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The primary purpose of this study is to assess the effect of mitapivat on the single oral dose pharmacokinetics (PK) of midazolam in healthy participants.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mitapivat and Midazolam | Experimental | Participants will receive single oral dose of 2 milligram (mg) midazolam on Day 1 followed by 100 mg mitapivat, orally, twice daily (BID) from Day 3 to 13. On Day 14, participants will receive single oral dose of 2 mg midazolam and 100 mg mitapivat orally, BID. Midazolam will be co-administered with morning mitapivat dose. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mitapivat | Drug | Oral tablets |
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| Measure | Description | Time Frame |
|---|---|---|
| Area Under the Plasma Concentration-Time Curve Extrapolated From Time Zero to Infinity (AUC0-infinity) of Midazolam | Pre-dose and at multiple timepoints post-dose up to Day 14 | |
| Area Under the Plasma Concentration-Time Curve From Time Zero to the Time of Last Quantifiable Concentration (AUC0-t) of Midazolam | Pre-dose and at multiple timepoints post-dose up to Day 14 | |
| Maximum Observed Plasma Concentration (Cmax) of Midazolam | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Measure | Description | Time Frame |
|---|---|---|
| Area Under the Plasma Concentration-Time Curve From Time Zero to 12 Hours Post-dose (AUC0-12) of Mitapivat | Pre-dose and at multiple timepoints post-dose up to Day 14 | |
| Maximum Observed Plasma Concentration (Cmax) of Mitapivat | Pre-dose and at multiple timepoints post-dose up to Day 14 |
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Inclusion Criteria:
Exclusion Criteria:
Significant history or clinical manifestation of any metabolic, allergic, dermatological, hepatic, renal, hematological, pulmonary, cardiovascular, gastrointestinal, neurological, respiratory, endocrine, ophthalmological (acute angle closure glaucoma), or psychiatric disorder, as determined by the investigator or designee.
History of significant hypersensitivity, intolerance, or allergy to any relevant drug compound, food, or other substance (ie, allergy to study intervention or excipients [microcrystalline cellulose, croscarmellose sodium, sodium stearyl fumarate, mannitol, magnesium stearate, and the Opadry Blue II film-coat [hypromellose, titanium dioxide, lactose monohydrate, triacetin, and FD&C Blue #2]]).
History of stomach or intestinal surgery or resection that would potentially alter absorption and/or excretion of orally administered drugs (e.g., cholecystectomy). Uncomplicated appendectomy and hernia repair are allowed.
Significant acute, new-onset illness (e.g., flu, gastroenteritis) within 2 weeks prior to dosing.
Confirmed systolic blood pressure >150 or <90 millimeters of mercury (mmHg), diastolic blood pressure >100 or <50 mmHg, or pulse rate >100 or <40 beats per minute (bpm). If any parameter falls outside of the specified range at screening or check-in, 2 repeat measurements will be performed and the participant will be excluded only if the mean of the parameter based on the 3 replicates falls outside of the specified range.
Clinically significant cardiac history or presence of ECG findings, including any of the following:
Positive hepatitis panel and/or positive human immunodeficiency virus test.
Administration of any vaccine within 30 days prior to dosing.
Use or intend to use any medications/products known to alter drug absorption, metabolism, or elimination processes, including St. John's wort, within 30 days prior to dosing, considered to potentially impact participant safety or the objectives of the study, as determined by the investigator or designee.
Use or intend to use any prescription medications/products, other than non-hormonal contraceptives, within 14 days prior to dosing, considered to potentially impact participant safety or the objectives of the study, as determined by the investigator or designee.
Use or intend to use any slow-release medications/products considered to still be active within 14 days prior to dosing, considered to potentially impact participant safety or the objectives of the study, as determined by the investigator or designee.
Use or intend to use any nonprescription medications/products including vitamins, minerals, high-dose biotin supplements and other supplements, and phytotherapeutic/herbal/plant-derived preparations within 7 days prior to dosing, considered to potentially impact participant safety or the objectives of the study, as determined by the investigator or designee.
Participation in a clinical study involving administration of an investigational medicinal product (new chemical entity) in the past 30 days or 5 half-lives of that drug (if known) prior to dosing, whichever is longer.
Has previously completed or withdrawn from this study or any other study investigating mitapivat and has previously received mitapivat.
Alcohol consumption of >21 units per week for males and >14 units for females. One unit of alcohol equals 12-ounce (oz) (360 mL) beer, 1½ oz (45 mL) liquor, or 5 oz (150 mL) wine.
Positive urine drug screen at screening; positive alcohol test result or positive urine drug screen at check-in.
History of alcoholism or drug/chemical abuse within 2 years prior to check-in.
Use of tobacco- or nicotine-containing products within 3 months prior to check-in, or positive cotinine at screening or check-in. Ingestion of poppy seed-, Seville orange-, or grapefruit-containing foods or beverages within 7 days prior to check-in and not willing to refrain from consumption of these foods or beverages throughout the study until end of study.
Consumption of caffeine- or xanthine-containing products within 48 hours prior to check-in and not willing to refrain from consumption of these products while at the study site.
Consumption of vegetables from the mustard green family (e.g., kale, broccoli, watercress, collard greens, kohlrabi, Brussel sprouts, and mustard greens), or charbroiled meat within 7 days prior to dosing and not willing to refrain from consumption of these foods until end of study.
Receipt of blood products within 2 months prior to check-in.
Donation of blood from 3 months prior to screening, plasma from 2 weeks prior to screening, or platelets from 6 weeks prior to screening.
Poor peripheral venous access.
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| Name | Affiliation | Role |
|---|---|---|
| Medical Affairs | Agios Pharmaceuticals, Inc. | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Fortrea Clinical Research Unit Inc. | Dallas | Texas | 75247 | United States |
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| ID | Term |
|---|---|
| C000634504 | mitapivat |
| D008874 | Midazolam |
| ID | Term |
|---|---|
| D001569 | Benzodiazepines |
| D001552 | Benzazepines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
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Single sequence crossover design
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| Midazolam | Drug | Oral syrup |
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| Area Under the Plasma Concentration-Time Curve Over a Dosing Interval (Tau) at Steady State (AUC0-tau,ss) of Mitapivat | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Maximum Observed Plasma Concentration at Steady State (Cmax,ss) of Mitapivat | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Time to Last Measurable Concentration (tlast) of Mitapivat | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Time to Reach Maximum Concentration (tmax) of Mitapivat | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Area Under the Plasma Concentration-Time Curve Extrapolated to Infinity (AUC0-infinity) of 1'-hydroxymidazolam | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Area Under the Plasma Concentration-Time Curve From Time Zero to the Time of Last Quantifiable Concentration (AUC0-t) of 1'-hydroxymidazolam | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Maximum Observed Plasma Concentration (Cmax) of 1'-hydroxymidazolam | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Metabolite-to-Parent Ratio of Area Under the Plasma Concentration-Time Curve Extrapolated to Infinity (AUC0-infinity) for Midazolam and 1'-hydroxymidazolam | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Metabolite-to-Parent Ratios of Area Under the Plasma Concentration-Time Curve From Time Zero to the Time of Last Quantifiable Concentration (AUC0-t) for Midazolam and 1'-hydroxymidazolam | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Metabolite-to-Parent Ratio of Maximum Observed Plasma Concentration (Cmax) for Midazolam and 1'-hydroxymidazolam | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Percentage of Area Under the Concentration-Time Curve Due to Extrapolation From the Last Quantifiable Concentration to Infinity (AUC%extrap) of Midazolam and 1'-hydroxymidazolam | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Time to Last Measurable Concentration (tlast) of Midazolam and 1'-hydroxymidazolam | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Time to Reach Maximum Concentration (tmax) of Midazolam and 1'-hydroxymidazolam | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Terminal Elimination Half-Life (t1/2) of Midazolam and 1'-hydroxymidazolam | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Apparent Total Body Clearance (CL/F) of Midazolam and 1'-hydroxymidazolam | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Apparent Volume of Distribution During the Terminal Phase (Vz/F) of Midazolam and 1'-hydroxymidazolam | Pre-dose and at multiple timepoints post-dose up to Day 14 |
| Number of Participants With Adverse Events (AEs), AEs by Severity, and Relatedness to Study Treatment | Up to Day 24 |
| Number of Participants With Clinically Significant Change From Baseline in Clinical Laboratory Assessments | Baseline up to Day 24 |
| Number of Participants With Clinically Significant Change From Baseline in 12-lead Electrocardiogram (ECG) Parameters | Baseline up to Day 14 |
| Number of Participants With Clinically Significant Change From Baseline in Vital Signs Parameters | Baseline up to Day 24 |
| D006571 | Heterocyclic Compounds |