E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
Chronic cough with no apparent cause |
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E.1.1.2 | Therapeutic area | Diseases [C] - Respiratory Tract Diseases [C08] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10066656 |
E.1.2 | Term | Chronic cough |
E.1.2 | System Organ Class | 100000004855 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To assess the effectiveness of serlopitant for the treatment of refractory chronic cough after 12 weeks of treatment in reducing 24-hour objective cough frequency. |
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E.2.2 | Secondary objectives of the trial |
To evaluate the effectiveness of serlopitant as compared to placebo after 4 and 8 weeks of treatment in reducing 24-hour objective cough frequency
To evaluate the effectiveness of serlopitant as compared to placebo after 4, 8 and 12 weeks of treatment in reducing awake objective cough frequency
To evaluate the effectiveness of serlopitant as compared to placebo after 4, 8 and 12 weeks of treatment in reducing sleep objective cough frequency
To evaluate the effectiveness of serlopitant in:
Reducing the cough severity measured by a Visual Analog Scale (VAS)
Improving cough-specific quality of life (LCQ)
To assess the safety and tolerability of repeated oral doses of serlopitant in subjects with treatment refractory chronic cough |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Females and males between 18 and 80 years of age inclusive, at Screening
2. Chest radiograph or CT Thorax within the last 5 years not demonstrating any abnormality considered to be significantly contributing to the chronic cough in the opinion of the Principal Investigator and/or Menlo Therapeutics Medical Monitor
3. Have a diagnosis of treatment refractory chronic cough or unexplained cough for at least one year
4. At Screening have a score of ≥ 40mm on the Cough Severity VAS
5. At Baseline (Day 0) have a score of ≥ 40mm on the Cough Severity VAS
6. All female subjects who are of childbearing potential must practice highly effective contraception (i.e., pregnancy prevention method with a failure rate of < 1% per year) from the time of the initial Screening visit until 4 weeks after last dose of study drug.
7. Have provided written informed consent
8. Are willing and able to comply with all aspects of the protocol
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E.4 | Principal exclusion criteria |
1. Prior treatment with serlopitant or other neurokinin-1 receptor (NK1-R) antagonists (e.g., aprepitant, orvepitant)
2. Current smoker or individuals who have given up smoking within the past 12 months
3. FEV1/FVC < 60%
4. Body mass index (BMI) < 18 kg/m2 or ≥ 40 kg/m2 at Screening
5. History of upper or lower respiratory tract infection or recent significant change in pulmonary status within 4 weeks of the Baseline Visit (Day 0)
6. History of cystic fibrosis
7. History of opioid use (for chronic cough) within 1 week of the Baseline Visit (Day 0)
8. Requiring concomitant therapy with prohibited medications
9. Treatment with biologic therapies within 8 weeks or 5 half-lives prior to the Baseline Visit (Day 0), whichever is longer
10. Treatment with strong CYP3A4 inhibitors within 4 weeks prior to the Baseline Visit (Day 0)
11. Treatment with any investigational therapy within 4 weeks (investigational biologic therapies within 8 weeks) prior to the Baseline Visit (Day 0)
12. Serum creatinine, total bilirubin, alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2x the upper limit of normal (ULN) during screening
13. Positive test for any drug of abuse (certain drugs of abuse are acceptable for non-cough indications)
14. History of malignancy within 5 years prior to the Baseline Visit (Day 0), with the exception of completely treated and non-metastatic basal cell carcinoma or squamous cell carcinoma of the skin
15. Any known psychiatric diagnosis meeting DSM-5 criteria which may confound the assessment of serlopitant safety or efficacy, or interfere with the subject’s ability to comply with protocol-mandated activities, within 3 years prior to randomization. Examples of such DSM-5 diagnoses include but are not limited to major depressive disorder, bipolar disorder, schizophrenia, psychotic disorder, intellectual disability, severe alcohol use disorder
16. Known active hepatitis infection
17. Known history of human immunodeficiency virus (HIV) infection
18. History of hypersensitivity to serlopitant or any of its components
19. Currently pregnant or breastfeeding female subject
20. Females of childbearing potential who are unable or unwilling to practice highly effective contraception (pregnancy prevention)
21. Presence of any medical condition or disability that, in the investigator’s or Menlo Therapeutics Medical Monitor’s opinion, could interfere with the assessment of safety or efficacy in this trial or compromise the safety of the subject, including clinically significant ECG abnormalities during screening
22. Planned or anticipated major surgical procedure or other activity that would interfere with the subject’s ability to comply with protocol-mandated assessments (e.g., extended international travel) during the subject’s participation in the study. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The change from Baseline in 24-hour Cough Frequency after 12 weeks (Day 84) of treatment. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
After 12 weeks (Day 84) of treatment. |
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E.5.2 | Secondary end point(s) |
1.) Change from Baseline in awake objective cough frequency after 12 weeks (Day 84) of treatment
2.) Proportion of subjects with ≥ 30% reduction in 24-hour objective cough frequency per hour at Week 12 (Day 84)
3.) Proportion of subjects with ≥30% reduction in awake objective cough frequency per hour at Week 12 (Day 84)
4.) Change from Baseline in Cough Severity Visual Analog Scale (VAS) at Week 12 (Day 84)
5.) Change from Baseline in 24-hour objective cough frequency after 4 and 8 weeks (Days 28 and 56) of treatment
6.) Change from Baseline in awake objective cough frequency after 4 and 8 weeks (Days 28 and 56) of treatment
7.) Change from Baseline and change from Day 84 in 24-hour objective cough frequency at the Follow-Up visit (Day 112)
8.) Change from Baseline in sleep objective cough frequency after 4, 8 and 12 weeks (Days 28, 56 and 84) of treatment
9.) Change from Baseline in Cough Severity Visual Analog Scale (VAS) at Weeks 4 and 8 (Days 28 and 56)
10.) Change from Baseline in Leicester Cough Questionnaire (LCQ) individual Domain and Total scores
11.) Patient's Global Impression of Change (PGIC)
12.) Clinician's Global Impression of Change (CGIC)
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1.) Awake objective cough frequency after Day 84 treatment
2.) Subjects ≥ 30% reduction in 24-hour objective cough frequency per hour- Day 84
3.) Subjects ≥30% reduction in awake objective cough frequency per hour- Day 84
4.) Cough Severity Visual Analog Scale- Day 84
5.) 24-hour objective cough frequency after Days 28 and 56 treatment
6.) Awake objective cough frequency after Days 28 and 56 treatment
7.) 24-hour objective cough frequency- Day 112
8.) Sleep objective cough frequency- Day 28, 56 and 84 treatment
9.) Cough Severity Visual Analog Scale- Day 28 and 56
10.) Leicester Cough Questionnaire individual Domain and Total scores- Day 0, 28, 56, 85, 113
11.) Patient's Global Impression of Change- Day 28, 56, 85
12.) Clinician's Global Impression of Change- Day 85 |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 10 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | |
E.8.9.1 | In the Member State concerned months | 15 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 15 |