Phase 2
Completed N=614
Danirixin Dose Ranging Study in Participants With Chronic Obstructive Pulmonary Disease (COPD)
Pulmonary Disease, Chronic Obstructive
Source: ClinicalTrials.gov NCT03034967 ↗
Enrolled (actual)
614
Serious AEs
9.1%
Results posted
Nov 2019
Primary outcomePrimary: Change From Baseline in Respiratory Symptoms Measured by Evaluating Respiratory Symptoms (E-RS) in COPD. E-RS: COPD Total Score — -2.11; -1.93; -1.47; -0.87 Scores on a scale
Summary
Danirixin (DNX) is a selective CXC chemokine receptor (CXCR2) antagonist being developed as a potential anti-inflammatory agent for the treatment of COPD. This is a Phase 2, randomized, double-blind (Sponsor Open) study. The primary objective of the study is to evaluate the clinical activity and safety of danirixin compared with placebo in participants with COPD. Following baseline assessments collected over a 7 day period participants will be randomized (1:1:1:1:1:1) to receive one of five dose strengths of danirixin (5 milligram [mg], 10 mg, 25 mg, 35 mg and 50 mg) or placebo. Study treatment will be administered orally twice daily for 24 weeks. Participants will continue with their standard of care inhaled medications (i.e. long acting bronchodilators with or without inhaled corticosteroids) while receiving study treatment. Follow up will continue up to 28 days post last dose. Approximately 700 participants will be screened with a target of 540 participants completing 24 weeks of treatment and key study assessments.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change From Baseline in Respiratory Symptoms Measured by Evaluating Respiratory Symptoms (E-RS) in COPD. E-RS: COPD Total Score |
-2.11; -1.93; -1.47; -0.87; -0.76; -0.71 | — |
| PRIMARY Change From Baseline in Respiratory Symptoms Measured by E-RS in COPD (E-RS: COPD Breathlessness Score) |
-0.82; -0.69; -0.41; -0.15; -0.10; -0.09 | — |
| PRIMARY Change From Baseline in Respiratory Symptoms Measured by E-RS in COPD (E-RS: COPD Cough and Sputum Score) |
-0.83; -0.79; -0.67; -0.46; -0.40; -0.37 | — |
| PRIMARY Change From Baseline in Respiratory Symptoms Measured by E-RS in COPD (E-RS: COPD Chest Symptoms Score) |
-0.36; -0.35; -0.34; -0.34; -0.34; -0.34 | — |
| PRIMARY Number of Participants With Adverse Events (AE) and Serious Adverse Events (SAE) |
63; 63; 69; 68; 63; 71 | — |
| PRIMARY Number of Participants With Worst Case Hematology Parameter Results by Potential Clinical Importance (PCI) |
97; 102; 101; 101; 101; 99 | — |
| PRIMARY Number of Participants With Worst Case Clinical Chemistry Parameter Results by PCI |
99; 102; 101; 102; 101; 100 | — |
| PRIMARY Number of Participants With Worst Case Vital Signs Parameter Results by PCI |
0; 0; 0; 0; 0; 1 | — |
| PRIMARY Number of Participants With Worst Case Post-Baseline Abnormal 12-lead Electrocardiogram (ECG) Findings |
52; 65; 68; 67; 62; 53 | — |
| SECONDARY Number of Moderate or Severe Healthcare Resource Utilization (HCRU) Exacerbations Per Participant |
66; 51; 61; 63; 55; 50 | — |
| SECONDARY Number of Responders E-RS in COPD (E-RS): COPD Total Score |
33; 48; 33; 30; 29; 32 | 0.089 |
| SECONDARY Number of EXACT Events Per Participant |
92; 92; 92; 92; 86; 86 | — |
| SECONDARY Time to First EXACT Event |
NA; NA; NA; NA; NA; NA | — |
| SECONDARY Severity of EXACT Event |
22.1; 26.7; 22.9; 28.6; 25.0; 26.4 | — |
| SECONDARY EXACT Event Duration for All Events |
45.3; 11.6; 45.8; 25.5; 17.6; 18.7 | — |
| SECONDARY Time to First HCRU-defined COPD Exacerbation |
110; 47; 63; 79; 70; 57 | — |
| SECONDARY Time to First Severe HCRU-defined COPD Exacerbation |
NA; NA; NA; NA; NA; NA | — |
| SECONDARY HCRU-defined Exacerbation Duration |
10.3; 12.3; 12.9; 14.0; 10.7; 14.2 | — |
| SECONDARY Change From Baseline in St. George's Respiratory Questionnaire for COPD Patients (SGRQ-C) Total Score |
-3.79; -3.63; -1.31; -3.19; -2.83; -2.48 | — |
| SECONDARY Number of SGRQ Responder |
39; 40; 35; 49; 35; 38 | 0.208 |
| SECONDARY Change From Baseline COPD Assessment Test (CAT) Total Score |
-2.02; -0.86; -0.63; -0.55; -1.51; -0.36 | — |
| SECONDARY Number of CAT Responder |
46; 44; 38; 37; 43; 36 | 0.973 |
| SECONDARY Change From Baseline in Post-bronchodilator FEV1 as a Lung Function Assessment |
0.016; -0.031; -0.029; -0.018; -0.027; 0.027 | — |
| SECONDARY Percent Predicted Normal FEV1 |
58.98; 56.75; 56.62; 56.84; 57.51; 57.84 | — |
| SECONDARY Change From Baseline in Post-bronchodilator Forced Vital Capacity (FVC) as a Lung Function Assessment |
0.024; -0.054; -0.043; 0.027; -0.049; 0.014 | — |
| SECONDARY Change From Baseline in Post-bronchodilator FEV1/FVC Ratio as a Lung Function Assessment |
-0.003; -0.001; -0.000; -0.013; -0.000; 0.014 | — |
| SECONDARY Change From Baseline Number of Puffs of Rescue Medication Per Day |
0.00; 0.36; 0.28; 0.15; -0.03; 0.28 | — |
| SECONDARY Participant Experience of Physical Activity Measured Using PROactive Physical Activity in COPD (C-PPAC) Questionnaire |
3.00; -5.75; -3.83; 0.42; -1.20; 2.33 | — |
| SECONDARY Danirixin Whole Blood Pharmacokinetic Concentration-Time Data |
2.1; 0.4; 0.3; 17.2; 3.9; 86.7 | — |
| SECONDARY Area Under the Plasma Concentration-time Curve From Time Zero to Last Time of Quantifiable Concentration [AUC(0-t)] of Danirixin in Whole Blood Using Dried Blood Spot |
543.0; 1373.1; 3851.5; 5485.1; 8073.4; 752.1 | — |
| SECONDARY Concentration Maximum (Cmax) of Danirixin in Whole Blood Using Dried Blood Spots |
164.9; 343.1; 1028.8; 1386.2; 2119.1; 171.9 | — |
| SECONDARY Time to Reach Maximum Plasma Concentration (Tmax) of Danirixin in Whole Blood Using Dried Blood Spots |
1.000; 1.000; 1.000; 1.000; 1.000; 1.000 | — |
Eligibility Criteria
Inclusion Criteria
- Participants must be aged between 40 to 80 years of age inclusive, at the time of signing the informed consent.
- Participants who have COPD (post bronchodilator FEV1/FVC ratio =40%) based on American Thoracic Society (ATS)/European Respiratory Society (ERS) current guidelines. Participants with a historical diagnosis of asthma may be included so long as they have a current diagnosis of COPD.
- History of respiratory symptoms including chronic cough, mucus hypersecretion, and dyspnea on most days for at least the previous 3 months prior to screening.
- Participants with a documented history of COPD exacerbation(s) in the 12 months prior to study participation (screening) meeting at least one of the following criteria: >=2 COPD exacerbations resulting in prescription for antibiotics and/or oral corticosteroids or hospitalization or extended observation in a hospital emergency room or outpatient center; 1 COPD exacerbation resulting in prescription for antibiotics and/or oral corticosteroids of hospitalization or extended observation in a hospital emergency room or outpatient center and a plasma fibrinogen concentration at screening >=3 grams/liter (300 milligram/deciliter)
- Current and former smokers with a cigarette smoking history of >=10 pack years (1 pack year = 20 cigarettes smoked per day for 1 year or equivalent). Current smokers are defined as those who are currently smoking cigarettes (i.e. have smoked at least one cigarette daily or most days for the month prior to Visit 1). Former smokers are defined as those who have stopped smoking for at least 6 months prior to Visit 1.
- Participants must have the ability and willingness to use an electronic diary (log pad) on a daily basis.
- Body weight >=45 kilogram (kg)
- Male or female: A male participant must agree to use contraception during the treatment period and for at least 60 hours after the last dose of study treatment, corresponding to approximately 6 half-lives (which is the time needed to eliminate any teratogenic study treatment) and to refrain from donating sperm during this period; A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: Not a woman of childbearing potential (WOCBP) OR A WOCBP who agrees to follow the contraceptive guidance during the treatment period and for at least 60 hours after the last dose of study treatment.
- Capable of giving signed informed consent.
Exclusion Criteria
- Diagnosis of other clinically relevant lung diseases (other than COPD), e.g. sarcoidosis, tuberculosis, pulmonary fibrosis, severe bronchiectasis or lung cancer.
- Alpha-1-antitrypsin deficiency as the underlying cause of COPD
- Pulse oximetry 120 beats per minute (bpm); sustained or non-sustained ventricular tachycardia; second degree heart block Mobitz type II and third degree heart block (unless pacemaker or defibrillator has been implanted); Corrected QT Interval using Fridericia formula (QTcF) >=500 millisecond (msec) in participants with QRS =530 msec in participants with QRS >=120 msec.
- Previous lung surgery (e.g. lobectomy, pneumonectomy) or lung volume reduction procedure.
- Current or expected chronic use of macrolide antibiotics during the study period for the prevention of COPD exacerbations. Examples of chronic use include, but are not limited to, daily or two to three times per week use for at least 3 months.
- Oral or injectable CYP3A4 or breast cancer resistance protein (BRCP) substrates with a narrow therapeutic index (CYP3A4 substrates include, but are not limited to, alfenatil, cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus, tacrolimus, and theophylline; BRCP substrates include, but are not limited to, topotecan.) The Investigator should consult with the Medical Monitor if necessary.
- Current or expected use of phosphodiesterase-4 inhibitors (e.g. roflumilast). Participants currently receiving ro
Data sourced from ClinicalTrials.gov (NCT03034967). 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. Informational only — not medical advice.