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| ID | Type | Description | Link |
|---|---|---|---|
| AF219-005 | Other Identifier | Afferent Pharmaceuticals | |
| MK-7264-005 | Other Identifier | Merck Protocol Number |
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The purpose of this study is to assess the efficacy of gefapixant (AF-219/MK-7264) in female participants with moderate to severe pain associated with interstitial cystitis/bladder pain syndrome (IC/BPS) after 4 weeks of treatment.
This study is a double-blind, placebo-controlled, randomized trial designed to assess the efficacy and safety of gefapixant in female participants with moderate to severe pain associated with IC/BPS. The study will consist of 4 phases: Screening, Baseline, Treatment, and Follow-up.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Gefapixant | Experimental | Female participants receive gefapixant, a total dose titrated from 50 mg to highest tolerated dose (maximum of 300 mg) twice daily (BID), orally over a period of 6 days with food depending on safety and tolerability, and then maintain that dose for the course of a 4-week treatment period. Participants were allowed to decrease the dose if tolerability issues occurred. |
|
| Placebo | Placebo Comparator | Female participants receive dose matched placebo tablets, BID, orally, with food for 4 weeks. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Gefapixant | Drug | 50 or 300 mg tablets for a total daily dose of 50, 100, 150, 200, 250 or 300 mg BID, orally with food for 4 weeks |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in the Average Mean Numeric Pain Rating Scale (NPRS) Score at Week 4 | The bladder pain severity was measured using 0-10 NPRS, with 0 representing 'no pain' and 10 representing 'the worst pain possible'. Participants were asked to select a number on the scale that best described the severity of bladder pain during past 24 hours over telephone using an interactive voice response system (IVRS) every evening at bedtime during the baseline assessment phase and treatment phase (up to 4 weeks). The primary analysis was conducted using a Mixed Model with Repeated Measures (MMRM) approach to calculate the Least Squares (LS) mean change from baseline in NPRS score and associated Standard Error (SE) at Week 4 for each treatment arm. Negative values indicate decrease in bladder pain severity. | Baseline and Week 4 |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in Painful Bladder/Interstitial Cystitis Symptom Diary (PBIC-SD) Score at Week 4 | To assess the severity of bladder pain syndrome (BPS), an 8-item participant self-report PBIC-SD measure was used. Participants were asked to select a number on the scale that best described the severity of bladder pain over telephone using an IVRS each evening on the three consecutive days (during the Baseline Assessment Phase and during each Treatment Week up to 4 weeks). Each item was graded on a scale from 0 (good condition) to 4 (poor condition) with a total score range 0-32. Higher scores indicate more severe BPS. The analysis was conducted using a MMRM approach to calculate the LS mean change from baseline PBIC-SD total score and associated SE at Week 4 for each treatment arm. Negative values indicate decrease in severity of BPS. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Medical Director | Afferent Pharmaceuticals, Inc., a subsidiary of Merck & Co., Inc. (Rahway, New Jersey USA) | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Afferent Investigative Site | Glendale | Alabama | 85306 | United States | ||
| Afferent Investigative Site |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32734597 | Derived | Imamura M, Scott NW, Wallace SA, Ogah JA, Ford AA, Dubos YA, Brazzelli M. Interventions for treating people with symptoms of bladder pain syndrome: a network meta-analysis. Cochrane Database Syst Rev. 2020 Jul 30;7(7):CD013325. doi: 10.1002/14651858.CD013325.pub2. |
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Of 107 participants randomized to the study, 105 received at least one dose of study treatment (All Treated Population) and were evaluable for all safety analysis.
Overall, 107 participants were randomized (55 in Gefapixant intervention group, and 52 in Placebo group).
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| ID | Title | Description |
|---|---|---|
| FG000 | Placebo | Female participants receive dose matched placebo tablets, twice daily (BID), orally, with food for 4 weeks. |
| FG001 | Gefapixant | Female participants receive gefapixant, a total dose titrated from 50 mg to highest tolerated dose (maximum of 300 mg) twice daily (BID), orally over a period of 6 days with food depending on safety and tolerability, and then maintain that dose for the course of a 4-week treatment period. Participants were allowed to decrease the dose if tolerability issues occurred. |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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Double Blind
| Placebo | Drug | Dose matched placebo tablets, BID, orally, with food for 4 weeks |
|
| Baseline and Week 4 |
| Change From Baseline in O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI) Score at Week 4 | To measure the severity of BPS (urgency and frequency of urination, nighttime urination, and pain or burning) over past month, a 4-item self-report ICSI measure was used. Participants were asked to select a number on the scale that best described the severity of symptoms over telephone using an IVRS every evening at bedtime during the baseline assessment phase and treatment phase (up to 4 weeks). The ICSI score range from 0 (Not at all) to 5 (Almost always) for the first 3 items and a score of 0 (Not at all) to 4 (Almost always) for the last item, with an index score range of 0-19. Higher scores indicate more severe BPS. The analysis was conducted using one-way ANCOVA model to calculate the LS mean change from baseline ICSI total score and associated SE at Week 4 for each treatment arm. Negative values indicate decrease in severity of BPS. | Baseline and Week 4 |
| Change From Baseline in Genitourinary Pain Index (GUPI) Score at Week 4 | To measure the degree of genitourinary pain symptoms, an 8-item self-report GUPI measure was used. Participants were asked to select a number on the scale that best described the severity of symptoms over telephone using an IVRS every evening at bedtime during the baseline assessment phase and treatment phase (up to 4 weeks). The GUPI instrument yields a total score of 0-45 and 3 subscales: pain (score = 0-23), urinary (score = 0-10), and quality of life (score = 0-12). Higher scores indicate more severe symptoms. The analysis was conducted using one-way ANCOVA model to calculate the LS mean change from baseline GUPI total score and associated SE at Week 4 for each treatment arm. Negative values indicate decrease in degree of genitourinary pain symptoms. | Baseline and Week 4 |
| Homewood |
| Alabama |
| 35209 |
| United States |
| Afferent Investigative Site | Mobile | Alabama | 36608 | United States |
| Afferent Investigative Site | Phoenix | Arizona | 85018 | United States |
| Afferent Investigative Site | Glendora | California | 91741 | United States |
| Afferent Investigative Site | Murrieta | California | 91741 | United States |
| Afferent Investigative Site | San Diego | California | 92120 | United States |
| Afferent Investigative Site | San Diego | California | 92123 | United States |
| Afferent Investigative Site | Farmington | Connecticut | 06032 | United States |
| Afferent Investigative Site | New Britain | Connecticut | 06052 | United States |
| Afferent Investigative Site | Boynton Beach | Florida | 33472 | United States |
| Afferent Investigative Site | Plantation | Florida | 33317 | United States |
| Afferent Investigative Site | Coeur d'Alene | Idaho | 83814 | United States |
| Afferent Investigative Site | Idaho Falls | Idaho | 83404 | United States |
| Afferent Investigative Site | Meridian | Idaho | 83642 | United States |
| Afferent Investigative Site | Shreveport | Louisiana | 71106 | United States |
| Afferent Investigative Site | Annapolis | Maryland | 21401 | United States |
| Afferent Investigative Site | Ann Arbor | Michigan | 48109 | United States |
| Afferent Investigative Site | Grand Rapids | Michigan | 49503 | United States |
| Afferent Investigative Site | Kalamazoo | Michigan | 49009 | United States |
| Afferent Investigative Site | Royal Oak | Michigan | 48073 | United States |
| Afferent Investigative Site | Voorhees Township | New Jersey | 08043 | United States |
| Afferent Investigative Site | Albuquerque | New Mexico | 87109 | United States |
| Afferent Investigative Site | Brooklyn | New York | 11215 | United States |
| Afferent Investigative Site | Hyde Park | New York | 11040 | United States |
| Afferent Investigative Site | Greenville | North Carolina | 27834 | United States |
| Afferent Investigative Site | Salisbury | North Carolina | 28144 | United States |
| Afferent Investigative Site | Winston-Salem | North Carolina | 27103 | United States |
| Afferent Investigative Site | Cincinnati | Ohio | 45212 | United States |
| Afferent Investigative Site | Cleveland | Ohio | 44109 | United States |
| Afferent Investigative Site | Tiffin | Ohio | 43351 | United States |
| Afferent Investigative Site | Zanesville | Ohio | 43701 | United States |
| Afferent Investigative Site | Bala-Cynwyd | Pennsylvania | 19004 | United States |
| Afferent Investigative Site | Lancaster | Pennsylvania | 17604 | United States |
| Afferent Investigative Site | Myrtle Beach | South Carolina | 29572 | United States |
| Afferent Investigative Site | Dallas | Texas | 75390 | United States |
| Afferent Investigative Site | Fort Worth | Texas | 76104 | United States |
| Afferent Investigative Site | Houston | Texas | 77062 | United States |
| Afferent Investigative Site | Irving | Texas | 75062 | United States |
| Afferent Investigative Site | Salt Lake City | Utah | 84124 | United States |
| Afferent Investigative Site | Virginia Beach | Virginia | 23462 | United States |
| Treated |
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| Titration Set |
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| COMPLETED |
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| NOT COMPLETED |
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All randomized participants
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| ID | Title | Description |
|---|---|---|
| BG000 | Gefapixant | Female participants receive gefapixant, a total dose titrated from 50 mg to highest tolerated dose (maximum of 300 mg) twice daily (BID), orally over a period of 6 days with food depending on safety and tolerability, and then maintain that dose for the course of a 4-week treatment period. Participants were allowed to decrease the dose if tolerability issues occurred. |
| BG001 | Placebo | Female participants receive dose matched placebo tablets, twice daily (BID), orally, with food for 4 weeks. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
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| Sex: Female, Male | Count of Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Region of Enrollment | Count of Participants | Participants |
| ||||||||||||||||
| Numeric Pain Rating Scale (NPRS) Score | Participants were instructed to select a number between 0 and 10 where 0 is no pain and 10 is the worst pain possible. The scale was completed by telephone (an interactive voice response system [IVRS]) every evening before bedtime. In order to qualify for study entry, participants must have had an average score of >=4 and <10 during the baseline assessment phase. | NPRS score was calculated only on randomized participants who received at least had one dose of study treatment. | Mean | Standard Deviation | Score on a scale |
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| 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 | Change From Baseline in the Average Mean Numeric Pain Rating Scale (NPRS) Score at Week 4 | The bladder pain severity was measured using 0-10 NPRS, with 0 representing 'no pain' and 10 representing 'the worst pain possible'. Participants were asked to select a number on the scale that best described the severity of bladder pain during past 24 hours over telephone using an interactive voice response system (IVRS) every evening at bedtime during the baseline assessment phase and treatment phase (up to 4 weeks). The primary analysis was conducted using a Mixed Model with Repeated Measures (MMRM) approach to calculate the Least Squares (LS) mean change from baseline in NPRS score and associated Standard Error (SE) at Week 4 for each treatment arm. Negative values indicate decrease in bladder pain severity. | Titration Completers Population - defined as participants who received at least 1 dose of drug, had at least 1 post-baseline NPRS Score, who titrated the dose in Week 1 of the treatment phase, and who completed the 4-week treatment phase | Posted | Least Squares Mean | Standard Error | Score on a scale | Baseline and Week 4 |
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| Secondary | Change From Baseline in Painful Bladder/Interstitial Cystitis Symptom Diary (PBIC-SD) Score at Week 4 | To assess the severity of bladder pain syndrome (BPS), an 8-item participant self-report PBIC-SD measure was used. Participants were asked to select a number on the scale that best described the severity of bladder pain over telephone using an IVRS each evening on the three consecutive days (during the Baseline Assessment Phase and during each Treatment Week up to 4 weeks). Each item was graded on a scale from 0 (good condition) to 4 (poor condition) with a total score range 0-32. Higher scores indicate more severe BPS. The analysis was conducted using a MMRM approach to calculate the LS mean change from baseline PBIC-SD total score and associated SE at Week 4 for each treatment arm. Negative values indicate decrease in severity of BPS. | Titration Completers Population - defined as participants who received at least 1 dose of drug, had at least 1 post-baseline PBIC-SD Score, who titrated the dose in Week 1 of the treatment phase, and who completed the 4-week treatment phase. | Posted | Least Squares Mean | Standard Error | Score on a scale | Baseline and Week 4 |
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| Secondary | Change From Baseline in O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI) Score at Week 4 | To measure the severity of BPS (urgency and frequency of urination, nighttime urination, and pain or burning) over past month, a 4-item self-report ICSI measure was used. Participants were asked to select a number on the scale that best described the severity of symptoms over telephone using an IVRS every evening at bedtime during the baseline assessment phase and treatment phase (up to 4 weeks). The ICSI score range from 0 (Not at all) to 5 (Almost always) for the first 3 items and a score of 0 (Not at all) to 4 (Almost always) for the last item, with an index score range of 0-19. Higher scores indicate more severe BPS. The analysis was conducted using one-way ANCOVA model to calculate the LS mean change from baseline ICSI total score and associated SE at Week 4 for each treatment arm. Negative values indicate decrease in severity of BPS. | Titration Completers Population - defined as participants who received at least 1 dose of drug, had at least 1 post-baseline ICSI Score, who titrated the dose in Week 1 of the treatment phase, and who completed the 4-week treatment phase. | Posted | Least Squares Mean | Standard Error | Score on a scale | Baseline and Week 4 |
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| Secondary | Change From Baseline in Genitourinary Pain Index (GUPI) Score at Week 4 | To measure the degree of genitourinary pain symptoms, an 8-item self-report GUPI measure was used. Participants were asked to select a number on the scale that best described the severity of symptoms over telephone using an IVRS every evening at bedtime during the baseline assessment phase and treatment phase (up to 4 weeks). The GUPI instrument yields a total score of 0-45 and 3 subscales: pain (score = 0-23), urinary (score = 0-10), and quality of life (score = 0-12). Higher scores indicate more severe symptoms. The analysis was conducted using one-way ANCOVA model to calculate the LS mean change from baseline GUPI total score and associated SE at Week 4 for each treatment arm. Negative values indicate decrease in degree of genitourinary pain symptoms. | Titration Completers Population - defined as participants who received at least 1 dose of drug, had at least 1 post-baseline GUPI Score, who titrated the dose in Week 1 of the treatment phase, and who completed the 4-week treatment phase. | Posted | Least Squares Mean | Standard Error | Score on a scale | Baseline and Week 4 |
|
Up to approximately 6 weeks
All-Cause Mortality reported for all randomized participants. Serious Adverse Events (SAEs) and Other Adverse Events (AEs) were reported for all participants who received at least 1 dose of study treatment.
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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 | Placebo | Female participants receive dose matched placebo tablets, twice daily (BID), orally, with food for 4 weeks. | 0 | 52 | 0 | 51 | 36 | 51 |
| EG001 | Gefapixant | Female participants receive gefapixant, a total dose titrated from 50 mg to highest tolerated dose (maximum of 300 mg) twice daily (BID), orally over a period of 6 days with food depending on safety and tolerability, and then maintain that dose for the course of a 4-week treatment period. Participants were allowed to decrease the dose if tolerability issues occurred. | 0 | 55 | 0 | 54 | 53 | 54 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Dysgeusia | Nervous system disorders | MedDRA 14.0 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA 14.0 | Systematic Assessment |
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| Ageusia | Nervous system disorders | MedDRA 14.0 | Systematic Assessment |
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| Hypogeusia | Nervous system disorders | MedDRA 14.0 | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Dry mouth | Gastrointestinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Paraesthesia oral | Gastrointestinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Salivary hypersecretion | Gastrointestinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Hypoaesthesia oral | Gastrointestinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Pollakiuria | Renal and urinary disorders | MedDRA 14.0 | Systematic Assessment |
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| Dysuria | Renal and urinary disorders | MedDRA 14.0 | Systematic Assessment |
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| Bladder pain | Renal and urinary disorders | MedDRA 14.0 | Systematic Assessment |
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| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Dry throat | Respiratory, thoracic and mediastinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Throat irritation | Respiratory, thoracic and mediastinal disorders | MedDRA 14.0 | Systematic Assessment |
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| Urine output decreased | Investigations | MedDRA 14.0 | Systematic Assessment |
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| Urinary tract infection | Infections and infestations | MedDRA 14.0 | Systematic Assessment |
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| Decreased appetite | Metabolism and nutrition disorders | MedDRA 14.0 | Systematic Assessment |
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| Flank pain | Musculoskeletal and connective tissue disorders | MedDRA 14.0 | Systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA 14.0 | Systematic Assessment |
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60 days prior to the submission of any results, the PI shall submit to SPONSOR any proposed PUBLICATION, which period may be extended for an additional 30 days if requested by SPONSOR. If any Confidential Information should be redacted or patent applications relating to an Invention should be filed prior to PUBLICATION, then PUBLICATION will be delayed until patent application has been filed. Delay of a PUBLICATION shall not exceed 24 months from the date of such notice to the PI.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Senior Vice President, Global Clinical Development | Merck Sharp & Dohme Corp. | 1-800-672-6372 | ClinicalTrialsDisclosure@merck.com |
| ID | Term |
|---|---|
| D018856 | Cystitis, Interstitial |
| ID | Term |
|---|---|
| D003556 | Cystitis |
| D001745 | Urinary Bladder Diseases |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
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| ID | Term |
|---|---|
| C000597312 | Gefapixant |
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| Between 18 and 65 years |
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| >=65 years |
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| Placebo |
Female participants receive dose matched placebo tablets, twice daily (BID), orally, with food for 4 weeks. |
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| OG001 | Placebo | Female participants receive dose matched placebo tablets, twice daily (BID), orally, with food for 4 weeks. |
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| Placebo |
Female participants receive dose matched placebo tablets, twice daily (BID), orally, with food for 4 weeks. |
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