Double-blind, randomised, placebo-controlled phase I trial with single-ascending and multiple-ascending dose to evaluate safety and pharmacokinetics of oral controlled-ileocolonic-release nicotinamide (CICR-NAM) compared to immediate-release nicotinamide and placebo in healthy subjects and in patients with inflammatory bowel diseases.
Nicotinamide (NAM) has been implicated in the restoration and maintenance of a healthy gut microbiome. Conventional NAM formulations are designed for systemic NAM supplementation and therefore release NAM in the stomach and upper small intestine for maximum absorption. In contrast, the novel CICR-NAM tablets (controlled-ileocolonic-release nicotinamide) start releasing in the lower small intestine for topical delivery of NAM to the microbiota and the mucosa in the ileum and colon, also leading to a reduced systemic exposure. This clinical Phase I trial investigates the safety and tolerability of CICR-NAM in single- and multiple-ascending doses (1, 2 and 4 g). At the beginning of the trial, single-dose pharmacokinetics (PK) of 1 g of conventional immediate-release NAM and CICR-NAM are compared. At the end of the trial, patients with inflammatory bowel diseases (IBD) receive a medium multiple dose (2 g for 4 weeks) to compare their exposure, PK and safety data with those of healthy subjects at the same dose level.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
DOUBLE
Enrollment
49
single- and multiple-ascending dose (SAD/MAD) or multiple dose (MD)
single-ascending dose (SAD)
single- and multiple-ascending dose (SAD/MAD)
University Medical Center Schleswig-Holstein
Kiel, Germany
Treatment-Emergent Adverse Events [Safety and Tolerability]
Adverse Events (AEs) during treatment period
Time frame: up to 60 days
Treatment-Emergent Serious Adverse Events [Safety and Tolerability]
Serious Adverse Events (SAEs) during treatment period
Time frame: up to 60 days
Haemoglobin
Haemoglobin (Hb) in %
Time frame: up to 60 days
White blood cells
White blood cell (WBC) count as x10\^9/l
Time frame: up to 60 days
Blood creatinine
Blood Creatinine in mmol/L
Time frame: up to 60 days
Blood urea
Urea in mmol/L
Time frame: up to 60 days
Blood uric acid
Uric acid in mmol/L
Time frame: up to 60 days
Glomerular filtration rate
Glomerular filtration rate (GFR, automatically calculated by the laboratory based on creatinine values) GFR in ml/min/1.73m2
Time frame: up to 60 days
Blood ALT
Alanine transaminase (ALT) in U/l
Time frame: up to 60 days
Blood AST
Aspartate transaminase (AST) in U/l
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single-ascending dose (SAD)
Time frame: up to 60 days
Blood GGT
Gamma glutamyl transferase (GGT) in U/l
Time frame: up to 60 days