A single-center, open-label, randomized, 3-way, 3-period, crossover study was conducted in a total of 15 healthy Japanese adult males (5 subjects per group). Subjects received a single oral dose of the ONO-4578 reference formulation in the fasted state, a single oral dose of the ONO-4578 test formulation in the fasted state, and test formulation in the fed state.
All 14 subjects enrolled in the study received the study drug as scheduled in each period, except for 1 subject. One subject discontinued the intervention period due to an AE in Period 2 and did not receive the study drug in Period 3.
After administration of the reference formulation in the fasted state, the test formulation in the fasted state, and test formulation in the fed state, AEs were observed in 3 of 15 subjects (20.0%), 1 of 15 subjects (6.7%), and 1 of 14 subjects (7.1%), respectively. Of these AEs, an AE in 1 subject (6.7%) after receiving the reference formulation in the fasted state (decreased appetite, Grade 1), an AE in 1 subject (6.7%) after receiving the test formulation in the fasted state (duodenal ulcer haemorrhage, Grade 3), and an AE in 1 subject (7.1%) after receiving the test formulation in the fed state (abdominal discomfort, Grade 2) were considered adverse drug reactions.
The geometric mean ratios of Cmax and AUClast of the test formulation to those of the reference formulation were 1.14 and 1.08, respectively. The geometric mean ratios of Cmax and AUClast were both within the range of 0.80 to 1.25. The relative bioavailability of the test formulation to the reference formulation, calculated from the geometric mean ratios of Cmax and AUClast, was 114% and 108%, respectively.
The geometric mean ratios of Cmax and AUClast of the test formulation fed to those of the test formulation fasted were 0.99 and 0.88, respectively. The geometric mean ratios of Cmax and AUClast were both within the range of 0.80 to 1.25.
The relative bioavailability of the test formulation to the reference formulation was 114% and 108%, respectively. Dose adjustment between the reference formulation and the test formulation was considered unnecessary.The effect of food on the PK of the test formulation was considered small.
The safety of a single oral dose of the ONO-4578 test formulation in the fasted state and in the fed state was within the range of the known risks, and it was considered that there was no problem in tolerability.