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A study to evaluate long term safety and effect on ability to thrive of EUR-1008 (APT-1008) 3,000 lipase units (Zenpep® [pancrelipase] delayed release capsules) in infants with exocrine pancreatic insufficiency (EPI) due to cystic fibrosis (CF).
This is a multi-center, open-label, safety extension of Aptalis (formerly Eurand) study PR-011 (NCT01100606) in pediatric participants with EPI due to CF. The study will be carried out in participants who completed the PR-011 study.
The study is comprised of 5 visits: an enrollment visit, treatment visit 1 (3 months), treatment visit 2 (6 months), treatment visit 3 (9 months) and treatment visit 4 (12 months). Once determined eligible for participation, participants will be enrolled into the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EUR-1008 (APT-1008) | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| EUR-1008 (APT-1008) | Drug | EUR-1008 (APT-1008) (Zenpep® [pancrelipase] 3,000 lipase units delayed release capsules) from open capsules mixed with a small amount of apple juice or apple sauce will be administered orally starting at the same dose as administered at the end of study PR-011 (NCT01100606), with dose increments of 3,000 lipase units. The dose will be adjusted based on participants' age and body weight. Total dose will not exceed 10,000 lipase units per kilogram (kg) of body weight per day unless clinically indicated. Total duration of study treatment will be up to 12 months. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Treatment-emergent Adverse Events (TEAEs) | TEAE was any event not present prior to exposure to study drug or any event already present that worsened in either intensity or frequency following exposure to test drug. Serious AE (SAE) was any event that resulted in death, immediately life threatening, hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, or a congenital anomaly/birth defect. Number of participants with TEAEs, SAEs, TEAE's relationship to study drug (unrelated, possible and probable) and on the basis of severity (mild [minimal/no treatment and did not interfere with daily activities], moderate [resulted in a low level of inconvenience or concern with the therapeutic measures and may have caused some interference with functioning] and severe [interrupted participant's usual daily activity, may have required systemic drug therapy or other treatment and were usually incapacitating]) with a frequency threshold of above 5% were reported. | Up to Month 12 or early termination |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in Growth Percentiles at Month 3, 6, 9 and 12 | Participant's ability to thrive was evaluated through growth percentiles for weight-for-age, length-for-age and weight-for-length recorded on Center for Disease Control and Prevention (CDC) growth charts during each treatment visit. | Baseline, Month 3, 6, 9 and 12 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Aptalis Medical Information | Forest Laboratories | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Nemours Children's Clinic | Jacksonville | Florida | 32250 | United States | ||
| Children's Lung Specialists Ltd. |
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Participants who completed previous study PR-011 (NCT01100606) and consented to continue treatment with EUR-1008 (APT-1008) 3,000 lipase units were enrolled in this study.
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| ID | Title | Description |
|---|---|---|
| FG000 | EUR-1008 (APT-1008) | EUR-1008 (APT-1008) (Zenpep® [pancrelipase] 3,000 lipase units delayed release capsules) from open capsules mixed with a small amount of apple juice or apple sauce orally starting at the same dose as administered at the end of study PR-011 (NCT01100606), with dose increments of 3,000 lipase units. The dose was adjusted based on participants' age and body weight. Total dose not to exceed 10,000 lipase units per kilogram (kg) of body weight per day unless clinically indicated. Total duration of study treatment was up to 12 months. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
Safety population included all participants who received at least 1 dose of study drug.
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| ID | Title | Description |
|---|---|---|
| BG000 | EUR-1008 (APT-1008) | EUR-1008 (APT-1008) (Zenpep® [pancrelipase] 3,000 lipase units delayed release capsules) from open capsules mixed with a small amount of apple juice or apple sauce orally starting at the same dose as administered at the end of study PR-011 (NCT01100606), with dose increments of 3,000 lipase units. The dose was adjusted based on participants' age and body weight. Total dose not to exceed 10,000 lipase units per kg body weight per day unless clinically indicated. Total duration of study treatment was up to 12 months. |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Median |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Number of Participants With Treatment-emergent Adverse Events (TEAEs) | TEAE was any event not present prior to exposure to study drug or any event already present that worsened in either intensity or frequency following exposure to test drug. Serious AE (SAE) was any event that resulted in death, immediately life threatening, hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, or a congenital anomaly/birth defect. Number of participants with TEAEs, SAEs, TEAE's relationship to study drug (unrelated, possible and probable) and on the basis of severity (mild [minimal/no treatment and did not interfere with daily activities], moderate [resulted in a low level of inconvenience or concern with the therapeutic measures and may have caused some interference with functioning] and severe [interrupted participant's usual daily activity, may have required systemic drug therapy or other treatment and were usually incapacitating]) with a frequency threshold of above 5% were reported. | Safety population included all participants who received at least 1 dose of study drug. | Posted | Number | participants | Up to Month 12 or early termination |
Up to Month 12 or early termination
Adverse event (AE) was defined as any untoward medical occurrence regardless of causal relationship to study medication. Serious AE was any event that resulted in death, life threatening, required or prolonged in-patient hospitalization, significant disability/incapacity, or was a congenital anomaly/birth defect.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | EUR-1008 (APT-1008) | EUR-1008 (APT-1008) (Zenpep® [pancrelipase] 3,000 lipase units delayed release capsules) from open capsules mixed with a small amount of apple juice or apple sauce will be administered orally starting at the same dose as administered at the end of study PR-011 (NCT01100606), with dose increments of 3,000 lipase units. The dose was adjusted based on participants' age and body weight. Total dose not to exceed 10,000 lipase units per kg body weight per day unless clinically indicated. Total duration of study treatment was up to 12 months. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Bronchopneumonia | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Rhinorrhoea | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Robert Winkler, MD, VP, Clinical Development and Operations | Aptalis Pharma US, Inc. | 1-800-472-2634 |
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| ID | Term |
|---|---|
| D003550 | Cystic Fibrosis |
| D010188 | Exocrine Pancreatic Insufficiency |
| ID | Term |
|---|---|
| D010182 | Pancreatic Diseases |
| D004066 | Digestive System Diseases |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
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| ID | Term |
|---|---|
| D020799 | Pancrelipase |
| ID | Term |
|---|---|
| D008049 | Lipase |
| D002265 | Carboxylic Ester Hydrolases |
| D004950 | Esterases |
| D006867 | Hydrolases |
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|
|
| Las Vegas |
| Nevada |
| 89107 |
| United States |
| Akron Children's Hospital | Akron | Ohio | 44308 | United States |
| Cincinnati Children's Hospital Medical Center | Cincinnati | Ohio | 45229 | United States |
| Penn State Milton S. Hershey Medical Center | Hershey | Pennsylvania | 17033 | United States |
| Cystic Fibrosis Care Center | Houston | Texas | 77030 | United States |
| months |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Weight | Median | Full Range | kilogram |
|
| Length | Number of participants evaluable for this baseline characteristic = 14 | Median | Full Range | centimeter |
|
| ID | Title | Description |
|---|
| OG000 | EUR-1008 (APT-1008) | EUR-1008 (APT-1008) (Zenpep® [pancrelipase] 3,000 lipase units delayed release capsules) from open capsules mixed with a small amount of apple juice or apple sauce orally starting at the same dose as administered at the end of study PR-011 (NCT01100606), with dose increments of 3,000 lipase units. The dose was adjusted based on participants' age and body weight. Total dose not to exceed 10,000 lipase units per kg body weight per day unless clinically indicated. Total duration of study treatment was up to 12 months. |
|
|
| Secondary | Change From Baseline in Growth Percentiles at Month 3, 6, 9 and 12 | Participant's ability to thrive was evaluated through growth percentiles for weight-for-age, length-for-age and weight-for-length recorded on Center for Disease Control and Prevention (CDC) growth charts during each treatment visit. | Safety population included all participants who received at least 1 dose of study drug. Here, 'n' specifies number of participants who were evaluable for various categories at each time point. | Posted | Median | Full Range | growth percentile | Baseline, Month 3, 6, 9 and 12 |
|
|
|
| 3 |
| 15 |
| 15 |
| 15 |
| Viral infection | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Anaphylactic shock | Immune system disorders | MedDRA (13.0) | Non-systematic Assessment | This AE was an acute reaction to peanuts and not related to study drug. |
|
| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Wheezing | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Nasal congestion | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Productive cough | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Respiratory tract congestion | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Rhonchi | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Asthma | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Dyspnoea | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Haemoptysis | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Oropharyngeal pain | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Rales | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Sputum increased | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Tonsillar hypertrophy | Respiratory, thoracic and mediastinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Diarrhoea | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Steatorrhoea | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Abnormal faeces | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Constipation | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Abdominal distension | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Faecal volume increased | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Flatulence | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Post-tussive vomiting | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Teething | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Faeces hard | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Frequent bowel movements | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Haematochezia | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Malabsorption | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Salivary hypersecretion | Gastrointestinal disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Upper respiratory tract infection | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Otitis media | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Bronchitis | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Pseudomonas infection | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Rhinitis | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Sinusitis | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Acute sinusitis | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Croup infectious | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Ear infection | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Gastroenteritis | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Influenza | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Nasopharyngitis | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Oral candidiasis | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Pharyngitis streptococcal | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Pneumonia | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Respiratory tract infection | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Staphylococcal infection | Infections and infestations | MedDRA (13.0) | Non-systematic Assessment |
|
| Pyrexia | General disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Fatigue | General disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Decreased appetite | Metabolism and nutrition disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Vitamin D deficiency | Metabolism and nutrition disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Weight gain poor | Metabolism and nutrition disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Weight decreased | Investigations | MedDRA (13.0) | Non-systematic Assessment |
|
| Band neutrophil count increased | Investigations | MedDRA (13.0) | Non-systematic Assessment |
|
| Pseudomonas test positive | Investigations | MedDRA (13.0) | Non-systematic Assessment |
|
| Cystic fibrosis lung | Congenital, familial and genetic disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Dermatitis diaper | Skin and subcutaneous tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Rash | Skin and subcutaneous tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Rash generalised | Skin and subcutaneous tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Rash macular | Skin and subcutaneous tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Seborrhoea | Skin and subcutaneous tissue disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Drug hypersensitivity | Immune system disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Tachycardia | Cardiac disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Cerumen impaction | Ear and labyrinth disorders | MedDRA (13.0) | Non-systematic Assessment |
|
| Eyelid margin crusting | Eye disorders | MedDRA (13.0) | Non-systematic Assessment |
|
Restrictions vary in accordance with each agreement with the individual investigators. Sponsor will allow publication after a multi-center publication has been published or after an agreed period of time if no such multi-center publication is submitted for publication. Sponsor can ask that Sponsor's confidential information be removed from any publication and can defer publication for a period of time to allow for Sponsor to obtain patent or other intellectual property right protection.
| D030342 |
| Genetic Diseases, Inborn |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
| D007232 | Infant, Newborn, Diseases |
| D004798 |
| Enzymes |
| D045762 | Enzymes and Coenzymes |
| D010184 | Pancreatic Extracts |
| D014020 | Tissue Extracts |
| D045424 | Complex Mixtures |
|
| Weight-for-age: Change at Month 9 (n=12) |
|
| Weight-for-age: Change at Month 12 (n=12) |
|
| Length-for-age: Baseline (n=14) |
|
| Length-for-age: Change at Month 3 (n=14) |
|
| Length-for-age: Change at Month 6 (n=12) |
|
| Length-for-age: Change at Month 9 (n=12) |
|
| Length-for-age: Change at Month 12 (n=12) |
|
| Weight-for-length: Baseline (n=14) |
|
| Weight-for-length: Change at Month 3 (n=14) |
|
| Weight-for-length: Change at Month 6 (n=12) |
|
| Weight-for-length: Change at Month 9 (n=12) |
|
| Weight-for-length: Change at Month 12 (n=12) |
|