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| Name | Class |
|---|---|
| Institute for Developing Science and Health Initiatives, Bangladesh | OTHER |
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Erythropoietin is a glycoprotein which stimulates red blood cell production. It is produced in the kidney and stimulates the division and differentiation of committed erythroid progenitors in the bone marrow. Erythropoietin, a 165 amino acid glycoprotein manufactured by recombinant DNA technology, has the same biological effects as endogenous erythropoietin. Erythropoietin binds to the surface receptor of erythroid precursor cells and activates signal transduction pathways that interfere with apoptosis and stimulates erythroid cell proliferation. Recombinant human erythropoietin is a substitute for the deficiency observed in CKD, therapy of anemia often involves many other issues such as Anemia in patients with non-myeloid malignancies where anemia is due to the effect of concomitantly administered chemotherapy, Anemic patients (hemoglobin > 10 to < 13 g/dL) scheduled to undergo elective, noncardiac, nonvascular surgery to reduce the need for allogeneic blood transfusions, Anemia related to therapy with zidovudine in HIV-infected patients are also needed to be considered in order to effectively correct anemia, reduce costs and minimize side effects.
In this study, 56 healthy adult volunteers will participate in a randomized, double-blinded, balanced, two-treatment, two-period, two-sequence, single-dose crossover trial. Each subject will receive a single subcutaneous injection of either Erythropoietin 4000 IU manufactured by Incepta Pharmaceuticals Ltd (test product) or Eprex 4000 IU manufactured by Janssen-Cilag Ltd (reference product) under fasting conditions, with a 28-day washout period between doses. The primary aim of the study is to compare the pharmacokinetic and pharmacodynamic profiles of the two products. Additionally, the study will assess immunogenicity by measuring serum anti-drug antibodies (ADA) and evaluate the safety of both formulations throughout the study duration.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Erythropoietin 4000 IU Injection of Incepta Pharmaceuticals Ltd | Experimental | Erythropoietin 4000 IU Injection, subcutaneous injection manufactured by Incepta Pharmaceuticals Ltd will be administered. |
|
| Eprex 4000 by Janssen-Cilag Ltd | Active Comparator | Eprex 4000, subcutaneous injection manufactured by Janssen-Cilag Ltd will be administered. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Erythropoietin alfa | Biological | Erythropoietin 4000 IU Injection, for subcutaneous injection. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Peak Plasma Concentration (Cmax) | The PK parameter Cmax shall be calculated by noncompartmental analysis using Phoenix® WinNonlin. The maximum observed serum EPO concentration (Cmax) shall be directly obtained from the data. | 144.00±1* hours following drug administration after each dose. |
| Reticulocyte count (%) | As primary PD parameter, maximum effect change (Delta Emax) and the area under the baseline-adjusted effect curve (Delta AUEC) shall be calculated by the linear trapezoidal method for the RET count. | 312±1 hours post dose. |
| Area under the plasma concentration versus time curve (AUC) | The PK parameters shall be calculated by noncompartmental analysis using Phoenix® WinNonlin. The maximum observed serum EPO concentration (Cmax) and the time of Cmax (Tmax) shall be directly obtained from the data. The AUClast shall be calculated by the linear trapezoidal method up to Tmax and by the log trapezoidal method after Tmax. The area under the curve extrapolated to infinity (AUCinf) shall be obtained with the following formula: AUCinf=AUClast+Clast, where Clast is the last observed serum EPO concentration and lambda z is a calculated terminal elimination rate constant. | 144.00±1* hours following drug administration |
| Measure | Description | Time Frame |
|---|---|---|
| t1/2 | The terminal half-life (t1/2) shall be calculated by dividing natural-log2 by lambda z. | 144.00±1* hours following drug administration. |
| Immunogenicity | By measuring Anti-drug Antibody (ADA) formation. |
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Inclusion Criteria:
• Age ≥ 18 years.
BMI of 18.0-30.0kg/m2.
Voluntarily participants who agree to observe the precautions in writing after receiving a complete explanation of this trial.
Willingness and ability to undertake all scheduled visits and assessments.
Subject who have no evidence of underlying disease during screening, medical history and whose physical examination is performed within 28 days prior to commencement of the study.
Subjects whose screening laboratory values are within normal limits or considered by the Investigator to be of no clinical significance.
Non-smokers, ex-smokers and light smokers can be included in the study. "Light smokers are defined as someone smoking < 10 cigarettes per day, ex-smokers as someone who completely stopped smoking for at least 03 months.
No alcohol dependence, alcohol abuse or drug abuse (Amphetamines, Cocaine, Tetra Hydro Cannabinoids, Benzodiazepines, Barbiturates and Opioids) within the past one year.
Subjects should not have consumed grape fruit juice or its products 72 hours before dosing and throughout the study periods.
For Female Subjects:
Exclusion Criteria:
• Subjects with any previous exposure to erythropoiesis stimulating agents.
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Faez Ahmed | Contact | +8801714086066 | +88028891688 | faez@inceptapharma.com |
| Name | Affiliation | Role |
|---|---|---|
| Dr. Umme Kulsum | Institute for developing Science and Health initiatives (ideSHi), Dhaka-1206, Bangladesh | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Universal Medical College and Hospital | Recruiting | Dhaka | Dhaka Division | 1215 | Bangladesh |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22162538 | Result | Yan X, Lowe PJ, Fink M, Berghout A, Balser S, Krzyzanski W. Population pharmacokinetic and pharmacodynamic model-based comparability assessment of a recombinant human Epoetin Alfa and the Biosimilar HX575. J Clin Pharmacol. 2012 Nov;52(11):1624-44. doi: 10.1177/0091270011421911. Epub 2011 Dec 12. | |
| 29138535 | Result |
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By publication in the journal
After completion of study
Journal
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| At 00.00 hours of period I and at 312±1 hours post dose of period II |
| Hemoglobin | Mean absolute change in Hb levels between the baseline period (pre dose) and the evaluation period. | From baseline and up to 312±1 hours following drug administration |
| Yoon S, Rhee SJ, Heo SJ, Oh TY, Yoon SH, Cho JY, Lee S, Yu KS. Comparable pharmacokinetics and pharmacodynamics of two epoetin alfa formulations Eporon(R) and Eprex(R) following a single subcutaneous administration in healthy male volunteers. Drug Des Devel Ther. 2017 Oct 27;11:3127-3135. doi: 10.2147/DDDT.S142673. eCollection 2017. |
| 18922615 | Result | Elliott S, Pham E, Macdougall IC. Erythropoietins: a common mechanism of action. Exp Hematol. 2008 Dec;36(12):1573-84. doi: 10.1016/j.exphem.2008.08.003. Epub 2008 Oct 14. |
| 35817525 | Result | Rashidi A, Garimella PS, Al-Asaad A, Kharadjian T, Torres MN, Thakkar J. Anemia Management in the Cancer Patient With CKD and End-Stage Kidney Disease. Adv Chronic Kidney Dis. 2022 Mar;29(2):180-187.e1. doi: 10.1053/j.ackd.2022.03.005. |
| 33842503 | Result | Portoles J, Martin L, Broseta JJ, Cases A. Anemia in Chronic Kidney Disease: From Pathophysiology and Current Treatments, to Future Agents. Front Med (Lausanne). 2021 Mar 26;8:642296. doi: 10.3389/fmed.2021.642296. eCollection 2021. |
| 24273483 | Result | Jelkmann W. Physiology and pharmacology of erythropoietin. Transfus Med Hemother. 2013 Oct;40(5):302-9. doi: 10.1159/000356193. Epub 2013 Jul 19. |