Clinical Trial Results:
A Single-dose dose escalation trial in a randomised, single-blind, placebo-controlled group-comparison design to investigate the safety and tolerability of XEN-D0501 in 24 patients with diabetes mellitus type 2
Summary
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EudraCT number |
2016-003843-12 |
Trial protocol |
DK |
Global end of trial date |
30 Aug 2019
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Results information
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Results version number |
v1(current) |
This version publication date |
10 Jun 2021
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First version publication date |
10 Jun 2021
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
PP-CT01
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
- | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
PILA PHARMA
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Sponsor organisation address |
Västergatan 1, Malmö, Sweden, 211 21
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Public contact |
Dorte X. Gram, PILA PHARMA, 46 739036969, info@pilapharma.com
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Scientific contact |
Dorte X. Gram, PILA PHARMA, 46 739036969, info@pilapharma.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
15 Nov 2020
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
30 Aug 2019
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Global end of trial reached? |
Yes
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Global end of trial date |
30 Aug 2019
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
To evaluate the safety and tolerability of single ascending oral doses of XEN-D0501, (1, 2 and 4 mg) versus placebo in type 2 diabetic patients in treatment with metformin.
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Protection of trial subjects |
No specific protection other than informing of the potential risk of the study medication and potential pain associated with blood sampling
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Background therapy |
No specific background therapy defined/ criteria | ||
Evidence for comparator |
Not applicable | ||
Actual start date of recruitment |
10 Jan 2017
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
Yes
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Denmark: 26
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Worldwide total number of subjects |
26
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EEA total number of subjects |
26
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
13
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From 65 to 84 years |
13
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85 years and over |
0
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Recruitment
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Recruitment details |
The trial was conducted in adult subjects with type 2 diabetes mellitus consenting to participate in the trial. The subjects were recruited directly at the outpatient clinics at Odense University Hospital, Denmark and via the Medicollect Research panel in Denmark | ||||||||||||||||||
Pre-assignment
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Screening details |
1. The subject had to give his/her signed and dated informed consent before any trial-related activities. Trial-related activities are any procedures that would not have been performed during the normal management of the subject. 2. Diagnosis of type 2 diabetes mellitus 3. HbA1C (glycosylated haemoglobin A1C) of 6.5-10 % 4. Age between 30 and 70 | ||||||||||||||||||
Period 1
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Period 1 title |
Overall period
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Is this the baseline period? |
Yes | ||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Single blind | ||||||||||||||||||
Roles blinded |
Subject | ||||||||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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1 mg XEN-D0501 | ||||||||||||||||||
Arm description |
Single dose of 1 mg XEN-D0501 po | ||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||
Investigational medicinal product name |
XEN-D0501
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
1mg single oral dose
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Arm title
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2 mg XEN-D0501 | ||||||||||||||||||
Arm description |
Single dose of 2 mg XEN-D0501 po | ||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||
Investigational medicinal product name |
XEN-D0501
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
2 mg single oral dose
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Arm title
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4 mg XEN-D0501 | ||||||||||||||||||
Arm description |
Single dose of 4 mg XEN-D0501 po | ||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||
Investigational medicinal product name |
XEN-D0501
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
4 mg single oral dose
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Arm title
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8 mg XEN-D0501 | ||||||||||||||||||
Arm description |
Single dose of 8 mg XEN-D0501 po | ||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||
Investigational medicinal product name |
XEN-D0501 8 mg
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
Single dose of 8 mg XEN-D0501 po
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Arm title
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Placebo | ||||||||||||||||||
Arm description |
Single dose of placebo po | ||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||
Investigational medicinal product name |
Reference treatment (placebo)
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
A single oral dose of placebo
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Baseline characteristics reporting groups
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Reporting group title |
1 mg XEN-D0501
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Reporting group description |
Single dose of 1 mg XEN-D0501 po | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
2 mg XEN-D0501
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Reporting group description |
Single dose of 2 mg XEN-D0501 po | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
4 mg XEN-D0501
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Reporting group description |
Single dose of 4 mg XEN-D0501 po | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
8 mg XEN-D0501
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Reporting group description |
Single dose of 8 mg XEN-D0501 po | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
Single dose of placebo po | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Subject analysis sets
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Subject analysis set title |
Per protocol analysis set
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Subject analysis set type |
Per protocol | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Subject analysis set description |
All patients enrolled in the study who completed without any major protocol deviations
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End points reporting groups
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Reporting group title |
1 mg XEN-D0501
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Reporting group description |
Single dose of 1 mg XEN-D0501 po | ||
Reporting group title |
2 mg XEN-D0501
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Reporting group description |
Single dose of 2 mg XEN-D0501 po | ||
Reporting group title |
4 mg XEN-D0501
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Reporting group description |
Single dose of 4 mg XEN-D0501 po | ||
Reporting group title |
8 mg XEN-D0501
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Reporting group description |
Single dose of 8 mg XEN-D0501 po | ||
Reporting group title |
Placebo
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Reporting group description |
Single dose of placebo po | ||
Subject analysis set title |
Per protocol analysis set
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Subject analysis set type |
Per protocol | ||
Subject analysis set description |
All patients enrolled in the study who completed without any major protocol deviations
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End point title |
Safety and tolerability [1] | ||||||||||||||||||||||||
End point description |
Recordings of numbers, types and severity of adverse events
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End point type |
Primary
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End point timeframe |
From the first trial related activity after the subject has signed the informed consent and until the end of trial participation.
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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 statistical analysis were performed for the primary endpoint - safety and tolerability of single ascending doses of XEN-D0501 versus placebo. Details of the safety profile are provided under Adverse events. |
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No statistical analyses for this end point |
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End point title |
Adverse events / serious adverse events | ||||||||||||||||||||||||||||||
End point description |
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End point type |
Secondary
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End point timeframe |
From signing of informed consent to end of trial
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No statistical analyses for this end point |
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End point title |
Hyperthermia events | ||||||||||||||||||||||||
End point description |
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End point type |
Secondary
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End point timeframe |
From signing of informed consent to end of trial participation
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No statistical analyses for this end point |
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End point title |
Hypoglycemic events | ||||||||||||||||||
End point description |
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End point type |
Secondary
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End point timeframe |
From signing of informed consent to end of trial participation
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No statistical analyses for this end point |
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End point title |
Pharmacokinetics - Cmax [2] | |||||||||||||||||||||||||
End point description |
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End point type |
Secondary
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End point timeframe |
8 hours after oral administration
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Notes [2] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period. Justification: No statistical analysis were performed for the Secondary endpoint Pharmacokinetics - Cmax |
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
From the first trial related activity after the subject has signed the informed consent and until the end of trial participation.
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Adverse event reporting additional description |
The Internal Safety Review Committee continously surveilled the electronic database for available safety data. Due to previously reported TRPV1-antagonists sideeffects, a special focus was on hyperthermia or hypo-glycemia, liver and renal functions as well as QTc values. Trial continuation/dose escalation was decided after each cohort.
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
22
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Reporting groups
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Reporting group title |
Single dose 1 mg XEN-D0501 po
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Reporting group description |
The first cohort of type 2 diabetic patients being exposed to a single oral tablet of 1 mg XEN-D0501. This was the first exposure ever of XEN-D0501 to patients with type 2 diabetes. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Single dose 2 mg XEN-D0501 po
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Reporting group description |
Second group of type 2 diabetic patients where the dose of XEN-D0501 was doubled to 2 mg. The cohort was discontinued after 2 patients since regulatory approval was given to go directly to 4 mg due to low incident of adverse events. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Single dose 4 mg XEN-D0501 po
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Reporting group description |
Third group of type 2 diabetic patients where the dose of XEN-D0501 was doubled to 4 mg. In non-diabetic subjects, the maximal tolerable dose was previously found to be bi-daily doses of 4 mg dosed for up to 28 days. This dose was expected to be the maximal tolerable dose in type 2 diabetics as well. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Single dose 8 mg XEN-D0501 po
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Reporting group description |
Fourth group of type 2 diabetic patients where the dose of XEN-D0501 was doubled to 8 mg. This dose level was not expected to be well tolerated by type 2 diabetic patients, since, in non-diabetic subjects the maximal tolerable dose was found to be bi-daily doses of 4 mg dosed for up to 28 days. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
Group of type 2 diabetic patients that were dosed with placebo tablets for comparison. Two patients were dosed with placebo with each group of XEN-D0501 exposed patients (2 placebo in each cohort). | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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14 Nov 2016 |
Amendment to Protocol Version 2.0
Changes made to protocol version 1.0 due to comments from EC 9/11-2016:
• New section added to section 7.5, p. 39, information about biobank.
• Information about ‘total blood loss volume’ – added to section 7.5.1, p. 39:
(The calculated blood sampling volume per patient is approximately 40 mL in total).
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12 Feb 2017 |
Changes made to protocol version 2.0 due to comments from DMA 22/12-2016:
• Definitions on Adverse reactions (ARs) and Suspected Unexpected Serious Adverse Reactions (SUSARs) are added to section 11.1, p. 46:
Changes made to protocol version 2.0 due to comments from DMA 22/12-2016:
• Definitions on Adverse reactions (ARs) and Suspected Unexpected Serious Adverse Reactions (SUSARs) are added to section 11.1, p. 46:
Adverse reaction (AR): All noxious and unintended responses to an investigational medicinal product related to any dose should be considered adverse drug reactions.
The phrase “responses to an investigational medicinal product” means that a causal relationship between a medicinal product and an adverse event is at least a reasonable possibility – in essence, the relationship cannot be ruled out.
Suspected Unexpected Serious Adverse Reaction (SUSAR):
A serious adverse event that has a suspected causal relationship with the investigational medicinal product and which is not consistent with the applicable investigator brochure.
• Changes to Chapter 7 Methods and assessments:
Changes to section 7.1 p. 28, Visit procedures:
Change from: ’Each subject will attend two screening visits (V1 and V2) to determine eligibility for participation in the trial. Subjects fulfilling all of the inclusion criteria and none of the exclusion criteria will be randomised to one of the given treatments. Randomized subjects will be scheduled to attend a visit 3 where the trial product is dosed (V3) and a follow up visit (V4).’
Change to: ‘Each subject will attend two screening visits (V1 and V2) to determine eligibility for participation in the trial. Subjects fulfilling all of the inclusion criteria and none of the exclusion criteria will be randomised to one of the given treatments. Randomized subjects will be scheduled to attend a visit 3 where the trial product is dosed (V3) and a follow up visit (V4).’
.. etc |
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23 Oct 2017 |
• Changes of Inclusion criteria, section 5.2 p. 22, due to lack of patients fulfilling the inclusion criteria:
Deletion of the following inclusion criterion:
3. In treatment with metformin, but no other anti- diabetic drugs
• Changes of Exclusion criteria, section 5.3 p. 22-24, due to lack of patients:
Deletion of the following exclusion criteria:
2. A subject who has a supine blood pressure at screening (including those on anti-hypertensives), after resting for 5 min, outside the range of 90-140 mmHg systolic or 50-90 mmHg diastolic (excluding white-coat hypertension; therefore, if a repeated measurement on a second screening visit shows values within the range, the subject can be included in the trial).
3. A subject who is in pharmacological treatment of hypertension if the current treatment includes other than an ACE-inhibitor
8. A subject who smokes more than 5 cigarettes, or the equivalent, per day and is unable to refrain from smoking during the in-house periods as determined by the Investigator.
15. A subject who has proliferative retinopathy or maculopathy, and/or severe neuropathy, in particular autonomic neuropathy, as judged by the Investigator.
Change of exclusion criterion 5 from:
5. A subject who has participated in any other trials involving investigational products within the 3 months preceding the start of dosing.
Change of exclusion criterion 5 to:
5. A subject who has participated in any other trials involving investigational products within the 1 month preceding the start of dosing.
• Changes of Visit exclusion criteria, section 5.3.1 p. 24-25, due to lack of patients:
Deletion of the following visit exclusion criteria:
1. Strenuous exercise within 48 h prior to screening visit to end of follow up visit, as judged by the Investigator.
5. A subject who has used any new non-prescribed systemic medication or topical medication, ... etc |
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23 Apr 2018 |
• Changes in Section 1.1 Objectives:
Changed from:
(1, 2 and 4 mg)
Changed to:
(1, 4 and 8 mg)
• Changes in Section 1.5 Trial products:
Changed from:
• Placebo
• XEN-D0501, 1 mg/tablet
• XEN-D0501, 2 mg/tablet
• XEN-D0501, 4 mg/tablet
Changed to:
• Placebo
• XEN-D0501, 1 mg/tablet
• XEN-D0501, 4 mg/tablet
• XEN-D0501, 8 mg, 2 x 4mg/tablet
Changes in Section 3.3 Objectives:
Changed from:
(1, 2 and 4 mg)
Changed to:
(1, 4 and 8 mg)
Changes in Section 4.2.1 Treatment of subjects:
Change from:
1. XEN-D0501, 1 mg p.o. (n=6) and placebo (n=2)
2. XEN-D0501, 2 mg p.o. (n=6) and placebo (n=2)
3. XEN-D0501, 4 mg p.o. (n=6) and placebo (n=2)
Change to:
1. XEN-D0501, 1 mg p.o. (n=6) and placebo (n=2)
2. XEN-D0501, 4 mg p.o. (n=6) and placebo (n=2)
3. XEN-D0501, 8 mg p.o. (n=6) and placebo (n=2)
Change from:
Each subject will be randomised to a given treatment. Cohorts of 8 patients are run subsequently whereof 2 patients receive placebo and 6 patients receive XEN-D0501 beginning with the 1 mg dose followed by the 2 and 4 mg dose groups.
Change to:
Each subject will be randomised to a given treatment. Cohorts of 8 patients are run subsequently whereof 2 patients receive placebo and 6 patients receive XEN-D0501 beginning with the 1 mg dose followed by the 4 and 8 mg dose groups.
• Changes in Section 8.1 Trial products:
Changed from:
• Placebo
• XEN-D0501, 1 mg/tablet
• XEN-D0501, 2 mg/tablet
• XEN-D0501, 4 mg/tablet
Changed to:
• Placebo
• XEN-D0501, 1 mg/tablet
• XEN-D0501, 4 mg/tablet
• XEN-D0501, 8 mg, 2 x 4mg/tablet |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported | |||
Online references |
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http://www.ncbi.nlm.nih.gov/pubmed/21676011 |