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RESEARCH PRODUCT

Phase 1B Study of the Pharmacokinetics and Safety of Posaconazole Intravenous Solution in Patients at Risk for Invasive Fungal Disease

Nicholas A. KartsonisJohan MaertensOliver A. CornelyWerner J. HeinzAndrew J. UllmannHetty WaskinMichael N. RobertsonHernando PatinoMaria CaceresGopal Krishna

subject

AdultMalemedicine.medical_specialtyPosaconazoleAntifungal AgentsPhases of clinical researchPharmacologyPlaceboGastroenterologyCohort StudiesPharmacokineticsInternal medicinemedicineHumansPharmacology (medical)DosingAgedPharmacologyDose-Response Relationship Drugbusiness.industryMiddle AgedTriazolesPharmaceutical SolutionsDose–response relationshipInfectious DiseasesMycosesTolerabilityInjections IntravenousCohortFemalebusinessmedicine.drug

description

ABSTRACT This was a phase 1B, dose-ranging, multicenter, pharmacokinetics, and safety study of cyclodextrin-based posaconazole intravenous (i.v.) solution administered through a central line to subjects at high risk for invasive fungal disease (part 1 of a 2-part study [phase 1B/3]). Initially, the safety and tolerability of single-dose posaconazole i.v. 200 mg ( n = 10) were compared with those of a placebo ( n = 11). Subsequently, 2 doses were evaluated, posaconazole i.v. 200 mg once daily (q.d.) ( n = 21) and 300 mg q.d. ( n = 24). The subjects received twice-daily (b.i.d.) posaconazole i.v. on day 1, followed by 13 days of posaconazole i.v. q.d., then 14 days of posaconazole oral suspension 400 mg b.i.d. The steady-state (day 14) exposure target (average concentration [areas under concentration-time curve {AUCs}/24 h, average concentrations at steady state { C avg s}], of ≥500 to ≤2,500 ng/ml in ≥90% of the subjects) was achieved by 94% of the subjects for 200 mg posaconazole q.d. and by 95% of subjects for 300 mg posaconazole q.d. The desired exposure target (mean steady-state C avg , ∼1,200 ng/ml) was 1,180 ng/ml in the 200-mg dosing cohort and was exceeded in the 300-mg dosing cohort (1,430 ng/ml). Posaconazole i.v. was well tolerated. Posaconazole i.v. 300 mg q.d. was selected for the phase 3 study segment. (This study has been registered at ClinicalTrials.gov under registration no. NCT01075984.)

https://doi.org/10.1128/aac.02686-13