Study to Evaluate the Pharmacokinetics and Safety of GSK2336805 in Subjects With Hepatic Impairment and Healthy Matched Control Subjects



Status:Completed
Conditions:Gastrointestinal, Hepatitis
Therapuetic Areas:Gastroenterology, Immunology / Infectious Diseases
Healthy:No
Age Range:18 - 74
Updated:5/3/2014
Start Date:May 2013
End Date:March 2014
Contact:US GSK Clinical Trials Call Center
Email:GSKClinicalSupportHD@gsk.com
Phone:877-379-3718

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A Phase I, Open-Label, Parallel-Group, Two-Part Study to Evaluate the Pharmacokinetics and Safety of GSK2336805 in Subjects With Hepatic Impairment and Healthy Matched Control Subjects (HAI117380)

This is a single-dose, open-label, two part, parallel group study. This study is being
conducted to determine the pharmacokinetics, safety and tolerability of GSK2336805 in
subjects with varying degrees of hepatic impairment. Part 1 of the study will enroll
subjects with mild and moderate hepatic impairment and healthy control subjects matched to
the subjects in the moderate hepatic impairment category. The decision to commence Part 2
will be based on a review of the preliminary safety and pharmacokinetic data from subjects
with moderate hepatic impairment. Part 2 will enroll subjects with severe hepatic
impairment. Additionally, based on emergent data from Part 1, matched controls to the severe
hepatic group may be enrolled (optional). Due to the potential difficulty in identifying
eligible subjects with severe hepatic impairment, the study may be stopped prior to full
enrollment in Part 2, provided that a minimum of 4 evaluable subjects with severe hepatic
impairment have been enrolled. The study will consist of a Screening visit, a single dose
Treatment Period and a Follow-up visit. Subjects will be screened for eligibility criteria
within 30 days of enrolment. Subjects will be admitted to the clinical unit on Day -1; each
subject will receive a single dose of GSK2336805 on Day 1 and will remain in the clinical
unit for 5 days (check-out on Day 4). The follow-up visit will be conducted within 7-10 days
after Day 1 dosing.


Inclusion Criteria:

- Male and female subjects aged 18 to 74 years inclusive, at the time of signing the
informed consent.

- Body weight >=45 kilogram (kg) for men and women and body mass index (BMI) within the
range 17- 41 kg/meter square (m^2) for hepatically impaired subjects; healthy matched
control subjects will be matched to BMI +/- 20% and must also remain in the BMI range
of 17- 41 kg/m^2.

- A female subject is eligible to participate if she is of non-childbearing potential
(postmenopausal defined as 12 months of spontaneous amenorrhea or pre-menopausal
females with a documented tubal ligation or hysterectomy).

- Male subjects with female partners of child-bearing potential must agree to use one
of the contraception methods listed in the protocol. This criterion must be followed
from the time of the first dose of study medication until the follow up visit.

- Capable of giving written informed consent, which includes compliance with the
requirements and restrictions listed in the consent form.

- The subject is able to understand and comply with protocol requirements, instructions
and protocol-stated restrictions and is likely to complete the study as planned.

- Ability and willingness to abstain from alcohol-containing beverages/foods from 48
hours prior to entry in the clinical study centre until discharge.

- Supplemental inclusion criteria for Healthy Volunteer subjects only: A male or female
is eligible for study participation if he/she is healthy as determined by a
responsible and experienced physician, based on a medical evaluation including
medical history, physical examination, laboratory tests and electrocardiogram (ECG),
including no cardiac, pulmonary, hepatic, biliary, gastrointestinal, or renal
disorders (defined as serum creatinine >1.5 milligram(mg)/decilitre (dL) or a
calculated creatinine clearance (CrCl)<50 millilitre (mL)/ minute(min), or cancer
within the past 5 years (except localized or in situ cancer of the skin). A subject
with a clinical abnormality or laboratory parameters outside the reference range for
the population being studied may be included only if the Investigator and the Medical
Monitor agree that the finding is unlikely to introduce additional risk factors and
will not interfere with the study procedures. A single repeat laboratory evaluation
is allowed for eligibility determination. Aspartate aminotransferase (AST), alanine
aminotransferase (ALT), alkaline phosphatase, and bilirubin less than the upper
limits of normal. The subject's systolic blood pressure is inside the range of 90-140
millimeter of mercury (mmHg) and diastolic blood pressure is inside the range of
45-90 mmHg and heart rate is inside the range of 50-100 beats per minute (bpm) for
female subjects or 45-100 bpm for male subjects.

- Supplemental inclusion criteria for all hepatically impaired subjects: Chronic (>6
months), stable (no acute episodes of illness within the previous 1 month prior to
screening due to deterioration in hepatic function) hepatic insufficiency with
features of cirrhosis due to any etiology. Subjects must also remain stable
throughout the Screening period.

- Subjects whose platelets are greater than or equal to 30,000 x 10^9/Liter of blood
who have not had any major bleeding episodes within the past 6 months.

- Supplemental inclusion criteria for all hepatically impaired subjects in the mild
group: A male or female is eligible for study participation if he/she is considered
to have mild hepatic insufficiency (of any etiology) and has been clinically stable
for at least 1 month prior to screening. To be classified as having mild hepatic
insufficiency, subjects must have: A Child-Pugh score of 5-6 with known medical
history of liver disease (with or without a known history of alcohol abuse) and
previous confirmation of liver cirrhosis by liver biopsy or other medical imaging
technique (including laparoscopy, computed tomography [CT] scan, Magnetic Resonance
Imaging [MRI] or ultrasonography) associated with an unambiguous medical history.

- Supplemental inclusion criteria for all hepatically impaired subjects in the moderate
group: A male or female is eligible for study participation if he/she is considered
to have moderate hepatic insufficiency (of any etiology) and has been clinically
stable for at least 1 month prior to screening. To be classified as having moderate
hepatic insufficiency, subjects must have: A Child-Pugh score of 7-9 with known
medical history of liver disease (with or without a known history of alcohol abuse)
and previous confirmation of liver cirrhosis by liver biopsy or other medical imaging
technique (including laparoscopy, CT scan, MRI or ultrasonography) associated with an
unambiguous medical history.

- Supplemental inclusion criteria for all hepatically impaired subjects in the severe
group: A male or female is eligible for study participation if he/she is considered
to have severe hepatic insufficiency (of any etiology) and has been clinically stable
for at least 1 month prior to screening. To be classified as having severe hepatic
insufficiency, subjects must have: A Child-Pugh score of >9 with known medical
history of liver disease (with or without a known history of alcohol abuse) and
previous confirmation of liver cirrhosis by liver biopsy or other medical imaging
technique (including laparoscopy, CT scan, MRI or ultrasonography) associated with an
unambiguous medical history

Exclusion Criteria:

- Pregnant females as determined by positive serum or urine Human Chorionic
Gonadotropin (hCG) test at screening or prior to dosing.

- Lactating females.

- History of regular alcohol consumption within 6 months of the study defined as an
average weekly intake of >14 drinks for males or >7 drinks for females. One drink is
equivalent to 12 grams (g) of alcohol: 12 ounces (360 mL) of beer, 5 ounces (150 mL)
of wine or 1.5 ounces (45 mL) of 80 proof distilled spirits.

- A positive test for human immunodeficiency virus (HIV) antibody.

- Where participation in the study would result in donation of blood or blood products
in excess of 500 mL within a 56 day period.

- The subject has participated in a clinical trial and has received an investigational
product within the following time period prior to the first dosing day in the current
study: 30 days, 5 half-lives or twice the duration of the biological effect of the
investigational product (whichever is longer).

- Consumption of red wine, seville oranges, grapefruit or grapefruit juice, pummelos,
satsuma, ugli, tangerine, and tangelo, exotic citrus fruits, grapefruit hybrids or
fruit juices from 7 days prior to the first dose of study medication.

- Use of prescription or non-prescription drugs, vitamins, and herbal and dietary
supplements (including St John's Wort) within 7 days (or 14 days if the drug is a
potential enzyme inducer) or 5 half-lives (whichever is longer) prior to the first
dose of study medication. Hepatically impaired subjects requiring prescription or
non-prescription drugs may be acceptable provided the medications are not on the
Prohibited Medications List of the protocol and in the opinion of the Investigator
the medication will not interfere with the study procedures or compromise subject
safety.

- History or presence of allergy or intolerance to the study drugs or their components
or drugs of their class, or a history of drug or other allergy that, in the opinion
of the physician responsible, contraindicates their participation. In addition, if
heparin is used during pharmacokinetic (PK) sampling, subjects with a history of
sensitivity to heparin or heparin-induced thrombocytopenia should not be enrolled.

- The subject has a positive pre-study drug/alcohol screen. A minimum list of drugs
that will be screened for include amphetamines, barbiturates, cocaine, opiates,
cannabinoids and benzodiazepines. For hepatically impaired subjects, a positive drug
screen will be allowed if it is due to a prescribed medication, provided that
medication is not on the Prohibited Medications List of the protocol.

- Exclusion criteria for screening ECG (a single repeat is allowed for eligibility
determination): Heart rate <45 and >100 beats per minute (bpm) (males) and <50 and
>100 bpm (females); PR Interval <120 and >220 milliseconds (msec); QRS duration <70
and >120 msec; corrected QT interval by Bazett's formula (QTcB) >450 msec or >480
msec in subjects with incomplete Bundle Branch Block; Evidence of previous ischemic,
valvular, or congenital heart disease (Does not include ST segment changes associated
with repolarization); Any clinically significant conduction abnormality (including
but not specific to left or right complete bundle branch block, atrioventricular (AV)
block [2nd degree or higher], Wolf Parkinson White [WPW] syndrome); Sinus Pauses >3
seconds; Any significant arrhythmia which, in the opinion of the principal
investigator, will interfere with the safety for the individual subject; and
Non-sustained or sustained ventricular tachycardia (>=3 consecutive ventricular
ectopic beats).

- Supplemental exclusion criteria for healthy volunteer subjects only: A positive
Hepatitis B surface antigen or positive Hepatitis C antibody result at screening.
Subjects with a pre-existing condition interfering with normal gastrointestinal
anatomy or motility, that could interfere with the absorption, metabolism, and/or
excretion of the study drugs. Subjects with a history of inflammatory bowel disease
should be excluded. Subjects with a history of peptic ulceration or pancreatitis
within the preceding 6 months of screening should be excluded. Subjects with any
previous gastrointestinal (GI) surgery (except appendectomy or gall bladder removal
more than three months prior to study) may be enrolled in this study only if, in the
opinion of the Investigator and the Medical Monitor, it is not expected to interfere
with the study procedures or to pose an additional safety risk to the subject.
Exposure to more than four new chemical entities within 12 months prior to the first
dosing day.

- Supplemental exclusion criteria for hepatically impaired subjects only:

- Evidence of recent, acute infection with Hepatitis B and/or Hepatitis C within
preceding 6 months. Subjects with chronic Hepatitis B or C (duration >6 months) are
eligible for enrolment.

- Subjects with a pre-existing condition (except hepatic impairment) interfering with
normal gastrointestinal anatomy or motility that could interfere with the absorption,
metabolism, and/or excretion of the study drugs. Subjects with a history of
inflammatory bowel disease should be excluded. Subjects with a history of peptic
ulceration or pancreatitis within the preceding 6 months of screening should be
excluded. Subjects with previous gastrointestinal (GI) surgery (except appendectomy
or gall bladder removal more than three months prior to study) may be enrolled in
this study only if, in the opinion of the Investigator and the Medical Monitor, it is
not expected to interfere with the study procedures or to pose an additional safety
risk to the subject.

- Subjects receiving lactulose who are medically unable to halt lactulose
administration from 8 hour (h) before dosing with study drug to 4h after dosing with
study drug.

- Subjects with severe encephalopathy (grade 3 or 4) as judged by the investigator or
significant Central Nervous System (CNS) disease (e.g. dementia, or seizures) which
the investigator considers will interfere with the informed consent, conduct,
completion, or results of this trial or constitutes an unacceptable risk to the
subject.

- Subjects with a change in dose regimen of medically required medication within the 2
weeks prior to dosing.

- Subjects with creatinine clearance <=50 mL/min (calculated by the Cockcroft-Gault
Formula). If the result calculated by Cockcroft-Gault is between 40 and 50 mL/min,
then the site may complete a 24 hour urine collection to more specifically calculate
the CrCl. A CrCl value < or = 50mL/min via 24-hour urine collection is also
exclusionary.

- History of gastric or esophageal variceal bleeding within the past 6 months and for
which varices have not been adequately treated with medication and/or surgical
procedures.

- Subjects with electrolyte imbalance whose serum sodium levels are less than or equal
to 125 millimol/litre (mmol/L); potassium levels are less than or equal to 2.5
mmol/L; calcium levels less than or equal to 6.1mmol/L).

- Presence of hepatopulmonary or hepatorenal syndrome.

- Primarily cholestatic liver diseases.

- History of liver transplantation.

- Subjects in the severe hepatic impairment group that are expecting a liver transplant
during the study participation period.

- Subjects with signs of active bacterial infection (including active spontaneous
bacterial peritonitis).

- Subjects with Transjugular Intrahepatic Portosystemic Shunt (TIPS) placement within
the past 3 months.

- Subjects with unstable cardiac function or subjects with hypertension whose blood
pressure that is not well controlled (based on the investigator's discretion)

- Diabetic subjects whose diabetes that is not controlled (based on the investigator's
discretion).
We found this trial at
4
sites
Lakewood, Colorado 80228
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Knoxville, Tennessee 37916
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Minneapolis, Minnesota 55404
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Orlando, Florida 32806
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