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Short Bowel SyndromePhase 3NCT03571516

Safety, Efficacy and Pharmacokinetic Study of Teduglutide in Infants 4 to 12 Months of Age With Short Bowel Syndrome

A Phase 3 study testing Teduglutide, Standard Medical Therapy and Syringe in people with Short Bowel Syndrome, run by Shire at 8 sites in 4 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of the study is to evaluate the safety, efficacy/pharmacodynamics (PD) and pharmacokinetics (PK) of teduglutide treatment in infants with short bowel syndrome (SBS) dependent on parenteral (PN) support. Read more about this study

Who is it for?
Ages 4 to 12 months
Conditions the study is for
Short Bowel Syndrome
What is being tested?
Teduglutide, Standard Medical Therapy and Syringe
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10 participants
Where
8 sitesin 4 countries
Study dates
31 Aug 2018to 24 Sep 2020
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 4 to 12 months
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Informed consent by the parent or legal guardian.
  • Male or female infant 4 to 12 months corrected gestational age at screening.
  • Weight at least 5 kilogram (kg) and weight-for-length Z-score greater than -2 at screening and baseline.
  • Short bowel syndrome with dependence on parenteral support to provide at least 50% of fluid or caloric needs.
  • Stable PN requirements for at least 1 month prior to screening, defined as a less than or equal to (<=) 10% change in the weight-normalized PN total fluid and caloric intake, despite attempts to wean PN, not withstanding transient instability for events such as sepsis or interruption of central venous access.
  • Parent or legal guardian understands and is willing and able to fully adhere to study requirements as defined in this protocol.

Who cannot join

  • Previous treatment with teduglutide.
  • Intestinal malabsorption due to a genetic condition, such as cystic fibrosis, microvillus inclusion disease, etc.
  • Severe, known dysmotility syndrome, such as pseudo-obstruction or persistent, severe, active gastroschisis-related dysmotility, that is the primary contributing factor to feeding intolerance and inability to reduce PN support, prior to screening. Dysmotility is defined as severe if it is expected to limit the advancement of enteral feeding.
  • Inability to advance oral or enteral feeding due to lack of access to the gut, such as oral aversion in the absence of a feeding tube.
  • Intestinal obstruction or clinically significant intestinal stenosis.
  • Major gastrointestinal surgical intervention, such as serial transverse enteroplasty or major intestinal resection or anastomosis, within 3 months prior to screening or planned during the study period.
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  • Unstable cardiac disease.
  • Renal dysfunction, defined as estimated glomerular filtration rate less than (<) 50 milliliter per minute (mL/min) per 1.73 square meter (m^2).
  • Biliary obstruction, stenosis, or malformation.
  • Clinically significant pancreatic disease.
  • Severe hepatic dysfunction or portal hypertension, defined by at least 2 of the following parameters:
  • International normalized ratio (INR) greater than (>) 1.5 not corrected with PN vitamin K
  • Platelet count <100×10^3/ microliter (mcL) due to portal hypertension
  • Presence of clinically significant gastric or esophageal varices
  • Documented cirrhosis
  • Persistent cholestasis defined as conjugated bilirubin >4 milligram per deciliter (mg/dL) (>68 micromoles per liter [mcmol/L]) over a 2 week period.
  • More than 3 serious complications of intestinal failure (example [e.g.], catheter-associated bloodstream infections, interruption of nutrition due to feeding intolerance, catheter-associated thrombosis, severe fluid or electrolyte disturbances) within 1 month prior to or during screening.
  • A history of cancer or a known cancer predisposition syndrome, such as juvenile polyposis or Beckwith-Wiedemann syndrome, or first degree relative with early onset of gastrointestinal cancer (including hepatobiliary and pancreatic cancers).
  • Concurrent treatment with glucagon-like peptide-1 (GLP-1); glucagon-like peptide-2 (GLP-2); insulin-like growth factor-1 (IGF-1); growth hormone, somatostatin, or analogs of these hormones; or glutamine.
  • Participation in a clinical study using an experimental drug within 3 months or 5.5 half-lives of the experimental drug, whichever is longer.
  • Known or suspected intolerance or hypersensitivity to the investigational product, closely-related compounds, or any of the stated ingredients.
  • Any condition, disease, illness, or circumstance that, in the investigator's opinion, puts the participant at any undue risk, prevents completion of the study, or interferes with analysis of the study results.

Trial locations and contacts

8 sites in 4 countries.

8 sites in 4 countries

United Kingdom4 sites
  • Birmingham Children's Hospital

    Birmingham, West Midlands, B4 6NH

  • Alder Hey Childrens Hospital

    Liverpool, Merseyside, L12 2AP

  • Great Ormond Street Hospital for Children

    London, Greater London, WC1N 3JH

  • Royal Manchester Children's Hospital

    Manchester, Greater Manchester, M13 9WL

Other trials in United Kingdom

France2 sites
  • Groupe Hospitalier Pellegrin - Hôpital des Enfants

    Bordeaux, Gironde, 33000

  • Hopital Jeanne de Flandre - CHRU Lille

    Lille, Nord, 59037

Other trials in France

Finland1 site
  • Helsingin yliopistollinen keskussairaala

    Helsinki, 00290

Other trials in Finland

Italy1 site
  • Ospedale Pediatrico Bambino Gesù

    Roma, 00165

Other trials in Italy

About this study

Official title: A Randomized, Open-label, 24-Week Safety, Efficacy, and Pharmacokinetic Study of Teduglutide in Infants 4 to 12 Months of Age With Short Bowel Syndrome Who Are Dependent on Parenteral Support

The purpose of the study is to evaluate the safety, efficacy/pharmacodynamics (PD) and pharmacokinetics (PK) of teduglutide treatment in infants with short bowel syndrome (SBS) dependent on parenteral (PN) support.

Being tested
Teduglutide, Standard Medical Therapy, Syringe, Needle
Keywords
Short bowel syndrome, Teduglutide
Medical subject headings
Short Bowel Syndrome

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TeduglutideDrug

    SC injection of 0.05 mg/kg teduglutide will be administered QD into abdomen or into either the thigh or arm for 24 weeks.

  • Standard Medical TherapyOther

    Standard medical therapy will be administered for 24 weeks.

  • SyringeDevice

    Teduglutide will be administered using syringe (510k number: K980987).

  • NeedleDevice

    Teduglutide will be administered using needle (510k number: K021475).

Study groups in NCT03571516
Study groupRoleWhat they receive
TeduglutideExperimentalParticipants will receive 0.05 milligram per kilogram (mg/kg) subcutaneous (SC) injection of teduglutide into abdomen or into either the thigh or arm once daily (QD) in addition to standard medical therapy for 24 weeks.
Receives: Drug: Teduglutide; Other: Standard Medical Therapy; Device: Syringe; Device: Needle
Standard of Care (SOC)OtherParticipants will receive standard medical therapy for 24 weeks.
Receives: Other: Standard Medical Therapy; Device: Syringe; Device: Needle

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Participants Who Achieved At Least 20 Percent (%) Reduction From Baseline in Weight-normalized Parenteral Support (PS) Volume at End of Treatment/Early Termination (EOT/ET)

    Number of participants who achieved at least 20% reduction from baseline in weight-normalized PS volume at EOT/ET (up to Week 24) were reported. EOT/ET was defined as the last available visit after the date of first dose (or randomization in standard of care treatment group) during the 24-week treatment period.

    Measured: Baseline, EOT/ET (up to Week 24)

Secondary outcomes (22)
  1. Plasma Concentration of Teduglutide at Nominal Time Points (Baseline at Pre-dose, and 1 Hour and 4 Hours Post-dose; 2 Hours Post-dose at Week 7)

    Mean plasma concentration of teduglutide was reported.

    Measured: Baseline: Pre-dose,1, 4 hours post-dose, and 2 hours post-dose at Week 7

  2. Number of Participants With Treatment-emergent Adverse Events (TEAEs)

    An adverse event (AE) was any untoward medical occurrence in a clinical investigation participant administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. TEAEs are defined as AEs that start or deteriorate on or after the date of the first dose of investigational product.

    Measured: From start of study treatment up to end of study (EOS) (up to Week 28)

  3. Change From Baseline in Body Weight Z-score at Week 24

    Body weight was measured using Z-score. Z-score was calculated as (observed value - median value of the reference population)/standard deviation value of reference population. A negative Z-score indicates values lower than the mean while a positive Z-score indicates values higher than the mean. Change from baseline in body weight Z-score at Week 24 was reported.

    Measured: Baseline, Week 24

  4. Change From Baseline in Length Z-Score at Week 24

    Length was measured using Z-score. Z-score was calculated as (observed value - median value of the reference population)/standard deviation value of reference population. A negative Z-score indicates values lower than the mean while a positive Z-score indicates values higher than the mean. Change from baseline in length Z-score at Week 24 was reported.

    Measured: Baseline, Week 24

  5. Change From Baseline in Head Circumference Z-Score at Week 24

    Head circumference was measured using Z-score. Z-score was calculated as (observed value - median value of the reference population)/standard deviation value of reference population. A negative Z-score indicates values lower than the mean while a positive Z-score indicates values higher than the mean. Change from baseline in head circumference Z-score at Week 24 was reported.

    Measured: Baseline, Week 24

  6. Change From Baseline in Weight-for-Length Z-Score at Week 24

    Weight-for-length was measured using Z-score. Z-score was calculated as (observed value - median value of the reference population)/standard deviation value of reference population. A negative Z-score indicates values lower than the mean while a positive Z-score indicates values higher than the mean. Change from baseline in weight-for-length Z-score at Week 24 was reported.

    Measured: Baseline, Week 24

  7. Change From Baseline in Average Total Urine Output at Week 24

    Average total urine output was recorded over a 48-hour period of nutritional stability at Week 24 was reported. Here, milliliter per kilogram per day is abbreviated as mL/kg/day.

    Measured: Baseline, Week 24

  8. Change From Baseline in Fecal Output at Week 24

    Change from baseline in the fecal output (average number of stools per day) at Week 24 was reported.

    Measured: Baseline, Week 24

  9. Number of Participants With Positive Specific Antibodies to Teduglutide

    Number of participants with positive specific antibodies to teduglutide were used to summarize the presence of antibodies.

    Measured: Baseline, EOS (up to week 28)

  10. Number of Participants Who Achieved At Least 20 Percent (%) Reduction From Baseline in Weight-normalized Parenteral Support (PS) Caloric Intake at End of Treatment/Early Termination (EOT/ET)

    Number of participants who achieved at least 20% reduction from baseline in weight-normalized PS caloric intake at EOT/ET (up to Week 24) were reported. EOT/ET was defined as the last available visit after the date of first dose (or randomization in standard of care treatment group) during the 24-week treatment period.

    Measured: Baseline, EOT/ET (up to Week 24)

  11. Number of Participants Who Achieved 100 Percent (%) Reduction in Complete Weaning Off (Enteral Autonomy) Parenteral Support (PS) Volume at Week 24

    Number of participants who achieved 100% reduction in complete weaning off (enteral autonomy) PS volume at Week 24 were reported.

    Measured: Week 24

  12. Number of Participants Who Achieved 100 Percent (%) Reduction in Complete Weaning Off (Enteral Autonomy) Parenteral Support (PS) Volume at End of Study (EOS)

    Number of participants who achieved 100% reduction in complete weaning off (enteral autonomy) PS volume at EOS (up to Week 28) were reported.

    Measured: EOS (up to Week 28)

  13. Change From Baseline in Weight-normalized Parenteral Support (PS) Volume at End of Treatment/Early Termination (EOT/ET)

    Change from baseline in weight-normalized PS volume at EOT/ET (up to Week 24) was reported. EOT/ET was defined as the last available visit after the date of first dose (or randomization in standard of care treatment group) during the 24-week treatment period.

    Measured: Baseline, EOT/ET (up to Week 24)

  14. Percent Change From Baseline in Weight-normalized Parenteral Support (PS) Volume at End of Treatment/Early Termination (EOT/ET)

    Percent change from baseline in weight-normalized PS volume at EOT/ET (up to Week 24) was reported. EOT/ET was defined as the last available visit after the date of first dose (or randomization in standard of care treatment group) during the 24-week treatment period.

    Measured: Baseline, EOT/ET (up to Week 24)

  15. Change From Baseline in Weight-normalized Parenteral Support (PS) Caloric Intake at End of Treatment/Early Termination (EOT/ET)

    Change from baseline in weight-normalized PS caloric intake at EOT/ET (up to Week 24) were reported. EOT/ET was defined as the last available visit after the date of first dose (or randomization in standard of care treatment group) during the 24-week treatment period. Here, kilo-calories per kilogram per day was abbreviated as (kcal/kg/day).

    Measured: Baseline, EOT/ET (up to Week 24)

  16. Percent Change From Baseline in Weight-normalized Parenteral Support (PS) Caloric Intake at End of Treatment/Early Termination (EOT/ET)

    Percent change from baseline in weight-normalized PS caloric intake at EOT/ET (up to Week 24) were reported. EOT/ET was defined as the last available visit after the date of first dose (or randomization in standard of care treatment group) during the 24-week treatment period.

    Measured: Baseline, EOT/ET (up to Week 24)

  17. Change From Baseline in Weight-normalized Enteral Nutrition (EN) Volume at End of Treatment/Early Termination (EOT/ET)

    Change from baseline in weight-normalized EN volume at EOT/ET (up to Week 24) was reported. EOT/ET was defined as the last available visit after the date of first dose (or randomization in standard of care treatment group) during the 24-week treatment period.

    Measured: Baseline, EOT/ET (up to Week 24)

  18. Percent Change From Baseline in Weight-normalized Enteral Nutrition (EN) Volume at End of Treatment/Early Termination (EOT/ET)

    Percent change from baseline in weight-normalized EN volume at EOT/ET (up to Week 24) was reported. EOT/ET was defined as the last available visit after the date of first dose (or randomization in standard of care treatment group) during the 24-week treatment period.

    Measured: Baseline, EOT/ET (up to Week 24)

  19. Change From Baseline in Weight-normalized Enteral Nutrition (EN) Caloric Intake at End of Treatment/Early Termination (EOT/ET)

    Change from baseline in weight-normalized EN caloric intake at EOT/ET (up to Week 24) were reported. EOT/ET was defined as the last available visit after the date of first dose (or randomization in standard of care treatment group) during the 24-week treatment period.

    Measured: Baseline, EOT/ET (up to Week 24)

  20. Percent Change From Baseline in Weight-normalized Enteral Nutrition (EN) Caloric Intake at End of Treatment/Early Termination (EOT/ET)

    Percent change from baseline in weight-normalized EN caloric intake at EOT/ET (up to Week 24) were reported. EOT/ET was defined as the last available visit after the date of first dose (or randomization in standard of care treatment group) during the 24-week treatment period.

    Measured: Baseline, EOT/ET (up to Week 24)

  21. Number of Participants Who Achieved At Least 20 Percent (%) Increase From Baseline in Weight-normalized Enteral Nutrition (EN) Volume at End of Treatment/Early Termination (EOT/ET)

    Number of participants who achieved at least 20% increase from baseline in weight-normalized EN volume at EOT/ET was reported. EOT/ET was defined as the last available visit after the date of first dose (or randomization in standard of care treatment group) during the 24-week treatment period.

    Measured: Baseline, EOT/ET (up to Week 24)

  22. Number of Participants Who Achieved At Least 20 Percent (%) Increase From Baseline in Weight-normalized Enteral Nutrition (EN) Caloric Intake at End of Treatment/Early Termination (EOT/ET)

    Number of participants who achieved at least 20% increase from baseline in weight-normalized EN caloric intake at EOT/ET was reported. EOT/ET was defined as the last available visit after the date of first dose (or randomization in standard of care treatment group) during the 24-week treatment period.

    Measured: Baseline, EOT/ET (up to Week 24)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Jun 2018
  2. Study start31 Aug 2018
  3. Primary completion24 Sep 2020
  4. Study completion24 Sep 2020

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
10 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03571516
Sponsor's protocol ID
SHP633-301
Other IDs
2017-003606-40, 2017
Status last verified
Apr 2021
First submitted
3 May 2018
Last updated
11 May 2021
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
Yes
Individual data sharing
No: De-identified individual participant data from this particular study will not be shared as there is a reasonable likelihood that individual patients could be re-identified (due to the limited number of study participants/study sites, …).

Publications

  • Chiba M, Masumoto K, Kaji T, Matsuura T, Morii M, Fagbemi A, Hill S, Pakarinen MP, Protheroe S, Urs A, Chen ST, Sakui S, Udagawa E, Wada M. Efficacy and Safety of Teduglutide in Infants and Children With Short Bowel Syndrome Dependent on Parenteral Support. J Pediatr Gastroenterol Nutr. 2023 Sep 1;77(3):339-346. doi: 10.1097/MPG.0000000000003867. Epub 2023 Jun 26.

    PubMed 37364133

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Teduglutide, Standard Medical Therapy and Syringe in people with Short Bowel Syndrome, run by Shire at 8 sites in 4 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 22 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 11 May 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 8 sites in United Kingdom, France, Finland, Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 8 Apr 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Participants Who Achieved At Least 20 Percent (%) Reduction From Baseline in Weight-normalized Parenteral Support (PS) Volume at End of Treatment/Early Termination (EOT/ET) (time frame: Baseline, EOT/ET (up to Week 24)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03571516, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 May 2021.

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