E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
healthy subjects and in subjects with mild, moderate or severe hepatic impairment |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 12.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10052254 |
E.1.2 | Term | Hepatic impairment |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To investigate the effect of varying degrees of hepatic impairment on the pharmacokinetics of FF and GW642444 following repeat administration of FF 200mcg/GW642444M 25mcg via a novel Dry Powder Inhaler (NDPI). |
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E.2.2 | Secondary objectives of the trial |
•To investigate the effect of varying degrees of hepatic impairment on serum cortisol suppression following repeat administration of FF 200mcg/GW642444M 25mcg via a NDPI. • To investigate the effect of varying degrees of hepatic impairment on heart rate following repeat administration of FF 200mcg/GW642444M 25mcg via a NDPI. • To investigate the effect of varying degrees of hepatic impairment on serum potassium following repeat administration of FF 200mcg/GW642444M 25mcg via a NDPI. • To investigate the effect of varying degrees of hepatic impairment on safety and tolerability following repeat administration of FF 200mcg/GW642444M 25mcg via a NDPI. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Male or female between 18 and 70 years of age inclusive, at the time of signing the informed consent. 2. A female subject is eligible to participate if she is of: • Non-childbearing potential defined as pre-menopausal females with a documented tubal ligation or hysterectomy; or postmenopausal defined as 12 months of spontaneous amenorrhea [in questionable cases a blood sample with simultaneous follicle stimulating hormone (FSH) > 40 MlU/ml and estradiol < 40 pg/ml (<140 pmol/L) (healthy subjects only) is confirmatory]. Females on hormone replacement therapy (HRT) and whose menopausal status is in doubt will be required to use one of the contraception methods in Section 8.1 if they wish to continue their HRT during the study. Otherwise, they must discontinue HRT to allow confirmation of post-menopausal status prior to study enrollment. For most forms of HRT, at least 2-4 weeks will elapse between the cessation of therapy and the blood draw; this interval depends on the type and dosage of HRT. Following confirmation of their post-menopausal status, they can resume use of HRT during the study without use of a contraceptive method. • Child-bearing potential and agrees to use one of the contraception methods listed in Section 8.1 for an appropriate period of time (as determined by the product label or investigator) prior to the start of dosing to sufficiently minimize the risk of pregnancy at that point. Female subjects must agree to use contraception until completion of the follow-up visit. 3. BMI within the range 19 – 33 kg/m2. 4. Able to satisfactorily use the dry powder inhalation inhaler. 5. Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the consent form. 6. Single QTcF < 450 msec; or QTcF < 480 msec in subjects with Bundle Branch Block. Healthy subjects 1. AST, ALT, alkaline phosphatase and bilirubin ≤ 1.5xULN (isolated bilirubin >1.5xULN is acceptable if bilirubin is fractionated and direct bilirubin <35%). 2. Healthy as determined by a responsible and experienced physician, based on a medical evaluation including medical history, physical examination, laboratory tests and cardiac monitoring. 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 GSK Medical Monitor agree that the finding is unlikely to introduce additional risk factors and will not interfere with the study procedures or outcome. Hepatically Impaired Subjects 1. Hepatically impaired. To be classified as hepatically impaired, subjects must have: Known medical history of liver disease with or without a known history of alcohol abuse; and A Child-Pugh score of 5-15 to cover all severities (Mild = 5-6 points; Moderate = 7- 9 points; Severe = 10-15 points). The components that contribute to the CP score should be directly related to the underlying hepatic disease and not to non-hepatic disease. 2. Subjects with no significant abnormality, apart from impaired hepatic function and related symptoms, or clinical examination. A subject with a clinical abnormality may be included only if the Investigator considers that the abnormality will not introduce additional risk factors and will not interfere with the study procedures. Hepatically impaired subjects with other laboratory parameters outside the reference ranges will only be included if, in the opinion of the Investigator, the result is not clinically important and introduces no additional risk factors.
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E.4 | Principal exclusion criteria |
1. Suffered a lower respiratory tract infection in the 4 weeks before the screening visit. 2. Taken oral corticosteroids less than 8 weeks before the screening visit. 3. Taken inhaled, intranasal or topical steroids less than 4 weeks before the screening visit. 4. Have a known sensitivity to corticosteroids and/or long acting beta agonists. 5. A positive pre-study drug/alcohol screen. 6. A positive test for HIV antibody. 7. The subject has participated in a clinical trial and has received an investigational product view page 26 of the protocol for further information. 8. Exposure to more than four new chemical entities within 12 months prior to the first dosing day. 9. History of sensitivity to any of the study medications, or components view page 26 of the protocol for further information. 10. Where participation in the study would result in donation of blood or blood products in excess of 500 mL within a 56 day period. 11. Pregnant females as determined by positive serum or urine hCG test at screening or prior to dosing. 12. Lactating females. 13. The subject has been treated for or diagnosed with depression within six months of screening or has a history of significant psychiatric illness. 14. Unwillingness or inability to follow the procedures outlined in the protocol. 15. Subject is mentally or legally incapacitated. 16. History of sensitivity to heparin or heparin-induced thrombocytopenia. 17. Subjects who have asthma or a history of asthma. 18. History of severe milk protein allergy. 19. Subjects with a smoking history of >10 cigarettes per day or regular use of tobacco or nicotine-containing products, within 6 months prior to screening. 20. Consumption of red wine, seville oranges, grapefruit or grapefruit juice and/or pummelos, exotic citrus fruits, grapefruit hybrids or fruit juices from 7 days prior to the first dose of study medication. Healthy subjects 1. If, in the opinion of the examining physician, an unstable cardiovascular, renal, hepatic condition, view page 26 of the protocol for further information. 2. Subjects with any predisposing condition that might interfere with the absorption, distribution, metabolism or excretion of drugs or any previous gastrointestinal (GI) surgery (view page 27 of the protocol for further information. 3. Haemoglobin values <12.9g/dL for males and <11.4g/dL for females. 4. A past history or current symptoms of significant hepatic or renal disease, pancreatitis or acute cholecystitis view page 27 of the protocol for further information. 5. A positive pre-study Hepatitis B surface antigen or positive Hepatitis C antibody result within 3 months of screening 6. Current or chronic history of liver disease, or known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones). 7. History of regular alcohol consumption within 6 months of the study defined as: View page 26 of the protocol. 8. Use of prescription or non-prescription drugs, including vitamins, herbal and dietary supplements view page 27 of the protocol for further information. 1. If in the opinion of the examining physician, an unstable cardiovascular, renal, pulmonary condition, view page 26 of the protocol for further information. 2. Severe ascities (Child-Pugh ascites score of 3) upon clinical exam, including physical exam and abdominal ultrasound at screening. View page 26 of the protocol page for further information. 3. History of oesophageal bleeding within the last 6 months before dosing. 4. Significant hepatic encephalopathy, degree of CNS impairment or other signs of hepatic function deterioration view page 27 of the protocol for further information. 5. Patients at risk of requiring a transfusion during the study period, or has haemoglobin < 9 g/dL - view page 27 of the protocol for further information. 6. Evidence of current significant infection (e.g. spontaneous bacterial peritonitis, pneumonia etc.). 7. Subjects who develop symptoms such as infections or haemorrhage between screening and dosing must not be included in the study. 8. Fluctuating or rapidly deteriorating hepatic function - view page 27 of the protocol for further information. 9. Subjects with significant renal insufficiency as defined by estimated creatinine clearance of <50 ml/min, using the Cockcroft and Gault equation. 10. Subjects with a diagnosis of primary biliary disease such as cholestasis or sclerosing cholangitis. 11. Subjects who need to take any concomitant medication, either prescribed or over-the counter, which may in the opinion of the Investigator, interfere in any way with the study procedure or be a safety concern view page 27 of the protocol for further information. 12. Subjects who, within the past six months, have had a history of significant drug abuse or alcohol abuse. |
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E.5 End points |
E.5.1 | Primary end point(s) |
• Fluticasone furoate and GW642444 pharmacokinetics (AUC(0-t), AUC (0-8), Cmax, tmax) on Day 1 and 7 and AUC(0-24) and t½ on Day 7. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.4.1 | Number of sites anticipated in Member State concerned | 1 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 3 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 9 |
E.8.9.2 | In all countries concerned by the trial days | 0 |