- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03492931
PK Study of Ticagrelor in Children Aged Less Than 24 Months, With Sickle Cell Disease (HESTIA4) (HESTIA4)
A Multi-centre, Phase I, Open-label, Single-dose Study to Investigate Pharmacokinetics (PK) of Ticagrelor in Infants and Toddlers, Aged 0 to Less Than 24 Months, With Sickle Cell Disease (HESTIA4)
The purpose of this Phase I study is to investigate the pharmacokinetic properties of ticagrelor in pediatric patients from 0 to less than 24 months with sickle cell disease.
Ticagrelor dose level adjustment will require a Protocol amendment and regulatory approval.
Study Overview
Detailed Description
Study design This Phase I paediatric study (in patients aged 0 to <24 months) with ticagrelor is planned to be a multi-centre, open-label, single dose study.
Primary Objective:
To determine the PK properties of ticagrelor after a single oral dose
Secondary Objectives:
To determine the PK properties of the active metabolite (AR-C124910XX) after a single oral dose To assess the acceptability and the palatability of a single oral dose of ticagrelor
Safety Objective:
To assess safety and tolerability of a single oral dose of ticagrelor
Duration of treatment At least 20 eligible patients will receive a single open label oral dose of ticagrelor on Day 1.
Statistical methods A population PK analysis approach will be used to determine the PK parameters of ticagrelor and its metabolite AR-C124910XX in paediatric patients aged 0 to <24 months eg, CL/F (oral clearance) (only for ticagrelor) and AUC.
The PK will also be described by presenting the observed plasma concentrations of Ticagrelor and its active metabolite for all individuals, as well as corresponding descriptive statistics.
No statistical comparisons are planned for the primary or secondary objectives, which will be summarised descriptively
Study Type
Enrollment (Actual)
Phase
- Phase 1
Contacts and Locations
Study Locations
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Edegem, Belgium, 2650
- Research Site
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Genova, Italy, 16100
- Research Site
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Kisumu, Kenya, 40100
- Research Site
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Nairobi, Kenya, 00100
- Research Site
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Beirut, Lebanon, 11-0236
- Research Site
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Tripoli, Lebanon, 1434
- Research Site
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Madrid, Spain, 28007
- Research Site
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London, United Kingdom, SE1 7EH
- Research Site
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Paediatric patients aged <24 months, diagnosed with homozygous sickle cell (HbSS) or sickle beta-zero-thalassemia (HbS/β0), as confirmed by high performance liquid chromatography or haemoglobin electrophoresis.
- Body weight ≥5 kg at the time of screening.
- If treated with an anti-sickling agent such as hydroxyurea, the weight-adjusted dose must be stable for 3 months before screening/enrolment.
- Provision of signed and dated written informed consent from parents/legal guardians prior to any study specific procedures not part of standard medical care.
Exclusion criteria
- History of transient ischaemic attack or cerebrovascular event/accident (ischaemic or haemorrhagic), severe head trauma, intracranial haemorrhage, intracranial neoplasm, arteriovenous malformation, aneurysm, or proliferative retinopathy.
- Significantly underdeveloped with regards to height, weight or head circumference for age, as judged by the Investigator.
- Severe developmental delay (eg, cerebral palsy or mental retardation).
- Receiving chronic treatment (>3 days/week) with non-steroidal anti-inflammatory drugs (NSAIDs).
- Receiving chronic treatment with anticoagulants or antiplatelet drugs that cannot be discontinued.
- Moderate or severe hepatic impairment, defined as laboratory values of alanine aminotransferase (ALT) >2 × upper limit of normal (ULN), total bilirubin >2 × ULN (unless judged by the Investigator to be caused by haemolysis), albumin <35 g/L and international normalised ratio (INR) >1.4, or symptoms of liver disease (eg, ascites).
- Renal failure requiring dialysis.
- Active pathological bleeding or increased risk of bleeding complications according to the Investigator.
- Haemoglobin <6 g/dL from test performed at Screening (Visit 1).
- Platelets <100 × 10^9/L from test performed at Screening (Visit 1).
- Patient considered to be at risk of bradycardic events (eg, known sick sinus syndrome or second or third degree atrioventricular block).
- Concomitant oral or intravenous therapy with moderate or strong CYP3A4 inhibitors, CYP3A4 substrates with narrow therapeutic indices, or strong CYP3A4 inducers that have not been stopped at least 5 half-lives before dose administration.
- Patient breastfed by mother who is under treatment of strong CYP3A4 inhibitors,
- Active untreated malaria. Patients with suspected malaria at Screening (Visit 1) will be tested.
- Surgical procedure planned to occur during the study including 5 days after ticagrelor administration.
- Known hypersensitivity or contraindication to ticagrelor.
- Concern for the inability of the patient or parents to comply with study procedures and/or follow-up.
- Any condition which, in the opinion of the Investigator, would make it unsafe or unsuitable for the patient to participate in this study.
- Previously administered ticagrelor in the present study.
- Participation in another clinical study with an investigational medicinal product (IMP) or device during the last 30 days preceding screening/enrolment.
- Involvement of member of patient's family in planning and/or conduct of the study (applies to both AstraZeneca personnel and personnel at study centre).
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Treatment arm
Single dose of ticagrelor based on age
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Patients will receive a single dose of ticagrelor
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Peak Plasma Concentration (Cmax) of Ticagrelor
Time Frame: 1,2,4,6 hours post dose
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This measure is obtained from observed plasma concentrations
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1,2,4,6 hours post dose
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Area under plasma concentration curve
Time Frame: 1,2,4,6 hours post dose
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This measure is obtained from the population PK analysis
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1,2,4,6 hours post dose
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CL/F (Oral clearance)
Time Frame: 1,2,4,6 hours post dose
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This measure is obtained from the population PK analysis.
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1,2,4,6 hours post dose
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
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Peak Plasma Concentration (Cmax) for active metabolite (AR-C124910XX)
Time Frame: 1,2,4,6 hours post dose
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1,2,4,6 hours post dose
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Area under plasma concentration curve
Time Frame: 1,2,4,6 hours post dose
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1,2,4,6 hours post dose
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Assessment of ticagrelor suspension for palatability
Time Frame: Day 1, single timepoint assessment
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Questionnaire with one five-options question reflecting different degrees of patients willingness to swallow, from "swallowed without problem" to "vomited up medication".
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Day 1, single timepoint assessment
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Collaborators and Investigators
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Hematologic Diseases
- Genetic Diseases, Inborn
- Anemia
- Anemia, Hemolytic, Congenital
- Anemia, Hemolytic
- Hemoglobinopathies
- Anemia, Sickle Cell
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Platelet Aggregation Inhibitors
- Purinergic P2Y Receptor Antagonists
- Purinergic P2 Receptor Antagonists
- Purinergic Antagonists
- Purinergic Agents
- Ticagrelor
Other Study ID Numbers
- D5136C00010
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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