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A Study of Teduglutide in Japanese Children With Short Bowel Syndrome Who Are 4 Months or Older

Primary Purpose

Short Bowel Syndrome

Status
Completed
Phase
Phase 3
Locations
Japan
Study Type
Interventional
Intervention
Teduglutide
Sponsored by
Takeda
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Short Bowel Syndrome

Eligibility Criteria

4 Months - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female pediatric patient of corrected gestational age 4 months or older.
  2. Body weight at the time of screening and baseline visits of at least 5 kg and <10 kg for participants with normal renal function or mild renal impairment (estimated glomerular filtration rate >=50 mL/min/1.73 m^2), OR at least 10 kg and <20 kg for participants with moderate or greater renal impairment (estimated glomerular filtration rate <50 mL/min/1.73 m^2).
  3. Diagnosis of short bowel syndrome (SBS) with intestinal failure, defined as dependence on PS to provide at least 30% of fluid or caloric needs.
  4. Participants to have stable PS for at least 1 month prior to screening as assessed by the investigator. Stable PS is defined as inability to significantly reduce parenteral nutrition/intravenous fluid (PN/IV) support, usually associated with minimal or no advance in enteral feeds (ie, 10% or less change in PN or advance in feeds), assessed by the investigator.

Exclusion Criteria:

  1. A parent/guardian who is not capable of understanding or not willing to adhere to the study visit schedule and other protocol requirements.
  2. Clinically significant intestinal obstruction, active or recurrent pancreatic or biliary disease, or dysmotility that prevents the advancement of enteral intake.
  3. Intestinal malabsorption due to a genetic condition, such as cystic fibrosis, microvillus inclusion disease, etc.
  4. Severe, known dysmotility syndrome, such as pseudo-obstruction or persistent, severe, active gastroschisis-related dysmotility, that is the primary contributing factor to feeding intolerance and inability to reduce PS, prior to screening. Dysmotility is defined as severe if it is expected to limit the advancement of enteral feeding.
  5. Major gastrointestinal (GI) surgical intervention including significant intestinal resection or bowel lengthening procedure within 3 months prior to screening (insertion of feeding tube, anastomotic ulcer repair, minor intestinal resections =<10 cm and endoscopic procedures are allowed).
  6. Cardiac disease that makes the patient vulnerable to changes in fluid status.
  7. History of cancer or known cancer predisposition syndrome, such as juvenile polyposis or Beckwith-Wiedemann syndrome, or first degree relative with early onset of GI cancer (including hepatobiliary and pancreatic cancer).
  8. Concurrent treatment with glucagon-like peptide-2 (GLP-2), human growth hormone, or analogs of these hormones within 6 months prior to the screening visit, or concurrent treatment with octreotide, or GLP-1 analogs within 30 days prior to the screening visit.
  9. Concurrent treatment with biological therapy (eg, anti-tumor necrosis factor [anti-TNF]) for active Crohn's disease within 6 months prior to the screening visit.
  10. Participation in a clinical study using an experimental drug (other than glutamine or omegaven) within 3 months or 5.5 half-lives of the experimental drug, whichever is longer, prior to the screening visit and for the duration of the study.
  11. Known or suspected intolerance or hypersensitivity to the study drug, closely related compounds, or any of the stated ingredients.
  12. Signs of active, severe, or unstable clinically significant hepatic impairment during the screening period as meeting at least 2 of any of the following parameters:

    1. International normalized ratio >1.5 not corrected with parenteral vitamin K
    2. Platelet count <100×10^3/mcrL due to portal hypertension
    3. Presence of clinically significant gastric or esophageal varices
    4. Cirrhosis
    5. Persistent cholestasis defined as conjugated bilirubin >4 mg/dL (>68 mcr mol/L) over a 2-week period during screening
    6. Total bilirubin >=2x upper limit of normal (ULN)
    7. Aspartate aminotransferase (AST) >=3x ULN
    8. Alanine aminotransferase (ALT) >=3x ULN

Sites / Locations

  • University of Tsukuba Hospital
  • Tohoku University Hospital
  • Showa University Hospital
  • Akita University Hospital
  • Kyushu University Hospital
  • Kagoshiha University Hospital

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Teduglutide 0.05 milligram per kilogram (mg/kg)

Arm Description

Participants will receive teduglutide 0.05 mg/kg (0.025 mg/kg for participants with moderate or greater renal impairment) subcutaneous (SC) injection once daily for 24 weeks followed by no treatment period for 4 weeks. The maximum duration of treatment is approximately 18 months.

Outcomes

Primary Outcome Measures

Number of Participants With Treatment-emergent Adverse Events (TEAEs)
An AE is defined as any untoward medical occurrence in a clinical investigation subject administered a drug; it does not necessarily have to have a causal relationship with this treatment. TEAEs were defined as any AEs whose onset occurred, severity worsened, or intensity increased after receiving the investigational product.
Number of Participants With Serious Adverse Events (SAEs)
An SAE is defined as any untoward medical occurrence that at any dose: Results in death, Is life threatening, Requires inpatient hospitalization or prolongation of existing hospitalization, Results in persistent or significant disability/incapacity, Leads to a congenital anomaly /birth defect, Is the other important medical event.
Number of Participants With Adverse Events of Special Interest (AESIs)
An AESI, whether serious or non-serious, is one of scientific and medical concern specific to the compound or program, for which ongoing monitoring and rapid communication by the investigator to the sponsor may be appropriate.
Number of Participants With Clinically Significant Abnormalities in Vital Signs Reported as an Adverse Event
Vital signs include systolic and diastolic blood pressure, heart rate and body temperature.
Change From Baseline in Z-Score of Body Weight
The Z-score indicates the number of standard deviations away from the mean.
Change From Baseline in Z-Score of Height
The Z-score indicates the number of standard deviations away from the mean.
Change From Baseline in Z-Score of Head Circumference
The Z-score indicates the number of standard deviations away from the mean.
Change From Baseline in Z-Score of Weight-for-Length
The Z-score indicates the number of standard deviations away from the mean.
Number of Participants With Clinically Significant Laboratory Safety Data Reported as an Adverse Event
Laboratory safety data includes biochemistry, hematology and urinalysis.
Number of Participants With Significant Change in Urine Output Reported as an Adverse Event
Urine and stool output will be recorded and calculated in the output diary over a 48-hour period of parenteral support (PS) and enteral nutrition (EN) stability before every site visit and within 1 week of implementing a change in the PS prescription.
Number of Participants With Significant Change in Stool Output Reported as an Adverse Event
Urine and stool output will be recorded and calculated in the output diary over a 48-hour period of PS and EN stability before every site visit and within 1 week of implementing a change in the PS prescription.

Secondary Outcome Measures

Change From Baseline in PS Volume
PS (parenteral nutrition or intravenous fluids) will be considered for managing nutritional support in terms of volume and calories during the treatment period.
Percent Change From Baseline in PS Volume
Percent change from baseline in PS volume will be calculated as follows; (PS volume at each point [Week 1, 2, 4, 8, 12, 16, 20, 24, and 28] - PS volume at baseline)/ PS volume at baseline *100 (percent). PS (parenteral nutrition or intravenous fluids) will be considered for managing nutritional support in terms of volume and calories during the treatment period.
Number of Participants who Demonstrate at least 20 Percent (%) Reduction From Baseline in PS Volume
PS (parenteral nutrition or intravenous fluids) will be considered for managing nutritional support in terms of volume and calories during the treatment period.
Number of Participants who Achieved Enteral Autonomy
Achieving enteral autonomy is defined as complete weaning off PS. PS (parenteral nutrition or intravenous fluids) will be considered for managing nutritional support in terms of volume and calories during the treatment period. Number of participants who achieved enteral autonomy at each time will be reported.
Change in Days per Week of PS
PS (parenteral nutrition or intravenous fluids) will be considered for managing nutritional support in terms of volume and calories during the treatment period.

Full Information

First Posted
August 26, 2021
Last Updated
September 28, 2023
Sponsor
Takeda
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1. Study Identification

Unique Protocol Identification Number
NCT05027308
Brief Title
A Study of Teduglutide in Japanese Children With Short Bowel Syndrome Who Are 4 Months or Older
Official Title
A Phase 3, Open-label Safety Study of Teduglutide in Japanese Pediatric Patients With Short Bowel Syndrome Who Are Dependent on Parenteral Support, Aged 4 Months of Corrected Gestational Age or Older, and Requiring the Dosing of 1.25 mg Formulation
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Completed
Study Start Date
January 4, 2022 (Actual)
Primary Completion Date
September 27, 2023 (Actual)
Study Completion Date
September 27, 2023 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Takeda

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
The main aims of the study are to check for side effects from teduglutide. Participants will receive a daily injection of teduglutide just under the skin (subcutaneous) for 24 weeks. Then they are followed up for another 4 weeks. Participants may be able to repeat this treatment if they meet specific criteria. The study doctors will check for side effects from teduglutide until it becomes commercially available. The maximum duration of treatment is approximately 18 months.
Detailed Description
A study of teduglutide in Japanese children with short bowel syndrome who are 4 months or older.

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
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
3 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Teduglutide 0.05 milligram per kilogram (mg/kg)
Arm Type
Experimental
Arm Description
Participants will receive teduglutide 0.05 mg/kg (0.025 mg/kg for participants with moderate or greater renal impairment) subcutaneous (SC) injection once daily for 24 weeks followed by no treatment period for 4 weeks. The maximum duration of treatment is approximately 18 months.
Intervention Type
Drug
Intervention Name(s)
Teduglutide
Other Intervention Name(s)
TAK-633
Intervention Description
Teduglutide 0.05 mg/kg SC injection
Primary Outcome Measure Information:
Title
Number of Participants With Treatment-emergent Adverse Events (TEAEs)
Description
An AE is defined as any untoward medical occurrence in a clinical investigation subject administered a drug; it does not necessarily have to have a causal relationship with this treatment. TEAEs were defined as any AEs whose onset occurred, severity worsened, or intensity increased after receiving the investigational product.
Time Frame
From start of study drug administration up to end of study (EOS) (up to Week 28)
Title
Number of Participants With Serious Adverse Events (SAEs)
Description
An SAE is defined as any untoward medical occurrence that at any dose: Results in death, Is life threatening, Requires inpatient hospitalization or prolongation of existing hospitalization, Results in persistent or significant disability/incapacity, Leads to a congenital anomaly /birth defect, Is the other important medical event.
Time Frame
From start of study drug administration up to end of study (EOS) (up to Week 28)
Title
Number of Participants With Adverse Events of Special Interest (AESIs)
Description
An AESI, whether serious or non-serious, is one of scientific and medical concern specific to the compound or program, for which ongoing monitoring and rapid communication by the investigator to the sponsor may be appropriate.
Time Frame
From start of study drug administration up to end of study (EOS) (up to Week 28)
Title
Number of Participants With Clinically Significant Abnormalities in Vital Signs Reported as an Adverse Event
Description
Vital signs include systolic and diastolic blood pressure, heart rate and body temperature.
Time Frame
From start of study drug administration up to end of study (EOS) (up to Week 28)
Title
Change From Baseline in Z-Score of Body Weight
Description
The Z-score indicates the number of standard deviations away from the mean.
Time Frame
From start of study drug administration up to end of study (EOS) (up to Week 28)
Title
Change From Baseline in Z-Score of Height
Description
The Z-score indicates the number of standard deviations away from the mean.
Time Frame
From start of study drug administration up to end of study (EOS) (up to Week 28)
Title
Change From Baseline in Z-Score of Head Circumference
Description
The Z-score indicates the number of standard deviations away from the mean.
Time Frame
From start of study drug administration up to end of study (EOS) (up to Week 28)
Title
Change From Baseline in Z-Score of Weight-for-Length
Description
The Z-score indicates the number of standard deviations away from the mean.
Time Frame
From start of study drug administration up to end of study (EOS) (up to Week 28)
Title
Number of Participants With Clinically Significant Laboratory Safety Data Reported as an Adverse Event
Description
Laboratory safety data includes biochemistry, hematology and urinalysis.
Time Frame
From start of study drug administration up to end of study (EOS) (up to Week 28)
Title
Number of Participants With Significant Change in Urine Output Reported as an Adverse Event
Description
Urine and stool output will be recorded and calculated in the output diary over a 48-hour period of parenteral support (PS) and enteral nutrition (EN) stability before every site visit and within 1 week of implementing a change in the PS prescription.
Time Frame
From start of study drug administration up to end of study (EOS) (up to Week 28)
Title
Number of Participants With Significant Change in Stool Output Reported as an Adverse Event
Description
Urine and stool output will be recorded and calculated in the output diary over a 48-hour period of PS and EN stability before every site visit and within 1 week of implementing a change in the PS prescription.
Time Frame
From start of study drug administration up to end of study (EOS) (up to Week 28)
Secondary Outcome Measure Information:
Title
Change From Baseline in PS Volume
Description
PS (parenteral nutrition or intravenous fluids) will be considered for managing nutritional support in terms of volume and calories during the treatment period.
Time Frame
Baseline, multiple timepoints after dose (Week 1, 2, 4, 8, 12, 16, 20, 24, and 28), and end of study (EOS: up to Week 28)
Title
Percent Change From Baseline in PS Volume
Description
Percent change from baseline in PS volume will be calculated as follows; (PS volume at each point [Week 1, 2, 4, 8, 12, 16, 20, 24, and 28] - PS volume at baseline)/ PS volume at baseline *100 (percent). PS (parenteral nutrition or intravenous fluids) will be considered for managing nutritional support in terms of volume and calories during the treatment period.
Time Frame
Baseline, multiple timepoints after dose (Week 1, 2, 4, 8, 12, 16, 20, 24, and 28), and end of study (EOS: up to Week 28)
Title
Number of Participants who Demonstrate at least 20 Percent (%) Reduction From Baseline in PS Volume
Description
PS (parenteral nutrition or intravenous fluids) will be considered for managing nutritional support in terms of volume and calories during the treatment period.
Time Frame
Baseline, multiple timepoints after dose (Week 1, 2, 4, 8, 12, 16, 20, 24, and 28), and end of study (EOS: up to Week 28)
Title
Number of Participants who Achieved Enteral Autonomy
Description
Achieving enteral autonomy is defined as complete weaning off PS. PS (parenteral nutrition or intravenous fluids) will be considered for managing nutritional support in terms of volume and calories during the treatment period. Number of participants who achieved enteral autonomy at each time will be reported.
Time Frame
Baseline, multiple timepoints after dose (Week 1, 2, 4, 8, 12, 16, 20, 24, and 28), and end of study (EOS: up to Week 28)
Title
Change in Days per Week of PS
Description
PS (parenteral nutrition or intravenous fluids) will be considered for managing nutritional support in terms of volume and calories during the treatment period.
Time Frame
Baseline, multiple timepoints after dose (Week 1, 2, 4, 8, 12, 16, 20, 24, and 28), and end of study (EOS: up to Week 28)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
4 Months
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female pediatric patient of corrected gestational age 4 months or older. Body weight at the time of screening and baseline visits of at least 5 kg and <10 kg for participants with normal renal function or mild renal impairment (estimated glomerular filtration rate >=50 mL/min/1.73 m^2), OR at least 10 kg and <20 kg for participants with moderate or greater renal impairment (estimated glomerular filtration rate <50 mL/min/1.73 m^2). Diagnosis of short bowel syndrome (SBS) with intestinal failure, defined as dependence on PS to provide at least 30% of fluid or caloric needs. Participants to have stable PS for at least 1 month prior to screening as assessed by the investigator. Stable PS is defined as inability to significantly reduce parenteral nutrition/intravenous fluid (PN/IV) support, usually associated with minimal or no advance in enteral feeds (ie, 10% or less change in PN or advance in feeds), assessed by the investigator. Exclusion Criteria: A parent/guardian who is not capable of understanding or not willing to adhere to the study visit schedule and other protocol requirements. Clinically significant intestinal obstruction, active or recurrent pancreatic or biliary disease, or dysmotility that prevents the advancement of enteral intake. Intestinal malabsorption due to a genetic condition, such as cystic fibrosis, microvillus inclusion disease, etc. Severe, known dysmotility syndrome, such as pseudo-obstruction or persistent, severe, active gastroschisis-related dysmotility, that is the primary contributing factor to feeding intolerance and inability to reduce PS, prior to screening. Dysmotility is defined as severe if it is expected to limit the advancement of enteral feeding. Major gastrointestinal (GI) surgical intervention including significant intestinal resection or bowel lengthening procedure within 3 months prior to screening (insertion of feeding tube, anastomotic ulcer repair, minor intestinal resections =<10 cm and endoscopic procedures are allowed). Cardiac disease that makes the patient vulnerable to changes in fluid status. History of cancer or known cancer predisposition syndrome, such as juvenile polyposis or Beckwith-Wiedemann syndrome, or first degree relative with early onset of GI cancer (including hepatobiliary and pancreatic cancer). Concurrent treatment with glucagon-like peptide-2 (GLP-2), human growth hormone, or analogs of these hormones within 6 months prior to the screening visit, or concurrent treatment with octreotide, or GLP-1 analogs within 30 days prior to the screening visit. Concurrent treatment with biological therapy (eg, anti-tumor necrosis factor [anti-TNF]) for active Crohn's disease within 6 months prior to the screening visit. Participation in a clinical study using an experimental drug (other than glutamine or omegaven) within 3 months or 5.5 half-lives of the experimental drug, whichever is longer, prior to the screening visit and for the duration of the study. Known or suspected intolerance or hypersensitivity to the study drug, closely related compounds, or any of the stated ingredients. Signs of active, severe, or unstable clinically significant hepatic impairment during the screening period as meeting at least 2 of any of the following parameters: International normalized ratio >1.5 not corrected with parenteral vitamin K Platelet count <100×10^3/mcrL due to portal hypertension Presence of clinically significant gastric or esophageal varices Cirrhosis Persistent cholestasis defined as conjugated bilirubin >4 mg/dL (>68 mcr mol/L) over a 2-week period during screening Total bilirubin >=2x upper limit of normal (ULN) Aspartate aminotransferase (AST) >=3x ULN Alanine aminotransferase (ALT) >=3x ULN
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Study Director
Organizational Affiliation
Takeda
Official's Role
Study Director
Facility Information:
Facility Name
University of Tsukuba Hospital
City
Tsukuba
State/Province
Ibaraki
Country
Japan
Facility Name
Tohoku University Hospital
City
Sendai
State/Province
Miyagi
Country
Japan
Facility Name
Showa University Hospital
City
Shinagawa-ku
State/Province
Tokyo
Country
Japan
Facility Name
Akita University Hospital
City
Akita
Country
Japan
Facility Name
Kyushu University Hospital
City
Fukuoka
Country
Japan
Facility Name
Kagoshiha University Hospital
City
Kagoshima
Country
Japan

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
De-identified individual participant data from this particular study will not be shared as there is a reasonable likelihood that individual patients could be reidentified (due to the limited number of study participants/study sites).
Links:
URL
https://clinicaltrials.takeda.com/study-detail/613b9c47c61629002b6311f0
Description
To obtain more information on the study, click here/on this link.

Learn more about this trial

A Study of Teduglutide in Japanese Children With Short Bowel Syndrome Who Are 4 Months or Older

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