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This is a phase I, open-label, two-part, fixed-sequence drug interaction study conducted to evaluate the effects of concomitant use of the potent CYP3A4 inhibitor itraconazole or the CYP3A4 inducer rifampin on the pharmacokinetics of Rocbrutinib in healthy subjects.
This study evaluated the changes in the pharmacokinetic profiles of Rocbrutinib under maximal CYP3A inhibition and induction conditions by investigating the co-administration of Rocbrutinib with potent CYP3A inhibitors or inducers at steady state, compared with Rocbrutinib administered alone.
To assess the potential clinical inhibition of OATP1B by Rocbrutinib, blank plasma samples were collected prior to Rocbrutinib administration and 24-hour plasma samples were collected post-administration. The concentration of coproporphyrin I (CP-I) in these samples was detected and analyzed.
Furthermore, the effect of P-gp inhibitors on the drug absorption of Rocbrutinib (when acting as a substrate) was evaluated by investigating two scenarios: co-administration of a single dose of Rocbrutinib with a single dose of the P-gp inhibitor rifampicin, and co-administration of a single dose of Rocbrutinib with the P-gp inhibitor itraconazole at steady state.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Inhibitor Group | Experimental | The Inhibitor Group was designed to investigate the drug-drug interaction between Rocbrutinib and itraconazole (a potent CYP3A inhibitor and P-gp inhibitor). Itraconazole is a recommended potent index CYP3A inhibitor for clinical studies in the ICH-M12 Guideline on Drug Interactions. In accordance with the recommendations in an industry white paper (CPT Pharmacometrics Syst Pharmacol. 2019 Aug 7;8(9):685-695), an initial loading dose of 400 mg followed by a maintenance dose of 200 mg once daily (QD) was selected as the itraconazole dosing regimen in this study. Based on the predicted proportion of plasma exposure of metabolites from previous mass balance studies and combined with the previously established safety profile of Rocbrutinib, potent CYP3A inhibition is expected to potentially significantly increase the plasma concentration of Rocbrutinib when co-administered. Therefore, the clinically confirmed minimum effective dose of Rocbrutinib (100 mg) was chosen for co-administration |
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| Inducer Group | Experimental | The Inducer Group was designed to investigate the drug-drug interaction between Rocbrutinib and rifampicin (a potent CYP3A inducer and P-gp inhibitor). Rifampicin is a recommended potent index CYP3A inducer for clinical studies in the ICH-M12 Guideline on Drug Interactions. The maximum dose and shortest dosing interval in its clinically recommended regimen is 600 mg once daily (QD), so 600 mg QD was selected as the rifampicin dosing regimen in this study. Potent CYP3A inducers are expected to either decrease the plasma concentration of Rocbrutinib or have no significant effect on it. Therefore, the clinically recommended higher dose of Rocbrutinib (200 mg) was chosen for co-administration with rifampicin in the Inducer Group. In Cycle 2, Rocbrutinib administration was initiated on Day 10 (the 7th day after the start of continuous rifampicin dosing) and continued until the day before the last blood collection for Rocbrutinib (Day 12), which was sufficient to cover the in vivo drug meta |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Rocbrutinib tablets | Drug | Dosage form: tablets Specification: 100 mg Dosage and administration: 100mg or 200mg, single dose, taken on the designated day according to the treatment plan. Dosage schedule: Depending on the cohort, subjects will need to take Rocbrutinib 2 times (inhibitor cohort) or 3 times (inducer cohort) during the study period. |
| Measure | Description | Time Frame |
|---|---|---|
| AUC | Area under the curve | Until 72 hours or 96 hours after Rocbrutinib |
| Cmax | Plasma peak concentration of Rocbrutinib | Until 72 hours or 96 hours after Rocbrutinib |
| t1/2 | Terminal phase half-life of Rocbrutinib | Until 72 hours or 96 hours after Rocbrutinib |
| Measure | Description | Time Frame |
|---|---|---|
| Plasma coprophyrin I (CP-I) concentration | Plasma coprophyrin I (CP-I) concentration | Baseline and 24 hours after Rocbrutinib |
| Adverse events | Adverse events were evaluated by investigators based on clinical examination findings and observations in accordance with the CTCAE Version 5.0 criteria. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Dongyang Prof. Liu, PhD | Contact | +8618610966092 | liudongyang@vip.sina.com | |
| Fangfang Dr. Wang, MD | Contact | +8601082266226 | doctorfancy@126.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking University Third Hospital | Recruiting | Beijing | Beijing Municipality | 100070 | China |
Since this is a clinical pharmacology study enrolling healthy subjects, it is planned to report the study results through peer-reviewed publications, and individual participant data will not be shared.
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| Itraconazole capsules | Drug | Dosage form: Capsules Specifications: 0.1g Dosage and administration: Take 400 mg (4*100 mg capsules) on Day 5, followed by 200 mg (2 100 mg capsules) once daily (QD) from Day 6 to Day 12. Duration of medication: The medication was administered for a total of 8 days during the study period. |
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| Rifampicin capsules | Drug | Dosage form: Capsules Specifications: 0.15g Dosage and administration: Day 4-Day 12, take 600 mg (4 150 mg capsules) once daily (QD). Duration of medication: The medication was administered for a total of 9 days during the study period. |
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| Up to 20 days after Rocbrutinib |
| ID | Term |
|---|---|
| D017964 | Itraconazole |
| D012293 | Rifampin |
| ID | Term |
|---|---|
| D014230 | Triazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D010879 | Piperazines |
| D012294 | Rifamycins |
| D006576 | Heterocyclic Compounds, 4 or More Rings |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D047029 | Lactams, Macrocyclic |
| D047028 | Macrocyclic Compounds |
| D011083 | Polycyclic Compounds |
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