Phase 3
N=318
A Study in Adolescents and Adults With Eosinophilic Esophagitis (EoE) Measuring Histologic Response and Determine if Reduction in Dysphagia is Achieved
Eosinophilic Esophagitis (EoE)
Bottom Line
View on ClinicalTrials.gov: NCT02605837 ↗Enrolled (actual)
318
Serious AEs
0.9%
Results posted
Mar 2020
Primary outcome: Primary: Number of Participants With Histologic Response at the Final Treatment Period Evaluation (Week 16) — 1; 113; 104; 100 Participants — p=<0.001
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Oral Budesonide Suspension (OBS) (Drug); Placebo (Drug)
- Age
- Pediatric, Adult · 11+ yrs
- Sex
- All
- Sponsor
- Shire
- Primary completion
- Jan 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants With Histologic Response at the Final Treatment Period Evaluation (Week 16) |
1; 113; 104; 100 | <0.001 sig |
| PRIMARY Number of Participants With Dysphagia Symptom Response at the Final Treatment Period Evaluation (Week 16) |
41; 112; 64; 101 | 0.024 sig |
| SECONDARY Change From Baseline in Dysphagia Symptom Questionnaire (DSQ) Combined Score at the Final Treatment Period Evaluation (Week 16) |
-9.07; -12.99 | 0.015 sig |
| SECONDARY Change From Baseline in Total Endoscopy Score at the Final Treatment Period Evaluation (Week 16) |
-2.2; -4.0 | <0.001 sig |
| SECONDARY Number of Participants With Peak Eosinophil Count Less Than (<)15/High-Powered Field (HPF) or Less Than or Equal to (<=)1/High-Powered Field (HPF) at the Final Treatment Period Evaluation (Week 16) |
1; 132; 104; 81; 0; 69 | <0.001 sig |
| SECONDARY Change From Baseline in the Peak Eosinophil Count at the Final Treatment Period Evaluation (Week 16) |
-5.5; -34.0; -12.9; -43.3; -4.9; -38.0 | <0.001 sig |
| SECONDARY Change From Baseline in the Histopathologic Epithelial Features Combined Total Score Ratio (TSR) at the Final Treatment Period Evaluation (Week 16) |
-0.03; -0.22; -0.0; -0.2 | <0.001 sig |
| SECONDARY Number of Participants With Dysphagia Symptom Response (Binary Response) at the Final Treatment Period Evaluation (Week 16) |
35; 88; 70; 125 | 0.164 |
| SECONDARY Number of Participants With Overall Binary Response I at the Final Treatment Period Evaluation (Week 16) |
0; 64; 105; 149 | 0.001 sig |
| SECONDARY Number of Participants With Overall Binary Response II at the Final Treatment Period Evaluation (Week 16) |
0; 48; 105; 165 | 0.004 sig |
| SECONDARY Change From Baseline in the Dysphagia Symptom Questionnaire (DSQ) + Pain Score (Questions 2 +3+4) at the Final Treatment Period Evaluation (Week 16) |
-12.24; -18.65 | 0.004 sig |
| SECONDARY Change From Baseline in the Dysphagia Symptom Questionnaire (DSQ) Pain Score (Question 4) at the Final Treatment Period Evaluation (Week 16) |
-3.01; -5.47 | 0.002 sig |
| SECONDARY Number of Participants With Treatment-Emergent Adverse Events (AE) |
64; 130 | — |
| SECONDARY Area Under the Plasma Concentration-Time Curve (AUCtau) Between the Defined Interval of Budesonide Doses |
5071 | — |
| SECONDARY Maximum Observed Concentration (Cmax) of Budesonide in Plasma |
914.8 | — |
| SECONDARY Time to Maximum Observed Plasma Concentration (Tmax) of Budesonide in Plasma |
2 | — |
| SECONDARY Terminal Rate Constant (Lambda Z) of Budesonide in Plasma |
0.2103 | — |
| SECONDARY Terminal Half-Life (t1/2) of Budesonide in Plasma |
3.296 | — |
| SECONDARY Apparent Oral Clearance (CL/F) of Budesonide in Plasma |
394.4 | — |
| SECONDARY Apparent Volume of Distribution (Vz/F) of Budesonide in Plasma |
1886 | — |
Summary
A study in adolescents and adults with eosinophilic esophagitis (EoE) to measure the histologic response and determine if any reduction in dysphagia is achieved.
Eligibility Criteria
Inclusion Criteria
- Participants is able to provide written informed consent (participant, parent or legal guardian, and, as appropriate, participant assent) to participate in the study before completing any study-related procedures.
- Participant is male or female aged 11-55 years, inclusive, at time of consent.
- Participant has histologic evidence of eosinophilic esophagitis (EoE) with a peak eosinophil count of greater than or equal to (>=) 15/ high-powered field (HPF), from 2 of 3 (proximal, mid-, and/or distal) levels of the esophagus at the screening endoscopy.
- Participant has a history of clinical symptoms of esophageal dysfunction (for example, eating problems, abdominal pain, heartburn, dysphagia, vomiting, food impaction, weight loss) intermittently or continuously at screening (Visit -1).
- Participants must have experienced dysphagia (response of "yes" to question 2 on Dysphagia Symptom Questionnaire [DSQ]) on a minimum of 4 days and completed the DSQ on >= 70 percent (%) of days in any 2 consecutive weeks of the screening period and in the last 2 weeks prior to the baseline visit (Visit 1).
- Participant must not have PPI-responsive EoE based on esophageal biopsies performed after the patient has been on at least 8 weeks of high-dose PPI therapy (high-dose therapy refers to the total daily dose, which may have been administered as a once or twice daily dosing regimen). This may occur at the time of the qualifying esophagogastroduodenoscopy (EGD) (in which case the same proton pump inhibitor (PPI) regimen must be continued), or this may have been done previously (in which case PPI therapy may have been stopped if there was no response to therapy based on esophageal biopsy results). If PPI responsiveness was excluded by a previous EGD and biopsy, the historical EGD and biopsy must have been performed after the patient had been on a minimum of 6 weeks of high-dose PPI therapy.
- Participant will be on a stable (no changes) diet >=3 months prior to the screening visit (Visit -1).
- Participant is willing and able to continue any dietary therapy, environmental therapy, and/or medical regimens (including gastric acid suppression) in effect at the screening visit (Visit -1). There should be no change to these regimens during study participation.
- All female participants must have a negative serum pregnancy test (beta-human chorionic gonadotropin [β-hCG]) prior to enrollment into the study. Females of childbearing potential must agree to continue acceptable birth control measures (for example, abstinence, stable oral contraceptives, or double-barrier methods) throughout study participation.
- Participant is willing and has an understanding and ability to fully comply with study procedures and restrictions defined in this protocol.
Exclusion Criteria
- Participant has any condition or abnormality (including laboratory abnormalities), current or past, that, in the opinion of the principal investigator or medical monitor, would compromise the safety of the participant or interfere with or complicate the assessment of signs or symptoms of EoE. Such conditions may include psychiatric problems; neurologic deficits or disease; developmental delay; cardiovascular, metabolic, or pulmonary disease; or previous gastroesophageal surgery. These should be discussed with the medical monitor.
- Participant has used immunomodulatory therapy within 8 weeks prior to the qualifying EGD or between the qualifying EGD and baseline visit (Visit 1) or anticipates using immunomodulatory therapy during the treatment period (except for any ongoing regimen of allergy shots). Use of long-acting immunomodulatory therapy (for example, Rituxan) within 3 months of the qualifying EGD should be reviewed with the medical monitor.
- Participant has been using swallowed topical corticosteroid for EoE or systemic corticosteroid for any condition within the 4 weeks prior to the qualifying EGD, between the qualifying EGD and baseline visit (Visit 1), or a
Data sourced from ClinicalTrials.gov (NCT02605837). 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.