Title

Trial to Evaluate Efficacy and Safety of Lenabasum in Cystic Fibrosis
A Multicenter, Randomized, Double-Blind, Placebo-Controlled Phase 2 Trial to Evaluate Efficacy and Safety of Lenabasum in Cystic Fibrosis
  • Phase

    Phase 2
  • Study Type

    Interventional
  • Study Participants

    447
This is a Phase 2 multicenter, double-blind, randomized, placebo-controlled study assessing the efficacy and safety of lenabasum for the treatment of cystic fibrosis in patients 12 years of age or older. Approximately 415 subjects will be enrolled in this study at about 100 sites in North America, and Europe. The planned duration of treatment with study drug is 28 weeks.

Study drug will be lenabasum 20 mg BID, lenabasum 5 mg BID, and placebo in a 2:1:2 ratio.
Study Started
Dec 22
2017
Primary Completion
Jun 17
2020
Study Completion
Jun 17
2020
Results Posted
Jan 18
2023
Last Update
Jan 18
2023

Drug Lenabasum 20 mg

Subjects will receive lenabasum 20 mg twice daily.

Drug Lenabasum 5 mg

Subjects will receive lenabasum 5 mg twice daily.

Other Placebo

Subjects will receive placebo twice daily.

Lenabasum 20 mg BID Experimental

Lenabasum 5 mg BID Experimental

Placebo BID Placebo Comparator

Criteria

Inclusion Criteria:

≥ 12 years of age at the time Informed Consent/ Assent is signed.
Weight ≥ 40 kg.
FEV1 ≥ 40% predicted and < 100% predicted in the last 12 months.
Physician-initiated treatment with an IV antibiotic 2 or 3 times in the last 12 months for a new PEx or physician-initiated treatment with an IV antibiotic 1 time in the last 12 months plus physician-initiated treatment with oral antibiotic(s) 1 or more times in the past 12 months for a new PEX.

Exclusion Criteria:

Severe or unstable CF at screening or Visit 1.

Any of the following values for laboratory tests at screening:

A positive pregnancy test.
Hemoglobin < 10 g/dL in males and < 9 g/dL in females.
Neutrophils < 1.0 x 10^9 /L.
Platelets < 75 x 10^9/L.
Creatinine clearance < 50 mL/min according to Modification of Diet in Renal Disease (MDRD) Study equation.
Serum transaminases > 2.5 x upper limit of normal.
Any medical condition or concurrent medical therapies at screening or Visit 1 that may put the subject at greater safety risk, influence response to study drug or interfere with study assessments.

Summary

Lenabasum 20 mg BID

Lenabasum 5 mg BID

Placebo

All Events

Event Type Organ System Event Term Lenabasum 20 mg BID Lenabasum 5 mg BID Placebo

Pulmonary Exacerbation (PEx) Rate Over 28 Weeks

Rate of PEx using the primary PEx definition with lenabasum 20 mg BID compared to placebo, during the treatment period. An primary PEx is defined on the physician's decision to treat with oral, intraveneous or inhaled antibiotics in the presence 4/12 Fuch's criteria (Change in sputum, new/increased hemoptysis, increased cough, increased dyspnea, malaise, fatigue/lethargy, Temperature greater than 38C, weight loss, sinus pain, change in sinus discharge, change in exam of chest, decrease in FEV1 of more than 10%, radiographic change). This excludes prophylactic antibiotics. A new PEx is a one that occurs at 28 days after the previous PEx.

Lenabasum 20 mg BID

0.911
events per participant/28 weeks

Lenabasum 5 mg BID

0.749
events per participant/28 weeks

Placebo BID

0.842
events per participant/28 weeks

Pulmonary Exacerbation (PEx) Rate

Event rate of PEx using the secondary PEx definition with lenabasum 20 mg BID compared to placebo. The secondary definition of a PEx is based on the physician's diagnosis of pulmonary exacerbation and commencement of new oral, intravenous, or inhaled antibiotics. A new PEx is defined one that starts 28 or more days after the previous confirmed PEx. The PEx rate is calculated as the number of PEx/28 weeks

Lenabasum 20 mg BID

1.08
events per participant/28 weeks

Lenabasum 5 mg BID

0.91
events per participant/28 weeks

Placebo

1.03
events per participant/28 weeks

Time to First New Pulmonary Exacerbation (PEx)

Time to first new PEx using the primary PEx definition with lenabasum 20 mg BID compared to placebo. An primary PEx is defined on the physician's decision to treat with oral, intraveneous or inhaled antibiotics in the presence 4/12 Fuch's criteria (Change in sputum, new/increased hemoptysis, increased cough, increased dyspnea, malaise, fatigue/lethargy, Temperature greater than 38C, weight loss, sinus pain, change in sinus discharge, change in exam of chest, decrease in FEV1 of more than 10%, radiographic change). This excludes prophylactic antibiotics. A new PEx is a one that occurs at 28 days after the previous PEx. The rate is calculate over a 28 week period from visit 1 to week 28 visit

Lenabasum 20 mg BID

162.0
days (Median)
Inter-Quartile Range: 59.0 to 183.0

Lenabasum 5 mg BID

148.0
days (Median)
Inter-Quartile Range: 58.0 to 183.0

Placebo

143.0
days (Median)
Inter-Quartile Range: 58.0 to 183.0

Pulmonary Exacerbation (PEx)

Time to first PEx using the secondary PEx definition with lenabasum 20 mg BID compared to placebo. The secondary definition of a PEx is based on the physician's diagnosis of pulmonary exacerbation and commencement of new oral, intravenous, or inhaled antibiotics. A new PEx is defined one that starts 28 or more days after the previous confirmed PEx.

Lenabasum 20 mg BID

116.0
days (Median)
Inter-Quartile Range: 38.0 to 183.0

Lenabasum 5 mg BID

113.0
days (Median)
Inter-Quartile Range: 54.0 to 183.0

Placebo

120.0
days (Median)
Inter-Quartile Range: 49.0 to 183.0

CFQ-R Respiratory Symptom Domain

Cystic Fibrosis Questionnaire - Revised measures change from baseline in CFQ-R respiratory symptom domain with lenabasum compared to placebo. Subjects >/= 14 years of age. 5 distinct 4-point Likert scales (e.g., always/often/ sometime/never) Scores for each HRQoL domain; after recoding, each item is summed to generate a domain score and standardized. Scores range from 0 to 100, with higher scores indicating better health.

Lenabasum 20 mg BID

1.16
scores on a scale (Least Squares Mean)
Standard Error: 1.41

Lenabasum 5 mg BID

-2.92
scores on a scale (Least Squares Mean)
Standard Error: 1.88

Placebo

-0.96
scores on a scale (Least Squares Mean)
Standard Error: 1.41

FEV1 % Predicted

Change from baseline to week 28 in Forced Expiratory Volume in 1 second (FEV1) expressed as a percentage of a normal range. A lower percentage FEV1 is indicative of decrease in lung functionality. The changes observed from baseline to week 28 for lenabasum will be compared with those observed for placebo treated participants.

Lenabasum 20 mg BID

0.014
percentage of Predicted FEV1 (Least Squares Mean)
Standard Error: 0.025

Lenabasum 5 mg BID

-0.005
percentage of Predicted FEV1 (Least Squares Mean)
Standard Error: 0.033

Placebo

-0.012
percentage of Predicted FEV1 (Least Squares Mean)
Standard Error: 0.025

Total

425
Participants

Age, Continuous

26.9
years (Mean)
Standard Deviation: 10.5

Body Mass Index

21.50
kg/m^2 (Mean)
Standard Deviation: 3.728

FEV1 (L)

2.15
liters (Mean)
Standard Deviation: 0.76

Weight

59.67
kg (Mean)
Standard Deviation: 13.390

CFTR Genotype

Ethnicity (NIH/OMB)

Number of Acute Pulmonary Exacerbations in Past Year

Race (NIH/OMB)

Sex: Female, Male

Overall Study

Lenabasum 20 mg BID

Lenabasum 5 mg BID

Placebo

Drop/Withdrawal Reasons

Lenabasum 20 mg BID

Lenabasum 5 mg BID

Placebo