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Drug-Related Side Effects and Adverse ReactionsPhase 1PRIMENCT03098680

A Study of the Pharmacokinetic and Pharmacodynamic Responses in Healthy and Altered Human Cardiovascular Systems

A Phase 1 study testing Albuterol Sulfate, Nicardipine Hydrochloride and Dobutamine Hydrochloride in people with Drug-Related Side Effects and Adverse Reactions and Cardiovascular System Disease, run by Cambridge University Hospitals NHS Foundation Trust at 1 site in United Kingdom.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Unwanted effects on the cardiovascular system is one of the most common causes of safety related discontinuation of a drug. This study aims to develop an in silico model of the human cardiovascular system that can be used to predict unwanted cardiovascular effects of drugs. Read more about this study

Who is it for?
Ages 18 years and older, men onlyHealthy volunteers can take part
What is being tested?
Albuterol Sulfate, Nicardipine Hydrochloride and Dobutamine Hydrochloride
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
18 participants
Where
1 siteUnited Kingdom
Study dates
24 Apr 2017to 29 Feb 2020
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 years and older
  • Men only
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

None listed.

Who cannot join

  • The presence of any of the following will preclude patient inclusion:
  • Less than 18 years old, >30 years old
  • BMI >30
  • On regular medications
  • Known allergy to medications
  • History of psychiatric, chronic cardiac / respiratory / renal disease
Show all 49Show fewer
  • Known diagnosis of diabetes
  • Habitual smoker
  • Screening heart rate of less than 60 beats per minute
  • Screening heart rate of greater than 100 beats per minute
  • Screening blood pressure of less than 100mmHg systolic and/or 55mmHg diastolic
  • Any concomitant condition or circumstance that, at the discretion of the investigator, may affect the participant's ability to complete the study
  • Current participation in another interventional research study
  • Part B Inclusion Criteria
  • To be included in the study the patient must:
  • Have given written informed consent to participate
  • Male
  • Be aged over 18 years at the time of first study appointment
  • Possess one of the following - known diagnosis of diabetes, known diagnosis of hypertension, obesity (BMI>30), aged >65
  • Deemed healthy to partake in the study at the discretion of the investigator
  • The presence of any of the following will preclude patient inclusion:
  • Less than 18 years old
  • On regular medications that are contraindicated for co-use with the study drugs
  • Known allergy to medications
  • Screening heart rate of less than 60 beats per minute
  • Screening heart rate of greater than 100 beats per minute
  • Screening blood pressure of less than 100mmHg systolic and/or 55mmHg diastolic
  • Any concomitant condition or circumstance that, at the discretion of the investigator, may affect the participant's ability to complete the study
  • Current participation in another interventional research study
  • Part C Inclusion Criteria
  • To be included in the study the patient must:
  • Have given written informed consent to participate
  • Male
  • Be aged over 18 years at the time of first study appointment
  • Clinical diagnosis of autonomic dysfunction
  • BMI<30
  • Deemed healthy to partake in the study at the discretion of the investigator
  • The presence of any of the following will preclude patient inclusion:
  • Less than 18 years old
  • BMI >30
  • On regular medication
  • Known allergy to medications
  • History of psychiatric, chronic cardiac / respiratory / renal disease
  • Habitual smoker
  • Screening heart rate of less than 60 beats per minute
  • Screening heart rate of greater than 100 beats per minute
  • Screening blood pressure of less than 100mmHg systolic and/or 55mmHg diastolic
  • Any concomitant condition or circumstance that, at the discretion of the investigator, may affect the participant's ability to complete the study
  • Current participation in another interventional research study

Trial locations and contacts

1 site in 1 country.

United Kingdom1 site
  • Addenbrooke's Hospital

    Cambridge, Cambridgeshire, CB2 0QQ

Other trials in United Kingdom

About this study

Unwanted effects on the cardiovascular system is one of the most common causes of safety related discontinuation of a drug. This study aims to develop an in silico model of the human cardiovascular system that can be used to predict unwanted cardiovascular effects of drugs. This will be achieved through a drug administration study that will generate comprehensive pharmacokinetic and pharmacodynamic data following the administration of the following drugs, all known to have effects on the cardiovascular system. Half the participants will receive: Placebo, Salbutamol, Nicardipine, Dobutamine and the other half will receive Placebo, Phenylephrine, Verapamil, Phentolamine.

Read the detailed description

Safety is an integral part of developing new medicines. Potential drugs can be withdrawn from development at any stage of the process if there are concerns over safety. In recent years, computer models that recreate physiology have been increasingly adopted in various aspects of drug development, including safety, to predict the effects of new drugs. The accuracy of this predictive model is however, dependent on the ability for animal data (which the model is usually based on) to be 'translated' to human data. As no animal is identical to humans, the difference between species needs to be understood for the model to be accurate.

Unwanted effects on the cardiovascular system is one of the most common causes of safety related discontinuation of a drug. The present study focuses on generating high quality human cardiovascular data that is comparable with existing animal data. This will be achieved through the collection of detailed pharmacokinetic and pharmacodynamic data following administration of drugs that are known to affect the cardiovascular system through a range of mechanisms. This will be first performed in healthy participants before extending it to those with pre-existing (or risk-factors for) cardiovascular disease. The aim is to understand the differences between species and the study populations and using the collected data to help inform how a translational model is to be built.

Study Design: Single centre, single (participant) blind, within subject, drug administration study

Drugs used in study:

  1. Salbutamol - a beta-2-adrenergic agonist
  2. Nicardipine - a dihydropyridine calcium channel antagonist
  3. Dobutamine - a beta-1-adrenergic agonist
  4. Phenylephrine - a selective alpha-1-adrenergic agonist
  5. Verapamil - a phenylalkylamine calcium channel antagonist
  6. Phentolamine - a non-selective alpha adrenergic antagonist

Study Population:

The study will take place in three parts (A, B and C), with each part representing population groups that are of interest.

Part A (16 participants): Healthy individuals with no identifiable cardiovascular risk factors will be recruited for this part of the study. The aim of this part is to enable the collection of physiological data after drug administration in a 'normal' cardiovascular system.

Part B (8 participants): Part B will involve the recruitment of participants who may possess an altered/challenged cardiovascular system. Participants recruited will possess one of the following factors: known diagnosis of diabetes, known diagnosis of hypertension, obesity (BMI>30), age >65. The data collected will provide information on how potential changes to baseline cardiovascular physiology may affect the effect of the drug.

Part C (8 participants): In order to understand the impact of medicines on cardiovascular physiology in the absence of the autonomic nervous system regulation, we will recruit participants with dysfunction of the autonomic system to Part C of the study.

Maximum duration of participation for each participant:

1x screening (1 hour duration), 4x study visits (8 hour duration each) with minimum 72 hours gap in between visits. Maximum duration is 4 months to complete all visits.

Being tested
Albuterol Sulfate, Nicardipine Hydrochloride, Dobutamine Hydrochloride, Phenylephrine Hydrochloride, Verapamil Hydrochloride
Keywords
Adverse reactions, Cardiovascular, Translation, Modelling, Pharmacokinetics, Pharmacodynamics
Medical subject headings
Drug-Related Side Effects and Adverse Reactions, Cardiovascular Diseases

What participants receive

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

  • Albuterol SulfateDrug

    Also called Salbutamol Sulfate

    see arm/group descriptions

  • Nicardipine HydrochlorideDrug

    see arm/group descriptions

  • Dobutamine HydrochlorideDrug

    see arm/group descriptions

  • Phenylephrine HydrochlorideDrug

    see arm/group descriptions

  • Verapamil HydrochlorideDrug

    Also called Securon IV

    see arm/group descriptions

  • Phentolamine MesylateDrug

    Also called Phentolamine Mesilate

    see arm/group descriptions

  • PlaceboDrug

    Also called 0.9% Sodium Chloride

    see arm/group descriptions

Study groups in NCT03098680
Study groupRoleWhat they receive
Group A (Placebo, Salbutamol, Nicardipine, Dobutamine)ExperimentalParticipants will receive each drug, to be given on separate study days. The drugs will be given as a 3 stage infusion with dose increasing at each stage. Each stage will be 30 minutes in duration. Placebo; Salbutamol(Albuterol) Sulfate (Dose: 2mcg/min, 5mcg/min, 10mcg/min); Nicardipine Hydrochloride (Dose: 1mg/hr, 2.5mg/hr, 5mg/hr); Dobutamine Hydrochloride (Dose: 1mcg/kg/min, 2.5mcg/kg/min, 5mcg/kg/min)
Receives: Drug: Albuterol Sulfate; Drug: Nicardipine Hydrochloride; Drug: Dobutamine Hydrochloride; Drug: Placebo
Group B (Placebo, Phenylephrine, Verapamil, Phentolamine)ExperimentalParticipants will receive each drug, to be given on separate study days. The drugs will be given as a 3 stage bolus with dose increasing at each stage. Each stage will be 30 minutes apart. Placebo; Phenylephrine Hydrochloride (Dose: 100mcg, 200mcg, 300mcg); Verapamil Hydrochloride (Dose: 1mg, 2.5mg, 5mg); Phentolamine Mesylate (Dose: 1mg, 2mg, 3mg)
Receives: Drug: Phenylephrine Hydrochloride; Drug: Verapamil Hydrochloride; Drug: Phentolamine Mesylate; Drug: Placebo

What is being measured

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

  1. Heart rate

    Change in heart rate from baseline over time after administration of drug

    Measured: At every study visit (each lasting up to 8 hours)

  2. Peripheral blood pressure

    Change in resting peripheral blood pressure (systolic, diastolic, pulse pressure and mean pressure) over time after administration of drug

    Measured: At every study visit (each lasting up to 8 hours)

  3. Central blood pressure

    Change in resting central aortic pressure (systolic, diastolic, pulse pressure and mean pressure) from baseline over time after administration of drug

    Measured: At every study visit (each lasting up to 8 hours)

  4. Cardiac output

    Change in cardiac output from baseline over time after administration of drug

    Measured: At every study visit (each lasting up to 8 hours)

  5. Stroke volume

    Change in stroke volume from baseline over time after administration of drug

    Measured: At every study visit (each lasting up to 8 hours)

  6. ECG/Cardiac monitor

    Change in ECG (PR interval/QRS interval/QT interval/QTc interval/RR interval) over time after administration of drug

    Measured: At every study visit (each lasting up to 8 hours)

Secondary outcomes (4)
  1. Plasma drug concentration (all drugs)

    Measure of drug levels (parent compound and active metabolites) at the specified time points

    Measured: These will be measured during each part of the study, estimated 6 months per part. Taken at: -(5mins, 10mins,15mins, 30mins, 35mins, 40mins, 45mins, 60mins, 65mins, 70mins, 75mins, 90mins, 120mins, 150mins, 180mins, 240mins, 360mins)

  2. Plasma drug (active) metabolite concentration (varapamil only)

    Measure of drug levels (parent compound and active metabolites) at the specified time points

    Measured: Throughout the study, estimated 6 months per part. Taken at specified timepoints (5mins, 10min, 15mins, 30mins, 35mins, 40mins, 45mins, 60mins, 65mins, 70mins, 75mins, 90mins, 120mins, 150mins, 180mins, 240mins, 360mins)

  3. Renal Function

    Changes in renal function throughout study

    Measured: Through study completion, up to 4 months

  4. Liver function

    Changes in liver function throughout study

    Measured: Through study completion, up to 4 months

Timeline

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

  1. First posted4 Apr 2017
  2. Study start24 Apr 2017
  3. Primary completion29 Feb 2020
  4. Study completion29 Feb 2020

Why it stopped: Unable to recruit in time before end of PhD studentship

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
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
18 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03098680
Sponsor's protocol ID
PRIME (A094136)
Acronym
PRIME
Status last verified
Mar 2021
First submitted
14 Mar 2017
Last updated
22 Mar 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Albuterol Sulfate, Nicardipine Hydrochloride and Dobutamine Hydrochloride in people with Drug-Related Side Effects and Adverse Reactions and Cardiovascular System Disease, run by Cambridge University Hospitals NHS Foundation Trust at 1 site in United Kingdom.

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 0 inclusion and 49 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: stopped early, as of the sponsor's last update on 22 Mar 2021. 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 Kingdom. 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 was stopped early (reason given: Unable to recruit in time before end of PhD studentship). Results are not available in the source record.

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?

Heart rate (time frame: At every study visit (each lasting up to 8 hours)). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 22 Mar 2021.

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