A Phase I, Randomised, Double-Blind, Placebo-Controlled, Dose-Escalation Clinical Trial to evaluate the Safety and Tolerability of Pentoxifylline PKB171 Gel in Single-Dose Intravaginal Administration, followed by an Extension Study with Multiple-Dose Administration in Healthy Volunteers. The primary ojective was to determine the maximum tolerated dose (MTD) in terms of local tolerability of PKB171 after single-dose intravaginal administration in healthy female volunteers; the secondary objectives evaluated the safety and tolerability of PKB171 after single-dose intravaginal administration and the pharmacokinetic (PK) profile of PKB171 after single-dose intravaginal administration. The extension substudy evaluated the safety and tolerability of PKB171 after multiple-dose intravaginal administration at the MTD in healthy volunteers.
Phase I, randomised, double-blind, placebo-controlled, dose-escalation study to determine the MTD of PKB171 after single-dose intravaginal administration, followed by a double-blind extension study with multiple-dose vaginal administration (two consecutive days) of PKB171at the MTD in healthy volunteers. Part A. Dose-Escalation: A single dose of PKB171 vaginal gel (5 g) was intravaginally administered to healthy volunteers. Three strengths of PKB171 gel were tested: 2% (100 mg pentoxifyline), 3% (150 mg pentoxifyline) and 4% (200 mg pentoxifyline). Three cohorts of 8 healthy female volunteers participated. Intrapatient dose escalation was not permitted. For each dose level, subjects were randomly allocated to receive either the study drug or the placebo (3:1) between day 7 and 21 of their menstrual cycle. In the first cohort (cohort A), a first volunteer received the study drug; after 24 hours of safety assessment, the rest of the volunteers of that cohort received the study drug (5 volunteers) or placebo (2 volunteers). Safety and tolerability of each strength level and dose-escalation decisions were made based on the occurrence of drug-related adverse events (AEs). The maximum tolerated dose (MTD) in terms of local tolerability was defined as the highest dose at which no more than 1 of 6 patients experienced a moderate or severe drug-related adverse events following PKB171 gel administration. Dose escalation proceeded until the highest strength of PKB171 vaginal gel (4%) or matching placebo. To obtain a full PK profile of PKB171 at each dose, blood samples (10 ml) were collected at baseline (pre-treatment), 10 minutes, 20 minutes, 30 minutes, 45 minutes, 1 h, 2 h, 4 h, 8 h and 24 hours post-administration (10 blood draws in total) to analyse the pharmacokinetic parameters (Cmax, Tmax, AUC0-t, T1/2, Vd, Clp) of PKB171 and its metabolite 5-OH-pentoxifylline. Part B. Multiple-dose extension substudy: After completing the dose-escalation phase, an extension substudy was planned in order to assess the tolerability and PK of PKB171 after multiple-dose administration (two consecutive days) using the MTD in healthy female volunteers. A subgroup of 6 patients that have participated in the first part of the study were invited to participate in the randomised, parallel-group, placebo-controlled extension study. Patients were randomly allocated to receive either the study drug or the placebo (2:1) between day 7 and 21 of their menstrual cycle. The MTD of PKB171 gel or matching placebo (5 g) were administered intravaginally in two consecutive days.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
QUADRUPLE
Enrollment
30
Subjects received a single dose of pentoxifylline PKB171 gel or placebo, in a one-dose form with an applicator device that allowed for vaginal administration following the randomisation list: * First dose level: 2% (100 mg) * Second dose level: 3% (150 mg) * Third dose level: 4% (200 mg) The treatment was provided by a member of the investigator's staff and self-administered by volunteers under clinical supervision. The dose-escalation process enabled to determine MTD or the highest dose that was safe to administer in later studies was determined. The results of this study helped to define the recommended doses to be used in the multiple-dose extension.
PKB vaginal gel at the MTD or placebo once every 24 hours for two consecutive days
Maximum Tolerated Dose (MTD) of PKB171
To determine the maximum tolerated dose (MTD) of PKB171 according to the dose at which a related adverse event occurs in one or more subjects.
Time frame: 3 weeks
Adverse events
Evaluate the adverse events (AEs) reported spontaneusly by the subjects, as well as those what are evident to the investigator, including adverse reactions.
Time frame: 3 weeks
Local reactions of PKB171
Evaluate local reactions observed by the gynaecoligist and/or reported by the volunteer after the treatment
Time frame: 3 weeks
Visual Analogue Scale
Evaluate the assessment of local reactions reported by VAS (Visual Analogue Scale). Is a straight horizontal line of fixed length, usually 100 mm. The ends are defined as the extreme limits of the parameter to be measured (symptom, pain, health) orientated from the left (worst) to the right (best)
Time frame: 3 weeks
Pregnancy
In case of pregnancy during the phase I study data collection, including information on pregnancy, fetal development and birth outcomes will be collected.
Time frame: 3 weeks
Peak Plasma Concentration (Cmax)
Complete PK profile at each concentration, blood samples (10mL) was drawn at baseline (pre-treatment), 10 minutes, 20 minutes, 30 minutes, 45 minutes, 1 h, 2 h, 4 h, 8 h and 12 h post-treatment (10 samples in total), in order to analyze the PK parameters of PKB171 and its metabolite 5-hydroxypentoxyphylline.
Time frame: 3 weeks
Tmax
Complete PK profile at each concentration, blood samples (10mL) was drawn at baseline (pre-treatment), 10 minutes, 20 minutes, 30 minutes, 45 minutes, 1 h, 2 h, 4 h, 8 h and 12 h post-treatment (10 samples in total), in order to analyze the PK parameters of PKB171 and its metabolite 5-hydroxypentoxyphylline.
Time frame: 3 weeks
Area Under the Curve (AUC0-t)
Complete PK profile at each concentration, blood samples (10mL) was drawn at baseline (pre-treatment), 10 minutes, 20 minutes, 30 minutes, 45 minutes, 1 h, 2 h, 4 h, 8 h and 12 h post-treatment (10 samples in total), in order to analyze the PK parameters of PKB171 and its metabolite 5-hydroxypentoxyphylline.
Time frame: 3 weeks
Volume of Distribution (Vd)
Complete PK profile at each concentration, blood samples (10mL) was drawn at baseline (pre-treatment), 10 minutes, 20 minutes, 30 minutes, 45 minutes, 1 h, 2 h, 4 h, 8 h and 12 h post-treatment (10 samples in total), in order to analyze the PK parameters of PKB171 and its metabolite 5-hydroxypentoxyphylline.
Time frame: 3 weeks
Half live (T1/2)
Complete PK profile at each concentration, blood samples (10mL) was drawn at baseline (pre-treatment), 10 minutes, 20 minutes, 30 minutes, 45 minutes, 1 h, 2 h, 4 h, 8 h and 12 h post-treatment (10 samples in total), in order to analyze the PK parameters of PKB171 and its metabolite 5-hydroxypentoxyphylline.
Time frame: 3 weeks
Blood test for pregnancy
A quantitative human chorionic gonadotropin (HCG or hCG) blood test measures the specific level of HCG in the blood. Results are given in milli-international units per milliliter (mIU/mL). In non-pregnant women is less than 5mIU/mL. In case of pregnancy during the phase I study data collection, including information on pregnancy, fetal development and birth outcomes will be collected.
Time frame: 3 weeks
Plasma Clearance (CLp)
Complete PK profile at each concentration, blood samples (10mL) was drawn at baseline (pre-treatment), 10 minutes, 20 minutes, 30 minutes, 45 minutes, 1 h, 2 h, 4 h, 8 h and 12 h post-treatment (10 samples in total), in order to analyze the PK parameters of PKB171 and its metabolite 5-hydroxypentoxyphylline.
Time frame: 3 weeks
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