Efficacy and Safety APT-1011 in Adult Subjects With Eosinophilic Esophagitis (EoE) (FLUTE-2)

NCT ID: NCT04281108

Last Updated: 2023-06-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

143 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-30

Study Completion Date

2022-10-24

Brief Summary

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This is a 2-part randomized, double-blind, placebo-controlled study followed by an open-label extension (OLE) of APT-1011 in adults with EoE.

Part A will evaluate the efficacy and safety of APT-1011 3 mg administered hora somni (HS; at bedtime) for the induction of response to treatment (histologic and symptomatic) over 12 weeks.

Part B will evaluate histological relapse-free status in patients re-randomized to continue APT-1011 or placebo (active treatment withdrawal) until Week 52.

Part C, the OLE, will continue until regulatory approval of APT-1011 or Sponsor termination of the study.

Detailed Description

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This is a 2-part randomized, double-blind, placebo-controlled study followed by an OLE of APT-1011 in adults with EoE.

Part A will evaluate the efficacy and safety of APT-1011 3 mg administered HS for the induction of response to treatment (histologic and symptomatic) over 12 weeks.

At Week 14, subjects will move into Part B. Subjects with histological response to APT-1011, defined as ≤6 peak eos/HPF, will be re-randomized to continue APT-1011 or receive placebo (active treatment withdrawal). APT-1011 histological non-responders will continue APT-1011, and placebo histological non-responders will receive APT-1011 3 mg HS. Placebo histological responders will continue placebo. The double-blind will be sustained throughout Part B. Histological responder status will be determined at the time of esophagogastroduodenoscopy (EGD) in Part B (at or prior to Week 52, depending on unscheduled EGDs performed when the Investigator deems the subject's symptoms necessitate EGD) and is defined as ≤6 peak eos/HPF.

At Week 52, subjects may enter Part C, an open-label single-arm extension phase, and continue study drug uninterrupted. Part C will terminate upon regulatory approval of APT-1011 or Sponsor termination of the study.

Conditions

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Eosinophilic Esophagitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SEQUENTIAL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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APT-1011

APT-1011 3 mg HS

Group Type EXPERIMENTAL

APT-1011

Intervention Type DRUG

APT-1011 is an orally disintegrating tablet that includes fluticasone propionate as its active ingredient.

Esophagogastroduodenoscopy

Intervention Type PROCEDURE

Esophagogastroduodenoscopy (EGD) is a test that involves an endoscope, a lighted camera on the end of a tube, that is passed down a subject's throat to visualize their esophagus.

Placebo

HS

Group Type PLACEBO_COMPARATOR

Placebo oral tablet

Intervention Type DRUG

Placebo orally disintegrating tablet.

Esophagogastroduodenoscopy

Intervention Type PROCEDURE

Esophagogastroduodenoscopy (EGD) is a test that involves an endoscope, a lighted camera on the end of a tube, that is passed down a subject's throat to visualize their esophagus.

Interventions

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APT-1011

APT-1011 is an orally disintegrating tablet that includes fluticasone propionate as its active ingredient.

Intervention Type DRUG

Placebo oral tablet

Placebo orally disintegrating tablet.

Intervention Type DRUG

Esophagogastroduodenoscopy

Esophagogastroduodenoscopy (EGD) is a test that involves an endoscope, a lighted camera on the end of a tube, that is passed down a subject's throat to visualize their esophagus.

Intervention Type PROCEDURE

Other Intervention Names

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fluticasone propionate PBO

Eligibility Criteria

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Inclusion Criteria

1. Male or female ≥18 years of age at the time of informed consent or assent
2. Each subject must read, understand, and provide consent on the ICF for this study and be willing and able to adhere to study-related treatment regimens, procedures, and visit schedule
3. Diagnosis or presumptive diagnosis of EoE that is confirmed during the Screening period by histology that demonstrates ≥15 peak eos/HPF. In order to ensure that a diagnosis can be made, at least 6 biopsies should be taken including both proximal and distal specimens (at least 3 each). Mid-esophageal biopsies are not required (optional). HPF will be defined as a standard area of 235 square microns in a microscope with 40x lens (0.3 mm\^2) and 22 mm ocular.

1. Esophagogastroduodenoscopies and biopsies are to be obtained during the Screening period
2. Biopsies will be read by a central pathologist
3. Esophagogastroduodenoscopies and biopsies performed outside the study will not be accepted to meet eligibility criteria
4. Optional biopsies may be taken and processed locally for local use, if specified in the local ICF. If serious pathology is unexpectedly encountered biopsies of such lesions must be processed locally
4. Have a subject-reported history of ≥6 episodes of dysphagia in the 14 days prior to baseline
5. Completion of the daily diary on at least 11 out of the 14 days during the 2-week Baseline Symptom Assessment

Exclusion Criteria

1. Have known contraindication, hypersensitivity, or intolerance to corticosteroids
2. Have a contraindication to, or factors that substantially increase the risk of, EGD procedure or esophageal biopsy or have narrowing of the esophagus that precludes EGD with a standard 9 mm endoscope
3. Have history of an esophageal stricture requiring dilatation within the 12 weeks prior to Screening
4. Have any physical, mental, or social condition or history of illness or laboratory abnormality that in the Investigator's judgment might interfere with study procedures or the ability of the subject to adhere to and complete the study or increase the safety risk to the subject such as uncontrolled diabetes or hypertension
5. History or presence of oral or esophageal mucosal infection whilst using inhaled or nasal corticosteroids
6. Have any mouth or dental condition that prevents normal eating (excluding braces)
7. Have any condition affecting the esophageal mucosa or altering esophageal motility other than EoE, including erosive esophagitis (grade B or higher as per the Los Angeles Classification of Gastroesophageal Reflux Disease; hiatus hernia longer than 3 cm, Barrett's esophagus, and achalasia)
8. Use of systemic (oral or parenteral) corticosteroids within 60 days before Screening, use of swallowed corticosteroids within 30 days before Screening
9. Initiation of either inhaled or nasal corticosteroids or high-potency dermal topical corticosteroids within 30 days before Screening
10. Use of calcineurin inhibitors or purine analogues (azathioprine, 6-mercaptopurine) in the 12 weeks before Screening
11. Use of potent cytochrome P450 (CYP) 3A4 inhibitors (eg, ritonavir and ketoconazole) in the 12 weeks before Screening
12. Initiation of an elimination diet or elemental diet within 30 days before Screening (diet must remain stable after signing ICF)
13. Morning (07:00 to 09:00, or as close to that window as possible) serum cortisol level ≤5 μg/dL (138 nmol/L) that is not responsive to adrenocorticotropic hormone (ACTH) stimulation: defined as a serum cortisol level \<16 μg/dL (440 nmol/L) at 60 minutes with ACTH stimulation test using 250 μg cosyntropin (i.e., an abnormal result on the ACTH stimulation test)
14. Use of biologic immunomodulators in the 24 weeks before Screening (allergy desensitization injection or oral therapy is allowed as long as the course of therapy is not altered during the study period)
15. Subjects who have initiated, discontinued, or changed dosage regimen of histamine H2 receptor antagonists, antacids or antihistamines for any condition such as gastro-esophageal reflux disease within 4 weeks before qualifying endoscopy during Screening. If already receiving these drugs, the dosage must remain constant throughout the study
16. Subjects who have changed dosage regimen of PPIs within 8 weeks before qualifying endoscopy. If already receiving PPIs, the dosage must remain constant throughout the study
17. Infection with hepatitis B, hepatitis C, or human immunodeficiency virus
18. Have gastrointestinal bleeding or documented active peptic ulcer within 4 weeks prior to Screening or entering a new study period
19. Have chronic infection such as prior or active tuberculosis, active chicken pox or measles or absence of prior measles, mumps and rubella vaccine. Subjects with tuberculosis exposure or who live in, or travel to, high endemic areas should be assessed locally for tuberculosis before consideration for the study
20. Immunosuppression or immunodeficiency disorder
21. Have a history or presence of Crohn's disease, celiac disease, or other inflammatory disease of the gastrointestinal tract, including eosinophilic gastroenteritis
22. Have current drug abuse in the opinion of the Investigator.
23. Have current alcohol abuse in the opinion of the Investigator.
24. Female subjects who are pregnant, breastfeeding, or planning to become pregnant during the study
25. Sexually active females of childbearing potential who do not agree to follow highly effective contraceptive methods through the End of Study visit
26. Have received an investigational product, as part of a clinical trial within 30 days (or 5 half-lives, whichever is longest) of Screening. Subjects who are currently participating in observational studies or enrolled in patient registries are allowed in this study
27. Have participated in a prior study with investigational product APT-1011
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ellodi Pharmaceuticals, LP

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Evan Dellon, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

UNC Center for Eosphageal Diseases and Swallowing

Locations

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Pinnacle Research Group, LLC

Anniston, Alabama, United States

Site Status

Gut P.C., dba; Digestive Health Specialists of the Southeast

Dothan, Alabama, United States

Site Status

East View Medical Research, LLC

Mobile, Alabama, United States

Site Status

Del Sol Research Management, LLC

Tucson, Arizona, United States

Site Status

Preferred Research Partners Inc.

Little Rock, Arkansas, United States

Site Status

Arkansas Gastroenterology

North Little Rock, Arkansas, United States

Site Status

Camarillo Endoscopy Center

Camarillo, California, United States

Site Status

Hope Clinical Research

Canoga Park, California, United States

Site Status

Facey Medical Foundation

Mission Hills, California, United States

Site Status

United Medical Doctors

Murrieta, California, United States

Site Status

Medical Associates Research Group

San Diego, California, United States

Site Status

Asthma and Allergy Associates, PC

Colorado Springs, Colorado, United States

Site Status

Peak Gastroenterology Associates

Colorado Springs, Colorado, United States

Site Status

Western States Clinical Research Inc.

Wheat Ridge, Colorado, United States

Site Status

Western Connecticut Medical Group - Gastroenterology

Danbury, Connecticut, United States

Site Status

Medical Research Center of Connecticut, LLC

Hamden, Connecticut, United States

Site Status

Fleming Island Center for Clinical Research

Fleming Island, Florida, United States

Site Status

Nature Coast Clinical Research

Inverness, Florida, United States

Site Status

Encore Borland Groover Clinical Research

Jacksonville, Florida, United States

Site Status

Endoscopic Research, Inc.

Orlando, Florida, United States

Site Status

DBC Research USA

Pembroke Pines, Florida, United States

Site Status

Summit Clinical Research

Athens, Georgia, United States

Site Status

University of Iowa Hospitals and Clinics

Iowa City, Iowa, United States

Site Status

MGG Group Co., Inc., Chevy Chase Clinical Research

Chevy Chase, Maryland, United States

Site Status

Gastro Center of Maryland

Columbia, Maryland, United States

Site Status

Michigan Medicine, University of Michigan

Ann Arbor, Michigan, United States

Site Status

Clinical Research Institute of Michigan LLC

Chesterfield, Michigan, United States

Site Status

Henry Ford Health System

Novi, Michigan, United States

Site Status

West Michigan Clinical Research Center

Wyoming, Michigan, United States

Site Status

Minnesota Gastroenterology, P.A.

Plymouth, Minnesota, United States

Site Status

Mayo Clinic

Rochester, Minnesota, United States

Site Status

Clinical Research Professionals

Chesterfield, Missouri, United States

Site Status

Bozeman Health GI Clinic

Bozeman, Montana, United States

Site Status

Long Island Gastrointestinal Research Group LLP

Great Neck, New York, United States

Site Status

University of North Carolina Health Systems (UNC Hospital)

Chapel Hill, North Carolina, United States

Site Status

Carolina Research

Greenville, North Carolina, United States

Site Status

Consultants for Clinical Research

Cincinnati, Ohio, United States

Site Status

Bernstein Clinical Research Center, LLC

Cincinnati, Ohio, United States

Site Status

Great Lakes Gastroenterology Research, LLC

Mentor, Ohio, United States

Site Status

Northshore Gastroenterology Research, LLC

Westlake, Ohio, United States

Site Status

Vital Prospects Clinical Research Institute, P.C.

Tulsa, Oklahoma, United States

Site Status

Perelman Center for Advanced Medicine

Philadelphia, Pennsylvania, United States

Site Status

Digestive Disease Associates LTD

Wyomissing, Pennsylvania, United States

Site Status

Rapid City Medical Center LLP

Rapid City, South Dakota, United States

Site Status

DHAT Research Institute

Garland, Texas, United States

Site Status

Advanced Research Institute

Ogden, Utah, United States

Site Status

Verity Research, Inc.

Fairfax, Virginia, United States

Site Status

Blue Ridge Medical Research

Lynchburg, Virginia, United States

Site Status

St. Vincent's Hospital Sydney

Darlinghurst, New South Wales, Australia

Site Status

Swallow Clinic, St George Hospital

Kogarah, New South Wales, Australia

Site Status

John Hunter Hospital

New Lambton, New South Wales, Australia

Site Status

Lyell McEwin Hospital

Elizabeth Vale, South Australia, Australia

Site Status

St. Vincent's Hospital

Fitzroy, Victoria, Australia

Site Status

Alfred Hospital

Melbourne, Victoria, Australia

Site Status

Hosital General de Tomelloso

Tomelloso, Ciudad Real, Spain

Site Status

Hospital Universitario Ramón y Cajal (Madrid)

Madrid, , Spain

Site Status

Countries

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United States Australia Spain

Other Identifiers

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SP-1011-003

Identifier Type: -

Identifier Source: org_study_id

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