Individualization of Dosage Regimens in Obese Patients: Application to Acyclovir
University Hospital, Toulouse
20 participants
Apr 9, 2024
INTERVENTIONAL
Conditions
Summary
The number of obese people will reach 50% of the world population by 2035. Obesity is a chronic disease. For obese patients, dosage regimens have been determined for patients with a "normal" BMI between 20-30 kg/m2. Based on plasma and urine concentrations, a pharmacokinetic model will be performed to study in healthy volunteers, the predictive character of lean mass, measured by DEXA, on renal elimination and therefore on acyclovir exposure. The main objective of this study is to evaluate, in 4 volunteers groups representative of (1) non-obese (18-24.9 kg/m2), (2) overweight (25-29.9 kg/m2), (3) grade 1 obesity (30-34.9 kg/m2) and (4) grade 2 obesity (35-39.9 kg/m2), the predictive nature of lean mass, measured by DEXA, on renal elimination and therefore on acyclovir exposure.
Eligibility
Inclusion Criteria5
- healthy volunteers with a BMI between 18 and 39,9 kg/m2, divided into 4 groups: 5 non-obese volunteers (BMI between 18 and 24,9 kg/m2), 5 overweight volunteers (BMI between 25 and 29,9 kg/m2), 5 volunteers with grade 1 obesity (BMI between 30 and 34,9 kg/m2) and 5 volunteers with grade 2 obesity (BMI between 35 and 39,9 kg/m2),
- volunteers with a aGFR > 50 ml/min,
- with a good venous pathway for kinetics,
- women on contraception or postmenopausal women,
- person who has given written consent and affiliated with the public health insurance.
Exclusion Criteria11
- volunteers with nephrotoxic co-prescriptions and/or co-prescriptions that would modify the pharmacokinetics of acyclovir like diuretics, NSAIDs or statins,
- having presented serious allergies to a drug (e.g. angioedema...), with large parenchyma insufficiencies (e.g., hepatic insufficiency, heart failure...),
- with diabetes or taking anti-diabetics due to the possible deterioration of renal function in diabetic patients,
- with arterial hypertension or taking antihypertensive drugs due to the possible modification of renal clearance by modification of blood flow,
- drug interactions with acyclovir (H2 receptor antagonists (e.g., Cimetidine), Probenecid, Mycophenolate Mofetil, Lithium, Anti-calcineurins (Ciclosporin, Tacrolimus)),
- volunteers taking anticoagulants,
- hypersensitivity to acyclovir,
- pregnant woman,
- participation in another clinical study in the last two months
- volunteers with ongoing viral HSV/VZV infection treated with acyclovir,
- adults under guardianship or other legal protection, deprived of their liberty by judicial or administrative decision
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Interventions
Subjects will receive a single dose of 5 mg/kg infused over 1 hour. Then, 13 blood samples after placement of a catheter, and 4 urine samples will be taken over the 12 hours following the start of administration
Locations(1)
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NCT05589688