Bioavailability Mechanistic Study of Hot-Melt Extruded Amorphous Solid Dispersions (BEAD)

Bioavailability Mechanistic Study of Hot-Melt-Extruded Amorphous Solid Dispersions

It is the aim of the study to investigate the functioning of a drug delivery system (drug-rich particles forming hot-melt extruded amorphous solid dispersions) with respect to mechanisms of bioavailability of poorly soluble drug substances.

Study Overview

• Status: Completed
• Conditions: Biological Availability; Amorphous Solid Dispersions
• Intervention / Treatment: Drug: Hot-melt extruded amorphous solid dispersion of Efavirenz; Drug: Hot-melt extruded amorphous solid dispersion of Efavirenz homogenized to drug rich particles; Drug: Efavirenz solution

Detailed Description

Poor drug solubility, and therefore low bioavailability, remains a problem in drug development that causes many drug candidates to drop out during drug development. Bioavailability is linked to drug solubility and intestinal permeability. A promising method to increase drug solubility, and therefore bioavailability, is the formulation of the drug as hot-melt extruded amorphous solid dispersion drug delivery systems, which have been shown to potentially increase in vivo and clinical bioavailability.The mechanisms that lead to increased bioavailability are not understood completely.

In this study, investigators investigate the role of amorphous solid dispersions and thereof generated drug-rich particles on bioavailability and their in vivo behaviour. Investigators do so by administering the delivery system at different stages in the process of drug availability.

Primary objectives are the pharmacokinetic analysis of a model formulation using efavirenz as model drug tracer in human.

• Comparison of pharmacokinetic parameters such as relative bioavailability and further parameters derived from pharmacokinetic analysis and corresponding interpatient variabilities.
• Mechanistic analysis of pharmacokinetic data, such as determination of in vivo dissolution from the solid formulation (study product 1) to drug rich particles (study product 2) using numerical deconvolution or analysis of the effect of drug rich particles on the absorption rate of Efavirenz in comparison to the solution of Efavirenz (study product 3).

Secondary objectives are the comparison of obtained pharmacokinetic profiles to existing data of a conventional formulation with respect to:

• Comparison of pharmacokinetic parameters such as relative bioavailability and further parameters derived from pharmacokinetic analysis and corresponding interpatient variabilities.
• Extrapolation investigation from in vitro to in vivo data.

Safety objectives are the recording of any side effects or tolerability issues of the investigational drug delivery system.

• Study Type: Interventional
• Enrollment (Actual): 16
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Switzerland
  • Basel, Switzerland, 4056
    • Pharmaceutical Technology, University of Basel, Pharmazentrum

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 50 years (Adult)
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Full mental and legal capacity, ability and willingness to understand and comply to study interventions and restrictions and to communicate with study personnel.
• Informed Consent, documented by signature (Informed Consent Form).
• Physically and mentally healthy male participants, age of 18 to 50 years.
• Body mass index (BMI) of 18.0 to 29.9 kg/m2, systolic blood pressure (SBP) 100-145 mmHg, diastolic blood pressure (DBP) 50- 90 mmHg and heart rate (HR) 45-90 bpm, measured on the leading arm, after 5 minutes in supine position, Hemoglobin ≥ 11 g/dl at screening.
• Normal physical examination, vital signs, laboratory workup (clinical chemistry and hematology), and electrocardiogram (ECG) (in opinion of the principal investigator).
• Normal renal and liver function based on blood tests (in opinion of the investigator).
• Medical history that is in line with the eligibility criteria. (in opinion of the investigator).
• No other conditions or circumstances that might compromise compliance with the study protocol or the quality of retrieved data (in opinion of the investigator).

Exclusion Criteria:

• Any acute or chronic illness or other clinically relevant findings at screening.
• Any physical or mental disorder or circumstance at present or in medical history that could interfere with the participant's safety during the clinical trial or with the study objectives.
• Any regular drug treatment within the last two weeks or planned for the time of the study (exceptions possible in opinion of the investigator).
• At presence of irregular drug treatment before the study, planned for the time of the study or irregular/regular substitution of endogenous substances, minerals, or trace elements, the investigator decides on exclusion on an individual basis valuing the safety of the participant and the quality of retrieved data (e.g. interactions with Efavirenz). For minor to moderate painful conditions, such as headaches or abdominal discomfort, paracetamol up to 1 g every 6 hours is acceptable.
• Any intake of a substance known to induce or inhibit drug metabolizing enzymes or transport system enzymes relevant for Efavirenz (CYP 2B6 and CYP 3A4) within a period of less than 10 times the respective elimination half-life.
• Vaccination (active or passive) ≤ one month before screening.
• Presence or history of allergies (except for mild forms of hay fever).
• History of hypersensitivity reactions to medication.
• History or presence of eating disorders.
• Presence of contraindications to treatment with Efavirenz, namely less than 40 kg body weight, co-medication with voriconazole, paritaprevir, ritonavir, dasabuvir, simeprevir, and hypericum perforatum.any co-medication (also plant products), or any liver disease.
• Presence of warnings concerning the treatment with Efavirenz, namely severe skin irritations in the medical history, psychiatric symptoms in the medical history, convulsions in the medical history, hepatitis B or C, presence of osteonecrosis in the medical history, or dyslipidemia at present or in medical history.
• History or presence of smoking, alcohol drinking (>20 g alcohol per day), or drug abuse.
• Blood donation or significant blood loss within 4 weeks prior to screening
• Known or suspected non-compliance
• Participation in another study with investigational drug within the 30 days preceding and during the present study
• Previous enrolment into the current study

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Basic Science
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Sequence 1,2,3; Period A/ Visit 2: Hot-melt extruded amorphous solid dispersion of Efavirenz, 50 mg, oral administration (product 1) Period B/ Visit 6: Hot-melt extruded amorphous solid dispersion of Efavirenz, 50 mg, homogenized to drug rich particles, oral administration (product 2) Period C/ Visit 10: Efavirenz solution, 3 mg, oral administration (product 3)	Drug: Hot-melt extruded amorphous solid dispersion of Efavirenz; Hot-melt extruded amorphous solid dispersion of Efavirenz, 50 mg, oral administration (product 1); Drug: Hot-melt extruded amorphous solid dispersion of Efavirenz homogenized to drug rich particles; Hot-melt extruded amorphous solid dispersion of Efavirenz, 50 mg, homogenized to drug rich particles, oral administration (product 2); Drug: Efavirenz solution; Efavirenz solution, 3 mg, oral administration (product 3)
Experimental: Sequence 2,3,1; Period A/ Visit 2: Hot-melt extruded amorphous solid dispersion of Efavirenz, 50 mg, homogenized to drug rich particles, oral administration (product 2) Period B/ Visit 6: Efavirenz solution, 3 mg, oral administration (product 3) Period C/ Visit 10: Hot-melt extruded amorphous solid dispersion of Efavirenz, 50 mg, oral administration (product 1)	Drug: Hot-melt extruded amorphous solid dispersion of Efavirenz; Hot-melt extruded amorphous solid dispersion of Efavirenz, 50 mg, oral administration (product 1); Drug: Hot-melt extruded amorphous solid dispersion of Efavirenz homogenized to drug rich particles; Hot-melt extruded amorphous solid dispersion of Efavirenz, 50 mg, homogenized to drug rich particles, oral administration (product 2); Drug: Efavirenz solution; Efavirenz solution, 3 mg, oral administration (product 3)
Experimental: Sequence 3,1,2; Period A/ Visit 2: Efavirenz solution, 3 mg, oral administration (product 3) Period B/ Visit 6: Hot-melt extruded amorphous solid dispersion of Efavirenz, 50 mg, oral administration (product 1) Period C/ Visit 10: Hot-melt extruded amorphous solid dispersion of Efavirenz, 50 mg, homogenized to drug rich particles, oral administration (product 2)	Drug: Hot-melt extruded amorphous solid dispersion of Efavirenz; Hot-melt extruded amorphous solid dispersion of Efavirenz, 50 mg, oral administration (product 1); Drug: Hot-melt extruded amorphous solid dispersion of Efavirenz homogenized to drug rich particles; Hot-melt extruded amorphous solid dispersion of Efavirenz, 50 mg, homogenized to drug rich particles, oral administration (product 2); Drug: Efavirenz solution; Efavirenz solution, 3 mg, oral administration (product 3)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
AUC	Area under the curve in plasma concentration - time profiles of efavirenz after administration of the different study products.	before dosing and at time points 15 minutes, 30 minutes, 45 minutes, 60 minutes, followed by sampling at 2 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 24 hours, 48 hours, and 72 hours after dosing
Relative bioavailability	Ratio between areas under the curve.	before dosing and at time points 15 minutes, 30 minutes, 45 minutes, 60 minutes, followed by sampling at 2 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 24 hours, 48 hours, and 72 hours after dosing
Cmax	Maximal concentration in the plasma concentration - time profiles of efavirenz after administration of the different study products.	before dosing and at time points 15 minutes, 30 minutes, 45 minutes, 60 minutes, followed by sampling at 2 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 24 hours, 48 hours, and 72 hours after dosing
Tmax	Time of maximal concentration in the plasma concentration - time profiles of efavirenz after administration of the different study products.	before dosing and at time points 15 minutes, 30 minutes, 45 minutes, 60 minutes, followed by sampling at 2 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 24 hours, 48 hours, and 72 hours after dosing
ka	Absorption rate constant from the concentration in the Plasma concentration - time profiles of efavirenz after administration of the different study products.	before dosing and at time points 15 minutes, 30 minutes, 45 minutes, 60 minutes, followed by sampling at 2 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 24 hours, 48 hours, and 72 hours after dosing
In vivo dissolution	Calculation of in vivo dissolution of based on the numerical deconvolution of plasma concentration - time profiles of efavirenz after administration of the different study products.	before dosing and at time points 15 minutes, 30 minutes, 45 minutes, 60 minutes, followed by sampling at 2 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 24 hours, 48 hours, and 72 hours after dosing

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of adverse drug reactions	Incidence and severity (CTCAE Version 5) of adverse reactions (adverse event suspected to be related to investigational drug deliver system, expected or not expected) during the whole study.	During inclusion into study (36 to 54 days)

Collaborators and Investigators

• Sponsor: University Hospital, Basel, Switzerland
• Collaborators: University of Basel
• Investigators: Principal Investigator: Stephan Krähenbühl, Prof. Dr., University of Basel, Department Biomedicine

Publications and helpful links

General Publications

• Schittny A, Waldner S, Duthaler U, Vorobyev A, Abramovich R, Krahenbuhl S, Puchkov M, Huwyler J. Particle Forming Amorphous Solid Dispersions: A Mechanistic Randomized Pharmacokinetic Study in Humans. Pharmaceutics. 2021 Mar 17;13(3):401. doi: 10.3390/pharmaceutics13030401.

Helpful Links

• Pharmaceutics 2021, 13(3), 401: Particle Forming Amorphous Solid Dispersions: A Mechanistic Randomized Pharmacokinetic Study in Humans

Study record dates

Study Major Dates

• Study Start (Actual): April 30, 2019
• Primary Completion (Actual): March 19, 2020
• Study Completion (Actual): March 19, 2020

Study Registration Dates

• First Submitted: March 20, 2019
• First Submitted That Met QC Criteria: March 20, 2019
• First Posted (Actual): March 22, 2019

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: December 17, 2024
• Last Verified: April 1, 2021

More Information

Terms related to this study

• Keywords: amorphous solid dispersion; Plasma concentration-time profile; Hot-Melt Extrusion
• Additional Relevant MeSH Terms: Anti-Infective Agents; Molecular Mechanisms of Pharmacological Action; Enzyme Inhibitors; Nucleic Acid Synthesis Inhibitors; Antiviral Agents; Cytochrome P-450 Enzyme Inhibitors; Reverse Transcriptase Inhibitors; Cytochrome P-450 CYP2C9 Inhibitors; Cytochrome P-450 CYP2B6 Inducers; Cytochrome P-450 Enzyme Inducers; Cytochrome P-450 CYP3A Inducers; Cytochrome P-450 CYP2C19 Inhibitors; Efavirenz
• Other Study ID Numbers: 2019-00282; ex18Huwyler

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No