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A Phase III Study to Evaluate the Efficacy, Safety, and Pharmacokinetics of Investigational Product MP-101 in Subjects With Short Bowel Syndrome Who Have Had an Inadequate Response to Anti-Diarrheals

Primary Purpose

Short Bowel Syndrome, Short Gut Syndrome, SBS

Status
Withdrawn
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Opium Tincture USP Deodorized
Opium Tincture USP Deodorized
Sponsored by
Marathon Pharmaceuticals, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Short Bowel Syndrome focused on measuring Short Bowel Syndrome, SBS, Chronic Diarrhea, Short Bowel, Short Gut, Short Gut Syndrome, Anti-Diarrheal, Opium Tincture, loperamide, diphenoxylate, ileostomies, tincture of opium, DTO, codeine, morphine, opiate

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Be male or female adults, 18 years of age or older at the time of consent
  2. Have SBS that is inadequately controlled on current antidiarrheal medication (e.g., loperamide or diphenoxylate), including subjects with ileostomies, based on the 7 days prior to Day 1 of the study

    a. Subjects must be >3months post intestinal resection

  3. Have a history of persistent loose stools for more than 4 weeks
  4. Be on a combination of Opium Tincture and an anti-diarrheal (loperamide or diphenoxylate) or an anti-diarrheal agent alone
  5. If currently taking Opium Tincture, be willing to stop the continued use of Opium Tincture at screening visit until the start of study treatment and willing to stop the use of any other anti-diarrheal for the duration of the study
  6. Be able to maintain their current diet for the duration of the study
  7. Be on stable nutritional support (parenteral or oral)
  8. Males or non-pregnant, non-lactating females who are postmenopausal, naturally or surgically sterile, or who agree to use effective contraceptive methods throughout the course of the study. Postmenopausal is defined as at least 12 months of natural spontaneous amenorrhea, or at least 6 weeks following surgical menopause (bilateral oophorectomy)
  9. Females of childbearing potential must agree to use 1 of the following acceptable birth control methods:

    1. Surgically sterile (hysterectomy or bilateral oophorectomy)
    2. Surgically sterile (bilateral tubal ligation with surgery at least 6 weeks prior to study initiation)
    3. Intrauterine device (IUD) in place for at least 3 months
    4. Abstinence (not having sexual intercourse)
    5. Barrier method (condom or diaphragm) with spermicide for at least 14 days prior to screening and through study completion
    6. Stable hormonal contraceptive for at least 3 months prior to study and through study completion
    7. Vasectomized partner
  10. Females of childbearing potential must have a negative serum human chorionic gonadotropin (hCG) pregnancy test at screening
  11. Be able to understand and provide signed informed consent

Exclusion Criteria:

  1. Unable or unwilling to stop the use of Opium Tincture or any anti-diarrheal medication at the screening visit.
  2. Have any history of or active neurological, endocrine, cardiovascular, pulmonary, hematological, immunologic, psychiatric, or metabolic disease that is considered clinically significant, is not currently controlled by medication, and is stable as deemed by the Investigator
  3. Have clinically significant electrocardiogram (ECG) abnormalities as determined by the PI or vital sign abnormalities (systolic blood pressure < 90 mmHg, diastolic blood pressure < 60 mmHg, or heart rate >100 bpm) at screening
  4. Have clinically significant elevation of liver enzymes (> 3 times the upper limit of normal) or clinically relevant renal disease, (creatinine >1.5) or any other clinically significant abnormal laboratory test results found during medical screening as determined by the Principal Investigator
  5. Have a history of major mental illness that in the opinion of the Investigator may affect the ability of the subject to safely participate and reliably complete the study
  6. Have a history of alcohol or substance abuse within the past 2 years. Alcohol abuse will be defined as >14 drinks per week (1 drink = 12 oz. beer, 5.0 oz. wine, or 1.5 oz. distilled spirits)
  7. Have a known allergy or intolerance to Opium Tincture or any of the excipients in the formulation (alcohol, opium, or morphine)
  8. Is currently taking an opioid derivative (other than Opium Tincture) or any other medication which, in the opinion of the investigator, could interfere with the interpretation of the study results
  9. Are currently taking antibiotics for bacterial overgrowth
  10. Have participated in another interventional clinical trial within 30 days prior to screening with the exception of observational cohort studies or non-interventional studies.
  11. Have known or suspected pregnancy, planned pregnancy, or lactation
  12. Have a planned surgery over the course of the study
  13. Have a condition the Investigator believes would interfere with the ability to provide informed consent or comply with study instructions, or that might confound the interpretation of the study results or put the subject at undue risk

Sites / Locations

  • Northwestern University Feinberg School of Medicine
  • Indiana University
  • Cleveland Clinic
  • Regional Infectious Diseases Infusion Center
  • Vanderbilt Center for Human Nutrition

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Group 1

Group 2

Arm Description

Assigned to receive Treatment A (Period 1), Treatment B (Period 2), Treatment C (Period 3)

Assigned to receive Treatment B (Period 1), Treatment A (Period 2), Treatment C (Period 3)

Outcomes

Primary Outcome Measures

Percentage of responders between Treatments A and B for the Intent-To-Treat (ITT) population
30% or greater reduction in 24-hour stool volume from baseline

Secondary Outcome Measures

Percentage of responders between Treatments A and B for the Modified-Intent-To-Treat (mITT) population
30% or greater reduction in 24-hour stool volume from baseline for subjects who complete both periods 1 and 2 of the randomized, blinded, crossover portion of the study
Establish non-inferiority of the percentage of responders between Treatment A and Treatment C
30% or greater reduction in stool volume from baseline between Treatment A (with uncharacterized material) and Treatment C (with reduced uncharacterized material) for ITT and mITT efficacy population (subjects from the ITT population who complete both Treatments A and C)
24-hour stool volume comparison between Treatment A and B for ITT and mITT
Comparison of stool volume measurements
24-hour fecal events between Treatment A and B for ITT and mITT
Changes in the number of 24-hour fecal events for ITT and mITT
24-hour nocturnal fecal events between Treatment A and B for ITT and mITT
Changes in the number of 24-hour nocturnal (ad defined for each subject) fecal events for ITT and mITT
Single and multiple dose Pharmacokinetic (PK) parameters
Evaluate the pharmacokinetics of morphine, codeine, thebaine and papaverine after single dose and multiple dose administration of MP-101
Number of Participants with Adverse Events
Review of safety events throughout the course of the study
Number of Participants Up-Titrated
Review of safety events throughout the course of the study

Full Information

First Posted
September 10, 2014
Last Updated
February 16, 2015
Sponsor
Marathon Pharmaceuticals, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT02242656
Brief Title
A Phase III Study to Evaluate the Efficacy, Safety, and Pharmacokinetics of Investigational Product MP-101 in Subjects With Short Bowel Syndrome Who Have Had an Inadequate Response to Anti-Diarrheals
Official Title
A Phase 3, Open Label Responder Treatment Period With a Randomized, Blinded, Three-Period Crossover, Followed by an Open Label Safety Period to Evaluate the Clinical Efficacy, Safety, and Pharmacokinetics of Investigational Drug MP-101 (Opium Tincture and Opium Tincture With Reduced Uncharacterized Material) to Treat Chronic Diarrhea in Subjects With Short Bowel Syndrome Who Have Had an Inadequate Response to Anti-Diarrheals
Study Type
Interventional

2. Study Status

Record Verification Date
October 2014
Overall Recruitment Status
Withdrawn
Why Stopped
Transfer of IND to new marketing authorization holder
Study Start Date
December 2014 (undefined)
Primary Completion Date
December 2017 (Anticipated)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Marathon Pharmaceuticals, LLC

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
MP-101 will be evaluated in this study to see if it is safe, tolerable, and can help people with Short Bowel Syndrome. This study will also find out if taking MP-101 can improve the symptoms of Short Bowel Syndrome and reduce the number of times subjects experience bowel movements.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Short Bowel Syndrome, Short Gut Syndrome, SBS, Short Bowel, Short Gut
Keywords
Short Bowel Syndrome, SBS, Chronic Diarrhea, Short Bowel, Short Gut, Short Gut Syndrome, Anti-Diarrheal, Opium Tincture, loperamide, diphenoxylate, ileostomies, tincture of opium, DTO, codeine, morphine, opiate

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Crossover Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1
Arm Type
Experimental
Arm Description
Assigned to receive Treatment A (Period 1), Treatment B (Period 2), Treatment C (Period 3)
Arm Title
Group 2
Arm Type
Experimental
Arm Description
Assigned to receive Treatment B (Period 1), Treatment A (Period 2), Treatment C (Period 3)
Intervention Type
Drug
Intervention Name(s)
Opium Tincture USP Deodorized
Intervention Description
Treatment A - 0.6 mL, MP-101 (10 mg/mL, Opium Tincture (OT)), USP (Deodorized) QID oral drops, followed by Treatment B - 0.6 mL, MP-101, 1/12 dilution, (0.833 mg/mL, OT), USP (Deodorized) QID oral drops, followed by Treatment C - 0.6 mL, MP-101 (10 mg/mL Opium Tincture with reduced uncharacterized material) QID oral drops
Intervention Type
Drug
Intervention Name(s)
Opium Tincture USP Deodorized
Intervention Description
Treatment B - 0.6 mL, MP-101, 1/12 dilution, (0.833 mg/mL, OT), USP (Deodorized) QID oral drops, followed by Treatment A - 0.6 mL, MP-101 (10 mg/mL, Opium Tincture (OT)), USP (Deodorized) QID oral drops, followed by Treatment C - 0.6 mL, MP-101 (10 mg/mL Opium Tincture with reduced uncharacterized material) QID oral drops
Primary Outcome Measure Information:
Title
Percentage of responders between Treatments A and B for the Intent-To-Treat (ITT) population
Description
30% or greater reduction in 24-hour stool volume from baseline
Time Frame
Last day of Periods 1 (Days 16-17) and 2 (Days 25-26)
Secondary Outcome Measure Information:
Title
Percentage of responders between Treatments A and B for the Modified-Intent-To-Treat (mITT) population
Description
30% or greater reduction in 24-hour stool volume from baseline for subjects who complete both periods 1 and 2 of the randomized, blinded, crossover portion of the study
Time Frame
Last day of Periods 1 (Days 16-17) and 2 (Days 25-26)
Title
Establish non-inferiority of the percentage of responders between Treatment A and Treatment C
Description
30% or greater reduction in stool volume from baseline between Treatment A (with uncharacterized material) and Treatment C (with reduced uncharacterized material) for ITT and mITT efficacy population (subjects from the ITT population who complete both Treatments A and C)
Time Frame
Last day of Period 3 (Day 34-35)
Title
24-hour stool volume comparison between Treatment A and B for ITT and mITT
Description
Comparison of stool volume measurements
Time Frame
Last day of Periods 1 (Day 16-17) and 2 (Day 25-26)
Title
24-hour fecal events between Treatment A and B for ITT and mITT
Description
Changes in the number of 24-hour fecal events for ITT and mITT
Time Frame
Period 1 (Day 10-16) and 2 (Day 19-25)
Title
24-hour nocturnal fecal events between Treatment A and B for ITT and mITT
Description
Changes in the number of 24-hour nocturnal (ad defined for each subject) fecal events for ITT and mITT
Time Frame
Period 1 (Day 10-16) and 2 (Day 19-25)
Title
Single and multiple dose Pharmacokinetic (PK) parameters
Description
Evaluate the pharmacokinetics of morphine, codeine, thebaine and papaverine after single dose and multiple dose administration of MP-101
Time Frame
Day-1, Day 1, Day 7, Day 57-59
Title
Number of Participants with Adverse Events
Description
Review of safety events throughout the course of the study
Time Frame
Up to 60 Days
Title
Number of Participants Up-Titrated
Description
Review of safety events throughout the course of the study
Time Frame
Days 35-60

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Be male or female adults, 18 years of age or older at the time of consent Have SBS that is inadequately controlled on current antidiarrheal medication (e.g., loperamide or diphenoxylate), including subjects with ileostomies, based on the 7 days prior to Day 1 of the study a. Subjects must be >3months post intestinal resection Have a history of persistent loose stools for more than 4 weeks Be on a combination of Opium Tincture and an anti-diarrheal (loperamide or diphenoxylate) or an anti-diarrheal agent alone If currently taking Opium Tincture, be willing to stop the continued use of Opium Tincture at screening visit until the start of study treatment and willing to stop the use of any other anti-diarrheal for the duration of the study Be able to maintain their current diet for the duration of the study Be on stable nutritional support (parenteral or oral) Males or non-pregnant, non-lactating females who are postmenopausal, naturally or surgically sterile, or who agree to use effective contraceptive methods throughout the course of the study. Postmenopausal is defined as at least 12 months of natural spontaneous amenorrhea, or at least 6 weeks following surgical menopause (bilateral oophorectomy) Females of childbearing potential must agree to use 1 of the following acceptable birth control methods: Surgically sterile (hysterectomy or bilateral oophorectomy) Surgically sterile (bilateral tubal ligation with surgery at least 6 weeks prior to study initiation) Intrauterine device (IUD) in place for at least 3 months Abstinence (not having sexual intercourse) Barrier method (condom or diaphragm) with spermicide for at least 14 days prior to screening and through study completion Stable hormonal contraceptive for at least 3 months prior to study and through study completion Vasectomized partner Females of childbearing potential must have a negative serum human chorionic gonadotropin (hCG) pregnancy test at screening Be able to understand and provide signed informed consent Exclusion Criteria: Unable or unwilling to stop the use of Opium Tincture or any anti-diarrheal medication at the screening visit. Have any history of or active neurological, endocrine, cardiovascular, pulmonary, hematological, immunologic, psychiatric, or metabolic disease that is considered clinically significant, is not currently controlled by medication, and is stable as deemed by the Investigator Have clinically significant electrocardiogram (ECG) abnormalities as determined by the PI or vital sign abnormalities (systolic blood pressure < 90 mmHg, diastolic blood pressure < 60 mmHg, or heart rate >100 bpm) at screening Have clinically significant elevation of liver enzymes (> 3 times the upper limit of normal) or clinically relevant renal disease, (creatinine >1.5) or any other clinically significant abnormal laboratory test results found during medical screening as determined by the Principal Investigator Have a history of major mental illness that in the opinion of the Investigator may affect the ability of the subject to safely participate and reliably complete the study Have a history of alcohol or substance abuse within the past 2 years. Alcohol abuse will be defined as >14 drinks per week (1 drink = 12 oz. beer, 5.0 oz. wine, or 1.5 oz. distilled spirits) Have a known allergy or intolerance to Opium Tincture or any of the excipients in the formulation (alcohol, opium, or morphine) Is currently taking an opioid derivative (other than Opium Tincture) or any other medication which, in the opinion of the investigator, could interfere with the interpretation of the study results Are currently taking antibiotics for bacterial overgrowth Have participated in another interventional clinical trial within 30 days prior to screening with the exception of observational cohort studies or non-interventional studies. Have known or suspected pregnancy, planned pregnancy, or lactation Have a planned surgery over the course of the study Have a condition the Investigator believes would interfere with the ability to provide informed consent or comply with study instructions, or that might confound the interpretation of the study results or put the subject at undue risk
Facility Information:
Facility Name
Northwestern University Feinberg School of Medicine
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
Indiana University
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46202
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Regional Infectious Diseases Infusion Center
City
Lima
State/Province
Ohio
ZIP/Postal Code
45801
Country
United States
Facility Name
Vanderbilt Center for Human Nutrition
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37212-1150
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Phase III Study to Evaluate the Efficacy, Safety, and Pharmacokinetics of Investigational Product MP-101 in Subjects With Short Bowel Syndrome Who Have Had an Inadequate Response to Anti-Diarrheals

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