This trial aims to characterise the pharmacokinetic (PK) profile and estimate drug exposure of a single oral dose of piperaquine (PQP) in a dispersible granule formulation compared to the PQP hard tablet formulation in the fasted state (Part 1), to advise the selection of dose when the PQP granule formulation is administered in a fed state in healthy adult participants. Part 2 will assess the effect on different types of meal composition on the PK of a single dose of PQP granule formulation in healthy adult participants.
Adult participants who give written informed consent will be screened within 45 days to determine their eligibility before entering the trial on Day -1. The trial will initially establish the pharmacokinetic (PK) profile and estimated drug exposure of a single oral dose of PQP in a dispersible granule formulation compared to the PQP hard tablet formulation in the fasted state (Part 1). In the second study part, and based on the PK results of Part 1, it is intended to administer the same dose level of 320 mg PQP dispersible granules concomitant with different fed conditions. However, if from Part 1 of the study it is shown that PQP dispersible granules formulation provides a significant improvement in Cmax values in the fasted state, this dose level may be adjusted for Part 2, in order to take into account a potential 3-fold increase in exposure which is the observed food effect when film-coated tablets (Eurartesim®) are administered with a high fat/high calorie meal. Such dose adjustment will be based on the safety and preliminary PK interim results of the granule formulation in the fasted state. The PQP dose selected in Part 2 (as dispersible granules formulation) will take into account a 3-fold factor increase in exposure when administered with food (see above) with such predicted exposure in the presence of food being not higher than after the administration of 960 mg PQP in tablet of Eurartesim® in adult subjects dosed in fasting conditions. Furthermore, sufficient data will be available to address key questions on both, safety and PK parameters to enable the review and recommendation by the SRC for the optimal dose of the granule formulation to be administered in Part 2.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Piperaquine tetraphosphate hard tablet 320 mg; single dose (320 mg) given orally with 240 ml of water
Piperaquine tetraphosphate dispersible granules 320 mg dose equivalent dispersed in 25 ml of water; single dose (320 mg) given orally
Ifakara Health Institute (IHI), Bagamoyo Research and Training Centre (BRTC)
Bagamoyo, Bagamoyo District, Pwani Region, Tanzania
Relative Bioavailability (Frel) of the Maximum Observed Plasma Concentration (Cmax) of the PQP Dispersible Granule Compared to the PQP Hard Tablet in the Fasted State (Frel Cmax).
Blood samples are analysed for PQP concentrations at the indicated time points to determine the maximum observed plasma concentration (Cmax) for PQP dispersible granule (test) and PQP hard tablet (reference) in the fasted state. Pharmacokinetic parameters are determined using standard non-compartmental analysis. Frel Cmax is calculated as the (%) ratio of Cmax of the PQP dispersible granule compared to the PQP hard tablet in the fasted state.
Time frame: Plasma samples taken pre-dose -0.5 hours, then 1, 2, 3, 4, 5, 6, 7, 8, 12, 24, 48, Day 5, Day 8, Day 15, Day 22 and Day 30 post-dose.
Relative Bioavailability (Frel) of the Area Under the Plasma Concentration-time Curve From Time Zero to 72h Hours (AUC0-72h) of the PQP Dispersible Granule Compared to the PQP Hard Tablet in the Fasted State (Frel AUC0-72h).
Blood samples are analysed for PQP concentrations at the indicated time points to calculate the area under the plasma concentration-time curve from time zero to 72 hours (AUC0-72h) for PQP dispersible granule (test) and PQP hard tablet (reference) in the fasted state. Pharmacokinetic parameters are determined using standard non-compartmental analysis. Frel AUC0-72h is calculated as the ratio of AUC0-72h of the PQP dispersible granule compared to the PQP hard tablet in the fasted state.
Time frame: Plasma samples taken pre-dose -0.5 hours, then 1, 2, 3, 4, 5, 6, 7, 8, 12, 24, 48, Day 5, Day 8, Day 15, Day 22 and Day 30 post-dose.
Relative Bioavailability (Frel) of the Area Under the Plasma Concentration-time Curve From Time Zero to the Last Quantifiable Concentration (AUC0-t) of the PQP Dispersible Granule Compared to the PQP Hard Tablet in the Fasted State (Frel AUC0-t).
Blood samples are analysed for PQP concentrations at the indicated time points to calculate the area under the plasma concentration-time curve from time zero to the last quantifiable concentration (AUC0-t) for PQP dispersible granule (test) and PQP hard tablet (reference) in the fasted state. Pharmacokinetic parameters are determined using standard non-compartmental analysis. Frel AUC0-t is calculated as the ratio of AUC0-t of the PQP dispersible granule compared to the PQP hard tablet in the fasted state.
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Masking
NONE
Enrollment
60
Time frame: Plasma samples taken pre-dose -0.5 hours, then 1, 2, 3, 4, 5, 6, 7, 8, 12, 24, 48, Day 5, Day 8, Day 15, Day 22 and Day 30 post-dose.
Relative Bioavailability (Frel) of the Area Under the Plasma Concentration-time Curve From Time Zero to 168 Hours (AUC0-168h) of the PQP Dispersible Granule Compared to the PQP Hard Tablet in the Fasted State (Frel AUC0-168h.
Blood samples are analysed for PQP concentrations at the indicated time points to calculate the area under the plasma concentration-time curve from time zero to 168 hours (AUC0-168h) for PQP dispersible granule (test) and PQP hard tablet (reference) in the fasted state. Pharmacokinetic parameters are determined using standard non-compartmental analysis. Frel AUC0-168h is calculated as the ratio of the AUC0-168h of the PQP dispersible granule compared to the PQP hard tablet in the fasted state.
Time frame: Plasma samples taken pre-dose -0.5 hours, then 1, 2, 3, 4, 5, 6, 7, 8, 12, 24, 48, Day 5, Day 8, Day 15, Day 22 and Day 30 post-dose.
Relative Bioavailability (Frel) of the Area Under the Plasma Concentration-time Curve From Time Zero Extrapolated to Infinity (AUC0-∞) of the PQP Dispersible Granule Compared to the PQP Hard Tablet in the Fasted State (Frel AUC0-∞).
Blood samples are analysed for PQP concentrations at the indicated time points to calculate the area under the plasma concentration-time curve from time zero extrapolated to infinity (AUC0-∞) for PQP dispersible granule (test) and PQP hard tablet (reference) in the fasted state. Pharmacokinetic parameters are determined using standard non-compartmental analysis. Frel AUC0-∞ is calculated as the ratio of the AUC0-∞ of the PQP dispersible granule compared to the PQP hard tablet in the fasted state.
Time frame: Plasma samples taken pre-dose 0.5 hours, then 1, 2, 3, 4, 5, 6, 7, 8, 12, 24, 48, Day 5, Day 8, Day 15, Day 22 and Day 30 post-dose.