Phase 2
N=308
Efficacy, Safety, and Pharmacokinetics of APT-1011 in Subjects With Eosinophilic Esophagitis (EoE)
Eosinophilic Esophagitis
Bottom Line
View on ClinicalTrials.gov: NCT03191864 ↗Enrolled (actual)
308
Serious AEs
1.2%
Results posted
Apr 2023
Primary outcome: Primary: Percentage of Subjects With ≤6 Peak Eosinophils/High-power Field (HPF) — 10; 19; 14; 16 Participants — p=0.001
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- APT-1011 (Drug); Placebo (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Adare Pharmaceuticals, Inc.
- Primary completion
- Jan 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Subjects With ≤6 Peak Eosinophils/High-power Field (HPF) |
10; 19; 14; 16; 0; 11 | 0.001 sig |
| SECONDARY Percentage of Subjects Who Met the Primary Endpoint at Week 12 and Maintained the Primary Endpoint at Weeks 26 and 52 |
7; 17; 11; 14; 7; 12 | — |
| SECONDARY Change From Baseline Eosinophilic Esophagitis Endoscopic Reference Score (EREFs) at Week 12, 26, and 52 |
-2.4; -2.7; -3.3; -2.2; -0.9; -3.1 | 0.020 sig |
| SECONDARY Percentage of Subjects With a Peak Eosinophils/HPF Number <1 and <15 |
7; 14; 12; 15; 0; 12 | — |
| SECONDARY Change From Baseline Global EoE Symptom Score |
-1.8; -1.3; -2.5; -1.6; -1.0; -2.6 | 0.067 |
| SECONDARY Change in the Number of Dysphagia Episodes |
-8.2; -4.4; -9.3; -9.1; -5.5; -12.8 | — |
| SECONDARY Change From Baseline 7-Day Eosinophilic Esophagitis Activity Index (EEsAI) Total Score |
-20.4; -15.6; -22.7; -22.6; -9.6; -25.6 | 0.079 |
| SECONDARY Change From Baseline 7-Day Eosinophilic Esophagitis Activity Index (EEsAI) Subscores |
-3.9; -2.5; -5.0; -4.1; -2.7; -3.1 | 0.459 |
| SECONDARY Percentage of Subjects With Mean 7-day EEsAI Total Score <20 |
4; 1; 6; 5; 2; 3 | — |
| SECONDARY Change From Baseline Patient Global Impression of Severity (PGIS) for EoE Symptoms as Assessed Prior to Randomization Post-Baseline Visit |
1; 0; 0; 0; 1; 0 | — |
| SECONDARY Change From Baseline PGIS for Difficulty With Food or Pills Going Down as Assessed Prior to Randomization Post-Baseline Visit |
2; 0; 0; 0; 1; 1 | — |
| SECONDARY Change From Baseline Patient Global Impression of Change (PGIC) for EoE Symptoms as Assessed Prior to Randomization Post-Baseline Visit |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Change From Baseline PGIC of Difficulty With Food or Pills as Assessed Prior to Randomization Post-Baseline Visit |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Percentage of Histologic Non-responders by Dose at Weeks 12, 26, and 52 |
11; 2; 7; 4; 19; 11 | — |
| SECONDARY Percentage of Subjects Requiring Emergency Endoscopic Food Dis-impaction |
0; 0; 0; 0; 0; 0 | — |
| SECONDARY Percentage of Subjects Requiring Esophageal Dilation |
0; 0; 0; 0; 0 | — |
Summary
Eosinophilic esophagitis (EoE) is an inflammatory disease of the esophagus, characterized by eosinophilic infiltration and gastrointestinal symptoms. Swallowed, topically acting corticosteroids, such as fluticasone, appear to be effective in resolving acute clinical and pathological features of EoE.
APT-1011 is an orally disintegrating tablet (ODT) formulation of fluticasone propionate. This study is designed to compare the efficacy and safety of APT-1011 with placebo in adults with EoE for an initial 12-week treatment period, followed by an additional 40-week maintenance treatment phase. Histologic response, pharmacokinetics, and dysphagia will be assessed.
Eligibility Criteria
Inclusion Criteria
- Male or female between ≥18 and ≤75 years of age at the time of informed consent
- Signed informed consent
- Evidence of EoE defined by ≥15 peak eosinophils per HPF as measured from proximal and distal biopsies
- Subject-reported history of ≥3 episodes of dysphagia in the 7 days prior to Screening
- 7-day Global EoE Symptom Score >3 at baseline and at screening
- Willing and able to adhere to study-related treatment regimens, procedures, and visit schedule
Exclusion Criteria
- Have known contraindication, hypersensitivity, or intolerance to corticosteroids;
- Have any physical, mental, or social condition or history of illness or laboratory abnormality that in the Investigator's judgment might interfere with study procedures or the ability of the subject to adhere to and complete the study;
- Presence of oral or esophageal mucosal infection of any type;
- Have any mouth or dental condition that prevents normal eating;
- Have any condition affecting the esophageal mucosa or altering esophageal motility other than EoE;
- Use of systemic corticosteroids within 60 days prior to Screening, use of inhaled/swallowed corticosteroids within 30 days prior to Screening, or extended use of high-potency dermal topical corticosteroids within 30 days prior to Screening;
- Initiation of an elimination diet or elemental diet within 30 days before Screening (diet must remain stable after signing ICF);
- Morning serum cortisol level ≤5 μg/dL (138 nmol/L);
- Use of biologic immunomodulators in the 24 weeks prior to Screening;
- Use of calcineurin inhibitors or purine analogues, or potent cytochrome P450 (CYP) 3A4 inhibitors in the 12 weeks prior to Screening;
- Have a contraindication to or factors that substantially increase the risk of EGD or esophageal biopsy or have narrowing of the esophagus that precludes EGD with a standard 9 mm endoscope;
- Have a history of an esophageal stricture requiring dilatation within the previous 12 weeks prior to Screening;
- Have initiated, discontinued or changed dosage regimen of PPIs, H2 antagonists, antacids or antihistamines for any condition such as GERD or allergic rhinitis within 4 weeks prior to qualifying endoscopy. These drugs must remain constant throughout the study.
- A serum cortisol level <18 μg/dL (497 nmol/L) at 60 minutes with adrenocorticotropic hormone (ACTH) stimulation test using 250 μg cosyntropin (i.e., a positive result on the ACTH stimulation test).
Data sourced from ClinicalTrials.gov (NCT03191864). 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.