Clinical trial NCT01386112: Safety and Tolerability Study of Oral EUR-1100 to Treat Eosinophilic Esophagitis
Official title: A Multicenter, Randomized, Double-blind, Placebo-controlled, Safety and Tolerability Phase 1/2a Study of Two Dosing Regimens of EUR-1100 for Oral Use, in Subjects With Eosinophilic Esophagitis (EoE)
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE1
PHASE2
Conditions: Eosinophilic Esophagitis
Lead sponsor: Forest Laboratories
Sponsor class: INDUSTRY
First posted: 2011-06-30
Enrollment: 24
Sex: ALL
Minimum age (years): 12
Maximum age (years): 55
Standard ages: CHILD
ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Eosinophilic esophagitis (EoE) is an inflammatory disease of the esophagus, characterized by eosinophilic infiltration and gastrointestinal (GI) symptoms. There are no pharmacological treatments for EoE approved by the US Food and Drug Administration (FDA). Supported by published case series and controlled trials in children and adults, the most widely used drug treatment for EoE is off-label use of corticosteroids intended for local (esophageal mucosal) action.

This study will evaluate the safety and tolerability of orally administered EUR-1100 once or twice daily. Eligible subjects will be randomized into one of the 3 treatment groups. The Treatment Period will be 8 weeks during which subjects will visit the clinic at the screening visit, randomization, week 4, 8 and 1 week after end of treatment for clinical symptom assessment and safety evaluation. Additional phone visits will occur at week 2 and week 6.


Eligibility criteria: Key Inclusion Criteria:

* Male and female subjects aged ≥ 12 and ≤ 55 years;
* Written informed consent (parent or guardian must sign when applicable) and assent form, if required;
* Evidence of eosinophilic esophagitis defined by esophageal mucosal eosinophil count greater than or equal to 24 per HPF (400x magnification) in at least 1 of the esophageal sites biopsied (proximal/middle and/or distal);
* Lack of histological response to previously administered high dose proton pump inhibitor;
* Clinical symptoms of eosinophilic esophagitis with at least one of the following symptoms: chest pain or discomfort, dysphagia (difficulty swallowing) or food impaction.

Key Exclusion Criteria:

* Known contraindication, hypersensitivity or intolerance to corticosteroids;
* Any physical, mental, or social condition, 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;
* Oral or esophageal mucosal infection of any type;
* Any condition affecting the esophageal mucosa or altering esophageal motility other than EoE;
* Use of systemic (oral or parenteral) or inhaled, intranasal or high-potency dermal topical corticosteroids in the 30 days prior to the esophageal biopsy required for entrance to this study (or prior to EGD if done during the pre-Screening period) or at any time between the biopsy and the Randomization Visit;
* Adrenal suppression;
* Any medical condition in which the use of anti-inflammatory or immunosuppressant drugs are required or may be anticipated to be required during the study;
* Contraindication to EGD or esophageal biopsy or narrowing of the esophagus precluding EGD;
* History of esophageal or gastric surgery (history of esophageal dilatation is allowed);
* Gastrointestinal bleeding;
* Current chronic infection, immunosuppression, immunodeficiency;
* History or presence of Crohn's disease, celiac disease, or other inflammatory disease of the gastrointestinal tract;
* Alcohol or drug abuse;
* Female subjects who are pregnant or breastfeeding;
* Participation in a clinical study involving an investigational drug within 30 days of the Screening Visit.

Primary outcomes:
measure: Morning serum cortisol (change from baseline measure)
timeFrame: Screening visit (up to 21 days), week 4, week 8 and follow-up
measure: Standard safety laboratory tests
timeFrame: Screening visit (up to 21 days), week 4, week 8 and follow-up
measure: Treatment-emergent adverse events collection
timeFrame: Screening visit (up to 21 days), Randomization day, week 2 and week 6(phone visit), week 4 and week 8 (office visit), follow-up (office visit, up to 11 days after week 8 visit)
measure: Physical examination and vital signs collection
timeFrame: Screening (up to 21 days), week4, week 8 and follow-up
Secondary outcomes:
measure: Esophagoduodenoscopy with multiple biopsies
timeFrame: Screening (up to 21 days) and week 8
measure: Patient reported outcomes, and physician global assessment
timeFrame: Screening (up to 21 days), week 4 and 8.
Other outcomes:
Locations:
city: Atlanta
country: United States
facility: Children's Center for Digestive Health
state: Georgia
city: Chicago
country: United States
facility: Northwestern University School of Medicine
state: Illinois
city: Indianapolis
country: United States
facility: Riley Hospital for Children
state: Indiana
city: Rochester
country: United States
facility: Mayo Clinic
state: Minnesota
city: Mays Landing
country: United States
facility: South Jersey Pediatric Gastroenterology
state: New Jersey
city: Philadelphia
country: United States
facility: University of Pennsylvania
state: Pennsylvania
city: Fairfax
country: United States
facility: O&O Alpan LLC Center for Clinical Trials
state: Virginia
Study officials:
affiliation: Northwestern University School of Medicine
name: Ikuo Hirano, MD
role: PRINCIPAL_INVESTIGATOR
References:
citation: Schoepfer AM, Hirano I, Coslovsky M, Roumet MC, Zwahlen M, Kuehni CE, Hafner D, Alexander JA, Dellon ES, Gonsalves N, Leung J, Bussmann C, Collins MH, Newbury RO, Smyrk TC, Woosley JT, Yang GY, Romero Y, Katzka DA, Furuta GT, Gupta SK, Aceves SS, Chehade M, Spergel JM, Falk GW, Meltzer BA, Comer GM, Straumann A, Safroneeva E; International EEsAI Study Group. Variation in Endoscopic Activity Assessment and Endoscopy Score Validation in Adults With Eosinophilic Esophagitis. Clin Gastroenterol Hepatol. 2019 Jul;17(8):1477-1488.e10. doi: 10.1016/j.cgh.2018.11.032. Epub 2018 Nov 23.