Phase 3
N=59
Short Bowel Syndrome Research Study for Children Up To 17 Years of Age on Parenteral Nutrition
Short Bowel Syndrome
Bottom Line
View on ClinicalTrials.gov: NCT02682381 ↗Enrolled (actual)
59
Serious AEs
66.1%
Results posted
Oct 2018
Primary outcome: Primary: Number of Participants Who Achieved at Least a 20 Percent (%) Reduction in Weight-Normalized Average Daily Parenteral Nutrition Intravenous (PN/IV) Volume at Week 24 — 13; 18; 1; 13 Participants
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Teduglutide 0.05mg/kg (Drug); Teduglutide 0.025 mg/kg (Drug); Standard of Care (Other)
- Age
- Pediatric · 0+ yrs
- Sex
- All
- Sponsor
- Shire
- Primary completion
- Aug 2017
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants Who Achieved at Least a 20 Percent (%) Reduction in Weight-Normalized Average Daily Parenteral Nutrition Intravenous (PN/IV) Volume at Week 24 |
13; 18; 1; 13; 18; 2 | — |
| SECONDARY Number of Participants With Treatment-emergent Adverse Events (TEAEs) |
24; 25; 9 | — |
| SECONDARY Number of Participants Who Were Completely Weaned Off Parenteral Nutrition Intravenous (PN/IV) Support at Week 24 |
2; 3; 0 | — |
| SECONDARY Change From Baseline in Parenteral Nutrition Intravenous (PN/IV) Volume at Week 24 |
-16.16; -23.30; -6.03; -11.28; -22.13; -5.84 | — |
| SECONDARY Change From Baseline in Parenteral Nutrition Intravenous (PN/IV) Caloric Intake at Week 24 |
-14.92; -18.99; -0.46; -11.76; -18.51; -0.27 | — |
| SECONDARY Change From Baseline in Plasma Citrulline Levels at Week 24 |
7.7; 12.0; 0.1 | — |
| SECONDARY Change From Baseline in Enteral Nutrition Volume at Week 24 |
7.69; 10.96; 0.74; 7.67; 8.17; 0.33 | — |
| SECONDARY Change From Baseline in Enteral Nutrition Caloric Intake at Week 24 |
8.43; 12.98; 4.22; 7.29; 11.47; 6.66 | — |
| SECONDARY Change From Week 24 in Parenteral Nutrition Intravenous (PN/IV) Volume at Week 28 |
2.63; 1.52; -2.99; 2.13; -0.35; -0.91 | — |
| SECONDARY Change From Week 24 in Parenteral Nutrition Intravenous (PN/IV) Caloric Intake at Week 28 |
0.88; -0.91; -4.21; 0.55; 0.08; -4.34 | — |
| SECONDARY Change From Week 24 in Plasma Citrulline Levels at Week 28 |
-6.0; -9.5; 1.8 | — |
| SECONDARY Change From Week 24 in Enteral Nutrition Volume at Week 28 |
-0.68; 1.38; -0.75; 1.67; 0.68; 0.39 | — |
| SECONDARY Change From Week 24 in Enteral Nutrition Caloric Intake at Week 28 |
-1.07; -0.14; -0.42; 1.28; -0.11; 0.45 | — |
| SECONDARY Change From Baseline in Body Weight Z-score at Week 28 |
-0.12; -0.18; -0.05 | — |
| SECONDARY Change From Baseline in Body Height Z-score at Week 28 |
0; 0.05; 0.16 | — |
| SECONDARY Change From Baseline in Head Circumference Z-score at Week 28 |
-0.014 | — |
| SECONDARY Change From Baseline in Body Mass Index (BMI) Z-score at Week 28 |
-0.13; -0.22; -0.25 | — |
| SECONDARY Change From Baseline in Participants' Stool Consistency at Week 28 |
-1.3; -1.4; -3.3 | — |
| SECONDARY Change From Baseline in Hours Per Day of Parenteral Nutrition Intravenous (PN/IV) Support at Week 24 |
-2.47; -3.03; -0.21; -1.48; -1.79; 0.11 | — |
| SECONDARY Change From Baseline in Days Per Week of Parenteral Nutrition Intravenous (PN/IV) Support at Week 24 |
-0.88; -1.34; 0; -0.79; -1.42; 0 | — |
Summary
Teduglutide is approved for treatment of adults with short bowel syndrome (SBS). The purpose of this study is to evaluate the safety and efficacy of teduglutide in children up to the age of 17 with SBS who are dependent on parenteral support. Subjects may choose whether to receive the study drug or to participate in a standard-of-care arm. All participants who complete the study may be eligible to receive the study drug in a long-term extension study.
Eligibility Criteria
Inclusion Criteria
- Informed consent by a parent or guardian or emancipated minor prior to any study-related procedures
- When applicable, an informed assent by the subject (as deemed appropriate by the Ethics Committee/Institutional Review Board) prior to any study-related procedures
- Current history of SBS as a result of major intestinal resection, (eg, due to necrotizing enterocolitis, midgut volvulus, intestinal atresia, or gastroschisis)
- Short bowel syndrome that requires PN/IV support that provides at least 30% of caloric and/or fluid/electrolyte needs prior to screening
- Stable PN/IV support, defined as inability to significantly reduce PN/IV support, usually associated with minimal or no advance in enteral feeds (ie, 10% or less change in PN or advance in feeds) for at least 3 months prior to and during screening, as assessed by the investigator.
- Sexually active female subjects of child-bearing potential (in the teduglutide treatment arm only) must use medically acceptable methods of birth control during and 4 weeks after the treatment period
Exclusion Criteria
- Subjects who are not expected to be able to advance oral or tube feeding regimens
- Serial transverse enteroplasty or any other bowel lengthening procedure performed within 3 months of screening
- Known clinically significant untreated intestinal obstruction contributing to feeding intolerance and inability to reduce parenteral support
- Unstable absorption due to cystic fibrosis or known DNA abnormalities
- Severe, known dysmotility syndrome, such as pseudo-obstruction or persistent, severe, active gastroschisis-related dysmotility, that is the primary contributing factor to feeding intolerance and inability to reduce parenteral support, prior to screening. Dysmotility is defined as severe if it is expected to limit the advancement of enteral feeding.
- Evidence of clinically significant obstruction on upper GI series done within 6 months prior to screening.
- Major GI surgical intervention including significant intestinal resection within 3 months prior to the screening visit (insertion of feeding tube, anastomotic ulcer repair, minor intestinal resections ≤ 10 cm, or endoscopic procedure is allowed).
- Unstable cardiac disease, congenital heart disease or cyanotic disease, with the exception of subjects who had undergone ventricular or atrial septal defect repair, and patent ductus arteriosus (PDA) ligation.
- History of cancer or clinically significant lymphoproliferative disease, not including resected cutaneous basal or squamous cell carcinoma, or in situ non aggressive and surgically resected cancer.
- Pregnant or lactating female subjects (in the teduglutide treatment arm only).
- Participation in a clinical study using an experimental drug (other than glutamine or Omegaven) within 3 months or 5.5 half-lives of the experimental drug, whichever is longer, prior to screening, and for the duration of the study.
- Previous use of teduglutide or native/synthetic glucagon-like peptide-2 (GLP-2)
- Previous use of glucagon-like peptide-1 analog or human growth hormone within 3 months prior to screening
- Previous use of octreotide, or dipeptidyl peptidase-4 (DPP-4) inhibitors within 3 months prior to screening
- Subjects with active Crohn's disease who had been treated with biological therapy (eg, antitumor necrosis factor [anti-TNF]) within the 6 months prior to the screening visit
- Subjects with inflammatory bowel disease (IBD) who require chronic systemic immunosuppressant therapy that had been introduced or changed during the 3 months prior to screening
- More than 3 SBS-related or PN-related hospital admissions (eg, documented infection-related catheter sepsis, clots, bowel obstruction, severe water-electrolyte disturbances) within 3 months prior to the screening visit
- Any major unscheduled hospital admission which affects parenteral support requirements within 1 month prior to or during screening, excluding
Data sourced from ClinicalTrials.gov (NCT02682381). 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.