Trial Outcomes & Findings for Randomized, Double-Blind, Placebo-Controlled Phase 2 Trial of BEKINDA (Ondansetron 12 mg Bimodal Release Tablets) for Diarrhea Predominant Irritable Bowel Syndrome (IBS-D) (NCT NCT02757105)

NCT ID: NCT02757105

Last Updated: 2018-08-28

Results Overview

A weekly stool consistency responder was defined in the FDA guidance on IBS-D as a patient who experienced (during a week) a ≥50% reduction in the number of days with at least one stool that has a consistency of Type 6 or 7 on the Bristol stool scale compared with baseline. In addition, to be considered a responder for the week, the patient could not have had an increase in average abdominal pain \>10% over baseline during that week. A patient was characterized as an overall stool consistency responder if the patient was a weekly responder for at least 50% of the planned weeks of treatment.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

127 participants

Primary outcome timeframe

8 weeks

Results posted on

2018-08-28

Participant Flow

Participant milestones

Participant milestones
Measure
RHB-102
1 tablet containing 3 mg immediate release and 9 mg sustained release ondansetron, once daily for 8 weeks
Placebo
1 tablet of matching placebo, once daily for 8 weeks
Overall Study
STARTED
75
52
Overall Study
Treated
75
51
Overall Study
COMPLETED
63
41
Overall Study
NOT COMPLETED
12
11

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Randomized, Double-Blind, Placebo-Controlled Phase 2 Trial of BEKINDA (Ondansetron 12 mg Bimodal Release Tablets) for Diarrhea Predominant Irritable Bowel Syndrome (IBS-D)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
RHB-102
n=75 Participants
1 tablet containing 3 mg immediate release and 9 mg sustained release ondansetron, once daily for 8 weeks
Placebo
n=51 Participants
1 tablet of matching placebo, once daily for 8 weeks
Total
n=126 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
71 Participants
n=5 Participants
49 Participants
n=7 Participants
120 Participants
n=5 Participants
Age, Categorical
>=65 years
4 Participants
n=5 Participants
2 Participants
n=7 Participants
6 Participants
n=5 Participants
Sex: Female, Male
Female
53 Participants
n=5 Participants
35 Participants
n=7 Participants
88 Participants
n=5 Participants
Sex: Female, Male
Male
22 Participants
n=5 Participants
16 Participants
n=7 Participants
38 Participants
n=5 Participants
Race/Ethnicity, Customized
American Indian or Alaskan Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
11 Participants
n=5 Participants
6 Participants
n=7 Participants
17 Participants
n=5 Participants
Race/Ethnicity, Customized
Black or African American
5 Participants
n=5 Participants
3 Participants
n=7 Participants
8 Participants
n=5 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race/Ethnicity, Customized
White
58 Participants
n=5 Participants
42 Participants
n=7 Participants
100 Participants
n=5 Participants
Race/Ethnicity, Customized
Other
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race/Ethnicity, Customized
Hispanic/Latino
9 Participants
n=5 Participants
4 Participants
n=7 Participants
13 Participants
n=5 Participants
Race/Ethnicity, Customized
Not Hispanic/Latino
66 Participants
n=5 Participants
47 Participants
n=7 Participants
113 Participants
n=5 Participants
Median C-reactive protein (CRP)
2.07 mg/L
n=5 Participants
2.25 mg/L
n=7 Participants
2.09 mg/L
n=5 Participants

PRIMARY outcome

Timeframe: 8 weeks

Population: Modified intent-to-treat (mITT) population analyzed included all patients who took at least one dose of double blinded study drug after randomization. In the mITT population, patients were analyzed by the treatment to which they were randomized. The population was used for a statistical analysis of efficacy endpoints.

A weekly stool consistency responder was defined in the FDA guidance on IBS-D as a patient who experienced (during a week) a ≥50% reduction in the number of days with at least one stool that has a consistency of Type 6 or 7 on the Bristol stool scale compared with baseline. In addition, to be considered a responder for the week, the patient could not have had an increase in average abdominal pain \>10% over baseline during that week. A patient was characterized as an overall stool consistency responder if the patient was a weekly responder for at least 50% of the planned weeks of treatment.

Outcome measures

Outcome measures
Measure
RHB-102
n=75 Participants
1 tablet containing 3 mg immediate release and 9 mg sustained release ondansetron, once daily for 8 weeks
Placebo
n=51 Participants
1 tablet of matching placebo, once daily for 8 weeks
Summary and Analysis of Overall Stool Consistency Response Rate - mITT Population
Response
42 Participants
18 Participants
Summary and Analysis of Overall Stool Consistency Response Rate - mITT Population
Non-response
33 Participants
33 Participants

PRIMARY outcome

Timeframe: 8 weeks

A weekly stool consistency responder was defined in the FDA guidance on IBS-D as a patient who experienced (during a week) a ≥50% reduction in the number of days with at least one stool that has a consistency of Type 6 or 7 on the Bristol stool scale compared with baseline. In addition, to be considered a responder for the week, the patient could not have had an increase in average abdominal pain \>10% over baseline during that week. A patient was characterized as an overall stool consistency responder if the patient was a weekly responder for at least 50% of the planned weeks of treatment.

Outcome measures

Outcome measures
Measure
RHB-102
n=22 Participants
1 tablet containing 3 mg immediate release and 9 mg sustained release ondansetron, once daily for 8 weeks
Placebo
n=16 Participants
1 tablet of matching placebo, once daily for 8 weeks
Summary and Analysis of Overall Stool Consistency Response Rate Males - mITT Population
Response
11 Participants
5 Participants
Summary and Analysis of Overall Stool Consistency Response Rate Males - mITT Population
Non-response
11 Participants
11 Participants

PRIMARY outcome

Timeframe: 8 weeks

A weekly stool consistency responder was defined in the FDA guidance on IBS-D as a patient who experienced (during a week) a ≥50% reduction in the number of days with at least one stool that has a consistency of Type 6 or 7 on the Bristol stool scale compared with baseline. In addition, to be considered a responder for the week, the patient could not have had an increase in average abdominal pain \>10% over baseline during that week. A patient was characterized as an overall stool consistency responder if the patient was a weekly responder for at least 50% of the planned weeks of treatment.

Outcome measures

Outcome measures
Measure
RHB-102
n=53 Participants
1 tablet containing 3 mg immediate release and 9 mg sustained release ondansetron, once daily for 8 weeks
Placebo
n=35 Participants
1 tablet of matching placebo, once daily for 8 weeks
Summary and Analysis of Overall Stool Consistency Response Rate Females - mITT Population
Response
31 Participants
13 Participants
Summary and Analysis of Overall Stool Consistency Response Rate Females - mITT Population
Non-response
22 Participants
22 Participants

PRIMARY outcome

Timeframe: 8 weeks

A weekly stool consistency responder was defined in the FDA guidance on IBS-D as a patient who experienced (during a week) a ≥50% reduction in the number of days with at least one stool that has a consistency of Type 6 or 7 on the Bristol stool scale compared with baseline. In addition, to be considered a responder for the week, the patient could not have had an increase in average abdominal pain \>10% over baseline during that week. A patient was characterized as an overall stool consistency responder if the patient was a weekly responder for at least 50% of the planned weeks of treatment.

Outcome measures

Outcome measures
Measure
RHB-102
n=75 Participants
1 tablet containing 3 mg immediate release and 9 mg sustained release ondansetron, once daily for 8 weeks
Placebo
n=51 Participants
1 tablet of matching placebo, once daily for 8 weeks
Summary and Analysis of Overall Stool Consistency Response Rate: Sensitivity Analysis Without Imputation for Use of Rescue Medication - mITT Population
Response
43 Participants
19 Participants
Summary and Analysis of Overall Stool Consistency Response Rate: Sensitivity Analysis Without Imputation for Use of Rescue Medication - mITT Population
Non-response
32 Participants
32 Participants

PRIMARY outcome

Timeframe: 8 weeks

Population: Patients with Baseline CRP \> Median

A weekly stool consistency responder was defined in the FDA guidance on IBS-D as a patient who experienced (during a week) a ≥50% reduction in the number of days with at least one stool that has a consistency of Type 6 or 7 on the Bristol stool scale compared with baseline. In addition, to be considered a responder for the week, the patient could not have had an increase in average abdominal pain \>10% over baseline during that week. A patient was characterized as an overall stool consistency responder if the patient was a weekly responder for at least 50% of the planned weeks of treatment.

Outcome measures

Outcome measures
Measure
RHB-102
n=37 Participants
1 tablet containing 3 mg immediate release and 9 mg sustained release ondansetron, once daily for 8 weeks
Placebo
n=26 Participants
1 tablet of matching placebo, once daily for 8 weeks
Summary and Analysis of Overall Stool Consistency Response Rate by Baseline CRP > Median - mITT Population
Response
22 Participants
6 Participants
Summary and Analysis of Overall Stool Consistency Response Rate by Baseline CRP > Median - mITT Population
Non-response
15 Participants
20 Participants

PRIMARY outcome

Timeframe: 8 weeks

Population: Patients with Baseline CRP ≤ Median

A weekly stool consistency responder was defined in the FDA guidance on IBS-D as a patient who experienced (during a week) a ≥50% reduction in the number of days with at least one stool that has a consistency of Type 6 or 7 on the Bristol stool scale compared with baseline. In addition, to be considered a responder for the week, the patient could not have had an increase in average abdominal pain \>10% over baseline during that week. A patient was characterized as an overall stool consistency responder if the patient was a weekly responder for at least 50% of the planned weeks of treatment.

Outcome measures

Outcome measures
Measure
RHB-102
n=38 Participants
1 tablet containing 3 mg immediate release and 9 mg sustained release ondansetron, once daily for 8 weeks
Placebo
n=25 Participants
1 tablet of matching placebo, once daily for 8 weeks
Summary and Analysis of Overall Stool Consistency Response Rate by Baseline CRP ≤ Median - mITT Population
Response
20 Participants
12 Participants
Summary and Analysis of Overall Stool Consistency Response Rate by Baseline CRP ≤ Median - mITT Population
Non-response
18 Participants
13 Participants

SECONDARY outcome

Timeframe: 8 weeks

A weekly pain responder was defined as a patient who experienced a decrease in the weekly average of worst abdominal pain in the past 24 hours score ≥30% compared with baseline and no increase in the number of days per week with Type 6 or 7 stool consistency. An overall pain responder was defined as a patient who was a weekly pain responder for at least 50% of the planned weeks of treatment.

Outcome measures

Outcome measures
Measure
RHB-102
n=75 Participants
1 tablet containing 3 mg immediate release and 9 mg sustained release ondansetron, once daily for 8 weeks
Placebo
n=51 Participants
1 tablet of matching placebo, once daily for 8 weeks
Summary and Analysis of Overall Worst Abdominal Pain Response Rate - mITT Population
Response
38 Participants
20 Participants
Summary and Analysis of Overall Worst Abdominal Pain Response Rate - mITT Population
Non-response
37 Participants
31 Participants

SECONDARY outcome

Timeframe: 8 weeks

A patient was characterized as an overall weekly responder if the patient met both the stool consistency and pain response definitions for a given week. A patient was characterized as a composite study responder if the patient met the criteria for both weekly stool consistency and pain response for at least 50% of the planned weeks of treatment.

Outcome measures

Outcome measures
Measure
RHB-102
n=75 Participants
1 tablet containing 3 mg immediate release and 9 mg sustained release ondansetron, once daily for 8 weeks
Placebo
n=51 Participants
1 tablet of matching placebo, once daily for 8 weeks
Summary and Analysis of Overall Study Response Rate - mITT Population
Response
30 Participants
13 Participants
Summary and Analysis of Overall Study Response Rate - mITT Population
Non-response
45 Participants
38 Participants

Adverse Events

RHB-102

Serious events: 0 serious events
Other events: 68 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 47 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
RHB-102
n=75 participants at risk
1 tablet containing 3 mg immediate release and 9 mg sustained release ondansetron, once daily for 8 weeks
Placebo
n=51 participants at risk
1 tablet matching placebo, once daily for 8 weeks
Gastrointestinal disorders
Constipation TEAE
13.3%
10/75 • 1 year, 2 months
3.9%
2/51 • 1 year, 2 months
Gastrointestinal disorders
Flatulence TEAE
8.0%
6/75 • 1 year, 2 months
0.00%
0/51 • 1 year, 2 months
Infections and infestations
Urinary Tract Infection TEAE
5.3%
4/75 • 1 year, 2 months
2.0%
1/51 • 1 year, 2 months
Investigations
Alanine aminotransferase increased TEAE
8.0%
6/75 • 1 year, 2 months
3.9%
2/51 • 1 year, 2 months
Investigations
Aspartate aminotransferase increased TEAE
8.0%
6/75 • 1 year, 2 months
9.8%
5/51 • 1 year, 2 months
Investigations
Blood creatinine increased TEAE
6.7%
5/75 • 1 year, 2 months
3.9%
2/51 • 1 year, 2 months
Investigations
Blood glucose increased TEAE
22.7%
17/75 • 1 year, 2 months
17.6%
9/51 • 1 year, 2 months
Investigations
Blood magnesium increased TEAE
6.7%
5/75 • 1 year, 2 months
3.9%
2/51 • 1 year, 2 months
Investigations
Blood potassium increased TEAE
6.7%
5/75 • 1 year, 2 months
3.9%
2/51 • 1 year, 2 months
Investigations
Blood sodium decreased TEAE
5.3%
4/75 • 1 year, 2 months
13.7%
7/51 • 1 year, 2 months
Investigations
Hemoglobin decreased TEAE
6.7%
5/75 • 1 year, 2 months
5.9%
3/51 • 1 year, 2 months
Investigations
Lymphocyte count decreased TEAE
6.7%
5/75 • 1 year, 2 months
9.8%
5/51 • 1 year, 2 months
Investigations
Protein urine present TEAE
36.0%
27/75 • 1 year, 2 months
33.3%
17/51 • 1 year, 2 months
Investigations
White blood cells urine positive TEAE
30.7%
23/75 • 1 year, 2 months
33.3%
17/51 • 1 year, 2 months
Investigations
pH urine increased TEAE
5.3%
4/75 • 1 year, 2 months
2.0%
1/51 • 1 year, 2 months
Nervous system disorders
Headache TEAE
9.3%
7/75 • 1 year, 2 months
11.8%
6/51 • 1 year, 2 months

Additional Information

Dr. Terry F. Plasse

RedHill Biopharma Ltd.

Phone: 972-(0)3-541-3131

Results disclosure agreements

  • Principal investigator is a sponsor employee The PI agree that the Sponsor shall have the right to the first publication of the results of the Study. Following the first publication, the PI may publish data or results from the Study; subject to Sponsor for review and approval in writing at least sixty (60) days prior to the date of the publication. Sponsor may require changes and may extend the embargo to protect its intellectual property or other proprietary interests and to allow for the taking actions for this purpose.
  • Publication restrictions are in place

Restriction type: OTHER