Chronic Obstructive Pulmonary Disease ExacerbationPhase 1NCT06118684
Clinical Trial to Assess Effect of Verapamil on Systemic Exposure of EP395 and Effect of EP395 on Systemic Exposure of Midazolam and Digoxin
A Phase 1 study testing EP395 (Part A and B), Verapamil (Part A) and Midazolam (Part B) in people with Chronic Obstructive Pulmonary Disease Exacerbation and COPD, run by EpiEndo Pharmaceuticals at 1 site in Sweden.
Trial summary
The aim of this trial is to assess the potential key drug-drug interactions with EP395 in the clinical setting. Read more about this study
- Who is it for?
- Ages 18 to 55 yearsHealthy volunteers can take part
- Conditions the study is for
- Chronic Obstructive Pulmonary Disease Exacerbation, COPD
- What is being tested?
- EP395 (Part A and B), Verapamil (Part A) and Midazolam (Part B)
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 37 participants
- Where
- 1 siteSweden
- Study dates
- 23 Oct 2023to 2 Jan 2024
- 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 55 years
- All sexes
- Healthy volunteers accepted
- Adult
Who may be able to join
- Willing and able to understand the information on the nature, the scope, and the relevance of the trial, and to provide voluntary, written informed consent to participate in the trial before any trial-related procedures.
- Healthy male or female participant aged 18 to 55 years, inclusive.
- Body mass index ≥ 19.0 and ≤ 33.0 kg/m2 at the time of the screening visit.
- Medically healthy participant without abnormal clinically significant medical history, physical findings, vital signs, ECG and laboratory values at the time of the screening visit, as judged by the Investigator.
- Non-smoker, or former smoker with <10 pack years who stopped smoking (including e-cigarettes) at least 6 months before the screening visit.
- Women of childbearing potential (WOCBP) must:
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- have a negative pregnancy test (blood) at the screening visit and (urine) Day 1.
- agree to use, and be able to comply with, highly effective measures of contraceptive control (failure rate less than 1% per year when used consistently and correctly) without interruption, during trial participation and until 90 days after the last IMP intake.
- agree to abstain from breast feeding during the trial participation and for 90 days after the last IP intake.
- Women defined as of non-childbearing potential are postmenopausal (no menses for at least 1 year without alternative medical cause [follicle stimulating hormone, FSH, measurement in serum may be done as additional confirmation at Investigator's discretion]) or surgically sterile women (tubal ligation, hysterectomy, or bilateral oophorectomy).
- Men must agree to use a condom during sexual intercourse with WOCBP during treatment and for 90 days after the last IP intake and should not donate sperm during this time.
Who cannot join
- Participants must not enter the trial if any of the following exclusion criteria are fulfilled:
- History of any clinically significant disease or disorder which, in the opinion of the Investigator, may either put the participant at risk because of participation in the trial, or influence the results, or the participant's ability to participate in the trial.
- Any clinically significant illness, medical/surgical procedure or trauma within 4 weeks of the (first) administration of IMP.
- Presence or history of lung disease, e.g., asthma, chronic obstructive pulmonary disease.
- Presence or history of significant gastrointestinal medical condition that could lead to abnormal absorption.
- History of or active tuberculosis at the time of the screening visit based on participant anamnesis. Participants who have been living together with another person with active tuberculosis at any time over the past 10 years will also be excluded.
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- Clinically significant abnormality on 12-lead ECG at the screening visit or Day 1 pre-dose, including prolonged QTcF (>450 msec men or >470 msec women) or PR interval >210 msec.
- Abnormal renal function at the time of the screening visit:
- serum creatinine >upper limit of normal (ULN); and/or
- estimated glomerular filtration rate <60 mL/min according to the revised Lund-Malmö GFR estimating equation.
- Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) >1.5 x ULN at the time of the screening visit.
- Use of prescription or non-prescription medications or herbal remedies within 28 days prior to Day 1, or unable to refrain from prescription or non-prescription medications or herbal remedies during the trial, with the following exceptions:
- hormone replacement therapy (HRT)
- contraception
- occasional use of paracetamol Note: other medications will be reviewed by the Medical Monitor and a participant may be included if both the Investigator and Medical Monitor agree that the medication will not interfere with the trial assessments or participant's safety.
- Live vaccine within 28 days or any other vaccine within 14 days prior to Day 1 until 28 days after the final dose (with the exception of COVID-19 vaccine boosters).
- Any positive result at the screening visit for serum hepatitis B surface antigen, hepatitis C antibodies and/or human immunodeficiency virus (HIV).
- Positive screening result for drugs of abuse, cotinine or alcohol at the screening visit or on admission to the trial site prior to the (first) administration of the IMP. A positive urine cotinine test (≥200 ng/mL) at screening or at Day -1 will exclude the participant from trial participation.
- History of alcohol abuse or excessive intake of alcohol, as judged by the Investigator.
- Presence or history of drug abuse, as judged by the Investigator.
- History of, or current use of anabolic steroids, as judged by the Investigator.
- Excessive caffeine consumption defined by a daily intake of > 5 cups (1 cup = approximately 240 mL) of coffee, or equal amount in other caffeine containing beverages, or unable to refrain from caffeine containing beverages, including energy drinks, during the trial, as judged by the Investigator.
- Former smoker with >10 pack years, or smoking (including use of e-cigarettes and vapes) within 6 months of the screening visit, or unable to refrain from smoking throughout the trial.
- Use of nicotine replacement products within 2 weeks of the screening visit and unable to refrain from nicotine replacement products throughout the trial.
- Participants who are pregnant, currently breastfeeding, or intend to become pregnant during the course of the trial.
- Known hypersensitivity to macrolides or EP395 or any of the excipients (dicalcium phosphate, croscarmellose sodium, magnesium stearate, microcrystalline cellulose).
- History of hypersensitivity to or contraindication (as indicated in the SmPC) to verapamil (Part A) or digoxin and/or midazolam (Part B).
- Any clinically significant allergy, as judged by the Investigator.
- Planned treatment or treatment with another investigational drug within 5 half-lives of said drug or 3 months prior to first IMP administration, whichever is longer. Participants consented and screened, but not dosed in previous Phase 1 trials are not excluded.
- Employees of the Sponsor or employees or relatives of the Investigator.
- Plasma donation within one month of screening or blood donation (or corresponding blood loss) during the last three months prior to the first IMP administration.
- The Investigator considers the participant unlikely to comply with trial procedures, restrictions and requirements.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: An Open-label, Healthy Subject, Two-part Study to Assess the Effect of Verapamil on Systemic Exposure of EP395 (Part A), and to Assess the Effect of EP395 on Systemic Exposure of Midazolam and Digoxin (Part B)
The aim of this trial is to assess the potential key drug-drug interactions with EP395 in the clinical setting.
Read the detailed description
This is an open-label, healthy subject, two-part study to assess the effect of verapamil on systemic exposure of EP395 (Part A), and to assess the effect of EP395 on systemic exposure of midazolam and digoxin (Part B).
The overall aim of this trial is to assess the potential key drug-drug interactions (DDIs) with EP395 in the clinical setting. The trial will be in two parts:
Part A will investigate EP395 as a 'victim' of DDIs. The impact of CYP3A4 and P-glycoprotein (Pgp) inhibition on the pharmacokinetics (PK) of EP395 will be assessed. Verapamil has been selected as a moderate inhibitor of CYP3A4 and an inhibitor of Pgp.
Part B will investigate EP395 as a 'perpetrator' of DDIs. The impact of EP395 on the PK of a CYP3A4 substrate and a Pgp substrate will be assessed. Midazolam has been selected as the CYP3A4 substrate and digoxin as the Pgp substrate.
The trial population is healthy adults.
- Being tested
- EP395 (Part A and B), Verapamil (Part A), Midazolam (Part B), Digoxin (Part B)
- Medical subject headings
- Pulmonary Disease, Chronic Obstructive
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
EP395 (Part A and B)Drug
EP395 (test product) oral capsule 125 mg. Part A: Dose: 1 capsule as a single dose on Day 1 and Day 14, total daily dose: 125 mg.
Part B: Dose: 3 capsules once daily on Days 9 to 28, total daily dose: 375 mg.
Verapamil (Part A)Drug
Verapamil (CYP3A4/Pgp inhibitor), tablet 40 mg. Part A: Dose: 3 tablets twice daily Days 10 to 18, total daily dose: 240 mg.
Midazolam (Part B)Drug
Midazolam (CYP3A4 substrate) oral solution 1 mg/mL. Part B: Dose: 4 mL as a single dose on Day 1 and Day 24, total daily dose: 4 mg.
Digoxin (Part B)Drug
Digoxin (Pgp substrate) tablet 0.25 mg. Part B: Dose: 1 tablet as a single dose on Day 1 and Day 24, total daily dose: 0.25 mg.
| Study group | Role | What they receive |
|---|---|---|
| Part A - EP395 as a 'victim' of DDIs | Experimental | Part A will investigate EP395 as a 'victim' of DDIs. The impact of CYP3A4 and P-glycoprotein (Pgp) inhibition on the pharmacokinetics (PK) of EP395 will be assessed. Verapamil has been selected as a moderate inhibitor of CYP3A4 and an inhibitor of Pgp. Receives: Drug: EP395 (Part A and B); Drug: Verapamil (Part A) |
| Part B - EP395 as a 'perpetrator' of DDIs | Experimental | Part B will investigate EP395 as a 'perpetrator' of DDIs. The impact of EP395 on the PK of a CYP3A4 substrate and a Pgp substrate will be assessed. Midazolam has been selected as the CYP3A4 substrate and digoxin as the Pgp substrate. Receives: Drug: EP395 (Part A and B); Drug: Midazolam (Part B); Drug: Digoxin (Part B) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Part A: PK parameters of EP395 - AUC0-24
Area under the plasma concentration vs. time curve from timepoint 0 to 24 hours of EP395.
Measured: Days 1 to 6 and Day 14 to 19
Part A: PK parameters of EP395 - AUC0-inf
Area under the plasma concentration vs. time curve from timepoint 0 to infinity of EP395.
Measured: Days 1 to 6 and Day 14 to 19
Part A: PK parameters of EP395 - AUC%extrap
Percent of AUCinf derived from extrapolation of the plasma concentration vs. time curve of EP395.
Measured: Days 1 to 6 and Day 14 to 19
Part A: PK parameters of EP395 - CL/F
Apparent total body clearance following extravascular administration of EP395.
Measured: Days 1 to 6 and Day 14 to 19
Part A: PK parameters of EP395 - Cmax
Maximum observed plasma concentration of EP395.
Measured: Days 1 to 6 and Day 14 to 19
Part A: PK parameters of EP395 - Tmax
Time to occurrence of Cmax of EP395.
Measured: Days 1 to 6 and Day 14 to 19
Part A: PK parameters of EP395 - T1/2
Terminal elimination half-life of EP395.
Measured: Days 1 to 6 and Day 14 to 19
Part A: PK parameters of EP395 - Vz/F
Volume of distribution following extravascular administration of EP395.
Measured: Days 1 to 6 and Day 14 to 19
Part B: PK parameters of midazolam and digoxin - AUC0-24
Area under the plasma concentration vs. time curve from timepoint 0 to 24 hours of midazolam and digoxin.
Measured: Days 1 to 3/6 and Day 24 to 29
Part B: PK parameters of midazolam and digoxin - AUC0-inf
Area under the plasma concentration vs. time curve from timepoint 0 to infinity of midazolam and digoxin.
Measured: Days 1 to 3/6 and Day 24 to 29
Part B: PK parameters of midazolam and digoxin - AUC%extrap
Percent of AUCinf derived from extrapolation of the plasma concentration vs. time curve of midazolam and digoxin.
Measured: Days 1 to 3/6 and Day 24 to 29
Part B: PK parameters of midazolam and digoxin - Cmax
Maximum observed plasma concentration of midazolam and digoxin.
Measured: Days 1 to 3/6 and Day 24 to 29
Part B: PK parameters of midazolam and digoxin - Tmax
Time to occurrence of Cmax of midazolam and digoxin.
Measured: Days 1 to 3/6 and Day 24 to 29
Part B: PK parameters of midazolam and digoxin - T1/2
Terminal elimination half-life of midazolam and digoxin.
Measured: Days 1 to 3/6 and Day 24 to 29
Secondary outcomes (25)
Part A: Assessment of adverse event occurrence
Measured: From screening to Day 30.
Part A: Absolute change from baseline in vital signs (Systolic and diastolic blood pressure)
Any vital signs outside of normal ranges will be judged as clinically significant or not clinically significant.
Measured: Screening (Day -28 to Day -1), Day 1, Day 10-19
Part A: Absolute change from baseline in vital signs (Pulse)
Any vital signs outside of normal ranges will be judged as clinically significant or not clinically significant.
Measured: Screening (Day -28 to Day -1), Day 1, Day 10-19
Part A: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (heart rate)
Number of patients with any clinically significant change in 12-lead Electrocardiogram (ECG) parameters.
The resting heart rate (HR) will be recorded. Any abnormalities in ECG will be specified and documented as clinically significant or not clinically significant.
Measured: Screening (Day -28 to Day -1), Day 1, Day 10-19
Part A: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (PQ/PR interval)
Number of patients with any clinically significant change in 12-lead Electrocardiogram (ECG) parameters.
The resting PQ/PR interval will be recorded. Any abnormalities in ECG will be specified and documented as clinically significant or not clinically significant.
Measured: Screening (Day -28 to Day -1), Day 1, Day 10-19
Part A: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (QRS interval)
Number of patients with any clinically significant change in 12-lead Electrocardiogram (ECG) parameters.
The resting QRS interval will be recorded. Any abnormalities in ECG will be specified and documented as clinically significant or not clinically significant.
Measured: Screening (Day -28 to Day -1), Day 1, Day 10-19
Part A: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (QT interval)
Number of patients with any clinically significant change in 12-lead Electrocardiogram (ECG) parameters.
The resting QT interval will be recorded. Any abnormalities in ECG will be specified and documented as clinically significant or not clinically significant.
Measured: Screening (Day -28 to Day -1), Day 1, Day 10-19
Part A: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (QTcF interval)
Number of patients with any clinically significant change in 12-lead Electrocardiogram (ECG) parameters.
The resting QTcF interval will be recorded. Any abnormalities in ECG will be specified and documented as clinically significant or not clinically significant.
Measured: Screening (Day -28 to Day -1), Day 1, Day 10-19
Part A: Absolute change from baseline in safety laboratory analytes (haematology).
Erythrocyte count, Leukocyte count with differential count, Haematocrit (EVF), Haemoglobin (Hb), Mean corpuscular haemoglobin (MCH), Mean corpuscular volume (MCV), Platelet count.
Absolute changes from baseline will be summarized for all assessed time points.
Measured: Screening (Day -28 to Day -1), Day -1, Day 10, Day 14, Day 19
Part A: Absolute change from baseline in safety laboratory analytes (clinical chemistry).
Alanine aminotransferase (ALT), Albumin, Alkaline phosphatase (ALP), Aspartate aminotransferase (AST), Bilirubin (total and conjugated), Calcium, Creatinine (estimated Glomerular Filtration Rate [eGFR] included), Gamma glutamyl transferase, Glucose (non-fasting, at screening only), Lactate dehydrogenase, Phosphate, Potassium, Protein (total), Sodium, Urea
Absolute changes from baseline will be summarized for all assessed time points.
Measured: Screening (Day -28 to Day -1), Day -1, Day 10, Day 14, Day 19
Part A: Absolute change from baseline in safety laboratory analytes (coagulation).
Activated Partial Thromboplastin Time (APTT), Prothrombin Complex International Normalised Ratio (PK[INR])
Absolute changes from baseline will be summarized for all assessed time points.
Measured: Screening (Day -28 to Day -1), Day -1, Day 10, Day 14, Day 19
Part B: Assessment of adverse event occurrence
Measured: From screening to Day 30.
Part B: Absolute change from baseline in vital signs (Systolic and diastolic blood pressure)
Any vital signs outside of normal ranges will be judged as clinically significant or not clinically significant.
Measured: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in vital signs (Pulse)
Any vital signs outside of normal ranges will be judged as clinically significant or not clinically significant.
Measured: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (heart rate).
Number of patients with any clinically significant change in 12-lead Electrocardiogram (ECG) parameters.
The resting heart rate (HR) will be recorded. Any abnormalities in ECG will be specified and documented as clinically significant or not clinically significant.
Measured: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (PQ/PRinterval).
Number of patients with any clinically significant change in 12-lead Electrocardiogram (ECG) parameters.
The resting PQ/PR interval will be recorded. Any abnormalities in ECG will be specified and documented as clinically significant or not clinically significant.
Measured: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (QRS interval).
Number of patients with any clinically significant change in 12-lead Electrocardiogram (ECG) parameters.
The resting QRS interval will be recorded. Any abnormalities in ECG will be specified and documented as clinically significant or not clinically significant.
Measured: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (QT interval).
Number of patients with any clinically significant change in 12-lead Electrocardiogram (ECG) parameters.
The resting QT interval will be recorded. Any abnormalities in ECG will be specified and documented as clinically significant or not clinically significant.
Measured: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (QTcF interval).
Number of patients with any clinically significant change in 12-lead Electrocardiogram (ECG) parameters.
The resting QTcF interval will be recorded. Any abnormalities in ECG will be specified and documented as clinically significant or not clinically significant.
Measured: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters
Number of patients with any clinically significant change in 12-lead Electrocardiogram (ECG) parameters.
The resting heart rate (HR) and PQ/PR, QRS, QT and QTcF intervals will be recorded. Any abnormalities in ECG will be specified and documented as clinically significant or not clinically significant.
Measured: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in safety laboratory analytes (haematology).
Erythrocyte count, Leukocyte count with differential count, Haematocrit (EVF), Haemoglobin (Hb), Mean corpuscular haemoglobin (MCH), Mean corpuscular volume (MCV), Platelet count.
Absolute changes from baseline will be summarized for all assessed time points.
Measured: Screening (Day -28 to Day -1), Day -1, Day 9, Day 16, Day 23, D28
Part B: Absolute change from baseline in safety laboratory analytes (clinical chemistry).
Alanine aminotransferase (ALT), Albumin, Alkaline phosphatase (ALP), Aspartate aminotransferase (AST), Bilirubin (total and conjugated), Calcium, Creatinine (estimated Glomerular Filtration Rate [eGFR] included), Gamma glutamyl transferase, Glucose (non-fasting, at screening only), Lactate dehydrogenase, Phosphate, Potassium, Protein (total), Sodium, Urea
Absolute changes from baseline will be summarized for all assessed time points.
Measured: Screening (Day -28 to Day -1), Day -1, Day 9, Day 16, Day 23, D28
Part B: Absolute change from baseline in safety laboratory analytes (coagulation).
Activated Partial Thromboplastin Time (APTT), Prothrombin Complex International Normalised Ratio (PK[INR])
Absolute changes from baseline will be summarized for all assessed time points.
Measured: Screening (Day -28 to Day -1), Day -1, Day 9, Day 16, Day 23, D28
Part B: PK parameters of EP395 and its major metabolites (Cmax)
The ratios of EP395 metabolite to parent systemic exposures in terms of Cmax and AUC0-24 will be calculated and expressed as percentages.
Measured: Days 1 to 3/6 and Day 24 to 29
Part B: PK parameters of EP395 and its major metabolites (AUC0-24)
The ratios of EP395 metabolite to parent systemic exposures in terms of Cmax and AUC0-24 will be calculated and expressed as percentages.
Measured: Days 1 to 3/6 and Day 24 to 29
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted7 Nov 2023
- Study start23 Oct 2023
- Primary completion2 Jan 2024
- Study completion2 Jan 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Chronic Obstructive Pulmonary Disease ExacerbationStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Model description
- This is a single centre, open label trial to assess the impact of CYP3A4 and Pgp inhibition on the PK of EP395 (Part A); and, to assess the impact of EP395 on the PK of a CYP3A4 substrate and a Pgp substrate (Part B). Parts A and B of the trial may be conducted concurrently.
- Masking
- None (open label)
- Enrolment
- 37 participants (actual)
Sponsor and investigators
- Lead sponsor
- EpiEndo Pharmaceuticals
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- CTC Clinical Trial Consultants AB
- Responsible party
- Sponsor
- Investigators
- Björn Schultze, MD, Principal investigator, CTC Clinical Trial Consultants AB
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06118684
- Sponsor's protocol ID
- EP395-004
- Status last verified
- Apr 2026
- First submitted
- 20 Oct 2023
- Last updated
- 29 Apr 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Singh D, Hanrott K, Breuer O, Bylund J, Schultze B, Norris V. Early clinical pharmacology evaluation of the novel anti-inflammatory macrolide, glasmacinal (EP395): tolerability, pharmacokinetics and drug interactions. Br J Clin Pharmacol. 2026 Jul;92(7):2349-2363. doi: 10.1002/bcp.70509. Epub 2026 Mar 17.
PubMed 41845869Sewunet T, Razavi M, Hanrott K, Norris V, Kricker J, Giske CG. Impact of the anti-inflammatory macrolide glasmacinal on the gut microbiota of healthy adults: an open-label trial. Nat Commun. 2026 Aug 20;17(1):8728. doi: 10.1038/s41467-026-76867-9.
PubMed 42624857
Study at a glance
From the registry record, last updated by the sponsor on 29 Apr 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- An Open-label, Healthy Subject, Two-part Study to Assess the Effect of Verapamil on Systemic Exposure of EP395 (Part A), and to Assess the Effect of EP395 on Systemic Exposure of Midazolam and Digoxin (Part B)
- ClinicalTrials.gov ID
- NCT06118684
- Acronym / sponsor ID
- EP395-004
- Phase
- Phase 1
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 37 participants (actual)
- Lead sponsor
- EpiEndo PharmaceuticalsIndustry (pharma, biotech, devices)
- Collaborators
- CTC Clinical Trial Consultants AB
- Study start
- 23 Oct 2023 (actual)
- Primary completion
- 2 Jan 2024 (actual)
- Study completion
- 2 Jan 2024 (actual)
- First posted
- 7 Nov 2023 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The aim of this trial is to assess the potential key drug-drug interactions with EP395 in the clinical setting.
Detailed description
This is an open-label, healthy subject, two-part study to assess the effect of verapamil on systemic exposure of EP395 (Part A), and to assess the effect of EP395 on systemic exposure of midazolam and digoxin (Part B).
The overall aim of this trial is to assess the potential key drug-drug interactions (DDIs) with EP395 in the clinical setting. The trial will be in two parts:
Part A will investigate EP395 as a 'victim' of DDIs. The impact of CYP3A4 and P-glycoprotein (Pgp) inhibition on the pharmacokinetics (PK) of EP395 will be assessed. Verapamil has been selected as a moderate inhibitor of CYP3A4 and an inhibitor of Pgp.
Part B will investigate EP395 as a 'perpetrator' of DDIs. The impact of EP395 on the PK of a CYP3A4 substrate and a Pgp substrate will be assessed. Midazolam has been selected as the CYP3A4 substrate and digoxin as the Pgp substrate.
The trial population is healthy adults.
Study design
- Primary purpose
- Treatment
- Allocation
- Non-randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- This is a single centre, open label trial to assess the impact of CYP3A4 and Pgp inhibition on the PK of EP395 (Part A); and, to assess the impact of EP395 on the PK of a CYP3A4 substrate and a Pgp substrate (Part B). Parts A and B of the trial may be conducted concurrently.
| Arm | Type | Receives |
|---|---|---|
| Part A - EP395 as a 'victim' of DDIs | Experimental | Drug: EP395 (Part A and B), Drug: Verapamil (Part A)Part A will investigate EP395 as a 'victim' of DDIs. The impact of CYP3A4 and P-glycoprotein (Pgp) inhibition on the pharmacokinetics (PK) of EP395 will be assessed. Verapamil has been selected as a moderate inhibitor of CYP3A4 and an inhibitor of Pgp. |
| Part B - EP395 as a 'perpetrator' of DDIs | Experimental | Drug: EP395 (Part A and B), Drug: Midazolam (Part B), Drug: Digoxin (Part B)Part B will investigate EP395 as a 'perpetrator' of DDIs. The impact of EP395 on the PK of a CYP3A4 substrate and a Pgp substrate will be assessed. Midazolam has been selected as the CYP3A4 substrate and digoxin as the Pgp substrate. |
Who may qualify
- Ages
- 18 to 55 years
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult
Key inclusion criteria (11 listed)
- Willing and able to understand the information on the nature, the scope, and the relevance of the trial, and to provide voluntary, written informed consent to participate in the trial before any trial-related procedures.
- Healthy male or female participant aged 18 to 55 years, inclusive.
- Body mass index ≥ 19.0 and ≤ 33.0 kg/m2 at the time of the screening visit.
- Medically healthy participant without abnormal clinically significant medical history, physical findings, vital signs, ECG and laboratory values at the time of the screening visit, as judged by the Investigator.
- Non-smoker, or former smoker with <10 pack years who stopped smoking (including e-cigarettes) at least 6 months before the screening visit.
Key exclusion criteria (32 listed)
- Participants must not enter the trial if any of the following exclusion criteria are fulfilled:
- History of any clinically significant disease or disorder which, in the opinion of the Investigator, may either put the participant at risk because of participation in the trial, or influence the results, or the participant's ability to participate in the trial.
- Any clinically significant illness, medical/surgical procedure or trauma within 4 weeks of the (first) administration of IMP.
- Presence or history of lung disease, e.g., asthma, chronic obstructive pulmonary disease.
- Presence or history of significant gastrointestinal medical condition that could lead to abnormal absorption.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| EP395 (Part A and B)EP395 (test product) oral capsule 125 mg. Part A: Dose: 1 capsule as a single dose on Day 1 and Day 14, total daily dose: 125 mg. Part B: Dose: 3 capsules once daily on Days 9 to 28, total daily dose: 375 mg. | Drug | Part A - EP395 as a 'victim' of DDIs, Part B - EP395 as a 'perpetrator' of DDIs |
| Verapamil (Part A)Verapamil (CYP3A4/Pgp inhibitor), tablet 40 mg. Part A: Dose: 3 tablets twice daily Days 10 to 18, total daily dose: 240 mg. | Drug | Part A - EP395 as a 'victim' of DDIs |
| Midazolam (Part B)Midazolam (CYP3A4 substrate) oral solution 1 mg/mL. Part B: Dose: 4 mL as a single dose on Day 1 and Day 24, total daily dose: 4 mg. | Drug | Part B - EP395 as a 'perpetrator' of DDIs |
| Digoxin (Part B)Digoxin (Pgp substrate) tablet 0.25 mg. Part B: Dose: 1 tablet as a single dose on Day 1 and Day 24, total daily dose: 0.25 mg. | Drug | Part B - EP395 as a 'perpetrator' of DDIs |
Primary outcome
Part A: PK parameters of EP395 - AUC0-24
Time frame: Days 1 to 6 and Day 14 to 19
Area under the plasma concentration vs. time curve from timepoint 0 to 24 hours of EP395.
Part A: PK parameters of EP395 - AUC0-inf
Time frame: Days 1 to 6 and Day 14 to 19
Area under the plasma concentration vs. time curve from timepoint 0 to infinity of EP395.
Part A: PK parameters of EP395 - AUC%extrap
Time frame: Days 1 to 6 and Day 14 to 19
Percent of AUCinf derived from extrapolation of the plasma concentration vs. time curve of EP395.
Part A: PK parameters of EP395 - CL/F
Time frame: Days 1 to 6 and Day 14 to 19
Apparent total body clearance following extravascular administration of EP395.
Part A: PK parameters of EP395 - Cmax
Time frame: Days 1 to 6 and Day 14 to 19
Maximum observed plasma concentration of EP395.
Part A: PK parameters of EP395 - Tmax
Time frame: Days 1 to 6 and Day 14 to 19
Time to occurrence of Cmax of EP395.
Part A: PK parameters of EP395 - T1/2
Time frame: Days 1 to 6 and Day 14 to 19
Terminal elimination half-life of EP395.
Part A: PK parameters of EP395 - Vz/F
Time frame: Days 1 to 6 and Day 14 to 19
Volume of distribution following extravascular administration of EP395.
Part B: PK parameters of midazolam and digoxin - AUC0-24
Time frame: Days 1 to 3/6 and Day 24 to 29
Area under the plasma concentration vs. time curve from timepoint 0 to 24 hours of midazolam and digoxin.
Part B: PK parameters of midazolam and digoxin - AUC0-inf
Time frame: Days 1 to 3/6 and Day 24 to 29
Area under the plasma concentration vs. time curve from timepoint 0 to infinity of midazolam and digoxin.
Part B: PK parameters of midazolam and digoxin - AUC%extrap
Time frame: Days 1 to 3/6 and Day 24 to 29
Percent of AUCinf derived from extrapolation of the plasma concentration vs. time curve of midazolam and digoxin.
Part B: PK parameters of midazolam and digoxin - Cmax
Time frame: Days 1 to 3/6 and Day 24 to 29
Maximum observed plasma concentration of midazolam and digoxin.
Part B: PK parameters of midazolam and digoxin - Tmax
Time frame: Days 1 to 3/6 and Day 24 to 29
Time to occurrence of Cmax of midazolam and digoxin.
Part B: PK parameters of midazolam and digoxin - T1/2
Time frame: Days 1 to 3/6 and Day 24 to 29
Terminal elimination half-life of midazolam and digoxin.
25 secondary outcomes
Part A: Assessment of adverse event occurrence
Time frame: From screening to Day 30.
Part A: Absolute change from baseline in vital signs (Systolic and diastolic blood pressure)
Time frame: Screening (Day -28 to Day -1), Day 1, Day 10-19
Part A: Absolute change from baseline in vital signs (Pulse)
Time frame: Screening (Day -28 to Day -1), Day 1, Day 10-19
Part A: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (heart rate)
Time frame: Screening (Day -28 to Day -1), Day 1, Day 10-19
Part A: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (PQ/PR interval)
Time frame: Screening (Day -28 to Day -1), Day 1, Day 10-19
Part A: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (QRS interval)
Time frame: Screening (Day -28 to Day -1), Day 1, Day 10-19
Part A: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (QT interval)
Time frame: Screening (Day -28 to Day -1), Day 1, Day 10-19
Part A: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (QTcF interval)
Time frame: Screening (Day -28 to Day -1), Day 1, Day 10-19
Part A: Absolute change from baseline in safety laboratory analytes (haematology).
Time frame: Screening (Day -28 to Day -1), Day -1, Day 10, Day 14, Day 19
Part A: Absolute change from baseline in safety laboratory analytes (clinical chemistry).
Time frame: Screening (Day -28 to Day -1), Day -1, Day 10, Day 14, Day 19
Part A: Absolute change from baseline in safety laboratory analytes (coagulation).
Time frame: Screening (Day -28 to Day -1), Day -1, Day 10, Day 14, Day 19
Part B: Assessment of adverse event occurrence
Time frame: From screening to Day 30.
Part B: Absolute change from baseline in vital signs (Systolic and diastolic blood pressure)
Time frame: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in vital signs (Pulse)
Time frame: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (heart rate).
Time frame: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (PQ/PRinterval).
Time frame: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (QRS interval).
Time frame: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (QT interval).
Time frame: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters (QTcF interval).
Time frame: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in 12-lead Electrocardiogram (ECG) parameters
Time frame: Screening (Day -28 to Day -1), Day 1, Day 9, Day 16, Day 24, Day 28
Part B: Absolute change from baseline in safety laboratory analytes (haematology).
Time frame: Screening (Day -28 to Day -1), Day -1, Day 9, Day 16, Day 23, D28
Part B: Absolute change from baseline in safety laboratory analytes (clinical chemistry).
Time frame: Screening (Day -28 to Day -1), Day -1, Day 9, Day 16, Day 23, D28
Part B: Absolute change from baseline in safety laboratory analytes (coagulation).
Time frame: Screening (Day -28 to Day -1), Day -1, Day 9, Day 16, Day 23, D28
Part B: PK parameters of EP395 and its major metabolites (Cmax)
Time frame: Days 1 to 3/6 and Day 24 to 29
Part B: PK parameters of EP395 and its major metabolites (AUC0-24)
Time frame: Days 1 to 3/6 and Day 24 to 29
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Apr 2026.
- Results publication: PubMed 41845869Singh D, Hanrott K, Breuer O, Bylund J, Schultze B, Norris V. Early clinical pharmacology evaluation of the novel anti-inflammatory macrolide, glasmacinal (EP395): tolerability, pharmacokinetics and drug interactions. Br J Clin Pharmacol. 2026 Jul;92(7):2349-2363. doi: 10.1002/bcp.70509. Epub 2026 Mar 17.
- Derived from this study: PubMed 42624857Sewunet T, Razavi M, Hanrott K, Norris V, Kricker J, Giske CG. Impact of the anti-inflammatory macrolide glasmacinal on the gut microbiota of healthy adults: an open-label trial. Nat Commun. 2026 Aug 20;17(1):8728. doi: 10.1038/s41467-026-76867-9.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Björn Schultze, MD principal investigator
CTC Clinical Trial Consultants AB
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 1 study testing EP395 (Part A and B), Verapamil (Part A) and Midazolam (Part B) in people with Chronic Obstructive Pulmonary Disease Exacerbation and COPD, run by EpiEndo Pharmaceuticals at 1 site in Sweden.
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 11 inclusion and 32 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 29 Apr 2026. 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 Sweden. 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?
Part A: PK parameters of EP395 - AUC0-24 (time frame: Days 1 to 6 and Day 14 to 19). The study lists 14 primary outcomes in all. 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 NCT06118684, which also lists 2 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 29 Apr 2026.