Trial Outcomes & Findings for Bioequivalence Study of Two Different Formulations of N-acetyl-cysteine (NAC) (NCT NCT02265224)

NCT ID: NCT02265224

Last Updated: 2021-11-05

Results Overview

Cmax is the maximum concentration level of the drug reached in plasma.

Recruitment status

COMPLETED

Study phase

PHASE1

Target enrollment

48 participants

Primary outcome timeframe

0-24h (5,15, 30, 45, 60, 75, 90 min and 2, 3, 4, 6, 8, 12, 16 and 24 h postdose)

Results posted on

2021-11-05

Participant Flow

48 healthy subjects were included in the study, as planned, and received test and reference treatment according to the cross-over design.

Subjects were assigned to a sequence of treatments (TR or RT) according to the randomisation list. Randomisation number was given to the subjects on study day -1, Period 1, and was used to assign the treatment sequence according to the randomisation list. The randomisation list was computer-generated by the Contract Research Organisation (CRO) Biometry Unit, using the PLAN procedure of SAS® version 9.3 (TS1M1) (24). The randomisation list was supplied to the Phase I Unit before study start.

Participant milestones

Participant milestones
Measure
Enrolled Subjects Set
According to the crossover design, all the enrolled subjects received both NAC formulations based on the randomization schedule.Two single doses of 600 mg of NAC (one with test and one with reference formulation) were administered to each volunteer in two subsequent study periods (morning of day 1), separated by a wash-out interval of at least 5 days.
Overall Study
STARTED
48
Overall Study
COMPLETED
48
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Bioequivalence Study of Two Different Formulations of N-acetyl-cysteine (NAC)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Enrolled Subjects Set
n=48 Participants
According to the crossover design, all the enrolled subjects received both NAC formulations based on the randomization schedule. Two single doses of 600 mg of NAC (one with test and one with reference formulation) were administered to each volunteer in two subsequent study periods (morning of day 1), separated by a wash-out interval of at least 5 days.
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
48 Participants
n=5 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
Age, Continuous
42.6 years
STANDARD_DEVIATION 8.6 • n=5 Participants
Sex: Female, Male
Female
25 Participants
n=5 Participants
Sex: Female, Male
Male
23 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
0 Participants
n=5 Participants
Race (NIH/OMB)
White
47 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
Region of Enrollment
Switzerland
48 participants
n=5 Participants

PRIMARY outcome

Timeframe: 0-24h (5,15, 30, 45, 60, 75, 90 min and 2, 3, 4, 6, 8, 12, 16 and 24 h postdose)

Population: PK set: all randomised subjects who fulfilled the study protocol requirements in terms of investigational medicinal product intake and had evaluable PK data readouts for the planned treatment comparisons, with no major deviations that could affect the PK results.

Cmax is the maximum concentration level of the drug reached in plasma.

Outcome measures

Outcome measures
Measure
Test
n=48 Participants
N-acetylcysteine (NAC) 600 mg uncoated tablet (single dose). The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
Reference
n=48 Participants
N-acetylcysteine (NAC) 600 mg film-coated tablet (single dose). The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
Cmax of NAC After Single Dose Administration of Test and Reference
2804.38 ng/mL
Standard Deviation 899.47
3215.63 ng/mL
Standard Deviation 1382.02

PRIMARY outcome

Timeframe: 0-24h (5,15, 30, 45, 60, 75, 90 min and 2, 3, 4, 6, 8, 12, 16 and 24 h postdose)

Population: PK set: all randomised subjects who fulfilled the study protocol requirements in terms of investigational medicinal product intake and had evaluable PK data readouts for the planned treatment comparisons, with no major deviations that could affect the PK results.

AUC0-t is the Area under the concentration-time curve from time zero to time t, calculated with the linear trapezoidal summation from time 0 to the last measurable data point.

Outcome measures

Outcome measures
Measure
Test
n=48 Participants
N-acetylcysteine (NAC) 600 mg uncoated tablet (single dose). The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
Reference
n=48 Participants
N-acetylcysteine (NAC) 600 mg film-coated tablet (single dose). The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
AUC0-t of NAC After Single Dose Administration of Test and Reference
10637.87 ng/mL*h
Standard Deviation 3100.94
11773.11 ng/mL*h
Standard Deviation 3775.43

SECONDARY outcome

Timeframe: 0-24h (5,15, 30, 45, 60, 75, 90 min and 2, 3, 4, 6, 8, 12, 16 and 24 h postdose)

Population: PK set: all randomised subjects who fulfilled the study protocol requirements in terms of investigational medicinal product intake and had evaluable PK data readouts for the planned treatment comparisons, with no major deviations that could affect the PK results.

AUC0-∞ is the area under the concentration-time curve extrapolated to infinity, calculated, if feasible, as AUC0-t + Ct/λz, where Ct is the last measurable drug concentration.

Outcome measures

Outcome measures
Measure
Test
n=48 Participants
N-acetylcysteine (NAC) 600 mg uncoated tablet (single dose). The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
Reference
n=48 Participants
N-acetylcysteine (NAC) 600 mg film-coated tablet (single dose). The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
AUC0-∞ of NAC After Single Dose Administration of Test and Reference
12586.17 ng/mL*h
Standard Deviation 3577.24
13739.43 ng/mL*h
Standard Deviation 4190.59

SECONDARY outcome

Timeframe: 0-24h (5,15, 30, 45, 60, 75, 90 min and 2, 3, 4, 6, 8, 12, 16 and 24 h postdose)

time to achieve the maximum concentration level of the drug in plasma.

Outcome measures

Outcome measures
Measure
Test
n=48 Participants
N-acetylcysteine (NAC) 600 mg uncoated tablet (single dose). The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
Reference
n=48 Participants
N-acetylcysteine (NAC) 600 mg film-coated tablet (single dose). The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
Tmax of NAC After Single Dose Administration of Test and Reference
1.00 hours
Interval 0.5 to 3.0
1.00 hours
Interval 0.25 to 3.0

SECONDARY outcome

Timeframe: 0-24h (5,15, 30, 45, 60, 75, 90 min and 2, 3, 4, 6, 8, 12, 16 and 24 h postdose)

Population: PK set: all randomised subjects who fulfilled the study protocol requirements in terms of investigational medicinal product intake and had evaluable PK data readouts for the planned treatment comparisons, with no major deviations that could affect the PK results.

Half-life (t1/2) is the time to halve the plasma concentration level of the drug.

Outcome measures

Outcome measures
Measure
Test
n=48 Participants
N-acetylcysteine (NAC) 600 mg uncoated tablet (single dose). The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
Reference
n=48 Participants
N-acetylcysteine (NAC) 600 mg film-coated tablet (single dose). The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
t1/2 of NAC After Single Dose Administration of Test and Reference
14.11 hours
Standard Deviation 4.16
13.59 hours
Standard Deviation 2.69

SECONDARY outcome

Timeframe: 0-24h (5,15, 30, 45, 60, 75, 90 min and 2, 3, 4, 6, 8, 12, 16 and 24 h postdose)

Population: PK set: all randomised subjects who fulfilled the study protocol requirements in terms of investigational medicinal product intake and had evaluable PK data readouts for the planned treatment comparisons, with no major deviations that could affect the PK results.

Lambda zeta is the terminal elimination rate constant. Individual estimate of the terminal elimination rate constant can be calculated using log-linear regression of the terminal portions of the plasma concentration-versus-time curves.

Outcome measures

Outcome measures
Measure
Test
n=48 Participants
N-acetylcysteine (NAC) 600 mg uncoated tablet (single dose). The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
Reference
n=48 Participants
N-acetylcysteine (NAC) 600 mg film-coated tablet (single dose). The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
Lambda Zeta of NAC After Single Dose Administration of Test and Reference
0.05 1/h
Standard Deviation 0.01
0.05 1/h
Standard Deviation 0.01

SECONDARY outcome

Timeframe: 0-24h (5,15, 30, 45, 60, 75, 90 min and 2, 3, 4, 6, 8, 12, 16 and 24 h postdose)

Population: PK set: all randomised subjects who fulfilled the study protocol requirements in terms of investigational medicinal product intake and had evaluable PK data readouts for the planned treatment comparisons, with no major deviations that could affect the PK results.

Frel is the relative bioavailability, calculated as ratio AUC0-t (test)/ AUC0-t (reference)

Outcome measures

Outcome measures
Measure
Test
n=48 Participants
N-acetylcysteine (NAC) 600 mg uncoated tablet (single dose). The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
Reference
N-acetylcysteine (NAC) 600 mg film-coated tablet (single dose). The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
Frel of NAC After Single Dose Administration of Test and Reference
92.82 percentage
Standard Deviation 18.05

Adverse Events

Test - Reference

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Reference - Test

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Test - Reference
n=48 participants at risk
N-acetylcysteine (NAC) 600 mg uncoated tablet (single dose) followed by NAC 600 mg film-coated tablet (single dose) N-acetylcysteine: The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
Reference - Test
n=48 participants at risk
N-acetylcysteine (NAC) 600 mg film-coated tablet (single dose) followed by NAC 600 mg uncoated tablet (single dose) N-acetylcysteine: The product was administered according to the randomisation list and cross-over design, with 150 mL of still mineral water under fasting conditions on study day 1 of periods 1 or 2 at 8:00±1 h.
Nervous system disorders
Dizziness
4.2%
2/48 • Number of events 2 • From the beginning of screening days ( day -21 ) up to Final Visit (Day 2).
0.00%
0/48 • From the beginning of screening days ( day -21 ) up to Final Visit (Day 2).
Nervous system disorders
Headache
4.2%
2/48 • Number of events 2 • From the beginning of screening days ( day -21 ) up to Final Visit (Day 2).
0.00%
0/48 • From the beginning of screening days ( day -21 ) up to Final Visit (Day 2).
Gastrointestinal disorders
Nausea
2.1%
1/48 • Number of events 1 • From the beginning of screening days ( day -21 ) up to Final Visit (Day 2).
2.1%
1/48 • Number of events 1 • From the beginning of screening days ( day -21 ) up to Final Visit (Day 2).
Gastrointestinal disorders
Abdominal discomfort
0.00%
0/48 • From the beginning of screening days ( day -21 ) up to Final Visit (Day 2).
2.1%
1/48 • Number of events 1 • From the beginning of screening days ( day -21 ) up to Final Visit (Day 2).
Gastrointestinal disorders
Vomiting
2.1%
1/48 • Number of events 1 • From the beginning of screening days ( day -21 ) up to Final Visit (Day 2).
0.00%
0/48 • From the beginning of screening days ( day -21 ) up to Final Visit (Day 2).

Additional Information

Isabella Salerio, PhD

Zambon S.p.A.

Phone: +3902665241

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place