A Study in Healthy Volunteers to Investigate the Effect of Food on the Bioavailability of Cytisine

Sponsor
Achieve Life Sciences (Industry)
Overall Status
Completed
CT.gov ID
NCT03268343
Collaborator
(none)
24
1
2
24
30.4

Study Details

Study Description

Brief Summary

This will be an open-label, randomised, 2-period, single-dose crossover study to determine the comparative bioavailability of cytisine following single-dose administration in healthy male and female subjects under fed and fasted conditions.

The study will be comprised of a pre-study screen, followed by 2 treatment periods (1 and 2) and a post-study follow-up.

Condition or Disease Intervention/Treatment Phase
Phase 1

Study Design

Study Type:
Interventional
Actual Enrollment :
24 participants
Allocation:
Randomized
Intervention Model:
Crossover Assignment
Masking:
None (Open Label)
Primary Purpose:
Treatment
Official Title:
A Phase 1 Open Label, Randomized, Two-Way Crossover Study in Healthy Volunteers to Investigate the Effect of Food on the Bioavailability of Cytisine
Actual Study Start Date :
Aug 8, 2017
Actual Primary Completion Date :
Aug 26, 2017
Actual Study Completion Date :
Sep 1, 2017

Arms and Interventions

Arm Intervention/Treatment
Experimental: Schedule A: Fed Then Fasted

Schedule A (12 subjects): Period 1: Cytisine (2 x 1.5 mg tablets) will be administered 30 minutes after the start of a high fat breakfast (fed state). Period 2: Cytisine (2 x 1.5 mg tablets) will be administered after an overnight fast of at least 10 hours (fasting state).

Drug: Cytisine
Cytisine 1.5 mg Film-Coated Tablets
Other Names:
  • Tabex
  • Experimental: Schedule B: Fasted Then Fed

    Schedule B (12 subjects): Period 1: Cytisine (2 x 1.5 mg tablets) will be administered after an overnight fast of at least 10 hours (fasting state). Period 2: Cytisine (2 x 1.5 mg tablets) will be administered 30 minutes after the start of a high fat breakfast (fed state).

    Drug: Cytisine
    Cytisine 1.5 mg Film-Coated Tablets
    Other Names:
  • Tabex
  • Outcome Measures

    Primary Outcome Measures

    1. Plasma Cytisine Pharmacokinetics (PK): Maximum Observed Plasma Concentration (Cmax) [Pre-dose (within 60 minutes of dosing); 15 minutes, 20 minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 14 hours, 16 hours and 24 hours post-dose (+/- 1 minute)]

    2. Plasma Cytisine PK: Total Area Under the Curve From Time Zero to Infinity (AUC0-∞) [Pre-dose (within 60 minutes of dosing); 15 minutes, 20 minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 14 hours, 16 hours and 24 hours post-dose (+/- 1 minute)]

    Secondary Outcome Measures

    1. Plasma Cytisine PK: Time of Occurrence of Cmax (Tmax) [Pre-dose (within 60 minutes of dosing); 15 minutes, 20 minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 14 hours, 16 hours and 24 hours post-dose (+/- 1 minute)]

    2. Plasma Cytisine PK: AUC From Time Zero to the Last Sampling Time (AUC0-t) [Pre-dose (within 60 minutes of dosing); 15 minutes, 20 minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 14 hours, 16 hours and 24 hours post-dose (+/- 1 minute)]

    3. Plasma Cytisine PK: Residual Area, or Percentage of Extrapolated Part for the Calculation of AUC0-∞ (AUC%) [Pre-dose (within 60 minutes of dosing); 15 minutes, 20 minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 14 hours, 16 hours and 24 hours post-dose (+/- 1 minute)]

    4. Plasma Cytisine PK: Apparent Terminal Elimination Rate Constant (Lambda z) [Pre-dose (within 60 minutes of dosing); 15 minutes, 20 minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 14 hours, 16 hours and 24 hours post-dose (+/- 1 minute)]

    5. Plasma Cytisine PK: Apparent Terminal Elimination Half-Life (t1/2) [Pre-dose (within 60 minutes of dosing); 15 minutes, 20 minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 14 hours, 16 hours and 24 hours post-dose (+/- 1 minute)]

    6. Urine Cytisine PK: Amount Excreted in Urine Over Time (Ae) [Pre-dose (within 30 minutes prior to first dose); 0-2 hours, 2-4 hours, 4-8 hours, 8-12 hours and 12-24 hours post-dose]

    7. Urine Cytisine PK: Percentage of Drug Excreted in Urine (Ae%) [Pre-dose (within 30 minutes prior to first dose); 0-2 hours, 2-4 hours, 4-8 hours, 8-12 hours and 12-24 hours post-dose]

      To assess the renal elimination of cytisine via measurement of urinary concentrations of cytisine.

    8. Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious TEAEs, and Discontinuation of Study Drug Due to AEs, by Severity and Relationship [Day -1 to Day 7 plus 6-8 days (post-study follow-up)]

      An adverse event (AE) is defined as any untoward medical occurrence which does not necessarily have a causal relationship with the treatment. TEAEs are defined as AEs not present prior to first administration of investigational product, or AEs present before first administration of study drug that worsen after the subject receives the first dose of study drug. A serious adverse event (SAE) is defined as an AE that: results in death; is life-threatening; requires hospitalization or prolongs existing inpatient's hospitalization; results in persistent or significant disability or incapacity; results in a congenital abnormality or birth defect; is an important medical event which requires medical intervention to prevent any of the above outcomes. Event severity was categorized as mild, moderate, or severe. Relationship of event to study drug was categorized as definite, probably, possible, unlikely, not related, or not applicable (N/A).

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 55 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    Yes
    Inclusion Criteria:
    1. Healthy males and females between 18 and 55 years of age.

    2. If a female subject of child bearing potential, a negative pregnancy test at screening and admission and willing to use an effective method of contraception (unless of non-childbearing potential or where abstaining from sexual intercourse is in line with the preferred and usual lifestyle of the subject) from first dose until 3 months after last dose of investigational medicinal product (IMP).

    3. If a female subject of non-child bearing potential, a negative pregnancy test at screening and admission. For the purposes of this study, this is defined as the subject being amenorrheic for at least 12 consecutive months or at least 4 months post-surgical sterilisation (including bilateral fallopian tube ligation or bilateral oophorectomy with or without hysterectomy). Menopausal status will be confirmed by demonstrating at screening that levels of follicle stimulating hormone (FSH) fall within the respective pathology reference range. In the event a subject's menopause status has been clearly established (for example, the subject indicates she has been amenorrheic for 10 years), but FSH levels are not consistent with a post-menopausal condition, determination of subject eligibility will be at Investigator's discretion following consultation with the Sponsor.

    4. If a male subject, willing to use an effective method of contraception (unless anatomically sterile or where abstaining from sexual intercourse is in line with the preferred and usual lifestyle of the subject) from first dose until 3 months after last dose of IMP.

    5. Subject with a body mass index (BMI) of 18-32 kg/m^2. BMI = body weight in kg / [height in m]^2.

    6. Subject with no clinically significant abnormal serum biochemistry, haematology and urine examination values within 28 days before the first dose of IMP.

    7. Subject with negative urinary drugs of abuse screen, determined within 28 days before the first dose of IMP (a positive alcohol or cotinine result may be repeated at Investigator's discretion).

    8. Subject with negative human immunodeficiency virus (HIV), hepatitis B surface antigen (Hep B) and hepatitis C virus antibody (Hep C) results.

    9. Subject with no clinically significant abnormalities in 12-lead ECG determined after minimum of 5 minutes in supine position within 28 days before the first dose of IMP.

    10. Subject with no clinically significant abnormalities in vital signs (systolic blood pressure between 90-150 mmHg, diastolic blood pressure (DBP) between 50 and 90 mmHg, and pulse rate (PR) between 40-110 bpm, measured on the dominant arm after minimum of 5 minutes in supine position) determined within 28 days before first dose of IMP.

    11. Subject must be available to complete the study (including post study follow-up) and comply with study restrictions.

    12. Subject must provide written informed consent to participate in the study.

    Exclusion Criteria:
    1. Known hypersensitivity/allergy reaction to varenicline, other cytisine-derivatives or any of the excipients in the Tabex formulation (lactose, cellulose, talc, magnesium).

    2. History of severe hypersensitivity reactions to any other drugs.

    3. History of any medical condition (e.g. gastrointestinal, renal or hepatic) or surgical condition (e.g. cholecystectomy, gastrectomy) that may affect drug pharmacokinetics (absorption, distribution, metabolism or excretion).

    4. Difficulty in donating blood on either arm or known history.

    5. History of alcoholism or drug abuse within last 2 years.

    6. Regular nicotine intake (e.g., smoking, nicotine patch, nicotine chewing gum or electronic cigarettes) within previous 3 months and inability to refrain from nicotine intake from Screening until end of study.

    7. Use of prescription or non-prescription drugs, including vitamins, herbal and dietary supplements within 14 days (or 5 half-lives, whichever is longer) prior to the first dose of IMP, unless in the opinion of the Investigator the medication will not interfere with the study procedures or compromise subject safety.

    8. Participated in any investigational drug clinical trial within the previous 3 months or a marketed drug trial within the previous 30 days prior to randomization on Day 1 of Period 1.

    9. Donation of 450 mL or more blood or had history of significant blood loss due to any reason or had plasmapheresis within 3 months before the first dose of IMP.

    10. Any special food restrictions that may hinder ability to consume the high fat breakfast provided during the study; such as lactose intolerance, vegan, low-fat, low sodium, etc.

    11. Any inability or difficulty in fasting.

    12. Inability to communicate well with Investigators (i.e., language problem, poor mental development or impaired cerebral function).

    13. Any other condition that the Principal Investigator considers making the subject unsuitable for this study.

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Simbec Research Ltd Merthyr Tydfil United Kingdom CF11 9AB

    Sponsors and Collaborators

    • Achieve Life Sciences

    Investigators

    • Principal Investigator: Annelize Koch, MD, Simbec Research Ltd (Simbec)

    Study Documents (Full-Text)

    More Information

    Publications

    None provided.
    Responsible Party:
    Achieve Life Sciences
    ClinicalTrials.gov Identifier:
    NCT03268343
    Other Study ID Numbers:
    • ACH-CYT-01
    • 2017-001562-19
    First Posted:
    Aug 31, 2017
    Last Update Posted:
    Feb 26, 2019
    Last Verified:
    Feb 1, 2019
    Individual Participant Data (IPD) Sharing Statement:
    Undecided
    Plan to Share IPD:
    Undecided
    Studies a U.S. FDA-regulated Drug Product:
    Yes
    Studies a U.S. FDA-regulated Device Product:
    No

    Study Results

    Participant Flow

    Recruitment Details
    Pre-assignment Detail
    Arm/Group Title 3 mg Cytisine, Schedule A: Fed Then Fasted 3 mg Cytisine, Schedule B: Fasted Then Fed
    Arm/Group Description Period 1: Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state). Period 2: Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state). Period 1: Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state). Period 2: Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state).
    Period Title: Overall Study
    STARTED 12 12
    COMPLETED 12 12
    NOT COMPLETED 0 0

    Baseline Characteristics

    Arm/Group Title 3 mg Cytisine
    Arm/Group Description 3 mg Cytisine, Schedule A: Fed Then Fasted Period 1: Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state). Period 2: Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state). 3 mg Cytisine, Schedule B: Fasted Then Fed Period 1: Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state). Period 2: Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state).
    Overall Participants 24
    Age (years) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [years]
    35.1
    (10.25)
    Sex: Female, Male (Count of Participants)
    Female
    13
    54.2%
    Male
    11
    45.8%
    Race/Ethnicity, Customized (Count of Participants)
    Caucasian
    23
    95.8%
    Other, Not Specified
    1
    4.2%

    Outcome Measures

    1. Primary Outcome
    Title Plasma Cytisine Pharmacokinetics (PK): Maximum Observed Plasma Concentration (Cmax)
    Description
    Time Frame Pre-dose (within 60 minutes of dosing); 15 minutes, 20 minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 14 hours, 16 hours and 24 hours post-dose (+/- 1 minute)

    Outcome Measure Data

    Analysis Population Description
    PK Set: All participants who received doses under both fed and fasted conditions and did not have an occurrence of vomiting which rendered the concentration profile unreliable. (Two participants were excluded for vomiting before twice the median Tmax had been reached following 3 mg cytisine administered in a fed state.)
    Arm/Group Title 3 mg Cytisine, Fed 3 mg Cytisine, Fasted
    Arm/Group Description Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state). Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state).
    Measure Participants 22 22
    Mean (Standard Deviation) [ng/mL]
    22.9
    (5.44)
    30.8
    (7.91)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection 3 mg Cytisine, Fed, 3 mg Cytisine, Fasted
    Comments
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Geometric LS Mean Ratio (%)
    Estimated Value 74.71
    Confidence Interval (2-Sided) 90%
    66.39 to 84.08
    Parameter Dispersion Type:
    Value:
    Estimation Comments fed / fasted; results obtained using an ANOVA with fixed effects of treatment, period, sequence and participant (sequence).
    2. Primary Outcome
    Title Plasma Cytisine PK: Total Area Under the Curve From Time Zero to Infinity (AUC0-∞)
    Description
    Time Frame Pre-dose (within 60 minutes of dosing); 15 minutes, 20 minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 14 hours, 16 hours and 24 hours post-dose (+/- 1 minute)

    Outcome Measure Data

    Analysis Population Description
    PK Set: All participants who received doses under both fed and fasted conditions and did not have an occurrence of vomiting which rendered the concentration profile unreliable. (Two participants were excluded for vomiting before twice the median Tmax had been reached following 3 mg cytisine administered in a fed state.)
    Arm/Group Title 3 mg Cytisine, Fed 3 mg Cytisine, Fasted
    Arm/Group Description Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state). Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state).
    Measure Participants 22 22
    Mean (Standard Deviation) [h*ng/mL]
    170
    (30.3)
    176
    (33.1)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection 3 mg Cytisine, Fed, 3 mg Cytisine, Fasted
    Comments
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Geometric LS Mean Ratio (%)
    Estimated Value 97.04
    Confidence Interval (2-Sided) 90%
    94.20 to 99.98
    Parameter Dispersion Type:
    Value:
    Estimation Comments fed / fasted; results obtained using an ANOVA with fixed effects of treatment, period, sequence and participant (sequence).
    3. Secondary Outcome
    Title Plasma Cytisine PK: Time of Occurrence of Cmax (Tmax)
    Description
    Time Frame Pre-dose (within 60 minutes of dosing); 15 minutes, 20 minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 14 hours, 16 hours and 24 hours post-dose (+/- 1 minute)

    Outcome Measure Data

    Analysis Population Description
    PK Set: All participants who received doses under both fed and fasted conditions and did not have an occurrence of vomiting which rendered the concentration profile unreliable. (Two participants were excluded for vomiting before twice the median Tmax had been reached following 3 mg cytisine administered in a fed state.)
    Arm/Group Title 3 mg Cytisine, Fed 3 mg Cytisine, Fasted
    Arm/Group Description Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state). Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state).
    Measure Participants 22 22
    Median (Full Range) [hours]
    2.75
    0.75
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection 3 mg Cytisine, Fed, 3 mg Cytisine, Fasted
    Comments
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value < 0.0001
    Comments
    Method Wilcoxon Signed-Rank test
    Comments
    Method of Estimation Estimation Parameter Median Difference (Final Values)
    Estimated Value 1.38
    Confidence Interval (2-Sided) 95%
    0.50 to 2.25
    Parameter Dispersion Type:
    Value:
    Estimation Comments Hodges-Lehmann method
    4. Secondary Outcome
    Title Plasma Cytisine PK: AUC From Time Zero to the Last Sampling Time (AUC0-t)
    Description
    Time Frame Pre-dose (within 60 minutes of dosing); 15 minutes, 20 minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 14 hours, 16 hours and 24 hours post-dose (+/- 1 minute)

    Outcome Measure Data

    Analysis Population Description
    PK Set: All participants who received doses under both fed and fasted conditions and did not have an occurrence of vomiting which rendered the concentration profile unreliable. (Two participants were excluded for vomiting before twice the median Tmax had been reached following 3 mg cytisine administered in a fed state.)
    Arm/Group Title 3 mg Cytisine, Fed 3 mg Cytisine, Fasted
    Arm/Group Description Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state). Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state).
    Measure Participants 22 22
    Mean (Standard Deviation) [h*ng/mL]
    163
    (29.4)
    169
    (33.0)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection 3 mg Cytisine, Fed, 3 mg Cytisine, Fasted
    Comments
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Geometric LS Mean Ratio (%)
    Estimated Value 96.52
    Confidence Interval (2-Sided) 90%
    93.30 to 99.85
    Parameter Dispersion Type:
    Value:
    Estimation Comments fed / fasted; results obtained using an ANOVA with fixed effects of treatment, period, sequence and participant (sequence).
    5. Secondary Outcome
    Title Plasma Cytisine PK: Residual Area, or Percentage of Extrapolated Part for the Calculation of AUC0-∞ (AUC%)
    Description
    Time Frame Pre-dose (within 60 minutes of dosing); 15 minutes, 20 minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 14 hours, 16 hours and 24 hours post-dose (+/- 1 minute)

    Outcome Measure Data

    Analysis Population Description
    PK Set: All participants who received doses under both fed and fasted conditions and did not have an occurrence of vomiting which rendered the concentration profile unreliable. (Two participants were excluded for vomiting before twice the median Tmax had been reached following 3 mg cytisine administered in a fed state.)
    Arm/Group Title 3 mg Cytisine, Fed 3 mg Cytisine, Fasted
    Arm/Group Description Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state). Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state).
    Measure Participants 22 22
    Mean (Standard Deviation) [percentage of extrapolated part]
    4.37
    (1.40)
    3.85
    (1.46)
    6. Secondary Outcome
    Title Plasma Cytisine PK: Apparent Terminal Elimination Rate Constant (Lambda z)
    Description
    Time Frame Pre-dose (within 60 minutes of dosing); 15 minutes, 20 minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 14 hours, 16 hours and 24 hours post-dose (+/- 1 minute)

    Outcome Measure Data

    Analysis Population Description
    PK Set: All participants who received doses under both fed and fasted conditions and did not have an occurrence of vomiting which rendered the concentration profile unreliable. (Two participants were excluded for vomiting before twice the median Tmax had been reached following 3 mg cytisine administered in a fed state.)
    Arm/Group Title 3 mg Cytisine, Fed 3 mg Cytisine, Fasted
    Arm/Group Description Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state). Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state).
    Measure Participants 22 22
    Mean (Standard Deviation) [1/hour]
    0.154
    (0.0391)
    0.156
    (0.0314)
    7. Secondary Outcome
    Title Plasma Cytisine PK: Apparent Terminal Elimination Half-Life (t1/2)
    Description
    Time Frame Pre-dose (within 60 minutes of dosing); 15 minutes, 20 minutes, 30 minutes, 45 minutes, 1 hour, 1.5 hours, 2 hours, 2.5 hours, 3 hours, 4 hours, 6 hours, 8 hours, 12 hours, 14 hours, 16 hours and 24 hours post-dose (+/- 1 minute)

    Outcome Measure Data

    Analysis Population Description
    PK Set: All participants who received doses under both fed and fasted conditions and did not have an occurrence of vomiting which rendered the concentration profile unreliable. (Two participants were excluded for vomiting before twice the median Tmax had been reached following 3 mg cytisine administered in a fed state.)
    Arm/Group Title 3 mg Cytisine, Fed 3 mg Cytisine, Fasted
    Arm/Group Description Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state). Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state).
    Measure Participants 22 22
    Mean (Standard Deviation) [hours]
    4.77
    (1.16)
    4.59
    (0.832)
    8. Secondary Outcome
    Title Urine Cytisine PK: Amount Excreted in Urine Over Time (Ae)
    Description
    Time Frame Pre-dose (within 30 minutes prior to first dose); 0-2 hours, 2-4 hours, 4-8 hours, 8-12 hours and 12-24 hours post-dose

    Outcome Measure Data

    Analysis Population Description
    PK Set: All participants who received doses under both fed and fasted conditions and did not have an occurrence of vomiting which rendered the concentration profile unreliable. (Two participants were excluded for vomiting before twice the median Tmax had been reached following 3 mg cytisine administered in a fed state.)
    Arm/Group Title 3 mg Cytisine, Fed 3 mg Cytisine, Fasted
    Arm/Group Description Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state). Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state).
    Measure Participants 22 22
    Mean (Standard Deviation) [mg]
    2.59
    (0.407)
    2.47
    (0.357)
    Statistical Analysis 1
    Statistical Analysis Overview Comparison Group Selection 3 mg Cytisine, Fed, 3 mg Cytisine, Fasted
    Comments
    Type of Statistical Test Superiority
    Comments
    Statistical Test of Hypothesis p-Value
    Comments
    Method
    Comments
    Method of Estimation Estimation Parameter Geometric LS Mean Ratio (%)
    Estimated Value 104.75
    Confidence Interval (2-Sided) 95%
    98.97 to 110.87
    Parameter Dispersion Type:
    Value:
    Estimation Comments fed / fasted; results obtained using an ANOVA with fixed effects of treatment, period, sequence and participant (sequence).
    9. Secondary Outcome
    Title Urine Cytisine PK: Percentage of Drug Excreted in Urine (Ae%)
    Description To assess the renal elimination of cytisine via measurement of urinary concentrations of cytisine.
    Time Frame Pre-dose (within 30 minutes prior to first dose); 0-2 hours, 2-4 hours, 4-8 hours, 8-12 hours and 12-24 hours post-dose

    Outcome Measure Data

    Analysis Population Description
    PK Set: All participants who received doses under both fed and fasted conditions and did not have an occurrence of vomiting which rendered the concentration profile unreliable. (Two participants were excluded for vomiting before twice the median Tmax had been reached following 3 mg cytisine administered in a fed state.)
    Arm/Group Title 3 mg Cytisine, Fed 3 mg Cytisine, Fasted
    Arm/Group Description Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state). Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state).
    Measure Participants 22 22
    Mean (Standard Deviation) [percentage of drug excreted]
    86.5
    (13.6)
    82.4
    (11.9)
    10. Secondary Outcome
    Title Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Serious TEAEs, and Discontinuation of Study Drug Due to AEs, by Severity and Relationship
    Description An adverse event (AE) is defined as any untoward medical occurrence which does not necessarily have a causal relationship with the treatment. TEAEs are defined as AEs not present prior to first administration of investigational product, or AEs present before first administration of study drug that worsen after the subject receives the first dose of study drug. A serious adverse event (SAE) is defined as an AE that: results in death; is life-threatening; requires hospitalization or prolongs existing inpatient's hospitalization; results in persistent or significant disability or incapacity; results in a congenital abnormality or birth defect; is an important medical event which requires medical intervention to prevent any of the above outcomes. Event severity was categorized as mild, moderate, or severe. Relationship of event to study drug was categorized as definite, probably, possible, unlikely, not related, or not applicable (N/A).
    Time Frame Day -1 to Day 7 plus 6-8 days (post-study follow-up)

    Outcome Measure Data

    Analysis Population Description
    Safety Analysis Set: all participants who received at least one dose of cytisine.
    Arm/Group Title 3 mg Cytisine, Fed 3 mg Cytisine, Fasted
    Arm/Group Description Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state). Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state).
    Measure Participants 24 24
    ≥ 1 TEAE
    6
    25%
    7
    NaN
    ≥ 1 Serious TEAE
    0
    0%
    0
    NaN
    ≥ 1 TEAE Leading to Withdrawal of Study Drug
    0
    0%
    0
    NaN
    ≥ 1 Mild TEAE
    6
    25%
    7
    NaN
    ≥ 1 Moderate TEAE
    0
    0%
    0
    NaN
    ≥ 1 Severe TEAE
    0
    0%
    0
    NaN
    ≥ 1 TEAE Definitely Related to Study Drug
    0
    0%
    0
    NaN
    ≥ 1 TEAE Probably Related to Study Drug
    1
    4.2%
    1
    NaN
    ≥ 1 TEAE Possibly Related to Study Drug
    3
    12.5%
    5
    NaN
    ≥ 1 TEAE Unlikely Related to Study Drug
    1
    4.2%
    1
    NaN
    ≥ 1 TEAE Not Related to Study Drug
    0
    0%
    0
    NaN
    ≥ 1 TEAE Relationship to Study Drug = N/A
    1
    4.2%
    0
    NaN

    Adverse Events

    Time Frame Day -1 to Day 7 plus 6-8 days (post-study follow-up)
    Adverse Event Reporting Description For each reporting group, a participant was counted only once per system organ class and preferred term. Consequently, if the same preferred term was observed for a participant in both fed and fasted states, the participant was counted only once in the "3 mg Cytisine, Overall" reporting group for that preferred term.
    Arm/Group Title 3 mg Cytisine, Fed 3 mg Cytisine, Fasted 3 mg Cytisine, Overall
    Arm/Group Description Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state). Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state). Cytisine (2 x 1.5 mg tablets) administered 30 minutes after the start of a high fat breakfast (fed state). Cytisine (2 x 1.5 mg tablets) administered after an overnight fast of at least 10 hours (fasting state).
    All Cause Mortality
    3 mg Cytisine, Fed 3 mg Cytisine, Fasted 3 mg Cytisine, Overall
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/24 (0%) 0/24 (0%) 0/24 (0%)
    Serious Adverse Events
    3 mg Cytisine, Fed 3 mg Cytisine, Fasted 3 mg Cytisine, Overall
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 0/24 (0%) 0/24 (0%) 0/24 (0%)
    Other (Not Including Serious) Adverse Events
    3 mg Cytisine, Fed 3 mg Cytisine, Fasted 3 mg Cytisine, Overall
    Affected / at Risk (%) # Events Affected / at Risk (%) # Events Affected / at Risk (%) # Events
    Total 6/24 (25%) 7/24 (29.2%) 10/24 (41.7%)
    Gastrointestinal disorders
    Abdominal pain lower 0/24 (0%) 1/24 (4.2%) 1/24 (4.2%)
    Nausea 1/24 (4.2%) 1/24 (4.2%) 2/24 (8.3%)
    Vomiting 2/24 (8.3%) 1/24 (4.2%) 3/24 (12.5%)
    General disorders
    Feeling hot 0/24 (0%) 1/24 (4.2%) 1/24 (4.2%)
    Infections and infestations
    Rhinitis 1/24 (4.2%) 0/24 (0%) 1/24 (4.2%)
    Nervous system disorders
    Dizziness 2/24 (8.3%) 3/24 (12.5%) 4/24 (16.7%)
    Headache 2/24 (8.3%) 2/24 (8.3%) 3/24 (12.5%)
    Hypoaesthesia 1/24 (4.2%) 0/24 (0%) 1/24 (4.2%)
    Somnolence 0/24 (0%) 1/24 (4.2%) 1/24 (4.2%)
    Skin and subcutaneous tissue disorders
    Cold sweat 1/24 (4.2%) 0/24 (0%) 1/24 (4.2%)
    Erythema 0/24 (0%) 1/24 (4.2%) 1/24 (4.2%)
    Surgical and medical procedures
    Tooth repair 0/24 (0%) 1/24 (4.2%) 1/24 (4.2%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

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

    Principal Investigators are bound by requirements outlined in their individual clinical trial agreements with regard to publication of trial results.

    Results Point of Contact

    Name/Title Daniel Cain, Senior Director Clinical Research
    Organization Achieve Life Sciences
    Phone 425.686.1546
    Email dcain@achievelifesciences.com
    Responsible Party:
    Achieve Life Sciences
    ClinicalTrials.gov Identifier:
    NCT03268343
    Other Study ID Numbers:
    • ACH-CYT-01
    • 2017-001562-19
    First Posted:
    Aug 31, 2017
    Last Update Posted:
    Feb 26, 2019
    Last Verified:
    Feb 1, 2019