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NCT Number: NCT05588323

Safety and Pharmacokinetics Study of Naldemedine in Paediatric Participants Receiving Opioids

The primary objective of this study is to evaluate the pharmacokinetic (PK) profile of naldemedine and nor-naldemedine after a single oral dose of naldemedine in pediatric participants who are receiving or about to receive opioids.

Recruiting

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Key information

Age range

2 year–18 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1 / Phase 2

Primary location

University Center Mother Theresa , Hospital - Onco-hematology department, Tirana, Albania

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Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

Disease Characteristics

  • Participants with cancer or non-cancer pain who are receiving (or who are about to receive) acute or chronic treatment with opioids.
  • Participants with either newly diagnosed constipation, a history of constipation treated with laxatives, or are expected to develop constipation after opioid treatment.
  • Able to remain in the clinic for blood sampling for at least 12 hours following the first study intervention dose and are able to return for blood sampling at the 24-hour time point.

Weight

  • Body mass index within approximately the 3rd to 97th percentile for their age according to the World Health Organization Child Growth Standards.

Exclusion criteria

Medical Conditions

  • History of a gastrointestinal (GI) neoplasm or an ongoing GI-related issue or any recent (within last 1 year) or planned GI tract surgery.
  • Signs or symptoms of GI obstruction or participants with recurrent obstruction who may be at increased risk of GI perforation.
  • Inability to eat/swallow or have need of a nasogastric tube.
  • No bowel movements reported for 7 consecutive days at the time of obtaining informed consent or on the initial day of study intervention administration (Study Day 1).
  • History of more than 1 week of Common Terminology Criteria for Adverse Events (CTCAE) Grade 3 neutropenia or thrombocytopenia with clinical sequelae.
  • Participants who need mechanical ventilation.
  • Severe CTCAE Grade 3 or above hepatic or renal impairment including end-stage renal disease requiring hemodialysis, as determined by the investigator.
  • Progressive neurological disorders or potential disruption to the blood-brain barrier (for example, primary brain malignancies, central nervous system metastases, active multiple sclerosis, etc.) considering the risk of opioid withdrawal or reduced analgesia.

Prior/Ongoing Medications

  • Currently receiving the first cycle of chemotherapy.
  • Previously received naldemedine.

Other Exclusions

  • Positive pregnancy test for females of childbearing potential.

Note: Other protocol-defined Inclusion/Exclusion criteria may apply.

Treatment and study plan

Naldemedine

Drug

Administered as an oral tablet (0.2 mg dose level only), or oral suspension (all dose levels)

Other names: Rizmoic

Primary outcomes

  1. Maximum Plasma Concentration (Cmax) of Naldemedine and Nor-naldemedine

    Time frame: Day 1: 0.5, 1, 5, and 12 hours postdose; Day 2: 24 hours post Day 1 dose, before administering the Day 2 dose; Day 7 (Cohort 1 only): Predose and 1 hour postdose

  2. Time to Achieve Maximum Plasma Concentration (Tmax) of Naldemedine and Nor-naldemedine

    Time frame: Day 1: 0.5, 1, 5, and 12 hours postdose; Day 2: 24 hours post Day 1 dose, before administering the Day 2 dose; Day 7 (Cohort 1 only): Predose and 1 hour postdose

  3. Area Under the Plasma Concentration-Time Curve From Time Zero to the Time of the Last Quantifiable Concentration (AUC0-last) of Naldemedine and Nor-naldemedine

    Time frame: Day 1: 0.5, 1, 5, and 12 hours postdose; Day 2: 24 hours post Day 1 dose, before administering the Day 2 dose; Day 7 (Cohort 1 only): Predose and 1 hour postdose

  4. AUC Extrapolated From Time Zero to Infinity (AUC0-inf) of Naldemedine and Nor-naldemedine

    Time frame: Day 1: 0.5, 1, 5, and 12 hours postdose; Day 2: 24 hours post Day 1 dose, before administering the Day 2 dose; Day 7 (Cohort 1 only): Predose and 1 hour postdose

  5. Terminal Elimination Rate Constant (λz) of Naldemedine and Nor-naldemedine

    Time frame: Day 1: 0.5, 1, 5, and 12 hours postdose; Day 2: 24 hours post Day 1 dose, before administering the Day 2 dose; Day 7 (Cohort 1 only): Predose and 1 hour postdose

  6. Terminal Elimination Half-life (t1/2,z) of Naldemedine and Nor-naldemedine

    Time frame: Day 1: 0.5, 1, 5, and 12 hours postdose; Day 2: 24 hours post Day 1 dose, before administering the Day 2 dose; Day 7 (Cohort 1 only): Predose and 1 hour postdose

  7. Apparent Total Clearance (CL/F) of Naldemedine

    Time frame: Day 1: 0.5, 1, 5, and 12 hours postdose; Day 2: 24 hours post Day 1 dose, before administering the Day 2 dose; Day 7 (Cohort 1 only): Predose and 1 hour postdose

  8. Mean Residence Time (MRT) of Naldemedine

    Time frame: Day 1: 0.5, 1, 5, and 12 hours postdose; Day 2: 24 hours post Day 1 dose, before administering the Day 2 dose; Day 7 (Cohort 1 only): Predose and 1 hour postdose

  9. Apparent Volume of Distribution in the Terminal Phase (Vz/F) of Naldemedine

    Time frame: Day 1: 0.5, 1, 5, and 12 hours postdose; Day 2: 24 hours post Day 1 dose, before administering the Day 2 dose; Day 7 (Cohort 1 only): Predose and 1 hour postdose

  10. Metabolic Ratio of Cmax of Nor-naldemedine to Cmax of Naldemedine (MRM/U, Cmax) for Nor-naldemedine

    Time frame: Day 1: 0.5, 1, 5, and 12 hours postdose; Day 2: 24 hours post Day 1 dose, before administering the Day 2 dose; Day 7 (Cohort 1 only): Predose and 1 hour postdose

  11. Metabolic Ratio of AUC of Nor-naldemedine to AUC of Naldemedine (MRM/U, AUC) for Nor-naldemedine

    Time frame: Day 1: 0.5, 1, 5, and 12 hours postdose; Day 2: 24 hours post Day 1 dose, before administering the Day 2 dose; Day 7 (Cohort 1 only): Predose and 1 hour postdose

Secondary outcomes

  1. Number of Participants Experiencing Treatment-emergent Adverse Events

    Time frame: Day 1 through Day 7

  2. Population PK Analysis: Cmax of Naldemedine

    Time frame: Day 1 through Day 7

  3. Population PK Analysis: Tmax of Naldemedine

    Time frame: Day 1 through Day 7

  4. Population PK Analysis: AUC From Time Zero to tau (AUC0-tau) of Naldemedine

    Time frame: Day 1 through Day 7

  5. Population PK Analysis: Accumulation Ratio for Cmax Calculated as Ratio of Day 7 to Day 1 Cmax (RCmax) of Naldemedine

    Time frame: Day 1 through Day 7

  6. Population PK Analysis: Accumulation Ratio for AUC Calculated as Ratio of Day 7 to Day 1 AUC (RAUC) of Naldemedine

    Time frame: Day 1 through Day 7

  7. Palatability of Naldemedine Powder for Oral Suspension in Participants Aged 6 Years and Above

    Time frame: Day 1 through Day 7

    Palatability will be assessed by participant self-reporting using a visual analogue scale (VAS).

  8. Palatability of Naldemedine Powder for Oral Suspension in Participants Aged 2 to Less Than 6 Years

    Time frame: Day 1 through Day 7

    Palatability will be assessed by the investigator or a participant's parent/legal guardian and, if possible, by participant self-reporting using a VAS with facial hedonic scale.

  9. Ability to Swallow Naldemedine Tablets

    Time frame: Day 1 through Day 7

    Ability to swallow will be assessed by self-reported ease of swallowing after the first dose. Willingness to swallow will be assessed based on the participant's behavior indicative of a negative response and the response to the taste of naldemedine powder for oral suspension formulation compared to the participant's response to all other oral medications currently being given.

Study contacts

Contact information is provided by the study sponsor or research team.

Shionogi Clinical Trials Administrator Clinical Support Help Line

CONTACT

[email protected]

800-849-9707

Sponsors and collaborators

Lead sponsor

Shionogi

Industry

Registry information

Official study title

A Phase 1/2, Multicentre, Open-label Study to Evaluate the Pharmacokinetics, Safety, and Tolerability of Naldemedine in Paediatric Patients Who Are Receiving or Who Are About to Receive Treatment With Opioids

Important dates

Study start
2023
Primary completion
2028
Study completion
2028
First posted
Oct 20, 2022
Registry last updated
Jul 28, 2026

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.

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