Prevalence of abnormal liver-associated enzymes in cocaine experienced adults versus healthy volunteers during Phase 1 clinical trials

• Published in: Contemporary clinical trials Vol. 28; no. 6; pp. 695 - 704
• Main Authors: Cantilena, Louis R., Cherstniakova, Svetlana A., Saviolakis, George, Kahn, Roberta, Elkashef, Ahmed, Rose, Lauren, Vocci, Frank
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.11.2007; Elsevier
• Subjects: Adolescent; Adult; Biological and medical sciences; Cardiovascular; Clinical Trials, Phase I as Topic; Cocaine; Cocaine - antagonists & inhibitors; Cocaine - metabolism; Dose-Response Relationship, Drug; Drug addictions; Enzymes - analysis; Enzymes - blood; Enzymes - drug effects; Female; Hematology, Oncology and Palliative Medicine; Humans; Inpatient trials; Inpatients; Liver - drug effects; Liver - enzymology; Liver-associated enzymes; Male; Medical sciences; Middle Aged; Phase 1; Retrospective Studies; Toxicology; United States; United States; Inpatient trials; Cocaine; Phase 1; Liver-associated enzymes; Drug addiction; Prevalence; CNS stimulant; Healthy subject; Digestive system; Psychotropic; Enzyme; Toxicity; Liver; Epidemiology; Ester; Phase I trial; Drug of abuse; Hospital; Comparative study
• ISSN: 1551-7144; 1559-2030
• DOI: 10.1016/j.cct.2007.03.005

The frequency and nature of elevation of liver-associated enzymes (LAE) are important safety endpoints in Phase 1 clinical trials of new anti-cocaine agents, yet very little information is available on the prevalence of abnormal LAE in cocaine experienced adults. The aim of this retrospective study was to investigate the alterations of liver-associated enzymes (LAE) aspartate- (AST) and alanine transaminase (ALT), alkaline phosphatase (ALP), gamma glutamyl transferase (GGT), and bilirubin in healthy “normal” (HN) and cocaine experienced (actively using cocaine preadmission (CE)) adults participating in long term inpatient clinical trials. We examined LAE values collected from 3 inpatient Phase 1 trials of anti-cocaine agents. Analysis of variance (ANOVA) was applied to determine the significance of various factors on LAE alterations. Gender, baseline BMI, treatment did not demonstrate significant group differences in LAE levels. CE study volunteers were found to have significantly higher AST and ALT values than HN volunteers ( P < 0.05) during their respective inpatient stays. 94.1% of the 17 subjects with abnormal LAE were CE, and 37.5% of these CE received placebo. In conclusion, despite normal baseline values, most subjects demonstrated an increase in the ALT level even on placebo. For CE subjects, differences (▵ALT and ▵AST) between baseline and the maximum observed values were significantly higher than that observed for HN subjects. The potential to obscure important signals for hepatotoxicity during Phase 1 research may be higher in the CE study population.