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CompletedNCT03401346Updated Mar 15, 2019

Bioavailability of DHE Administered by I123 POD Device, IV Injection, and Migranal Nasal Spray in Healthy Adults

A Phase 1 interventional study of INP104 and Dihydroergotamine Mesylate (DHE) in Migraine Headache, sponsored by Impel Pharmaceuticals. Completed at 1 site in Australia. Open to participants aged 18 Years to 55 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2019-03-15.

Sponsored by Impel Pharmaceuticals · Phase 1, Interventional, and Treatment

Phase
Phase 1
Study type
Interventional
Enrollment
36
Allocation
Randomized
Ages
18 Years to 55 Years
Sex
All
01

Study summary

A Phase I clinical trial to compare the bioavailability of dihydroergotamine mesylate (DHE) following a single dose administration of INP104 (DHE administered by I123 Precision Olfactory Delivery (POD) Device Nasal Spray) to that of D.H.E. 45 for Injection (Intravenous) and Migranal Nasal Spray in healthy adult subjects.

It is hypothesized that INP104 will address the current variability in nasal administration and give more reproducible dose delivery compared to Migranal nasal spray.

Blood concentrations of all three investigational products will be compared for 48 hours following dosing. The safety and tolerability of INP104 will be monitored throughout the study.

INP104 has been developed for the treatment of acute migraine headache. The device in which the drug will be delivered has been designed to deliver the medication to the upper nasal cavity with minimal variation in dose absorption, eg loss via dripping out of the nose or the dose being swallowed.

Approximately 36 participants in general good health (equal ratio of males and females desired) will be enrolled and will be allocated to receive 3 treatments in a randomized sequence. They will receive a single dose of INP104, a single dose of DHE via intravenous injection, and a single dose of Migranal Nasal Spray. There will be a wash out period where no treatment will be administered for 7 days in between each treatment. Participants are required to attend 3 inpatient periods and 1 final outpatient visit. Each participant will be in the study for up to 43 days.

02

Conditions studied

  • Migraine Headache
03

Who can participate

Ages eligible
18 Years to 55 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  • Adult male and females, 18 to 55 years of age (inclusive) at the time of screening.
  • Subjects must be in good general health, with no significant medical history (including migraine), have no clinically significant abnormalities on physical examination at screening, and/or before administration of the initial dose of investigational product.
  • Subjects must have a Body Mass Index (BMI) between 18 and 32 kg/m2, inclusive.
  • Subjects must have clinical laboratory values within normal range as specified by the testing laboratory, or assessed as not clinically significant by the Principal Investigator.
  • Negative urine drug screen/alcohol breath test at screening.
  • Subjects who are willing to refrain from smoking for the duration of the study.

Exclusion criteria

Exclusion Criteria:

  • Subjects with a recent history of migraine and its variants including hemiplegic migraine and basilar migraine. A recent history of migraine is defined as (a) current or past history of migraine with at least 1 attack in last 6 months or (b) those receiving antimigraine prophylaxis.
  • Positive testing for human immunodeficiency virus (HIV), hepatitis B surface antigen (HBsAg), or hepatitis C antibodies (HCV).
  • Subjects who have ingested caffeine within 48 hours before admission on Day -1. Subjects must also agree to refrain from consumption of caffeinated drinks for 48 hours before admission of Days 7 and 14 (i.e. prior to each subsequent dosing), and throughout confinement.
  • Subjects with ischemic heart disease or subjects who have clinical symptoms or findings consistent with coronary artery vasospasm including Prinzmetal's variant angina.
  • Subjects with hypertension, known peripheral arterial disease, Raynaud's phenomenon, sepsis, history of vascular surgery or severely impaired hepatic or renal function
  • Subjects who have previously shown hypersensitivity to ergot alkaloids or metoclopramide.
  • Use of any relevant prescription, over-the-counter medication (with the exception of oral contraceptives), foods (e.g. grapefruit juice) or supplements (including herbal) within 14 days of randomization [especially those affecting the Cytochrome P450 3A4 (CYP3A4) metabolic pathway].
  • History or presence of alcoholism or drug abuse within the 2 years prior to the first investigational product administration.
  • Surgery within the past three months prior to the first investigational product administration as determined by the PI to be clinically relevant.
  • Active infection and/or use of macrolide antibiotics within 14 days prior to enrollment.
  • History of recurrent infections.
  • Any nasal congestion or physical blockage in either nostril, or deviated nasal septum as determined by nasal examination.
04

Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
None (open label)
Enrollment
36 participants (actual)

Study arms

  • Experimental
    INP104

    Single dose 1.45 mg Dihydroergotamine Mesylate (DHE), administered by I123 Precision Olfactory Delivery (POD) device nasal spray (INP104)

    Combination Product: INP104

  • Active comparator
    D.H.E. 45 Injection (IV)

    Single dose 1 mg Dihydroergotamine Mesylate (DHE) for intravenous injection

    Drug: Dihydroergotamine Mesylate (DHE)

  • Active comparator
    Migranal Nasal Spray

    Single dose 2 mg Migranal Nasal Spray Dihydroergotamine Mesylate (DHE)

    Combination Product: Migranal Nasal Spray

Interventions

  • Combination productINP104

    Dihydroergotamine Mesylate (DHE) administered via I123 Precision Olfactory Delivery (POD) Device

  • DrugDihydroergotamine Mesylate (DHE)

    Dihydroergotamine Mesylate (DHE) injection (intravenous)

  • Combination productMigranal Nasal Spray

    Dihydroergotamine Mesylate (DHE) delivered via Migranal Nasal Spray pump

05

What researchers measure

Primary outcomes

  1. DHE pharmacokinetics

    Cmax

    Time frame: 48 hours

  2. DHE pharmacokinetics

    Tmax

    Time frame: 48 hours

  3. DHE pharmacokinetics

    AUC(0-t)

    Time frame: 48 hours

  4. DHE pharmacokinetics

    kel

    Time frame: 48 hours

  5. DHE pharmacokinetics

    T(1/2)

    Time frame: 48 hours

  6. DHE pharmacokinetics

    AUC(0-inf)

    Time frame: 48 hours

  7. DHE pharmacokinetics

    CL/F (CL for IV administration)

    Time frame: 48 hours

Secondary outcomes

  1. Incidence of treatment-emergent adverse events

    Incidence of treatment-emergent adverse events after one dose of INP-104, Migranal Nasal Spray or DHE45 by IV injection

    Time frame: Day 1 to day 22 post first dosing

  2. 8'-OH-DHE pharmacokinetics

    Cmax

    Time frame: 48 hours

  3. 8'-OH-DHE pharmacokinetics

    Tmax

    Time frame: 48 hours

  4. 8'-OH-DHE pharmacokinetics

    AUC(0-t)

    Time frame: 48 hours

  5. 8'-OH-DHE pharmacokinetics

    kel

    Time frame: 48 hours

  6. 8'-OH-DHE pharmacokinetics

    T(1/2)

    Time frame: 48 hours

  7. 8'-OH-DHE pharmacokinetics

    AUC(0-inf)

    Time frame: 48 hours

  8. 8'-OH-DHE pharmacokinetics

    CL/F (CL for IV administration)

    Time frame: 48 hours

06

Study locations

1 site
  • Centre for Clinical Studies/Nucleus Network
    Melbourne, Victoria 3004, Australia
07

References and documents

Publications

  • Shrewsbury SB, Jeleva M, Satterly KH, Lickliter J, Hoekman J. STOP 101: A Phase 1, Randomized, Open-Label, Comparative Bioavailability Study of INP104, Dihydroergotamine Mesylate (DHE) Administered Intranasally by a I123 Precision Olfactory Delivery (POD(R) ) Device, in Healthy Adult Subjects. Headache. 2019 Mar;59(3):394-409. doi: 10.1111/head.13476. Epub 2019 Jan 19. PubMed 30659611 ↗

Individual participant data

Plan to share: No

08

Registry details

Key details

Study ID
NCT03401346
Lead sponsor
Impel Pharmaceuticals
Responsible party
Sponsor
First posted
Jan 17, 2018
Start date
Oct 19, 2017
Primary completion
Dec 1, 2017
Completion
Dec 6, 2017
Last update
Mar 15, 2019

Study contacts

Jason Lickliter, MD
principal investigator · Centre for Clinical Studies/Nucleus Network

Oversight

FDA-regulated drug
Yes
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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