Multiple Dose Pharmacokinetics of LCZ696 and Its Metabolites in Subjects With Severe Renal Impairment vs. Matched Healthy Subjects With Normal Renal Function

Sponsor
Novartis Pharmaceuticals (Industry)
Overall Status
Completed
CT.gov ID
NCT01569828
Collaborator
(none)
12
3
2
6
4
0.7

Study Details

Study Description

Brief Summary

An open label, parallel-group study to determine multiple dose pharmacokinetics of LCZ696 and its metabolites in subjects with severe renal impairment compared to matched healthy subjects with normal renal function

Condition or Disease Intervention/Treatment Phase
Phase 2

Study Design

Study Type:
Interventional
Actual Enrollment :
12 participants
Allocation:
Non-Randomized
Intervention Model:
Parallel Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
An Open Label, Parallel-group Study to Determine Multiple Dose Pharmacokinetics of LCZ696 and Its Metabolites in Subjects With Severe Renal Impairment Compared to Matched Healthy Subjects With Normal Renal Function
Study Start Date :
Mar 1, 2009
Actual Primary Completion Date :
Sep 1, 2009
Actual Study Completion Date :
Sep 1, 2009

Arms and Interventions

Arm Intervention/Treatment
Experimental: Renal Impaired Subjects

once daily administration of 400 mg LCZ696 for 5 days

Drug: LCZ696A

Experimental: Healthy Volunteers

once daily administration of 400 mg LCZ696 for 5 days

Drug: LCZ696A
once daily administration of 400 mg LCZ696 for 5 days

Outcome Measures

Primary Outcome Measures

  1. Time to Reach Maximum Peak Plasma Concentration (Tmax) After Single Dose (Day 1), and After Multiple Dose Administration (Day 5) [1 and 5 days]

  2. (Cmax) After Single Dose (Day 1), and After Multiple Dose Administration (Day 5) [1 and 5 days]

  3. AUC 0-24h After Single Dose (Day 1), and After Multiple Dose Administration (Day 5) [1 and 5 days]

  4. T1/2 After Multiple Dose Administration (Day 5) [5 days]

    Summary statistics for plasma PK parameters following 5 days QD dose of 400mg LCZ696

  5. CL/F After Multiple Dose Administration (Day 5) [5 days]

    Summary statistics for plasma PK parameters following 5 days QD dose of 400mg LCZ696

  6. CLr After Multiple Dose Administration (Day 5) [5 days]

    Summary statistics for plasma PK parameters following 5 days QD dose of 400mg LCZ696

Secondary Outcome Measures

  1. 24 hr Sodium Urinary Excretion in Subjects With Severe Renal Impairment and Their Matched Healthy Volunteers [5 days]

Eligibility Criteria

Criteria

Ages Eligible for Study:
18 Years to 65 Years
Sexes Eligible for Study:
All
Accepts Healthy Volunteers:
Yes
Inclusion Criteria:
Exclusion Criteria:

Contacts and Locations

Locations

Site City State Country Postal Code
1 Novartis Investigative Site Neuss Germany 41460
2 Novartis Investigative Site Moscow Russian Federation 117292
3 Novartis Investigative Site Belgrade Serbia

Sponsors and Collaborators

  • Novartis Pharmaceuticals

Investigators

  • Study Director: Novartis Pharmaceuticals, Novartis Pharmaceuticals

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.
Responsible Party:
Novartis Pharmaceuticals
ClinicalTrials.gov Identifier:
NCT01569828
Other Study ID Numbers:
  • CLCZ696A2205
  • 2007-005482-36
First Posted:
Apr 3, 2012
Last Update Posted:
Sep 29, 2015
Last Verified:
Aug 1, 2015
Keywords provided by Novartis Pharmaceuticals
Additional relevant MeSH terms:

Study Results

Participant Flow

Recruitment Details
Pre-assignment Detail
Arm/Group Title Severe Renal Impaired Subjects Matched Healthy Volunteers
Arm/Group Description Subjects with severe (CrCl from <30 mL/min), renal function who were otherwise in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.8°C, systolic blood pressure (95-180 mm Hg), diastolic blood pressure (60-110 mm Hg), pulse rate (54-95 bpm), laboratory tests and urinalysis. Creatinine clearance (CrCl) was calculated by the Cockcroft-Gault (CG) formula with patient stratification based on the screening serum creatinine measurement. Once daily administration of 400 mg LCZ696 p.o. for 5 days All healthy volunteers were matched by age (±5 years), sex and BMI (±10%) to the renal subjects enrolled into the study. Subjects were to be in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.2 °C, systolic blood pressure (95-140 mm Hg), diastolic blood, pressure (60-100 mm Hg), pulse rate (45-90 bpm), laboratory tests and urinalysis. Healthy subjects must have a CrCl of >80 mL/min.Once daily administration of 400 mg LCZ696 p.o. for 5 days
Period Title: Overall Study
STARTED 6 6
COMPLETED 6 6
NOT COMPLETED 0 0

Baseline Characteristics

Arm/Group Title Severe Renal Impaired Subjects Matched Healthy Volunteers Total
Arm/Group Description Subjects with severe (CrCl from <30 mL/min), renal function who were otherwise in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.8°C, systolic blood pressure (95-180 mm Hg), diastolic blood pressure (60-110 mm Hg), pulse rate (54-95 bpm), laboratory tests and urinalysis. Creatinine clearance (CrCl) was calculated by the Cockcroft-Gault (CG) formula with patient stratification based on the screening serum creatinine measurement. Once daily administration of 400 mg LCZ696 p.o. for 5 days All healthy volunteers were matched by age (±5 years), sex and BMI (±10%) to the renal subjects enrolled into the study. Subjects were to be in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.2 °C, systolic blood pressure (95-140 mm Hg), diastolic blood, pressure (60-100 mm Hg), pulse rate (45-90 bpm), laboratory tests and urinalysis. Healthy subjects must have a CrCl of >80 mL/min. Once daily administration of 400 mg LCZ696 p.o. for 5 days Total of all reporting groups
Overall Participants 6 6 12
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]
53.8
(7.76)
52.5
(6.98)
53.2
(7.07)
Sex: Female, Male (Count of Participants)
Female
3
50%
3
50%
6
50%
Male
3
50%
3
50%
6
50%

Outcome Measures

1. Primary Outcome
Title Time to Reach Maximum Peak Plasma Concentration (Tmax) After Single Dose (Day 1), and After Multiple Dose Administration (Day 5)
Description
Time Frame 1 and 5 days

Outcome Measure Data

Analysis Population Description
Pharmacokinetic analysis set
Arm/Group Title Renal Impaired Subjects Healthy Volunteers
Arm/Group Description Subjects with severe (CrCl from <30 mL/min), renal function who were otherwise in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.8°C, systolic blood pressure (95-180 mm Hg), diastolic blood pressure (60-110 mm Hg), pulse rate (54-95 bpm), laboratory tests and urinalysis. Creatinine clearance (CrCl) was calculated by the Cockcroft-Gault (CG) formula with patient stratification based on the screening serum creatinine measurement. Once daily administration of 400 mg LCZ696 p.o. for 5 days All healthy volunteers were matched by age (±5 years), sex and BMI (±10%) to the renal subjects enrolled into the study. Subjects were to be in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.2 °C, systolic blood pressure (95-140 mm Hg), diastolic blood, pressure (60-100 mm Hg), pulse rate (45-90 bpm), laboratory tests and urinalysis. Healthy subjects must have a CrCl of >80 mL/min. Once daily administration of 400 mg LCZ696 p.o. for 5 days
Measure Participants 6 6
AHU377 (Sacubitril) on day 1
0.5
0.5
AHU377 (Sacubitril) on day 5
0.5
0.5
LBQ657(Sacubitril pro-drug) on day 1
3
3
LBQ657(Sacubitril pro-drug) on day 5
2
2.5
VAL489 (valsartan) on day 1
2
2
VAL489 (valsartan) on day 5
2
2
2. Secondary Outcome
Title 24 hr Sodium Urinary Excretion in Subjects With Severe Renal Impairment and Their Matched Healthy Volunteers
Description
Time Frame 5 days

Outcome Measure Data

Analysis Population Description
[Not Specified]
Arm/Group Title Renal Impaired Subjects Healthy Volunteers
Arm/Group Description Subjects with severe (CrCl from <30 mL/min), renal function who were otherwise in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.8°C, systolic blood pressure (95-180 mm Hg), diastolic blood pressure (60-110 mm Hg), pulse rate (54-95 bpm), laboratory tests and urinalysis. Creatinine clearance (CrCl) was calculated by the Cockcroft-Gault (CG) formula with patient stratification based on the screening serum creatinine measurement. Once daily administration of 400 mg LCZ696 p.o. for 5 days All healthy volunteers were matched by age (±5 years), sex and BMI (±10%) to the renal subjects enrolled into the study. Subjects were to be in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.2 °C, systolic blood pressure (95-140 mm Hg), diastolic blood, pressure (60-100 mm Hg), pulse rate (45-90 bpm), laboratory tests and urinalysis. Healthy subjects must have a CrCl of >80 mL/min. Once daily administration of 400 mg LCZ696 p.o. for 5 days
Measure Participants 6 6
baseline
172.658
(79.9239)
177.833
(39.5533)
Day 1
133.000
(35.5564)
187.000
(42.8392)
Day 2
89.333
(34.5714)
156.833
(26.4607)
Day 3
106.050
(39.6424)
145.500
(31.5325)
Day 4
94.683
(21.3792)
140.500
(30.9629)
Day 5
93.500
(36.2171)
156.667
(32.1165)
Day 6
88.400
(23.1383)
96.167
(28.6316)
Day 7
107.150
(36.1899)
107.667
(57.4514)
3. Primary Outcome
Title (Cmax) After Single Dose (Day 1), and After Multiple Dose Administration (Day 5)
Description
Time Frame 1 and 5 days

Outcome Measure Data

Analysis Population Description
Pharmacokinetic analysis set
Arm/Group Title Renal Impaired Subjects Healthy Volunteers
Arm/Group Description Subjects with severe (CrCl from <30 mL/min), renal function who were otherwise in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.8°C, systolic blood pressure (95-180 mm Hg), diastolic blood pressure (60-110 mm Hg), pulse rate (54-95 bpm), laboratory tests and urinalysis. Creatinine clearance (CrCl) was calculated by the Cockcroft-Gault (CG) formula with patient stratification based on the screening serum creatinine measurement. Once daily administration of 400 mg LCZ696 p.o. for 5 days All healthy volunteers were matched by age (±5 years), sex and BMI (±10%) to the renal subjects enrolled into the study. Subjects were to be in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.2 °C, systolic blood pressure (95-140 mm Hg), diastolic blood, pressure (60-100 mm Hg), pulse rate (45-90 bpm), laboratory tests and urinalysis. Healthy subjects must have a CrCl of >80 mL/min. Once daily administration of 400 mg LCZ696 p.o. for 5 days
Measure Participants 6 6
AHU377 (Sacubitril)on day 1
5215
(3220)
2810
(862)
AHU377(Sacubitril) on day 5
4960
(3430)
2407
(1780)
LBQ657 (Sacubitril prodrug)on day 1
15967
(3380)
14633
(2233)
LBQ657 ( Sacubitril prodrug) on day 5
30650
(11462)
18233
(1975)
VAL489 (valsartan) on day 1
5935
(2191)
4988
(1093)
VAL489 (valsartan) on day 5
5852
(3306)
5672
(1314)
4. Primary Outcome
Title AUC 0-24h After Single Dose (Day 1), and After Multiple Dose Administration (Day 5)
Description
Time Frame 1 and 5 days

Outcome Measure Data

Analysis Population Description
Pharmacokinetic analysis set
Arm/Group Title Renal Impaired Subjects Healthy Volunteers
Arm/Group Description Subjects with severe (CrCl from <30 mL/min), renal function who were otherwise in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.8°C, systolic blood pressure (95-180 mm Hg), diastolic blood pressure (60-110 mm Hg), pulse rate (54-95 bpm), laboratory tests and urinalysis. Creatinine clearance (CrCl) was calculated by the Cockcroft-Gault (CG) formula with patient stratification based on the screening serum creatinine measurement. Once daily administration of 400 mg LCZ696 p.o. for 5 days All healthy volunteers were matched by age (±5 years), sex and BMI (±10%) to the renal subjects enrolled into the study. Subjects were to be in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.2 °C, systolic blood pressure (95-140 mm Hg), diastolic blood, pressure (60-100 mm Hg), pulse rate (45-90 bpm), laboratory tests and urinalysis. Healthy subjects must have a CrCl of >80 mL/min. Once daily administration of 400 mg LCZ696 p.o. for 5 days
Measure Participants 6 6
AHU377 (Sacubitril) on day 1
5918
(3430.4)
4101
(815.36)
AHU377(Sacubitril) on day 5
5495
(2890.2)
4336
(745.88)
LBQ657(Sacubitril prodrug) on day 1
254000
(72562)
146100
(17346)
LBQ657 (Sacubitril prodrug) on day 5
538300
(268650)
185500
(29759)
VAL489 (valsartan) on day 1
40560
(11344)
29870
(8756.9)
VAL489 (valsartan) on day 5
51080
(33780)
32470
(8687.1)
5. Primary Outcome
Title T1/2 After Multiple Dose Administration (Day 5)
Description Summary statistics for plasma PK parameters following 5 days QD dose of 400mg LCZ696
Time Frame 5 days

Outcome Measure Data

Analysis Population Description
Pharmacokinetic analysis set
Arm/Group Title Renal Impaired Subjects Healthy Volunteers
Arm/Group Description Subjects with severe (CrCl from <30 mL/min), renal function who were otherwise in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.8°C, systolic blood pressure (95-180 mm Hg), diastolic blood pressure (60-110 mm Hg), pulse rate (54-95 bpm), laboratory tests and urinalysis. Creatinine clearance (CrCl) was calculated by the Cockcroft-Gault (CG) formula with patient stratification based on the screening serum creatinine measurement. Once daily administration of 400 mg LCZ696 p.o. for 5 days All healthy volunteers were matched by age (±5 years), sex and BMI (±10%) to the renal subjects enrolled into the study. Subjects were to be in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.2 °C, systolic blood pressure (95-140 mm Hg), diastolic blood, pressure (60-100 mm Hg), pulse rate (45-90 bpm), laboratory tests and urinalysis. Healthy subjects must have a CrCl of >80 mL/min. Once daily administration of 400 mg LCZ696 p.o. for 5 days
Measure Participants 6 6
AHU377 (Sacubitril)on day 5
2.030
(1.2793)
1.916
(0.69234)
LBQ657(Sacubitril prodrug) on day 5
38.55
(17.301)
13.16
(2.6829)
VAL489 (valsartan) on day 5
26.40
(9.1992)
12.98
(2.9882)
6. Primary Outcome
Title CL/F After Multiple Dose Administration (Day 5)
Description Summary statistics for plasma PK parameters following 5 days QD dose of 400mg LCZ696
Time Frame 5 days

Outcome Measure Data

Analysis Population Description
Pharmacokinetic analysis set
Arm/Group Title Renal Impaired Subjects Healthy Volunteers
Arm/Group Description Subjects with severe (CrCl from <30 mL/min), renal function who were otherwise in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.8°C, systolic blood pressure (95-180 mm Hg), diastolic blood pressure (60-110 mm Hg), pulse rate (54-95 bpm), laboratory tests and urinalysis. Creatinine clearance (CrCl) was calculated by the Cockcroft-Gault (CG) formula with patient stratification based on the screening serum creatinine measurement. Once daily administration of 400 mg LCZ696 p.o. for 5 days All healthy volunteers were matched by age (±5 years), sex and BMI (±10%) to the renal subjects enrolled into the study. Subjects were to be in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.2 °C, systolic blood pressure (95-140 mm Hg), diastolic blood, pressure (60-100 mm Hg), pulse rate (45-90 bpm), laboratory tests and urinalysis. Healthy subjects must have a CrCl of >80 mL/min. Once daily administration of 400 mg LCZ696 p.o. for 5 days
Measure Participants 6 6
AHU377(Sacubitril) on day 5
45100
(24523)
45900
(8168.0)
LBQ657( Sacubitril prodrug) on day 5
NA
(NA)
NA
(NA)
VAL489 (valsartan) on day 5
7370
(8063.0)
6792
(2051.1)
7. Primary Outcome
Title CLr After Multiple Dose Administration (Day 5)
Description Summary statistics for plasma PK parameters following 5 days QD dose of 400mg LCZ696
Time Frame 5 days

Outcome Measure Data

Analysis Population Description
Pharmacokinetic analysis set
Arm/Group Title Renal Impaired Subjects Healthy Volunteers
Arm/Group Description Subjects with severe (CrCl from <30 mL/min), renal function who were otherwise in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.8°C, systolic blood pressure (95-180 mm Hg), diastolic blood pressure (60-110 mm Hg), pulse rate (54-95 bpm), laboratory tests and urinalysis. Creatinine clearance (CrCl) was calculated by the Cockcroft-Gault (CG) formula with patient stratification based on the screening serum creatinine measurement.Once daily administration of 400 mg LCZ696 p.o. for 5 days All healthy volunteers were matched by age (±5 years), sex and BMI (±10%) to the renal subjects enrolled into the study. Subjects were to be in good health as determined by past medical history, physical examination, electrocardiogram, vital signs (measured after 3 minutes rest in the supine position) which are within the following ranges; oral body temperature between 35.0-37.2 °C, systolic blood pressure (95-140 mm Hg), diastolic blood, pressure (60-100 mm Hg), pulse rate (45-90 bpm), laboratory tests and urinalysis. Healthy subjects must have a CrCl of >80 mL/min. Once daily administration of 400 mg LCZ696 p.o. for 5 days
Measure Participants 6 6
AHU377 (Sacubitril) on day 5
24.18
(28.781)
111.8
(82.310)
LBQ657 (Sacubitril prodrug) on day 5
47.39
(38.392)
436.9
(72.388)
VAL489 (valsartan) on day 5
28.89
(20.781)
299.4
(97.887)

Adverse Events

Time Frame 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 (FSFT) until Last Subject Last Visit (LSLV).
Adverse Event Reporting Description
Arm/Group Title Severe Renal Impaired Patients Matched Healthy Volunteers
Arm/Group Description
All Cause Mortality
Severe Renal Impaired Patients Matched Healthy Volunteers
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total / (NaN) / (NaN)
Serious Adverse Events
Severe Renal Impaired Patients Matched Healthy Volunteers
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 0/6 (0%) 0/6 (0%)
Other (Not Including Serious) Adverse Events
Severe Renal Impaired Patients Matched Healthy Volunteers
Affected / at Risk (%) # Events Affected / at Risk (%) # Events
Total 6/6 (100%) 5/6 (83.3%)
Cardiac disorders
Postural orthostatic tachycardia syndrome 3/6 (50%) 0/6 (0%)
Sinus bradycardia 1/6 (16.7%) 0/6 (0%)
Ear and labyrinth disorders
Vertigo 0/6 (0%) 1/6 (16.7%)
Gastrointestinal disorders
Diarrhoea 0/6 (0%) 1/6 (16.7%)
Flatulence 0/6 (0%) 1/6 (16.7%)
General disorders
Fatigue 0/6 (0%) 1/6 (16.7%)
Musculoskeletal and connective tissue disorders
Myalgia 0/6 (0%) 2/6 (33.3%)
Nervous system disorders
Somnolence 0/6 (0%) 1/6 (16.7%)
Vascular disorders
Diastolic hypertension 1/6 (16.7%) 0/6 (0%)
Orthostatic hypertension 3/6 (50%) 0/6 (0%)
Orthostatic hypotension 3/6 (50%) 0/6 (0%)
Systolic hypertension 1/6 (16.7%) 0/6 (0%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

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

The terms and conditions of Novartis' agreements with its investigators may vary. However, Novartis does not prohibit any investigator from publishing. Any publications from a single-site are postponed until the publication of the pooled data (ie, data from all sites) in the clinical trial

Results Point of Contact

Name/Title Study Director
Organization Novartis Pharmaceuticals
Phone 862-778-8300
Email
Responsible Party:
Novartis Pharmaceuticals
ClinicalTrials.gov Identifier:
NCT01569828
Other Study ID Numbers:
  • CLCZ696A2205
  • 2007-005482-36
First Posted:
Apr 3, 2012
Last Update Posted:
Sep 29, 2015
Last Verified:
Aug 1, 2015