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    Clinical Trial Results:
    Long-Term, Follow-up Study of Subjects Who Completed Phase III Trials of ATX-101-10-16 or ATX-101-10-17 (Sodium Deoxycholate Injection) for the Reduction of Localized Subcutaneous Fat in the Submental Area

    Summary
    EudraCT number
    2011-005026-21
    Trial protocol
    DE  
    Global end of trial date
    13 Dec 2013

    Results information
    Results version number
    v1(current)
    This version publication date
    30 Sep 2018
    First version publication date
    30 Sep 2018
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    1403740
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02052622
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Allergan Pharmaceuticals International Limited
    Sponsor organisation address
    Clonshaugh Industrial Estate, Coolock, Dublin 17, Ireland, D17 E400
    Public contact
    Clinical Trials Registry Team, Allergan Pharmaceuticals International Limited, 001 877‐277‐8566, IR-CTRegistration@allergan.com
    Scientific contact
    Therapeutic Area Head, Allergan Pharmaceuticals International Limited, 001 877-277-8566, IR-CTRegistration@Allergan.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
    13 Dec 2013
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    13 Dec 2013
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The objective of this non-treatment, placebo-controlled, observational, 24-month follow-up study was to evaluate the long-term efficacy and safety of subcutaneous (SC) injections of deoxycholic acid (ATX-101) in the submental area. No treatment was administered in this study. Participants who previously received deoxycholic acid injections in studies ATX-101-10-16 or ATX-101-10-17 were enrolled in this non-treatment observational follow-up study to further evaluate safety and efficacy.
    Protection of trial subjects
    All study participants were required to read and sign an Informed Consent Form.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    14 Feb 2012
    Long term follow-up planned
    Yes
    Long term follow-up rationale
    Safety, Efficacy
    Long term follow-up duration
    24 Months
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Germany: 201
    Worldwide total number of subjects
    201
    EEA total number of subjects
    201
    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)
    199
    From 65 to 84 years
    2
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    A subset of participants at selected centers who had successfully completed Phase 3 clinical studies ATX-101-10-16 or ATX-101-10-17 for the reduction of submental fat were enrolled in this non-treatment observational long-term follow-up (LTFU) study.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Data analyst

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Deoxycholic Acid Injection, 5 mg/mL
    Arm description
    Non-treatment observational follow-up study: Participants were previously treated with deoxycholic acid injection, 5 mg/mL, in studies ATX-101-10-16 or ATX-101-10-17.
    Arm type
    Experimental

    Investigational medicinal product name
    Deoxycholic acid Injection
    Investigational medicinal product code
    Other name
    Kybella
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Previously treated with deoxycholic acid injection, 5 mg/mL, in studies ATX-101-10-16 or ATX-101-10-17

    Arm title
    Deoxycholic Acid Injection, 10 mg/mL
    Arm description
    Non-treatment observational follow-up study: Participants were previously treated with deoxycholic acid injection, 10 mg/mL, in studies ATX-101-10-16 or ATX-101-10-17.
    Arm type
    Experimental

    Investigational medicinal product name
    Deoxycholic acid Injection
    Investigational medicinal product code
    Other name
    Kybella
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Previously treated with deoxycholic acid injection, 10 mg/mL, in studies ATX-101-10-16 or ATX-101-10-17

    Arm title
    Placebo
    Arm description
    Non-treatment observational follow-up study: Participants were previously treated with placebo in studies ATX-101-10-16 or ATX-101-10-17.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo, 10 mM sodium phosphate, 0.9% [w/v] sodium chloride in water for injection
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Subcutaneous use
    Dosage and administration details
    Previously treated with placebo in studies ATX-101-10-16 or ATX-101-10-17

    Number of subjects in period 1
    Deoxycholic Acid Injection, 5 mg/mL Deoxycholic Acid Injection, 10 mg/mL Placebo
    Started
    60
    75
    66
    Completed
    60
    75
    65
    Not completed
    0
    0
    1
         Withdrawal by subject
    -
    -
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Deoxycholic Acid Injection, 5 mg/mL
    Reporting group description
    Non-treatment observational follow-up study: Participants were previously treated with deoxycholic acid injection, 5 mg/mL, in studies ATX-101-10-16 or ATX-101-10-17.

    Reporting group title
    Deoxycholic Acid Injection, 10 mg/mL
    Reporting group description
    Non-treatment observational follow-up study: Participants were previously treated with deoxycholic acid injection, 10 mg/mL, in studies ATX-101-10-16 or ATX-101-10-17.

    Reporting group title
    Placebo
    Reporting group description
    Non-treatment observational follow-up study: Participants were previously treated with placebo in studies ATX-101-10-16 or ATX-101-10-17.

    Reporting group values
    Deoxycholic Acid Injection, 5 mg/mL Deoxycholic Acid Injection, 10 mg/mL Placebo Total
    Number of subjects
    60 75 66 201
    Age Categorical
    Units: Subjects
        18-30 years
    7 5 3 15
        31-50 years
    29 39 29 97
        51-65 years
    24 31 34 89
    Age Continuous
    Units: years
        arithmetic mean (standard deviation)
    46.9 ± 10.33 47.9 ± 9.23 49.2 ± 9.09 -
    Gender Categorical
    Units: Subjects
        Female
    49 59 44 152
        Male
    11 16 22 49

    End points

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    End points reporting groups
    Reporting group title
    Deoxycholic Acid Injection, 5 mg/mL
    Reporting group description
    Non-treatment observational follow-up study: Participants were previously treated with deoxycholic acid injection, 5 mg/mL, in studies ATX-101-10-16 or ATX-101-10-17.

    Reporting group title
    Deoxycholic Acid Injection, 10 mg/mL
    Reporting group description
    Non-treatment observational follow-up study: Participants were previously treated with deoxycholic acid injection, 10 mg/mL, in studies ATX-101-10-16 or ATX-101-10-17.

    Reporting group title
    Placebo
    Reporting group description
    Non-treatment observational follow-up study: Participants were previously treated with placebo in studies ATX-101-10-16 or ATX-101-10-17.

    Primary: Percentage of Participants Maintaining Clinician-Reported Submental Fat Rating Scale (CR-SMFRS) 1-Grade Response During the 24 Months of Follow up, i.e. % of Participants who were CR-SMFRS 1-Grade Responders at both LTFU Baseline and at 24-Month Visit

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    End point title
    Percentage of Participants Maintaining Clinician-Reported Submental Fat Rating Scale (CR-SMFRS) 1-Grade Response During the 24 Months of Follow up, i.e. % of Participants who were CR-SMFRS 1-Grade Responders at both LTFU Baseline and at 24-Month Visit [1]
    End point description
    The CR-SMFRS was based on the investigator’s clinical evaluation of the participant's chin and neck area using a 5-point ordinal scale (0 to 4) with 0=Absent Submental Convexity: no localized submental fat evident; 1=Mild Submental Convexity: minimal, localized submental fat; 2=Moderate Submental Convexity: prominent, localized submental fat; 3=Severe Submental Convexity; a marked amount of chin fat; and 4=Extreme Submental Convexity: marked, localized submental fat. 1-grade response=At least a 1-grade reduction from original study baseline in the CR-SMFRS assessment. The full analysis set included all participants who received a clearly identifiable treatment in the previous study and had at least one visit in the LTFU study. Participants were included in the analysis according to their randomized treatment assignment. Missing values at Month 24 were imputed using LOCF. Non-responders at LTFU baseline in each treatment group (including placebo) were not included in the analysis.
    End point type
    Primary
    End point timeframe
    LTFU Baseline (Month 0) to Month 24
    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: No inferential statistical analyses were performed for this endpoint.
    End point values
    Deoxycholic Acid Injection, 5 mg/mL Deoxycholic Acid Injection, 10 mg/mL Placebo
    Number of subjects analysed
    40
    54
    22
    Units: percentage of participants
        number (not applicable)
    90.0
    87.0
    90.9
    No statistical analyses for this end point

    Primary: Percentage of Participants with Maintenance of Response as Assessed by the Subject Satisfaction Rating Scale (SSRS) During the 24 Months of Follow up, i.e. % of Participants who were SSRS Responders at both LTFU Baseline and at 24-Month Visit

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    End point title
    Percentage of Participants with Maintenance of Response as Assessed by the Subject Satisfaction Rating Scale (SSRS) During the 24 Months of Follow up, i.e. % of Participants who were SSRS Responders at both LTFU Baseline and at 24-Month Visit [2]
    End point description
    For the SSRS, the participant was asked to answer the question: “Considering your appearance in association with your face and chin, how satisfied do you feel with your appearance at the present time?” using a 7-point scale: 0=Extremely dissatisfied, 1=Dissatisfied, 2=Slightly dissatisfied, 3=neither satisfied nor dissatisfied, 4=Slightly satisfied, 5=Satisfied, and 6=Extremely satisfied. SSRS responder was a participant whose response was ≥ 4. A positive change from Baseline indicates improvement. The full analysis set included all participants who received a clearly identifiable treatment in the previous study and had at least one visit in the LTFU study. Participants were included in the analysis according to their randomized treatment assignment. Missing values at Month 24 were imputed using last observation carried forward (LOCF). Non-responders at LTFU baseline in each treatment group (including placebo) were not included in the analysis.
    End point type
    Primary
    End point timeframe
    LTFU Baseline (Month 0) to Month 24
    Notes
    [2] - 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: No inferential statistical analyses were performed for this endpoint.
    End point values
    Deoxycholic Acid Injection, 5 mg/mL Deoxycholic Acid Injection, 10 mg/mL Placebo
    Number of subjects analysed
    43
    48
    25
    Units: percentage of participants
        number (not applicable)
    62.8
    81.3
    80.0
    No statistical analyses for this end point

    Secondary: Percentage of Participants Maintaining Clinician-Reported Submental Fat Rating Scale (CR-SMFRS) 2-Grade Response During the 24 Months of Follow up, i.e. % of Participants who were CR-SMFRS 2-Grade Responders at both LTFU Baseline and at 24-Month Visit

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    End point title
    Percentage of Participants Maintaining Clinician-Reported Submental Fat Rating Scale (CR-SMFRS) 2-Grade Response During the 24 Months of Follow up, i.e. % of Participants who were CR-SMFRS 2-Grade Responders at both LTFU Baseline and at 24-Month Visit
    End point description
    The CR-SMFRS was based on the investigator’s clinical evaluation of the participant's chin and neck area using a 5-point ordinal scale (0 to 4) with 0=Absent Submental Convexity: no localized submental fat evident; 1=Mild Submental Convexity: minimal, localized submental fat; 2=Moderate Submental Convexity: prominent, localized submental fat; 3=Severe Submental Convexity; a marked amount of chin fat; and 4=Extreme Submental Convexity: marked, localized submental fat. 2-grade response=At least a 2-grade reduction from original study baseline in the CR-SMFRS assessment. The full analysis set included all participants who received a clearly identifiable treatment in the previous study and had at least one visit in the LTFU study. Participants were included in the analysis according to their randomized treatment assignment. Missing values at Month 24 were imputed using LOCF. Non-responders at LTFU baseline in each treatment group (including placebo) were not included in the analysis.
    End point type
    Secondary
    End point timeframe
    LTFU Baseline (Month 0) to Month 24
    End point values
    Deoxycholic Acid Injection, 5 mg/mL Deoxycholic Acid Injection, 10 mg/mL Placebo
    Number of subjects analysed
    8
    13
    2
    Units: percentage of participants
        number (not applicable)
    87.5
    61.5
    50.0
    No statistical analyses for this end point

    Secondary: Patient-Reported Submental Fat Impact Scale (PR-SMFIS)

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    End point title
    Patient-Reported Submental Fat Impact Scale (PR-SMFIS)
    End point description
    The PR-SMFIS assessed the impact of submental fat on self-perception of 6 emotional and visual characteristics related to the appearance of submental fullness (unhappy, bothered, self-conscious, embarrassed, look older, and look overweight) as evaluated by the participant. Each item was rated on an 11-point numeric scale from 0 to 10. Scores for the 6 items were averaged to generate a PR-SMFIS total scale score ranging from 0 to 10 where low scores reflect a positive impact and high scores reflect a negative impact. The full analysis set included all participants who received a clearly identifiable treatment in the previous study and had at least one visit in the LTFU study. Participants were included in the analysis according to their randomized treatment assignment. Here, "n" represents the number of participants evaluated at specific time points.
    End point type
    Secondary
    End point timeframe
    LTFU Baseline (Month 0) to Month 24
    End point values
    Deoxycholic Acid Injection, 5 mg/mL Deoxycholic Acid Injection, 10 mg/mL Placebo
    Number of subjects analysed
    60
    75
    66
    Units: score on a scale
    median (full range (min-max))
        LTFU Baseline (n= 60, 74, 66)
    -2.65 (-9.3 to 2.3)
    -3.00 (-8.4 to 2.9)
    -1.05 (-8.3 to 4.3)
        Month 24 (n= 60, 74, 65)
    -2.50 (-9.5 to 3.1)
    -3.25 (-9.0 to 3.5)
    -1.50 (-8.3 to 3.0)
    No statistical analyses for this end point

    Secondary: Percentage of Participants Maintaining Composite SMFRS 1-Grade Response During the 24 Months of Follow up, i.e. % of Participants who were Composite SMFRS 1-Grade Responders at both LTFU Baseline and at 24-Month Visit

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    End point title
    Percentage of Participants Maintaining Composite SMFRS 1-Grade Response During the 24 Months of Follow up, i.e. % of Participants who were Composite SMFRS 1-Grade Responders at both LTFU Baseline and at 24-Month Visit
    End point description
    Participants who had at least a 1-grade reduction in both the CR-SMFRS and PR-SMFRS from the original baseline value in the predecessor study were defined as composite SMFRS-1 responders. The full analysis set included all participants who received a clearly identifiable treatment in the previous study and had at least one visit in the LTFU study. Participants were included in the analysis according to their randomized treatment assignment. Missing values at Month 24 were imputed using last observation carried forward (LOCF). Non-responders at LTFU baseline in each treatment group (including placebo) were not included in the analysis for this endpoint.
    End point type
    Secondary
    End point timeframe
    LTFU Baseline (Month 0) to Month 24
    End point values
    Deoxycholic Acid Injection, 5 mg/mL Deoxycholic Acid Injection, 10 mg/mL Placebo
    Number of subjects analysed
    29
    43
    16
    Units: percentage of participants
        number (not applicable)
    69.0
    81.4
    81.3
    No statistical analyses for this end point

    Secondary: Percentage of Participants with at Least One Treatment-Emergent Adverse Event (TEAE)

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    End point title
    Percentage of Participants with at Least One Treatment-Emergent Adverse Event (TEAE)
    End point description
    An adverse event was any undesirable medical occurrence or worsening of an existing condition, irrespective of whether the event was considered treatment-related. A treatment-emergent adverse event was defined as an adverse event with an onset that occurs after receiving treatment. The safety set included all participants who received a clearly identifiable treatment in the previous study. Participants were included in the analysis according to the actual treatments received.
    End point type
    Secondary
    End point timeframe
    Up to approximately 24 months
    End point values
    Deoxycholic Acid Injection, 5 mg/mL Deoxycholic Acid Injection, 10 mg/mL Placebo
    Number of subjects analysed
    60
    75
    66
    Units: percentage of participants
        number (not applicable)
    10.0
    12.0
    1.5
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Treatment-emergent Adverse Events Associated with the Treatment Area (Drug-related)

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    End point title
    Percentage of Participants with Treatment-emergent Adverse Events Associated with the Treatment Area (Drug-related)
    End point description
    An adverse event was any undesirable medical occurrence or worsening of an existing condition, irrespective of whether the event was considered treatment-related. A treatment-emergent adverse event was defined as an adverse event with an onset that occurs after receiving treatment. The safety set included all participants who received a clearly identifiable treatment in the previous study. Participants were included in the analysis according to the actual treatments received.
    End point type
    Secondary
    End point timeframe
    Up to approximately 24 months
    End point values
    Deoxycholic Acid Injection, 5 mg/mL Deoxycholic Acid Injection, 10 mg/mL Placebo
    Number of subjects analysed
    60
    75
    66
    Units: percentage of participants
        number (not applicable)
    3.3
    8.0
    0.0
    No statistical analyses for this end point

    Secondary: Percentage of Participants with Treatment-emergent Adverse Events of Special Interest (AESIs)

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    End point title
    Percentage of Participants with Treatment-emergent Adverse Events of Special Interest (AESIs)
    End point description
    An adverse event was any undesirable medical occurrence or worsening of an existing condition, irrespective of whether the event was considered treatment-related. A treatment-emergent adverse event was defined as an adverse event with an onset that occurs after receiving treatment. AESIs for this study are common treatment reactions (consistently reported for overall AEs, treatment area-related AEs, or study-drug-related AEs) that were observed in earlier deoxycholic acid injection studies and identified as likely to be related to the injection procedure. The safety set included all participants who received a clearly identifiable treatment in the previous study. Participants were included in the analysis according to the actual treatments received.
    End point type
    Secondary
    End point timeframe
    Up to approximately 24 months
    End point values
    Deoxycholic Acid Injection, 5 mg/mL Deoxycholic Acid Injection, 10 mg/mL Placebo
    Number of subjects analysed
    60
    75
    66
    Units: percentage of participants
        number (not applicable)
    1.7
    6.7
    0.0
    No statistical analyses for this end point

    Adverse events

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    Adverse events information [1]
    Timeframe for reporting adverse events
    Approximately 24 months
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    16.1
    Reporting groups
    Reporting group title
    Deoxycholic Acid Injection, 5 mg/mL
    Reporting group description
    Non-treatment observational follow-up study: Participants were previously treated with deoxycholic acid injection, 5 mg/mL, in studies ATX-101-10-16 or ATX-101-10-17.

    Reporting group title
    Deoxycholic Acid Injection, 10 mg/mL
    Reporting group description
    Non-treatment observational follow-up study: Participants were previously treated with deoxycholic acid injection, 10 mg/mL, in studies ATX-101-10-16 or ATX-101-10-17.

    Reporting group title
    Placebo
    Reporting group description
    Non-treatment observational follow-up study: Participants were previously treated with placebo in studies ATX-101-10-16 or ATX-101-10-17.

    Notes
    [1] - There are no non-serious adverse events recorded for these results. It is expected that there will be at least one non-serious adverse event reported.
    Justification: No non-serious adverse events occurred at the 5% threshold.
    Serious adverse events
    Deoxycholic Acid Injection, 5 mg/mL Deoxycholic Acid Injection, 10 mg/mL Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    3 / 60 (5.00%)
    2 / 75 (2.67%)
    1 / 66 (1.52%)
         number of deaths (all causes)
    0
    0
    0
         number of deaths resulting from adverse events
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Parathyroid tumour benign
         subjects affected / exposed
    1 / 60 (1.67%)
    0 / 75 (0.00%)
    0 / 66 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Limb injury
         subjects affected / exposed
    0 / 60 (0.00%)
    1 / 75 (1.33%)
    0 / 66 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Radius fracture
         subjects affected / exposed
    0 / 60 (0.00%)
    0 / 75 (0.00%)
    1 / 66 (1.52%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Endocrine disorders
    Hyperthyroidism
         subjects affected / exposed
    0 / 60 (0.00%)
    1 / 75 (1.33%)
    0 / 66 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Enterocolitis bacterial
         subjects affected / exposed
    1 / 60 (1.67%)
    0 / 75 (0.00%)
    0 / 66 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    Vestibular neuronitis
         subjects affected / exposed
    1 / 60 (1.67%)
    0 / 75 (0.00%)
    0 / 66 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
         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
    Deoxycholic Acid Injection, 5 mg/mL Deoxycholic Acid Injection, 10 mg/mL Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    0 / 60 (0.00%)
    0 / 75 (0.00%)
    0 / 66 (0.00%)

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? No

    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
    For support, Contact us.
    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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