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

Completed · Phase 3 · Has a placebo group

Conditions studied: Eosinophilic Esophagitis

In brief

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.

Key facts

Study ID

NCT04281108

Run by

Ellodi Pharmaceuticals, LP

People needed

143

Starts

2020-01-30

Expected to finish

2022-10-24

Last updated by the study team

2023-06-12

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Male or female ≥18 years of age at the time of informed consent or assent
• 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
• 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.
• Esophagogastroduodenoscopies and biopsies are to be obtained during the Screening period
• Biopsies will be read by a central pathologist
• Esophagogastroduodenoscopies and biopsies performed outside the study will not be accepted to meet eligibility criteria
• 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
• Have a subject-reported history of ≥6 episodes of dysphagia in the 14 days prior to baseline
• Completion of the daily diary on at least 11 out of the 14 days during the 2-week Baseline Symptom Assessment

You may not qualify if…

• Have known contraindication, hypersensitivity, or intolerance to corticosteroids
• 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
• Have history of an esophageal stricture requiring dilatation within the 12 weeks prior to Screening
• 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
• History or presence of oral or esophageal mucosal infection whilst using inhaled or nasal corticosteroids
• Have any mouth or dental condition that prevents normal eating (excluding braces)
• 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)
• Use of systemic (oral or parenteral) corticosteroids within 60 days before Screening, use of swallowed corticosteroids within 30 days before Screening
• Initiation of either inhaled or nasal corticosteroids or high-potency dermal topical corticosteroids within 30 days before Screening
• Use of calcineurin inhibitors or purine analogues (azathioprine, 6-mercaptopurine) in the 12 weeks before Screening
• Use of potent cytochrome P450 (CYP) 3A4 inhibitors (eg, ritonavir and ketoconazole) in the 12 weeks before Screening
• Initiation of an elimination diet or elemental diet within 30 days before Screening (diet must remain stable after signing ICF)
• 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)
• 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)
• 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
• 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
• Infection with hepatitis B, hepatitis C, or human immunodeficiency virus
• Have gastrointestinal bleeding or documented active peptic ulcer within 4 weeks prior to Screening or entering a new study period
• 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
• Immunosuppression or immunodeficiency disorder
• Have a history or presence of Crohn's disease, celiac disease, or other inflammatory disease of the gastrointestinal tract, including eosinophilic gastroenteritis
• Have current drug abuse in the opinion of the Investigator.
• Have current alcohol abuse in the opinion of the Investigator.
• Female subjects who are pregnant, breastfeeding, or planning to become pregnant during the study
• Sexually active females of childbearing potential who do not agree to follow highly effective contraceptive methods through the End of Study visit

Where it is running

• Gut P.C., dba; Digestive Health Specialists of the Southeast — Dothan, Alabama, United States
• East View Medical Research, LLC — Mobile, Alabama, United States
• Del Sol Research Management, LLC — Tucson, Arizona, United States
• Preferred Research Partners Inc. — Little Rock, Arkansas, United States
• Arkansas Gastroenterology — North Little Rock, Arkansas, United States
• Camarillo Endoscopy Center — Camarillo, California, United States
• Hope Clinical Research — Canoga Park, California, United States
• Facey Medical Foundation — Mission Hills, California, United States
• United Medical Doctors — Murrieta, California, United States
• Medical Associates Research Group — San Diego, California, United States
• Asthma and Allergy Associates, PC — Colorado Springs, Colorado, United States
• Peak Gastroenterology Associates — Colorado Springs, Colorado, United States
• Western States Clinical Research Inc. — Wheat Ridge, Colorado, United States
• Western Connecticut Medical Group - Gastroenterology — Danbury, Connecticut, United States
• Medical Research Center of Connecticut, LLC — Hamden, Connecticut, United States
• Fleming Island Center for Clinical Research — Fleming Island, Florida, United States
• Nature Coast Clinical Research — Inverness, Florida, United States
• Encore Borland Groover Clinical Research — Jacksonville, Florida, United States
• Endoscopic Research, Inc. — Orlando, Florida, United States
• DBC Research USA — Pembroke Pines, Florida, United States
• Summit Clinical Research — Athens, Georgia, United States
• University of Iowa Hospitals and Clinics — Iowa City, Iowa, United States
• MGG Group Co., Inc., Chevy Chase Clinical Research — Chevy Chase, Maryland, United States
• Gastro Center of Maryland — Columbia, Maryland, United States
• Pinnacle Research Group, LLC — Anniston, Alabama, United States

Full record on ClinicalTrials.gov

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