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48 Weeks, Study to Evaluate Overall Safety and Tolerability of Co-administration of Tesofensine and Metoprolol in Subjects With Hypothalamic Injury-induced Obesity (HIO)

Phase 2
Completed
Conditions
Hypothalamic Injury-induced Obesity (HIO)
Interventions
Registration Number
NCT03845075
Lead Sponsor
Saniona
Brief Summary

Double-blind, randomized, placebo-controlled, single- center study followed by an open-label extension period.

• The study will have two parts:

* Part 1: 24 weeks double-blind treatment (DB), followed by

* Part 2: 24 weeks open-label extension (OLE) - all subjects still participating at the end of Part 1 will be given an option to continue for additional 24 weeks on the active drug if evaluated eligible by the Investigator

Detailed Description

Part 1 - the double-blind (DB) part: The active medication arm will be given co-administration of 0.5 mg tesofensine/50 mg metoprolol daily for 24 weeks. The placebo arm will receive matching placebo tablets.

Part 2 - the open-label extension (OLE) part: All active participants at the end of the double-blind part will be given the active medication 0.5 mg tesofensine/50 mg metoprolol daily for 24 weeks.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
21
Inclusion Criteria
  • Informed consent obtained before any trial-related activities
  • Males and females, aged 18-75
  • Confirmed diagnosis of HIO
  • BMI ≥27 kg/m2 (where overweight is related to the HIO)
Exclusion Criteria
  • Blood Pressure (BP) ≥160/90 mmHg
  • Heart rate (HR) ≥ 90, <50 bpm
  • Type 1 diabetes, Cushings disease, acromegaly, hypophysitis, infiltrative diseases or Prader-Willi syndrome
  • Heart failure New York Heart Association (NYHA) level II or greater, decompensated heart failure
  • Previous myocardial infarction or stroke within the last 5 years

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
placebo armPlaceboThe placebo arm will receive matching placebo tesofensine and placebo metoprolol.
active armTesofensine/MetoprololThe active medication arm will be given co-administration of 0.5 mg tesofensine/50 mg metoprolol daily for 24 weeks.
Primary Outcome Measures
NameTimeMethod
Safety as Assessed by Liver and Kidney Function Testsfrom Baseline to week 24

Number and percentage of deviations from normal range (as defined by the investigational site's laboratory) for gamma glutamyl transferase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), glomerular filtration rate (GFR), and urea at baseline, week 12, and week 24 in each of the two treatment arms

Participants (Number and Percentage) With and Type of Serious Adverse Eventsfrom Baseline to week 24

Number and percentage of participants with at least one serious adverse event, indicating type, in each of the two treatment arms

Safety as Assessed by Diastolic Blood Pressure [mmHg]from Baseline to week 24

Diastolic blood pressure in mmHg measured at each visit in each of the two treatment arms

Number of Participants With Treatment Emergent Adverse Eventsfrom Baseline to week 24

Number and percentage of participants with adverse events in each of the two treatment arms

Safety as Assessed by Heart Rate [Bpm]from Baseline to week 24

Heart rate measured in beats per minute (bpm) at each visit in each of the two treatment arms

Safety as Assessed by Hematology Parametersfrom Baseline to week 24

Number and percentage of deviations from normal range (as defined by the investigational site's laboratory) for hemoglobin, platelet counts, white cells count, differential counts at baseline, week 12 and week 24 in each of the two treatment arms

Safety as Assessed by Electrolytes and Creatininefrom Baseline to week 24

Number and percentage of deviations from normal range (as defined by the investigational site's laboratory) for sodium, potassium, creatinine at each visit in each of the two treatment arms

Number of Participants With at Least One Mild, Moderate or Severe Adverse Eventfrom Baseline to week 24

Number and percentage of participants with mild, moderate or severe adverse events in each of the two treatment arms.

Safety as Assessed by Systolic Blood Pressure [mmHg]from Baseline to week 24

Systolic blood pressure in mmHg measured at each visit in each of the two treatment arms

Secondary Outcome Measures
NameTimeMethod
Body Composition - Fat Massfrom baseline to week 24, from baseline to week 48 and from week 24 to week 48

Change in body fat mass as measured in kg by DXA scan measured at baseline, week 24 and week 48 for each of the two treatment arms. mITT observed values.

Quality of Life - SF-36from baseline to week 24, from baseline to week 48 and from week 24 to week 48

Change in quality of life by use of the Short Form 36 Health Survey (SF-36) scores from baseline to week 24, from baseline to week 48, and from week 24 to week 48

The physical component summary score includes the aggregated scores for scales of physical functioning, role-physical, bodily pain, and general health. The mental health component summary score includes the aggregated scores for scales of vitality, social functioning, role-emotional, and mental health. Scores range from 0 to 100; higher score indicates better health.

mITT observed values.

Blood Pressure (Change)from baseline to week 24, from baseline to week 48 and from week 24 to week 48

Change in blood pressure from baseline to week 24, from baseline to week 48, and from week 24 to week 48. mITT observed values.

24 Hours Blood Pressurefrom baseline to week 12 and baseline to week 24

Changes in 24 hours blood pressure from baseline to week 12 and baseline to week 24

Plasma Trough Concentrationsbaseline to week 48

Plasma trough concentrations of tesofensine, metabolite NS2360 and metoprolol for the active arm (the first 24 weeks and then continuously up to week 48) and placebo arm (start of treatment at week 25 and then continuously up to week 48). mITT observed values.

Body Weightfrom baseline to week 24, from baseline to week 48 and from week 24 to week 48

Change in body weight from baseline to week 24, from baseline to 48 and from week 24 to week 48 measured at each visit for each of the two treatment arms

Body Composition - Lean Body Massfrom baseline to week 24, from baseline to week 48 and from week 24 to week 48

Change in lean body mass as measured in kg by DXA scan measured at baseline, week 24 and week 48 for each of the two treatment arms. mITT observed values.

Lipid Profilefrom baseline to week 24, from baseline to week 48 and from week 24 to week 48

Change in lipid profile from baseline to week 24, from baseline to week 48, and from week 24 to week 48. mITT observed values.

Glycemic Control - HbA1cfrom baseline to week 24, from baseline to week 48 and from week 24 to week 48

Change in HbA1c from baseline to week 24, baseline to week 48 and week 24 to week 48 for each of the two treatment arms. mITT observed values.

Thirstfrom baseline to week 24, from baseline to week 48 and from week 24 to week 48

Change in thirst by the use of a visual analog scale (VAS) from baseline to week 24, from baseline to week 48, and from week 24 to week 48

The VAS consisted of a 100-mm horizontal line; subjects placed a vertical line on the VAS to indicate the level of intensity of their thirst. The VAS value is the distance in mm (0-100 mm) from the left end of the line to the subject's vertical line (higher value represents an increase in perception of thirst).

mITT observed values.

Number of Participants With Adverse Event(s) and/or Serious Adverse Event(s) - Open-label Extensionfrom week 24 to week 48

Number of participants with adverse event(s) and/or serious adverse event(s) reported from week 24 to week 48

Heart Rate (Change)from baseline to week 24, from baseline to week 48 and from week 24 to week 48

Change in heart rate from baseline to week 24, from baseline to week 48, and from week 24 to week 48. mITT observed values.

Waist Circumferencefrom baseline to week 24, from baseline to week 48 and from week 24 to week 48

Change in waist circumference from baseline to week 24, from baseline to week 48, and from week 24 to week 48. mITT observed values.

Composite Satiety Score (CSS)from baseline to week 24, from baseline to week 48 and from week 24 to week 48

Change in satiety and appetite using the CSS from Baseline to week 24, from Baseline to week 48 and from week 24 to week 48 measured at each visit for each of the two treatment arms

Full name of the scale: composite satiety score (CSS), sometimes referred to as "appetite suppression score". Range of values is 0-100; lower the value, hungrier a person is. CSS = (satiety + fullness + \[100 - hunger\] + \[100 - prospective food consumption\]) / 4. The four variables included are measured by visual analog scales (0-100 mm)

Glycemic Control - Fasting Plasma Glucosefrom baseline to week 24, from baseline to week 48 and from week 24 to week 48

Change in fasting plasma glucose from baseline to week 24, baseline to week 48 and week 24 to week 48 measured at each visit for each of the two treatments arms. mITT observed values.

Craving for Something Sweet, Salty, Meat/Fish, or Fattyfrom baseline to week 24, from baseline to week 48 and from week 24 to week 48

Change in craving for something sweet, salty, meat/fish, or fatty by the use of visual analogue scales (VAS) from baseline to week 24, from baseline to week 48, and from week 24 to week 48

The VAS consisted of a 100-mm horizontal line; subjects placed a vertical line on the VAS to indicate the level of intensity of their food craving. The VAS value is the distance in mm (0-100 mm) from the left end of the line to the subject's vertical line (higher value represents less craving).

mITT observed values.

48 Hours Heart Rate and QT Interval at Baseline, Week 12 and Week 24baseline, week 12 and week 24

For Part 1, 48 hours HR and QT interval from week 12 to week 24 were not recorded in the database and analysis of changes not evaluated. Instead, abnormal findings over visits were summarized.

Abnormal ECG findings detected in the three Tesomet treated subjects are:

* QTc prolongation (466 ms)

* Bradycardia (56 bpm)

* QTc prolongation (460 ms) All were considered not clinically significant.

Trial Locations

Locations (1)

Rigshospitalet

🇩🇰

Copenhagen, Denmark

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