Trial Outcomes & Findings for A Study to Compare How Different Substances (Caffeine, Warfarin, Omeprazole, Metoprolol, and Midazolam) Are Handled by the Body of Healthy People and People With Liver Cirrhosis (NCT NCT05741385)

NCT ID: NCT05741385

Last Updated: 2025-09-10

Results Overview

Area under the concentration time curve of caffeine, omeprazole and metoprolol in plasma over the time interval from 0 to 24 hours (AUC0-24) is reported.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

4 participants

Primary outcome timeframe

2 hours before drug administration and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, 48-72 and 96 (+/-12) hours after drug administration.

Results posted on

2025-09-10

Participant Flow

The study aimed to investigate whether the metabolic activity of selected CYP isozymes differs between F4 liver cirrhosis patients receiving standard therapy and healthy subjects. It was planned that 12 healthy subjects, 12 compensated F4 Child-Pugh A patients and a minimum of 6 decompensated Child-Pugh B patients following clinical confirmation enter the study. Due to insufficient enrollment only 4 patients, all from Child-Pugh A cohort, were entered into the trial.

All subjects were screened for eligibility prior to participation in the trial. Subjects attended a specialist site which ensured that they (the subjects) strictly met all inclusion and none of the exclusion criteria. Subjects were not to be allocated to a treatment group if any of the entry criteria were violated

Participant milestones

Participant milestones
Measure
Child-Pugh A
Patients with compensated liver cirrhosis and advanced fibrosis grade F4 and hepatic impairment that met the criteria for Child-Pugh A received a drug cocktail of caffeine, warfarin, omeprazole, metoprolol and midazolam. The drug cocktail was given as single oral dose of 100 mg caffeine (2 tablets), 5 mg warfarin sodium (1 tablet), 20 mg omeprazole (1 tablet), 50 mg metoprolol (1 tablet) and 2 mg/mL oral solution midazolam, with 240 mL of water after a standardized breakfast on Day 1.
Overall Study
STARTED
4
Overall Study
COMPLETED
4
Overall Study
NOT COMPLETED
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

A Study to Compare How Different Substances (Caffeine, Warfarin, Omeprazole, Metoprolol, and Midazolam) Are Handled by the Body of Healthy People and People With Liver Cirrhosis

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Child-Pugh A
n=4 Participants
Patients with compensated liver cirrhosis and advanced fibrosis grade F4 and hepatic impairment that met the criteria for Child-Pugh A received a drug cocktail of caffeine, warfarin, omeprazole, metoprolol and midazolam. The drug cocktail was given as single oral dose of 100 mg caffeine (2 tablets), 5 mg warfarin sodium (1 tablet), 20 mg omeprazole (1 tablet), 50 mg metoprolol (1 tablet) and 2 mg/mL oral solution midazolam, with 240 mL of water after a standardized breakfast on Day 1.
Age, Continuous
66.8 Years
STANDARD_DEVIATION 7.1 • n=5 Participants
Sex: Female, Male
Female
3 Participants
n=5 Participants
Sex: Female, Male
Male
1 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
4 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 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
4 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

PRIMARY outcome

Timeframe: 2 hours before drug administration and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, 48-72 and 96 (+/-12) hours after drug administration.

Population: Pharmacokinetic parameter analysis set (PKS): All subjects in the treated set (TS) who provide at least one PK endpoint that was defined as primary and was not excluded due to a protocol deviation relevant to the evaluation of PK or due to PK non-evaluability.

Area under the concentration time curve of caffeine, omeprazole and metoprolol in plasma over the time interval from 0 to 24 hours (AUC0-24) is reported.

Outcome measures

Outcome measures
Measure
Child-Pugh A
n=4 Participants
Patients with compensated liver cirrhosis and advanced fibrosis grade F4 and hepatic impairment that met the criteria for Child-Pugh A received a drug cocktail of caffeine, warfarin, omeprazole, metoprolol and midazolam. The drug cocktail was given as single oral dose of 100 mg caffeine (2 tablets), 5 mg warfarin sodium (1 tablet), 20 mg omeprazole (1 tablet), 50 mg metoprolol (1 tablet) and 2 mg/mL oral solution midazolam, with 240 mL of water after a standardized breakfast on Day 1.
Area Under the Concentration Time Curve of Caffeine, Omeprazole and Metoprolol in Plasma Over the Time Interval From 0 to 24 Hours (AUC0-24)
Caffeine
20600 Hour*nanogram/milliliter
Geometric Coefficient of Variation 37.3
Area Under the Concentration Time Curve of Caffeine, Omeprazole and Metoprolol in Plasma Over the Time Interval From 0 to 24 Hours (AUC0-24)
Omeprazole
1520 Hour*nanogram/milliliter
Geometric Coefficient of Variation 164
Area Under the Concentration Time Curve of Caffeine, Omeprazole and Metoprolol in Plasma Over the Time Interval From 0 to 24 Hours (AUC0-24)
Metoprolol
287 Hour*nanogram/milliliter
Geometric Coefficient of Variation 71.1

PRIMARY outcome

Timeframe: 2 hours before drug administration and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, 48-72 and 96 (+/-12) hours after drug administration.

Population: Pharmacokinetic parameter analysis set (PKS): All subjects in the treated set (TS) who provide at least one PK endpoint that was defined as primary and was not excluded due to a protocol deviation relevant to the evaluation of PK or due to PK non-evaluability.

Area under the concentration time curve of midazolam in plasma over the time interval from 0 to 24 hours (AUC0-24) is reported.

Outcome measures

Outcome measures
Measure
Child-Pugh A
n=4 Participants
Patients with compensated liver cirrhosis and advanced fibrosis grade F4 and hepatic impairment that met the criteria for Child-Pugh A received a drug cocktail of caffeine, warfarin, omeprazole, metoprolol and midazolam. The drug cocktail was given as single oral dose of 100 mg caffeine (2 tablets), 5 mg warfarin sodium (1 tablet), 20 mg omeprazole (1 tablet), 50 mg metoprolol (1 tablet) and 2 mg/mL oral solution midazolam, with 240 mL of water after a standardized breakfast on Day 1.
Area Under the Concentration Time Curve of Midazolam in Plasma Over the Time Interval From 0 to 24 Hours (AUC0-24)
31200 Hour*picogram/milliliter
Geometric Coefficient of Variation 51.1

PRIMARY outcome

Timeframe: 2 hours before drug administration and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, 48-72 and 96 (+/-12) hours after drug administration.

Population: Pharmacokinetic parameter analysis set (PKS): All subjects in the treated set (TS) who provide at least one PK endpoint that was defined as primary and was not excluded due to a protocol deviation relevant to the evaluation of PK or due to PK non-evaluability.

Area under the concentration time curve of R-warfarin and S-warfarin in plasma over the time interval from 0 to 96 hours (AUC0-96) is reported.

Outcome measures

Outcome measures
Measure
Child-Pugh A
n=4 Participants
Patients with compensated liver cirrhosis and advanced fibrosis grade F4 and hepatic impairment that met the criteria for Child-Pugh A received a drug cocktail of caffeine, warfarin, omeprazole, metoprolol and midazolam. The drug cocktail was given as single oral dose of 100 mg caffeine (2 tablets), 5 mg warfarin sodium (1 tablet), 20 mg omeprazole (1 tablet), 50 mg metoprolol (1 tablet) and 2 mg/mL oral solution midazolam, with 240 mL of water after a standardized breakfast on Day 1.
Area Under the Concentration Time Curve of R-warfarin and S-warfarin in Plasma Over the Time Interval From 0 to 96 Hours (AUC0-96)
R-warfarin
11200 Hour*nanogram/milliliter
Geometric Coefficient of Variation 18.3
Area Under the Concentration Time Curve of R-warfarin and S-warfarin in Plasma Over the Time Interval From 0 to 96 Hours (AUC0-96)
S-warfarin
5350 Hour*nanogram/milliliter
Geometric Coefficient of Variation 24.7

PRIMARY outcome

Timeframe: 2 hours before drug administration and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, 48-72 and 96 (+/-12) hours after drug administration.

Population: Pharmacokinetic parameter analysis set (PKS): All subjects in the treated set (TS) who provide at least one PK endpoint that was defined as primary and was not excluded due to a protocol deviation relevant to the evaluation of PK or due to PK non-evaluability.

Maximum measured concentration of caffeine, omeprazole, metoprolol, R-warfarin and S-warfarin in plasma (Cmax) is reported.

Outcome measures

Outcome measures
Measure
Child-Pugh A
n=4 Participants
Patients with compensated liver cirrhosis and advanced fibrosis grade F4 and hepatic impairment that met the criteria for Child-Pugh A received a drug cocktail of caffeine, warfarin, omeprazole, metoprolol and midazolam. The drug cocktail was given as single oral dose of 100 mg caffeine (2 tablets), 5 mg warfarin sodium (1 tablet), 20 mg omeprazole (1 tablet), 50 mg metoprolol (1 tablet) and 2 mg/mL oral solution midazolam, with 240 mL of water after a standardized breakfast on Day 1.
Maximum Measured Concentration of Caffeine, Omeprazole, Metoprolol, R-warfarin and S-warfarin in Plasma (Cmax)
Caffeine
2650 Nanogram/milliliter
Geometric Coefficient of Variation 23.4
Maximum Measured Concentration of Caffeine, Omeprazole, Metoprolol, R-warfarin and S-warfarin in Plasma (Cmax)
Omeprazole
487 Nanogram/milliliter
Geometric Coefficient of Variation 67.9
Maximum Measured Concentration of Caffeine, Omeprazole, Metoprolol, R-warfarin and S-warfarin in Plasma (Cmax)
Metoprolol
73.9 Nanogram/milliliter
Geometric Coefficient of Variation 72.3
Maximum Measured Concentration of Caffeine, Omeprazole, Metoprolol, R-warfarin and S-warfarin in Plasma (Cmax)
R-warfarin
225 Nanogram/milliliter
Geometric Coefficient of Variation 26.3
Maximum Measured Concentration of Caffeine, Omeprazole, Metoprolol, R-warfarin and S-warfarin in Plasma (Cmax)
S-warfarin
226 Nanogram/milliliter
Geometric Coefficient of Variation 26.8

PRIMARY outcome

Timeframe: 2 hours before drug administration and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 10, 12, 24, 48-72 and 96 (+/-12) hours after drug administration.

Population: Pharmacokinetic parameter analysis set (PKS): All subjects in the treated set (TS) who provide at least one PK endpoint that was defined as primary and was not excluded due to a protocol deviation relevant to the evaluation of PK or due to PK non-evaluability.

Maximum measured concentration of midazolam in plasma (Cmax) is reported.

Outcome measures

Outcome measures
Measure
Child-Pugh A
n=4 Participants
Patients with compensated liver cirrhosis and advanced fibrosis grade F4 and hepatic impairment that met the criteria for Child-Pugh A received a drug cocktail of caffeine, warfarin, omeprazole, metoprolol and midazolam. The drug cocktail was given as single oral dose of 100 mg caffeine (2 tablets), 5 mg warfarin sodium (1 tablet), 20 mg omeprazole (1 tablet), 50 mg metoprolol (1 tablet) and 2 mg/mL oral solution midazolam, with 240 mL of water after a standardized breakfast on Day 1.
Maximum Measured Concentration of Midazolam in Plasma (Cmax)
9520 Picogram/milliliter
Geometric Coefficient of Variation 38.9

Adverse Events

Child-Pugh A

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
Child-Pugh A
n=4 participants at risk
Patients with compensated liver cirrhosis and advanced fibrosis grade F4 and hepatic impairment that met the criteria for Child-Pugh A received a drug cocktail of caffeine, warfarin, omeprazole, metoprolol and midazolam. The drug cocktail was given as single oral dose of 100 mg caffeine (2 tablets), 5 mg warfarin sodium (1 tablet), 20 mg omeprazole (1 tablet), 50 mg metoprolol (1 tablet) and 2 mg/mL oral solution midazolam, with 240 mL of water after a standardized breakfast on Day 1.
Cardiac disorders
Atrioventricular block first degree
25.0%
1/4 • Adverse events and all-cause mortality: From administration of drug cocktail plus residual effect period, up to 9 days.
Treated Set (TS): All subjects who signed informed consent and were treated with study drug.
Musculoskeletal and connective tissue disorders
Back pain
25.0%
1/4 • Adverse events and all-cause mortality: From administration of drug cocktail plus residual effect period, up to 9 days.
Treated Set (TS): All subjects who signed informed consent and were treated with study drug.

Additional Information

Boehringer Ingelheim, Call Center

Boehringer Ingelheim

Phone: 1-800-243-0127

Results disclosure agreements

  • Principal investigator is a sponsor employee Boehringer Ingelheim (BI) acknowledges that investigators have the right to publish the study results. Investigators shall provide BI with a copy of any publication or presentation for review prior to any submission. Such review will be done with regard to proprietary information, information related to patentable inventions, medical, scientific, and statistical accuracy within 60 days. BI may request a delay of the publication in order to protect BI's intellectual property rights
  • Publication restrictions are in place

Restriction type: OTHER