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Joung KH, Kim TN, Ku EJ, Lee SS, Yoo WS, Park KS, Kwon SK, Ku BJ. A phase 4 randomized active-controlled clinical study to compare the efficacy and safety of sustained-release pregabalin with immediate-release pregabalin in type 2 diabetic patients with peripheral neuropathic pain. J Diabetes Complications 2024; 38:108809. [PMID: 39018898 DOI: 10.1016/j.jdiacomp.2024.108809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 06/26/2024] [Accepted: 07/07/2024] [Indexed: 07/19/2024]
Abstract
AIMS The objective of this study was to demonstrate that sustained-release (SR) pregabalin is non-inferior to immediate-release (IR) pregabalin in attenuating diabetic peripheral neuropathic (DPN) pain along with patient satisfaction and compliance. METHODS This was an 8-week, randomized, active-controlled, open-label, phase 4 study. Eligible subjects who had been on IR pregabalin for 4 weeks were randomized to 1:1 ratio to either continue with twice-daily IR pregabalin (75 mg), or to switch to once-daily SR pregabalin (150 mg). Primary efficacy endpoint was the change in visual analogue scale (VAS) scores after 8 weeks of treatment compared to baseline in both SR and IR pregabalin groups. RESULTS Among 130 randomized subjects, 125 patients were included in full analysis set. For the change in VAS pain score, the least squares (LS) mean were -17.95 (SR pregabalin) and -18.74 (IR pregabalin) and the LS mean difference between both groups was 0.79, with the upper limit of the 95 % confidence interval [-5.99, 7.58] below the pre-specified non-inferiority margin of 9.2 mm. CONCLUSIONS This study demonstrates that the new once-daily SR pregabalin formulation is not different to the twice-daily IR pregabalin in alleviating DPN pain, indicating its potential as a promising treatment for DPN pain with a comparable safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT05624853.
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Affiliation(s)
- Kyong Hye Joung
- Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong, 30099, Republic of Korea; Department of Internal Medicine, College of Medicine, Chungnam National University School of Medicine, Daejeon, 35015, Republic of Korea
| | - Tae Nyun Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, 48108, Republic of Korea
| | - Eu Jeong Ku
- Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center and Seoul National University College of Medicine, Seoul, 06236, Republic of Korea
| | - Seong Su Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, 14647, Republic of Korea
| | - Won Sang Yoo
- Department of Internal Medicine, Dankook University College of Medicine, Chungcheongnam-do, 31116, Republic of Korea
| | - Kang Seo Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, 35233, Republic of Korea
| | - Su Kyoung Kwon
- Department of Endocrinology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, 49267, Republic of Korea
| | - Bon Jeong Ku
- Department of Internal Medicine, College of Medicine, Chungnam National University School of Medicine, Daejeon, 35015, Republic of Korea; Department of Internal Medicine, Chungnam National University Hospital, Daejeon, 35015, Republic of Korea.
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Yoo H, Shin W, Lee B, Park J, Lee Y, Kim A. Pharmacokinetics and Food Effect Between a 100-mg Sustained-Release Tablet and a 50-mg Immediate-Release Tablet of Vildagliptin in Healthy Subjects. Clin Pharmacol Drug Dev 2024; 13:122-127. [PMID: 37548105 DOI: 10.1002/cpdd.1313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/19/2023] [Indexed: 08/08/2023]
Abstract
Vildagliptin is one of the dipeptidyl peptidase-4 inhibitors. This study aimed to compare vildagliptin exposure between 50-mg immediate-release (IR) and 100-mg new sustained-release (SR) tablets, and evaluate the food effect on the pharmacokinetics (PKs) of vildagliptin. A randomized, open-label, 3-period, 3-treatment, 6-sequence crossover study was conducted on healthy subjects. During each period, subjects received the SR tablet either in the fasted (T1) or high-fat fed (T2) state once a day, or IR tablets administered twice a day in the fasted state (R). Blood samples for PK analysis were obtained serially up to 24 hours after dosing. Thirty-four subjects completed the study. The geometric mean ratios for the Cmax and AUC0-24h of T1 to R were 1.15 and 0.89, respectively. The corresponding values of T2 to T1 were 0.94 and 1.07, respectively. Vildagliptin exposure over 24 hours was similar between the SR and IR tablets. In addition, the PK profiles of the SR tablets were not altered by food. The SR tablets can be administered without a food effect and be an alternative option to IR tablets.
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Affiliation(s)
- Hyounggyoon Yoo
- Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Wonsuk Shin
- Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - BackHwan Lee
- Department of Clinical Development, Alvogen Korea, Yeongdeungpo-gu, Seoul, Republic of Korea
| | - JinSoo Park
- Department of Clinical Development, Alvogen Korea, Yeongdeungpo-gu, Seoul, Republic of Korea
| | - Yilseob Lee
- Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Anhye Kim
- Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam-si, Gyeonggi-do, Republic of Korea
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Park M, Choi S, Han S, Shin W, Kim A, Han S, Kim B, Lim Y, Yoo H. Pharmacokinetic properties of a new sustained-release pregabalin tablet in subjects with reduced renal function. Transl Clin Pharmacol 2023; 31:226-237. [PMID: 38197000 PMCID: PMC10772055 DOI: 10.12793/tcp.2023.31.e20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/11/2024] Open
Abstract
A new sustained-release (SR) pregabalin tablet, YHD1119, was formulated for once-daily dosing. In the current study, we aimed to evaluate the pharmacokinetics of YHD1119 tablets in patients with reduced renal function. Subjects were grouped by creatinine clearance: > 60 mL/min/1.73m2 (Cohort A) and 30-60 mL/min/1.73m2 (Cohort B). Eight subjects in Cohort A received a YHD1119 75 mg tablet (Y75T) and a YHD1119 150 mg tablet (Y150T) in each period, and eight subjects in Cohort B received a Y75T. Non-compartment analysis and population pharmacokinetic analysis using a one-compartment model with first-order elimination and first-order absorption with lag time were performed. Sixteen subjects completed the study. The geometric mean ratio (GMR) (90% confidence intervals [CI]) for maximum concentration (Cmax), and area under the concentration-time profile from 0 to the last measurable time (AUClast) after Y75T of Cohort B to those of Y75T of Cohort A were 1.2273 (1.0245-1.4701), and 2.4146 (1.8142-3.2138), respectively. The GMR (90% CI) for Cmax, and AUClast after Y75T of Cohort B to those of Y150T of Cohort A were 0.6476 (0.5229-0.8021), and 1.1471 (0.8418-1.5632), respectively. Simulated steady-steady pregabalin concentrations after once-daily Y75T dosing in subjects with eGFR 45 mL/min/1.73 m2 were within the range of steady-state concentrations simulated after once-daily Y150T dosing in subjects with eGFR 90 mL/min/1.73 m2. The total pregabalin exposure of Y75T in patients with moderate renal impairment was comparable with that of Y150T in subjects with near-normal renal function. Trial Registration ClinicalTrials.gov Identifier: NCT05012436.
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Affiliation(s)
- Maria Park
- Department of Clinical Pharmacology and Therapeutics, The Catholic University of Korea Seoul St. Mary’s Hospital, Seoul 06591, Korea
- Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Suein Choi
- Department of Clinical Pharmacology and Therapeutics, The Catholic University of Korea Seoul St. Mary’s Hospital, Seoul 06591, Korea
- Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Sungpil Han
- Department of Clinical Pharmacology and Therapeutics, The Catholic University of Korea Seoul St. Mary’s Hospital, Seoul 06591, Korea
- Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Wonsuk Shin
- Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, Seongnam 13520, Korea
- Department of Clinical Pharmacology and Therapeutics, CHA University School of Medicine, Seongnam 13520, Korea
| | - Anhye Kim
- Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, Seongnam 13520, Korea
- Department of Clinical Pharmacology and Therapeutics, CHA University School of Medicine, Seongnam 13520, Korea
| | - Seunghoon Han
- Department of Clinical Pharmacology and Therapeutics, The Catholic University of Korea Seoul St. Mary’s Hospital, Seoul 06591, Korea
- Department of Pharmacology, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea
| | - Bomin Kim
- Clinical Development and Medical Division, Yuhan Corporation, Seoul 06927, Korea
| | - Yeji Lim
- Clinical Development and Medical Division, Yuhan Corporation, Seoul 06927, Korea
| | - Hyounggyoon Yoo
- Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, Seongnam 13520, Korea
- Department of Clinical Pharmacology and Therapeutics, CHA University School of Medicine, Seongnam 13520, Korea
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Han KA, Lee YH, Son HS, Song KH, Kim SY, Chung CH, Jang HC, Lee KW, Cha BY, Song KH, Ko YK, Lee PB, Kim BJ, Kim S, An T, Kim YC. Efficacy and Safety of a New Sustained-release Pregabalin Formulation Compared With Immediate-release Pregabalin in Patients With Peripheral Neuropathic Pain: A Randomized Noninferiority Phase 3 Trial. Clin J Pain 2022; 38:343-350. [PMID: 35220330 PMCID: PMC8994039 DOI: 10.1097/ajp.0000000000001028] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 12/01/2021] [Accepted: 12/06/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study investigated whether a new sustained-release (SR) pregabalin formulation is noninferior to immediate-release (IR) pregabalin in alleviating peripheral neuropathic pain in Korean patients. MATERIALS AND METHODS This was a randomized, double-blind, active-controlled phase 3 study of patients with diabetic peripheral neuropathy or postherpetic neuralgia from 41 sites in South Korea in 2017-2018. Eligible patients were randomized (1:1) to receive once-daily SR pregabalin or twice-daily IR pregabalin (150 to 600 mg/d) in a double-dummy manner for 12 weeks according to a stratified permuted block randomization scheme. The primary endpoint was the Daily Pain Rating Scale score at the end of treatment, averaged from the last 7 available scores. RESULTS A total of 319 of 371 (86.0%) randomized patients completed the 12-week treatment (SR pregabalin: n=154; IR pregabalin: n=165; per-protocol set: n=296). The least square mean difference between both groups for the primary endpoint was 0.06 (SE 0.19); (95% confidence interval -0.31 to 0.42), with the lower limit of the confidence interval above the pre-specified margin (-0.78; Pnoninferiority<0.0001). Drug-related treatment-emergent adverse events (TEAEs) were comparable between both groups. The incidence of drug-related TEAEs leading to treatment discontinuation was low (SR pregabalin: 2.7%; IR pregabalin: 1.1%). No serious drug-related TEAEs or deaths occurred. DISCUSSION The results demonstrate that the new once-daily SR pregabalin formulation is noninferior to twice-daily IR pregabalin in reducing peripheral neuropathic pain and is well tolerated in Korean patients with diabetic peripheral neuropathy or postherpetic neuralgia after 12 weeks of treatment.
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Affiliation(s)
| | | | - Hyun-Shik Son
- The Catholic University of Korea Uijeongbu St. Mary’s Hospital, Uijeongbu
| | - Ki-Ho Song
- The Catholic University of Korea Yeouido St. Mary’s Hospital
| | | | | | - Hak Chul Jang
- Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam
| | | | - Bong Yun Cha
- Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine
| | | | - Young Kwon Ko
- Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Pyung-Bok Lee
- Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam
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