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    Clinical Trial Results:
    A double-blind, randomised, placebo-controlled, crossover study to assess the efficacy of XEN-D0501, a TRPV1 antagonist, in reducing the frequency of cough in patients with chronic obstructive pulmonary disease.

    Summary
    EudraCT number
    2013-004041-17
    Trial protocol
    GB  
    Global end of trial date
    25 Feb 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    09 Jul 2016
    First version publication date
    09 Jul 2016
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    XEN-D0501-CL-05
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT02233699
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Xention Ltd
    Sponsor organisation address
    Unit 5, Quesrn House, Hinton Way, Great Shelford, United Kingdom, CB22 5LD
    Public contact
    Chief Medical Officer, Xention Limited, + 44 1223493900, info@xention.com
    Scientific contact
    Chief Medical Officer, Xention Limited, + 44 1223493900, info@xention.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
    25 Feb 2015
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    25 Feb 2015
    Global end of trial reached?
    Yes
    Global end of trial date
    25 Feb 2015
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To evaluate the effectiveness of XEN-D0501 over placebo in reducing objective daytime cough frequency.
    Protection of trial subjects
    No specific measures
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    07 Feb 2014
    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
    United Kingdom: 27
    Worldwide total number of subjects
    27
    EEA total number of subjects
    27
    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)
    10
    From 65 to 84 years
    17
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Screening procedures to determine subject eligibility were performed within 28 days prior to the first dose administration

    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, Monitor, Data analyst, Assessor

    Arms
    Are arms mutually exclusive
    No

    Arm title
    XEN-D0501
    Arm description
    subjects received XEN-D0501 for 14 days and then matching placebo for an additional period of 14 days with 2 weeks minimum washout period between the 2 treatments.
    Arm type
    Experimental

    Investigational medicinal product name
    XEN-D0501
    Investigational medicinal product code
    XEN-D0501
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    4 mg XEN-D0501 taken as oral tablet formulation twice daily for 14 days.

    Arm title
    Placebo
    Arm description
    Subjects received Placebo for 14 days and then XEN-D0501 for an additional period of 14 days with 2 weeks minimum washout period between the 2 treatments.
    Arm type
    Experimental

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Placebo
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    4 mg matching placebo taken as oral tablet formulation twice daily for 14 days.

    Number of subjects in period 1
    XEN-D0501 Placebo
    Started
    27
    27
    Completed
    27
    27

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    XEN-D0501
    Reporting group description
    subjects received XEN-D0501 for 14 days and then matching placebo for an additional period of 14 days with 2 weeks minimum washout period between the 2 treatments.

    Reporting group title
    Placebo
    Reporting group description
    Subjects received Placebo for 14 days and then XEN-D0501 for an additional period of 14 days with 2 weeks minimum washout period between the 2 treatments.

    Reporting group values
    XEN-D0501 Placebo Total
    Number of subjects
    27 27 27
    Age categorical
    Units: Subjects
        In utero
    0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0
        Newborns (0-27 days)
    0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0
        Children (2-11 years)
    0 0 0
        Adolescents (12-17 years)
    0 0 0
        Adults (18-64 years)
    10 10 10
        From 65-84 years
    17 17 17
        85 years and over
    0 0 0
    Gender categorical
    Units: Subjects
        Female
    10 10 10
        Male
    17 17 17

    End points

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    End points reporting groups
    Reporting group title
    XEN-D0501
    Reporting group description
    subjects received XEN-D0501 for 14 days and then matching placebo for an additional period of 14 days with 2 weeks minimum washout period between the 2 treatments.

    Reporting group title
    Placebo
    Reporting group description
    Subjects received Placebo for 14 days and then XEN-D0501 for an additional period of 14 days with 2 weeks minimum washout period between the 2 treatments.

    Primary: change from baseline in the objective daytime cough frequency

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    End point title
    change from baseline in the objective daytime cough frequency
    End point description
    change from baseline in the objective daytime cough frequency
    End point type
    Primary
    End point timeframe
    after 14 days treatment with XEN-D0501 or placebo
    End point values
    XEN-D0501 Placebo
    Number of subjects analysed
    25
    25
    Units: coughs per hour
        geometric mean (standard deviation)
    -1.35 ± 6.85
    -3.91 ± 11.74
    Statistical analysis title
    Treatmetn ratio of geometric mean
    Comparison groups
    XEN-D0501 v Placebo
    Number of subjects included in analysis
    50
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.6353
    Method
    Mixed models analysis
    Confidence interval

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    from signing informed consent form to the last patient last visit.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    16.1
    Reporting groups
    Reporting group title
    XEN-D0501
    Reporting group description
    -

    Reporting group title
    Placebo
    Reporting group description
    -

    Serious adverse events
    XEN-D0501 Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 27 (0.00%)
    0 / 25 (0.00%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Frequency threshold for reporting non-serious adverse events: 0.05%
    Non-serious adverse events
    XEN-D0501 Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    25 / 27 (92.59%)
    15 / 25 (60.00%)
    Investigations
    Body temperature increased
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Injury, poisoning and procedural complications
    Excoriation
         subjects affected / exposed
    0 / 27 (0.00%)
    3 / 25 (12.00%)
         occurrences all number
    0
    3
    Contusion
         subjects affected / exposed
    0 / 27 (0.00%)
    2 / 25 (8.00%)
         occurrences all number
    0
    2
    Thermal burn
         subjects affected / exposed
    2 / 27 (7.41%)
    0 / 25 (0.00%)
         occurrences all number
    2
    0
    Joint injury
         subjects affected / exposed
    0 / 27 (0.00%)
    1 / 25 (4.00%)
         occurrences all number
    0
    1
    Sunburn
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Vascular disorders
    Flushing
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Hot flush
         subjects affected / exposed
    0 / 27 (0.00%)
    1 / 25 (4.00%)
         occurrences all number
    0
    1
    Surgical and medical procedures
    Tooth extraction
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Nervous system disorders
    Thermohypoaesthesia
         subjects affected / exposed
    8 / 27 (29.63%)
    1 / 25 (4.00%)
         occurrences all number
    8
    1
    Dysgeusia
         subjects affected / exposed
    5 / 27 (18.52%)
    0 / 25 (0.00%)
         occurrences all number
    5
    0
    Headache
         subjects affected / exposed
    2 / 27 (7.41%)
    2 / 25 (8.00%)
         occurrences all number
    2
    2
    Hypogeusia
         subjects affected / exposed
    4 / 27 (14.81%)
    0 / 25 (0.00%)
         occurrences all number
    4
    0
    Paraesthesia
         subjects affected / exposed
    1 / 27 (3.70%)
    1 / 25 (4.00%)
         occurrences all number
    1
    1
    Ageusia
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Burning sensation
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Dysaesthesia
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    General disorders and administration site conditions
    Feeling hot
         subjects affected / exposed
    4 / 27 (14.81%)
    1 / 25 (4.00%)
         occurrences all number
    4
    1
    Feeling cold
         subjects affected / exposed
    3 / 27 (11.11%)
    0 / 25 (0.00%)
         occurrences all number
    3
    0
    chilis
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Drug intolerance
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Feeling of body temperature change
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Gastrointestinal disorders
    Paraesthesia oral
         subjects affected / exposed
    2 / 27 (7.41%)
    0 / 25 (0.00%)
         occurrences all number
    2
    0
    Dry mouth
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Dyspepsia
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Glossodynia
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Hypoaesthesia oral
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Oral mucosal blistering
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Vomiting
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Respiratory, thoracic and mediastinal disorders
    Chronic obstructive pulmonary disease
         subjects affected / exposed
    2 / 27 (7.41%)
    2 / 25 (8.00%)
         occurrences all number
    2
    2
    Cough
         subjects affected / exposed
    0 / 27 (0.00%)
    2 / 25 (8.00%)
         occurrences all number
    0
    2
    Choking
         subjects affected / exposed
    0 / 27 (0.00%)
    1 / 25 (4.00%)
         occurrences all number
    0
    1
    Dysphonia
         subjects affected / exposed
    0 / 27 (0.00%)
    1 / 25 (4.00%)
         occurrences all number
    0
    1
    Nasal congestion
         subjects affected / exposed
    0 / 27 (0.00%)
    1 / 25 (4.00%)
         occurrences all number
    0
    1
    Oropharyngeal pain
         subjects affected / exposed
    0 / 27 (0.00%)
    1 / 25 (4.00%)
         occurrences all number
    0
    1
    Productive cough
         subjects affected / exposed
    0 / 27 (0.00%)
    1 / 25 (4.00%)
         occurrences all number
    0
    1
    Rhinorrhoea
         subjects affected / exposed
    0 / 27 (0.00%)
    1 / 25 (4.00%)
         occurrences all number
    0
    1
    Sputum increased
         subjects affected / exposed
    0 / 27 (0.00%)
    1 / 25 (4.00%)
         occurrences all number
    0
    1
    Skin and subcutaneous tissue disorders
    Cold sweat
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Dermatitis
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Rash generalised
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Stasis dermatitis
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Psychiatric disorders
    Nervousness
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Musculoskeletal and connective tissue disorders
    Arthralgia
         subjects affected / exposed
    2 / 27 (7.41%)
    0 / 25 (0.00%)
         occurrences all number
    2
    0
    Back pain
         subjects affected / exposed
    0 / 27 (0.00%)
    1 / 25 (4.00%)
         occurrences all number
    0
    1
    Infections and infestations
    Folliculitis
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Herpes zoster
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0
    Rhinitis
         subjects affected / exposed
    0 / 27 (0.00%)
    1 / 25 (4.00%)
         occurrences all number
    0
    1
    Tooth abscess
         subjects affected / exposed
    1 / 27 (3.70%)
    0 / 25 (0.00%)
         occurrences all number
    1
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    19 Dec 2013
    • Revised exclusion criterion 8 to list the excluded medications listed in Section 9.8.3 of the protocol • Revised inclusion criterion 5 to remove the condition that no contraception was required if the partner was already pregnant • Removed specific vendors for SAE reporting and for safety laboratory testing • Updated questions 4 and 15 of the LCQ.
    25 Feb 2014
    Addition of a baseline VAS diary assessment to comply with study objectives
    16 Apr 2014
    • To document a change of statistician • Revised inclusion criterion 2 and exclusion criteria 1 and 10 to reduce the excessive number of screen failures. Changed inclusion criterion 2 to include patients with a pre-bronchodilator FEV1 of at least 1.0 L at Visit 1. Changed exclusion criterion 1 to exclude patients with a BMI >40 kg/m2 and criterion 10 was revised to allow inclusion of patients with Type 2 diabetes, if the Investigators opinion was that they were well controlled and had no had no history suggestive of autonomic neuropathy • Revised the hourly change in cough frequency secondary endpoint so that the endpoint was assessed at the end of each treatment period. The cough severity and urge to cough secondary endpoints were also amended so that the change from Baseline was assessed over each treatment period • Revised the statistical methods section to include repeated measure models for the analysis of the hourly change in cough frequency, cough severity and urge to cough secondary endpoints • Amended the wording for the safety study population to safety analysis set for consistency.
    22 Sep 2014
    • Removed the requirement for the capsaicin challenge to be completed by all 22 patients, as a sample size of 15 patients was considered sufficient to interpret the data • Revised inclusion criteria numbering from 2 to 3 and clarified that only patients included in the capsaicin challenge cohort were required to have a pre-bronchodilator FEV1 of at least 1.0 L at Visit 1 throughout the protocol • Added a new exclusion criterion 20 to exclude COPD patients with respiratory failure that required long-term oxygen therapy and revised subsequent exclusion criteria numbering • Revised the planned number of patients to allow approximately 25 patients to be randomised to treatment and enable 22 patients to complete the study of which at least 15 patients were to complete the capsaicin challenge • Added a new study population for the capsaicin challenge cohort, the CCAS.

    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
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