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Safety, Efficacy, PD of FE203799 in Short Bowel Syndrome on Parenteral Support

Primary Purpose

Short Bowel Syndrome

Status
Completed
Phase
Phase 1
Locations
Denmark
Study Type
Interventional
Intervention
FE203799 GLP-2 analogue
FE203799 Placebo GLP-2 analogue
FE203799 GLP-2 analogue
Sponsored by
GlyPharma Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Short Bowel Syndrome

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

  1. Males and females with SBS secondary to surgical resection of small intestine
  2. 18-80 years of age
  3. Body Mass Index (BMI) between 16.0 and 32.0
  4. Patients with a jejuno- or ileostomy and a faecal wet weight excretion of at least 1500 g/day, as recorded within the last 18 months according to the patient's medical record
  5. Parenteral support ≥3 times/week for ≥12 months according to the patient's medical record
  6. At least 6 months since last surgical bowel resection
  7. Willing to adhere to a defined oral intake of fluids on certain days as required by the protocol (and based on the individual's routine daily consumption)
  8. Women of childbearing potential must agree to use an adequate method of contraception during the trial and for 60 days after the end-of-trial visit. Adequate methods of contraception include intrauterine device or hormonal contraception (oral contraceptive pill, depot injections or implant, transdermal depot patch or vaginal ring). To be considered sterilised or infertile, females must have undergone surgical sterilisation (bilateral tubectomy, hysterectomy or bilateral ovariectomy) or be post-menopausal (defined as at least 12 months amenorrhoea and confirmed with follicle-stimulating hormone [FSH] test)

Exclusion Criteria

  1. Pregnancy or lactation
  2. Positive results on the human immunodeficiency virus (HIV), hepatitis B and/or C tests
  3. A history of clinically significant intestinal adhesions and/or chronic abdominal pain
  4. Require chronic systemic narcotics for treatment of pain that exceeds an amount corresponding to 80 mg of morphine per day
  5. History of cancer or clinically significant lymphoproliferative disease within ≤5 years, except for adequately treated basal cell skin cancer
  6. History of gallstone within the past 3 years. Gallstones with subsequent cholecystectomy to resolve the issues is acceptable
  7. Inflammatory bowel disease (IBD) patients who have NOT been on a stable drug treatment regimen for at least the past 4 weeks
  8. Evidence of active IBD in the past 12 weeks
  9. Visible blood in the stool within the last 3 months
  10. Catheter sepsis experienced within the last 3 months
  11. Decompensated heart failure (New York Heart Association [NYHA] class III-IV) and/or known coronary heart disease defined as unstable angina pectoris and/or myocardial infarction within the last 6 months prior to screening
  12. Radiation enteritis, scleroderma or other condition of intestinal dysmotility, coeliac disease, refractory or tropical sprue
  13. History of alcohol and/or drug abuse within the last 12 months
  14. Inadequate hepatic function as defined by: bilirubin >upper limit of normal (ULN), alanine transaminase (ALT) or aspartate transaminase (AST) >2.0 × ULN; alkaline phosphatase (ALP) >2.5 × ULN; or international normalised ratio (INR) >1.5 × ULN
  15. Inadequate renal function as defined by serum creatinine or blood urea nitrogen >2.5 × ULN
  16. Unplanned hospitalisation of >24 hours duration within 1 month before the screening visit
  17. Systemic corticosteroids, methotrexate, cyclosporine, tacrolimus, sirolimus, infliximab or other biologic therapy/immune modifiers within 30 days of screening
  18. Any use of growth hormone, glutamine or growth factors such as native glucagon-like peptide 2 (GLP 2) or GLP 2 analogue within the last 3 months
  19. Any use of antibiotics within the last 30 days
  20. Participation in another clinical trial within the last 3 months and during this trial
  21. Previously been randomised in this trial
  22. Loss of blood or donation of blood or plasma >500 mL within 3 months prior to screening
  23. Patient not capable of understanding or not willing to adhere to the trial visit schedules and other protocol requirements
  24. For any other reason judged not eligible by the investigator

Sites / Locations

  • Rigshospitalet

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Placebo Comparator

Other

Arm Label

FE203799 5 mg

Placebo

FE203799 10 mg

Arm Description

FE203799 GLP-2 analogue, once weekly, subcutaneous administration

Placebo FE203799 GLP-2 analogue, once weekly, subcutaneous administration

FE203799 GLP-2 analogue, once weekly, subcutaneous administration

Outcomes

Primary Outcome Measures

Incidence of treatment-emergent adverse events
Adverse events (AEs) as assessed by CTCAE v4.03

Secondary Outcome Measures

Assessment of intestinal failure and gut absorption
Measurement of urinary output (ml)
Assessment of intestinal failure and gut absorption
Measurement of urinary sodium (mmol/d)
Assessment of intestinal failure and gut absorption
Measurement of Parenteral Support (L)
Assessment of intestinal failure and gut absorption
Measurement of oral fluids intake (L)
Assessment of intestinal failure and gut absorption
Changes from baseline in lean body mass by DEXA scan
Assessment of intestinal failure and gut absorption
Changes from baseline in fat mass by DEXA scan
Assessment of intestinal failure and gut absorption
Changes from baseline in bone mineral content by DEXA scan
Assessment of gut regeneration
Measurements of the plasma citrulline (ng/ml)
Plasma Trough concentration (Ctrough) of study drug
Ctrough
Plasma concentration post 72 hours (C72) of study drug
C72

Full Information

First Posted
November 16, 2017
Last Updated
October 22, 2020
Sponsor
GlyPharma Therapeutics
Collaborators
VectivBio AG
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1. Study Identification

Unique Protocol Identification Number
NCT03415594
Brief Title
Safety, Efficacy, PD of FE203799 in Short Bowel Syndrome on Parenteral Support
Official Title
A Once-weekly, Repeated Dose, Placebo Controlled, Double Blind, Randomised Cross-over Trial Investigating Safety, Efficacy and Pharmacodynamics of FE 203799 in Patients With Short Bowel Syndrome With Intestinal Failure Requiring Parenteral Support Followed by an Additional Treatment Period in an Open Label Regimen.
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
May 8, 2018 (Actual)
Primary Completion Date
November 21, 2019 (Actual)
Study Completion Date
November 21, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
GlyPharma Therapeutics
Collaborators
VectivBio AG

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Part A:once weekly dosing for 4 weeks in patients with short bowel syndrome who require total parenteral nutrition; patients will complete period 1 and after a 6-10 week wash-out, they will enter period 2 (active treatment and placebo); Part B: treatment period 3, is an open label extension to part A and starts after a washout of 6-10 weeks after the last dose in treatment period 2. patients are dosed once weekly for 4 weeks.
Detailed Description
This trial is divided into 2 parts. Part A of this trial is a repeated dose, placebo controlled, double blind, randomised cross-over trial investigating safety, efficacy and PD of FE 203799 in 8-10 patients with SBS. Additionally, the plasma concentration of FE 203799 will be assessed for determination of the trough and post-dose concentration in SBS patients. The patients will receive a subcutaneous (SC) dose of 5 mg FE 203799 or placebo once weekly for 4 consecutive weeks, and after a washout period of 6-10 weeks, the alternate treatment will be administered once weekly for 4 consecutive weeks. Safety follow-up assessments will be performed 6-10 weeks after the last dose in each treatment period. Part B of this trial, treatment period 3, is an open label extension to part A that will test a new dose. Following a washout period of 6-10 weeks after the last dose in treatment period 2, the new dose will be administered once weekly for 4 weeks. Safety follow-up assessments will be performed 4-6 weeks after the last dose in treatment period 3. The first two administrations of trial drug in each treatment period will be performed at the clinic, while the third and fourth dose can be either self-administered by the patient or administered at the clinic if the patient prefers to travel to the site or other considerations make a site visit preferable. Prior to each administration of trial drug, liver function parameters will be analysed and assessed. During each treatment period, patients who develop extremely high or persistently elevated liver enzymes following trial drug administration will be discontinued from the trial. The patients will complete a diary during each treatment period with daily data on parenteral support (PS) usage, oral liquid intake at specific periods, trial drug administrations performed at home, local tolerability and adverse events (AEs).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Short Bowel Syndrome

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 1, Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderOutcomes Assessor
Allocation
Randomized
Enrollment
8 (Actual)

8. Arms, Groups, and Interventions

Arm Title
FE203799 5 mg
Arm Type
Experimental
Arm Description
FE203799 GLP-2 analogue, once weekly, subcutaneous administration
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo FE203799 GLP-2 analogue, once weekly, subcutaneous administration
Arm Title
FE203799 10 mg
Arm Type
Other
Arm Description
FE203799 GLP-2 analogue, once weekly, subcutaneous administration
Intervention Type
Drug
Intervention Name(s)
FE203799 GLP-2 analogue
Intervention Description
FE203799 5 mg subQ once weekly
Intervention Type
Drug
Intervention Name(s)
FE203799 Placebo GLP-2 analogue
Intervention Description
Placebo subQ once weekly
Intervention Type
Drug
Intervention Name(s)
FE203799 GLP-2 analogue
Intervention Description
FE203799 10 mg subQ once weekly
Primary Outcome Measure Information:
Title
Incidence of treatment-emergent adverse events
Description
Adverse events (AEs) as assessed by CTCAE v4.03
Time Frame
Day -28 to Day 29
Secondary Outcome Measure Information:
Title
Assessment of intestinal failure and gut absorption
Description
Measurement of urinary output (ml)
Time Frame
Day -3 - Day 28
Title
Assessment of intestinal failure and gut absorption
Description
Measurement of urinary sodium (mmol/d)
Time Frame
Day -3 - Day 28
Title
Assessment of intestinal failure and gut absorption
Description
Measurement of Parenteral Support (L)
Time Frame
Day -3 - Day 29
Title
Assessment of intestinal failure and gut absorption
Description
Measurement of oral fluids intake (L)
Time Frame
Day -3 - Day 28
Title
Assessment of intestinal failure and gut absorption
Description
Changes from baseline in lean body mass by DEXA scan
Time Frame
Day -3 and Day 29
Title
Assessment of intestinal failure and gut absorption
Description
Changes from baseline in fat mass by DEXA scan
Time Frame
Day -3 and Day 29
Title
Assessment of intestinal failure and gut absorption
Description
Changes from baseline in bone mineral content by DEXA scan
Time Frame
Day -3 and Day 29
Title
Assessment of gut regeneration
Description
Measurements of the plasma citrulline (ng/ml)
Time Frame
Day 1 - Day 29
Title
Plasma Trough concentration (Ctrough) of study drug
Description
Ctrough
Time Frame
Day 1 - Day 29
Title
Plasma concentration post 72 hours (C72) of study drug
Description
C72
Time Frame
Day 1 - Day 29

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Males and females with SBS secondary to surgical resection of small intestine 18-80 years of age Body Mass Index (BMI) between 16.0 and 32.0 Patients with a jejuno- or ileostomy and a faecal wet weight excretion of at least 1500 g/day, as recorded within the last 18 months according to the patient's medical record Parenteral support ≥3 times/week for ≥12 months according to the patient's medical record At least 6 months since last surgical bowel resection Willing to adhere to a defined oral intake of fluids on certain days as required by the protocol (and based on the individual's routine daily consumption) Women of childbearing potential must agree to use an adequate method of contraception during the trial and for 60 days after the end-of-trial visit. Adequate methods of contraception include intrauterine device or hormonal contraception (oral contraceptive pill, depot injections or implant, transdermal depot patch or vaginal ring). To be considered sterilised or infertile, females must have undergone surgical sterilisation (bilateral tubectomy, hysterectomy or bilateral ovariectomy) or be post-menopausal (defined as at least 12 months amenorrhoea and confirmed with follicle-stimulating hormone [FSH] test) Exclusion Criteria Pregnancy or lactation Positive results on the human immunodeficiency virus (HIV), hepatitis B and/or C tests A history of clinically significant intestinal adhesions and/or chronic abdominal pain Require chronic systemic narcotics for treatment of pain that exceeds an amount corresponding to 80 mg of morphine per day History of cancer or clinically significant lymphoproliferative disease within ≤5 years, except for adequately treated basal cell skin cancer History of gallstone within the past 3 years. Gallstones with subsequent cholecystectomy to resolve the issues is acceptable Inflammatory bowel disease (IBD) patients who have NOT been on a stable drug treatment regimen for at least the past 4 weeks Evidence of active IBD in the past 12 weeks Visible blood in the stool within the last 3 months Catheter sepsis experienced within the last 3 months Decompensated heart failure (New York Heart Association [NYHA] class III-IV) and/or known coronary heart disease defined as unstable angina pectoris and/or myocardial infarction within the last 6 months prior to screening Radiation enteritis, scleroderma or other condition of intestinal dysmotility, coeliac disease, refractory or tropical sprue History of alcohol and/or drug abuse within the last 12 months Inadequate hepatic function as defined by: bilirubin >upper limit of normal (ULN), alanine transaminase (ALT) or aspartate transaminase (AST) >2.0 × ULN; alkaline phosphatase (ALP) >2.5 × ULN; or international normalised ratio (INR) >1.5 × ULN Inadequate renal function as defined by serum creatinine or blood urea nitrogen >2.5 × ULN Unplanned hospitalisation of >24 hours duration within 1 month before the screening visit Systemic corticosteroids, methotrexate, cyclosporine, tacrolimus, sirolimus, infliximab or other biologic therapy/immune modifiers within 30 days of screening Any use of growth hormone, glutamine or growth factors such as native glucagon-like peptide 2 (GLP 2) or GLP 2 analogue within the last 3 months Any use of antibiotics within the last 30 days Participation in another clinical trial within the last 3 months and during this trial Previously been randomised in this trial Loss of blood or donation of blood or plasma >500 mL within 3 months prior to screening Patient not capable of understanding or not willing to adhere to the trial visit schedules and other protocol requirements For any other reason judged not eligible by the investigator
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Palle B Jeppeson, MD
Organizational Affiliation
Department of Gastroenterology CA-2121, Rigshospitalet, Copenhagen, Denmark
Official's Role
Principal Investigator
Facility Information:
Facility Name
Rigshospitalet
City
Copenhagen
Country
Denmark

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
34287970
Citation
Eliasson J, Hvistendahl MK, Freund N, Bolognani F, Meyer C, Jeppesen PB. Apraglutide, a novel glucagon-like peptide-2 analog, improves fluid absorption in patients with short bowel syndrome intestinal failure: Findings from a placebo-controlled, randomized phase 2 trial. JPEN J Parenter Enteral Nutr. 2022 May;46(4):896-904. doi: 10.1002/jpen.2223. Epub 2021 Sep 7.
Results Reference
derived

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Safety, Efficacy, PD of FE203799 in Short Bowel Syndrome on Parenteral Support

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