A Study to Estimate the Effect of CYP3A4 Inhibitors (Itraconazole, Diltiazem or Verapamil) on the Pharmacokinetics of Single Dose PF- 00489791 in Healthy Volunteers

Sponsor
Pfizer (Industry)
Overall Status
Completed
CT.gov ID
NCT02319148
Collaborator
(none)
22
1
3
3
7.3

Study Details

Study Description

Brief Summary

The primary objective of the study is to estimate the effects of different strong enzyme (CYP3A4) inhibitors, itraconazole, diltiazem, or verapamil on the single dose pharmacokinetics of PF-00489791 in healthy volunteers. The study will enroll approximately 18 subjects that are randomized to 1 of 3 treatment groups. The study is also intended to determine the safety and tolerability of single-dose PF- 00489791 when it is administered with steady-state itraconazole, diltiazem, or verapamil.

Condition or Disease Intervention/Treatment Phase
Phase 1

Study Design

Study Type:
Interventional
Actual Enrollment :
22 participants
Allocation:
Randomized
Intervention Model:
Crossover Assignment
Masking:
None (Open Label)
Primary Purpose:
Basic Science
Official Title:
A Phase 1, Randomized, Open-label, 3-sequence, 4-treatment, Incomplete Block Design To Estimate The Effect Of Steady State Cyp3a4 Inhibitors (Itraconazole, Diltiazem Or Verapamil) On The Pharmacokinetics Of Singe Dose Pf-00489791 In Healthy Volunteers
Study Start Date :
Jul 1, 2014
Actual Primary Completion Date :
Oct 1, 2014
Actual Study Completion Date :
Oct 1, 2014

Arms and Interventions

Arm Intervention/Treatment
Experimental: Treatment B

Treatment B subjects receive single dose administration of 20 mg PF-00489791 and multiple dose administration of itraconazole (200 mg once daily).

Drug: itraconazole
itraconazole dosed at 200 mg

Drug: PF-00489791
PF-00489791 20 mg single dose administration

Experimental: Treatment C

Treatment C subjects receive single dose administration of 20 mg PF-00489791 and multiple dose administration of diltiazem (240 mg once daily).

Drug: diltiazem
diltiazem dosed at 240 mg

Drug: PF-00489791
PF-00489791 20 mg single dose administration

Experimental: Treatment D

Treatment D subjects receive single dose administration of 20 mg PF-00489791 and multiple dose administration of verapamil (240 mg once daily).

Drug: SR verapamil
SR verapamil dosed at 240 mg

Drug: PF-00489791
PF-00489791 20 mg single dose administration

Outcome Measures

Primary Outcome Measures

  1. Maximum Observed Plasma Concentration (Cmax) of PF-00489791 [Pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 12 hours after PF-00489791 administration]

  2. Area Under the Plasma Concentration-Time Profile From Time 0 Extrapolated to Infinite Time (AUCinf) of PF-00489791 [Pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 12 hours after PF-00489791 administration]

    AUC is a measure of the plasma concentration of the drug over time. It is used to characterize drug absorption.

Secondary Outcome Measures

  1. Area Under the Curve From Time Zero to Last Quantifiable Concentration (AUClast) of PF-00489791 [Pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 12 hours after PF-00489791 administration]

    Area under the plasma concentration time-curve from zero to the last measured concentration (AUClast).

  2. Time to Reach Maximum Observed Plasma Concentration (Tmax) of PF-00489791 [Pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 12 hours after PF-00489791 administration]

  3. Apparent Volume of Distribution (Vz/F) of PF-00489791 [Pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 12 hours after PF-00489791 administration]

    Volume of distribution is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired plasma concentration of a drug. Apparent volume of distribution after oral dose (Vz/F) is influenced by the fraction absorbed.

  4. Apparent Oral Clearance (CL/F) of PF-00489791 [Pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 12 hours after PF-00489791 administration]

    Clearance of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes. Clearance obtained after oral dose (apparent oral clearance) is influenced by the fraction of the dose absorbed. Drug clearance is a quantitative measure of the rate at which a drug substance is removed from the blood.

  5. Terminal Elimination Half-Life (t1/2) of PF-00489791 [Pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 12 hours after PF-00489791 administration]

    t1/2 is the time measured for the plasma concentration to decrease by one half.

  6. Number of Participants With Laboratory Abnormalities Meeting the Criteria for Potential Clinical Concern [Baseline up to 28 days after last study drug administration]

    The following laboratory parameters were analyzed: hematology (hemoglobin, hematocrit, red blood cell [RBC] count, RBC morphology, platelet count, white blood cell [WBC] count, total neutrophils, eosinophils, monocytes, basophils, lymphocytes); blood chemistry (blood urea nitrogen [BUN], creatinine, glucose, calcium, sodium, potassium, chloride, total bicarbonate, aspartate aminotransferase [AST], alanine aminotransferase [ALT], total bilirubin, alkaline phosphatase, uric acid, albumin, and total protein; urinalysis (pH, glucose, protein, blood, ketones, nitrites, leukocyte esterase, microscopy [if urine dipstick was positive for blood, protein, nitrites or leukocyte esterase]); others (coagulation panel, circulating immune complex, and complement activation).

  7. Number of Participants With Potentially Clinically Significant Vital Signs Findings [Baseline up to Day 9]

    Vital signs assessment included pulse rate and blood pressure. Criteria for vital sign values meeting potential clinical concern included: supine/sitting pulse rate <40 or >120 beats per minute (bpm), standing pulse rate <40 or >140 bpm; systolic blood pressure (SBP) of >=30 millimeters of mercury (mm Hg) change from baseline in same posture or SBP <90 mm Hg, diastolic blood pressure (DBP) >=20 mmHg change from baseline in same posture or DBP <50 mm Hg.

  8. Number of Participants With Potentially Clinically Significant Electrocardiogram (ECG) Findings [Pre-dose (Periods 1 and 2), 4, 72 and 96 hours post-dose in Period 2]

    ECG parameters included PR interval, QRS interval, and corrected QT interval using Fridericia's formula (QTcF). Criteria for ECG changes meeting potential clinical concern included: PR interval greater than or equal to (>=)300 milliseconds (msec) or >=25% increase when baseline is greater than (>)200 msec and >=50% increase when baseline is less than or equal to (≤)200 msec; QRS interval >=140 msec or >=50% increase from baseline (IFB); and QTcF >=450 msec or >=30 msec increase. The number of participants with potentially clinically significant ECG findings at any visit were reported.

  9. Number of Participants Who Used at Least 1 Concomitant Medication [Baseline up to Day 15 (final study evaluation)]

    Participants were to abstain from all concomitant treatments, except for the treatment of AEs. Treatments taken after the first dose of study treatment were documented as concomitant treatments.

  10. Number of Participants With Treatment-Emergent Adverse Events (AEs) or Serious Adverse Events (SAEs) [Baseline up to 28 days after last study drug administration]

    An AE was any untoward medical occurrence in a participant who received study drug. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent are events between first dose of study drug and up to 28 days after last dose that were absent before treatment or that worsened relative to pre-treatment state. AEs included both SAEs and non-SAEs.

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years to 55 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
Yes
Inclusion Criteria:
  • Healthy male and/or female subjects between the ages of 18 and 55 years, inclusive (healthy is defined as no clinically relevant abnormalities identified by a detailed medical history, full physical examination, including blood pressure and pulse rate measurement, 12-lead ECG and clinical laboratory tests) with a Body Mass Index (BMI) of 17.5 to 30.5 kg/m2; and a total body weight >50 kg (110 lbs.) and with a personally signed and dated informed consent document and who are willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures.

  • Participating female subjects of non-childbearing potential must meet at least one of the following criteria: achieved postmenopausal status; have undergone a documented hysterectomy and/or bilateral oophorectomy; have medically confirmed ovarian failure. All other female subjects (including females with tubal ligations and females that do NOT have a documented hysterectomy, bilateral oophorectomy and/or ovarian failure) will be considered to be of childbearing potential.

Exclusion Criteria:
  • Subjects cannot be included in the study if there is: the presence/ history of any disorder that prevents study completion

  • Evidence/history of clinically significant hematological, renal, endocrine, pulmonary, gastrointestinal, cardiovascular, hepatic, psychiatric, neurologic, or allergic disease

  • Any surgical or medical condition that may interfere with the absorption distribution, metabolism, or excretion of the study drug

  • A positive urine drug screen or history of regular excessive alcohol consumption or use of tobacco-or nicotine-containing products in excess or from 24-hours prior to admission until discharge

  • Treatment with an investigational drug within 30 days (or as determined by the local requirement) or 5 halflives preceding the first dose of study med.

  • Out of range blood pressure including current evidence of orthostatic change in blood pressure

  • Abnormal ECG or history or current evidence of clinically important cardiac conduction abnormalities.

  • Also excluded are: pregnant or breastfeeding female subjects; male subjects with partners currently pregnant; male and female subjects of childbearing potential who are unwilling or unable to use a highly effective method of contraception as described in the protocol for the duration of the study and for at least 28 days after the last dose of investigational product.

Contacts and Locations

Locations

Site City State Country Postal Code
1 Pfizer Clinical Research Unit Brussels Belgium B-1070

Sponsors and Collaborators

  • Pfizer

Investigators

  • Study Director: Pfizer CT.gov Call Center, Pfizer

Study Documents (Full-Text)

None provided.

More Information

Additional Information:

Publications

None provided.
Responsible Party:
Pfizer
ClinicalTrials.gov Identifier:
NCT02319148
Other Study ID Numbers:
  • A7331022
  • 2014-001979-31
First Posted:
Dec 18, 2014
Last Update Posted:
Sep 16, 2016
Last Verified:
Jul 1, 2016
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details
Pre-assignment Detail
Arm/Group Title PF-00489791 20 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Arm/Group Description All participants who received a single-dose of PF-00489791 20 mg tablet orally during Period 1. All participants who received itraconazole 200 mg orally once daily for 7 days and a single-dose of PF-00489791 20 mg on Day 5 during Period 2. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days and a single-dose of PF-00489791 20mg on Day 11 during Period 2 All participants who received verapamil 240 mg SR tablet orally once daily for 13 days and a single-dose of PF-00489791 20 mg on Day 11 during Period 2.
Period Title: First Intervention Period
STARTED 22 0 0 0
COMPLETED 22 0 0 0
NOT COMPLETED 0 0 0 0
Period Title: First Intervention Period
STARTED 22 0 0 0
COMPLETED 22 0 0 0
NOT COMPLETED 0 0 0 0
Period Title: First Intervention Period
STARTED 0 7 7 8
COMPLETED 0 6 6 6
NOT COMPLETED 0 1 1 2

Baseline Characteristics

Arm/Group Title PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg Total
Arm/Group Description All participants who received itraconazole 200 mg orally once daily for 7 days and a single-dose of PF-00489791 20 mg on Day 5 during Period 2. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days and a single-dose of PF-00489791 20mg on Day 11 during Period 2 All participants who received verapamil 240 mg SR tablet orally once daily for 13 days and a single-dose of PF-00489791 20 mg on Day 11 during Period 2. Total of all reporting groups
Overall Participants 7 7 8 22
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]
38.1
(6.1)
33.4
(9.9)
35.1
(10.1)
35.5
(8.7)
Sex: Female, Male (Count of Participants)
Female
0
0%
0
0%
0
0%
0
0%
Male
7
100%
7
100%
8
100%
22
100%

Outcome Measures

1. Primary Outcome
Title Maximum Observed Plasma Concentration (Cmax) of PF-00489791
Description
Time Frame Pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 12 hours after PF-00489791 administration

Outcome Measure Data

Analysis Population Description
The pharmacokinetic (PK) analysis population included all participants randomized and treated who had at least 1 of the PK parameters of primary interest in at least 1 treatment period.
Arm/Group Title PF-00489791 20 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Arm/Group Description All participants who received a single-dose of PF-00489791 20 mg tablet orally during Period 1. All participants who received itraconazole 200 mg orally once daily for 7 days and a single-dose of PF-00489791 20 mg on Day 5 during Period 2. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days and a single-dose of PF-00489791 20mg on Day 11 during Period 2 All participants who received verapamil 240 mg SR tablet orally once daily for 13 days and a single-dose of PF-00489791 20 mg on Day 11 during Period 2.
Measure Participants 22 6 6 6
Geometric Mean (Geometric Coefficient of Variation) [nanograms per milliliter (ng/mL)]
1140
(34)
1238
(33)
1198
(33)
1186
(21)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection PF-00489791 20 mg, PF-00489791 20 mg + Itraconazole 200 mg
Comments
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value
Comments
Method
Comments
Method of Estimation Estimation Parameter Ratio of adjusted geometric means
Estimated Value 105.28
Confidence Interval (2-Sided) 90%
92.11 to 120.34
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection PF-00489791 20 mg, PF-00489791 20 mg + Diltiazem 240 mg
Comments
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value
Comments
Method
Comments
Method of Estimation Estimation Parameter Ratio of adjusted geometric means
Estimated Value 92.54
Confidence Interval (2-Sided) 90%
80.96 to 105.77
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection PF-00489791 20 mg, PF-00489791 20 mg + Verapamil 240 mg
Comments
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value
Comments
Method
Comments
Method of Estimation Estimation Parameter Ratio of adjusted geometric means
Estimated Value 116.36
Confidence Interval (2-Sided) 90%
101.86 to 132.92
Parameter Dispersion Type:
Value:
Estimation Comments
2. Primary Outcome
Title Area Under the Plasma Concentration-Time Profile From Time 0 Extrapolated to Infinite Time (AUCinf) of PF-00489791
Description AUC is a measure of the plasma concentration of the drug over time. It is used to characterize drug absorption.
Time Frame Pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 12 hours after PF-00489791 administration

Outcome Measure Data

Analysis Population Description
The PK analysis population included all participants randomized and treated who had at least 1 of the PK parameters of primary interest in at least 1 treatment period.
Arm/Group Title PF-00489791 20 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Arm/Group Description All participants who received a single-dose of PF-00489791 20 mg tablet orally during Period 1. All participants who received itraconazole 200 mg orally once daily for 7 days and a single-dose of PF-00489791 20 mg on Day 5 during Period 2. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days and a single-dose of PF-00489791 20mg on Day 11 during Period 2 All participants who received verapamil 240 mg SR tablet orally once daily for 13 days and a single-dose of PF-00489791 20 mg on Day 11 during Period 2.
Measure Participants 22 6 6 6
Geometric Mean (Geometric Coefficient of Variation) [nanogram*hour per milliliter (ng*hr/mL)]
17880
(36)
18140
(24)
16840
(20)
19560
(30)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection PF-00489791 20 mg, PF-00489791 20 mg + Itraconazole 200 mg
Comments
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value
Comments
Method
Comments
Method of Estimation Estimation Parameter Ratio of adjusted geometric means
Estimated Value 90.16
Confidence Interval (2-Sided) 90%
78.57 to 103.46
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection PF-00489791 20 mg, PF-00489791 20 mg + Diltiazem 240 mg
Comments
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value
Comments
Method
Comments
Method of Estimation Estimation Parameter Ratio of adjusted geometric means
Estimated Value 106.38
Confidence Interval (2-Sided) 90%
92.70 to 122.07
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection PF-00489791 20 mg, PF-00489791 20 mg + Verapamil 240 mg
Comments
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value
Comments
Method
Comments
Method of Estimation Estimation Parameter Ratio of adjusted geometric means
Estimated Value 101.71
Confidence Interval (2-Sided) 90%
88.68 to 116.66
Parameter Dispersion Type:
Value:
Estimation Comments
3. Secondary Outcome
Title Area Under the Curve From Time Zero to Last Quantifiable Concentration (AUClast) of PF-00489791
Description Area under the plasma concentration time-curve from zero to the last measured concentration (AUClast).
Time Frame Pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 12 hours after PF-00489791 administration

Outcome Measure Data

Analysis Population Description
The PK analysis population included all participants randomized and treated who had at least 1 of the PK parameters of primary interest in at least 1 treatment period.
Arm/Group Title PF-00489791 20 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Arm/Group Description All participants who received a single-dose of PF-00489791 20 mg tablet orally during Period 1. All participants who received itraconazole 200 mg orally once daily for 7 days and a single-dose of PF-00489791 20 mg on Day 5 during Period 2. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days and a single-dose of PF-00489791 20mg on Day 11 during Period 2 All participants who received verapamil 240 mg SR tablet orally once daily for 13 days and a single-dose of PF-00489791 20 mg on Day 11 during Period 2.
Measure Participants 22 6 6 6
Geometric Mean (Geometric Coefficient of Variation) [ng.hr/mL]
17580
(36)
17980
(24)
16760
(20)
19400
(30)
Statistical Analysis 1
Statistical Analysis Overview Comparison Group Selection PF-00489791 20 mg, PF-00489791 20 mg + Itraconazole 200 mg
Comments
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value
Comments
Method
Comments
Method of Estimation Estimation Parameter Ratio of adjusted geometric means
Estimated Value 91.33
Confidence Interval (2-Sided) 90%
79.49 to 104.94
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 2
Statistical Analysis Overview Comparison Group Selection PF-00489791 20 mg, PF-00489791 20 mg + Diltiazem 240 mg
Comments
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value
Comments
Method
Comments
Method of Estimation Estimation Parameter Ratio of adjusted geometric means
Estimated Value 106.97
Confidence Interval (2-Sided) 90%
93.10 to 122.91
Parameter Dispersion Type:
Value:
Estimation Comments
Statistical Analysis 3
Statistical Analysis Overview Comparison Group Selection PF-00489791 20 mg, PF-00489791 20 mg + Verapamil 240 mg
Comments
Type of Statistical Test Superiority or Other
Comments
Statistical Test of Hypothesis p-Value
Comments
Method
Comments
Method of Estimation Estimation Parameter Ratio of adjusted geometric means
Estimated Value 102.69
Confidence Interval (2-Sided) 90%
89.42 to 117.93
Parameter Dispersion Type:
Value:
Estimation Comments
4. Secondary Outcome
Title Time to Reach Maximum Observed Plasma Concentration (Tmax) of PF-00489791
Description
Time Frame Pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 12 hours after PF-00489791 administration

Outcome Measure Data

Analysis Population Description
The PK analysis population included all participants randomized and treated who had at least 1 of the PK parameters of primary interest in at least 1 treatment period.
Arm/Group Title PF-00489791 20 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Arm/Group Description All participants who received a single-dose of PF-00489791 20 mg tablet orally during Period 1. All participants who received itraconazole 200 mg orally once daily for 7 days and a single-dose of PF-00489791 20 mg on Day 5 during Period 2. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days and a single-dose of PF-00489791 20mg on Day 11 during Period 2 All participants who received verapamil 240 mg SR tablet orally once daily for 13 days and a single-dose of PF-00489791 20 mg on Day 11 during Period 2.
Measure Participants 22 6 6 6
Median (Full Range) [hour]
4.00
3.50
4.00
4.00
5. Secondary Outcome
Title Apparent Volume of Distribution (Vz/F) of PF-00489791
Description Volume of distribution is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired plasma concentration of a drug. Apparent volume of distribution after oral dose (Vz/F) is influenced by the fraction absorbed.
Time Frame Pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 12 hours after PF-00489791 administration

Outcome Measure Data

Analysis Population Description
The PK analysis population included all participants randomized and treated who had at least 1 of the PK parameters of primary interest in at least 1 treatment period.
Arm/Group Title PF-00489791 20 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Arm/Group Description All participants who received a single-dose of PF-00489791 20 mg tablet orally during Period 1. All participants who received itraconazole 200 mg orally once daily for 7 days and a single-dose of PF-00489791 20 mg on Day 5 during Period 2. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days and a single-dose of PF-00489791 20mg on Day 11 during Period 2 All participants who received verapamil 240 mg SR tablet orally once daily for 13 days and a single-dose of PF-00489791 20 mg on Day 11 during Period 2.
Measure Participants 22 6 6 6
Geometric Mean (Geometric Coefficient of Variation) [liter]
18.06
(34)
21.65
(18)
19.98
(31)
19.23
(23)
6. Secondary Outcome
Title Apparent Oral Clearance (CL/F) of PF-00489791
Description Clearance of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes. Clearance obtained after oral dose (apparent oral clearance) is influenced by the fraction of the dose absorbed. Drug clearance is a quantitative measure of the rate at which a drug substance is removed from the blood.
Time Frame Pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 12 hours after PF-00489791 administration

Outcome Measure Data

Analysis Population Description
The PK analysis population included all participants randomized and treated who had at least 1 of the PK parameters of primary interest in at least 1 treatment period.
Arm/Group Title PF-00489791 20 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Arm/Group Description All participants who received a single-dose of PF-00489791 20 mg tablet orally during Period 1. All participants who received itraconazole 200 mg orally once daily for 7 days and a single-dose of PF-00489791 20 mg on Day 5 during Period 2. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days and a single-dose of PF-00489791 20mg on Day 11 during Period 2 All participants who received verapamil 240 mg SR tablet orally once daily for 13 days and a single-dose of PF-00489791 20 mg on Day 11 during Period 2.
Measure Participants 22 6 6 6
Geometric Mean (Geometric Coefficient of Variation) [milliliter per minute (mL/min)]
18.64
(36)
18.37
(24)
19.81
(20)
17.02
(30)
7. Secondary Outcome
Title Terminal Elimination Half-Life (t1/2) of PF-00489791
Description t1/2 is the time measured for the plasma concentration to decrease by one half.
Time Frame Pre-dose, 0.5, 1, 2, 3, 4, 6, 8 and 12 hours after PF-00489791 administration

Outcome Measure Data

Analysis Population Description
The PK analysis population included all participants randomized and treated who had at least 1 of the PK parameters of primary interest in at least 1 treatment period.
Arm/Group Title PF-00489791 20 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Arm/Group Description All participants who received a single-dose of PF-00489791 20 mg tablet orally during Period 1. All participants who received itraconazole 200 mg orally once daily for 7 days and a single-dose of PF-00489791 20 mg on Day 5 during Period 2. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days and a single-dose of PF-00489791 20mg on Day 11 during Period 2 All participants who received verapamil 240 mg SR tablet orally once daily for 13 days and a single-dose of PF-00489791 20 mg on Day 11 during Period 2.
Measure Participants 22 6 6 6
Mean (Standard Deviation) [hour]
11.39
(2.15)
13.85
(2.79)
11.75
(1.69)
13.29
(2.56)
8. Secondary Outcome
Title Number of Participants With Laboratory Abnormalities Meeting the Criteria for Potential Clinical Concern
Description The following laboratory parameters were analyzed: hematology (hemoglobin, hematocrit, red blood cell [RBC] count, RBC morphology, platelet count, white blood cell [WBC] count, total neutrophils, eosinophils, monocytes, basophils, lymphocytes); blood chemistry (blood urea nitrogen [BUN], creatinine, glucose, calcium, sodium, potassium, chloride, total bicarbonate, aspartate aminotransferase [AST], alanine aminotransferase [ALT], total bilirubin, alkaline phosphatase, uric acid, albumin, and total protein; urinalysis (pH, glucose, protein, blood, ketones, nitrites, leukocyte esterase, microscopy [if urine dipstick was positive for blood, protein, nitrites or leukocyte esterase]); others (coagulation panel, circulating immune complex, and complement activation).
Time Frame Baseline up to 28 days after last study drug administration

Outcome Measure Data

Analysis Population Description
The safety analysis population included all participants who received the study medication.
Arm/Group Title PF-00489791 20 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Arm/Group Description All participants who received a single-dose of PF-00489791 20 mg tablet orally during Period 1. All participants who received itraconazole 200 mg orally once daily for 7 days and a single-dose of PF-00489791 20 mg on Day 5 during Period 2. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days and a single-dose of PF-00489791 20mg on Day 11 during Period 2 All participants who received verapamil 240 mg SR tablet orally once daily for 13 days and a single-dose of PF-00489791 20 mg on Day 11 during Period 2.
Measure Participants 22 6 6 6
Number [participants]
3
42.9%
0
0%
0
0%
2
9.1%
9. Secondary Outcome
Title Number of Participants With Potentially Clinically Significant Vital Signs Findings
Description Vital signs assessment included pulse rate and blood pressure. Criteria for vital sign values meeting potential clinical concern included: supine/sitting pulse rate <40 or >120 beats per minute (bpm), standing pulse rate <40 or >140 bpm; systolic blood pressure (SBP) of >=30 millimeters of mercury (mm Hg) change from baseline in same posture or SBP <90 mm Hg, diastolic blood pressure (DBP) >=20 mmHg change from baseline in same posture or DBP <50 mm Hg.
Time Frame Baseline up to Day 9

Outcome Measure Data

Analysis Population Description
The safety analysis population included all participants who received the study medication; n=number of participants evaluated against criteria.
Arm/Group Title PF-00489791 20 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Arm/Group Description All participants who received a single-dose of PF-00489791 20 mg tablet orally during Period 1. All participants who received itraconazole 200 mg orally once daily for 7 days and a single-dose of PF-00489791 20 mg on Day 5 during Period 2. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days and a single-dose of PF-00489791 20mg on Day 11 during Period 2 All participants who received verapamil 240 mg SR tablet orally once daily for 13 days and a single-dose of PF-00489791 20 mg on Day 11 during Period 2.
Measure Participants 22 7 7 8
Supine SBP <90 mm Hg (n=22,7,7,8)
0
0%
0
0%
0
0%
1
4.5%
Standing SBP <90 mm Hg (n=22,7,6,8)
0
0%
0
0%
0
0%
1
4.5%
Supine DBP <50 mm Hg (n=22,7,7,8)
0
0%
0
0%
0
0%
0
0%
Standing DBP <50 mm Hg (n=22,7,6,8)
0
0%
0
0%
0
0%
1
4.5%
Supine Pulse Rate <40 or >120 bpm (n=22,7,7,8)
0
0%
0
0%
0
0%
0
0%
Standing Pulse Rate <40 or >120 bpm (n=22,7,6,8)
0
0%
0
0%
0
0%
0
0%
Supine SBP >=30 mm Hg IFB (n=22,6,6,7)
0
0%
0
0%
0
0%
0
0%
Standing SBP >=30 mm Hg IFB (n=22,6,6,7)
0
0%
0
0%
0
0%
0
0%
Supine DBP >=20 mm Hg IFB (n=22,6,6,7)
0
0%
0
0%
0
0%
0
0%
Standing DBP >=20 mm Hg IFB (n=22,6,6,7)
0
0%
0
0%
0
0%
0
0%
Supine SBP >=30 mm Hg DFB (n=22,6,6,7)
0
0%
0
0%
0
0%
0
0%
Standing SBP >=30 mm Hg DFB (n=22,6,6,7)
0
0%
0
0%
1
12.5%
1
4.5%
Supine DBP >=20 mm Hg DFB (n=22,6,6,7)
0
0%
0
0%
0
0%
0
0%
Standing DBP >=20 mm Hg DFB (n=22,6,6,7)
1
14.3%
0
0%
1
12.5%
1
4.5%
10. Secondary Outcome
Title Number of Participants With Potentially Clinically Significant Electrocardiogram (ECG) Findings
Description ECG parameters included PR interval, QRS interval, and corrected QT interval using Fridericia's formula (QTcF). Criteria for ECG changes meeting potential clinical concern included: PR interval greater than or equal to (>=)300 milliseconds (msec) or >=25% increase when baseline is greater than (>)200 msec and >=50% increase when baseline is less than or equal to (≤)200 msec; QRS interval >=140 msec or >=50% increase from baseline (IFB); and QTcF >=450 msec or >=30 msec increase. The number of participants with potentially clinically significant ECG findings at any visit were reported.
Time Frame Pre-dose (Periods 1 and 2), 4, 72 and 96 hours post-dose in Period 2

Outcome Measure Data

Analysis Population Description
The safety analysis population included all participants who received the study medication; n=number of participants evaluated against criteria.
Arm/Group Title PF-00489791 20 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Arm/Group Description All participants who received a single-dose of PF-00489791 20 mg tablet orally during Period 1. All participants who received itraconazole 200 mg orally once daily for 7 days and a single-dose of PF-00489791 20 mg on Day 5 during Period 2. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days and a single-dose of PF-00489791 20mg on Day 11 during Period 2 All participants who received verapamil 240 mg SR tablet orally once daily for 13 days and a single-dose of PF-00489791 20 mg on Day 11 during Period 2.
Measure Participants 22 7 7 8
PR Interval >=300 msec (n=22,7,7,8)
0
0%
0
0%
0
0%
0
0%
QRS Complex >=140 msec (n=22,7,7,8)
0
0%
0
0%
0
0%
0
0%
QTcF Interval 450-<480 msec (n=22,7,7,8)
0
0%
0
0%
0
0%
0
0%
QTcF Interval 480-<500 msec (n=22,7,7,8)
0
0%
0
0%
0
0%
0
0%
QTcF Interval >=500 msec (n=22,7,7,8)
0
0%
0
0%
0
0%
0
0%
PR Interval >=25/50% IFB (n=22,6,6,7)
0
0%
0
0%
0
0%
0
0%
QRS Interval >=50% IFB (n=22,6,6,7)
0
0%
0
0%
0
0%
0
0%
QTcF Interval 30-<60 msec IFB (n=22,6,6,7)
0
0%
1
14.3%
0
0%
0
0%
QTcF Interval >=60 msec IFB (n=22,6,6,7)
0
0%
0
0%
0
0%
0
0%
11. Secondary Outcome
Title Number of Participants Who Used at Least 1 Concomitant Medication
Description Participants were to abstain from all concomitant treatments, except for the treatment of AEs. Treatments taken after the first dose of study treatment were documented as concomitant treatments.
Time Frame Baseline up to Day 15 (final study evaluation)

Outcome Measure Data

Analysis Population Description
The safety analysis population included all participants who received the study medication.
Arm/Group Title PF-00489791 20 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Arm/Group Description All participants who received a single-dose of PF-00489791 20 mg tablet orally during Period 1. All participants who received itraconazole 200 mg orally once daily for 7 days and a single-dose of PF-00489791 20 mg on Day 5 during Period 2. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days and a single-dose of PF-00489791 20mg on Day 11 during Period 2 All participants who received verapamil 240 mg SR tablet orally once daily for 13 days and a single-dose of PF-00489791 20 mg on Day 11 during Period 2.
Measure Participants 22 6 6 6
Drug Treatments
10
142.9%
2
28.6%
4
50%
2
9.1%
Non-Drug Treatments
0
0%
0
0%
0
0%
0
0%
12. Secondary Outcome
Title Number of Participants With Treatment-Emergent Adverse Events (AEs) or Serious Adverse Events (SAEs)
Description An AE was any untoward medical occurrence in a participant who received study drug. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent are events between first dose of study drug and up to 28 days after last dose that were absent before treatment or that worsened relative to pre-treatment state. AEs included both SAEs and non-SAEs.
Time Frame Baseline up to 28 days after last study drug administration

Outcome Measure Data

Analysis Population Description
The safety analysis population included all participants who received the study medication.
Arm/Group Title PF-00489791 20 mg Itraconazole 200 mg Diltiazem 240 mg Verapamil 240 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Arm/Group Description All participants who received a single-dose of PF-00489791 20 mg tablet orally during Period 1. All participants who received itraconazole 200 mg orally once daily for 7 days. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days. All participants who received verapamil 240 mg SR tablet orally once daily for 13 days. All participants who received itraconazole 200 mg orally once daily for 7 days and a single-dose of PF-00489791 20 mg on Day 5 during Period 2. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days and a single-dose of PF-00489791 20mg on Day 11 during Period 2 All participants who received verapamil 240 mg SR tablet orally once daily for 13 days and a single-dose of PF-00489791 20 mg on Day 11 during Period 2.
Measure Participants 22 7 7 8 6 6 6
AEs
18
257.1%
6
85.7%
4
50%
3
13.6%
6
NaN
4
NaN
5
NaN
SAEs
0
0%
0
0%
0
0%
0
0%
0
NaN
0
NaN
0
NaN

Adverse Events

Time Frame Baseline up to 28 days after last study drug administration
Adverse Event Reporting Description The same event may appear as both an AE and a SAE. However, what is presented are distinct events. An event may be categorized as serious in one participant and as non-serious in another participant, or one participant may have experienced both a serious and non-serious event during the study.
Arm/Group Title PF-00489791 20 mg Itraconazole 200 mg Diltiazem 240 mg Verapamil 240 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Arm/Group Description All participants who received a single-dose of PF-00489791 20 mg tablet orally during Period 1. All participants who received itraconazole 200 mg orally once daily for 7 days. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days. All participants who received verapamil 240 mg SR tablet orally once daily for 13 days. All participants who received itraconazole 200 mg orally once daily for 7 days and a single-dose of PF-00489791 20 mg on Day 5 during Period 2. All participants who received diltiazem 240 mg MR tablet orally once daily for 13 days and a single-dose of PF-00489791 20mg on Day 11 during Period 2 All participants who received verapamil 240 mg SR tablet orally once daily for 13 days and a single-dose of PF-00489791 20 mg on Day 11 during Period 2.
All Cause Mortality
PF-00489791 20 mg Itraconazole 200 mg Diltiazem 240 mg Verapamil 240 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total / (NaN) / (NaN) / (NaN) / (NaN) / (NaN) / (NaN) / (NaN)
Serious Adverse Events
PF-00489791 20 mg Itraconazole 200 mg Diltiazem 240 mg Verapamil 240 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/22 (0%) 0/7 (0%) 0/7 (0%) 0/8 (0%) 0/6 (0%) 0/6 (0%) 0/6 (0%)
Other (Not Including Serious) Adverse Events
PF-00489791 20 mg Itraconazole 200 mg Diltiazem 240 mg Verapamil 240 mg PF-00489791 20 mg + Itraconazole 200 mg PF-00489791 20 mg + Diltiazem 240 mg PF-00489791 20 mg + Verapamil 240 mg
Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 18/22 (81.8%) 6/7 (85.7%) 4/7 (57.1%) 3/8 (37.5%) 6/6 (100%) 4/6 (66.7%) 5/6 (83.3%)
Cardiac disorders
Palpitations 0/22 (0%) 0/7 (0%) 1/7 (14.3%) 0/8 (0%) 0/6 (0%) 0/6 (0%) 0/6 (0%)
Gastrointestinal disorders
Abdominal discomfort 0/22 (0%) 0/7 (0%) 0/7 (0%) 0/8 (0%) 2/6 (33.3%) 0/6 (0%) 0/6 (0%)
Abdominal distension 0/22 (0%) 2/7 (28.6%) 2/7 (28.6%) 0/8 (0%) 0/6 (0%) 0/6 (0%) 0/6 (0%)
Diarrhoea 0/22 (0%) 1/7 (14.3%) 0/7 (0%) 0/8 (0%) 1/6 (16.7%) 0/6 (0%) 0/6 (0%)
Dyspepsia 2/22 (9.1%) 0/7 (0%) 0/7 (0%) 0/8 (0%) 1/6 (16.7%) 0/6 (0%) 0/6 (0%)
Flatulence 0/22 (0%) 0/7 (0%) 0/7 (0%) 0/8 (0%) 0/6 (0%) 1/6 (16.7%) 0/6 (0%)
Nausea 5/22 (22.7%) 0/7 (0%) 0/7 (0%) 0/8 (0%) 2/6 (33.3%) 1/6 (16.7%) 0/6 (0%)
Vomiting 3/22 (13.6%) 0/7 (0%) 0/7 (0%) 0/8 (0%) 0/6 (0%) 0/6 (0%) 1/6 (16.7%)
General disorders
Fatigue 2/22 (9.1%) 0/7 (0%) 0/7 (0%) 1/8 (12.5%) 0/6 (0%) 0/6 (0%) 1/6 (16.7%)
Investigations
Alanine aminotransferase increased 0/22 (0%) 0/7 (0%) 0/7 (0%) 1/8 (12.5%) 0/6 (0%) 0/6 (0%) 0/6 (0%)
Musculoskeletal and connective tissue disorders
Arthralgia 0/22 (0%) 0 0/7 (0%) 0 0/7 (0%) 0 1/8 (12.5%) 0 0/6 (0%) 0 0/6 (0%) 0 0/6 (0%) 0
Back pain 8/22 (36.4%) 4/7 (57.1%) 0/7 (0%) 0/8 (0%) 1/6 (16.7%) 0/6 (0%) 0/6 (0%)
Muscle spasms 4/22 (18.2%) 0/7 (0%) 0/7 (0%) 1/8 (12.5%) 0/6 (0%) 0/6 (0%) 0/6 (0%)
Neck pain 0/22 (0%) 0/7 (0%) 0/7 (0%) 0/8 (0%) 1/6 (16.7%) 0/6 (0%) 0/6 (0%)
Sensation of heaviness 2/22 (9.1%) 0/7 (0%) 0/7 (0%) 0/8 (0%) 0/6 (0%) 0/6 (0%) 1/6 (16.7%)
Myalgia 3/22 (13.6%) 1/7 (14.3%) 1/7 (14.3%) 1/8 (12.5%) 1/6 (16.7%) 0/6 (0%) 1/6 (16.7%)
Nervous system disorders
Dizziness 2/22 (9.1%) 0/7 (0%) 0/7 (0%) 0/8 (0%) 0/6 (0%) 0/6 (0%) 0/6 (0%)
Head discomfort 0/22 (0%) 0/7 (0%) 0/7 (0%) 0/8 (0%) 0/6 (0%) 0/6 (0%) 2/6 (33.3%)
Headache 14/22 (63.6%) 1/7 (14.3%) 4/7 (57.1%) 2/8 (25%) 6/6 (100%) 4/6 (66.7%) 2/6 (33.3%)
Psychiatric disorders
Irritability 1/22 (4.5%) 0/7 (0%) 0/7 (0%) 1/8 (12.5%) 0/6 (0%) 0/6 (0%) 1/6 (16.7%)
Renal and urinary disorders
Nocturia 0/22 (0%) 1/7 (14.3%) 0/7 (0%) 0/8 (0%) 1/6 (16.7%) 0/6 (0%) 0/6 (0%)
Polyuria 1/22 (4.5%) 1/7 (14.3%) 0/7 (0%) 0/8 (0%) 1/6 (16.7%) 0/6 (0%) 0/6 (0%)
Reproductive system and breast disorders
Spontaneous penile erection 0/22 (0%) 0/7 (0%) 0/7 (0%) 0/8 (0%) 0/6 (0%) 2/6 (33.3%) 1/6 (16.7%)
Skin and subcutaneous tissue disorders
Rash 0/22 (0%) 0/7 (0%) 1/7 (14.3%) 0/8 (0%) 0/6 (0%) 0/6 (0%) 0/6 (0%)
Vascular disorders
Haematoma 0/22 (0%) 0/7 (0%) 0/7 (0%) 1/8 (12.5%) 0/6 (0%) 0/6 (0%) 1/6 (16.7%)
Hot flush 3/22 (13.6%) 0/7 (0%) 0/7 (0%) 0/8 (0%) 5/6 (83.3%) 2/6 (33.3%) 1/6 (16.7%)
Orthostatic hypotension 0/22 (0%) 0/7 (0%) 0/7 (0%) 0/8 (0%) 0/6 (0%) 0/6 (0%) 1/6 (16.7%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

Pfizer has the right to review disclosures, requesting a delay of less than 60 days. Investigator will postpone single center publications until after disclosure of pooled data (all sites), less than 12 months from study completion/termination at all participating sites. Investigator may not disclose previously undisclosed confidential information other than study results.

Results Point of Contact

Name/Title Pfizer ClinicalTrials.gov Call Center
Organization Pfizer, Inc.
Phone 1-800-718-1021
Email ClinicalTrials.gov_Inquiries@pfizer.com
Responsible Party:
Pfizer
ClinicalTrials.gov Identifier:
NCT02319148
Other Study ID Numbers:
  • A7331022
  • 2014-001979-31
First Posted:
Dec 18, 2014
Last Update Posted:
Sep 16, 2016
Last Verified:
Jul 1, 2016