Skip to main content
OpenTrials
Completed

NCT Number: NCT04873063

Evaluation of Systemic Bioavailability and Effects on 24-Hour Plasma Cortisol Profile of 6 mg Delivered Once Daily Versus 3 mg Delivered Twice Daily in Healthy Adult Male Volunteers

Single-centre, randomized, double-blind, two-period, two-sequence, cross-over 7-day study.

This study is the first safety/tolerability evaluation of a product -suppository formulation containing 6 mg BDP (once daily dosing), a second-generation oral or rectal corticosteroids with high topical anti-inflammatory efficacy in the gut and minimal systemic bioavailability (BA).

BDP is marketed in different pharmaceutical formulations, including 3 mg suppositories, and approved for ulcerative proctosigmoiditis in the first attack or exacerbation phase at the dosage of 3 mg twice a day. For these reasons, a 6 mg suppository (Test - "T" product) is a scale-up of the 3 mg formulation (Reference - "R" product).

For locally-applied-locally acting drug products that result in quantifiable systemic availability due to absorption from the administration site, relative systemic BA is informative for safety, but also with respect to efficacy. Therefore, safety/tolerability of T is evaluated through a comparison to R.

Completed

Looking for future studies?

Notify Me

Key information

Age range

18 year–55 year

Sex eligibility

Male

Study type

Interventional

Phase

Phase 1

Primary location

Centro Ricerche Cliniche AOU Integrata di Verona - Policlinico Universitario G.B. Rossi

Verona, 37134, Italy

About this study

Primary objective is the evaluation of systemic safety of T, based on valid surrogate outcomes - systemic BA (relative BA) at the start of treatment (first 24 hours) and after 7 days of continuous treatment; effects on the hypothalamo-pituitary-adrenal axis (HPA) assessed based on 24-hour cortisol profile after 7 days of continuous treatment. This includes identification of subjects with cortisol levels <10 μg/dL at the last sampling point in the 24-hour cortisol profile (08:00 a.m. on Day 8). In such cases, identified subjects will undergo ACTH stimulation test in the morning of Day 9.

Secondary objective is the evaluation of safety/tolerability based on clinical and laboratory adverse events.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Healthy male, aged between 18 and 55 years. Healthy subjects are defined as individuals who are free from clinically significant illness or disease as determined by their medical history, physical examination, laboratory and other (e.g. ECG) tests.
  • BMI 19.0 - 29.0 kg/m2;
  • Signed and dated written informed consent of the subject to participate in the clinical study;
  • The subject is willing to refrain from the use of illicit drugs and alcohol and to adhere to other protocol-stated restrictions while participating in the study;
  • The subject is able to understand and comply with the protocol requirements and instructions and is likely to complete the study as planned;
  • Non-smoker for at least 3 months.

Exclusion criteria

  • Subject with a significant abnormality in the past and/or at the Screening that influences the present general health condition and requires pharmacological treatment during the study;
  • History of serious allergic diseases, including allergy to medicinal products, which in opinion of the investigator, contraindicates participation to the trial;
  • History of diseases of the alimentary tract, liver or kidneys that may influence absorption, distribution and elimination;
  • History of average alcohol consumption;
  • Hypersensitivity to BDP or study products inactive ingredients;
  • Use of any pharmacological treatments (including high dose vitamins, lozenges, herbal and dietary supplements), with the exception of paracetamol ≤ 1 g/daily, within 15 days before the admission to the study Site in the Period 1;
  • Use of steroids, anabolic or hormonal therapy within 3 months before the admission to the study Site in the Period 1;
  • Laboratory indication of adrenocortical dysfunction;
  • Blood loss exceeding 200 ml over the last 4 weeks before the day of Screening;
  • Positive results to Sars Cov-2 nasopharyngeal swab;
  • Positive results of HBsAg, anti-HCV, anti-HIV tests;
  • Blood pressure: systolic >140mmHg or < 90mmHg, diastolic <60 mmHg or >90 mmHg during screening procedures;
  • Subject who adhere to a special diet (e.g. low calories, vegetarian etc.);
  • Consumption of products containing methylxanthines in the following average quantities: > 3 cups of 200 ml of strong coffee a day;
  • Presence of metabolites of illicit drugs (opioids, cannabis) during screening procedures;
  • Participation in other clinical trials during the 6 months preceding the study, counting from the day of last product administration.

Treatment and study plan

Beclomethasone dipropionate

Drug

BDP 3 mg bid (R product) BDP 6 mg qd (T product)

Other names: Beclomethasone 17,21-dipropionate, BDP

Primary outcomes

  1. Pharmacokinetics - Cmax, morning;

    Time frame: Day 1 and Day 7 of each Period

    Peak exposure after the morning dose (Cmax, morning)

  2. Pharmacokinetics - Cmax, evening;

    Time frame: Day 1 and Day 7 of each Period

    Peak exposure after the evening dose (Cmax, evening)

  3. Pharmacokinetics - AUC0-24

    Time frame: Day 1 and Day 7 of each Period

    • Total exposure over 24 hours (AUC0-24)
  4. Pharmacokinetics - AUC0-12

    Time frame: Day 1 and Day 7 of each Period

    • Total exposure during dosing interval - morning (AUC0-12)
  5. Pharmacokinetics - AUC12-24

    Time frame: Day 1 and Day 7 of each Period

    • Total exposure during dosing interval - evening (AUC12-24)
  6. HPA-axis: 24-hour plasma cortisol - AUC0-24, cortisol

    Time frame: Baseline and Day 7 of each Period

    Area under the cortisol level-time curve over 24 hours (AUC0-24, cortisol). AUC will be determined for each subject/treatment at baseline and at Day 7 by the linear trapezoidal rule and ln-transformed.

    Ln(AUCs) will be used to determine intra-subject difference Day 7 - baseline that will be subject to analysis.

  7. HPA-axis: 24-hour plasma cortisol - AUC0-12, cortisol

    Time frame: Baseline and Day 7 of each Period

    Area under the cortisol level-time curve over 12 hours after the morning dose (AUC0-12, cortisol).

    As above.

  8. HPA-axis: 24-hour plasma cortisol - AUC12-24, cortisol

    Time frame: Baseline and Day 7 of each Period

    Area under the cortisol level-time curve over 12 hours after the evening dose (AUC12-24, cortisol).

    As above.

  9. HPA-axis: 24-hour plasma cortisol - pAUC2-8, cortisol

    Time frame: Baseline and Day 7 of each Period

    Partial area under the cortisol level-time curve "covering" 3rd, 4th, 5th, 6th, 7th and 8th hour post morning dose (i.e., between 10:00 and 16:00 hours, that is, between sampling times at 2 and 8 hours post-dose) - a time period during which normal cortisol levels are still relatively high and the strongest suppression after morning dose could be expected (pAUC2-8, cortisol).

    As above.

Secondary outcomes

  1. Pharmacokinetics - trough concentrations

    Time frame: Day 1 and Day 7 of each Period

    Trough concentrations for R (C12) and T (C24) dosing on Day 1 and Day 7 as well as morning pre-dose (C0)

  2. Pharmacokinetics - Cmax morning/AUC0-12 ratio

    Time frame: Day 1 and Day 7 of each Period

    Ratio of the peak exposure after the morning dose to exposure over the subsequent 12 hours (illustrates absorption rate) (Cmax,morning/AUC0-12)

  3. Pharmacokinetics - Tmax, morning

    Time frame: Day 1 and Day 7 of each Period

    Time to peak exposure after the morning dose (Tmax,morning)

  4. Pharmacokinetics - Percent fluctuation (%PTF12)

    Time frame: Day 7 of each Period

    Day 7 - percent fluctuation over 12 hours after morning dose (%PTF12)

  5. Pharmacokinetics - Percent fluctuation (%PTF24)

    Time frame: Day 7 of each Period

    Day 7 - percent fluctuation over 24 hours (%PTF24)

  6. Pharmacokinetics - Accumulation ratio

    Time frame: Day 1 and Day 7 of each Period

    Accumulation ratio (Cmax,morning Day 7/Day 1; AUC0-24 Day 7/Day 1). Accumulation ratio will be estimated based on two outcomes: peak exposure after the morning dose (Cmax, morning) and total exposure over 24 hours (AUC0-24).

  7. HPA axis - Number (proportion) of subjects with cortisol <10 μg/dL

    Time frame: Day 8 and 9 of each Period

    ACTH stimulation test results on the morning of Day 9 (first post-dosing day) dichotomized as "normal" or "abnormal"

  8. HPA axis - Number/proportion of subjects with abnormal ACTH stimulation test.

    Time frame: Day 8 and 9 of each Period

    Number (proportion) of subjects with cortisol levels <10 μg/dL at 08:00 a.m. on Day 8 and number (proportion) of subjects with abnormal ACTH stimulation test results in the morning of Day 9 (should any subject be submitted).

  9. HPA axis - 24-hour cortisol profile

    Time frame: Baseline and Day 7 of each Period

    24-hour cortisol profile: time-point-by-time-point differences Day 7 vs. baseline

Other outcomes

  1. Safety - Adverse Events

    Time frame: From screening to follow up (approximately 59 days)

    Adverse events reporting

  2. Safety - Laboratory values

    Time frame: At screening, before each period and at follow-up (+21 days after the end of Period 2)

    Incidence of abnormal laboratory test results (Urinalysis, biochemical and haematological tests performed)

Sponsors and collaborators

Lead sponsor

SOFAR S.p.A.

Industry

Registry information

Official study title

Explorative Study of the Safety/Tolerability of Beclomethasone Dipropionate Suppositories: Evaluation of Systemic Bioavailability and Effects on 24-Hour Plasma Cortisol Profile of 6 mg Delivered Once Daily Versus 3 mg Delivered Twice Daily in Healthy Adult Male Volunteers

Important dates

Study start
2021
Primary completion
2022
Study completion
2022
First posted
May 5, 2021
Registry last updated
May 4, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.