverse events (SAEs) were collected and reported. A participant with multiple occurrences of AEs counted once in AE category. A participant with multiple AEs within a primary system organ class was counted once in system organ class.
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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 | Prototype Mini Lozenges | Participants randomized to receive a single dose of Treatment A: 4 mg of Prototype Mini Lozenge administered orally in either Treatment Period 1 (on Day 1) or Treatment Period 2 (Day 5 to 7). All these doses were administered after an overnight fast of at least 10 hours in each period. Participants were confined in the study facility for approximately 60 hours during each treatment period (for 36 hours predose and for 24 hours postdose) with abstinence from smoking during which they were subjected to random measurements of expired CO to confirm abstinence (CO levels must have been <= 10 ppm throughout the treatment period). |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abdominal discomfort | Gastrointestinal disorders | MedDRA (vs 21.0) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| GSK Response Center | GlaxoSmithKline | 866-435-7343 | GSKClinicalSupportHD@gsk.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 | Nov 29, 2018 | Nov 12, 2019 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jan 18, 2019 | Nov 13, 2019 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D014029 | Tobacco Use Disorder |
| ID | Term |
|---|---|
| D019966 | Substance-Related Disorders |
| D064419 | Chemically-Induced Disorders |
| D001523 | Mental Disorders |
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|
| Nicorette Mini Lozenge | Drug | A single dose of a 4 mg nicotine polacrilex mini lozenge (Nicorette Minis) will be placed in participants mouth, occasionally moving it side to side. Allowing it to slowly dissolve and try to minimize swallowing. Participants will be instructed not to chew lozenge. The lozenge should be completely dissolved. |
|
Blood samples were collected at designated timepoints. Bioequivalence of prototype mini lozenges with nicorette mini lozenge was assessed by measuring Cmax that was taken directly from bioanalytical data. Geometric Coefficient of variation was provided as percentage. A linear mixed-effects model was fit to the natural log (ln)-transformed PK variable (Cmax) as the dependent variable, and treatment, period, and sequence as fixed effects. Participant nested within sequence was a random effect. The treatment difference and its 90% CI were exponentiated to obtain the GMR between the test and reference products and its 90% CI. Geometric Coefficient of variation was provided as percentage.
| 0.75, 0.5, 0.25 hours predose and 0.08, 0.17, 0.33, 0.5, 0.67, 0.83, 1, 1.25, 1.5, 2, 3, 4, 6, 8 10, 14, 16, 20 and 24 hours postdose in each treatment period |
| Comparison of Prototype Mini Lozenges With Nicorette Mini Lozenge by Measuring Apparent Elimination Half-Life (t1/2) | t1/2 was defined as apparent elimination half-life that was calculated as t1/2 = ln(2) / Kel, where Kel= elimination rate constant. | 0.75, 0.5, 0.25 hours predose and 0.08, 0.17, 0.33, 0.5, 0.67, 0.83, 1, 1.25, 1.5, 2, 3, 4, 6, 8 10, 14, 16, 20 and 24 hours postdose in each treatment period |
| Comparison of Prototype Mini Lozenges With Nicorette Mini Lozenge by Measuring Apparent Elimination Rate Constant for Plasma Nicotine (Kel) | kel was defined as apparent elimination rate constant for plasma nicotine that was calculated as negative of the slope of a linear regression of the log(concentration)- time for all concentrations > lower limit of quantification. | 0.75, 0.5, 0.25 hours predose and 0.08, 0.17, 0.33, 0.5, 0.67, 0.83, 1, 1.25, 1.5, 2, 3, 4, 6, 8 10, 14, 16, 20 and 24 hours postdose in each treatment period |
| Number of Participants With Clinically Significant Change in Laboratory Test Values | Haematological, biochemistry and urinalysis parameters were analyzed. Clinical significance was judged by the investigator based upon the out of range values of standard range set for each parameter. | From signing of the informed consent form until 5 days after last administration of study drug (up to Day 13) |
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| COMPLETED |
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| 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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|
| Primary | Assessment of Bioequivalence of Prototype Mini Lozenges With Nicorette Mini Lozenge by Measuring Area Under the Plasma Concentration Versus Time Curve Calculated From Time Zero to Infinity (AUC [(0-inf]) | Bioequivalence of prototype mini lozenges with nicorette mini lozenge was assessed by measuring AUC(0-inf). AUC(0-inf) = AUC0-t + (Clast/kel), where, AUC0-t= area under the plasma concentration versus time curve from time zero to time t; Clast= last observed/measured plasma concentration and kel= elimination rate constant. A linear mixed-effects model was fit to the natural log (ln)-transformed PK variable (AUC[0-inf]), as the dependent variable, and treatment, period, and sequence as fixed effects. Participant nested within sequence was a random effect. The treatment difference and its 90% CI were exponentiated to obtain the GMR between the test and reference products and its 90% CI. Geometric Coefficient of variation was provided as percentage. | Analysis performed on PKAS1, that included all randomized participants who completed both periods, had no major protocol deviations concerning pharmacokinetics, excluding those with baseline nicotine concentration > 5% of individual Cmax for either period. Here, number analyzed indicates participants with available data for this outcome measure. | Posted | Geometric Mean | Geometric Coefficient of Variation | ng*hr/mL | 0.75, 0.5, 0.25 hours predose and 0.08, 0.17, 0.33, 0.5, 0.67, 0.83, 1, 1.25, 1.5, 2, 3, 4, 6, 8 10, 14, 16, 20 and 24 hours postdose in each treatment period |
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| Secondary | Comparison of Prototype Mini Lozenges With Nicorette Mini Lozenge by Measuring Time of Maximum Plasma Nicotine Concentration (Tmax) | Tmax was defined as the time to maximum plasma nicotine concentration. If the maximum value occurred at more than one time point, Tmax was defined as the first time point with this value. | Analysis performed on PKAS1, that included all randomized participants who completed both periods, had no major protocol deviations concerning pharmacokinetics, excluding those with baseline nicotine concentration > 5% of individual Cmax for either period. | Posted | Median | Inter-Quartile Range | hour | 0.75, 0.5, 0.25 hours predose and 0.08, 0.17, 0.33, 0.5, 0.67, 0.83, 1, 1.25, 1.5, 2, 3, 4, 6, 8 10, 14, 16, 20 and 24 hours postdose in each treatment period |
|
|
|
| Secondary | Comparison of Prototype Mini Lozenges With Nicorette Mini Lozenge by Measuring Apparent Elimination Half-Life (t1/2) | t1/2 was defined as apparent elimination half-life that was calculated as t1/2 = ln(2) / Kel, where Kel= elimination rate constant. | Analysis performed on PKAS1, that included all randomized participants who completed both periods, had no major protocol deviations concerning pharmacokinetics, excluding those with baseline nicotine concentration > 5% of individual Cmax for either period. Here, number analyzed indicates participants with available data for this outcome measure. | Posted | Mean | Full Range | hour | 0.75, 0.5, 0.25 hours predose and 0.08, 0.17, 0.33, 0.5, 0.67, 0.83, 1, 1.25, 1.5, 2, 3, 4, 6, 8 10, 14, 16, 20 and 24 hours postdose in each treatment period |
|
|
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| Secondary | Comparison of Prototype Mini Lozenges With Nicorette Mini Lozenge by Measuring Apparent Elimination Rate Constant for Plasma Nicotine (Kel) | kel was defined as apparent elimination rate constant for plasma nicotine that was calculated as negative of the slope of a linear regression of the log(concentration)- time for all concentrations > lower limit of quantification. | Analysis performed on PKAS1, that included all randomized participants who completed both periods, had no major protocol deviations concerning pharmacokinetics, excluding those with baseline nicotine concentration > 5% of individual Cmax for either period. Here, number analyzed indicates participants with available data for this outcome measure. | Posted | Mean | Full Range | fraction per hour | 0.75, 0.5, 0.25 hours predose and 0.08, 0.17, 0.33, 0.5, 0.67, 0.83, 1, 1.25, 1.5, 2, 3, 4, 6, 8 10, 14, 16, 20 and 24 hours postdose in each treatment period |
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| Secondary | Number of Participants With Clinically Significant Change in Laboratory Test Values | Haematological, biochemistry and urinalysis parameters were analyzed. Clinical significance was judged by the investigator based upon the out of range values of standard range set for each parameter. | Safety population was defined as all randomized participants who received at least one dose of study medication. | Posted | Count of Participants | Participants | From signing of the informed consent form until 5 days after last administration of study drug (up to Day 13) |
|
|
|
| Primary | Assessment of Bioequivalence of Prototype Mini Lozenges With Nicorette Mini Lozenge by Measuring Maximum Observed Plasma Nicotine Concentration (Cmax) | Blood samples were collected at designated timepoints. Bioequivalence of prototype mini lozenges with nicorette mini lozenge was assessed by measuring Cmax that was taken directly from bioanalytical data. Geometric Coefficient of variation was provided as percentage. A linear mixed-effects model was fit to the natural log (ln)-transformed PK variable (Cmax) as the dependent variable, and treatment, period, and sequence as fixed effects. Participant nested within sequence was a random effect. The treatment difference and its 90% CI were exponentiated to obtain the GMR between the test and reference products and its 90% CI. Geometric Coefficient of variation was provided as percentage. | Analysis performed on PKAS1, that included all randomized participants who completed both periods, had no major protocol deviations concerning pharmacokinetics, excluding those with baseline nicotine concentration > 5% of individual Cmax for either period. | Posted | Geometric Mean | Geometric Coefficient of Variation | nanograms per milliliter | 0.75, 0.5, 0.25 hours predose and 0.08, 0.17, 0.33, 0.5, 0.67, 0.83, 1, 1.25, 1.5, 2, 3, 4, 6, 8 10, 14, 16, 20 and 24 hours postdose in each treatment period |
|
|
|
|
| 0 |
| 36 |
| 0 |
| 36 |
| 13 |
| 36 |
| EG001 | Nicorette Mini Lozenges | Participants randomized to receive a single dose of Treatment B: 4 mg of Nicorette Mini lozenge administered orally in either Treatment Period 1 (on Day 5 to 7) or Treatment Period 2 (Day 1). All these doses were administered after an overnight fast of at least 10 hours in each period. Participants were confined in the study facility for approximately 60 hours during each treatment period (for 36 hours predose and for 24 hours postdose) with abstinence from smoking during which they were subjected to random measurements of expired CO to confirm abstinence (CO levels must have been <= 10 ppm throughout the treatment period). | 0 | 35 | 0 | 35 | 6 | 35 |
| EG002 | All Treatment Combined | All randomized participants received either a single dose of TreatmentA:4mg of Prototype Mini Lozenge administered orally on Day0 in Treatment Period1 followed by TreatmentB:4mg of Nicorette Mini lozenge administered orally on any one day from Day 5-Day 7(depending upon washout period) in Treatment Period2 or vice versa. Washout period was of at least 5days to maximum of 7days between two treatment periods. All these doses were administered after an overnight fast of at least 10 hours in each period. Participants were confined in the study facility for approximately 60 hours during each treatment period (for 36 hours predose and for 24 hours postdose) with abstinence from smoking during which they were subjected to random measurements of expired CO to confirm abstinence (CO levels must have been <=10 ppm throughout the treatment period). | 0 | 37 | 0 | 37 | 16 | 37 |
| Dyspepsia | Gastrointestinal disorders | MedDRA (vs 21.0) | Systematic Assessment |
|
| Gingival oedema | Gastrointestinal disorders | MedDRA (vs 21.0) | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA (vs 21.0) | Systematic Assessment |
|
| Oral discomfort | Gastrointestinal disorders | MedDRA (vs 21.0) | Systematic Assessment |
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| Toothache | Gastrointestinal disorders | MedDRA (vs 21.0) | Systematic Assessment |
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| Chest discomfort | General disorders | MedDRA (vs 21.0) | Systematic Assessment |
|
| Post procedural complication | Injury, poisoning and procedural complications | MedDRA (vs 21.0) | Systematic Assessment |
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| Dizziness | Nervous system disorders | MedDRA (vs 21.0) | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA (vs 21.0) | Systematic Assessment |
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| Paraesthesia | Nervous system disorders | MedDRA (vs 21.0) | Systematic Assessment |
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| Anxiety | Psychiatric disorders | MedDRA (vs 21.0) | Systematic Assessment |
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| Hiccups | Respiratory, thoracic and mediastinal disorders | MedDRA (vs 21.0) | Systematic Assessment |
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| Oropharyngeal pain | Respiratory, thoracic and mediastinal disorders | MedDRA (vs 21.0) | Systematic Assessment |
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| Throat irritation | Respiratory, thoracic and mediastinal disorders | MedDRA (vs 21.0) | Systematic Assessment |
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| Rash macular | Skin and subcutaneous tissue disorders | MedDRA (vs 21.0) | Systematic Assessment |
|
GSK agreements may vary with individual investigators but will not prohibit any investigator from publishing. GSK supports the publication of results from all centers of a multi-center trial but requests that reports based on single-site data not precede the primary publication of the entire clinical trial.