Correlation of Mesalamine Pharmacokinetics With Local Availability

University of Michigan

Status: Completed

Conditions: Local Drug Concentration in Gastrointestinal Tract

Treatments: Drug: Delzicol 100 mg mesalamine x 1 with 245 mL water; single dose; Drug: Pentasa 500 mg capsule x 2 with 240 mL water; single dose; Drug: Apriso 375 mg capsule x 3 with 240 mL water; single dose; Drug: Lialda 1200 mg tablet x 1 with 240 mL water; single dose

Study type: Interventional

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT01999400

FDA-SOL-1120920

HHSF223201300460A (Other Grant/Funding Number)

HHSF223201000082C (Other Grant/Funding Number)

Details and patient eligibility

About

This study is designed to provide data to the FDA correlating pharmacokinetics with local availability of medications within the gastrointestinal tract. This study will support the establishment of scientifically based standards for evaluating drugs which act locally within the gastrointestinal tract. Specific objectives of this study are to: (1) quantify how the plasma concentrations of mesalamine, an agent used to treat inflammatory bowel disease, are correlated with the concentrations in gastrointestinal fluids; and (2) improve the physiologically based models for drug absorption from the intestine. Information from this study in concert with in vitro dissolution data will be used to evaluate in vivo-in vitro correlation (IVIVC) for concentrations in plasma and intestinal lumen and dissolution of mesalamine products.

Full description

This study evaluated the pharmacokinetics of mesalamine and its major metabolite of mesalamine known as N-acetyl-mesalamine in plasma. Mesalamine is available in different formulations that control the rate at which they are released in the gastrointestinal tract. Three formulations of mesalamine, Pentasa, Apriso, and Lialda, were studied in the crossover phase, while an oral solution formulation of mesalamine was studied in the single-arm phase. Each subject participated in a crossover phase study with one of the three formulations assigned at random using block randomization. Then the subject entered the single-arm phase study. After participation in one crossover phase study and one single-arm phase study, the subject could opt to participate in crossover phase studies using the other formulations also chosen at random until all three formulations were studied. The single-arm phase study was not repeated on returning subjects who participated in more than one crossover phase study.

Enrollment: 30 patients

Sex: All

Ages: 18 to 55 years old

Volunteers: Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria

1. Adults age 18 to 55.
2. Male or female voluntarily able to give informed consent.
3. Body mass index (BMI) 18.5 to 35.

Exclusion Criteria

1. Adults unable to consent for themselves or mentally incapacitated.
2. Prisoners.
3. Significant clinical illness within 3 weeks prior to Screening.
4. Use of concomitant medications within 2 weeks prior to receiving study drug, including but not limited to prescription drugs, herbal and dietary supplements, over the counter medications, and vitamins. Oral contraception is permitted.
5. History of gastrointestinal surgery.
6. History of allergy to non-steroidal anti-inflammatory drugs (NSAIDs) or to any of the ingredients of Asacol, Pentasa, Apriso, or Lialda.
7. History of severe allergic diseases including drug allergies, with the exception of seasonal allergies.
8. Any other factor, condition, or disease, including, but not limited to, cardiovascular, renal, hepatic, or gastrointestinal disorders that may, in the opinion of the Investigator, jeopardize the safety of the patient or impact the validity of the study results.
9. History of drug addiction or alcohol abuse within the past 12 months.
10. Pregnant or lactating females.
11. Surgery within the past 3 months.
12. Received an investigational drug within 60 days prior to receiving the study drug.
13. Any clinically significant abnormal lab values during Screening.

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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30 participants in 6 patient groups

Arm 1: Pentasa then Delzicol then Apriso then Lialda

Experimental group

Description:

1. Pentasa 500 mg capsule x 2 with 240 mL water, single dose. 2. Washout period of 10 days. 3. Delzicol 100 mg mesalamine x 1 with 245 mL water, single dose. 4. Washout period of 10 days. 5. Apriso 375 mg capsule x 3 with 240 mL water, single dose. 6. Washout period of 10 days. 7. Lialda 1200 mg tablet x 1 with 240 mL water, single dose.

Treatment:

Drug: Apriso 375 mg capsule x 3 with 240 mL water; single dose

Drug: Pentasa 500 mg capsule x 2 with 240 mL water; single dose

Drug: Lialda 1200 mg tablet x 1 with 240 mL water; single dose

Drug: Delzicol 100 mg mesalamine x 1 with 245 mL water; single dose

Arm 2: Pentasa then Delzicol then Lialda then Apriso

Experimental group

Description:

1. Pentasa 500 mg capsule x 2 with 240 mL water, single dose. 2. Washout period of 10 days. 3. Delzicol 100 mg mesalamine x 1 with 245 mL water, single dose. 4. Washout period of 10 days. 5. Lialda 1200 mg tablet x 1 with 240 mL water, single dose. 6. Washout period of 10 days. 7. Apriso 375 mg capsule x 3 with 240 mL water, single dose.

Treatment:

Drug: Apriso 375 mg capsule x 3 with 240 mL water; single dose

Drug: Pentasa 500 mg capsule x 2 with 240 mL water; single dose

Drug: Lialda 1200 mg tablet x 1 with 240 mL water; single dose

Drug: Delzicol 100 mg mesalamine x 1 with 245 mL water; single dose

Arm 3: Apriso then Delzicol then Pentasa then Lialda

Experimental group

Description:

1. Apriso 375 mg capsule x 3 with 240 mL water, single dose. 2. Washout period of 10 days. 3. Delzicol 100 mg mesalamine x 1 with 245 mL water, single dose. 4. Washout period of 10 days. 5. Pentasa 500 mg capsule x 2 with 240 mL water, single dose. 6. Washout period of 10 days. 7. Lialda 1200 mg tablet x 1 with 240 mL water, single dose.

Treatment:

Drug: Apriso 375 mg capsule x 3 with 240 mL water; single dose

Drug: Pentasa 500 mg capsule x 2 with 240 mL water; single dose

Drug: Lialda 1200 mg tablet x 1 with 240 mL water; single dose

Drug: Delzicol 100 mg mesalamine x 1 with 245 mL water; single dose

Arm 4: Apriso then Delzicol then Lialda then Pentasa

Experimental group

Description:

1. Apriso 375 mg capsule x 3 with 240 mL water, single dose. 2. Washout period of 10 days. 3. Delzicol 100 mg mesalamine x 1 with 245 mL water, single dose. 4. Washout period of 10 days. 5. Lialda 1200 mg tablet x 1 with 240 mL water, single dose. 6. Washout period of 10 days. 7. Pentasa 500 mg capsule x 2 with 240 mL water, single dose.

Treatment:

Drug: Apriso 375 mg capsule x 3 with 240 mL water; single dose

Drug: Pentasa 500 mg capsule x 2 with 240 mL water; single dose

Drug: Lialda 1200 mg tablet x 1 with 240 mL water; single dose

Drug: Delzicol 100 mg mesalamine x 1 with 245 mL water; single dose

Arm 5: Lialda then Delzicol then Pentasa then Apriso

Experimental group

Description:

1. Lialda 1200 mg tablet x 1 with 240 mL water, single dose. 2. Washout period of 10 days. 3. Delzicol 100 mg mesalamine x 1 with 245 mL water, single dose. 4. Washout period of 10 days. 5. Pentasa 500 mg capsule x 2 with 240 mL water, single dose. 6. Washout period of 10 days. 7. Apriso 375 mg capsule x 3 with 240 mL water, single dose.

Treatment:

Drug: Apriso 375 mg capsule x 3 with 240 mL water; single dose

Drug: Pentasa 500 mg capsule x 2 with 240 mL water; single dose

Drug: Lialda 1200 mg tablet x 1 with 240 mL water; single dose

Drug: Delzicol 100 mg mesalamine x 1 with 245 mL water; single dose

Arm 6: Lialda then Delzicol then Apriso then Pentasa

Experimental group

Description:

1. Lialda 1200 mg tablet x 1 with 240 mL water, single dose. 2. Washout period of 10 days. 3. Delzicol 100 mg mesalamine x 1 with 245 mL water, single dose. 4. Washout period of 10 days. 5. Apriso 375 mg capsule x 3 with 240 mL water, single dose. 6. Washout period of 10 days. 7. Pentasa 500 mg capsule x 2 with 240 mL water, single dose.

Treatment:

Drug: Apriso 375 mg capsule x 3 with 240 mL water; single dose

Drug: Pentasa 500 mg capsule x 2 with 240 mL water; single dose

Drug: Lialda 1200 mg tablet x 1 with 240 mL water; single dose

Drug: Delzicol 100 mg mesalamine x 1 with 245 mL water; single dose