Study to Evaluate the Pharmacokinetics, Safety, Tolerability of Single Dose Lacosamide in Subjects With Renal Impairment Compared to Healthy Subjects

Open, Non-randomized, Sequential Group Comparison to Investigate the Pharmacokinetics, Safety, and Tolerability of 100 mg SPM 927 in Male and Female Subjects With Renal Impairment Including Subjects Requiring Dialysis Compared With Male and Female Healthy Subjects Following Single-dose Administration

To investigate the Pharmacokinetics (PK) of oral administered Lacosamide in renal impaired subjects and healthy subjects.

Study Overview

• Status: Completed
• Conditions: Healthy; Renal Impairment
• Intervention / Treatment: Drug: Lacosamide tablet

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Phase 1

Contacts and Locations

Study Locations

• Germany
  • Cologne, Germany
    • 1
  • Rendsburg, Germany
    • 2

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Subject was informed and given ample time and opportunity to think about his/her participation and had given his/her written informed consent
• Subject was willing and able to comply with all trial requirements
• Subject was a male or female Caucasian, between 18 and 70 years of age (inclusive)
• If female, subject was of non-childbearing potential (post-menopausal or hysterectomized) or was using medically adequate contraception
• If female of childbearing potential, subject had a negative pregnancy test
• Subject had a Body Mass Index (BMI) between 20 and 34 kg/m2 (inclusive)
• Subject was healthy without clinically relevant cardiovascular, renal, gastrointestinal, hepatic, metabolic, endocrine, neurological, or psychiatric abnormalities detected during Eligibility Assessment (EA)

Subjects with renal impairment also had to fulfill the following inclusion criteria:

• Subject had no clinically relevant cardiovascular or endocrine findings during EA
• Subject had a renal impairment. The subjects were assigned to 1 of the following treatment groups according to Creatinine Clearance (CLCr) values determined 2 to 7 days prior to dosing:
• Group 2: 80 mL/min > CLCr ≥ 50 mL/min (subjects with mild renal impairment)
• Group 3: 50 mL/min > CLCr ≥ 30 mL/min (subjects with moderate renal impairment)
• Group 4: CLCr < 30 mL/min (subjects with severe renal impairment, not on dialysis between 2 weeks before EA and end of the trial)

Inclusion criteria for Group 5:

• Subject was informed and given ample time and opportunity to think about his/her participation and had given his/her written informed consent
• Subject was willing and able to comply with all trial requirements
• Subject was a male or female Caucasian, between 18 and 70 years of age (inclusive)
• If female, subject was of non-childbearing potential (post-menopausal or hysterectomized) or was using medically adequate contraception
• If female of childbearing potential, subject had a negative pregnancy test
• Subject had a BMI between 20 and 34 kg/m2 (inclusive)
• Subject had no clinically relevant cardiovascular or endocrine findings during EA
• Subject had an endstage renal disease (CLCr < 15 mL/min, determined approximately 2 to 7 days before first dosing) treated with extracorporal hemodialysis for at least 4 months

Exclusion Criteria:

Healthy subjects:

• Subject had previously participated in this trial
• Subject had participated in another trial of an investigational product within the last 3 months or was currently participating in another trial of an investigational product
• Subject had donated blood or had a comparable blood loss (> 500 mL) within the last 3 months prior to EA
• Subject smoked more than 5 cigarettes per day or had done so within the 6 months prior to commencement of this trial
• Subject had a history of chronic alcohol or drug abuse within the last 6 months prior to commencement of this trial
• Subject consumed more than 40 g of alcohol/day (amount corresponds to 1 L beer/day or 0.5 L wine/day or 120 mL liquor/day)
• Subject had positive tests for alcohol (urine or breath test) or drugs (urine test)
• Subject had clinically relevant changes in the electrocardiogram (ECG), such as second- or third-degree atrioventricular (AV) block, prolongation of the QRS complex over 120 ms or of the corrected QT (QTc) interval > 430 ms (male subjects) or > 450 ms (female subjects)
• Subject had a history or present condition of clinically relevant respiratory or cardiovascular disorders, eg, cardiac insufficiency, coronary heart disease, hypertension, arrhythmia, tachyarrhythmia, or status after myocardial infarction
• Subject had a history or present condition of psychic abnormality, psychiatric or neurologic illness, or autonomic neuropathy that, in the opinion of the Investigator, could have jeopardized or would have compromised the subject's ability to participate in the trial
• Subject had a history or present condition of seizure disorder
• Subject had a history or present condition of malignancy
• Subject had a history or present condition of renal disorders (albuminuria, chronic infections) or renal impairment
• Subject had a history or present condition of Diabetes Mellitus or thyroid dysfunction, especially Hyperthyreosis, or other endocrine disorders
• Subject had a clinically relevant allergy
• Subject had a known or suspected drug hypersensitivity, in particular to the trial medication
• Subject was taking any concomitant medication currently or within 2 weeks prior to the first day of dosing (with the exception of oral contraceptives and Paracetamol [maximum allowed dose: 1000 mg/dose], which were allowed up to 48 hours prior to dosing); further exceptions could be made if the Investigator and the sponsor jointly considered the medication as acceptable
• Subject was tested positive for human immunodeficiency virus 1/2 antibodies (HIV-1/2-Ab), hepatitis B surface antigen (HBs-Ag), or hepatitis C virus antibody (HCV-Ab)
• Subject had any clinically relevant abnormality in the physical examination or in vital sign measurements (systolic blood pressure > 150 mmHg or < 100 mmHg, diastolic blood pressure > 95 mmHg or < 60 mmHg, pulse rate > 100 beats per minute (bpm) or < 50 bpm)
• Subject had a clinically relevant deviation from the norm in the clinical chemistry, hematology, or urinalysis evaluations

Exclusion criteria for Groups 2-4:

• Exclusion criteria 1 to 12 for healthy subjects also applied to subjects with renal impairment
• Subject had a clinically relevant allergy
• Subject had a known or suspected drug hypersensitivity, in particular to the trial medication
• Subject was taking any concomitant medication currently or within 2 weeks prior to dosing that could have interfered with the investigational product
• Subject was tested positive for HIV-1/2-Ab, HBs-Ag, or HCV-Ab
• Subject had any clinically relevant abnormality in the physical examination or in vital sign measurements (systolic blood pressure > 180 mmHg or < 100 mmHg, diastolic blood pressure > 110 mmHg, pulse rate > 100 bpm or < 60 bpm)
• Subject had a clinically relevant deviation from the norm in the clinical chemistry, hematology or urinalysis evaluations other than expected for a subject with renal impairment, eg, hemoglobin < 8.0 g/dL

Exclusion criteria for Group 5:

• Exclusion criteria 1 to 12 for healthy subjects also applied to subjects in Group 5
• Subject had a clinically relevant allergy
• Subject had a known or suspected drug hypersensitivity, in particular to the trial medication
• Subject was tested positive for HIV-1/2-Ab, HBs-Ag, or HCV-Ab
• Subject was taking any concomitant medication that might interfere with the investigational product currently or within 2 weeks prior to dosing
• Subject had any clinically relevant abnormality in the physical examination or in vital sign measurements (systolic blood pressure > 200 mmHg [predialysis value] or < 100 mmHg, diastolic blood pressure > 110 mmHg, pulse rate > 100 bpm or < 60 bpm)
• Subject had a clinically relevant deviation from the norm in the clinical chemistry, hematology, or urinalysis evaluations other than expected for a patient with renal impairment, eg, hemoglobin < 8.0 g/dL

Study Plan

How is the study designed?

Design Details

• Allocation: Non-Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

5

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group 1: Healthy subjects; Single dose of 100 mg Lacosamide	Drug: Lacosamide tablet; Single dose of 100 mg Lacosamide tablet; Other Names: Vimpat
Experimental: Group 2: Subjects with mild renal insufficiency; Single dose of 100 mg Lacosamide	Drug: Lacosamide tablet; Single dose of 100 mg Lacosamide tablet; Other Names: Vimpat
Experimental: Group 3: Subjects with moderate renal insufficiency; Single dose of 100 mg Lacosamide	Drug: Lacosamide tablet; Single dose of 100 mg Lacosamide tablet; Other Names: Vimpat
Experimental: Group 4: Subjects with severe renal insufficiency; Single dose of 100 mg Lacosamide	Drug: Lacosamide tablet; Single dose of 100 mg Lacosamide tablet; Other Names: Vimpat
Experimental: Group 5: Subjects with end stage renal insufficiency; Single dose of 100 mg Lacosamide	Drug: Lacosamide tablet; Single dose of 100 mg Lacosamide tablet; Other Names: Vimpat

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Area under the Lacosamide plasma concentration time curve from 0 to the last quantifiable data point (AUC(0-tz))	Blood sampling at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 36, 48, 60, 72, 84, and 96 hours after single dose administration; > 24 hours excluded for group 5	Day 1 to Day 5 of study
Measured maximal concentration (Cmax) of Lacosamide	Blood sampling at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 36, 48, 60, 72, 84, and 96 hours after single dose administration; > 24 hours excluded for group 5	Day 1 to Day 5 of study
Area under the Lacosamide plasma concentration-time curve from 0 to the last quantifiable data point (AUC (0-tz)), normalized by body weight	Blood sampling at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 36, 48, 60, 72, 84, and 96 hours after single dose administration; > 24 hours excluded for group 5	Day 1 to Day 5 of study
Measured maximal concentration (Cmax, norm) of Lacosamide normalized by body weight	Blood sampling at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 36, 48, 60, 72, 84, and 96 hours after single dose administration; > 24 hours excluded for group 5	Day 1 to Day 5 of study

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time of observed maximum (tmax) of Lacosamide concentration	Blood sampling at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 36, 48, 60, 72, 84, and 96 hours after single dose administration; > 24 hours excluded for group 5	Day 1 to Day 5 of study
Time of observed maximum (tmax) of Lacosamide metabolite (SPM12809) concentration	Blood sampling at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 36, 48, 60, 72, 84, and 96 hours after single dose administration; > 24 hours excluded for group 5	Day 1 to Day 5 of study
Terminal half-life (t1/2) of Lacosamide	Blood sampling at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 36, 48, 60, 72, 84, and 96 hours after single dose administration; > 24 hours excluded for group 5	Day 1 to Day 5 of study
Terminal half-life (t1/2) of Lacosamide metabolite (SPM12809)	Blood sampling at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 36, 48, 60, 72, 84, and 96 hours after single dose administration; > 24 hours excluded for group 5	Day 1 to Day 5 of study
Apparent total clearance (CL/f) of Lacosamide from plasma	Blood sampling at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 36, 48, 60, 72, 84, and 96 hours after single dose administration; > 24 hours excluded for group 5	Day 1 to Day 5 of study
Area under the lacosamide metabolite (SPM12809) plasma concentration-time curve from 0 to the last quantifiable data point (AUC(0-tz))	Blood sampling at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 36, 48, 60, 72, 84, and 96 hours after single dose administration; > 24 hours excluded for group 5	Day 1 to Day 5 of study
Amount of Lacosamide excreted in urine from 0 to defined time point (Ae(0-48)) (t=48 hours)	Urine sampling predose, 0-4, 4-8, 8-12, 12-24, 24-36, and 36-48 hours postdose	Day 1 to Day 3 of study
Amount of Lacosamide metabolite (SPM12809) excreted in urine from 0 to defined time point (Ae(0-48)) (t=48 hours)	Urine sampling predose, 0-4, 4-8, 8-12, 12-24, 24-36, and 36-48 hours postdose	Day 1 to Day 3 of study
Measured maximal concentration (Cmax) of Lacosamide metabolite (SPM12809)	Blood sampling at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 36, 48, 60, 72, 84, and 96 hours after single dose administration; > 24 hours excluded for group 5	Day 1 to Day 5 of study
Area under the Lacosamide metabolite (SPM12809) plasma concentration time curve from 0 to the last quantifiable data point (AUC(0-tz)), normalized by body weight	Blood sampling at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 36, 48, 60, 72, 84, and 96 hours after single dose administration; > 24 hours excluded for group 5	Day 1 to Day 5 of study
Measured maximal Lacosamide metabolite (SPM12809) concentration (Cmax,norm), normalized by body weight	Blood sampling at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 36, 48, 60, 72, 84, and 96 hours after single dose administration; > 24 hours excluded for group 5	Day 1 to Day 5 of study
Terminal half-life (t1/2) of Lacosamide in urine	Urine sampling predose, 0-4, 4-8, 8-12, 12-24, 24-36, and 36-48 hours postdose	Day 1 to Day 3 of study
Lacosamide concentration in dialysis inlet line (Cin)	Dialysis samples collected 4 hours and 6 hours after administration (1.5 hours and 3.5 hours after start of dialysis)	From 4 hours up to 6 hours postdose
Lacosamide metabolite (SPM12809) concentration in dialysis inlet line (Cin)	Dialysis samples collected 4 hours and 6 hours after administration (1.5 hours and 3.5 hours after start of dialysis)	From 4 hours up to 6 hours postdose
Lacosamide concentration in dialysis outlet line (Cout)	Dialysis samples collected 4 hours and 6 hours after administration (1.5 hours and 3.5 hours after start of dialysis)	From 4 hours up to 6 hours postdose
Lacosamide metabolite (SPM12809) concentration in dialysis outlet line (Cout)	Dialysis samples collected 4 hours and 6 hours after administration (1.5 hours and 3.5 hours after start of dialysis)	From 4 hours up to 6 hours postdose
Extraction rate (E) of Lacosamide	Dialysis samples collected 4 hours and 6 hours after administration (1.5 hours and 3.5 hours after start of dialysis)	From 4 hours up to 6 hours postdose
Extraction rate (E) of Lacosamide metabolite (SPM12809)	Dialysis samples collected 4 hours and 6 hours after administration (1.5 hours and 3.5 hours after start of dialysis)	From 4 hours up to 6 hours postdose
Dialysis clearance (CLdial) of Lacosamide	Dialysis samples collected 4 hours and 6 hours after administration (1.5 hours and 3.5 hours after start of dialysis)	From 4 hours up to 6 hours postdose
Dialysis clearance (CLdial) of Lacosamide metabolite (SPM12809)	Dialysis samples collected 4 hours and 6 hours after administration (1.5 hours and 3.5 hours after start of dialysis)	From 4 hours up to 6 hours postdose
Rate constant of Lacosamide elimination	Blood sampling at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 36, 48, 60, 72, 84, and 96 hours after single dose administration; > 24 hours excluded for group 5	Day 1 to Day 5 of study
Rate constant of Lacosamide metabolite (SPM12809) elimination	Blood sampling at 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 24, 36, 48, 60, 72, 84, and 96 hours after single dose administration; > 24 hours excluded for group 5	Day 1 to Day 5 of study

Collaborators and Investigators

• Sponsor: UCB BIOSCIENCES GmbH

Publications and helpful links

General Publications

• Cawello W, Fuhr U, Hering U, Maatouk H, Halabi A. Impact of impaired renal function on the pharmacokinetics of the antiepileptic drug lacosamide. Clin Pharmacokinet. 2013 Oct;52(10):897-906. doi: 10.1007/s40262-013-0080-7.

Study record dates

Study Major Dates

• Study Start: June 1, 2004
• Primary Completion (Actual): November 1, 2004
• Study Completion (Actual): November 1, 2004

Study Registration Dates

• First Submitted: February 19, 2013
• First Submitted That Met QC Criteria: February 21, 2013
• First Posted (Estimate): February 22, 2013

Study Record Updates

• Last Update Posted (Estimate): October 20, 2014
• Last Update Submitted That Met QC Criteria: October 17, 2014
• Last Verified: February 1, 2013

More Information

Terms related to this study

• Keywords: Pharmacokinetics; Renal Impairment; Single Dose; Lacosamide; Vimpat
• Additional Relevant MeSH Terms: Kidney Diseases; Urologic Diseases; Renal Insufficiency; Molecular Mechanisms of Pharmacological Action; Membrane Transport Modulators; Anticonvulsants; Voltage-Gated Sodium Channel Blockers; Sodium Channel Blockers; Lacosamide
• Other Study ID Numbers: SP0641