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Kidney DiseasePhase 1CKDNCT01087749

Pharmacokinetic Study in Patients With Chronic Kidney Disease and Healthy Volunteers

A Phase 1 study testing Propranolol, Losartan and Eprosartan in people with Kidney Disease, run by University of California, San Francisco at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to find out how chemicals in the blood of patients with chronic kidney disease affect how medications are removed from the body. The patient will take one dose of three different drugs, one on each week, for a total of three single doses. Read more about this study

Who is it for?
Ages 18 to 70 yearsHealthy volunteers can take part
Conditions the study is for
Kidney Disease
What is being tested?
Propranolol, Losartan and Eprosartan
Could I receive a placebo?
No, everyone receives an active treatment
How many people
24 participants
Where
1 siteUnited States
Study dates
Mar 2010to Dec 2012
Phase
Phase 1
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Male or Female 18-70 years of age.
  • Healthy volunteers or chronic kidney disease (GFR<40)
  • Be able to provide written informed consent and comply with requirements of the study.
  • Avoid eating grapefruit and drinking grapefruit juice from 7 days prior to the first study day until completion of the study.
  • Abstinence from alcoholic beverages, caffeinated beverages and orange juice from 6pm the night before a study day until completion of the study day.
  • Fast from food and beverages at least 8 hours prior to medication dosing.
  • Be able to read, speak, and understand English.

Who cannot join

  • Subjects with contraindications to taking the study drugs
  • Subjects with known allergies to propranolol, losartan, or eprosartan.
  • Subjects who smoke tobacco.
  • Subjects with ongoing alcohol or illegal drug use.
  • Subjects who are pregnant, lactating, or attempting to conceive.
  • Subjects unable to maintain adequate birth control during the study.
Show all 11Show fewer
  • Subjects unable to follow protocol instructions or protocol criteria.
  • Subjects with hematocrit < 30mg/dL.
  • Subjects who are insulin requiring diabetics.
  • Subjects with low, or low normal blood pressure (systolic blood pressure [BP] <100mmHg)
  • Subjects with uncontrolled high blood pressure.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Clinical Reserach Center, UCSF

    San Francisco, California, 94143

Other trials in United States

About this study

Official title: Pharmacokinetic Study of Propranolol, Losartan, and Eprosartan in Healthy Volunteers and Patients With Chronic Kidney Disease

The purpose of this study is to find out how chemicals in the blood of patients with chronic kidney disease affect how medications are removed from the body. The patient will take one dose of three different drugs, one on each week, for a total of three single doses. The investigators want to find out if these three different medications are affected in different ways by the chemicals in the blood of patients with kidney disease.

Read the detailed description

It has been demonstrated that proteins known as drug transporters in different human organs and tissues are important for a drug to be absorbed, distributed, metabolized, and eliminated (ADME)18. The chemical properties of drugs can affect whether it needs a transporter protein to enter the cell or not. It is not well known how these proteins are affected in chronic disease and how different drugs may be absorbed, metabolized, or eliminated differently in certain diseases. Preliminary studies suggest that some drugs (those requiring drug transporter proteins) may show altered elimination in the presence of uremic toxins. Uremic toxins are substances accumulated in the blood of patients with chronic kidney disease and many are not removed through hemodialysis (HD). We hypothesize that the different classes of drugs (BDDCS class1, 2, and 3) will have different degrees of changes in AUC, meaning that for a class 1 drug we would see less of a change in AUC than in a class 3 drug because a class 3 drug requires transporters. Previous studies can't make that comparison because they used different patients for each drug, so even if there were a change in a class 1 drug, it can't be compared to a class 3 drug. In order to get an accurate comparison, we will test the three drugs on the same patient and see how he AUC changes from drug to drug within the same patient comparing it to the healthy volunteer (taking the same three drugs).

Conditions
Kidney Disease
Being tested
Propranolol, Losartan, Eprosartan
Medical subject headings
Kidney Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • PropranololDrug

    Also called Propranolol Hydrochloride, Ciplar, Ciplar LA, Inderal

    Propranolol 40mg PO will be given with 6oz of water.Blood samples will be obtained for 12 hours to determine the medication concentration in the plasma. There is no therapeutic effect on this study, since patients will receive a low single dose of the medication, and we'll assess the different pharmacokinetic parameters based on the concentrations of the medicine in plasma.

  • LosartanDrug

    Also called Cozaar, Losartan potassium, Anin

    Losartan 50mg PO will be given with 6oz of water. Blood samples will be obtained for 12 hours to determine the medication concentration in the plasma. There is no therapeutic effect on this study, since patients will receive a low single dose of the medication, and we'll assess the different pharmacokinetic parameters based on the concentrations of the medicine in plasma.

  • EprosartanDrug

    Also called Teveten, Eprozar, Teveten HCT (paired with hydrochlorothiazide), Teveten Plus (paired with hydrochlorothiazide)

    Erythromycin 125mg PO will be given with 6oz of water. Blood samples will be obtained for 12 hours to determine the medication concentration in the plasma. There is no therapeutic effect on this study, since patients will receive a low single dose of the medication, and we'll assess the different pharmacokinetic parameters based on the concentrations of the medicine in plasma.

Study groups in NCT01087749
Study groupRoleWhat they receive
Chronic Kidney DiseaseExperimentalPropranolol, Losartan, and Eprosartan will be administered to patients who have been diagnosed with Chronic Kidney disease and have a glomerular filtration rate (GFR) below 40ml/min.
Receives: Drug: Propranolol; Drug: Losartan; Drug: Eprosartan
Healthy VolunteersExperimentalPropranolol, Losartan, and Eprosartan will be administered to healthy volunteers without chronic kidney disease.
Receives: Drug: Propranolol; Drug: Losartan; Drug: Eprosartan

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Pharmacokinetic parameters

    Three 12-hour days visits (on different weeks) will be investigated to obtain blood samples for 12 hours for three different medications. Blood samples will be obtained to determine the medication concentration in the plasma. There is no therapeutic effect on this study, since patients will receive a low single dose of the medication, and we'll assess the different pharmacokinetic parameters based on the concentrations of the medicine in plasma.

    Measured: 3 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Mar 2010 (estimated)
  2. Study startMar 2010
  3. Primary completionDec 2012
  4. Study completionDec 2012

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1
Allocation
Non-randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
24 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01087749
Sponsor's protocol ID
PKUCSF2010
Acronym
CKD
Status last verified
May 2013
First submitted
15 Mar 2010
Last updated
30 May 2013
Results posted
No
Data monitoring committee
Yes

Publications

  • Bianchetti G, Graziani G, Brancaccio D, Morganti A, Leonetti G, Manfrin M, Sega R, Gomeni R, Ponticelli C, Morselli PL. Pharmacokinetics and effects of propranolol in terminal uraemic patients and in patients undergoing regular dialysis treatment. Clin Pharmacokinet. 1976;1(5):373-84. doi: 10.2165/00003088-197601050-00004.

    PubMed 1017154
  • Lam JL, Shugarts SB, Okochi H, Benet LZ. Elucidating the effect of final-day dosing of rifampin in induction studies on hepatic drug disposition and metabolism. J Pharmacol Exp Ther. 2006 Nov;319(2):864-70. doi: 10.1124/jpet.106.108282. Epub 2006 Aug 11.

    PubMed 16905688
  • Lau YY, Okochi H, Huang Y, Benet LZ. Pharmacokinetics of atorvastatin and its hydroxy metabolites in rats and the effects of concomitant rifampicin single doses: relevance of first-pass effect from hepatic uptake transporters, and intestinal and hepatic metabolism. Drug Metab Dispos. 2006 Jul;34(7):1175-81. doi: 10.1124/dmd.105.009076. Epub 2006 Apr 19.

    PubMed 16624870
  • Lau YY, Huang Y, Frassetto L, Benet LZ. effect of OATP1B transporter inhibition on the pharmacokinetics of atorvastatin in healthy volunteers. Clin Pharmacol Ther. 2007 Feb;81(2):194-204. doi: 10.1038/sj.clpt.6100038. Epub 2006 Dec 27.

    PubMed 17192770
  • Guevin C, Michaud J, Naud J, Leblond FA, Pichette V. Down-regulation of hepatic cytochrome p450 in chronic renal failure: role of uremic mediators. Br J Pharmacol. 2002 Dec;137(7):1039-46. doi: 10.1038/sj.bjp.0704951.

    PubMed 12429576
  • Martin DE, Chapelsky MC, Ilson B, Tenero D, Boike SC, Zariffa N, Jorkasky DK. Pharmacokinetics and protein binding of eprosartan in healthy volunteers and in patients with varying degrees of renal impairment. J Clin Pharmacol. 1998 Feb;38(2):129-37. doi: 10.1002/j.1552-4604.1998.tb04401.x.

    PubMed 9549643
  • Michaud J, Naud J, Chouinard J, Desy F, Leblond FA, Desbiens K, Bonnardeaux A, Pichette V. Role of parathyroid hormone in the downregulation of liver cytochrome P450 in chronic renal failure. J Am Soc Nephrol. 2006 Nov;17(11):3041-8. doi: 10.1681/ASN.2006010035. Epub 2006 Oct 4.

    PubMed 17021269
  • Naud J, Michaud J, Leblond FA, Lefrancois S, Bonnardeaux A, Pichette V. Effects of chronic renal failure on liver drug transporters. Drug Metab Dispos. 2008 Jan;36(1):124-8. doi: 10.1124/dmd.107.018192. Epub 2007 Oct 16.

    PubMed 17940133
  • Nolin TD, Naud J, Leblond FA, Pichette V. Emerging evidence of the impact of kidney disease on drug metabolism and transport. Clin Pharmacol Ther. 2008 Jun;83(6):898-903. doi: 10.1038/clpt.2008.59. Epub 2008 Apr 2.

    PubMed 18388866
  • Sica DA, Halstenson CE, Gehr TW, Keane WF. Pharmacokinetics and blood pressure response of losartan in end-stage renal disease. Clin Pharmacokinet. 2000 Jun;38(6):519-26. doi: 10.2165/00003088-200038060-00005.

    PubMed 10885588
  • Sun H, Huang Y, Frassetto L, Benet LZ. Effects of uremic toxins on hepatic uptake and metabolism of erythromycin. Drug Metab Dispos. 2004 Nov;32(11):1239-46. doi: 10.1124/dmd.104.000521. Epub 2004 Jul 30.

    PubMed 15286055
  • Vanholder R, De Smet R, Glorieux G, Argiles A, Baurmeister U, Brunet P, Clark W, Cohen G, De Deyn PP, Deppisch R, Descamps-Latscha B, Henle T, Jorres A, Lemke HD, Massy ZA, Passlick-Deetjen J, Rodriguez M, Stegmayr B, Stenvinkel P, Tetta C, Wanner C, Zidek W; European Uremic Toxin Work Group (EUTox). Review on uremic toxins: classification, concentration, and interindividual variability. Kidney Int. 2003 May;63(5):1934-43. doi: 10.1046/j.1523-1755.2003.00924.x.

    PubMed 12675874
  • Wu CY, Benet LZ. Predicting drug disposition via application of BCS: transport/absorption/ elimination interplay and development of a biopharmaceutics drug disposition classification system. Pharm Res. 2005 Jan;22(1):11-23. doi: 10.1007/s11095-004-9004-4.

    PubMed 15771225

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Propranolol, Losartan and Eprosartan in people with Kidney Disease, run by University of California, San Francisco at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 30 May 2013. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Pharmacokinetic parameters (time frame: 3 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01087749, which also lists 13 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 May 2013.

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