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Bioequivalence Assessment of Cannabidiol (CBD) Administrated in Oral Formulations

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ClinicalTrials.gov Identifier: NCT03877991
Recruitment Status : Not yet recruiting
First Posted : March 18, 2019
Last Update Posted : March 22, 2019
Sponsor:
Information provided by (Responsible Party):
Hadassah Medical Organization

Tracking Information
First Submitted Date  ICMJE March 14, 2019
First Posted Date  ICMJE March 18, 2019
Last Update Posted Date March 22, 2019
Estimated Study Start Date  ICMJE April 2019
Estimated Primary Completion Date August 2019   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: March 14, 2019)
Pharmacokinetic parameters of CBD [ Time Frame: 1 year ]
Assesment of the pharmacokinetic profile of Cannabidiol in healthy volunteers. Plasma concentrations will be determined using HPLC-MS/MS validiated assay. The unit of measure will be provided as ng/ml.
Original Primary Outcome Measures  ICMJE Same as current
Change History Complete list of historical versions of study NCT03877991 on ClinicalTrials.gov Archive Site
Current Secondary Outcome Measures  ICMJE
 (submitted: March 14, 2019)
Exposure to the metabolites of the study drugs [ Time Frame: 1 year ]
Assessment of the metabolic profile of the major cannabidiol metabolites: 7-hydroxy-CBD and CBD-glucoronide-11 in healthy volunteers. Plasma metabolites concentrations will be determined using HPLC-MS/MS validiated assay. The unit of measure will be provided as ng/ml.
Original Secondary Outcome Measures  ICMJE Same as current
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Bioequivalence Assessment of Cannabidiol (CBD) Administrated in Oral Formulations
Official Title  ICMJE Bioequivalence Assessment of Cannabidiol (CBD) Administrated in Oral Formulations
Brief Summary The oral bio-availability of cannabidiol (CBD) is low due to poor water solubility and susceptibility to extensive first pass metabolism, resulting in relative bio-availability of 6%.This project is designed to evaluate the plasma concentration vs. time profile of a self emulsifying drug delivery system termed Long Chain Nano Lipospheres (LNL) for enhancing the oral bio-availability of cannabidiol (CBD). The main goal of this study is to evaluate the bio-equivalence of CBD in the LNL product, compared to CBD in a sesame oil vehicle and CBD without any formulation, in powder form. Bio-equivalence is measured by AUC 0-24h, Tmax and Cmax.
Detailed Description

Cannabidiol (CBD) is considered the non-psychoactive component of the cannabis plant with a myriad of pharmacological attributes. There is preliminary data that CBD can be a useful treatment for different therapeutic conditions such as epilepsy, anxiety, pain etc. CBD has been investigated for its analgesic effect in patients with neuropathic and chronic pain, especially resistant to other treatments. Further supportive evidence for CBD's efficacy in treatment of pain, is established pre-clinically and requires additional research in a clinical setting. The use of CBD in epilepsy has been assimilated in treatment guidelines in many countries including Israel. However, the potential medical use of whole-plant cannabis extracts, particularly in children with a developing brain, is limited by the psychoactive properties and the adverse effects associated with long-term THC use.

Although a therapeutic rational for the use of CBD has been demonstrated, an optimal oral dosage form to deliver this compound is not available yet. Oral administration is challenging because of CBD's poor solubility and extensive first pass metabolism, leading to an oral bioavailability of approximately 6%.

In this project, investigators utilize a bio-pharmaceutical method to enhance the bioavailability of CBD using an advanced self-emulsifying drug delivery system termed Long Chain Nano Lipospheres (LNL). The LNL formulation is composed of long chain triglycerides, surfactants and co-solvent. This constellation is termed the pre-concentrate, which dissolves CBD in its lipid core and administered in a soft gelatin capsule. When reaching the aqueous phase of the GI tract, this pre-concentrate spontaneously forms a drug encapsulated O/W nano emulsion. Previously, investigators have shown in a pre-clinical investigation that incorporation of CBD into the LNL is a promising strategy to increase the compound's bioavailability.

The primary goal of this study is to evaluate the bioequivalence of the developed CBD-LNL product to CBD in a sesame oil vehicle and CBD in powder form. Sesame oil is the commonly used vehicle for cannabinoids oral uptake for lack of other options. However, this option often leads to significant inter and intra subject variability in cannabinoids' plasma concentrations.

The study will be performed on 12 healthy male volunteers. It will be randomized, blind, three way cross-over study intended to evaluate the pharmacokinetics of CBD. Each volunteer will receive CBD-LNL capsule, CBD in sesame oil vehicle capsule and CBD without any vehicle in powder form. All study groups will receive the same dose of CBD-90 mg. Blood samples will be drawn from forearm 30 minutes before (pre-dose) and every 30 minutes interval for the first 4 hours, then samples will be taken at 5,6,7,8,12 and 24 hours after the intake of the study drug. Blood concentration profiles of CBD and its main metabolites 7-hydroxy-CBD and CBD-glucoronide-11 will be determined in order to calculate the pharmacokinetic parameters of CBD.

Study Type  ICMJE Interventional
Study Phase  ICMJE Early Phase 1
Study Design  ICMJE Allocation: Randomized
Intervention Model: Crossover Assignment
Intervention Model Description:
randomized blind, three way cross-over study
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Basic Science
Condition  ICMJE Pain
Intervention  ICMJE
  • Drug: CBD-sesame oil capsule
    A capsule containing cannabidiol dissolved in sesame oil and surfactant vehicle.
    Other Name: Cannabidiol in sesame oil vehicle cpausle
  • Drug: CBD-LNL capsule
    A capsule containing Cannabidiol dissolved in self nano emulsifying formulation
    Other Name: Cannabidiol in Long Chain Nano Lipospheres formulation
  • Drug: CBD powder form capsule
    Powder of Cannabidiol filled in a hard gelatin capsule, without formulation.
    Other Name: Cannabidiol solid dosage form
Study Arms  ICMJE
  • Experimental: CBD-sesame oil capsule
    12 volunteers will receive a single oral dose of CBD in a sesame oil vehicle filled in a capsule, with 200 mL of water. The dose of CBD to be administrated is 90 mg.
    Intervention: Drug: CBD-sesame oil capsule
  • Experimental: CBD-LNL capsule
    12 volunteers will receive a single oral dose of CBD-LNL formulation filled in a capsule, with 200 mL of water. The dose of CBD to be administrated is 90 mg.
    Intervention: Drug: CBD-LNL capsule
  • Experimental: CBD powder form capsule
    12 volunteers will receive a single oral dose of CBD in powder form filled in a hard gelatin capsule, with 200 mL of water. The dose of CBD to be administrated is 90 mg.
    Intervention: Drug: CBD powder form capsule
Publications * Not Provided

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Not yet recruiting
Estimated Enrollment  ICMJE
 (submitted: March 14, 2019)
12
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE August 2019
Estimated Primary Completion Date August 2019   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

1. Men 18 through 45 years of age with body mass index in the range of: 19 through 30 kg/m2.

2. Participants should be able to ingest and absorb oral medications.

3. Subjects must be in good health as determined by medical history, vital signs measurements, physical examination (routine examination performed by the general physician), and clinical laboratory tests (blood count and biochemistry conducted in the Health maintenance organization in Israel( "kupat holim").

4. Potential participants will undergo a screening/explanatory interview in which their compatibility will be examined. The screening interview will be held prior to the first day of trial (at least during the near month preceding the first day of trial).

5. Subjects must be able to understand and comply with the requirements of the study (e.g. all medication, dietary, and alcohol restrictions).

6. Subjects must provide written informed consent to participate in the study after reading the information and consent form, and after having an opportunity to discuss the study with the investigator.

7. Subjects must complete the screening process within 4 weeks prior to the admission visit.

Exclusion Criteria:

  1. Previous participation in an research trial involving administration of any of the investigated compounds within one month prior to the current study.
  2. The subject is suffering from, or has a clinically significant history of, one or more of the following: impaired glucose tolerance, diabetes mellitus, renal disease, edema, stroke or neurological disorder, rheumatological disorder (including arthritis, joint or tendon abnormalities), pulmonary disorder (including a personal history of asthma, but excluding resolved pediatric asthma), hepatic disorder, has a personal history of seizures, history of psychosis any addictive or other psychiatric disease disorder or a history of any illness that, in the opinion of the investigator, might confound the results of the study or pose additional risk to the subject by participation in the study.
  3. The subject has a known history of hepatitis B, hepatitis C, or human immunodeficiency virus (HIV) 1 or 2.
  4. Any history of adverse events associated with cannabis intoxication or dependence.
  5. A subject that has used one of the forbidden drugs, substances or foods as follows:

    • Any investigational product (THC or/and CBD ingestion or smoking) within one month preceding the study.
    • Any prescription or non-prescription medication (including herbal remedies, vitamins or dietary supplements) or vaccine within 14 days of the first day of study drug administration (Day 1) or within 5 half-lives before the first day of study drug administration, whichever is longer.

    Exceptions are locally acting medications (eg, topical creams), which are not allowed within 5 days of study drug administration, and the occasional use of acetaminophen (up to 3 g/day) and ibuprofen (up to 1200 mg/day).

    • Consumption of grapefruit, grapefruit juice, Seville oranges, pomelo containing products, within the 14 days prior to Day -1 and then throughout the entire study.
    • Consumption of excessive amounts of alcoholic beverages, defined as >3 drinks per day (beer, wine, or distilled spirits), or unwilling to comply with the restricted use of alcohol during the study (48 hours prior to admission and throughout the study), who have history of alcoholism.
  6. Subject that has any condition that may possibly interfere with drug absorption, distribution, metabolism, or excretion (eg, previous surgery on the gastrointestinal tract [including removal of parts of stomach, bowel, liver, gall bladder, or pancreas] or stomach banding).
  7. Exhausting physical exercise 48 hours prior to drug administration.
  8. The subject does not agree to abstain from excessive caffeine and xanthine containing foods and beverages (ie, equivalent to >4 cups brewed coffee per day) from 48hr prior to Day -1 and throughout the entire study.
  9. Those who had donated >0.5 L blood within 30 days of study.
  10. Abnormal blood pressure and heart rate values according to the following criteria:

    • The subject has a supine pulse rate outside of the range of 40 to 100 bpm (following at least a 10-minute rest) measured at screening or Day -1.
    • The subject has a supine blood pressure outside of the range of 90 to 139 mm Hg systolic or 50 to 89 mm Hg diastolic (following at least a 10 minute rest) measured at screening or Day-1. Note: The blood pressure measurement may be repeated up to 3 times to meet eligibility requirements. In this case, the average of these 3 measurements must meet eligibility criteria.
  11. A subject with a clinically significant history of drug allergies (including cannabis extracts, ethanol, or sesame oil), drug hypersensitivity or history of idiosyncratic reactions to any drug.
  12. History of abuse of any drug/chemical.
  13. Inability to relate to and/or cooperate with the investigators.
  14. A subject with any other condition, which, in the opinion of the investigator, makes the subject inappropriate for the study.
Sex/Gender  ICMJE
Sexes Eligible for Study: Male
Ages  ICMJE 18 Years to 45 Years   (Adult)
Accepts Healthy Volunteers  ICMJE Yes
Contacts  ICMJE
Contact: Elyad Davidson, MD +972507874098 EDAVIDSON@hadassah.org.il
Contact: Dvora Izgelov +972547504230 dvora.izgelov@mail.huji.ac.il
Listed Location Countries  ICMJE Israel
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT03877991
Other Study ID Numbers  ICMJE 0352-18-HMO-CTIL
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE Not Provided
Responsible Party Hadassah Medical Organization
Study Sponsor  ICMJE Hadassah Medical Organization
Collaborators  ICMJE Not Provided
Investigators  ICMJE
Principal Investigator: Elyad Davidson, MD Hadassah Medical Organization
PRS Account Hadassah Medical Organization
Verification Date February 2019

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP