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    Clinical Trial Results:
    Phase 2 Assessment of the Relationship between Serotonin and Efficacy in Ulcerative Colitis: A Multi-Center Randomized, Double Blind, Placebo-Controlled, Pilot Study to Evaluate Safety and Preliminary Efficacy of Orally Administered LX1606 in Subjects with Acute, Mild to Moderate Ulcerative Colitis

    Summary
    EudraCT number
    2011-003532-32
    Trial protocol
    SK   LT  
    Global end of trial date
    03 Sep 2013

    Results information
    Results version number
    v1(current)
    This version publication date
    13 Jun 2019
    First version publication date
    13 Jun 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    LX1606.1-204-UC
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01456052
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Lexicon Pharmaceuticals, Inc.
    Sponsor organisation address
    8800 Technology Forest Place, The Woodlands, United States, TX 77381
    Public contact
    Shanna Jackson, Lexicon Pharmaceuticals, Inc., 001 281 863 3484, sjackson@lexpharma.com
    Scientific contact
    Shanna Jackson, Lexicon Pharmaceuticals, Inc., 001 281 863 3484, sjackson@lexpharma.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    03 Sep 2013
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    03 Sep 2013
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of this study is to evaluate the safety and tolerability of orally administered telotristat etiprate (LX1606) after 8 weeks in a cohort of subjects with acute, mild to moderate ulcerative colitis.
    Protection of trial subjects
    All study subjects were required to read and sign an Informed Consent Form.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    30 Jan 2012
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Poland: 24
    Country: Number of subjects enrolled
    Slovakia: 6
    Country: Number of subjects enrolled
    Lithuania: 13
    Country: Number of subjects enrolled
    United States: 16
    Worldwide total number of subjects
    59
    EEA total number of subjects
    43
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    57
    From 65 to 84 years
    2
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Up to 60 subjects were enrolled and treated in the blinded Treatment period across 24 US and international sites. The recruitment period lasted approximately 10 months.

    Pre-assignment
    Screening details
    The study consisted of an approximately 15 days Screening period prior to the blinded Treatment period.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Carer, Assessor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Placebo
    Arm description
    Matching placebo administered orally.
    Arm type
    Experimental

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Matching placebo administered orally.

    Arm title
    Low Dose Telotristat Etiprate
    Arm description
    500 mg telotristat etiprate (LX1606) administered orally once daily (QD).
    Arm type
    Experimental

    Investigational medicinal product name
    Telotristat etiprate
    Investigational medicinal product code
    LX1606
    Other name
    LX1606 Hippurate
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Telotristat etiprate was administered orally as 250 mg capsules at doses of 500 mg (2 x 250 mg capsules) QD.

    Arm title
    High Dose Telotristat Etiprate
    Arm description
    500 mg telotristat etiprate (LX1606) administered orally three times daily (TID).
    Arm type
    Experimental

    Investigational medicinal product name
    Telotristat etiprate
    Investigational medicinal product code
    LX1606
    Other name
    LX1606 Hippurate
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Telotristat etiprate was administered orally as 250 mg capsules at doses of 500 mg (2 x 250 mg capsules) TID.

    Number of subjects in period 1
    Placebo Low Dose Telotristat Etiprate High Dose Telotristat Etiprate
    Started
    10
    25
    24
    Completed
    8
    20
    19
    Not completed
    2
    5
    5
         Physician Decision
    1
    -
    1
         Adverse Event
    1
    1
    2
         Treatment Failure
    -
    1
    1
         Protocol Violation
    -
    1
    -
         Consent withdrawn
    -
    2
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Placebo
    Reporting group description
    Matching placebo administered orally.

    Reporting group title
    Low Dose Telotristat Etiprate
    Reporting group description
    500 mg telotristat etiprate (LX1606) administered orally once daily (QD).

    Reporting group title
    High Dose Telotristat Etiprate
    Reporting group description
    500 mg telotristat etiprate (LX1606) administered orally three times daily (TID).

    Reporting group values
    Placebo Low Dose Telotristat Etiprate High Dose Telotristat Etiprate Total
    Number of subjects
    10 25 24 59
    Age categorical
    Units: Subjects
        In utero
    0 0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0 0
        Newborns (0-27 days)
    0 0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0 0
        Children (2-11 years)
    0 0 0 0
        Adolescents (12-17 years)
    0 0 0 0
        Adults (18-64 years)
    9 24 24 57
        From 65-84 years
    1 1 0 2
        85 years and over
    0 0 0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    39.2 ± 16.16 45.9 ± 12.38 41.7 ± 12.69 -
    Gender categorical
    Units: Subjects
        Female
    4 13 7 24
        Male
    6 12 17 35
    Race
    Units: Subjects
        Asian
    0 0 1 1
        Black or African American
    0 0 1 1
        White
    10 25 22 57

    End points

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    End points reporting groups
    Reporting group title
    Placebo
    Reporting group description
    Matching placebo administered orally.

    Reporting group title
    Low Dose Telotristat Etiprate
    Reporting group description
    500 mg telotristat etiprate (LX1606) administered orally once daily (QD).

    Reporting group title
    High Dose Telotristat Etiprate
    Reporting group description
    500 mg telotristat etiprate (LX1606) administered orally three times daily (TID).

    Primary: Number of Subjects Experiencing a Treatment Emergent Adverse Event

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    End point title
    Number of Subjects Experiencing a Treatment Emergent Adverse Event [1]
    End point description
    End point type
    Primary
    End point timeframe
    8 weeks
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Statistical analyses were not planned for this endpoint.
    End point values
    Placebo Low Dose Telotristat Etiprate High Dose Telotristat Etiprate
    Number of subjects analysed
    10
    24
    24
    Units: Subjects
    3
    9
    10
    No statistical analyses for this end point

    Secondary: Number of Subjects Achieving Clinical Response

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    End point title
    Number of Subjects Achieving Clinical Response
    End point description
    Clinical response is defined as a decrease in the total modified Mayo score from baseline of ≥3 or a ≥30% decrease in the total modified Mayo score from baseline, along with a decrease in the rectal bleeding score ≥1 or an absolute rectal bleeding score ≤1 at Week 8.
    End point type
    Secondary
    End point timeframe
    Baseline to 8 weeks
    End point values
    Placebo Low Dose Telotristat Etiprate High Dose Telotristat Etiprate
    Number of subjects analysed
    10
    25
    24
    Units: Subjects
    4
    8
    8
    No statistical analyses for this end point

    Secondary: Number of Subjects Achieving Clinical Remission

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    End point title
    Number of Subjects Achieving Clinical Remission
    End point description
    Clinical remission is defined as a total modified Mayo score ≤2 with no individual score >1 at Week 8.
    End point type
    Secondary
    End point timeframe
    Baseline to 8 weeks
    End point values
    Placebo Low Dose Telotristat Etiprate High Dose Telotristat Etiprate
    Number of subjects analysed
    10
    25
    24
    Units: Subjects
    2
    2
    3
    No statistical analyses for this end point

    Secondary: Change From Baseline in Total Modified Mayo Score

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    End point title
    Change From Baseline in Total Modified Mayo Score
    End point description
    A modified Mayo score was used to evaluate disease activity using 4 components, including stool frequency, rectal bleeding, endoscopy, and physician assessment. Components = Stool frequency score 0-3 (normal- >4 stools/day more than normal), rectal bleeding score 0-3 (none-passing blood alone), mucosal appearance at endoscopy 0-3 (normal-severe disease), physician rating of disease activity 0-3 (normal-severe). The total Modified Mayo score ranges from 0 to 12, with higher scores indicating greater disease severity. “n” is the number of subjects with evaluable data at the given time-point.
    End point type
    Secondary
    End point timeframe
    Baseline to 8 weeks
    End point values
    Placebo Low Dose Telotristat Etiprate High Dose Telotristat Etiprate
    Number of subjects analysed
    8
    19
    19
    Units: Score on a scale
        arithmetic mean (standard deviation)
    -2.38 ± 2.973
    -1.89 ± 2.865
    -2.53 ± 2.389
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    10 weeks
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    14.1
    Reporting groups
    Reporting group title
    Placebo
    Reporting group description
    Placebo: Matching placebo administered orally

    Reporting group title
    Low Dose Telotristat Etiprate
    Reporting group description
    500 mg telotristat etiprate (LX1606) administered orally once daily.

    Reporting group title
    High Dose Telotristat Etiprate
    Reporting group description
    500 mg telotristat etiprate (LX1606) administered orally three times daily.

    Serious adverse events
    Placebo Low Dose Telotristat Etiprate High Dose Telotristat Etiprate
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 10 (10.00%)
    3 / 24 (12.50%)
    2 / 24 (8.33%)
         number of deaths (all causes)
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    Blood and lymphatic system disorders
    Iron deficiency anemia
         subjects affected / exposed
    0 / 10 (0.00%)
    0 / 24 (0.00%)
    1 / 24 (4.17%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Colitis ulcerative
         subjects affected / exposed
    1 / 10 (10.00%)
    3 / 24 (12.50%)
    0 / 24 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 3
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Appendicitis
         subjects affected / exposed
    0 / 10 (0.00%)
    0 / 24 (0.00%)
    1 / 24 (4.17%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Placebo Low Dose Telotristat Etiprate High Dose Telotristat Etiprate
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    3 / 10 (30.00%)
    9 / 24 (37.50%)
    2 / 24 (8.33%)
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 24 (0.00%)
    0 / 24 (0.00%)
         occurrences all number
    1
    0
    0
    Memory impairment
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 24 (0.00%)
    0 / 24 (0.00%)
         occurrences all number
    1
    0
    0
    Gastrointestinal disorders
    Colitis ulcerative
         subjects affected / exposed
    1 / 10 (10.00%)
    2 / 24 (8.33%)
    1 / 24 (4.17%)
         occurrences all number
    1
    2
    1
    Abdominal pain
         subjects affected / exposed
    0 / 10 (0.00%)
    2 / 24 (8.33%)
    0 / 24 (0.00%)
         occurrences all number
    0
    2
    0
    Diarrhoea
         subjects affected / exposed
    0 / 10 (0.00%)
    2 / 24 (8.33%)
    0 / 24 (0.00%)
         occurrences all number
    0
    2
    0
    Dyspepsia
         subjects affected / exposed
    0 / 10 (0.00%)
    2 / 24 (8.33%)
    0 / 24 (0.00%)
         occurrences all number
    0
    2
    0
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 24 (0.00%)
    1 / 24 (4.17%)
         occurrences all number
    1
    0
    1
    Sinusitis
         subjects affected / exposed
    0 / 10 (0.00%)
    2 / 24 (8.33%)
    0 / 24 (0.00%)
         occurrences all number
    0
    2
    0
    Influenza
         subjects affected / exposed
    1 / 10 (10.00%)
    0 / 24 (0.00%)
    0 / 24 (0.00%)
         occurrences all number
    1
    0
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    19 Mar 2012
    Amendment 1: 1. The week 8 visit could occur over multiple days, if needed, to provide flexibility in scheduling the endoscopic evaluation. The original protocol permitted Screening to occur over multiple days, if needed, for the same reason. 2. The list of defined SAEs was clarified, in alignment with ICH E2A reporting conventions, to include important medical events and omitted text that suggested these events had to be considered related to study medication, by the Investigator, to be reported. 3. Cross-referenced text regarding the procedure for withdrawal was updated in Section 6.2.1 to the identical language already in Section 7.11.3 regarding prohibited medications. 4. Schedule of events table in the original protocol included some inadvertent omissions or notations, which were revised under this amendment.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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