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An Investigational Study of Hydrocortisone

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ClinicalTrials.gov Identifier: NCT01960530
Recruitment Status : Completed
First Posted : October 10, 2013
Results First Posted : April 13, 2017
Last Update Posted : April 13, 2017
Sponsor:
Collaborator:
Simbec Research
Information provided by (Responsible Party):
Diurnal Limited

Study Description
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Brief Summary:

This study will investigate a new drug called Infacort®; a newly-developed immediate release formulation of a well-established drug called hydrocortisone. Hydrocortisone is used as a replacement treatment for people whose adrenal glands are not producing enough natural cortisol - a condition known as adrenal insufficiency. The study will assess how Infacort® acts once inside the body, by measuring cortisol and other hormone levels in the body, compared to already marketed hydrocortisone tablet and hydrocortisone intravenous (through the vein) injection.

The population who are eligible to take part in the study are healthy male volunteers, aged between 18 and 60 years of age.


Condition or disease Intervention/treatment Phase
Adrenal Insufficiency Drug: Hydrocortisone granules Drug: Hydrocortisone Tablet Drug: i.v. Hydrocortisone Injection Other: Dexamethasone Phase 1

Detailed Description:
The study will evaluate the normal physiology, PK and metabolism of cortisol, investigate the PK and bioavailability of cortisol from the test Infacort® Granules (hydrocortisone) and the reference hydrocortisone tablets and i.v injection in healthy adult male volunteers and explore the role of cortisol in the regulation of metabolic pathways.
Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 14 participants
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: None (Open Label)
Primary Purpose: Other
Official Title: An Open Label, Partially Randomised, Single Dose, Crossover Study to Evaluate the PK, Oral Bioavailability and Relationship to Metabolic Parameters of Hydrocortisone and Infacort® in Healthy Adult Male Volunteers.
Study Start Date : October 2013
Actual Primary Completion Date : November 2014
Actual Study Completion Date : November 2014

Resource links provided by the National Library of Medicine


Arms and Interventions
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Arm Intervention/treatment
No Intervention: Endogenous Cortisol
No Study medication will be given during this study period, however various blood, urine and saliva samples will be taken in order to measure normal levels of hormones and other chemicals at several time-points.
Dexamethasone
1mg Dexamethasone will be administered at 22:00 on Day 1 and at 06:00 and 12:00 on Day 2. Various blood, urine and saliva samples will be taken in order to measure normal levels of hormones and other chemicals at several time-points. Dexamethasone is considered a challenge agent and therefore a non-IMP
 Other: Dexamethasone
Challenge agent
Other Name: Non-IMP
Experimental: Infacort®
20mg Infacort® will be administered on Day 2 at 07:00. Dexamethasone is a challenge agent and will be taken to suppress endogenous adrenocorticotropic Hormone (ACTH) and cortisol. 1mg Dexamethasone will be administered at 22:00 on Day 1 and 06:00 and 12:00 on Day 2. Various blood, urine and saliva samples will be taken in order to measure normal levels of hormones and other chemicals at several time-points.
 Drug: Hydrocortisone granules
Multi-particulate granules
Other Name: Infacort
Active Comparator: Hydrocortisone Tablet
20mg Hydrocortisone Tablet will be administered on Day 2 at 07:00. Dexamethasone is a challenge agent and will be taken to suppress endogenous ACTH and Cortisol. 1mg Dexamethasone will be administered at 22:00 on Day 1 and 06:00 and 12:00 on Day 2. Various blood, urine and saliva samples will be taken in order to measure normal levels of hormones and other chemicals at several time-points.
 Drug: Hydrocortisone Tablet
Standard hydrocortisone tablets
Other Name: Commerical supply
Active Comparator: i.v Hydrocortisone Injection
20mg i.v. Hydrocortisone Injection will be administered on Day 2 at 07:00. Dexamethasone is a challenge agent and will be taken to suppress endogenous ACTH and Cortisol. 1mg Dexamethasone will be administered at 22:00 on Day 1 and 06:00 and 12:00 on Day 2. Various blood, urine and saliva samples will be taken in order to measure normal levels of hormones and other chemicals at several time-points.
 Drug: i.v. Hydrocortisone Injection
Standard hydrocortisone solution for intravenous injection
Other Name: Commerical supply


Outcome Measures
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Primary Outcome Measures :
  1. Maximum Serum Concentration (Cmax) [ Time Frame: Hourly from 0 to 24 hours ]
    Derived PK for Serum Cortisol: Maximum serum concentration (Cmax)

  2. AUC0-t [ Time Frame: Hourly from 0 to 24 hours ]
    Derived PK for Serum Cortisol: Area under the curve from 0-24 hours


Secondary Outcome Measures :
  1. Adverse Events (AEs) [ Time Frame: Days 1-2 during each Study Period ]
    Number of subjects with adverse events throughout the study.

  2. Concentrations of Cortisol Binding Protein [ Time Frame: Blood samples on Day 1 and/or Day 2 of each Study Period ]
    Cortisol protein binding under physiological conditions and after the administration of dexamethasone and hydrocortisone.

  3. Insulin Sensitivity Under Physiological Conditions and After Administration of Dexamethasone and Infacort®, Hydrocortisone Tablets and i.v Hydrocortisone. [ Time Frame: Blood samples on Day 1 and/or Day 2 of each Study Period ]
    A standardised mixed meal elevates blood glucose and provides a reproducible stimulation of insulin release. Lower levels of insulin secretion, whilst maintaining normoglycaemia would indicate enhanced insulin sensitivity and glucose disposal; higher insulin levels will reflect insulin resistance.

  4. PK and Metabolism of Cortisol [ Time Frame: Blood, urine & saliva samples on Day 1 and/or Day 2 of each Study Period ]
    Blood: Serum cortisol under physiological conditions and after administration of dexamethasone and Infacort® Granules, Hydrocortisone Tablets and i.v Hydrocortisone Injection.


Eligibility Criteria
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Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 60 Years   (Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Healthy male volunteers between 18 and 60 years of age, inclusive (at screening).
  • Subjects with a Body Mass Index (BMI) of 21-28. Body Mass Index = Body weight (kg) / (Height (m))*2.
  • Subjects with no clinically significant abnormal serum biochemistry, haematology and urinalysis values within 14 days prior to Day 1 of Study Period 1.
  • Subjects with a negative urinary drugs of abuse screen, determined within 14 days prior to Day 1 of Study Period 1. A positive alcohol test may be repeated at the discretion of the Investigator.
  • Subjects with negative HIV and Hepatitis B and C results.
  • Subjects with no clinically significant abnormalities in 12-lead electrocardiogram (ECG) determined within 14 days prior to Day 1 of Study Period 1.
  • Subjects with no clinically-significant deviation outside the normal ranges for blood pressure and pulse measurements.

  • Subjects (unless anatomically sterile or where abstaining from sexual intercourse is in line with the preferred and usual lifestyle of the subject) and sexual partners must use effective contraception methods during the trial and for 3 months after the last dose, for example:

    • Oral contraceptive + condom
    • Intra-uterine device (IUD) + condom
    • Diaphragm with spermicide + condom
  • Subjects must be available to complete the study.
  • Subjects must satisfy a medical examiner about their fitness to participate in the study.
  • Subjects must provide written informed consent to participate in the study.

Exclusion Criteria:

  • A clinically significant history of gastrointestinal disorder likely to influence drug absorption.
  • Receipt of regular medication within 14 days prior to Day 1 of Study Period 1 (including high dose vitamins, dietary supplements or herbal remedies).
  • Receipt of any vaccination within 14 days prior to Day 1 of Study Period 1.
  • Evidence of renal, hepatic, central nervous system, respiratory, cardiovascular or metabolic dysfunction.
  • Presence of clinically significant infections (systemic fungal and viral infections, acute bacterial infections).
  • Current or previous history of tuberculosis.
  • A clinically significant history of previous allergy / sensitivity to Hydrocortisone and/or Dexamethasone.
  • A clinically significant history or family history of psychiatric disorders/illnesses.
  • A clinically significant history of drug or alcohol abuse.
  • Inability to communicate well with the Investigator (i.e., language problem, poor mental development or impaired cerebral function).
  • Participation in a New Chemical Entity clinical study within the previous 4 months or a marketed drug clinical study within the previous 3 months. (N.B. The washout period between trials is defined as the period of time elapsed between the last dose of the previous study and the first dose of the next study)
  • Subjects who have consumed more than 2 units of alcohol per day within seven (7) days prior to Day 1 of Study Period 1or have consumed any alcohol within the 48 hour period prior to Day 1 of Study Period 1.
  • Donation of 450ml or more of blood within the previous 3 months.
  • Subjects who smoke (or ex-smokers who have smoked within 6 months prior to Day 1 of Study Period 1).
  • Subjects who work shifts (i.e. regularly alternate between days, afternoons and nights).
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01960530


Locations
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United Kingdom
Simbec Research Limited
Merthyr Tydfil, United Kingdom, CF48 4DR
Sponsors and Collaborators
Diurnal Limited
Simbec Research
Investigators
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Principal Investigator: Girish Sharma Simbec Research
More Information
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Responsible Party: Diurnal Limited
ClinicalTrials.gov Identifier: NCT01960530    
Other Study ID Numbers: Infacort 002
First Posted: October 10, 2013    Key Record Dates
Results First Posted: April 13, 2017
Last Update Posted: April 13, 2017
Last Verified: April 2017
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No
Additional relevant MeSH terms:
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Adrenal Insufficiency
Adrenal Gland Diseases
Endocrine System Diseases
Dexamethasone
Hydrocortisone
Hydrocortisone 17-butyrate 21-propionate
Hydrocortisone acetate
Hydrocortisone hemisuccinate
Anti-Inflammatory Agents
Antiemetics
 Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Gastrointestinal Agents
Glucocorticoids
Hormones
Hormones, Hormone Substitutes, and Hormone Antagonists
Antineoplastic Agents, Hormonal
Antineoplastic Agents