Open-label Treatment in Cushing's Syndrome (OPTICS)
Cushing Syndrome, Cushing Disease
About this trial
This is an interventional treatment trial for Cushing Syndrome
Eligibility Criteria
Inclusion Criteria:
- Completed the Extended Evaluation Phase of Study COR-2012-01 (i.e. M12)
Completed the Restoration Phase of Study COR-2017-01 (i.e. RES2)
NOTE: Subjects meeting criteria 1 or 2 above who have had a break in therapy may be eligible only after discussion with the Medical Monitor. If eligible, such subjects may require re-establishment of the Therapeutic Dose via titration. All subjects who have had a break in therapy should be discussed with the Medical Monitor to determine the starting dose of levoketoconazole. Prior to resuming treatment with levoketoconazole, other therapies for Cushing's Syndrome must undergo an appropriate washout period, with minimum durations as follows:
- Ketoconazole or metyrapone: 2 weeks;
- Dopamine agonists: bromocriptine (2 weeks), cabergoline (8 weeks);
- Octreotide acetate LAR, lanreotide Autogel, pasireotide LAR: 12 weeks;
- Lanreotide SR: 8 weeks;
- Octreotide acetate (immediate release) or short-acting pasireotide: 1 week;
- Mifepristone (RU 486, KORLYM): 4 weeks;
- Megestrol acetate or medroxyprogesterone acetate (and selected other synthetic progestins): 6 weeks.
- Currently in a named patient program or other Expanded Access Program receiving levoketoconazole
- Were levoketoconazole-naïve prior to entry and received early rescue therapy with open-label levoketoconazole in Study COR-2017-01.
- Achieved a clinically meaningful partial response (with reduction of UFC) in Study COR-2017-01 at dose level 7 or at a maximally tolerated dose of levoketoconazole but did not meet the randomization criteria for Study COR-2017-01 at the end of the Dose Titration and Maintenance Phase when randomization was open.
- Were levoketoconazole-naïve prior to entry and were enrolled in Study COR-2017-01 in the Dose Titration and Maintenance Phase when randomization was closed. (NOTE: Such subjects must receive at least 1 dose of levoketoconazole before transitioning to this study.)
Exclusion Criteria:
- Discontinued levoketoconazole while participating in Study COR-2012-01 or Study COR-2017-01 or a named patient program or other Expanded Access program, due to safety or tolerability concerns or lack of efficacy.
- Scheduled for surgery for treatment of CS or received surgery for treatment of CS within the 6 weeks prior to Screening.
- Treated with mitotane within 6 months prior to enrollment.
- History of malignancy, including adrenal or pituitary carcinomas (other than low-risk, well-differentiated carcinomas of thyroid, breast or prostate that are very unlikely to require further treatment in the opinion of the treating physician, or squamous cell or basal cell carcinoma of the skin).
Sites / Locations
- The Center for Diabetes and Endocrine Care
- Emory University
- Washington University School of Medicine
- University of New Mexico HSC - HSC Sponsored Projects Office
- Columbia University Medical Center
- Memorial Sloan Kettering Cancer Center
- Cleveland Clinic
- Oregon Health & Science University
- Sveti Georgy University Hospital Clinic of Endocrinology and Metabolic Diseases
- Alexandovska University Hospital
- University Specialized Hospital for Active Treatment in Endocrinology
- APHM Hôpital de la Conception
- General Hospital of Athens Evangelismos Department of Endocrinology and Diabete
- Hippokration General Hospital Endocrinology and Diabetes Department
- Semmelweis Egyetem II. Belgyógyászati Klinika
- Bnai Zion Medical Center Endocrinology Institute
- Rabin Medical Center, Beilinson Campus
- Tel Aviv-Sourasky Medical Center Institute Endocrinology Metabolism & Hypertension
- Clinica Endocrinologia malattie del Metabolismo
- AOU Policlinico G. Martino Sezione di Endocrinologia
- Via Sergio Pansini 5 Uni Naples FedericoII Dept of Molecular&Clinical Endocrinology&Oncology
- Policlinico Universitario Sant'Andrea
- University of Turin
- Erasmus Medical Center
- Instytut Centrum Zdrowia Matki Polki
- Institutul National de Endocrinologie C.I. Parhon
- Spitalul Clinic Judetean de Urgenta Cluj-Napoca
- Spitalul Clinic Judetean Mures
- Hospital Universidad De La Ribera
- Hospital Universitario Ramón y Cajal
Arms of the Study
Arm 1
Experimental
Levoketoconazole
Levoketoconazole taken twice daily up to 1200 mg daily