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MNTX

Phase 4

Bowel Dysfunction | Small molecule | Gastrointestinal |Bausch Health Companies Inc.|Trials Updated: Aug 20, 2020

MNTX development status

Highest phase Phase 4 (NCT00858754)
Phase scored for BHCPhase 2
Registered trials 21 across 1 sponsor since Apr 2006

MNTX target and mechanism

ModalitySmall molecule

Also known as MNTX tablet (Formulation 1), SC MNTX, Methylnaltrexone, MOA-728

Success Probability

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Market & Valuation

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Trial Design

RandomizedCONTROLLED
Total Trials20
Total Enrollment3,447

FDA Designations

No designations recorded

MNTX clinical trials

MNTX · 20 trials · 16 indications

Phase 3 9Phase 2 4Phase 1 7
NCT01186770A Study of Oral Methylnaltrexone (MNTX) for the Treatment of Opioid-Induced Constipation (OIC) in Participants With Chronic, Non-Malignant PainOpioid-Induced Constipation
COMPLETED804 Analytics
NCT00936884Study Evaluating the Efficacy and Safety of Subcutaneous Methylnaltrexone (MOA-728) for the Treatment of Opioid-Induced-ConstipationConstipation
COMPLETED50 Analytics
NCT00528970A Study Evaluating Intravenous (IV) MOA-728 for the Treatment of Postoperative Ileus (POI) in Participants After Ventral Hernia RepairIleus
COMPLETED374 Analytics
NCT00387309Study Evaluating IV Methylnaltrexone for the Treatment of Post Operative IleusPost Operative Bowel Dysfunction
COMPLETED495 Analytics
NCT00401375Study of Intravenous (IV) Methylnaltrexone Bromide (MNTX) in the Treatment of Post-Operative Ileus (POI)Post-Operative Ileus (POI)
COMPLETED524 Analytics
NCT01367613Open-Label Treatment Extension of Protocol MNTX 302Terminal Illness
COMPLETED89 Analytics
NCT00402038Study of Methylnaltrexone (MNTX) for the Relief of ConstipationAdvance Illness Patients With OIC
COMPLETED134 Analytics
NCT00401362A a Single Dose Efficacy Study in Inducing Laxation in Advance Illness PatientsAdvanced Illness Patients With Opioid Induced Constipation
COMPLETED154 Analytics
NCT01367600Open-Label Treatment Extension of Protocol MNTX 301Terminal Illness
COMPLETED27 Analytics
PHASE3COMPLETED
A Study of Oral Methylnaltrexone (MNTX) for the Treatment of Opioid-Induced Constipation (OIC) in Participants With Chronic, Non-Malignant Pain
Opioid-Induced ConstipationUnlock trial analytics
PHASE3COMPLETED
Study Evaluating the Efficacy and Safety of Subcutaneous Methylnaltrexone (MOA-728) for the Treatment of Opioid-Induced-Constipation
ConstipationUnlock trial analytics
PHASE3COMPLETED
A Study Evaluating Intravenous (IV) MOA-728 for the Treatment of Postoperative Ileus (POI) in Participants After Ventral Hernia Repair
IleusUnlock trial analytics
PHASE3COMPLETED
Study Evaluating IV Methylnaltrexone for the Treatment of Post Operative Ileus
Post Operative Bowel DysfunctionUnlock trial analytics
PHASE3COMPLETED
Study of Intravenous (IV) Methylnaltrexone Bromide (MNTX) in the Treatment of Post-Operative Ileus (POI)
Post-Operative Ileus (POI)Unlock trial analytics
PHASE3COMPLETED
Open-Label Treatment Extension of Protocol MNTX 302
Terminal IllnessUnlock trial analytics
PHASE3COMPLETED
Study of Methylnaltrexone (MNTX) for the Relief of Constipation
Advance Illness Patients With OICUnlock trial analytics
PHASE3COMPLETED
A a Single Dose Efficacy Study in Inducing Laxation in Advance Illness Patients
Advanced Illness Patients With Opioid Induced ConstipationUnlock trial analytics
PHASE3COMPLETED
Open-Label Treatment Extension of Protocol MNTX 301
Terminal IllnessUnlock trial analytics

Study Endpoints

Primary Endpoints

Average Percentage of Dosing Days That Resulted in Rescue-Free Bowel Movements (RFBMs) Within 4 Hours of Dosing During Weeks 1 to 4
Weeks 1 to 4

RFBM was defined as a bowel movement without laxative use within 24 hours prior to bowel movement.

The Proportion of Subjects Having a Rescue-free Bowel Movement (RFBM) Within 4 Hours After the First Injection.
Up to 4 hours after the first injection

There were 2 co-primary endpoints for this study. This measurement is the first of the 2 co-primary endpoints. This endpoint measures the percentage of patients who had an RFBM within 4 hours after the first dose of test article during the double-blind period; data are expressed as percentages of patients for the MNTX and placebo groups. To qualify as rescue free, the bowel movement could not occur within 6 hours after a rectal intervention (ie, rectal suppository, enema, manual disimpaction). Note that efficacy results (primary and secondary outcomes) are presented for the double-blind period only. Therefore, no efficacy results are presented for the open-label period.

The Proportion of Subjects Having a Rescue-free Bowel Movement (RFBM) Within 4 Hours After Each Dose During Double-blind Period.
Within 4 Hours After Each Dose During the 2 weeks Double-Blind Period

This measurement is the second of the 2 co-primary endpoints. This endpoint measures the percentage of patients who had an RFBM within 4 hours after each dose of test article during the double-blind period; data are expressed as percentages of patients by dose (first, second, third, fourth, etc.) for the MNTX and placebo groups. The definition of RFBM is described above (see first co-primary endpoint).

Time to First Bowel Movement
Day 1 (From the time of end of surgery [that is; from the first dose of study drug administration]) up to Day 10

Time to first bowel movement was measured from the end of surgery (defined as the time when the last skin suture or staple was placed in the participant). Time of the first bowel movement was recorded on the electronic case report form (eCRF). The first bowel movement was defined as a normal stool for a postoperative participant based on the clinical judgment of the investigator or designee. Analysis was performed by Kaplan-Meier estimate. Participants who had a bowel movement but were readmitted to the hospital within 1 week after discharge with a diagnosis of postoperative ileus (POI) were considered censored at the time of the first bowel movement as if the bowel movement had not occurred.

Primary Objective: In subjects who have undergone segmental colectomy, the time between the end of surgery and first bowel movement is significantly shorter with the MOA-728 regimen than with a placebo regimen.
Number of patients with adverse events
3 months

To provide access to treatment with MNTX, administered SC, to patients who completed Progenics' Protocol MNTX 302

Laxation within four hours of a single dose of SC MNTX and efficacy of SC MNTX every other day over a 1 week period.
2 weeks

To determine the efficacy of a single dose of SC MNTX compared with placebo in inducing laxation within 4 hours. To determine the efficacy of SC MNTX every other day over a 1-week treatment period in relieving OIC in patients with AMI.

Efficacy of SC MNTX compared with placebo in inducing laxation
29 days

The primary objective is to determine the efficacy of SC MNTX administered as a single dose, dose 1 and dose 2 compared with placebo in inducing laxation in 4 hours in patients with advanced medical illness and OIC who are poorly responsive to laxatives.

Percentage of Participants Witn Spontaneous Bowel Movements Within 3 Hours of Treatment
3 hours
The effect of the interventional treatment will be measured by the change from baseline in the number of bowel movements per week during the double-blind treatment period.
Time to tolerance of liquids
7 days

To assess the activity of parenterally administered MNTX compared with placebo in shortening the duration of or preventing post-operative ileus in patients who have undergone segmental colectomies.

Number of subjects who have a bowel movement within four hours of dosing
Up to 4 weeks

To access the efficacy of various fixed unit doses of MNTX SC in patients with advanced medical illnesses and poorly controlled opioid-induced constipation.

It is not known if the activity of MOA-728 is related to the peak concentration or the overall exposure (AUC). This study is designed to evaluate the PK and PD effect of MOA-728 administered either as a 20-minute or 4-hour infusion.
Pharmacokinetics
Pharmacokinetics and Pharmacodynamics
Oral-cecal transit time will be evaluated.
Safety
Peak Plasma Concentration (Cmax) of MNTX in patients with impaired renal function compared to healthy subjects
6 days

To compare the PK of MNTX administered subcutaneously as a single dose in patients with impaired renal function with the PK of MNTX administered to healthy subjects.

Plasma Concentration of SC MNTX
20 days

To evaluate the pharmacokinetics of MNTX administered subcutaneously as a single dose in individuals with impaired liver and hepatic function compared to healthy controls.

Secondary Endpoints

Percentage of Participants Who Responded (Responder) to Study Drug During Weeks 1 to 4
Weeks 1 to 4
Change in Weekly Number of RFBMs From Baseline Over the Entire First 4 Weeks (28 Days) of Dosing
Baseline, Weeks 1 to 4
Percentage of Injections Resulting in RFBM Within 4 Hours After Test Article Administration.
Within 4 Hours After Each Dose During the 2 weeks Double-Blind Period
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Study Design & Arms

AllocationRANDOMIZED
MaskingQUADRUPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
MNTX 150 mgEXPERIMENTALParticipants will receive methylnaltrexone (MNTX) 150 milligrams (mg) (1 tablet of MNTX 150 mg and 2 matching placebo tablets) orally once daily (QD) for 28 days (4 weeks), then MNTX tablets at a dose as needed (PRN) for remaining 56 days (8 weeks).
MNTX 300 mgEXPERIMENTALParticipants will receive MNTX 300 mg (2 tablets of MNTX 150 mg each and 1 matching placebo tablet) orally QD for 28 days (4 weeks), then MNTX tablets at a dose PRN for remaining 56 days (8 weeks).
MNTX 450 mgEXPERIMENTALParticipants will receive MNTX 450 mg (3 tablets of MNTX 150 mg each) orally QD for 28 days (4 weeks), then MNTX tablets at a dose PRN for remaining 56 days (8 weeks).
PlaceboPLACEBO_COMPARATORParticipants will receive 3 tablets of placebo matched to MNTX orally QD for 84 days (12 weeks).
Methylnaltrexone double-blindEXPERIMENTALMethylnaltrexone once every other day.
Methylnaltrexone open-labelOTHERSubjects who completed the double-blind period had the option to receive methylnaltrexone once every other day during a 12-week, open-label extension period.
MOA-728 12 mgEXPERIMENTALParticipants will receive methylnaltrexone (MOA-728) 12 mg as an IV infusion over approximately 20 minutes for approximately every 6 hours for a total of 4 doses in 24-hour period. The first dose of study drug will be administered within approximately 90 minutes after completion of the surgical procedure (defined as the time when the last skin suture or staple is placed in the participant). Dose administration will be continued for a maximum of 10 days.
MOA-728 24 mgEXPERIMENTALParticipants will receive MOA-728 24 mg as an IV infusion over approximately 20 minutes for approximately every 6 hours for a total of 4 doses in 24-hour period. The first dose of study drug will be administered within approximately 90 minutes after completion of the surgical procedure (defined as the time when the last skin suture or staple is placed in the participant). Dose administration will be continued for a maximum of 10 days.
MNTX 12 mgEXPERIMENTALParticipants will receive methylnaltrexone (MNTX) 12 milligrams (mg) as an intravenous (IV) infusion over approximately 20 minutes for every 6 hours until one of the following occurs: 1) 24 hours elapsed after the first bowel movement and the participant was tolerating clear liquids, 2) the participant was discharged from the hospital, or 3) a maximum of 10 days elapsed. The first dose of study drug will be administered within the first 90 minutes after the end of surgery (defined as the time when the last skin suture or staple is placed in the participant).
MNTX 24 mgEXPERIMENTALParticipants will receive MNTX 24 mg as an IV infusion over approximately 20 minutes for every 6 hours until one of the following occurs: 1) 24 hours elapsed after the first bowel movement and the participant was tolerating clear liquids, 2) the participant was discharged from the hospital, or 3) a maximum of 10 days elapsed. The first dose of study drug will be administered within the first 90 minutes after the end of surgery (defined as the time when the last skin suture or staple is placed in the participant).
Arm 1EXPERIMENTAL -
Arm 2PLACEBO_COMPARATOR -
Arm 3PLACEBO_COMPARATOR -
150 mgEXPERIMENTALMOA-728
300 mgEXPERIMENTALMOA-728
450 mgEXPERIMENTALMOA-728
600 mgEXPERIMENTALMOA-728

Interventions

NameTypeDescription
MethylnaltrexoneDRUGMethylnaltrexone will be administered as per the dose and schedule specified in the respective arms.
PlaceboDRUGPlacebo matching to methylnaltrexone will be administered as per the schedule specified in the respective arms.
MOA-728DRUGMOA-728 will be administered per the dose and schedule specified in the arm.
Methylnaltrexone (MOA-728)DRUG -
SC MethylnaltrexoneDRUG -
SC PlaceboDRUG -
SC Methylnaltrexone (MNTX)DRUG -
IV Methylnaltrexone (MNTX)DRUG -
SC MNTXDRUGDose 1
Methylnaltrexone (MNTX)DRUG -
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites2

Key Inclusion Criteria: 1. History of chronic non-malignant pain (originating from a non-malignant source) with condition(s) underlying the chronic pain of greater than or equal to (≥) 2 months' duration before the screening visit. 2. Taking oral, transdermal, intravenous (IV), or subcutaneous (SC)...

Countries:United StatesSouth KoreaTaiwanAustraliaBelgiumCanadaGermanyHungaryItalyNetherlandsPolandSouth AfricaRomaniaSerbia and Montenegro
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Frequently asked questions about MNTX

What is MNTX used for?

MNTX is being developed for bowel dysfunction, specifically opioid-induced bowel dysfunction. It is a small molecule therapeutic candidate studied in adults aged 18 years and older. Development is at Phase 2, and the program is led by Bausch Health Companies Inc. under the ticker BHC.

Who makes MNTX?

MNTX is developed by Bausch Health Companies Inc., which trades under the ticker BHC. The company is the sponsor behind the clinical program evaluating MNTX in bowel dysfunction, including the Phase 2 study conducted in the United States.

What phase is MNTX in?

MNTX is in Phase 2 clinical development for bowel dysfunction. It is an investigational small molecule and has not been approved by the FDA for this use. One Phase 2 trial has been completed, and no active trials are currently listed for the program.

What clinical trials is MNTX in?

MNTX has been studied in one completed Phase 2 trial, NCT01367574, titled Methylnaltrexone in Patients With Opioid-Induced Bowel Dysfunction. The randomized, controlled study enrolled 39 adults aged 18 years and older in the United States and included both sexes.

Is MNTX the same as MNTX tablet (Formulation 1) or SC MNTX?

Yes. MNTX is also known as MNTX tablet (Formulation 1) and SC MNTX. These names refer to the same investigational small molecule being developed by Bausch Health Companies Inc. for bowel dysfunction, including opioid-induced bowel dysfunction.