Clinical Trial Results:
A Phase 1, Randomized, Parallel-group, Open-label, Multicenter Study to Evaluate the Pharmacokinetics, Pharmacodynamics and Safety of Vonoprazan (10 or 20 mg Once Daily) in Children Aged ≥ 6 to < 12 Years Who Have Symptomatic Gastroesophageal Reflux Disease
Summary
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EudraCT number |
2022-003228-42 |
Trial protocol |
Outside EU/EEA |
Global end of trial date |
29 Apr 2024
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Results information
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Results version number |
v1(current) |
This version publication date |
06 Nov 2024
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First version publication date |
06 Nov 2024
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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 |
VPED-103
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT06106022 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Phathom Pharmaceuticals, Inc.
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Sponsor organisation address |
2150 East Lake Cook Road, Suite 800, Buffalo Grove, IL, United States, 60089
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Public contact |
Phathom Medical Information, Phathom Pharmaceuticals, Inc., 1 888-775-7428, medicalinformation@phathompharma.com
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Scientific contact |
Phathom Medical Information, Phathom Pharmaceuticals, Inc., 1 888-775-7428, medicalinformation@phathompharma.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
Yes
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EMA paediatric investigation plan number(s) |
EMEA-002703-PIP01-19 | ||
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? |
Yes
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
29 Apr 2024
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
29 Apr 2024
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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 |
The main objective of the trial was to evaluate the pharmacokinetic profile of vonoprazan (10 or 20 mg once daily [QD]) in children ≥ 6 to < 12 years of age who have symptomatic gastroesophageal reflux disease (GERD).
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Protection of trial subjects |
This study was performed according to the International Council for Harmonisation harmonized tripartite guideline E6(R2): Good Clinical Practice.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
01 Nov 2023
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
No
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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 |
United States: 22
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Worldwide total number of subjects |
22
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EEA total number of subjects |
0
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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) |
22
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
0
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From 65 to 84 years |
0
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85 years and over |
0
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Recruitment
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Recruitment details |
- | ||||||||||||||||||
Pre-assignment
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Screening details |
A total of 22 participants were enrolled at 6 study sites in the United States between November 2023 and April 2024. | ||||||||||||||||||
Period 1
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Period 1 title |
Overall Study (overall period)
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Is this the baseline period? |
Yes | ||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Not blinded | ||||||||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Vonoprazan 10 mg | ||||||||||||||||||
Arm description |
Participants received vonoprazan 10 mg QD for 14 days. | ||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||
Investigational medicinal product name |
Vonoprazan
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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 |
Administered orally.
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Arm title
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Vonoprazan 20 mg | ||||||||||||||||||
Arm description |
Participants received vonoprazan 20 mg QD for 14 days. | ||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||
Investigational medicinal product name |
Vonoprazan
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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 |
Administered orally.
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Baseline characteristics reporting groups
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Reporting group title |
Vonoprazan 10 mg
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Reporting group description |
Participants received vonoprazan 10 mg QD for 14 days. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Vonoprazan 20 mg
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Reporting group description |
Participants received vonoprazan 20 mg QD for 14 days. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Vonoprazan 10 mg
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Reporting group description |
Participants received vonoprazan 10 mg QD for 14 days. | ||
Reporting group title |
Vonoprazan 20 mg
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Reporting group description |
Participants received vonoprazan 20 mg QD for 14 days. |
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End point title |
Maximum Drug Concentration at Steady-state (Cmax,ss) of Vonoprazan [1] | ||||||||||||
End point description |
Plasma pharmacokinetic (PK) parameters were estimated using a non-linear mixed effects model and were determined from the concentration-time data for all evaluable participants. Actual sampling times, rather than scheduled or nominal sampling times, were used in all computations using sampling time. Data presented based on collections on both Day 7 and Day 14.
PK Set: includes all participants who received at least 1 dose of study drug and had sufficient concentration data to support accurate estimation of at least 1 PK parameter.
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End point type |
Primary
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End point timeframe |
Day 7: pre-dose, 0.5 to 1.5 hour and 2.5 to 3.5 hours post dose; Day 14: pre-dose, 1 to 2 hours and 3 to 4 hours post dose
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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 analyses were pre-specified for this endpoint. |
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No statistical analyses for this end point |
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End point title |
Area Under the Plasma Concentration-time Curve During the Dosing Interval τ at Steady State (AUCτ,ss) of Vonoprazan [2] | ||||||||||||
End point description |
Plasma PK parameters were estimated using a non-linear mixed effects model and were determined from the concentration-time data for all evaluable participants. Actual sampling times, rather than scheduled or nominal sampling times, were used in all computations using sampling time.
PK Set: includes all participants who received at least 1 dose of study drug and had sufficient concentration data to support accurate estimation of at least 1 PK parameter.
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End point type |
Primary
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End point timeframe |
Day 7: pre-dose, 0.5 to 1.5 hour and 2.5 to 3.5 hours post dose; Day 14: pre-dose, 1 to 2 hours and 3 to 4 hours post dose
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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 statistical analyses were pre-specified for this endpoint. |
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No statistical analyses for this end point |
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End point title |
Apparent Oral Clearance (CL/F) at Steady State of Vonoprazan [3] | ||||||||||||
End point description |
Oral PK parameters were estimated using a non-linear mixed effects model and were determined from the concentration-time data for all evaluable participants. Actual sampling times, rather than scheduled or nominal sampling times, were used in all computations using sampling time.
PK Set: includes all participants who received at least 1 dose of study drug and had sufficient concentration data to support accurate estimation of at least 1 PK parameter.
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End point type |
Primary
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End point timeframe |
Day 7: pre-dose, 0.5 to 1.5 hour and 2.5 to 3.5 hours post dose; Day 14: pre-dose, 1 to 2 hours and 3 to 4 hours post dose
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Notes [3] - 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 analyses were pre-specified for this endpoint. |
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No statistical analyses for this end point |
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End point title |
Apparent Central Volume of Distribution (Vz/F) at Steady State of Vonoprazan [4] | ||||||||||||
End point description |
Plasma PK parameters were estimated using a non-linear mixed effects model and were determined from the concentration-time data for all evaluable participants. Actual sampling times, rather than scheduled or nominal sampling times, were used in all computations using sampling time.
PK Set: includes all participants who received at least 1 dose of study drug and had sufficient concentration data to support accurate estimation of at least 1 PK parameter.
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End point type |
Primary
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End point timeframe |
Day 7: pre-dose, 0.5 to 1.5 hour and 2.5 to 3.5 hours post dose; Day 14: pre-dose, 1 to 2 hours and 3 to 4 hours post dose
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Notes [4] - 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 analyses were pre-specified for this endpoint. |
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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 |
Up to Day 28
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Adverse event reporting additional description |
Safety Set: includes all participants who received at least 1 dose of study drug.
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Assessment type |
Systematic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
24.0
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Reporting groups
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Reporting group title |
Vonoprazan 10 mg
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Reporting group description |
Participants received vonoprazan 10 mg QD for 14 days. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Vonoprazan 20 mg
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Reporting group description |
Participants received vonoprazan 20 mg QD for 14 days. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 0% | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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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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23 Jun 2023 |
The purposes of the amendment were to:
• Remove requirement that body weight be ≥30 kg.
• Clarify that the primary endpoints comprise PK assessments from data collected on Day 7 and Day 14.
• Revise justification for dose selection using an updated popPK model.
• Add electrocardiograms to safety endpoints.
• Add the following: Following completion of study drug dosing on Day 14 or early discontinuation, the subject will be transitioned to local standard of care for 14 days during the Follow-up Period.
• Addition of inclusion and exclusion criteria.
• Clarify instructions for administration of study drug by specifying when study drug will be taken.
• Provide additional instructions for recording date/time of each dose and actions required for missed study drug doses and missed visits/poor compliance.
• Differentiate timing of PK blood samples between Days 7 and 14. Sodium heparin vacutainer collection tubes were specified.
• Add bone fracture and hematologic abnormalities as adverse event of special interest.
• Add urine pregnancy tests for female participants who had experienced menarche to protocol-required safety laboratory assessments.
• Add Tanner staging to the physical examination.
• Remove the measurement of electrocardiogram intervals, and specify that electrocardiograms were to be read and interpreted centrally by a pediatric cardiologist.
• Define the pharmacodynamic population to include participants who received at least 1 dose of study drug and had sufficient pH data to support calculation of pharmacodynamic parameters.
• Include a potential popPK analysis of interim data from a subset of participants prior to completion of enrollment to assess whether plasma exposure in pediatric participants aged ≥6 to <12 years was within the range observed in adults receiving the same dose.
• Add appendices for contraceptive guidance, Tanner Staging criteria and growth charts. |
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30 Aug 2023 |
The purposes of the amendment were to:
• Change exclusion criterion for creatinine from >2 mg/dL (>177 µmol/L) to >0.8 mg/dL (>70 µmol/L).
• Change the reporting period for pregnancy during administration of active study drug from ‘after Visit 2 or within 4 weeks of the last dose of active study drug’ to ‘after Visit 2 or within 2 weeks of the last dose of active study drug’.
• Remove the requirement for an 8-hour fast before obtaining a glucose measurement.
• Require participants to be dressed in light clothing and without shoes when body weight was measured.
• Remove the telephone call at the Day 14 in-clinic visit from the schedule of assessments. |
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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 |