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    Clinical Trial Results:
    An open label, randomized, three period, single-dose, crossover study to determine the bioavailability of 300 mg aliskiren mini-tablets relative to the 300 mg aliskiren market tablet under fasted condition and to evaluate the effect of food on the pharmacokinetics of 300 mg aliskiren mini-tablets in healthy subjects

    Summary
    EudraCT number
    2012-000855-15
    Trial protocol
    Outside EU/EEA  
    Global end of trial date
    22 Feb 2010

    Results information
    Results version number
    v1(current)
    This version publication date
    25 Oct 2018
    First version publication date
    25 Oct 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    CSPP100A2109
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Novartis Pharma AG
    Sponsor organisation address
    CH 4002, Basel, Switzerland,
    Public contact
    Clinical Disclosure Office, Clinical Disclosure Office, +41 613241111,
    Scientific contact
    Clinical Disclosure Office, Clinical Disclosure Office, +41 613241111,
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    Yes
    EMA paediatric investigation plan number(s)
    EMEA-000362-PIP08-04
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    22 Feb 2010
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    22 Feb 2010
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The main objective of the trial was to determine the bioavailability of a single oral dose of 300 milligrams (mg) aliskiren mini-tablets relative to the 300 mg aliskiren market tablet under fasted condition in healthy subjects and to evaluate the effect of food on the pharmacokinetics of a single oral dose of 300 mg aliskiren mini-tablets in healthy subjects.
    Protection of trial subjects
    The study was in compliance with the ethical principles derived from the Declaration of Helsinki and in compliance with all International Conference on Harmonization (ICH) Good Clinical Practice (GCP) Guidelines. All the local regulatory requirements pertinent to safety of trial subjects were followed.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    31 Dec 2009
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    India: 69
    Worldwide total number of subjects
    69
    EEA total number of subjects
    0
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    69
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The study was conducted at one center in India.

    Pre-assignment
    Screening details
    A total of 69 subjects were enrolled in the study.

    Period 1
    Period 1 title
    Overall period
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded
    Blinding implementation details
    The study was open-label study, hence no blinding was performed.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Mini (fasted) then FMI (fasted) then Mini tablet (fed)
    Arm description
    Subjects were orally administered with single dose of aliskiren equivalent to 300 mg mini-tablets followed by single dose of aliskiren 300 mg final market image (FMI) tablets under fasted conditions and finally with single dose of aliskiren equivalent to 300 mg mini-tablets under fed condition. A washout interval of least 14 days (maximum 21 days) was maintained between two treatments.
    Arm type
    Experimental

    Investigational medicinal product name
    Aliskiren
    Investigational medicinal product code
    SPP100
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Subjects after having an overnight fast of at least 10 hours (h) were orally administered with single dose of aliskiren equivalent to 300 mg mini-tablets administered with a teaspoon of low fat vanilla ice cream followed by single dose of aliskiren 300 mg FMI tablets, administered with 240 milliliters (mL) of water under fasted condition. Subjects continued to fast till 4 h post dose, during which they were served a standard lunch. Finally subjects received a single dose of aliskiren equivalent to 300 mg mini-tablets, administered with a teaspoon of low fat vanilla ice cream followed by 240 mL of water under fed condition. Dosing of which, was done 30 minutes after start of a USFDA recommended standard high-fat breakfast. Throughout water was not allowed 1 h before and 1 h after dose except that taken with the study medication. Water was then made available as and when needed. A washout interval of least 14 days (maximum 21 days) was maintained between two treatments.

    Arm title
    FMI (fasted) then Mini (fed) then Mini tablet (fasted)
    Arm description
    Subjects were orally administered with single dose of aliskiren 300 mg FMI tablets under fasted conditions followed by single dose of aliskiren equivalent to 300 mg mini-tablets under fed condition and finally with single dose of aliskiren equivalent to 300 mg mini-tablets tablets under fasted conditions. A washout interval of least 14 days (maximum 21 days) was maintained between two treatments.
    Arm type
    Experimental

    Investigational medicinal product name
    Aliskiren
    Investigational medicinal product code
    SPP100
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Subjects after having an overnight fast of at least 10 h were orally administered with single dose of aliskiren 300 mg FMI tablets, administered with 240 mL of water under fasted condition followed by a single dose of aliskiren equivalent to 300 mg mini-tablets, administered with a teaspoon of low fat vanilla ice cream followed by 240 mL of water under fed condition. Dosing was done 30 minutes after start of a USFDA recommended standard high-fat breakfast. Finally subjects received a single dose of aliskiren equivalent to 300 mg mini-tablets administered with a teaspoon of low fat vanilla ice cream followed by 240 mL of water under fasted condition. Subjects continued to fast till 4 h post dose and were served a standard lunch. Throughout water was not allowed 1 h before and 1 h after dose except that taken with the study medication. Water was then made available as and when needed. A washout interval of least 14 days (maximum 21 days) was maintained between two treatments.

    Arm title
    Mini (fed) then Mini (fasted) then FMI tablet (fasted)
    Arm description
    Subjects were orally administered with single dose of aliskiren equivalent to 300 mg mini-tablets under fed condition followed by single dose of aliskiren equivalent to 300 mg mini-tablets tablets under fasted conditions and finally with single dose of aliskiren 300 mg FMI tablets under fasted conditions. A washout interval of least 14 days (maximum 21 days) was maintained between two treatments.
    Arm type
    Experimental

    Investigational medicinal product name
    Aliskiren
    Investigational medicinal product code
    SPP100
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Subjects after having an overnight fast were orally administered with single dose of aliskiren equivalent to 300 mg mini-tablets, administered with a teaspoon of low fat vanilla ice cream followed by 240 mL of water under fed condition. Dosing was done 30 minutes after start of a USFDA recommended standard high-fat breakfast followed by single dose of aliskiren equivalent to 300 mg mini-tablets administered with a teaspoon of low fat vanilla ice cream followed by 240 mL of water under fasted condition. Finally subjects received a single dose of aliskiren 300 mg FMI tablets, administered with 240 mL of water under fasted condition. Subjects continued to fast till 4 h post dose, during which they were served a standard lunch. Throughout water was not allowed 1 h before and 1 h after dose except that taken with the study medication. Water was then made available as and when needed. A washout interval of least 14 days (maximum 21 days) was maintained between two treatments.

    Number of subjects in period 1
    Mini (fasted) then FMI (fasted) then Mini tablet (fed) FMI (fasted) then Mini (fed) then Mini tablet (fasted) Mini (fed) then Mini (fasted) then FMI tablet (fasted)
    Started
    23
    23
    23
    Completed
    18
    19
    18
    Not completed
    5
    4
    5
         Administrative problems
    3
    1
    2
         Lost to follow-up
    1
    1
    1
         Adverse Event (s)
    1
    2
    2

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Mini (fasted) then FMI (fasted) then Mini tablet (fed)
    Reporting group description
    Subjects were orally administered with single dose of aliskiren equivalent to 300 mg mini-tablets followed by single dose of aliskiren 300 mg final market image (FMI) tablets under fasted conditions and finally with single dose of aliskiren equivalent to 300 mg mini-tablets under fed condition. A washout interval of least 14 days (maximum 21 days) was maintained between two treatments.

    Reporting group title
    FMI (fasted) then Mini (fed) then Mini tablet (fasted)
    Reporting group description
    Subjects were orally administered with single dose of aliskiren 300 mg FMI tablets under fasted conditions followed by single dose of aliskiren equivalent to 300 mg mini-tablets under fed condition and finally with single dose of aliskiren equivalent to 300 mg mini-tablets tablets under fasted conditions. A washout interval of least 14 days (maximum 21 days) was maintained between two treatments.

    Reporting group title
    Mini (fed) then Mini (fasted) then FMI tablet (fasted)
    Reporting group description
    Subjects were orally administered with single dose of aliskiren equivalent to 300 mg mini-tablets under fed condition followed by single dose of aliskiren equivalent to 300 mg mini-tablets tablets under fasted conditions and finally with single dose of aliskiren 300 mg FMI tablets under fasted conditions. A washout interval of least 14 days (maximum 21 days) was maintained between two treatments.

    Reporting group values
    Mini (fasted) then FMI (fasted) then Mini tablet (fed) FMI (fasted) then Mini (fed) then Mini tablet (fasted) Mini (fed) then Mini (fasted) then FMI tablet (fasted) Total
    Number of subjects
    23 23 23 69
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    23 23 23 69
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    26.8 ± 5.93 25.8 ± 4.29 27.7 ± 5.57 -
    Gender categorical
    Units: Subjects
        Male
    23 23 23 69

    End points

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    End points reporting groups
    Reporting group title
    Mini (fasted) then FMI (fasted) then Mini tablet (fed)
    Reporting group description
    Subjects were orally administered with single dose of aliskiren equivalent to 300 mg mini-tablets followed by single dose of aliskiren 300 mg final market image (FMI) tablets under fasted conditions and finally with single dose of aliskiren equivalent to 300 mg mini-tablets under fed condition. A washout interval of least 14 days (maximum 21 days) was maintained between two treatments.

    Reporting group title
    FMI (fasted) then Mini (fed) then Mini tablet (fasted)
    Reporting group description
    Subjects were orally administered with single dose of aliskiren 300 mg FMI tablets under fasted conditions followed by single dose of aliskiren equivalent to 300 mg mini-tablets under fed condition and finally with single dose of aliskiren equivalent to 300 mg mini-tablets tablets under fasted conditions. A washout interval of least 14 days (maximum 21 days) was maintained between two treatments.

    Reporting group title
    Mini (fed) then Mini (fasted) then FMI tablet (fasted)
    Reporting group description
    Subjects were orally administered with single dose of aliskiren equivalent to 300 mg mini-tablets under fed condition followed by single dose of aliskiren equivalent to 300 mg mini-tablets tablets under fasted conditions and finally with single dose of aliskiren 300 mg FMI tablets under fasted conditions. A washout interval of least 14 days (maximum 21 days) was maintained between two treatments.

    Subject analysis set title
    Mini tablet (fasted)
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Subjects after having an overnight fast of at least 10 h were orally administered with single dose of aliskiren equivalent to 300 mg mini-tablets administered with a teaspoon of low fat vanilla ice cream followed by 240 mL of water under fasted condition. Subjects continued to fast till 4 h post dose, during which they were served a standard lunch. Water was not allowed 1 h before and 1 h after dose except that taken with the study medication. Water was then made available as and when needed.

    Subject analysis set title
    FMI tablet (fasted)
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Subjects after having an overnight fast of at least 10 h were orally administered with single dose of aliskiren 300 mg FMI tablets, administered with 240 mL of water under fasted condition. Subjects continued to fast till 4 h post dose, during which they were served a standard lunch. Water was not allowed 1 h before and 1 h after dose except that taken with the study medication. Water was then made available as and when needed.

    Subject analysis set title
    Mini tablet (fed)
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Subjects after having an overnight fast were orally administered with single dose of aliskiren equivalent to 300 mg mini-tablets, administered with a teaspoon of low fat vanilla ice cream followed by 240 mL of water under fed condition. Dosing was done 30 minutes after start of a USFDA recommended standard high-fat breakfast. Water was not allowed 1 h before and 1 h after dose except that taken with the study medication. Water was then made available as and when needed.

    Primary: Area under the curve from time zero to the last measurable concentration sampling time (AUClast) of aliskiren

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    End point title
    Area under the curve from time zero to the last measurable concentration sampling time (AUClast) of aliskiren
    End point description
    AUClast was defined as the area under the plasma concentration-time curve up to the last measurable concentration time point and was calculated as the sum of linear trapezoids using non-compartmental analysis were determined using WinNonlin Pro (Version 5.0.1). Plasma concentrations of aliskiren was analyzed using a validated liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay with a lower limit of quantification (LLOQ) of 0.5 nanogram (ng)/mL. The analysis was performed on pharmacokinetic (PK) analysis set (PAS) defined as all subjects who completed at least one treatment period with evaluable aliskiren PK data.
    End point type
    Primary
    End point timeframe
    Pre-dose, 0.25 h, 0.5 h, 1h, 1.5h, 2h, 3h, 4h, 6h, 8h, 12h at Day 1; Day 2, Day 3, Day 4, Day 5, Day 7 and Day 8 post dose
    End point values
    Mini tablet (fasted) FMI tablet (fasted) Mini tablet (fed)
    Number of subjects analysed
    60
    61
    62
    Units: ng.hr/mL
        geometric mean (geometric coefficient of variation)
    2872 ± 39.12
    2809 ± 44.35
    447.3 ± 46.28
    Statistical analysis title
    Bioavailability: AUClast of aliskiren
    Statistical analysis description
    Comparison of AUClast for Mini tablet fasted with FMI tablet fasted was evaluated to determine the bioavailability of a single oral dose of 300 mg mini-tablets relative to the 300 mg FMI tablet under fasted condition. The number of subjects analyzed for this end point were 60 and 61 respectively, but since this is a cross-over study, the subjects analyzed feature as 121 below, which is the total of the two arms that are being compared [Mini tablet fasted (N=60) and FMI tablet fasted (N=61)].
    Comparison groups
    Mini tablet (fasted) v FMI tablet (fasted)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    Method
    Parameter type
    Geometric mean ratio
    Point estimate
    1.02
    Confidence interval
         level
    90%
         sides
    2-sided
         lower limit
    0.92
         upper limit
    1.14
    Statistical analysis title
    Food effect: AUClast of aliskiren
    Statistical analysis description
    Comparison of AUClast for Mini tablet fed with Mini tablet fasted was evaluated to determine the effect of food on the pharmacokinetics of a single oral dose of 300 mg mini-tablets. The number of subjects analyzed for this end point were 62 and 60 respectively, but since this is a cross-over study, the subjects analyzed feature as 122 below, which is the total of the two arms that are being compared [Mini tablet fed (N=62) and Mini tablet fasted (N=60)].
    Comparison groups
    Mini tablet (fed) v Mini tablet (fasted)
    Number of subjects included in analysis
    122
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    Method
    Parameter type
    Geometric mean ratio
    Point estimate
    0.16
    Confidence interval
         level
    90%
         sides
    2-sided
         lower limit
    0.14
         upper limit
    0.18

    Primary: Area under the concentration-time curve to infinity (AUCinf) of aliskiren

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    End point title
    Area under the concentration-time curve to infinity (AUCinf) of aliskiren
    End point description
    AUCinf was defined as the area under the curve from time zero to infinity. AUCinf was calculated using non-compartmental methods using WinNonlin Pro (Version 5.0.1) by adding area under the curve from time zero to the last measurable concentration sampling time (AUClast) and the value obtained from dividing the last measurable plasma concentration (Clast) by terminal elimination rate constant (ke). Plasma concentrations of aliskiren was analyzed using a validated LC-MS/MS assay with LLOQ of 0.5 ng/mL. The analysis was performed on PAS population.
    End point type
    Primary
    End point timeframe
    Pre-dose, 0.25 h, 0.5 h, 1h, 1.5h, 2h, 3h, 4h, 6h, 8h, 12h at Day 1; Day 2, Day 3, Day 4, Day 5, Day 7 and Day 8 post dose
    End point values
    Mini tablet (fasted) FMI tablet (fasted) Mini tablet (fed)
    Number of subjects analysed
    60
    61
    62
    Units: ng.hr/mL
        geometric mean (geometric coefficient of variation)
    3115 ± 37.98
    3050 ± 42.94
    504.7 ± 45.76
    Statistical analysis title
    Bioavailability: AUCinf of aliskiren
    Statistical analysis description
    Comparison of AUCinf for Mini tablet fasted with FMI tablet fasted was evaluated to determine the bioavailability of a single oral dose of 300 mg mini-tablets relative to the 300 mg FMI tablet under fasted condition. The number of subjects analyzed for this end point were 60 and 61 respectively, but since this is a cross-over study,the subjects analyzed feature as 121 below, which is the total of the two arms that are being compared [Mini tablet fasted (N=60) and FMI tablet fasted (N=61)].
    Comparison groups
    Mini tablet (fasted) v FMI tablet (fasted)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    Method
    Parameter type
    Geometric mean ratio
    Point estimate
    1.01
    Confidence interval
         level
    90%
         sides
    2-sided
         lower limit
    0.91
         upper limit
    1.12
    Statistical analysis title
    Food effect: AUCinf of aliskiren
    Statistical analysis description
    Comparison of AUClast for Mini tablet fed with Mini tablet fasted was evaluated to determine the effect of food on the pharmacokinetics of a single oral dose of 300 mg mini-tablets. The number of subjects analyzed for this end point were 62 and 60 respectively, but since this is a cross-over study, the subjects analyzed feature as 122 below, which is the total of the two arms that are being compared [Mini tablet fed (N=62) and Mini tablet fasted (N=60)].
    Comparison groups
    Mini tablet (fasted) v Mini tablet (fed)
    Number of subjects included in analysis
    122
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    Method
    Parameter type
    Geometric mean ratio
    Point estimate
    0.17
    Confidence interval
         level
    90%
         sides
    2-sided
         lower limit
    0.15
         upper limit
    0.19

    Primary: Maximum plasma concentration (Cmax) of aliskiren

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    End point title
    Maximum plasma concentration (Cmax) of aliskiren
    End point description
    Cmax was defined as the maximum (peak) observed drug concentration in blood after single dose administration. Cmax was directly determined from the raw plasma concentration-time data using WinNonLin Professional version 5.2. Plasma concentrations of aliskiren was analyzed using a validated LC-MS/MS assay with LLOQ of 0.5 ng/mL. The analysis was performed on PAS population.
    End point type
    Primary
    End point timeframe
    Pre-dose, 0.25 h, 0.5 h, 1h, 1.5h, 2h, 3h, 4h, 6h, 8h, 12h at Day 1; Day 2, Day 3, Day 4, Day 5, Day 7 and Day 8 post dose
    End point values
    Mini tablet (fasted) FMI tablet (fasted) Mini tablet (fed)
    Number of subjects analysed
    60
    61
    62
    Units: ng/mL
        geometric mean (geometric coefficient of variation)
    414.4 ± 50.22
    390.9 ± 53.02
    19.29 ± 50.98
    Statistical analysis title
    Bioavailability: Cmax of aliskiren
    Statistical analysis description
    Comparison of Cmax for Mini tablet fasted with FMI tablet fasted was evaluated to determine the bioavailability of a single oral dose of 300 mg mini-tablets relative to the 300 mg FMI tablet under fasted condition. The number of subjects analyzed for this end point were 60 and 61 respectively, but since this is a cross-over study,the subjects analyzed feature as 121 below, which is the total of the two arms that are being compared [Mini tablet fasted (N=60) and FMI tablet fasted (N=61)].
    Comparison groups
    Mini tablet (fasted) v FMI tablet (fasted)
    Number of subjects included in analysis
    121
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    Method
    Parameter type
    Geometric mean ratio
    Point estimate
    1.06
    Confidence interval
         level
    90%
         sides
    2-sided
         lower limit
    0.94
         upper limit
    1.21
    Statistical analysis title
    Food effect: Cmax of aliskiren
    Statistical analysis description
    Comparison of Cmax for Mini tablet fed with Mini tablet fasted was evaluated to determine the effect of food on the pharmacokinetics of a single oral dose of 300 mg mini-tablets. The number of subjects analyzed for this end point were 62 and 60 respectively, but since this is a cross-over study, the subjects analyzed feature as 122 below, which is the total of the two arms that are being compared [Mini tablet fed (N=62) and Mini tablet fasted (N=60)].
    Comparison groups
    Mini tablet (fasted) v Mini tablet (fed)
    Number of subjects included in analysis
    122
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    Method
    Parameter type
    Geometric mean ratio
    Point estimate
    0.05
    Confidence interval
         level
    90%
         sides
    2-sided
         lower limit
    0.04
         upper limit
    0.05

    Primary: Time to reach maximum (peak) drug concentration (Tmax ) of aliskiren

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    End point title
    Time to reach maximum (peak) drug concentration (Tmax ) of aliskiren [1]
    End point description
    Tmax was defined as the time to reach maximum (peak) drug concentration after single dose administration. Tmax was directly determined from the raw plasma concentration-time data using WinNonLin Professional version 5.2. Plasma concentrations of aliskiren was analyzed using a validated LC-MS/MS assay with LLOQ of 0.5 ng/mL. The analysis was performed on PAS population.
    End point type
    Primary
    End point timeframe
    Pre-dose, 0.25 h, 0.5 h, 1h, 1.5h, 2h, 3h, 4h, 6h, 8h, 12h at Day 1; Day 2, Day 3, Day 4, Day 5, Day 7 and Day 8 post dose
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Only descriptive summary statistics was planned for this outcome measure.
    End point values
    Mini tablet (fasted) FMI tablet (fasted) Mini tablet (fed)
    Number of subjects analysed
    60
    61
    62
    Units: hours
        median (full range (min-max))
    1 (0.5 to 6)
    2 (0.3 to 6)
    1.5 (0.3 to 12)
    No statistical analyses for this end point

    Primary: The elimination half-life associated with the terminal slope (λz) of a semilogarithmic concentration-time curve (T1/2) of aliskiren

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    End point title
    The elimination half-life associated with the terminal slope (λz) of a semilogarithmic concentration-time curve (T1/2) of aliskiren [2]
    End point description
    T1/2 was defined as the elimination half-life associated with the terminal slope of a semi logarithmic concentration-time curve. T1/2 was calculated using non-compartmental methods using WinNonlin Pro (Version 5.0.1) calculated as Ln2/ke. Plasma concentrations of aliskiren was analyzed using a validated LC-MS/MS assay with LLOQ of 0.5 ng/mL. The analysis was performed on PAS population.
    End point type
    Primary
    End point timeframe
    Pre-dose, 0.25 h, 0.5 h, 1h, 1.5h, 2h, 3h, 4h, 6h, 8h, 12h at Day 1; Day 2, Day 3, Day 4, Day 5, Day 7 and Day 8 post dose
    Notes
    [2] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Only descriptive summary statistics was planned for this outcome measure.
    End point values
    Mini tablet (fasted) FMI tablet (fasted) Mini tablet (fed)
    Number of subjects analysed
    58
    60
    52
    Units: hour
        median (full range (min-max))
    64.51 (39.9 to 99)
    67.36 (22.9 to 102)
    61.97 (15.8 to 106)
    No statistical analyses for this end point

    Primary: The apparent total body clearance of drug from the plasma (CL/F) of aliskiren

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    End point title
    The apparent total body clearance of drug from the plasma (CL/F) of aliskiren [3]
    End point description
    CL/F was defined as the apparent clearance of a drug from the blood after oral administration. CL/F was analyzed using non-compartmental methods using WinNonlin Pro (Version 5.0.1). Plasma concentrations of aliskiren was analyzed using a validated LC-MS/MS assay with LLOQ of 0.5 ng/mL. The analysis was performed on PAS population.
    End point type
    Primary
    End point timeframe
    Pre-dose, 0.25 h, 0.5 h, 1h, 1.5h, 2h, 3h, 4h, 6h, 8h, 12h at Day 1; Day 2, Day 3, Day 4, Day 5, Day 7 and Day 8 post dose
    Notes
    [3] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Only descriptive summary statistics was planned for this outcome measure.
    End point values
    Mini tablet (fasted) FMI tablet (fasted) Mini tablet (fed)
    Number of subjects analysed
    58
    60
    52
    Units: mL/h
        geometric mean (geometric coefficient of variation)
    96320 ± 37.98
    98360 ± 42.94
    594400 ± 45.76
    No statistical analyses for this end point

    Secondary: Number of subjects with Adverse Events (AEs), Serious Adverse Events (SAEs), AE leading to discontinuation and who died

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    End point title
    Number of subjects with Adverse Events (AEs), Serious Adverse Events (SAEs), AE leading to discontinuation and who died
    End point description
    AEs are defined as any unfavorable and unintended diagnosis, symptom, sign (including an abnormal laboratory finding), syndrome or disease which either occurs during study, having been absent at baseline, or, if present at baseline, appears to worsen. Serious adverse events are any untoward medical occurrences that result in death, are life threatening, require (or prolong) hospitalization, cause persistent or significant disability/incapacity, result in congenital anomalies or birth defects, or are other conditions which in judgment of investigators represent significant hazards. The analysis was performed on safety set population defined as all subjects who received at least one dose of the study drug.
    End point type
    Secondary
    End point timeframe
    From Day 1 to 30 days after the last subject treatment (approximately 30 days)
    End point values
    Mini tablet (fasted) FMI tablet (fasted) Mini tablet (fed)
    Number of subjects analysed
    60
    61
    62
    Units: Subjects
        AEs
    12
    11
    21
        SAEs
    0
    0
    0
        AEs leading to discontinuation
    0
    1
    4
        Deaths
    0
    0
    0
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Serious Adverse Events are monitored from date of First Subject First Visit (FSFV) until Last Subject Last Visit (LSLV). All other adverse events are monitored from First Subject First Treatment until LSLV.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    12.1
    Reporting groups
    Reporting group title
    Mini-tablets fed
    Reporting group description
    Subjects after having an overnight fast were orally administered with single dose of aliskiren equivalent to 300 mg mini-tablets, administered with a teaspoon of low fat vanilla ice cream followed by 240 mL of water under fed condition. Dosing was done 30 minutes after start of a USFDA recommended standard high-fat breakfast. Water was not allowed 1 h before and 1 h after dose except that taken with the study medication. Water was then made available as and when needed.

    Reporting group title
    Market-tablet fasted
    Reporting group description
    Subjects after having an overnight fast of at least 10 h were orally administered with single dose of aliskiren 300 mg FMI tablets, administered with 240 mL of water under fasted condition. Subjects continued to fast till 4 h post dose, during which they were served a standard lunch. Water was not allowed 1 h before and 1 h after dose except that taken with the study medication. Water was then made available as and when needed.

    Reporting group title
    All Subjects
    Reporting group description
    Subjects after having an overnight fast of at least 10 h were orally administered with aliskiren, administered with 240 mL of water under fasted condition. Water was not allowed 1 h before and 1 h after dose except that taken with the study medication. Water was then made available as and when needed.

    Reporting group title
    Mini-tablets fasted
    Reporting group description
    Subjects after having an overnight fast of at least 10 h were orally administered with single dose of aliskiren equivalent to 300 mg mini-tablets administered with a teaspoon of low fat vanilla ice cream followed by 240 mL of water under fasted condition. Subjects continued to fast till 4 h post dose, during which they were served a standard lunch. Water was not allowed 1 h before and 1 h after dose except that taken with the study medication. Water was then made available as and when needed.

    Serious adverse events
    Mini-tablets fed Market-tablet fasted All Subjects Mini-tablets fasted
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 62 (0.00%)
    0 / 61 (0.00%)
    0 / 69 (0.00%)
    0 / 60 (0.00%)
         number of deaths (all causes)
    0
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Mini-tablets fed Market-tablet fasted All Subjects Mini-tablets fasted
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    15 / 62 (24.19%)
    5 / 61 (8.20%)
    23 / 69 (33.33%)
    8 / 60 (13.33%)
    Investigations
    Blood creatinine increased
         subjects affected / exposed
    2 / 62 (3.23%)
    1 / 61 (1.64%)
    4 / 69 (5.80%)
    1 / 60 (1.67%)
         occurrences all number
    2
    1
    4
    1
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    3 / 62 (4.84%)
    0 / 61 (0.00%)
    6 / 69 (8.70%)
    3 / 60 (5.00%)
         occurrences all number
    3
    0
    6
    3
    Headache
         subjects affected / exposed
    4 / 62 (6.45%)
    3 / 61 (4.92%)
    7 / 69 (10.14%)
    2 / 60 (3.33%)
         occurrences all number
    4
    3
    9
    2
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    3 / 62 (4.84%)
    1 / 61 (1.64%)
    5 / 69 (7.25%)
    1 / 60 (1.67%)
         occurrences all number
    3
    1
    6
    2
    Nausea
         subjects affected / exposed
    2 / 62 (3.23%)
    0 / 61 (0.00%)
    4 / 69 (5.80%)
    2 / 60 (3.33%)
         occurrences all number
    2
    0
    4
    2
    Vomiting
         subjects affected / exposed
    3 / 62 (4.84%)
    1 / 61 (1.64%)
    6 / 69 (8.70%)
    2 / 60 (3.33%)
         occurrences all number
    3
    1
    6
    2

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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