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Octreotide capsule is a novel, orally-administered formulation of the commercially-available injectable drug octreotide. In a recent phase 3 trial, oral octreotide capsules demonstrated maintenance of biochemical response up to 13 months in the majority of patients with acromegaly previously managed with somatostatin analog injections (reference below).
This is a double blind, randomized study that assesses the efficacy and safety of octreotide capsules vs. placebo. Eligible acromegaly patients, treated with injectable somatostatin analogs, who are biochemically controlled and have prior evidence of active disease, will be randomized to receive either octreotide capsules or placebo for up to 36 weeks. At the end of this double blind, placebo controlled period, eligible patients will receive octreotide capsules in an open-labeled extension for at least one year. Patients failing to respond (per protocol), to oral treatment, (either placebo or octreotide capsules), will be rescued with the standard of care and upon meeting the eligibility criteria could also enroll into the long term extension with octreotide capsules.
This study received agreement from the FDA, under a special protocol assessment.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Octreotide capsules | Active Comparator | Octreotide capsules |
|
| Matching Placebo | Placebo Comparator | Matching placebo capsules |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| octreotide capsules | Drug | octreotide capsules 40 mg/day, 60 mg/day, 80 mg/day (individual dose titration) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Number of Patients Who Maintain Their Biochemical Response at the End of the Double Blind Placebo Controlled (DPC) Period. | Maintenance of response was defined by using the average IGF-1 level of the last 2 available assessments in the DPC period. If the average IGF-1 is ≤ 1×ULN, a patient was classified as a responder (i.e., maintained their biochemical response). If the average IGF-1 is > 1×ULN, a patient was classified as a non-responder. Patients who discontinue study medication during the DPC period for any reason was classified as non-responders for the primary analysis, regardless of their IGF-1 values. | Week 36 |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Patients Who Maintain Growth Hormone (GH) Response at the End of the Double Blind Placebo Controlled Period | Maintenance of GH response was defined as having mean Growth Hormone (5 measurements 30 minutes apart) < 2.5 ng/mL at the end of the double blind placebo controlled period, out of those who were responders on Somatostatin Receptor Ligands (SRLs) injections at Screening. | Week 36 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Susan L Samson, MD PhD | Pituitary Center at Baylor St. Luke's Medical | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Keck Medical Center of University of Southern California | Los Angeles | California | 90033 | United States | ||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25664604 | Background | Melmed S, Popovic V, Bidlingmaier M, Mercado M, van der Lely AJ, Biermasz N, Bolanowski M, Coculescu M, Schopohl J, Racz K, Glaser B, Goth M, Greenman Y, Trainer P, Mezosi E, Shimon I, Giustina A, Korbonits M, Bronstein MD, Kleinberg D, Teichman S, Gliko-Kabir I, Mamluk R, Haviv A, Strasburger C. Safety and efficacy of oral octreotide in acromegaly: results of a multicenter phase III trial. J Clin Endocrinol Metab. 2015 Apr;100(4):1699-708. doi: 10.1210/jc.2014-4113. Epub 2015 Feb 9. | |
| 22539587 |
| Label | URL |
|---|---|
| Chiasma Web Page | View source |
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| ID | Title | Description |
|---|---|---|
| FG000 | Octreotide Capsules | Octreotide capsules octreotide capsules: octreotide capsules 40mg/day, 60mg/day, 80 mg/day (individual dose titration) |
| FG001 | Matching Placebo | Matching placebo capsules Matching placebo: Matching placebo capsules |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Nov 29, 2017 | Aug 10, 2020 |
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| Matching placebo | Drug | Matching placebo capsules |
|
|
| Number of Patients Who Begin Rescue Treatment | Number of Patients who Began Rescue Treatment Prior to and Including Week 36 | Week 36 |
| Cedars-Sinai Medical Center |
| Los Angeles |
| California |
| 90048 |
| United States |
| UCLA Medical Center | Los Angeles | California | 90095 | United States |
| Stanford University School of Medicine | Palo Alto | California | 94304 | United States |
| University of Colorado | Aurora | Colorado | 80045 | United States |
| The Emory Clinic | Atlanta | Georgia | 30322 | United States |
| John H. Stroger Jr. Hospital of Cook County | Chicago | Illinois | 60612 | United States |
| Johns Hopkins University Clinical Trials Unit | Baltimore | Maryland | 21287 | United States |
| Massachusetts General Hospital | Boston | Massachusetts | 02114 | United States |
| Washington University School of Medicine | St Louis | Missouri | 63110 | United States |
| Columbia University Medical Center | New York | New York | 10032 | United States |
| Memorial Sloan Kettering Cancer Center | New York | New York | 10065 | United States |
| Cleveland Clinic | Cleveland | Ohio | 44195 | United States |
| Ohio State University | Columbus | Ohio | 43203 | United States |
| Oregon Health and Science University | Portland | Oregon | 97239 | United States |
| Thomas Jefferson University Hospital | Philadelphia | Pennsylvania | 19107 | United States |
| Allegheny Endocrinology Associates | Pittsburgh | Pennsylvania | 15212 | United States |
| Baylor College of Medicine | Houston | Texas | 77030 | United States |
| Huntsman Cancer Hospital | Salt Lake City | Utah | 84108 | United States |
| St Vincent's Private Hospital-NSW | Darlinghurst | New South Wales | 2010 | Australia |
| Royal North Shore Public Hospital | St Leonards | New South Wales | 2065 | Australia |
| St Vincent's Hospital-VIC | Fitzroy | Victoria | 3065 | Australia |
| The Alfred | Melbourne | Victoria | 3004 | Australia |
| Melbourne Health | Parkville | Victoria | 3050 | Australia |
| Keogh Institute (Sir Charles Gardner) | Nedlands | Western Australia | 6009 | Australia |
| University Specialized Hospital for Active Treatment of Endocrinology "Acad. Iv. Pencev" EAD | Sofia | 1431 | Bulgaria |
| University of British Columbia | Vancouver | British Columbia | V5Z 1M9 | Canada |
| St Joseph's Health Care | London | Ontario | N6A 4V2 | Canada |
| McGill University Health Centre | Montreal | Quebec | H4A 3J1 | Canada |
| Aarhus University Hospital | Aarhus | 8000 | Denmark |
| Rigshospitalet The Department of Endocrinology | Copenhagen | 2100 | Denmark |
| RWTH Aachen University Hospital, Medical Clinic III Division of Endocrinology and Diabetes | Aachen | 52074 | Germany |
| Klinikum der LMU Muenchen, Medizinische Klinik und Poliklinik IV, Endokrinologie | Munich | 80336 | Germany |
| Magyar Honvedseg Egeszsegugyi Kozpont, II. sz. Belgyogyaszati Osztaly | Budapest | H-1062 | Hungary |
| University of Semmelweiss, Budapest | Budapest | H-1088 | Hungary |
| Szegedi Tudományegyetem, I. Belgyógyászati Klinika | Szeged | H-6720 | Hungary |
| Hadassah Ein-Karem Medical Center | Jerusalem | 91120 | Israel |
| Rabin Medical Center, Beilinson Hospital | Petah Tikva | 49100 | Israel |
| Tel Aviv Sourasky Medical Center | Tel Aviv | 64239 | Israel |
| Policlinico di Monserrato U.O.C. Endocrinologia e Diabetologia | Monserrato | 09042 | Italy |
| Azienda Ospedaliero-Universitaria Pisana, Università di Pisa | Pisa | 56124 | Italy |
| Riga Eastern Clinical University, Hospital Gailezers Department of Endocrinology | Riga | 1038 | Latvia |
| Leids Universitair Medisch Centrum | Leiden | 2333 ZA | Netherlands |
| Erasmus Medisch Centrum | Rotterdam | 3015 CE | Netherlands |
| Dunedin Hospital | Dunedin | 9016 | New Zealand |
| Wellington Hospital | Wellington | 6021 | New Zealand |
| Katedra i Klinika Endokrynologii i Chorob Wewnetrznych | Gdansk | 80-211 | Poland |
| Uniwersyteckie Centrum Okulistyki i Onkologii Samodzielny Publiczny Szpital Kliniczny Slaskiego Uniwersytetu Medycznego w Katowicach, Oddzial Endokrynologii | Katowice | 40-541 | Poland |
| Szpital Uniwersytecki w Krakowie, Oddzial Kliniczny Endokrynologii | Krakow | 31-501 | Poland |
| Klinika Chorob Wewnetrznych i Endokrynologii | Warsaw | 02-097 | Poland |
| Samodzielny Publiczny Szpital Kliniczny nr 1 we Wroclawiu, Klinika Endokrynologii, Diabetologii i Leczenia Izotopami | Wroclaw | 50-367 | Poland |
| Medical University Centre Ljubljana | Ljubljana | 1000 | Slovenia |
| Sahlgrenska University Hospital | Gothenburg | SE-413 45 | Sweden |
| Ankara University, Faculty of Medicine | Ankara | 6100 | Turkey (Türkiye) |
| Hacettepe University Medical School | Ankara | 6100 | Turkey (Türkiye) |
| Ege University Medical Faculty Internal Diseases | Izmir | 35040 | Turkey (Türkiye) |
| Erciyes University Medical Faculty | Kayseri | 38080 | Turkey (Türkiye) |
| University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital | Birmingham | B15 2GW | United Kingdom |
| Central Manchester University Hospitals NHS Foundation Trust, Manchester Royal Infirmary | Manchester | M13 9WL | United Kingdom |
| Royal Victoria Infirmary | Newcastle upon Tyne | NE1 4LP | United Kingdom |
| Background |
| Tuvia S, Atsmon J, Teichman SL, Katz S, Salama P, Pelled D, Landau I, Karmeli I, Bidlingmaier M, Strasburger CJ, Kleinberg DL, Melmed S, Mamluk R. Oral octreotide absorption in human subjects: comparable pharmacokinetics to parenteral octreotide and effective growth hormone suppression. J Clin Endocrinol Metab. 2012 Jul;97(7):2362-9. doi: 10.1210/jc.2012-1179. Epub 2012 Apr 26. |
| 34173129 | Derived | Labadzhyan A, Nachtigall LB, Fleseriu M, Gordon MB, Molitch M, Kennedy L, Samson SL, Greenman Y, Biermasz N, Bolanowski M, Haviv A, Ludlam W, Patou G, Strasburger CJ. Oral octreotide capsules for the treatment of acromegaly: comparison of 2 phase 3 trial results. Pituitary. 2021 Dec;24(6):943-953. doi: 10.1007/s11102-021-01163-2. Epub 2021 Jun 25. |
| 32882036 | Derived | Samson SL, Nachtigall LB, Fleseriu M, Gordon MB, Bolanowski M, Labadzhyan A, Ur E, Molitch M, Ludlam WH, Patou G, Haviv A, Biermasz N, Giustina A, Trainer PJ, Strasburger CJ, Kennedy L, Melmed S. Maintenance of Acromegaly Control in Patients Switching From Injectable Somatostatin Receptor Ligands to Oral Octreotide. J Clin Endocrinol Metab. 2020 Oct 1;105(10):e3785-97. doi: 10.1210/clinem/dgaa526. |
| Melmed et al. JCEM 2015 | View source |
| COMPLETED |
|
| NOT COMPLETED |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Octreotide Capsules | Octreotide capsules octreotide capsules: octreotide capsules 40mg/day, 60mg/day, 80 mg/day (individual dose titration) |
| BG001 | Matching Placebo | Matching placebo capsules Matching placebo: Matching placebo capsules |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants | No |
| |||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Baseline average Insulin-like Growth Factor 1 (IGF-1) (categorical) | Count of Participants | Participants |
|
| 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 Patients Who Maintain Their Biochemical Response at the End of the Double Blind Placebo Controlled (DPC) Period. | Maintenance of response was defined by using the average IGF-1 level of the last 2 available assessments in the DPC period. If the average IGF-1 is ≤ 1×ULN, a patient was classified as a responder (i.e., maintained their biochemical response). If the average IGF-1 is > 1×ULN, a patient was classified as a non-responder. Patients who discontinue study medication during the DPC period for any reason was classified as non-responders for the primary analysis, regardless of their IGF-1 values. | Number of Patients who Maintained Their Biochemical Response at the End of the DPC Period | Posted | Count of Participants | Participants | Week 36 |
|
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Number of Patients Who Maintain Growth Hormone (GH) Response at the End of the Double Blind Placebo Controlled Period | Maintenance of GH response was defined as having mean Growth Hormone (5 measurements 30 minutes apart) < 2.5 ng/mL at the end of the double blind placebo controlled period, out of those who were responders on Somatostatin Receptor Ligands (SRLs) injections at Screening. | Number of patients who maintain Growth Hormone (GH) response at the end of the double blind placebo controlled period | Posted | Count of Participants | Participants | Week 36 |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Number of Patients Who Begin Rescue Treatment | Number of Patients who Began Rescue Treatment Prior to and Including Week 36 | The number of patients who began rescue treatment | Posted | Count of Participants | Participants | Week 36 |
|
|
1 year, 10 months
Safety population: All participants enrolled in the study who received any amount of the study drug.
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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 | Octreotide Capsules | Octreotide capsules octreotide capsules: octreotide capsules 40mg/day, 60mg/day, 80 mg/day (individual dose titration) | 0 | 28 | 2 | 28 | 28 | 28 |
| EG001 | Matching Placebo | Matching placebo capsules Matching placebo: Matching placebo capsules | 0 | 28 | 1 | 28 | 27 | 28 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Cholecystitis acute | Hepatobiliary disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Joint dislocation | Injury, poisoning and procedural complications | MedDRA (18.1) | Systematic Assessment |
| |
| Arthritis | Musculoskeletal and connective tissue disorders | MedDRA (18.1) | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abdominal discomfort | Gastrointestinal disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Abdominal pain | Gastrointestinal disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Abdominal pain upper | Gastrointestinal disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Constipation | Gastrointestinal disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Diarrhoea | Gastrointestinal disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Dyspepsia | Gastrointestinal disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Flatulence | Gastrointestinal disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Large intestinal polyp | Gastrointestinal disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Nausea | Gastrointestinal disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Tongue disorder | Gastrointestinal disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Fatigue | General disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Influenza-like illness | General disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Oedema peripheral | General disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Pain | General disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Peripheral swelling | General disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Cholelithiasis | Hepatobiliary disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Nasopharyngitis | Infections and infestations | MedDRA (18.1) | Systematic Assessment |
| |
| Sinusitis | Infections and infestations | MedDRA (18.1) | Systematic Assessment |
| |
| Upper respiratory tract infection | Infections and infestations | MedDRA (18.1) | Systematic Assessment |
| |
| Urinary tract infection | Infections and infestations | MedDRA (18.1) | Systematic Assessment |
| |
| Blood glucose increased | Investigations | MedDRA (18.1) | Systematic Assessment |
| |
| Gamma-glutamyltransferase increased | Investigations | MedDRA (18.1) | Systematic Assessment |
| |
| Insulin-like growth factor increased | Investigations | MedDRA (18.1) | Systematic Assessment |
| |
| Weight increased | Investigations | MedDRA (18.1) | Systematic Assessment |
| |
| Hypercholesterolaemia | Metabolism and nutrition disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Arthritis | Musculoskeletal and connective tissue disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Back pain | Musculoskeletal and connective tissue disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Musculoskeletal pain | Musculoskeletal and connective tissue disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Osteoarthritis | Musculoskeletal and connective tissue disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Pain in extremity | Musculoskeletal and connective tissue disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Soft tissue swelling | Musculoskeletal and connective tissue disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Carpal tunnel syndrome | Nervous system disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Headache | Nervous system disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Hypoaesthesia | Nervous system disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Paraesthesia | Nervous system disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Anxiety | Psychiatric disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Hyperhidrosis | Skin and subcutaneous tissue disorders | MedDRA (18.1) | Systematic Assessment |
| |
| Night sweats | Skin and subcutaneous tissue disorders | MedDRA (18.1) | Systematic Assessment |
|
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Asi Haviv, VP Clinical development | Chiasma | 972-8-939-3888 | Asi@chiasmapharma.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Nov 29, 2017 | Aug 10, 2020 | SAP_001.pdf |
Not provided
| ID | Term |
|---|---|
| D000172 | Acromegaly |
| ID | Term |
|---|---|
| D001849 | Bone Diseases, Endocrine |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D006964 | Hyperpituitarism |
| D010900 | Pituitary Diseases |
| D007027 | Hypothalamic Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D004700 | Endocrine System Diseases |
Not provided
Not provided
| ID | Term |
|---|---|
| D015282 | Octreotide |
| ID | Term |
|---|---|
| D010456 | Peptides, Cyclic |
| D047028 | Macrocyclic Compounds |
| D011083 | Polycyclic Compounds |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
Not provided
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| Male |
|
| Not Hispanic or Latino |
|
| Unknown or Not Reported |
|
| Asian |
|
| Native Hawaiian or Other Pacific Islander |
|
| Black or African American |
|
| White |
|
| More than one race |
|
| Unknown or Not Reported |
|
| IGF > 1 to < 1.3 ULN |
|
| IGF≥ 1.3 ULN |
|
|
|
|
|