Title

Oral Testosterone for the Treatment of Hypogonadism
A Phase 2, Randomized, Double-blind, Dose Response Study of Oral Testosterone in Subjects With Hypogonadism
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Study Participants

    130
Low testosterone is a condition that occurs when the body is unable to produce sufficient quantities of testosterone. The medical name for low testosterone is hypogonadism. Hypogonadism can be caused by many factors. Symptoms include: decrease in libido, lack of energy and mood swings. The goal of testosterone replacement therapy is to return testosterone levels to the normal range and relieve symptoms.

The purpose of this study is to evaluate the ability of TSX-002, which is testosterone provided in easy to swallow capsules, to maintain serum (blood) testosterone levels within the normal range in hypogonadal men. This will be determined by blood sampling at specified times during the study. The study is also intended to evaluate the tolerability of TSX-002, which will be taken orally twice per day for 15 days. In addition, the study is intended to determine a dosing regimen(s) that achieves testosterone levels within the normal range. Related Outcome Measures will be reported for Parts 1, 2, and 4.

A portion of the study (Part 3) to also assess the effect of a high-calorie, high-fat meal on the single dose pharmacokinetic exposure of TSX-002. Related outcome measures to be reported for Part 3.
Study Started
Oct 31
2012
Primary Completion
Aug 31
2014
Study Completion
Dec 31
2014
Results Posted
Dec 15
2015
Estimate
Last Update
Dec 15
2015
Estimate

Drug TSX-002

TSX-002 are capsules with testosterone as the active ingredient.

  • Other names: Testosterone

Part 1: 120 mg BID Experimental

Oral TSX-002 120 mg BID (total dose = 240 mg/day) for a duration of 15 days

Part 1: 240 mg BID Experimental

Oral TSX-002 240 mg BID (total dose = 480 mg/day) for a duration of 15 days

Part 2: 120 mg BID Experimental

Single cohort, open-label, nonrandomized oral TSX 002 120 mg BID (total dose = 240 mg/day) for a duration of 15 days

Part 3: A-B-C 120 mg QD Experimental

Open-label, randomized, 3-way crossover of 3 treatments, A, B, and C. Treatment A: Oral TSX-002 (1 x 120-mg capsules) administered 30 minutes after a high-calorie, high-fat meal. No food was allowed 4 hours before the high calorie, high-fat meal and no food was allowed for at least 10 hours after dosing. Treatment B: Oral TSX-002 (1 x 120-mg capsules) administered 4 hours after a high-calorie, high fat meal. No food was allowed 4 hours before the high calorie, high-fat meal and no food was allowed for at least 10 hours after dosing. Treatment C: Oral TSX-002 (1 x 120-mg capsules) administered 30 minutes before a high-calorie, high-fat meal. No food was allowed 4 hours before the high-calorie, high-fat meal and no food was allowed for at least 10 hours after dosing.

Part 3: B-C-A 120 mg QD Experimental

Open-label, randomized, 3-way crossover of 3 treatments, A, B, and C. Treatment A: Oral TSX-002 (1 x 120-mg capsules) administered 30 minutes after a high-calorie, high-fat meal. No food was allowed 4 hours before the high calorie, high-fat meal and no food was allowed for at least 10 hours after dosing. Treatment B: Oral TSX-002 (1 x 120-mg capsules) administered 4 hours after a high-calorie, high fat meal. No food was allowed 4 hours before the high calorie, high-fat meal and no food was allowed for at least 10 hours after dosing. Treatment C: Oral TSX-002 (1 x 120-mg capsules) administered 30 minutes before a high-calorie, high-fat meal. No food was allowed 4 hours before the high-calorie, high-fat meal and no food was allowed for at least 10 hours after dosing.

Part 3: C-A-B 120 mg QD Experimental

Open-label, randomized, 3-way crossover of 3 treatments, A, B, and C. Treatment A: Oral TSX-002 (1 x 120-mg capsules) administered 30 minutes after a high-calorie, high-fat meal. No food was allowed 4 hours before the high calorie, high-fat meal and no food was allowed for at least 10 hours after dosing. Treatment B: Oral TSX-002 (1 x 120-mg capsules) administered 4 hours after a high-calorie, high fat meal. No food was allowed 4 hours before the high calorie, high-fat meal and no food was allowed for at least 10 hours after dosing. Treatment C: Oral TSX-002 (1 x 120-mg capsules) administered 30 minutes before a high-calorie, high-fat meal. No food was allowed 4 hours before the high-calorie, high-fat meal and no food was allowed for at least 10 hours after dosing.

Part 4 Cohort 1: 60 mg BID/ 60 mg TID Experimental

Oral TSX-002 60 mg BID for 15 days then 60 mg TID for 15 days

Part 4 Cohort 2: 90 mg BID/ 90 mg TID Experimental

Oral TSX-002 90 mg BID for 15 days then 90 mg TID for 15 days

Part 4 Cohort 3: 180 mg QD Experimental

Oral TSX-002 180 mg once daily (QD) for 15 days

Part 4 Cohort 4: 120 mg BID Experimental

Oral TSX-002 120 mg BID for 15 days

Criteria

Inclusion Criteria:

Prior documentation of a diagnosis of hypogonadism as evidenced by a screening serum testosterone < 300 ng/dL (based on the average of 2 morning samples taken at least 1 week apart)
Men over the age of 18 years with a body mass index (BMI) < 39.0 kg/m2 and weighing ≥ 55 kg
Hemoglobin levels at screening and baseline > 12.5 g/dL
Testosterone treatment not contraindicated
No evidence of suspected reversible hypogonadism
Willing to abstain from current treatment for hypogonadism in accordance with approved labeling to facilitate an appropriate washout period before study participation (for nondepot formulations of testosterone only)
Understands the requirements of the study and voluntarily consents to participate in the study

Exclusion Criteria:

-

Summary

Part 1: 120 mg BID

Part 1: 240 mg BID

Part 2: 120 mg BID

Part 3: A-B-C 120 mg QD

Part 3: B-C-A 120 mg QD

Part 3: C-A-B 120 mg QD

Part 4 Cohort 1: 60 mg BID

Part 4 Cohort 1: 60 mg TID

Part 4 Cohort 2: 90 mg BID

Part 4 Cohort 2: 90 mg TID

Part 4 Cohort 3: 180 mg QD

Part 4 Cohort 4: 120 mg BID

All Events

Event Type Organ System Event Term Part 1: 120 mg BID Part 1: 240 mg BID Part 2: 120 mg BID Part 3: A-B-C 120 mg QD Part 3: B-C-A 120 mg QD Part 3: C-A-B 120 mg QD Part 4 Cohort 1: 60 mg BID Part 4 Cohort 1: 60 mg TID Part 4 Cohort 2: 90 mg BID Part 4 Cohort 2: 90 mg TID Part 4 Cohort 3: 180 mg QD Part 4 Cohort 4: 120 mg BID

Percentage of Subjects Achieving a 24 Hour Average Total Serum Testosterone Concentration (Cavg,0-24h) in the Range of 300 to 1050 ng/dL After 15 Days of Treatment With TSX-002

Percentage of subjects achieving a 24-hour average total serum testosterone concentration (Cavg,0-24h) in the range of 300 to 1050 ng/dL after 15 days of treatment with TSX-002. PK samples taken at 0 ,2 ,4, 5 ,6, 7, 9, 12, 14, 16, 17, 18, 21, 24 hours post-dose after 15 days of treatment for Part 1. PK samples taken at 0, 1, 2, 3, 4, 5, 6, 8, 12, 16, 17, 18, 19, 20, 21, 22, 24 hours post-dose after 15 days of treatment for Part 2. PK samples taken at 0, 1, 2, 3, 4, 5, 6, 8 ,12, 13, 14, 15, 16, 17, 18, 20, 24 hours post-dose after 15 days of treatment for Part 4.

Part 4 Cohort 1: 60 mg BID

41.0
percentage of participants

Part 4 Cohort 1: 60 mg TID

53.0
percentage of participants

Part 4 Cohort 2: 90 mg BID

19.0
percentage of participants

Part 4 Cohort 2: 90 mg TID

20.0
percentage of participants

Part 4 Cohort 3: 180 mg QD

31.0
percentage of participants

Part 4 Cohort 4: 120 mg BID

27.0
percentage of participants

Part 1: 120 mg BID

59.0
percentage of participants

Part 1: 240 mg BID

31.0
percentage of participants

Part 2: 120 mg BID

35.0
percentage of participants

Percentage of Subjects With Cmax ≤ 1500 ng/dL After 15 Days of Treatment 2. Percentage of Subjects With Cmax ≥ 1800 and ≤ 2500 ng/dL After 15 Days of BID Treatment 3. Percentage of Subjects With Cmax > 2500 ng/dL After 15 Days of BID Treatment

Cmax. PK samples taken at 0, 2, 4, 5, 6, 7, 9, 12, 14, 16, 17, 18, 21, 24 hours post-dose after 15 days of treatment for Part 1. PK samples taken at 0, 1, 2, 3, 4, 5, 6, 8, 12, 16, 17, 18, 19, 20, 21, 22, 24 hours post-dose after 15 days of treatment for Part 2. PK samples taken at 0, 1, 2, 3, 4, 5, 6, 8, 12, 13, 14, 15, 16, 17,18, 20, 24 hours post-dose after 15 days of treatment for Part 4.

Part 1: 120 mg BID

Percentage of subjects with Cmax ≤ 1500 ng/dL afte

100.0
percentage of subjects

Percentage of subjects with Cmax ≥ 1800 and ≤ 2500

Percentage of subjects with Cmax > 2500 ng/dL afte

Part 1: 240 mg BID

Percentage of subjects with Cmax ≤ 1500 ng/dL afte

100.0
percentage of subjects

Percentage of subjects with Cmax ≥ 1800 and ≤ 2500

Percentage of subjects with Cmax > 2500 ng/dL afte

Part 2: 120 mg BID

Percentage of subjects with Cmax ≤ 1500 ng/dL afte

94.1
percentage of subjects

Percentage of subjects with Cmax ≥ 1800 and ≤ 2500

Percentage of subjects with Cmax > 2500 ng/dL afte

Part 4 Cohort 1: 60 mg BID

Percentage of subjects with Cmax ≤ 1500 ng/dL afte

100.0
percentage of subjects

Percentage of subjects with Cmax ≥ 1800 and ≤ 2500

Percentage of subjects with Cmax > 2500 ng/dL afte

Part 4 Cohort 1: 60 mg TID

Percentage of subjects with Cmax ≤ 1500 ng/dL afte

100.0
percentage of subjects

Percentage of subjects with Cmax ≥ 1800 and ≤ 2500

Percentage of subjects with Cmax > 2500 ng/dL afte

Part 4 Cohort 2: 90 mg BID

Percentage of subjects with Cmax ≤ 1500 ng/dL afte

100.0
percentage of subjects

Percentage of subjects with Cmax ≥ 1800 and ≤ 2500

Percentage of subjects with Cmax > 2500 ng/dL afte

Part 4 Cohort 2: 90 mg TID

Percentage of subjects with Cmax ≤ 1500 ng/dL afte

100.0
percentage of subjects

Percentage of subjects with Cmax ≥ 1800 and ≤ 2500

Percentage of subjects with Cmax > 2500 ng/dL afte

Part 4 Cohort 3: 180 mg QD

Percentage of subjects with Cmax ≤ 1500 ng/dL afte

100.0
percentage of subjects

Percentage of subjects with Cmax ≥ 1800 and ≤ 2500

Percentage of subjects with Cmax > 2500 ng/dL afte

Part 4 Cohort 4: 120 mg BID

Percentage of subjects with Cmax ≤ 1500 ng/dL afte

93.75
percentage of subjects

Percentage of subjects with Cmax ≥ 1800 and ≤ 2500

6.25
percentage of subjects

Percentage of subjects with Cmax > 2500 ng/dL afte

Cavg 0-24 Hrs (ng/dL) After 120 mg Dose

PK samples taken at 0, 1, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24 hours post-dose after 1 day of treatment for Part 3. Mean of Cavg values from all time points for 14 subjects.

Part 3:120 mg QD Treatment A

296.0
ng/dL (Least Squares Mean)
Standard Deviation: 108

Part 3:120 mg QD Treatment B

297.0
ng/dL (Least Squares Mean)
Standard Deviation: 75

Part 3:120 mg QD Treatment C

273.0
ng/dL (Least Squares Mean)
Standard Deviation: 109

AUC 0-24 Hrs After 120 mg Dose of TSX-002

AUC 0-24 hrs with PK samples taken at 0, 1, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24 hours post-dose after 1 day of treatment for Part 3.

Part 3:120 mg QD Treatment A

1941.0
hr×ng/dL (Median)
Standard Deviation: 1198

Part 3:120 mg QD Treatment B

2117.0
hr×ng/dL (Median)
Standard Deviation: 1351

Part 3:120 mg QD Treatment C

1516.0
hr×ng/dL (Median)
Standard Deviation: 1217

Total

130
Participants

Age, Customized

Race (NIH/OMB)

Region of Enrollment

Sex/Gender, Customized

Part 1 (Duration of 15 Days)

Part 1: 120 mg BID

Part 1: 240 mg BID

Part 2 (Duration of 15 Days)

Part 2: 120 mg BID

Part 3 - Treatment 1 (Duration of 1 Day)

Part 3: A-B-C 120 mg QD

Part 3: B-C-A 120 mg QD

Part 3: C-A-B 120 mg QD

Part 3 - Treatment 2 (Duration of 1 Day)

Part 3: A-B-C 120 mg QD

Part 3: B-C-A 120 mg QD

Part 3: C-A-B 120 mg QD

Part 3 - Treatment 3 (Duration of 1 Day)

Part 3: A-B-C 120 mg QD

Part 3: B-C-A 120 mg QD

Part 3: C-A-B 120 mg QD

Part 4-Treatment 1 (Duration of 15 Days)

Part 4 Cohort 1: 60 mg BID

Part 4 Cohort 2: 90 mg BID

Part 4 Cohort 3: 180 mg QD

Part 4 Cohort 4: 120 mg BID

Part 4-Treatment 2 (Duration of 15 Days)

Part 4 Cohort 1: 60 mg TID

Part 4 Cohort 2: 90 mg TID

Drop/Withdrawal Reasons

Part 1: 240 mg BID

Part 4 Cohort 1: 60 mg TID

Part 4 Cohort 2: 90 mg TID

Part 4 Cohort 4: 120 mg BID