This study is conducted to evaluate the effect of single and multiple therapeutic and supratherapeutic oral doses of E4/DRSP combinations on PK parameters, safety, tolerability and on cardiac repolarization, as detected by QT interval corrected with Fridericia's formula (QTcF).
This will be a randomized, double-blind, placebo-controlled, parallel, single center study in healthy female subjects. A total of 42 female subjects will be enrolled in 3 groups of 14 subjects each. A potential fourth group of 14 healthy female subjects may be added. In each group, subjects will be randomized in a 2.5 to 1 ratio between active (n=10) and placebo (n=4). Subjects will receive a single dose on Day 1 and, after a washout of at least 14 days, multiple doses on 14 consecutive days from Days 15 to 28. Group 1 and Group 2 may be dosed in parallel. After completion of Group 1 and Group 2, a Dose Escalation Report (DER), including PK data up to at least 24 hours post-last dose, will be prepared by the Principal Investigator (PI). Escalation to the planned dose level of 60 mg E4/12 mg DRSP will only proceed if the safety and tolerability of the dose levels of 15 mg E4/3 mg DRSP and 30 mg E4/6 mg DRSP up to 24 hours post-last dose, are acceptable to the PI and the Sponsor and, if deemed necessary by the Independent Ethics Committee (IEC) following their review of the protocol, after a statement of no objection of the DER from the IEC. After completion of Group 3, a second DER, including PK data, will be prepared by the PI. If in Group 3 the expected exposure level of approximately 4 times the exposure of Group 1 is not achieved, and treatment in Group 3 is well tolerated, an additional group with 14 subjects may be enrolled, using a dose level that is estimated to result in at least 4 times the exposure after administration of the 15 mg E4/3 mg DRSP therapeutic dose.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
55
a single oral dose of 15 mg E4/3 mg DRSP (n=10) followed, after a washout of at least 14 days, by multiple oral doses of 15 mg E4/3 mg DRSP (n=10) once daily for 14 days
a single oral dose of 30 mg E4/6 mg DRSP, followed, after a washout of at least 14 days, by multiple oral doses of 30 mg E4/6 mg DRSP once daily for 14 days
a single oral dose of 60 mg E4/12 mg DRSP, followed, after a washout of at least 14 days, by oral doses of 60 mg E4/12 mg DRSP once daily for 14 days
Cmax: Maximum observed plasma concentration of E4 and DSRP
PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35
Time frame: On day 1 and day 28 (steady state)
Tmax: time to attain maximum observed plasma concentration of E4 and DSRP
PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35
Time frame: On day 1 and day 28 (steady state)
AUC0-t: Area under the plasma concentration-time curve up to time t, where t is the last point with concentrations above the lower limit of quantitation (LLOQ) - for E4 and DSRP
PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35
Time frame: On day 1 and day 28 (steady state)
AUC0-24: area under the plasma concentration-time curve up to time 24 hours (where 24 hours is the dosing interval) using linear-log trapezoidal rule - for E4 and DSRP
PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35
Time frame: On day 1 only
AUC0-inf: Area under the plasma concentration-time curve from time 0 to infinity calculated as: AUC0-inf = AUC0-t + Clast/kel, where Clast is the last measurable plasma concentration
PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35
Time frame: On day 1 only
Kel: terminal elimination rate constant of E4 and DSRP
PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35
Time frame: On day 1 and day 28 (steady state)
T1/2: terminal elimination half-life of E4 and DSRP, calculated as 0.693/kel
PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35
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a single oral dose of a placebo which visually matches the active medication, followed, after a washout of at least 14 days, by multiple oral doses of matching placebo once daily for 14 days
a single oral dose of 75 mg E4/15 mg DRSP, followed, after a washout of at least 14 days, by oral doses of 75 mg E4/15 mg DRSP once daily for 14 days
Time frame: On day 1 and day 28 (steady state)
AUC0-tau: Area under the plasma concentration time curve over a dosing interval tau - of E4 and DSRP
PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35
Time frame: On day 28 only
Ra: Accumulation ratio for AUC
PK sampling on day 1, 2-3, 4-8, 16-25, 26-27, 28, 29, 30, 31-35
Time frame: On day 1 and day 28 (steady state)
Number of adverse events and number of subjects with AEs as a measure of safety and tolerability
Any clinically significant observations in results of clinical laboratory tests, 12-lead ECGs, echocardiography, continuous cardiac monitoring (Holter monitoring), vital signs, or physical examinations will be recorded as AEs
Time frame: From admission until follow-up visit (between day 37 and 41)
deltaQTcF as measured by Holter monitoring (continuous cardiac monitoring)
To define the effect of E4 in combination with DRSP on QT interval corrected with Fridericia's formula (QTcF)
Time frame: Time matched on day -1 (for baseline measurements) and on day 28: 1 hour pre-dose until 24h post-dose
ECG parameters
To define the effect of E4 in combination with DRSP on heart rate (HR), PR, and QRS
Time frame: Once during screening period; on day -2, 2, 15, 28, 29; once between day 2-3 and once between day 37 and 41 (follow-up)