A Phase 2, Double-blind, Randomized, Placebo-controlled, Two-Treatment, Two-Period Crossover Efficacy and Safety Study in Idiopathic Pulmonary Fibrosis (IPF) With Nalbuphine ER Tablets for the Treatment of Cough
试验速览
- 阶段
- 2 期
- 状态
- 已完成
- 入组人数
- 42
- 试验地点
- 11
- 主要终点
- Number of Participants Who Experienced at Least One Treatment Emergent Adverse Events (TEAEs)
研究概览
简要总结
To evaluate the safety and tolerability of nalbuphine ER tablets in the study population and to evaluate the effect of NAL ER tablets on the mean daytime cough frequency (coughs per hour) at Day 22 (dose 162 mg BID) as compared to placebo tablets.
详细描述
This is a double-blind, randomized, placebo-controlled, 2-treatment, 2-period crossover efficacy and safety study in IPF subjects with NAL ER tablets for the treatment of cough. The study consists of 2 treatment periods of 3 weeks, each followed by a washout period of 2 weeks.
Treatment Period 1: During Treatment Period 1, eligible subjects will be randomized (1:1) to one of the following treatment arms:
- Arm 1: Active NAL ER followed by crossover Placebo in Treatment Period 2
- Arm 2: Placebo followed by crossover NAL ER in Treatment Period 2
Following 3 weeks of dosing in Treatment Period 1, subjects will complete a 2-week washout period before entering Treatment Period 2. Subjects assigned to Arm 1 will receive placebo and subjects assigned to Arm 2 will receive NAL ER during Treatment Period 2. A final 2-week washout period will occur at the completion of Treatment Period 2.
NAL ER Dosing Subjects on NAL ER will have the dose titrated from 27 mg once daily (QD) to 54 mg twice a day (BID) over a 5-day period and then maintained at 54 mg twice a day (BID) for approximately 4 days. Doses will be subsequently escalated and maintained at 108 mg twice a day (BID) over 1 week and then to 162 mg twice a day (BID) over 6 days.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 80 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Individuals diagnosed with Idiopathic Pulmonary Fibrosis
- •Chronic cough > 8 weeks.
- •Daytime cough severity score ≥ 4 on Cough Severity Numerical Rating Scale at screening.
排除标准
- •The following conditions are excluded:
- •Interstitial lung disease (ILD) known to be caused by domestic and occupational environmental exposures.
- •Interstitial lung disease (ILD) known to be caused by connective tissue disease.
- •Interstitial lung disease (ILD) known to be caused by drug related toxicity.
- •Currently on continuous oxygen therapy.
- •History of substance abuse that, as determined by the Investigator, may interfere with the conduct of the study.
研究组 & 干预措施
NAL ER then placebo
Participants received NAL ER in treatment period 1 at dose 27 mg once daily (QD) to 54 mg twice daily (BID) over a 5-day period and then maintained at 54 mg BID for 4 days. Dose was increased to 108 mg BID for 1 week then to 162 mg BID for 6 days, followed by placebo matching NAL ER for 3 weeks in treatment period 2. Both the treatment periods were separated by 2 weeks of washout period.
干预措施: NAL ER (Drug)
NAL ER then placebo
Participants received NAL ER in treatment period 1 at dose 27 mg once daily (QD) to 54 mg twice daily (BID) over a 5-day period and then maintained at 54 mg BID for 4 days. Dose was increased to 108 mg BID for 1 week then to 162 mg BID for 6 days, followed by placebo matching NAL ER for 3 weeks in treatment period 2. Both the treatment periods were separated by 2 weeks of washout period.
干预措施: Placebo (Drug)
Placebo then NAL ER
Participants received placebo matching NAL ER for 3 weeks in treatment period 1 followed by NAL ER in treatment period 2 at dose 27 mg QD to 54 mg BID over a 5-day period and then maintained at 54 mg BID for 4 days. Dose was increased to 108 mg BID for 1 week then to 162 mg BID for 6 days. Both the treatment periods were separated by 2 weeks of washout period.
干预措施: NAL ER (Drug)
Placebo then NAL ER
Participants received placebo matching NAL ER for 3 weeks in treatment period 1 followed by NAL ER in treatment period 2 at dose 27 mg QD to 54 mg BID over a 5-day period and then maintained at 54 mg BID for 4 days. Dose was increased to 108 mg BID for 1 week then to 162 mg BID for 6 days. Both the treatment periods were separated by 2 weeks of washout period.
干预措施: Placebo (Drug)
结局指标
主要结局
Number of Participants Who Experienced at Least One Treatment Emergent Adverse Events (TEAEs)
时间窗: Up to Day 72
An AE was defined as any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. A TEAE was defined as any AE that occurs after the first dose of study drug. TEAEs included both serious and non-serious TEAEs.
Number of Participants With Clinically Significant Abnormalities in Laboratory Parameters
时间窗: Up to Day 72
The clinical laboratory parameters included the urinalysis, hematology, serum chemistry, coagulation and liver function parameters. Clinical significance was determined by the investigator.
Number of Participants With Clinically Significant Changes in Vital Sign Parameters
时间窗: Up to Day 72
Vital signs measurements included blood pressure, heart rate, and respiration rate, body temperature, pulse oximetry, and weight. Clinical significance was determined by the investigator.
Number of Participants With Clinically Significant Changes in Physical Examination Parameters
时间窗: Up to Day 72
Physical examination included examination of the following body systems: general appearance, eyes, ears, nose, throat, head and neck, chest and lungs, cardiovascular, abdomen, musculoskeletal, lymphatic, dermatological, neurological, and extremities. Clinical significance was determined by the investigator.
Number of Participants With Clinically Significant Abnormalities in 12-Lead Electrocardiogram (ECG)
时间窗: Up to Day 72
Changes in ECG data such as heart rate, rhythm, and other clinically significant abnormalities (left ventricular hypertrophy, pathological Q-waves) were measured. Clinical significance was determined by the investigator.
Change From Baseline in Forced Vital Capacity (FVC) at Day 21
时间窗: Baseline, Day 21
Spirometry was used to assess FVC. It was used to assess pulmonary breathing mechanics.
Subjective Opiate Withdrawal (SOWS) Total Raw Score
时间窗: Up to Day 72
The SOWS is a self-administered scale for grading opioid withdrawal symptoms and was collected via the study issued e-diary. It consisted of 16 symptoms related to how the participant felt. Each symptom was scored between 0 to 4. The total score ranges between 0 to 64, higher score indicates more severe symptoms.
Daytime Cough Frequency at Baseline
时间窗: At Baseline
Daytime cough was defined as cough that occurs between the time that the participant is a wake in the 24 hours after the digital cough monitor was applied for use. Assessment was done using objective digital cough monitoring. Baseline was defined as the last available assessment prior to the first Treatment Period 1 IP intake.
Percent Change From Baseline in Daytime Cough Frequency at Day 22
时间窗: Baseline, Day 22
Daytime cough was defined as cough that occurs between the time that the participant is a wake in the 24 hours after the digital cough monitor was applied for use. Assessment was done using objective digital cough monitoring. Percent change in daytime cough frequency (coughs per hour) from baseline was assessed. Baseline was defined as the last available assessment prior to the first Treatment Period 1 IP intake.
次要结局
- Change From Baseline in Daytime Cough Frequency at Day 22(Baseline, Day 22)
- Percent Change From Baseline in 24-Hour Cough Frequency at Day 22(Baseline, Day 22)
- Percent Change From Baseline in Nighttime Cough Frequency at Day 22(Baseline, Day 22)
- Mean Change From Baseline in the Evaluating Respiratory Symptoms (E-RS) Diary Cough Subscale at Days 9, 16, and 22(Baseline, Days 9, 16, and 22)
- Mean Change From Baseline in E-RS Breathlessness Score at Days 9, 16, and 22(Baseline, Days 9, 16, and 22)
- Mean Change From Baseline in the Cough Severity Numerical Rating Scale (NRS) at Days 8, 15, and 21(Baseline, Days 8, 15, and 21)
- Mean Change From Baseline in the 14-item EXAcerbation of Chronic Pulmonary Disease Tool (EXACT) v1.1 e-Diary Tool Total Score at Days 9, 16, and 22(Baseline, Days 9, 16, and 22)
- Mean Change From Baseline in the Patient Reported Outcomes Measurement Information System (PROMIS) Item Bank v1.0 Fatigue Short Form 7a Scale Total Score at Day 21(Baseline, Day 21)
- Clinical Global Impression of Change (CGI-C) Over Time Measured at Day 21(At Day 21)
