Phase 2
N=79
Dose Response of 28 Days of Dosing of GSK962040 in Type I and II Diabetic Male and Female Subjects With Gastroparesis
Gastroparesis
Bottom Line
View on ClinicalTrials.gov: NCT01262898 ↗Enrolled (actual)
79
Serious AEs
2.5%
Results posted
Oct 2017
Primary outcome: Primary: Gastric Half Emptying Time (GEt1/2) — 131.2; 106.5; 118.2; 131.1 Minutes
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- GSK962040 (5 mg tablet) (Drug); GSK962040 (25 mg tablet) (Drug); GSK962040 (125 mg tablet) (Drug); Placebo (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- GlaxoSmithKline
- Primary completion
- Feb 2013
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Gastric Half Emptying Time (GEt1/2) |
131.2; 106.5; 118.2; 131.1; 124.1; 106.6 | — |
| SECONDARY Number of Participants With On-treatment Adverse Events (AES) and Serious Adverse Events(SAEs) |
13; 14; 13; 18; 1; 0 | — |
| SECONDARY Change From Baseline in Systolic Blood Pressure (SBP) and Diastolic Blood Pressure(DBP) at Specified Time Points in Semi-supine Position |
0.6; -1.8; 0.8; -2.3; 3.2; -1.1 | — |
| SECONDARY Change From Baseline in Heart Rate at Specified Time Points in Semi-supine Position |
-0.3; -0.8; -0.3; 2.1; -3.9; -1.5 | — |
| SECONDARY Change From Baseline in Electrocardiography Parameters (12-lead ECG) |
-2.6; 3.2; 0.5; -0.9; -5.5; 0.6 | — |
| SECONDARY Number of Participants Outside the Normal Range for SBP and DBP |
0; 0; 0; 0; 0; 1 | — |
| SECONDARY Number of Participants Outside the Normal Range for Heart Rate |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Number of Participants Outside the Normal Range for 12-lead ECG |
6; 7; 6; 5; 0; 0 | — |
| SECONDARY Mean Change From Baseline in Clinical Chemistry: Alkaline Phosphatase, Alanine Amino Transferase, Aspartate Amino Transferase, Gamma Glutamyl Transferase, Creatine Kinase, Lactate Dehydrogenase |
3.0; 4.3; 4.0; -1.1; 2.7; 5.0 | — |
| SECONDARY Mean Change From Baseline in Clinical Chemistry: Direct Bilirubin, Total Bilirubin, Creatinine, Uric Acid |
0.1; -0.2; -0.1; -0.0; 0.1; 0.0 | — |
| SECONDARY Mean Change From Baseline in Clinical Chemistry : Albumin, Total Protein |
-0.68; 0.49; 0.11; -0.66; -0.3; 0.7 | — |
| SECONDARY Mean Change From Baseline in Clinical Chemistry : Calcium, Chloride, Glucose, Potassium, Sodium, Urea/BUN, Carbon Dioxide Content/Bicarbonate |
-0.018; -0.017; 0.027; -0.031; 0.26; -0.93 | — |
| SECONDARY Mean Change From Baseline in Hematology Parameters : Basophils, Eosinophils, Lymphocytes, Monocytes, Total Neutrophils (Total ANC - Total Absolute Neutrophil Count), Platelet Count, White Blood Cell Count |
0.0066; -0.0388; -0.0322; 0.1072; -0.0167; 0.0431 | — |
| SECONDARY Mean Change From Baseline in Hematology Parameters : Hematocrit |
-0.0025; 0.0021; 0.0019; -0.0059 | — |
| SECONDARY Mean Change From Baseline in Hematology Parameters : Mean Corpuscle Hemoglobin |
0.05; 0.15; -0.15; -0.14 | — |
| SECONDARY Mean Change From Baseline in Hematology Parameters : Hemoglobin, Mean Corpuscle Hemoglobin Concentration |
0.4; 1.1; -0.2; -2.7; 2.8; 1.6 | — |
| SECONDARY Mean Change From Baseline in Hematology Parameters : Mean Corpuscle Volume |
-0.52; -0.24; 0.43; 0.13 | — |
| SECONDARY Mean Change From Baseline in Hematology Parameters : Red Blood Cell Count, Reticulocytes |
0.003; 0.035; 0.003; -0.072; -0.0080; -0.0051 | — |
| SECONDARY Area Under the Concentration-time Curve From Time Zero (Pre-dose) to Last Time of Quantifiable Concentration AUC(0-t) at Specified Time Points |
854.9; 4083.1; 12911.9; 1908.1; 7347.2; 22173.3 | — |
| SECONDARY Maximum Observed Concentration (Cmax) at Specified Time Points |
70.21; 385.73; 1239.62; 131.71; 530.97; 1703.29 | — |
| SECONDARY Time of Occurrence of Cmax (Tmax) at Specified Time Points |
2.174; 2.238; 2.092; 2.189; 2.168; 2.026 | — |
| SECONDARY Pre-dose (Trough) Concentration at the End of the Dosing Interval (Ct) at Specified Time Points |
63.73; 214.26; 537.23; 62.60; 205.03; 597.39 | — |
| SECONDARY Apparent Clearance Following Oral Dosing (CL/F) at Specified Time Points |
— | — |
| SECONDARY Apparent Volume of Distribution (V/F) at Specified Time Points |
— | — |
| SECONDARY Apparent Terminal Elimination Half-life (t1/2) at Specified Time Points |
— | — |
| SECONDARY Time to First Bowel Movement After First Dose |
28.94; 53.98; 17.52; 15.73 | — |
| SECONDARY Daily Bowel Movement Frequency |
1.30; 1.33; 1.50; 1.39; 2.23; 1.59 | — |
| SECONDARY Daily Average Stool Consistency |
2.91; 3.24; 2.80; 3.71; 2.98; 2.81 | — |
| SECONDARY Change From Baseline in Upper Gastrointestinal (GI) Symptoms as Assessed by Total Gastrointestinal Cardinal Symptom Index - Daily Diary (GCSI-DD) |
-0.48; -0.46; -0.58; -0.57; -0.68; -1.04 | — |
| SECONDARY Change From Baseline in Whole Bowel Transit Time, 100 % Gastric Emptying Time (Truncated at 240 Minutes), Small Bowel Transit Time, Colonic Transit Time as Determined by Wireless Motility Capsule (WMC) |
-159.9; -240.3; -323.8; -381.0; -243.0; -15.4 | — |
Summary
GSK962040 is a novel small molecule motilin agonist. The Phase I studies (MOT107043 and MOT109681) demonstrated that single doses of GSK962040 up to 150 mg and repeat dosing of up to 125 mg/day for 14 days were well tolerated with adverse events not occurring in greater prevalence than placebo, and no significant abnormal vital sign, ECG, or clinical laboratory findings. Pharmacokinetic parameters were linear and approximately dose proportional over the range of doses administered. Single doses of 50 mg - 150 mg GSK962040 significantly increased the rate of gastric emptying up to 40% as measured by the 13C octanoic acid stable isotope breath test. A similar effect of 50 mg and 125 mg on gastric emptying was observed throughout repeated dosing to healthy volunteers for 14-days.
The aims of the present investigation (MOT114479) are to assess the pharmacodynamic effects (gastric emptying and symptoms), safety, tolerability, and pharmacokinetics of GSK962040 after 28 days of once-daily dosing in Type I and Type II diabetic subjects with gastroparesis. An additional aim is to characterize the dose/exposure - pharmacodynamic effect relationship.
Eligibility Criteria
Inclusion Criteria
- Type I or II Diabetes Mellitus (HbA1C upper limit of normal as determined by 13C-oral breath test)
- Patient must have a > or = 3 month history of relevant symptoms of gastroparesis (e.g., chronic post-prandial fullness, early satiety, postprandial nausea), patients will have a mean of the daily scores over a minimum of 7 days indicating > or = mild (2) and 40 MlU/mL, or a value consistent with the local laboratory standard value, is confirmatory. OR Child-bearing potential and agrees to use one of the contraception methods listed in Section 8.1 for an appropriate period of time (as determined by the product label or investigator) prior to the start of dosing to sufficiently minimize the risk of pregnancy at that point. Female patients must agree to use contraception for at least 5 days following the last dose of study medication.
- Male patients must agree to use one of the contraception methods listed in Section 8.1. This criterion must be followed from the time of the first dose of study medication through at least 5 days after the last dose of study medication.
- BMI >18 and or = 30 mL/min.
- QTcB or QTcF 1.5xULN is acceptable if bilirubin is fractionated and direct bilirubin <35%).
Exclusion Criteria
- Patient has acute severe gastroenteritis
- Patient has a gastric pacemaker
- Patient is on chronic parenteral feeding
- Patient has pronounced dehydration
- Recent (last 6 weeks) history of poor control of diabetes e.g. hypoglycaemia requiring medical intervention, diabetic ketoacidosis, admission for control diabetes or complications of diabetes
- Patient has evidence of severe cardiovascular autonomic neuropathy (e.g. history of recurrent syncope in the last 6 months)
- Patient has a history of eating disorders (anorexia nervosa, binge eating, bulimia)
- Use of medications potentially influencing upper gastrointestinal motility or appetite within one week of the study (e.g., prokinetic drugs, macrolide antibiotics (erythromycin), GLP-1 mimetics)
- Regular opiate use
- Use of prohibited medications listed in Section 9.2 within the restricted timeframe relative to the first dose of study medication.
- History or presence of clinically significant gastro-intestinal, hepatic or renal disease or other condition that would in the opinion of the investigator or medical monitor make the subject unsuitable for inclusion in this clinical study.
- The patient has participated in a clinical trial and has received an investigational product within the following time period prior to the first dosing day in the current study: 30 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer).
- History of sensitivity to any of the study medications, or components thereof or a history of drug or other allergy that, in the opinion of the investigator or GSK Medical Monitor, contraindicates their participation.
- Where participation in the study would result in donation of blood or blood products in excess of 500 mL within a 56 day time-period.
- Pregnant females as determined by positive serum or urine hCG test (from the first urine of the day) at screening or prior to dosing.
- Lactating females.
- Current or chronic history of liver disease, or known hepatic or biliary abnormalities (with the exception of Gilbert's syndrome or asymptomatic gallstones).
- A positive pre-study Hepatitis B surface antigen or positive Hepatitis C antibody result within 3 months of screening
Data sourced from ClinicalTrials.gov (NCT01262898). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.