Title

Assessing the Behavior of Met DR in Subjects With Kidney Dysfunction
A Randomized, Crossover Study Assessing the Single Dose Pharmacokinetics of Delayed-Release Metformin in Subjects With Renal Dysfunction
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Intervention/Treatment

    sitagliptin ...
  • Study Participants

    39
This study evaluated how a single dose of delayed-release metformin (Met DR) behaves in subjects with normal kidney function, mild kidney dysfunction, moderate kidney dysfunction, or severe kidney dysfunction. The safety and tolerability of Met DR was also examined. In addition, this study compared the behavior of a single dose of Met DR with that of extended-release metformin (Met XR) and placebo in subjects with the varying levels of kidney function described above.
Study Started
Jan 31
2014
Primary Completion
Jun 30
2014
Study Completion
Jun 30
2014
Results Posted
Dec 30
2015
Estimate
Last Update
Dec 30
2015
Estimate

Drug Met DR

metformin delayed-release tablets

Drug Met XR

metformin extended-release tablets

Drug Placebo

Met DR Experimental

One dose of 1000 mg metformin delayed-release

Met XR Active Comparator

One dose of 1000 mg metformin extended-release

Placebo Placebo Comparator

One dose of Placebo

Criteria

Inclusion Criteria:

18 to 80 (inclusive) years old at Visit 1 (Screening)

Male, or female and met all of the following criteria:

Not breastfeeding
Negative pregnancy test result at Visit 1 (Screening) (not applicable to postmenopausal or surgically sterile females)
Surgically sterile, postmenopausal, or if of childbearing potential, practiced and was willing to continue to practice appropriate birth control during the entire duration of the study
Body weight of ≥45 kg
Body mass index (BMI) of 18.0 to 40.0 kg/m² (inclusive) at Visit 1 (Screening)
Had type 2 diabetes mellitus and an HbA1c ≤10.0%
Had a physical examination with no clinically significant abnormalities as judged by the investigator
Estimated glomerular filtration rate (eGFR) ≥15 mL/min/1.73 m² based on the Modification of Diet in Renal Disease (MDRD) equation
Ability to understand and willingness to adhere to protocol requirements

Exclusion Criteria:

Had End Stage Renal Disease requiring dialysis or severe renal dysfunction with eGFR <15 mL/min/1.73 m²
Was on dialysis or had been on dialysis within 12 months of Visit 1 (Screening)
Had received or planned to receive any iodinated contrast dye within 1 week prior to Visit 1 (Screening) or after study medication administration
Was taking or had taken within 1 week of Visit 1 cationic drugs that are eliminated by renal tubular secretion (e.g., amiloride, digoxin, morphine, procainamide, quinidine, quinine, ranitidine, triamterene, trimethoprim, and vancomycin)

Had a clinically significant medical condition that could potentially affect study participation and/or personal well-being, as judged by the investigator, including but not limited to the following conditions:

Hepatic disease
Gastrointestinal disease
Endocrine disorder (type 2 diabetes mellitus was allowed)
Cardiovascular disease
Central nervous system diseases
Psychiatric or neurological disorders
Organ transplantation
Chronic or acute infection
Orthostatic hypotension, fainting spells or blackouts
Allergy or hypersensitivity
Had any chronic disease requiring medication that had been adjusted in the past 14 days (subjects could take acute intermittent over-the-counter medications such as Tylenol, if needed)
Had major surgery of any kind within 6 months of Visit 1 (Screening)
Had a clinically significant finding of an electrocardiogram (ECG) as assessed by the investigator at Visit 1 (Screening)
Had clinical laboratory test (clinical chemistry, hematology, or urinalysis) abnormalities, other than those related to diabetes or renal disease and other stable diseases, judged by the investigator to be clinically significant at Visit 1 (Screening)
Had a hemoglobin result <8 g/dL or a level indicating severe anemia of renal origin
Had a physical, psychological, or historical finding that, in the investigator's opinion, would make the subject unsuitable for the study
Had received Byetta® or short-acting insulin within 3 days of Visit 1 (Screening)
Had received metformin within 4 weeks of Visit 1 (Screening)
Had any drug treatment that affects gastrointestinal motility or gastric pH (prescription or over-the-counter), including any antacids or medications such as Rolaids or Pepcid, within 2 days of Visit 2
Abused drugs or alcohol or had a history of abuse that in the investigator's opinion would cause the individual to be noncompliant with study procedures
Smoked more than 10 cigarettes, 3 cigars, or 3 pipes per day
Had donated blood within 2 months of Visit 1 (Screening) or was planning to donate blood during the study
Had received any investigational drug within one month (or seven half-lives of the investigational drug, whichever was greater) of Visit 1 (Screening)
Had known allergies or hypersensitivity to any component of study treatment
Was employed by Elcelyx Therapeutics, Inc (that is an employee, temporary contract worker, or designee of the company)

Summary

Placebo

Met DR

Met XR

All Events

Event Type Organ System Event Term Placebo Met DR Met XR

AUC (0-t) of Plasma Metformin

AUC (0-t) = Area under the curve from the time of dosing (0 h) to the time of the last quantifiable concentration following dose administration

Met DR

Mild RI (N = 10)

8705.0
ng*h/mL (Least Squares Mean)
Standard Error: 1368

Moderate RI (N = 9)

11477.0
ng*h/mL (Least Squares Mean)
Standard Error: 1915

Normal (N = 8)

5362.0
ng*h/mL (Least Squares Mean)
Standard Error: 943

Severe RI (N = 7)

22893.0
ng*h/mL (Least Squares Mean)
Standard Error: 4307

Met XR

Mild RI (N = 10)

11788.0
ng*h/mL (Least Squares Mean)
Standard Error: 1853

Moderate RI (N = 9)

20240.0
ng*h/mL (Least Squares Mean)
Standard Error: 3377

Normal (N = 8)

10411.0
ng*h/mL (Least Squares Mean)
Standard Error: 1831

Severe RI (N = 7)

43683.0
ng*h/mL (Least Squares Mean)
Standard Error: 8218

Cmax of Plasma Metformin

Cmax = Maximum concentration from the time of dosing (0 h) to the time of the last quantifiable metformin concentration following dose administration

Met DR

Mild RI (N = 10)

1036.0
ng/mL (Least Squares Mean)
Standard Error: 147

Moderate RI (N = 9)

925.0
ng/mL (Least Squares Mean)
Standard Error: 139

Normal (N = 8)

969.0
ng/mL (Least Squares Mean)
Standard Error: 153

Severe RI (N = 7)

1414.0
ng/mL (Least Squares Mean)
Standard Error: 239

Met XR

Mild RI (N = 10)

1340.0
ng/mL (Least Squares Mean)
Standard Error: 189

Moderate RI (N = 9)

1634.0
ng/mL (Least Squares Mean)
Standard Error: 245

Normal (N = 8)

1479.0
ng/mL (Least Squares Mean)
Standard Error: 234

Severe RI (N = 7)

2590.0
ng/mL (Least Squares Mean)
Standard Error: 438

Correlation of Placebo-adjusted Change From Pre-dose Value in Lactate Versus Metformin Concentration

To determine the exposure-response relationship of metformin and plasma lactate concentrations

Met DR

0.000011129

Met XR

0.069527

Total

39
Participants

Age, Continuous

65.1
years (Mean)
Standard Deviation: 9.83

BMI

31.9
kg/m² (Mean)
Standard Deviation: 3.75

Body Weight

95.7
kg (Mean)
Standard Deviation: 13.73

Ethnicity (NIH/OMB)

Race (NIH/OMB)

Sex: Female, Male

Overall Study

Sequence ABC

Sequence CAB

Sequence BCA

Drop/Withdrawal Reasons

Sequence BCA

Sequence ABC