Trial Outcomes & Findings for Study to Evaluate Effect of Belatacept on Pharmacokinetics of Inje Cocktail in Healthy Volunteers (NCT NCT01766050)

NCT ID: NCT01766050

Last Updated: 2014-06-27

Results Overview

Samples for the assessment of plasma concentrations of Inje cocktail components (midazolam, losartan, omeprazole, dextromethorphan and caffeine) and their metabolites (1'-hydroxy-midazolam, E-3174, 5-hydroxyomeprazole, dextrorphan, and paraxanthine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Adjusted geometric mean for midazolam with and without belatacept, along with adjusted geometric mean ratios for Days 4, 7, and 11 versus Day 1, respectively, are presented. Cmax measured in nanograms per milliliter (ng/mL). Inje cocktail components (Midazolam) measured using High Performance Liquid Chromatography (HPLC) with Tandem Mass Spectrometry (MS/MS) Detection.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

45 participants

Primary outcome timeframe

Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Results posted on

2014-06-27

Participant Flow

Study initiated January 2013 and completed April 2013. Participants (healthy volunteers) checked into a clinical pharmacology unit (CPU) on Day -1 for screening.

45 were enrolled and 22 dosed with study drug. Reasons for not dosing: 5 withdrew consent, 1 lost to follow up, 1 poor/non-compliance, 15 no longer met study criteria, and 1 other.

Participant milestones

Participant milestones
Measure
Inje Cocktail Alone and Inje Cocktail Plus Belatacept
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Overall Study
STARTED
22
Overall Study
COMPLETED
18
Overall Study
NOT COMPLETED
4

Reasons for withdrawal

Reasons for withdrawal
Measure
Inje Cocktail Alone and Inje Cocktail Plus Belatacept
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Overall Study
Adverse Event
1
Overall Study
Lost to Follow-up
1
Overall Study
Withdrawal by Subject
2

Baseline Characteristics

Study to Evaluate Effect of Belatacept on Pharmacokinetics of Inje Cocktail in Healthy Volunteers

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Inje Cocktail Alone and Inje Cocktail Plus Belatacept
n=22 Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Age, Continuous
31.5 years
STANDARD_DEVIATION 5.96 • n=5 Participants
Sex: Female, Male
Female
1 Participants
n=5 Participants
Sex: Female, Male
Male
21 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
7 Participants
n=5 Participants
Race (NIH/OMB)
White
15 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
Region of Enrollment
United States
22 participants
n=5 Participants
Body Mass Index (kg/m^2)
24.62 kg/m^2
STANDARD_DEVIATION 2.886 • n=5 Participants

PRIMARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Participants who received any study drug and had at least 1 adequate Pharmacokinetic (PK) profile for any Inje cocktail analytes (parent or metabolite).

Samples for the assessment of plasma concentrations of Inje cocktail components (midazolam, losartan, omeprazole, dextromethorphan and caffeine) and their metabolites (1'-hydroxy-midazolam, E-3174, 5-hydroxyomeprazole, dextrorphan, and paraxanthine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Adjusted geometric mean for midazolam with and without belatacept, along with adjusted geometric mean ratios for Days 4, 7, and 11 versus Day 1, respectively, are presented. Cmax measured in nanograms per milliliter (ng/mL). Inje cocktail components (Midazolam) measured using High Performance Liquid Chromatography (HPLC) with Tandem Mass Spectrometry (MS/MS) Detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Adjusted Geometric Mean Maximum Drug Concentration (Cmax) of Midazolam With and Without the Coadministration of Belatacept - Pharmacokinetic (PK) Evaluable Population
24.376 ng/mL
90% Confidence Interval 42 • Interval 21.117 to 28.137
24.152 ng/mL
Interval 20.632 to 28.271
22.211 ng/mL
Interval 19.131 to 25.787
24.220 ng/mL
Interval 20.835 to 28.154

PRIMARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

AUC(0-T): area under the plasma concentration-time curve from zero to the last time of the last quantifiable concentration and AUC (INF): AUC from time zero extrapolated to infinite time were measured in ng\*h/mL. Samples for the assessment of plasma concentrations of Inje cocktail components (midazolam, losartan, omeprazole, dextromethorphan and caffeine) and their metabolites (1'-hydroxy-midazolam, E-3174, 5-hydroxyomeprazole, dextrorphan, and paraxanthine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Adjusted geometric mean for midazolam with and without belatacept, along with adjusted geometric mean ratios for Days 4, 7, and 11 versus Day 1, respectively, are presented. Midazolam measured using HPLC with MS/MS Detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Adjusted Geometric Mean Area Under the Concentration Time Curve (AUC) From Zero to Last Concentration (0-T) and AUC Extrapolated to Infinity (INF) of Midazolam With and Without the Coadministration of Belatacept - Pharmacokinetic (PK) Evaluable Population
AUC (0-T);N=22, 21, 21, 20)
65.548 ng*h/mL
Interval 53.271 to 80.655
68.833 ng*h/mL
Interval 57.008 to 83.111
63.303 ng*h/mL
Interval 52.24 to 76.707
67.717 ng*h/mL
Interval 56.128 to 81.697
Adjusted Geometric Mean Area Under the Concentration Time Curve (AUC) From Zero to Last Concentration (0-T) and AUC Extrapolated to Infinity (INF) of Midazolam With and Without the Coadministration of Belatacept - Pharmacokinetic (PK) Evaluable Population
AUC (INF);N=22, 21, 21, 20)
67.743 ng*h/mL
Interval 54.839 to 83.683
71.039 ng*h/mL
Interval 58.555 to 86.186
65.555 ng*h/mL
Interval 54.019 to 79.554
69.841 ng*h/mL
Interval 57.771 to 84.433

PRIMARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Cmax measured in ng/mL. Samples for assessment of plasma concentrations of Inje cocktail components (midazolam, losartan, omeprazole, dextromethorphan and caffeine) and their metabolites (1'-hydroxy-midazolam, E-3174, 5-hydroxyomeprazole, dextrorphan, and paraxanthine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Adjusted geometric mean for losartan with and without belatacept, along with adjusted geometric mean ratios for Days 4, 7, and 11 versus Day 1, respectively, are presented. Inje cocktail components (losartan) measured using HPLC with MS/MS Detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Adjusted Geometric Mean Cmax of Losartan With and Without the Coadministration of Belatacept - PK Evaluable Population
119.789 ng/mL
Interval 89.629 to 134.485
118.663 ng/mL
Interval 97.209 to 144.85
127.184 ng/mL
Interval 105.467 to 153.373
126.461 ng/mL
Interval 101.676 to 157.288

PRIMARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

AUC (0-T): area under the concentration curve from time 0 to the time of the last quantifiable concentration and AUC (INF) extrapolated to infinity were measured in ng\*h/mL. Samples for assessment of plasma concentrations of Inje cocktail components (midazolam, losartan, omeprazole, dextromethorphan and caffeine) and their metabolites (1'-hydroxy-midazolam, E-3174, 5-hydroxyomeprazole, dextrorphan, and paraxanthine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Adjusted geometric mean for losartan with and without belatacept, along with adjusted geometric mean ratios for Days 4, 7, and 11 versus Day 1, respectively, are presented. Inje cocktail components (losartan) measured using HPLC with MS/MS Detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Adjusted Geometric Mean AUC (0-T) and AUC (INF) of Losartan With and Without the Coadministration of Belatacept - Pharmacokinetic (PK) Evaluable Population
AUC (0-T) N=22, 21, 21, 20)
332.191 ng*h/mL
Interval 283.753 to 388.898
336.531 ng*h/mL
Interval 291.278 to 388.815
337.487 ng*h/mL
Interval 295.482 to 385.462
332.400 ng*h/mL
Interval 280.799 to 393.484
Adjusted Geometric Mean AUC (0-T) and AUC (INF) of Losartan With and Without the Coadministration of Belatacept - Pharmacokinetic (PK) Evaluable Population
AUC (INF) N=22, 21, 21, 20)
338.033 ng*h/mL
Interval 289.143 to 395.189
341.644 ng*h/mL
Interval 296.237 to 394.012
343.508 ng*h/mL
Interval 301.494 to 391.378
338.646 ng*h/mL
Interval 286.824 to 399.831

PRIMARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Cmax: Maximum observed plasma concentration was measured in ng/mL. Samples for assessment of plasma concentrations of Inje cocktail components (midazolam, losartan, omeprazole, dextromethorphan and caffeine) and their metabolites (1'-hydroxy-midazolam, E-3174, 5-hydroxyomeprazole, dextrorphan, and paraxanthine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Adjusted geometric mean for omeprazole with and without belatacept, along with adjusted geometric mean ratios for Days 4, 7, and 11 versus Day 1, respectively, are presented. Inje cocktail components (omeprazole) measured using HPLC with MS/MS Detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Adjusted Geometric Mean Cmax of Omeprazole With and Without the Coadministration of Belatacept - Pharmacokinetic (PK) Evaluable Population
583.047 ng/mL
Interval 473.091 to 718.56
734.776 ng/mL
Interval 587.28 to 919.316
753.126 ng/mL
Interval 597.946 to 948.579
686.929 ng/mL
Interval 555.59 to 849.315

PRIMARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

AUC(0-T): Area under the plasma concentration-time curve from time zero zero to the time of the last quantifiable concentration and AUC (INF): AUC extrapolated to infinity were measured in ng\*h/mL. Samples for assessment of plasma concentrations of Inje cocktail components (midazolam, losartan, omeprazole, dextromethorphan and caffeine) and their metabolites (1'-hydroxy-midazolam, E-3174, 5-hydroxyomeprazole, dextrorphan, and paraxanthine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Adjusted geometric mean for omeprazole with and without belatacept, along with adjusted geometric mean ratios for Days 4, 7, and 11 versus Day 1, respectively, are presented. Inje cocktail components (omeprazole) measured using HPLC with MS/MS Detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Adjusted Geometric Mean AUC (0-T) and AUC (INF) of Omeprazole With and Without the Coadministration of Belatacept - Pharmacokinetic (PK) Evaluable Population
AUC (0-T); (N= 22, 21, 21, 20)
1361.024 ng*h/mL
Interval 1066.457 to 1736.953
1577.017 ng*h/mL
Interval 1200.238 to 2072.075
1671.173 ng*h/mL
Interval 1278.936 to 2183.704
1653.491 ng*h/mL
Interval 1264.315 to 2162.463
Adjusted Geometric Mean AUC (0-T) and AUC (INF) of Omeprazole With and Without the Coadministration of Belatacept - Pharmacokinetic (PK) Evaluable Population
AUC (INF); (N= 22, 19, 21, 18)
1368.593 ng*h/mL
Interval 1072.836 to 1745.885
1632.455 ng*h/mL
Interval 1251.956 to 2128.597
1679.693 ng*h/mL
Interval 1286.299 to 2193.4
1779.717 ng*h/mL
Interval 1380.25 to 2294.798

PRIMARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Cmax was measured in ng/mL. Samples for assessment of plasma concentrations of Inje cocktail components (midazolam, losartan, omeprazole, dextromethorphan and caffeine) and their metabolites (1'-hydroxy-midazolam, E-3174, 5-hydroxyomeprazole, dextrorphan, and paraxanthine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Adjusted geometric mean for dextromethorphan with and without belatacept, along with adjusted geometric mean ratios for Days 4, 7, and 11 versus Day 1, respectively, are presented. The poor metabolizer of CYP2D6 was excluded from the statistical analysis. Inje cocktail components (dextromethorphan) measured using HPLC with MS/MS Detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=19 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=19 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=19 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Adjusted Geometric Mean Cmax of Dextromethorphan With and Without the Coadministration of Belatacept - PK Evaluable Population
0.927 ng/mL
Interval 0.566 to 1.518
0.800 ng/mL
Interval 0.512 to 1.25
0.855 ng/mL
Interval 0.553 to 1.32
0.794 ng/mL
Interval 0.49 to 1.286

PRIMARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

AUC(0-T): area under the plasma concentration-time curve from time zero to the time of the last quantifiable concentration and AUC (INF): AUC extrapolated to infinity, were measured as ng\*h/mL. Samples for assessment of plasma concentrations of Inje cocktail components (midazolam, losartan, omeprazole, dextromethorphan and caffeine) and their metabolites (1'-hydroxy-midazolam, E-3174, 5-hydroxyomeprazole, dextrorphan, and paraxanthine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Adjusted geometric mean for dextromethorphan with and without belatacept, along with adjusted geometric mean ratios for Days 4, 7, and 11 versus Day 1, respectively, are presented. The poor metabolizer of CYP2D6 was excluded from the statistical analysis. Inje cocktail components (dextromethorphan) measured using HPLC with MS/MS Detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=19 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=19 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=19 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Adjusted Geometric Mean AUC (0-T) and AUC (INF) of Dextromethorphan With and Without the Coadministration of Belatacept - PK Evaluable Population
AUC (0-T); N= 21, 19, 19, 19
6.176 ng*h/mL
Interval 3.466 to 11.005
5.651 ng*h/mL
Interval 3.305 to 9.661
6.195 ng*h/mL
Interval 3.705 to 10.358
5.949 ng*h/mL
Interval 3.465 to 10.215
Adjusted Geometric Mean AUC (0-T) and AUC (INF) of Dextromethorphan With and Without the Coadministration of Belatacept - PK Evaluable Population
AUC (INF); N= 18, 17, 18, 15
6.220 ng*h/mL
Interval 3.743 to 10.337
5.455 ng*h/mL
Interval 3.372 to 8.825
6.412 ng*h/mL
Interval 4.2 to 9.79
6.359 ng*h/mL
Interval 1.143 to 9.76

PRIMARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Samples for assessment of plasma concentrations of Inje cocktail components (midazolam, losartan, omeprazole, dextromethorphan and caffeine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Inje cocktail components were each measured using HPLC with MS/MS detection. Cmax was measured in ng/mL.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=18 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Adjusted Geometric Mean Cmax of Caffeine With and Without the Coadministration of Belatacept - PK Evaluable Population
4696.505 ng/mL
Interval 4252.803 to 5186.499
4450.019 ng/mL
Interval 4172.484 to 4746.014
4332.326 ng/mL
Interval 3993.257 to 4700.186
4479.687 ng/mL
Interval 4141.21 to 4845.83

PRIMARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Samples for assessment of plasma concentrations of Inje cocktail components (midazolam, losartan, omeprazole, dextromethorphan and caffeine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Inje cocktail components were each measured using HPLC with MS/MS detection. AUC (0-T) and AUC (INF) were measured as ng\*h/mL.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=18 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Adjusted Geometric Mean AUC (0-T) and AUC (INF) of Caffeine With and Without the Coadministration of Belatacept - PK Evaluable Population
AUC (0-T); N= 22, 21, 21, 18
37394.5 ng*h/mL
Interval 33103.4 to 42241.8
35200.3 ng*h/mL
Interval 31255.9 to 39642.5
36853.4 ng*h/mL
Interval 32319.8 to 42022.9
38407.0 ng*h/mL
Interval 34164.2 to 43176.7
Adjusted Geometric Mean AUC (0-T) and AUC (INF) of Caffeine With and Without the Coadministration of Belatacept - PK Evaluable Population
AUC (INF); N= 22, 21, 21, 18
40084.1 ng*h/mL
Interval 34881.6 to 46062.5
37647.8 ng*h/mL
Interval 32705.5 to 43336.9
40149.9 ng*h/mL
Interval 34434.3 to 46814.1
41537.6 ng*h/mL
Interval 36092.9 to 47803.7

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Samples for assessment of plasma concentrations of Inje cocktail components (midazolam, losartan, omeprazole, dextromethorphan and caffeine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. The poor metabolizer of CYP2D6 was excluded from summary of dextromethorphan parameters. Inje cocktail components were each measured using HPLC with MS/MS detection. Tmax was measured in hours (h).

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Time of Maximum Observed Plasma Concentration (Tmax) of the Inje Cocktail Components (Midazolam, Losartan, Omeprazole, Dextromethorphan, and Caffeine) With and Without Coadministration of Belatacept - PK Evaluable Population
Midazolam (N=22,21,21,20)
0.50 h
Interval 0.5 to 1.5
0.50 h
Interval 0.5 to 1.5
0.50 h
Interval 0.5 to 1.5
1.0 h
Interval 0.5 to 1.03
Time of Maximum Observed Plasma Concentration (Tmax) of the Inje Cocktail Components (Midazolam, Losartan, Omeprazole, Dextromethorphan, and Caffeine) With and Without Coadministration of Belatacept - PK Evaluable Population
Losartan (N= 22, 21, 21, 20)
1.52 h
Interval 0.5 to 3.0
2.00 h
Interval 0.5 to 4.0
1.50 h
Interval 0.5 to 3.0
1.50 h
Interval 0.5 to 3.0
Time of Maximum Observed Plasma Concentration (Tmax) of the Inje Cocktail Components (Midazolam, Losartan, Omeprazole, Dextromethorphan, and Caffeine) With and Without Coadministration of Belatacept - PK Evaluable Population
Omeprazole (N=22,21,21,20)
2.00 h
Interval 1.5 to 4.0
3.00 h
Interval 1.0 to 8.05
3.00 h
Interval 1.0 to 5.0
3.00 h
Interval 1.0 to 12.0
Time of Maximum Observed Plasma Concentration (Tmax) of the Inje Cocktail Components (Midazolam, Losartan, Omeprazole, Dextromethorphan, and Caffeine) With and Without Coadministration of Belatacept - PK Evaluable Population
Dextromethorphan (N=21, 19, 19, 19)
3.00 h
Interval 1.0 to 6.0
3.00 h
Interval 1.5 to 6.0
3.00 h
Interval 1.5 to 5.15
3.00 h
Interval 1.0 to 6.0
Time of Maximum Observed Plasma Concentration (Tmax) of the Inje Cocktail Components (Midazolam, Losartan, Omeprazole, Dextromethorphan, and Caffeine) With and Without Coadministration of Belatacept - PK Evaluable Population
Caffeine (N= 22,21,21,18)
1.00 h
Interval 0.5 to 2.0
1.00 h
Interval 0.5 to 3.0
1.50 h
Interval 0.5 to 4.0
1.50 h
Interval 0.5 to 2.0

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Samples for assessment of plasma concentrations of Inje cocktail components (midazolam, losartan, omeprazole, dextromethorphan and caffeine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. The poor metabolizer of CYP2D6 was excluded from summary of dextromethorphan parameters. Inje cocktail components were each measured using HPLC with MS/MS detection. T-HALF was measured in hours (h).

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Plasma Half-Life (T-HALF) of the Inje Cocktail Components (Midazolam, Losartan, Omeprazole, Dextromethorphan, and Caffeine) With and Without Coadministration of Belatacept - PK Evaluable Population
Caffeine (N=22, 21, 21, 18)
5.61 h
Standard Deviation 1.87
5.71 h
Standard Deviation 2.01
6.17 h
Standard Deviation 2.29
6.03 h
Standard Deviation 2.13
Plasma Half-Life (T-HALF) of the Inje Cocktail Components (Midazolam, Losartan, Omeprazole, Dextromethorphan, and Caffeine) With and Without Coadministration of Belatacept - PK Evaluable Population
Dextromethorphan (N=18, 17, 18, 15)
6.76 h
Standard Deviation 2.09
6.98 h
Standard Deviation 2.67
6.33 h
Standard Deviation 1.69
6.70 h
Standard Deviation 2.29
Plasma Half-Life (T-HALF) of the Inje Cocktail Components (Midazolam, Losartan, Omeprazole, Dextromethorphan, and Caffeine) With and Without Coadministration of Belatacept - PK Evaluable Population
Midazolam (N=22, 21, 21, 20)
4.01 h
Standard Deviation 1.86
4.43 h
Standard Deviation 1.89
4.27 h
Standard Deviation 1.88
4.05 h
Standard Deviation 1.61
Plasma Half-Life (T-HALF) of the Inje Cocktail Components (Midazolam, Losartan, Omeprazole, Dextromethorphan, and Caffeine) With and Without Coadministration of Belatacept - PK Evaluable Population
Losartan (N=22, 21, 21, 20)
2.96 h
Standard Deviation 1.29
2.56 h
Standard Deviation 1.31
3.30 h
Standard Deviation 1.49
2.87 h
Standard Deviation 1.52
Plasma Half-Life (T-HALF) of the Inje Cocktail Components (Midazolam, Losartan, Omeprazole, Dextromethorphan, and Caffeine) With and Without Coadministration of Belatacept - PK Evaluable Population
Omeprazole (N= 22, 19, 21, 18)
1.19 h
Standard Deviation 0.497
1.39 h
Standard Deviation 0.569
1.28 h
Standard Deviation 0.470
1.36 h
Standard Deviation 0.907

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Samples for assessment of plasma concentrations of Inje cocktail components (midazolam, losartan, omeprazole, dextromethorphan and caffeine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. The poor metabolizer of CYP2D6 was excluded from summary of dextromethorphan parameters. Inje cocktail components were each measured using HPLC with MS/MS detection. CLT/F was measured as liters/hour (L/h)

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Apparent Total Body Clearance (CLT/F) of the Inje Cocktail Components (Midazolam, Losartan, Omeprazole, Dextromethorphan and Caffeine) With and Without Coadministration of Belatacept - PK Evaluable Population
Midazolam (N=22, 21, 21, 20)
73.8 L/h
Geometric Coefficient of Variation 49
71.3 L/h
Geometric Coefficient of Variation 48
77.3 L/h
Geometric Coefficient of Variation 50
71.4 L/h
Geometric Coefficient of Variation 51
Apparent Total Body Clearance (CLT/F) of the Inje Cocktail Components (Midazolam, Losartan, Omeprazole, Dextromethorphan and Caffeine) With and Without Coadministration of Belatacept - PK Evaluable Population
Losartan (N=22, 21, 21, 20)
148 L/h
Geometric Coefficient of Variation 37
146 L/h
Geometric Coefficient of Variation 36
146 L/h
Geometric Coefficient of Variation 34
151 L/h
Geometric Coefficient of Variation 44
Apparent Total Body Clearance (CLT/F) of the Inje Cocktail Components (Midazolam, Losartan, Omeprazole, Dextromethorphan and Caffeine) With and Without Coadministration of Belatacept - PK Evaluable Population
Omeprazole (N=22, 19, 21, 18)
29.2 L/h
Geometric Coefficient of Variation 66
23.7 L/h
Geometric Coefficient of Variation 72
24.7 L/h
Geometric Coefficient of Variation 79
25.3 L/h
Geometric Coefficient of Variation 69
Apparent Total Body Clearance (CLT/F) of the Inje Cocktail Components (Midazolam, Losartan, Omeprazole, Dextromethorphan and Caffeine) With and Without Coadministration of Belatacept - PK Evaluable Population
Dextromethorphan (N=18,17,18,18)
3916 L/h
Geometric Coefficient of Variation 85
4247 L/h
Geometric Coefficient of Variation 84
4264 L/h
Geometric Coefficient of Variation 126
3968 L/h
Geometric Coefficient of Variation 107
Apparent Total Body Clearance (CLT/F) of the Inje Cocktail Components (Midazolam, Losartan, Omeprazole, Dextromethorphan and Caffeine) With and Without Coadministration of Belatacept - PK Evaluable Population
Caffeine (N=22, 21, 21, 18)
4.99 L/h
Geometric Coefficient of Variation 34
5.30 L/h
Geometric Coefficient of Variation 32
4.97 L/h
Geometric Coefficient of Variation 36
4.83 L/h
Geometric Coefficient of Variation 36

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Samples for assessment of plasma concentrations of Inje cocktail component metabolites (1'-hydroxy-midazolam, E-3174, 5-hydroxyomeprazole, dextrorphan, and paraxanthine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. The poor metabolizer of CYP2D6 was excluded from summary of Dextrorphan parameters. Inje cocktail component metabolites were each measured using HPLC with MS/MS detection. Cmax was measured in ng/mL.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Cmax of Inje Cocktail Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without Coadministration of Belatacept - PK Evaluable Population
1'-Hydroxy-Midazolam (N=22, 21, 21, 20)
11.1 ng/mL
Geometric Coefficient of Variation 40
11.9 ng/mL
Geometric Coefficient of Variation 40
11.4 ng/mL
Geometric Coefficient of Variation 38
12.3 ng/mL
Geometric Coefficient of Variation 36
Cmax of Inje Cocktail Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without Coadministration of Belatacept - PK Evaluable Population
E-3174 (N=22, 21, 21, 20)
262 ng/mL
Geometric Coefficient of Variation 37
276 ng/mL
Geometric Coefficient of Variation 33
300 ng/mL
Geometric Coefficient of Variation 33
291 ng/mL
Geometric Coefficient of Variation 41
Cmax of Inje Cocktail Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without Coadministration of Belatacept - PK Evaluable Population
5-Hydroxyomeprazole (N=22, 21, 21, 20)
335 ng/mL
Geometric Coefficient of Variation 41
360 ng/mL
Geometric Coefficient of Variation 40
332 ng/mL
Geometric Coefficient of Variation 38
337 ng/mL
Geometric Coefficient of Variation 38
Cmax of Inje Cocktail Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without Coadministration of Belatacept - PK Evaluable Population
Dextrorphan (N=21,20,20,19)
342 ng/mL
Geometric Coefficient of Variation 30
324 ng/mL
Geometric Coefficient of Variation 32
312 ng/mL
Geometric Coefficient of Variation 31
331 ng/mL
Geometric Coefficient of Variation 35
Cmax of Inje Cocktail Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without Coadministration of Belatacept - PK Evaluable Population
Paraxanthine (N=17,19,18,18)
1291 ng/mL
Geometric Coefficient of Variation 15
1367 ng/mL
Geometric Coefficient of Variation 12
1320 ng/mL
Geometric Coefficient of Variation 13
1358 ng/mL
Geometric Coefficient of Variation 15

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Area under the plasma concentration-time curve from zero to the last time of the last quantifiable concentration \[AUC(0-T)\] was measured in ng\*h/mL. Samples for assessment of plasma concentrations of Inje cocktail components metabolites (1'-hydroxy-midazolam, E-3174, 5-hydroxyomeprazole, dextrorphan, and paraxanthine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. The poor metabolizer of CYP2D6 was excluded from summary of Dextrorphan parameters. Inje cocktail components were each measured using HPLC with MS/MS detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
AUC(0-T) of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without Coadministration of Belatacept - PK Evaluable Population
1'-hydroxy-midazolam (N=22, 21, 21, 20)
28.9 ng*h/mL
Geometric Coefficient of Variation 39
31.8 ng*h/mL
Geometric Coefficient of Variation 30
32.5 ng*h/mL
Geometric Coefficient of Variation 32
33.6 ng*h/mL
Geometric Coefficient of Variation 27
AUC(0-T) of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without Coadministration of Belatacept - PK Evaluable Population
E-3174 (N= 22,21,21,20)
1995 ng*h/mL
Geometric Coefficient of Variation 32
1999 ng*h/mL
Geometric Coefficient of Variation 29
2089 ng*h/mL
Geometric Coefficient of Variation 30
2072 ng*h/mL
Geometric Coefficient of Variation 37
AUC(0-T) of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without Coadministration of Belatacept - PK Evaluable Population
5-hydroxyomeprazole (N=22,21,21,20)
997 ng*h/mL
Geometric Coefficient of Variation 36
967 ng*h/mL
Geometric Coefficient of Variation 33
929 ng*h/mL
Geometric Coefficient of Variation 35
995 ng*h/mL
Geometric Coefficient of Variation 35
AUC(0-T) of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without Coadministration of Belatacept - PK Evaluable Population
dextrorphan (N=21,20,20,19)
1636 ng*h/mL
Geometric Coefficient of Variation 27
1570 ng*h/mL
Geometric Coefficient of Variation 26
1519 ng*h/mL
Geometric Coefficient of Variation 27
1644 ng*h/mL
Geometric Coefficient of Variation 26
AUC(0-T) of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without Coadministration of Belatacept - PK Evaluable Population
paraxanthine (N=17,19,18,18)
20592 ng*h/mL
Geometric Coefficient of Variation 15
21077 ng*h/mL
Geometric Coefficient of Variation 16
20680 ng*h/mL
Geometric Coefficient of Variation 18
21353 ng*h/mL
Geometric Coefficient of Variation 20

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Area under the plasma concentration-time curve from time zero extrapolated to infinite time \[AUC(INF)\] was measured in ng\*h/mL. Samples for assessment of plasma concentrations of Inje cocktail components metabolites (1'-hydroxy-midazolam, E-3174, 5-hydroxyomeprazole, dextrorphan, and paraxanthine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. The poor metabolizer of CYP2D6 was excluded from summary of Dextrorphan parameters. Inje cocktail components were each measured using HPLC with MS/MS detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
AUC(INF) of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without Coadministration of Belatacept - PK Evaluable Population
1'-hydroxy-midazolam (N=22,21,20,20)
30.5 ng*h/mL
Geometric Coefficient of Variation 38
33.8 ng*h/mL
Geometric Coefficient of Variation 32
32.9 ng*h/mL
Geometric Coefficient of Variation 27
35.1 ng*h/mL
Geometric Coefficient of Variation 27
AUC(INF) of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without Coadministration of Belatacept - PK Evaluable Population
E-3174 (N=22,20,21,20)
2103 ng*h/mL
Geometric Coefficient of Variation 32
2060 ng*h/mL
Geometric Coefficient of Variation 29
2187 ng*h/mL
Geometric Coefficient of Variation 31
2182 ng*h/mL
Geometric Coefficient of Variation 38
AUC(INF) of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without Coadministration of Belatacept - PK Evaluable Population
5-hydroxyomeprazole (N=22,20,21,17
1010 ng*h/mL
Geometric Coefficient of Variation 36
990 ng*h/mL
Geometric Coefficient of Variation 34
938 ng*h/mL
Geometric Coefficient of Variation 35
1063 ng*h/mL
Geometric Coefficient of Variation 32
AUC(INF) of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without Coadministration of Belatacept - PK Evaluable Population
dextrorphan (N=21,20,20,19)
1679 ng*h/mL
Geometric Coefficient of Variation 25
1610 ng*h/mL
Geometric Coefficient of Variation 25
1562 ng*h/mL
Geometric Coefficient of Variation 26
1682 ng*h/mL
Geometric Coefficient of Variation 25
AUC(INF) of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without Coadministration of Belatacept - PK Evaluable Population
paraxanthine (N=7,8,6,6)
22401 ng*h/mL
Geometric Coefficient of Variation 18
22905 ng*h/mL
Geometric Coefficient of Variation 24
22063 ng*h/mL
Geometric Coefficient of Variation 12
21874 ng*h/mL
Geometric Coefficient of Variation 20

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Samples for assessment of plasma concentrations of Inje cocktail components metabolites (1'-hydroxy-midazolam, E-3174, 5-hydroxyomeprazole, dextrorphan, and paraxanthine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. The poor metabolizer of CYP2D6 was excluded from summary of Dextrorphan parameters. Inje cocktail components were each measured using HPLC with MS/MS detection. Time of maximum observed plasma concentration (Tmax) was measured in hours (h).

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Tmax of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without the Coadministration of Belatacept - PK Evaluable Population
1'-Hydroxy-Midazolam (N=22,21,21,20)
1.00 h
Interval 0.5 to 1.5
1.00 h
Interval 0.5 to 2.0
1.00 h
Interval 0.5 to 1.5
1.00 h
Interval 0.5 to 1.5
Tmax of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without the Coadministration of Belatacept - PK Evaluable Population
E-3174 (N=22, 21, 21, 20)
4.00 h
Interval 3.0 to 5.03
4.00 h
Interval 2.0 to 8.0
4.00 h
Interval 3.0 to 5.15
4.00 h
Interval 3.0 to 6.02
Tmax of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without the Coadministration of Belatacept - PK Evaluable Population
5-Hydroxyomeprazole (N=22,21,21,20)
2.00 h
Interval 1.5 to 5.0
3.00 h
Interval 1.0 to 8.05
3.00 h
Interval 1.0 to 5.0
2.53 h
Interval 1.0 to 12.0
Tmax of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without the Coadministration of Belatacept - PK Evaluable Population
Dextrorphan (N=21,20,20,19)
2.00 h
Interval 1.5 to 4.0
2.00 h
Interval 1.5 to 4.0
2.00 h
Interval 1.5 to 3.0
2.00 h
Interval 1.5 to 4.0
Tmax of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without the Coadministration of Belatacept - PK Evaluable Population
Paraxanthine (N=17, 19, 18, 18)
8.00 h
Interval 3.0 to 12.02
8.00 h
Interval 5.0 to 12.0
8.00 h
Interval 4.0 to 12.0
8.00 h
Interval 4.0 to 12.0

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Plasma half-life (T-HALF) was measured in hours (h). Samples for assessment of plasma concentrations of Inje cocktail components metabolites (1'-hydroxy-midazolam, E-3174, 5-hydroxyomeprazole, dextrorphan, and paraxanthine) were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. The poor metabolizer of CYP2D6 was excluded from summary of Dextrorphan parameters. Inje cocktail components were each measured using HPLC with MS/MS detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
T-HALF of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without the Coadministration of Belatacept - PK Evaluable Population
1'-Hydroxy-Midazolam (N=22,21,20,20)
5.29 h
Standard Deviation 2.98
6.35 h
Standard Deviation 3.60
5.61 h
Standard Deviation 3.47
5.31 h
Standard Deviation 2.65
T-HALF of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without the Coadministration of Belatacept - PK Evaluable Population
E-3174 (N=22, 20, 21, 20)
4.86 h
Standard Deviation 0.749
4.57 h
Standard Deviation 0.757
4.75 h
Standard Deviation 0.757
4.88 h
Standard Deviation 0.690
T-HALF of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without the Coadministration of Belatacept - PK Evaluable Population
5-Hydroxyomeprazole (N=22,20,21,17)
1.43 h
Standard Deviation 0.308
1.55 h
Standard Deviation 0.397
1.52 h
Standard Deviation 0.371
1.54 h
Standard Deviation 0.624
T-HALF of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without the Coadministration of Belatacept - PK Evaluable Population
Dextrorphan (N=21,20,20,19)
4.26 h
Standard Deviation 1.60
4.36 h
Standard Deviation 1.46
4.23 h
Standard Deviation 1.13
4.08 h
Standard Deviation 0.999
T-HALF of Inje Cocktail Component Metabolites (1'-Hydroxy-Midazolam, E-3174, 5-Hydroxyomeprazole, Dextrorphan, and Paraxanthine) With and Without the Coadministration of Belatacept - PK Evaluable Population
Paraxanthine (N=7,8,6,6)
7.33 h
Standard Deviation 1.91
6.86 h
Standard Deviation 1.71
7.33 h
Standard Deviation 1.55
7.44 h
Standard Deviation 2.67

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Metabolite (paraxanthine) to parent (caffeine) ratio was corrected for molecular weight. AUC (0-T) and AUC (INF) measured in ng\*h/mL. Samples for assessment of plasma concentrations of Inje cocktail components and the metabolites of those components were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Inje cocktail components were each measured using HPLC with MS/MS detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=17 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=19 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=18 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=18 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Ratio of Paraxanthine AUC(0-T) to Caffeine AUC(0-T) and Paraxanthine AUC (INF) to Caffeine AUC (INF), Corrected for Molecular Weight [MR_AUC(0-T) and MR_AUC (INF)] With and Without Coadministration of Belatacept - PK Evaluable Population
MR_AUC(0-T) ratio; N=17,19,18,18
0.627 ratio
Geometric Coefficient of Variation 24
0.677 ratio
Geometric Coefficient of Variation 17
0.635 ratio
Geometric Coefficient of Variation 20
0.603 ratio
Geometric Coefficient of Variation 21
Ratio of Paraxanthine AUC(0-T) to Caffeine AUC(0-T) and Paraxanthine AUC (INF) to Caffeine AUC (INF), Corrected for Molecular Weight [MR_AUC(0-T) and MR_AUC (INF)] With and Without Coadministration of Belatacept - PK Evaluable Population
MR_AUC(INF) ratio; N=7, 8, 6, 6
0.827 ratio
Geometric Coefficient of Variation 15
0.827 ratio
Geometric Coefficient of Variation 8
0.799 ratio
Geometric Coefficient of Variation 14
0.781 ratio
Geometric Coefficient of Variation 12

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Metabolite (paraxanthine) to parent (caffeine) ratio was corrected for molecular weight. Cmax measured in ng/mL. Samples for assessment of plasma concentrations of Inje cocktail components and their metabolites were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Inje cocktail components were each measured using HPLC with MS/MS detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=17 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=19 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=18 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=18 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Ratio of Paraxanthine (Cmax) to Caffeine (Cmax), Corrected for Molecular Weight (MR_Cmax) With and Without Coadministration of Belatacept - PK Evaluable Population
0.303 ratio
Geometric Coefficient of Variation 22
0.337 ratio
Geometric Coefficient of Variation 15
0.333 ratio
Geometric Coefficient of Variation 23
0.323 ratio
Geometric Coefficient of Variation 20

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Metabolite (E-3174) to parent (losartan) ratio was corrected for molecular weight. AUC (0-T) and AUC (INF) measured in ng\*h/mL. Samples for assessment of plasma concentrations of Inje cocktail components and the metabolites of those components were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Inje cocktail components were each measured using HPLC with MS/MS detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Ratio of E-3174 AUC(0-T) to Losartan AUC(0-T) and E3174 AUC (INF) to Losartan AUC (INF) Corrected for Molecular Weight [MR_AUC(0-T), MR_AUC(INF)] With and Without Coadministration of Belatacept - PK Evaluable Population
MR_AUC (0-T) ratio; N=22,21,21,20
5.81 ratio
Geometric Coefficient of Variation 32
5.75 ratio
Geometric Coefficient of Variation 33
5.99 ratio
Geometric Coefficient of Variation 33
6.17 ratio
Geometric Coefficient of Variation 33
Ratio of E-3174 AUC(0-T) to Losartan AUC(0-T) and E3174 AUC (INF) to Losartan AUC (INF) Corrected for Molecular Weight [MR_AUC(0-T), MR_AUC(INF)] With and Without Coadministration of Belatacept - PK Evaluable Population
MR_AUC (INF) ratio; N=22,20,21,20
6.02 ratio
Geometric Coefficient of Variation 30
5.99 ratio
Geometric Coefficient of Variation 32
6.16 ratio
Geometric Coefficient of Variation 32
6.37 ratio
Geometric Coefficient of Variation 31

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Metabolite (E-3174) to parent (losartan) ratio was corrected for molecular weight. Cmax measured in ng/mL. Samples for assessment of plasma concentrations of Inje cocktail components and the metabolites of those components were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Inje cocktail components were each measured using HPLC with MS/MS detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Ratio of E-3174 (Cmax) to Losartan (Cmax), Corrected for Molecular Weight (MR_Cmax) With and Without Coadministration of Belatacept - PK Evaluable Population
2.31 ratio
Geometric Coefficient of Variation 39
2.24 ratio
Geometric Coefficient of Variation 45
2.26 ratio
Geometric Coefficient of Variation 43
2.26 ratio
Geometric Coefficient of Variation 45

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Metabolite (5-Hydroxyomeprazole) to parent (omeprazole) ratio was corrected for molecular weight. AUC (0-T) and AUC (INF) measured in ng\*h/mL. Samples for assessment of plasma concentrations of Inje cocktail components and the metabolites of those components were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Inje cocktail components were each measured using HPLC with MS/MS detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Ratio of 5-Hydroxyomeprazole AUC(0-T) to Omeprazole AUC(0-T) and 5-Hydroxyomeprazole AUC(INF) to Omeprazole AUC(INF) , Corrected for Molecular Weight [MR_AUC(0-T), MR_AUC(INF)] With and Without Coadministration of Belatacept - PK Evaluable Population
MR_AUC (0-T) ratio; N=22,21,21,20
0.700 ratio
Geometric Coefficient of Variation 57
0.609 ratio
Geometric Coefficient of Variation 66
0.551 ratio
Geometric Coefficient of Variation 70
0.610 ratio
Geometric Coefficient of Variation 66
Ratio of 5-Hydroxyomeprazole AUC(0-T) to Omeprazole AUC(0-T) and 5-Hydroxyomeprazole AUC(INF) to Omeprazole AUC(INF) , Corrected for Molecular Weight [MR_AUC(0-T), MR_AUC(INF)] With and Without Coadministration of Belatacept - PK Evaluable Population
MR_AUC (INF) ratio; N=22,19,21,17
0.705 ratio
Geometric Coefficient of Variation 56
0.558 ratio
Geometric Coefficient of Variation 61
0.553 ratio
Geometric Coefficient of Variation 69
0.679 ratio
Geometric Coefficient of Variation 62

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Metabolite (5-hydroxyomeprazole) to parent (omeprazole) ratio was corrected for molecular weight. Cmax measured in ng/mL. Samples for assessment of plasma concentrations of Inje cocktail components and the metabolites of those components were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Inje cocktail components were each measured using HPLC with MS/MS detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Ratio of 5-Hydroxyomeprazole (Cmax) to Omeprazole (Cmax), Corrected for Molecular Weight (MR_Cmax) With and Without Coadministration of Belatacept - PK Evaluable Population
0.548 ratio
Geometric Coefficient of Variation 54
0.471 ratio
Geometric Coefficient of Variation 60
0.424 ratio
Geometric Coefficient of Variation 65
0.478 ratio
Geometric Coefficient of Variation 59

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Metabolite (5-dextrorphan ) to parent (dextromethorphan) ratio was corrected for molecular weight. AUC (0-T) and AUC (INF) measured in ng\*h/mL. Samples for assessment of plasma concentrations of Inje cocktail components and the metabolites of those components were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. The poor metabolizer of CYP2D6 was excluded from summary of Dextrorphan parameters. Inje cocktail components were each measured using HPLC with MS/MS detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=19 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Ratio of 5-Dextrorphan AUC(0-T) to Dextromethorphan AUC(0-T) and 5-Dextrorphan AUC(INF) to Dextromethorphan AUC(INF), Corrected for Molecular Weight [MR_AUC(0-T), MR_AUC (INF)] With and Without Coadministration of Belatacept - PK Evaluable Population
MR_AUC (0-T) ratio; N=21,20,20,19
201 ratio
Geometric Coefficient of Variation 103
200 ratio
Geometric Coefficient of Variation 94
177 ratio
Geometric Coefficient of Variation 124
193 ratio
Geometric Coefficient of Variation 99
Ratio of 5-Dextrorphan AUC(0-T) to Dextromethorphan AUC(0-T) and 5-Dextrorphan AUC(INF) to Dextromethorphan AUC(INF), Corrected for Molecular Weight [MR_AUC(0-T), MR_AUC (INF)] With and Without Coadministration of Belatacept - PK Evaluable Population
MR_AUC (INF) ratio; N=18,17,18,15
173 ratio
Geometric Coefficient of Variation 95
177 ratio
Geometric Coefficient of Variation 90
170 ratio
Geometric Coefficient of Variation 122
173 ratio
Geometric Coefficient of Variation 102

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Metabolite (5-dextrorphan) to parent (dextromethorphan) ratio was corrected for molecular weight. Cmax measured in ng/mL. Samples for assessment of plasma concentrations of Inje cocktail components and the metabolites of those components were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. The poor metabolizer of CYP2D6 was excluded from summary of Dextrorphan parameters. Inje cocktail components were each measured using HPLC with MS/MS detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=19 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Ratio of 5-Dextrorphan (Cmax) to Dextromethorphan (Cmax), Corrected for Molecular Weight (MR_Cmax) With and Without Coadministration of Belatacept - PK Evaluable Population
280 ratio
Geometric Coefficient of Variation 107
303 ratio
Geometric Coefficient of Variation 99
275 ratio
Geometric Coefficient of Variation 88
303 ratio
Geometric Coefficient of Variation 84

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Metabolite (1'-hydroxy-midazolam) to parent (midazolam) ratio was corrected for molecular weight. AUC (0-T) and AUC (INF) measured in ng\*h/mL. Samples for assessment of plasma concentrations of Inje cocktail components and the metabolites of those components were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Inje cocktail components were each measured using HPLC with MS/MS detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Ratio of 1'-Hydroxy-Midazolam AUC(0-T) to Midazolam AUC(0-T) and 1'-Hydroxy-Midazolam AUC(INF) to Midazolam AUC(INF), Corrected for Molecular Weight [MR_AUC(0-T), MR_AUC (INF)] With and Without Coadministration of Belatacept - PK Evaluable Population
MR_AUC (0-T) ratio; N=22, 21, 21, 20
0.421 ratio
Geometric Coefficient of Variation 56
0.447 ratio
Geometric Coefficient of Variation 46
0.495 ratio
Geometric Coefficient of Variation 55
0.472 ratio
Geometric Coefficient of Variation 55
Ratio of 1'-Hydroxy-Midazolam AUC(0-T) to Midazolam AUC(0-T) and 1'-Hydroxy-Midazolam AUC(INF) to Midazolam AUC(INF), Corrected for Molecular Weight [MR_AUC(0-T), MR_AUC (INF)] With and Without Coadministration of Belatacept - PK Evaluable Population
MR_(INF) ratio; N=22, 21, 20, 20
0.428 ratio
Geometric Coefficient of Variation 57
0.460 ratio
Geometric Coefficient of Variation 47
0.479 ratio
Geometric Coefficient of Variation 52
0.478 ratio
Geometric Coefficient of Variation 55

SECONDARY outcome

Timeframe: Pre-dose to 24 hours after dose of the Inje Cocktail on Days 1, 4, 7 and 11

Population: Evaluable PK population: Participants who received any study drug and had at least 1 adequate PK profile for any Inje cocktail analytes (parent or metabolite).

Metabolite (1'-hydroxy-midazolam) to parent (midazolam) ratio was corrected for molecular weight. Cmax measured in ng/mL. Samples for assessment of plasma concentrations of Inje cocktail components and the metabolites of those components were collected at time = 0 (predose), 0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 12, and 24 hours relative to the dosing of belatacept on Day 4 and Inje cocktail dosing on Days 1, 4, 7, and 11, respectively. Inje cocktail components were each measured using HPLC with MS/MS detection.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Ratio of 1'-Hydroxy-Midazolam (Cmax) to Midazolam (Cmax), Corrected for Molecular Weight (MR_Cmax) With and Without Coadministration of Belatacept - PK Evaluable Population
0.432 ratio
Geometric Coefficient of Variation 45
0.476 ratio
Geometric Coefficient of Variation 44
0.497 ratio
Geometric Coefficient of Variation 46
0.490 ratio
Geometric Coefficient of Variation 46

SECONDARY outcome

Timeframe: Day 1 to Day of discharge (Day 46±2)

Population: All participants who received any study medication.

Adverse events were coded according to the Medical Dictionary for Regulatory Activities (MedDRA), version 15.1. AE=any new unfavorable symptom, sign, or disease or worsening of a preexisting condition that may not have a causal relationship with treatment. SAE=a medical event that at any dose results in death, persistent or significant disability/incapacity, or drug dependency/abuse; is life-threatening, an important medical event, or a congenital anomaly/birth defect; or requires or prolongs hospitalization. Events captured from Day 1 (pre-dose) to last day prior to discharge (Day 46 ±2). In the total group, a participant with an AE is only counted once (ie, data reflected in Days 1, 4, 7, and 11 below could be the same participant with an AE on multiple days of the study).

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
n=22 Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Number of Participants With Adverse Events (AEs), Serious AEs (SAEs), Deaths, and AEs Leading to Discontinuation - All Treated Participants
Adverse Events
4 participants
2 participants
1 participants
1 participants
5 participants
Number of Participants With Adverse Events (AEs), Serious AEs (SAEs), Deaths, and AEs Leading to Discontinuation - All Treated Participants
SAEs
0 participants
0 participants
0 participants
0 participants
0 participants
Number of Participants With Adverse Events (AEs), Serious AEs (SAEs), Deaths, and AEs Leading to Discontinuation - All Treated Participants
Deaths
0 participants
0 participants
0 participants
0 participants
0 participants
Number of Participants With Adverse Events (AEs), Serious AEs (SAEs), Deaths, and AEs Leading to Discontinuation - All Treated Participants
AEs leading to discontinuation
0 participants
0 participants
1 participants
0 participants
1 participants

SECONDARY outcome

Timeframe: Day -1 to Day 46 ±2 days or at early termination

Population: Participants who received any study medication and had laboratory test results.

Samples for laboratory tests were obtained at Screening visit, Day -1 or prior to dosing on Day 1, Days 3, 6, 10, 46, and at early termination, after 10 hours fasting. Upper limits of normal (ULN); Lower limits of normal (LLN); Pre-therapy (Rx); micromoles per liter (µmol/L); millimoles per liter (mmol/L); grams per liter (g/L); Units per liter (U/L); Aspartate Aminotransferase (AST); Blood Urea Nitrogen (BUN) Total Bilirubin: \>1.1\*ULN if Pre-Rx\<= ULN or Pre-Rx is missing, or \>1.2\*Pre-Rx if Pre-Rx \>ULN. AST: \>1.25\*Pre-Rx if Pre-Rx \>ULN or 1.25\*ULN if Pre-Rx \<= ULN or Pre-Rx is missing. BUN: \>1.1\*ULN if Pre-Rx\<= ULN or Pre-Rx is missing, or \>1.2\*Pre-Rx if Pre-Rx \>ULN. Phosphorus: \<0.85\*LLN if Pre-RX \>= LLN or is missing or if Pre-Rx \< LLN. total Protein: \<0.9\*LLN if Pre-Rx\>= LLN or is missing or Pre-Rx \> LLN. Creatine Kinase: \>1.5\*Pre-Rx if Pre-Rx \> ULN or is missing or Pre-Rx is \<= ULN. Lactate Dehydrogenase: \>1.25\*ULN if Pre-Rx \<= ULN or missing, \>1.5\*Pre-Rx if Pre-Rx \> ULN.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Number of Participants With Marked Serum Chemistry Laboratory Abnormalities - All Treated Participants
Total bilirubin >1.1*ULN µmol/L (N=22)
1 participants
Number of Participants With Marked Serum Chemistry Laboratory Abnormalities - All Treated Participants
AST >1.25*Pre-Rx U/L (N=22)
1 participants
Number of Participants With Marked Serum Chemistry Laboratory Abnormalities - All Treated Participants
BUN >1.1*ULN mmol/L (N=22)
1 participants
Number of Participants With Marked Serum Chemistry Laboratory Abnormalities - All Treated Participants
Inorganic Phosphorus <0.85*LLN mmol/L (N=22)
1 participants
Number of Participants With Marked Serum Chemistry Laboratory Abnormalities - All Treated Participants
Total Protein <0.9*LLN g/L (N=22)
1 participants
Number of Participants With Marked Serum Chemistry Laboratory Abnormalities - All Treated Participants
Creatine Kinase > 1.5* Pre-Rx U/L (N=22)
2 participants
Number of Participants With Marked Serum Chemistry Laboratory Abnormalities - All Treated Participants
Lactate Dehydrogenase >1.25*ULN U/L (N=22)
1 participants

SECONDARY outcome

Timeframe: Day -1 to Day 46 ±2 days or at early termination

Population: Participants who received any study medication and had laboratory test results.

Samples for laboratory tests were obtained at Screening visit, Day -1 or prior to dosing on Day 1, Days 3, 6, 10, 46 ±2, and at early termination, after 10 hours fasting. Leukocytes: \*10\^9 cells per liter (c/L) \< 0.85\*Pre-Rx if Pre-Rx \< LLN or \<0.9\*LLN if LLN \<= Pre-Rx or Pre-Rx is missing. Neutrophils (absolute): \*10\^12 c/L \< 0.85\* Pre-Rx if Pre-Rx \< 1.5, \<1.5 if Pre-Rx \>= 1.5, \< 1.5 if Pre-Rx missing. Urine blood from dipstick: \>=2 if Pre-Rx \<1 or was missing or if Pre-Rx \>=1. Urinary microscopic white blood cells (WBC) and red blood cells (RBC) \>= 2 if Pre-Rx \<2 or if Pre-Rx was missing or \>=4 if Pre-Rx \>=2.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Number of Participants With Marked Hematology and Urinalysis Laboratory Abnormalities - All Treated Participants
Leukocytes <0.85*Pre-Rx *10^9 c/L (N=22)
1 participants
Number of Participants With Marked Hematology and Urinalysis Laboratory Abnormalities - All Treated Participants
Neutrophils <0.85*Pre-Rx *10^12 c/L (N=22)
4 participants
Number of Participants With Marked Hematology and Urinalysis Laboratory Abnormalities - All Treated Participants
Urine Blood >= 2 (N=22)
2 participants
Number of Participants With Marked Hematology and Urinalysis Laboratory Abnormalities - All Treated Participants
Urinary RBC microscopic >= 2 (N=8)
1 participants
Number of Participants With Marked Hematology and Urinalysis Laboratory Abnormalities - All Treated Participants
Urinary WBC microscopic >= 2 (N=8)
1 participants

SECONDARY outcome

Timeframe: Day 1 to Day 46 ±2 days or at early termination

Population: All participants who received any study medication and had an ECG performed on Day 1, Day 46 or early termination.

Participants had 12-Lead electrocardiograms (ECGs) performed at Screening Visit, Day 1 prior to dosing, Day 46 ±2, and at early termination. Definition of out-of-range: PR Interval \>210 milliseconds (msec); QRS \> 120 msec, QT \> 500 msec or \> 30 msec change from baseline (Day 1); QT with Fridericia correction (QTcF) \> 450 msec or change from baseline of \> 30 msec to \<= 60 msec or change from baseline \> 60 msec.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=18 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Number of Participants With Out-of-Range Electrocardiogram Intervals - All Treated Participants
Day 46 (N=18)
0 participants
Number of Participants With Out-of-Range Electrocardiogram Intervals - All Treated Participants
Early Termination (N=2)
0 participants

SECONDARY outcome

Timeframe: Baseline and 0.5 and 2.0 hours Post Dose on Days 1, 4, 7, and 11

Population: All participants who received any study medication and had a baseline and specific day blood pressure measurement available.

Systolic and Diastolic blood pressures were taken after the participant had been sitting quietly for at least 5 minutes and the pressures were measured in millimeters of mercury (mm Hg). Pressures were obtained at screening visit, Day -1, and at 0 hour (pre-dose), 0.5 hour (post dose), and 2 hours (post dose) on Days 1, 4, 7, 11. Baseline was defined as last non-missing result with a collection date-time less than the date-time of the first active dose of study drug.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Mean Change From Baseline in Sitting Systolic and Diastolic Blood Pressure - All Treated Participants
Systolic 0.5 hour post dose (N=22,21,21,20)
-0.6 mm Hg
Standard Deviation 10.15
0.1 mm Hg
Standard Deviation 12.81
-4.9 mm Hg
Standard Deviation 9.05
-4.7 mm Hg
Standard Deviation 10.13
Mean Change From Baseline in Sitting Systolic and Diastolic Blood Pressure - All Treated Participants
Systolic 2.0 hour post dose (N=22,21,21,20)
0.2 mm Hg
Standard Deviation 10.09
2.0 mm Hg
Standard Deviation 11.79
-2.7 mm Hg
Standard Deviation 9.85
-2.9 mm Hg
Standard Deviation 11.73
Mean Change From Baseline in Sitting Systolic and Diastolic Blood Pressure - All Treated Participants
Diastolic 0.5 hour post dose (N=22,21,21,20)
-1.7 mm Hg
Standard Deviation 6.52
-0.2 mm Hg
Standard Deviation 6.03
-2.2 mm Hg
Standard Deviation 7.54
-2.2 mm Hg
Standard Deviation 5.38
Mean Change From Baseline in Sitting Systolic and Diastolic Blood Pressure - All Treated Participants
Diastolic 2.0 hour post dose (N=22,21,21,20)
0.9 mm Hg
Standard Deviation 4.67
-2.0 mm Hg
Standard Deviation 4.53
-3.4 mm Hg
Standard Deviation 5.22
-1.0 mm Hg
Standard Deviation 5.83

SECONDARY outcome

Timeframe: Baseline and 0.5 and 2.0 hours Post Dose on Days 1, 4, 7, and 11

Population: All participants who received study medication and had baseline and specific day measurement.

Heart Rate was taken after the participant had been sitting quietly for at least 5 minutes and the heart rate was measured in beats per minute (bpm). Heart Rates were obtained at screening visit, Day -1, and at 0 hour (pre-dose), 0.5 hour (post dose), and 2 hours (post dose) on Days 1, 4, 7, 11. Baseline was defined as last non-missing result with a collection date-time less than the date-time of the first active dose of study drug.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=22 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
n=21 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
n=20 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Mean Change From Baseline in Sitting Heart Rate - All Treated Participants
Heart Rate 0.5 hour post dose (N=22, 21, 21, 20)
-3.3 bpm
Standard Deviation 12.38
-4.2 bpm
Standard Deviation 13.15
-1.8 bpm
Standard Deviation 12.58
-1.6 bpm
Standard Deviation 10.03
Mean Change From Baseline in Sitting Heart Rate - All Treated Participants
Heart Rate 2.0 hour post dose (N=22, 21, 21, 20)
-3.5 bpm
Standard Deviation 10.61
0.2 bpm
Standard Deviation 13.86
0.5 bpm
Standard Deviation 11.95
3.1 bpm
Standard Deviation 11.91

SECONDARY outcome

Timeframe: Baseline and Day 46 ±2 days

Population: All participants who had received study drug during the treatment period and had measurements at baseline and at discharge.

Systolic and Diastolic blood pressures were taken after the participant had been sitting quietly for at least 5 minutes and the pressures were measured in millimeters of mercury (mm Hg). Systolic and Diastolic blood pressures were taken on Day 46 (day of discharge from the study). Baseline was defined as last non-missing result with a collection date-time less than the date-time of the first active dose of study drug.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=18 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Mean Change From Baseline in Systolic and Diastolic Blood Pressure at Study Discharge (Day 46±2 Days)
Systolic (N=18)
-5.9 mm Hg
Standard Deviation 11.25
Mean Change From Baseline in Systolic and Diastolic Blood Pressure at Study Discharge (Day 46±2 Days)
Diastolic (N=18)
-5.7 mm Hg
Standard Deviation 8.87

SECONDARY outcome

Timeframe: Baseline and Day 46 ±2 days

Population: All participants who received study drug during the treatment period and had measurements at baseline and discharge.

Heart Rate was taken after the participant had been sitting quietly for at least 5 minutes and was measured in beats per minute (bpm). Hear rate was taken on Day 46 (day of discharge) during the follow up period. Baseline was defined as last non-missing result with a collection date-time less than the date-time of the first active dose of study drug.

Outcome measures

Outcome measures
Measure
Day 1 Inje Cocktail
n=18 Participants
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 1.
Day 4 Inje Cocktail Plus Belatacept
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 4. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered only on Day 4.
Day 7 Inje Cocktail
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 7.
Day 11 Inje Cocktail
Single oral dose of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) was administered on Day 11.
All Participants
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Mean Change From Baseline in Heart Rate at Study Discharge (Day 46±2 Days)
1.0 bpm
Standard Deviation 15.86

Adverse Events

Inje Cocktail Alone and Inje Cocktail Plus Belatacept

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Inje Cocktail Alone and Inje Cocktail Plus Belatacept
n=22 participants at risk
Single oral doses of Inje Cocktail consisting of: caffeine (200 mg), losartan (50 mg tablet), omeprazole (40 mg delayed-release capsule), dextromethorphan (30 mg), and midazolam (5 mg oral syrup) were administered on Days 1, 4, 7 and 11. A single 10 mg/kg intravenous (IV) infusion of belatacept over 30 minutes was administered on Day 4.
Nervous system disorders
Headache
13.6%
3/22 • Day 1 to Day of discharge (Day 46 ±2 days)

Additional Information

Bristol-Myers Squibb Study Director

Bristol-Myers Squibb

Results disclosure agreements

  • Principal investigator is a sponsor employee Bristol-Myers Squibb Co. agreements with investigators vary; constant is our right to embargo communications regarding trial results prior to public release for a period ≤60 days from submittal for review. We will not prohibit investigators from publishing, but will prohibit the disclosure of previously undisclosed confidential information other than study results, and request postponement of single-center publications until after disclosure of the clinical trial's primary publication.
  • Publication restrictions are in place

Restriction type: OTHER