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    Clinical Trial Results:
    A Phase 1/2, randomised, placebo-controlled study of EDP2939 in healthy volunteers and participants with moderate plaque psoriasis.

    Summary
    EudraCT number
    2022-001631-82
    Trial protocol
    PL   BG  
    Global end of trial date
    06 Sep 2023

    Results information
    Results version number
    v1(current)
    This version publication date
    13 Dec 2023
    First version publication date
    13 Dec 2023
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    EDP2939-101
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    -
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Evelo Biosciences Ltd
    Sponsor organisation address
    One Kendall Square, 600/700 Ste7-201, Cambridge, United States, MA 02139
    Public contact
    Duncan McHale, Evelo Biosciences Ltd, duncan@evelobio.com
    Scientific contact
    Duncan McHale, Evelo Biosciences Ltd, duncan@evelobio.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
    26 Oct 2023
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    06 Sep 2023
    Global end of trial reached?
    Yes
    Global end of trial date
    06 Sep 2023
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    • To demonstrate the superiority of EDP2939 compared to placebo on the proportion of participants with moderate plaque psoriasis achieving PASI-50
    Protection of trial subjects
    The study was performed in accordance with the ethical principles that have their origin in the Declaration of Helsinki, ICH GCP, and all applicable country and local regulations. A written informed consent was obtained from each participant before entering the study or performing any non routine procedure. Each prospective participant or his or her legal guardian was given a full explanation of the study, was allowed to read the approved ICF, and had any questions answered. Participants were free to withdraw their consent at any point during the study.
    Background therapy
    No background therapy. All prior and concomitant medications were listed.
    Evidence for comparator
    This was a placebo-controlled study.
    Actual start date of recruitment
    12 Dec 2022
    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: 66
    Country: Number of subjects enrolled
    Bulgaria: 22
    Country: Number of subjects enrolled
    Canada: 28
    Country: Number of subjects enrolled
    United Kingdom: 35
    Worldwide total number of subjects
    151
    EEA total number of subjects
    88
    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)
    138
    From 65 to 84 years
    13
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Subjects who met all of the inclusion and none of the exclusion criteria were enrolled into the study. Part A: A total of 35 participants in 3 dose-ascending cohorts (3.9 x10^12, 1.95x10^13, 1.12x10^14 eTPN QD), received EDP2939 or placebo (2:1) Part B: A total of 116 participants received 3.9 x10^12 EDP2939 or placebo (1:1)

    Pre-assignment
    Screening details
    Both Parts A and B consisted of a Screening period of 4 weeks. Part A consisted of healthy volunteers aged 18-65 years. Part B consisted of participants aged 18-75 years with a documented diagnosis of plaque psoriasis, patient-/clinician-reported disease duration>=6 months with PGA=3, BSA5-20% and PASI score of 5-20 at screening and baseline.

    Period 1
    Period 1 title
    Treatment Period (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Investigator, Monitor, Data analyst, Carer, Subject, Assessor
    Blinding implementation details
    Part A of the study was participant-blind and investigator-blind, but the treatment allocations were unblinded for the sponsor with the exception of the medical monitor. The random treatment allocation was implemented by the sponsor using a central randomisation schedule. Part B of the study was participant-blind, investigator-blind and sponsor-blind. The random treatment allocation was implemented using an IRT system. No unblinding occurred prior to the locking of the clinical databases.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Part A Cohort 1 EDP2939 Low Dose
    Arm description
    1 capsule of EDP2939 3.9x10^12 eTPN (equivalent total particle number) once daily for 10 days
    Arm type
    Experimental

    Investigational medicinal product name
    EDP2939 1 Capsule Low Dose
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    One polymer-coated capsule containing 3.9 x 10^12 equivalent total particle number (eTPN) of EDP2939 was self-administered orally once per day for 10 days. Total daily dose was 3.9 x 10^12 eTPN of EDP2939.

    Arm title
    Part A Cohort 2 EDP2939 Medium Dose
    Arm description
    5 Capsules of EDP2939 3.9 x 10^12 eTPN (equivalent total particle number) once daily for 10 days
    Arm type
    Experimental

    Investigational medicinal product name
    EDP2939 5 Capsules Low Dose
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Five polymer-coated capsules each containing 3.9 x 10^12 equivalent total particle number (eTPN) of EDP2939 was self-administered orally once per day for 10 days. Total daily dose was 1.95 x 10^13 eTPN of EDP2939.

    Arm title
    Part A Cohort 3 EDP2939 High Dose
    Arm description
    2 capsules of EDP2939 5.6 x 10^13 eTPN (equivalent total particle number), once daily for 10 days
    Arm type
    Experimental

    Investigational medicinal product name
    EDP2939 1 Capsule High Dose
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Two polymer-coated capsules each containing 5.6 x 10^13 equivalent total particle number (eTPN) of EDP2939 was self-administered orally once per day for 10 days. Total daily dose was 1.12 x 10^14 eTPN of EDP2939.

    Arm title
    Part B EDP2939
    Arm description
    1 capsule of EDP2939 3.9 x10^12 equivalent total particle equivalent (eTPN), once daily for 16 weeks
    Arm type
    Experimental

    Investigational medicinal product name
    EDP2939 1 Capsule
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    One polymer-coated capsule containing 3.9 x 10^12 equivalent total particle number (eTPN) of EDP2939 was self-administered orally once per day for16 weeks. Total daily dose was 3.9 x 10^12 eTPN of EDP2939.

    Arm title
    Part B Placebo
    Arm description
    1 capsule of placebo matching Part B EDP2939, once daily for 16 weeks
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    One placebo capsule self-administered orally once per day for16 weeks. Placebo was identical to Part B EDP2939 capsules but did not contain active pharmaceutical ingredient.

    Arm title
    Part A Placebo
    Arm description
    1 (Cohort 1), 5 (Cohort 2) or 2 (Cohort 3) capsules of placebo matching relevant Part A EDP2393 administered once daily for 10 days
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Cohort 1: 1 capsule placebo matching EDP2939 low dose; Cohort 2: 5 capsules placebo matching EDP2939 low dose; Cohort 3: 2 capsules placebo matching EDP2939 high dose. Capsules were self-administered orally once per day for 10 days. Placebo was identical to corresponding EDP2939 capsules but did not contain active pharmaceutical ingredient.

    Number of subjects in period 1
    Part A Cohort 1 EDP2939 Low Dose Part A Cohort 2 EDP2939 Medium Dose Part A Cohort 3 EDP2939 High Dose Part B EDP2939 Part B Placebo Part A Placebo
    Started
    8
    8
    7
    58
    58
    12
    Completed
    8
    8
    7
    47
    44
    11
    Not completed
    0
    0
    0
    11
    14
    1
         Consent withdrawn by subject
    -
    -
    -
    5
    3
    -
         Unable to attend final dose visit, personal reason
    -
    -
    -
    -
    -
    1
         Lost to follow-up
    -
    -
    -
    1
    -
    -
         Randomised in error, not treated
    -
    -
    -
    -
    1
    -
         Lack of efficacy
    -
    -
    -
    4
    9
    -
         Protocol deviation
    -
    -
    -
    1
    1
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Part A Cohort 1 EDP2939 Low Dose
    Reporting group description
    1 capsule of EDP2939 3.9x10^12 eTPN (equivalent total particle number) once daily for 10 days

    Reporting group title
    Part A Cohort 2 EDP2939 Medium Dose
    Reporting group description
    5 Capsules of EDP2939 3.9 x 10^12 eTPN (equivalent total particle number) once daily for 10 days

    Reporting group title
    Part A Cohort 3 EDP2939 High Dose
    Reporting group description
    2 capsules of EDP2939 5.6 x 10^13 eTPN (equivalent total particle number), once daily for 10 days

    Reporting group title
    Part B EDP2939
    Reporting group description
    1 capsule of EDP2939 3.9 x10^12 equivalent total particle equivalent (eTPN), once daily for 16 weeks

    Reporting group title
    Part B Placebo
    Reporting group description
    1 capsule of placebo matching Part B EDP2939, once daily for 16 weeks

    Reporting group title
    Part A Placebo
    Reporting group description
    1 (Cohort 1), 5 (Cohort 2) or 2 (Cohort 3) capsules of placebo matching relevant Part A EDP2393 administered once daily for 10 days

    Reporting group values
    Part A Cohort 1 EDP2939 Low Dose Part A Cohort 2 EDP2939 Medium Dose Part A Cohort 3 EDP2939 High Dose Part B EDP2939 Part B Placebo Part A Placebo Total
    Number of subjects
    8 8 7 58 58 12 151
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    8 8 7 51 52 12 138
        From 65-84 years
    0 0 0 7 6 0 13
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    34.0 ± 11.71 31.9 ± 10.34 28.0 ± 9.81 45.9 ± 14.44 44.1 ± 14.13 29.8 ± 12.1 -
    Gender categorical
    Units: Subjects
        Female
    1 1 3 22 18 3 48
        Male
    7 7 4 36 40 9 103
    Subject analysis sets

    Subject analysis set title
    Part A Safety Set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The Part A Safety Set consists of all participants who received any IMP during Part A of the Study. All analyses using the Safety Set grouped participants according to treatment received.

    Subject analysis set title
    Part B Full Analysis Set
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The Part B Full Analysis Set consists of all participants who were randomised to treatment during Part B of the study. All analyses using the Full Analysis Set grouped participants according to randomised treatment.

    Subject analysis set title
    Part B Safety Set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The Part B Safety Set consists of all participants who received any IMP during Part B of the Study. All analyses using the Safety Set grouped participants according to treatment received.

    Subject analysis sets values
    Part A Safety Set Part B Full Analysis Set Part B Safety Set
    Number of subjects
    35
    116
    115
    Age categorical
    Units: Subjects
        Adults (18-64 years)
    35
    103
    102
        From 65-84 years
    0
    13
    13
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    30.8 ± 10.92
    45.0 ± 14.26
    45.2 ± 14.21
    Gender categorical
    Units: Subjects
        Female
    8
    40
    39
        Male
    27
    76
    76

    End points

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    End points reporting groups
    Reporting group title
    Part A Cohort 1 EDP2939 Low Dose
    Reporting group description
    1 capsule of EDP2939 3.9x10^12 eTPN (equivalent total particle number) once daily for 10 days

    Reporting group title
    Part A Cohort 2 EDP2939 Medium Dose
    Reporting group description
    5 Capsules of EDP2939 3.9 x 10^12 eTPN (equivalent total particle number) once daily for 10 days

    Reporting group title
    Part A Cohort 3 EDP2939 High Dose
    Reporting group description
    2 capsules of EDP2939 5.6 x 10^13 eTPN (equivalent total particle number), once daily for 10 days

    Reporting group title
    Part B EDP2939
    Reporting group description
    1 capsule of EDP2939 3.9 x10^12 equivalent total particle equivalent (eTPN), once daily for 16 weeks

    Reporting group title
    Part B Placebo
    Reporting group description
    1 capsule of placebo matching Part B EDP2939, once daily for 16 weeks

    Reporting group title
    Part A Placebo
    Reporting group description
    1 (Cohort 1), 5 (Cohort 2) or 2 (Cohort 3) capsules of placebo matching relevant Part A EDP2393 administered once daily for 10 days

    Subject analysis set title
    Part A Safety Set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The Part A Safety Set consists of all participants who received any IMP during Part A of the Study. All analyses using the Safety Set grouped participants according to treatment received.

    Subject analysis set title
    Part B Full Analysis Set
    Subject analysis set type
    Full analysis
    Subject analysis set description
    The Part B Full Analysis Set consists of all participants who were randomised to treatment during Part B of the study. All analyses using the Full Analysis Set grouped participants according to randomised treatment.

    Subject analysis set title
    Part B Safety Set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    The Part B Safety Set consists of all participants who received any IMP during Part B of the Study. All analyses using the Safety Set grouped participants according to treatment received.

    Primary: Summary and Analysis of PASI-50 Responders

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    End point title
    Summary and Analysis of PASI-50 Responders [1]
    End point description
    A PASI-50 response is defined as a reduction from baseline of at least 50% in the Psoriasis Area and Severity Index (PASI) Score. The primary estimand used a composite strategy (assumption of non-response) for the use of any prohibited therapy prior to week 16 or where the participant had withdrawn from treatment due to a treatment-failure related reason (related AE, lack of efficacy, requirement for other psoriasis treatment). Withdrawal from treatment for other reasons was considered under a hypothetical strategy with no imputation of missing data after discontinuation of treatment. No other intercurrent events were considered and all other data was analysed as collected.
    End point type
    Primary
    End point timeframe
    Week 16
    Notes
    [1] - 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: Part A treatment groups did not form part of the efficacy analysis and were used for safety endpoints only.
    End point values
    Part B EDP2939 Part B Placebo
    Number of subjects analysed
    56
    52
    Units: Subjects
        PASI-50 Responder
    11
    13
    Statistical analysis title
    PASI-50: EDP2939 vs Placebo
    Statistical analysis description
    Estimates come from a generalised linear mixed model (GLMM) with a logit link function, including terms for treatment, visit, baseline PASI score, country, sex and treatment-by-visit interaction. All visits are included in the model, but only the results for the primary timepoint at Week 16 is shown here.
    Comparison groups
    Part B EDP2939 v Part B Placebo
    Number of subjects included in analysis
    108
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.51
    Method
    Mixed models analysis
    Parameter type
    Odds ratio (OR)
    Point estimate
    0.71
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.26
         upper limit
    1.97

    Secondary: Summary and Analysis of PASI-75 Responders

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    End point title
    Summary and Analysis of PASI-75 Responders [2]
    End point description
    A PASI-75 response is defined as a reduction from baseline of at least 75% in the Psoriasis Area and Severity Index (PASI) Score. The primary estimand used a composite strategy (assumption of non-response) for the use of any prohibited therapy prior to week 16 or where the participant had withdrawn from treatment due to a treatment-failure related reason (related AE, lack of efficacy, requirement for other psoriasis treatment). Withdrawal from treatment for other reasons was considered under a hypothetical strategy with no imputation of missing data after discontinuation of treatment. No other intercurrent events were considered and all other data was analysed as collected.
    End point type
    Secondary
    End point timeframe
    Week 16
    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: Part A treatment groups did not form part of the efficacy analysis and were used for safety endpoints only.
    End point values
    Part B EDP2939 Part B Placebo
    Number of subjects analysed
    56
    52
    Units: Subjects
        PASI-75 Responder
    2
    4
    Statistical analysis title
    PASI-75: EDP2939 vs Placebo
    Statistical analysis description
    Estimates come from a generalised linear mixed model (GLMM) with a logit link function, including terms for treatment, visit, baseline PASI score, country, sex and treatment-by-visit interaction. All visits are included in the model, but only the results for the primary timepoint at Week 16 is shown here.
    Comparison groups
    Part B EDP2939 v Part B Placebo
    Number of subjects included in analysis
    108
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.094
    Method
    Mixed models analysis
    Parameter type
    Odds ratio (OR)
    Point estimate
    0.33
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.09
         upper limit
    1.21

    Secondary: Summary and Analysis of PGA of 0 or 1 Responders

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    End point title
    Summary and Analysis of PGA of 0 or 1 Responders [3]
    End point description
    The estimand used a composite strategy (assumption of non-response) for the use of any prohibited therapy prior to week 16 or where the participant had withdrawn from treatment due to a treatment-failure related reason (related AE, lack of efficacy, requirement for other psoriasis treatment). Withdrawal from treatment for other reasons was considered under a hypothetical strategy with no imputation of missing data after discontinuation of treatment. No other intercurrent events were considered and all other data was analysed as collected.
    End point type
    Secondary
    End point timeframe
    Week 16
    Notes
    [3] - 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: Part A treatment groups did not form part of the efficacy analysis and were used for safety endpoints only.
    End point values
    Part B EDP2939 Part B Placebo
    Number of subjects analysed
    56
    52
    Units: Subjects
        PGA 0 or 1 Responders
    7
    5
    Statistical analysis title
    PGA 0 or 1: EDP2939 vs Placebo
    Statistical analysis description
    Estimates come from a generalised linear mixed model (GLMM) with a logit link function, including terms for treatment, visit, baseline PGA score, country, sex and treatment-by-visit interaction. All visits are included in the model, but only the results for the primary timepoint at Week 16 is shown here.
    Comparison groups
    Part B EDP2939 v Part B Placebo
    Number of subjects included in analysis
    108
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.649
    Method
    Mixed models analysis
    Parameter type
    Odds ratio (OR)
    Point estimate
    1.37
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.35
         upper limit
    5.29

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Part A: 10 day treatment period + 14 day follow-up period Part B: 16 week treatment period + 4 week follow-up period
    Adverse event reporting additional description
    A treatment-emergent adverse event (TEAE) is defined as an adverse event with onset date and time on or after the date and time of the first dose of study drug.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    25.1
    Reporting groups
    Reporting group title
    Part A Cohort 1 EDP2939 Low Dose
    Reporting group description
    1 capsule of EDP2939 3.9x10^12 eTPN (equivalent total particle number) once daily for 10 days

    Reporting group title
    Part A Cohort 2 EDP2939 Medium Dose
    Reporting group description
    5 Capsules of EDP2939 3.9 x 10^12 eTPN (equivalent total particle number) once daily for 10 days

    Reporting group title
    Part A Cohort 3 EDP2939 High Dose
    Reporting group description
    2 capsules of EDP2939 5.6 x 10^13 eTPN (equivalent total particle number), once daily for 10 days

    Reporting group title
    Part A Placebo
    Reporting group description
    1 (Cohort 1), 5 (Cohort 2) or 2 (Cohort 3) capsules of placebo matching relevant Part A EDP2393 administered once daily for 10 days

    Reporting group title
    Part B EDP2939
    Reporting group description
    1 capsule of EDP2939 3.9 x10^12 equivalent total particle equivalent (eTPN), once daily for 16 weeks

    Reporting group title
    Part B Placebo
    Reporting group description
    1 capsule of placebo matching Part B EDP2939, once daily for 16 weeks

    Serious adverse events
    Part A Cohort 1 EDP2939 Low Dose Part A Cohort 2 EDP2939 Medium Dose Part A Cohort 3 EDP2939 High Dose Part A Placebo Part B EDP2939 Part B Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 8 (0.00%)
    0 / 7 (0.00%)
    0 / 12 (0.00%)
    0 / 58 (0.00%)
    1 / 57 (1.75%)
         number of deaths (all causes)
    0
    0
    0
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    0
    0
    0
    Musculoskeletal and connective tissue disorders
    Osteoarthritis
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 8 (0.00%)
    0 / 7 (0.00%)
    0 / 12 (0.00%)
    0 / 58 (0.00%)
    1 / 57 (1.75%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Part A Cohort 1 EDP2939 Low Dose Part A Cohort 2 EDP2939 Medium Dose Part A Cohort 3 EDP2939 High Dose Part A Placebo Part B EDP2939 Part B Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    2 / 8 (25.00%)
    4 / 8 (50.00%)
    1 / 7 (14.29%)
    4 / 12 (33.33%)
    10 / 58 (17.24%)
    5 / 57 (8.77%)
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    0 / 8 (0.00%)
    1 / 8 (12.50%)
    1 / 7 (14.29%)
    0 / 12 (0.00%)
    0 / 58 (0.00%)
    0 / 57 (0.00%)
         occurrences all number
    0
    1
    1
    0
    0
    0
    Headache
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 8 (0.00%)
    0 / 7 (0.00%)
    0 / 12 (0.00%)
    1 / 58 (1.72%)
    0 / 57 (0.00%)
         occurrences all number
    1
    0
    0
    0
    1
    0
    Tension headache
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 8 (0.00%)
    0 / 7 (0.00%)
    0 / 12 (0.00%)
    0 / 58 (0.00%)
    0 / 57 (0.00%)
         occurrences all number
    1
    0
    0
    0
    0
    0
    Gastrointestinal disorders
    Gingival swelling
         subjects affected / exposed
    0 / 8 (0.00%)
    1 / 8 (12.50%)
    0 / 7 (0.00%)
    1 / 12 (8.33%)
    0 / 58 (0.00%)
    0 / 57 (0.00%)
         occurrences all number
    0
    1
    0
    0
    0
    0
    Abdominal discomfort
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 8 (0.00%)
    0 / 7 (0.00%)
    1 / 12 (8.33%)
    0 / 58 (0.00%)
    0 / 57 (0.00%)
         occurrences all number
    0
    0
    0
    1
    0
    0
    Respiratory, thoracic and mediastinal disorders
    Nasal congestion
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 8 (0.00%)
    1 / 7 (14.29%)
    0 / 12 (0.00%)
    0 / 58 (0.00%)
    0 / 57 (0.00%)
         occurrences all number
    0
    0
    1
    0
    0
    0
    Oropharyngeal pain
         subjects affected / exposed
    0 / 8 (0.00%)
    1 / 8 (12.50%)
    0 / 7 (0.00%)
    0 / 12 (0.00%)
    0 / 58 (0.00%)
    0 / 57 (0.00%)
         occurrences all number
    0
    1
    0
    0
    0
    0
    Rhinorrhoea
         subjects affected / exposed
    0 / 8 (0.00%)
    1 / 8 (12.50%)
    0 / 7 (0.00%)
    0 / 12 (0.00%)
    0 / 58 (0.00%)
    0 / 57 (0.00%)
         occurrences all number
    0
    1
    0
    0
    0
    0
    Skin and subcutaneous tissue disorders
    Erythema
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 8 (0.00%)
    0 / 7 (0.00%)
    1 / 12 (8.33%)
    0 / 58 (0.00%)
    0 / 57 (0.00%)
         occurrences all number
    0
    0
    0
    1
    0
    0
    Rash
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 8 (0.00%)
    0 / 7 (0.00%)
    1 / 12 (8.33%)
    0 / 58 (0.00%)
    0 / 57 (0.00%)
         occurrences all number
    0
    0
    0
    1
    0
    0
    Infections and infestations
    Gastroenteritis
         subjects affected / exposed
    0 / 8 (0.00%)
    1 / 8 (12.50%)
    0 / 7 (0.00%)
    1 / 12 (8.33%)
    0 / 58 (0.00%)
    1 / 57 (1.75%)
         occurrences all number
    0
    1
    0
    1
    0
    1
    Nasopharyngitis
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 8 (0.00%)
    0 / 7 (0.00%)
    0 / 12 (0.00%)
    3 / 58 (5.17%)
    4 / 57 (7.02%)
         occurrences all number
    1
    0
    0
    0
    3
    4
    Viral upper respiratory tract infection
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 8 (0.00%)
    0 / 7 (0.00%)
    0 / 12 (0.00%)
    4 / 58 (6.90%)
    0 / 57 (0.00%)
         occurrences all number
    0
    0
    0
    0
    4
    0
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 8 (0.00%)
    0 / 7 (0.00%)
    0 / 12 (0.00%)
    3 / 58 (5.17%)
    1 / 57 (1.75%)
         occurrences all number
    0
    0
    0
    0
    3
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    25 May 2022
    Change to the reference of enteric-coated capsules to polymer-coated capsules and addition of a footnote to the schedule of activities in Part A to clarify an end of study pregnancy test was to be carried out in all participants. This was not submitted to the competent authorities and ethics committee .
    27 Jun 2022
    • Change in study design such that Part B could commence dosing following SRC review of Part A, Cohort 1 (3.9 × 1012 eTPN QD dose level). • Change in Phase 2 (Part B) dose from 7.5 × 1013 to 3.9 × 1012 eTPN QD. • Deletion of reference to Data Monitoring Committee and change in the safety committee from Dose-Level Review Committee to SRC. • Change in minimum number of participants with safety data required for each SRC (changed from 8 to 10 participants). • Update the requirement in Part A for blood samples for biomarkers and systemic levels of EDP2939 to be taken predose on Day 10. • Separate text for Part A and Part B permitted and contraindicated immunizations. • Iteration of specific study halting criteria for Part B. • Specification that SRC review was to be initially performed in a blinded manner. Unblinded review was only to be done if a potential safety signal needed to be confirmed or rejected. This was not submitted to the competent authorities and ethics committee.
    23 Aug 2022
    • Change in exclusion criterion number 22 that participants in Part B would be permitted to use unmedicated emollients and moisturizers during the study (but were to be withheld on visit days when skin assessments were made). Other topical treatments were excluded if used within 14 days of randomization. • Change in exclusion criterion number 24 with deletion of “bilirubin >1.5 × upper limit of normal”. • Inclusion of monkeypox vaccine in list of live vaccines. • Update of description of the VAS to be rated between 0 (fatigue is no problem) to 100 (fatigue is major problem). • Addition of the Declaration and Signature of the investigator page. This was the first version submitted to regulatory authorities and ethics committees.
    14 Nov 2022
    • Change in grading of intensity of AEs for healthy participants in Part A to be mild, moderate, or severe. The CTCAE grading scale was only to be used for participants in Part B. • Deletion of bilateral tubal ligation as a reason to consider a female to be of nonchildbearing potential. • Update in highly effective contraception methods text to change “tubal occlusion” to “tubal occlusion/ligation”. • Clarification that Part B investigators would have immediate and unrestricted access within the IRT system to unblind in case of emergency. Additionally, the investigator responsibilities in determining the need for unblinding were clarified and the time frame for sponsor notification were kept the same for Parts A and B.

    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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