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LCI699

Phase 2

Cushings Disease | Small molecule | Endocrine |Novartis AG|Last Updated: Jul 6, 2021

Success Probability

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Market & Valuation

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Trial Design

CONTROLLED
Total Trials1
Total Enrollment31

FDA Designations

No designations recorded

Clinical trial landscape

LCI699 · 5 trials · 5 indications

Phase 2 5
NCT01331239Safety and Efficacy of LCI699 in Cushing's Disease PatientsCushings Disease
COMPLETED31 Analytics
NCT00817414A Study to Evaluate the Effects of LCI699 on Cortisol in Participants With HypertensionHypertension
COMPLETED63 Analytics
NCT00817635A Study to Evaluate the Efficacy and Safety of LCI699 Compared to Placebo in Participants With Resistant HypertensionHypertension
COMPLETED155 Analytics
NCT00758524A Study to Evaluate Efficacy and Safety of LCI699 in Participants With Essential HypertensionEssential Hypertension
COMPLETED628 Analytics
NCT00732771Proof-of-concept for the Aldosterone Synthase Inhibitor LCI699 in Patients With Primary HyperaldosteronismPrimary Hyperaldosteronism
COMPLETED12 Analytics
PHASE2COMPLETED
Safety and Efficacy of LCI699 in Cushing's Disease Patients
Cushings DiseaseUnlock trial analytics
PHASE2COMPLETED
A Study to Evaluate the Effects of LCI699 on Cortisol in Participants With Hypertension
HypertensionUnlock trial analytics
PHASE2COMPLETED
A Study to Evaluate the Efficacy and Safety of LCI699 Compared to Placebo in Participants With Resistant Hypertension
HypertensionUnlock trial analytics
PHASE2COMPLETED
A Study to Evaluate Efficacy and Safety of LCI699 in Participants With Essential Hypertension
Essential HypertensionUnlock trial analytics
PHASE2COMPLETED
Proof-of-concept for the Aldosterone Synthase Inhibitor LCI699 in Patients With Primary Hyperaldosteronism
Primary HyperaldosteronismUnlock trial analytics

Study Endpoints

Primary Endpoints

Percentage of Responders to LCI699 Based on the Change in Mean Urinary Free Cortisol (UFC) From Baseline to Week 10
10 weeks

A patient was considered to be a responder if his/her mean UFC level from the three 24-hour urine samples collected at Week 10 was ≤ Upper Limit of Normal (ULN), as defined by the local laboratories, or represented a ≥50% decrease from baseline. Patients who discontinued for a disease or treatment related reason (e.g. death, adverse event, clinical disease progression etc.), or whose mean Week 10 24-hour UFC levels were higher than the normal limit and experienced \<50% decrease in UFC were classified as non-responders.

Maximum Tolerated Dose (MTD) of LCI699 With Respect to Effect on the Adrenocorticotropic Hormone (ACTH)-Stimulated Cortisol Response Following ACTH Stimulation in Hypertensive Participants
Up to Week 6

As per the protocol, MTD is the dose at which 4 participants exhibited ACTH-stimulated cortisol results \<400 nanomoles per liter (nmol/L). The change in the distribution across the treatments were analyzed using 1- way analysis of variance (ANOVA) for continuous variables.

Change From Baseline in MSSBP at Week 8 Last Observation Carried Forward (LOCF)
Baseline, Week 8

Arterial blood pressure (BP) determinations were made after the participant was in the sitting position for 5 minutes according to the American Heart Association guidelines using a calibrated standard aneroid or mercury sphygmomanometer or a calibrated standard sphygmomanometer. The change in the MSSBP was calculated comparing the Week 8 readings to the readings taken at Baseline. The change from Baseline in MSSBP was analyzed using an analysis of covariance model (ANCOVA) with treatment and country as factors and Baseline MSSBP as a covariate.

Core Period: Change From Baseline in Mean Sitting Diastolic Blood Pressure (MSDBP) at Week 8 Last Observation Carried Forward (LOCF), as Measured by Office Blood Pressure (OBP)
Baseline, Week 8

Automated arterial BP determinations were made after the participant was in the sitting position for 5 minutes according to the Guidelines for management of hypertension: report of the 4th working party of the British Hypertension Society, 2004-BHS IV, using an automated BP device (such as the Omron BP monitor). The change in the MSDBP was calculated comparing the Week 8 readings to the readings taken at Baseline. The change from baseline in MSDBP was analyzed using an analysis of covariance model (ANCOVA) with treatment and region as factors and baseline MSDBP level as a covariate.

Systolic blood pressure over a 7-week forced titration treatment period
7 weeks

Secondary Endpoints

Actual Change From Baseline (BL) in Steroid Hormones of Hypothalamic-Pituitary-Adrenal (HPA)-Axis: 11- Deoxycorticosterone (Overall)
baseline, Week 22, Week 70, Last observed value (LOV), up to Month 88
Actual Change From Baseline (BL) in Steroid Hormones of HPA-axis: 11-Deoxycortisol (Overall)
baseline, Week 22, Week 70, Last observed value (LOV), up to Month 88
Actual Change From Baseline (BL) in Steroid Hormones of HPA-axis: Aldosterone, Thyroxine, Free (T4)
baseline, Week 22, Week 70, Last observed value (LOV), up to Month 88
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Study Design & Arms

AllocationNON_RANDOMIZED
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Part l: Core cohortEXPERIMENTALParticipants took an ascending dose of LCI699 (osilodrostat) from 2mg bid or 5 mg bid, up to 30 mg bid and participated in Part I of this study. 4 patients in this cohort moved to Part II of the study
Part II Core: Expansion cohortEXPERIMENTALParticipants took an ascending dose from 2mg bid or 5 mg bid, up to 30 mg bid and participated in the Part II Core Expansion of this study. These patients were all newly enrolled into the phase II part of the study
Part II Core: Follow-up cohortEXPERIMENTALParticipants took an ascending dose from 2mg bid or 5 mg bid, up to 30 mg bid and participated in the Part II Core Follow-up of this study. These patients were patients who transferred from Part I Core phase of the study
Cohort A: LCI699 0.5 mg QDEXPERIMENTALParticipants received LCI699 0.5 mg, capsules, orally, once daily (QD), with or without food for up to 6 weeks.
Cohort A: LCI699 1.0 mg QDEXPERIMENTALParticipants received LCI699 1.0 mg, capsules, orally, QD, with or without food for up to 6 weeks.
Cohort B1: LCI699 1.0 mg BIDEXPERIMENTALParticipants received LCI699 1.0 mg, capsules, orally, twice daily (BID), with or without food for up to 6 weeks.
Cohort B1: LCI699 2.0 mg QDEXPERIMENTALParticipants received LCI699 2.0 mg, capsules, orally, QD, with or without food for up to 6 weeks.
PlaceboPLACEBO_COMPARATORParticipants received LCI699-matching placebo, capsules, orally, QD or BID, with or without food for up to 6 weeks.
LCI699 0.25 mg BIDEXPERIMENTALFollowing a 2-week placebo run-in period, participants received LCI699 0.25 mg, capsules, orally, twice daily (BID), with or without food for up to 8 weeks.
LCI699 1 mg QDEXPERIMENTALFollowing a 2-week placebo run-in period, participants received LCI699 1 mg, capsules, orally, once daily (QD), with or without food for up to 8 weeks.
LCI699 0.5 mg followed by LCI699 1 mg BIDEXPERIMENTALFollowing a 2-week placebo run-in period, participants received LCI699 0.5 mg, capsules, orally, BID, with or without food for up to 4 weeks, followed by LCI699 1 mg, capsules, orally, BID with or without food for up to 4 weeks.
Eplerenone 50 mg BIDACTIVE_COMPARATORFollowing a 2-week placebo run-in period, participants received eplerenone 50 mg, capsules, orally, BID, with or without food for up to 8 weeks.
Core Period: LCI699 0.25 mg QDEXPERIMENTALParticipants received LCI699 0.25 mg capsules, orally, once daily (QD), with or without food for up to 8 weeks.
Core Period: LCI699 0.5 mg QDEXPERIMENTALParticipants received LCI699 0.5 mg capsules, orally, QD, with or without food for up to 8 weeks.
Core Period: LCI699 1.0 mg QDEXPERIMENTALParticipants received LCI699 1 mg capsules, orally, QD, with or without food for up to 8 weeks.
Core Period: LCI699 0.5 mg BIDEXPERIMENTALParticipants received LCI699 0.5 mg capsules, orally, twice daily (BID), with or without food for up to 8 weeks.
Core Period: Eplerenone 50 mg BIDACTIVE_COMPARATORParticipants received eplerenone 50 mg capsules, orally, BID, with or without food for up to 8 weeks.
Core Period: PlaceboPLACEBO_COMPARATORParticipants received LCI699-matching placebo or eplerenone-matching placebo, capsules, orally, QD or BID, with or without food for up to 8 weeks.
Withdrawal Period: LCI699 0.25 mg QDEXPERIMENTALParticipants received LCI699 0.25 mg capsules, orally, QD, with or without food for up to 1 week (Week 8 to Week 9).
Withdrawal Period: LCI699 0.25 mg QD PlaceboPLACEBO_COMPARATORParticipants received LCI699 matching placebo capsules, orally, QD, with or without food for up to 1 week (Week 8 to Week 9).
Withdrawal Period: LCI699 0.5 mg QDEXPERIMENTALParticipants received LCI699 0.5 mg capsules, orally, QD, with or without food for up to 1 week (Week 8 to Week 9).
Withdrawal Period: LCI699 0.5 mg QD PlaceboPLACEBO_COMPARATORParticipants received LCI699 matching placebo capsules, orally, QD, with or without food for up to 1 week (Week 8 to Week 9).
Withdrawal Period: LCI699 1.0 mg QDEXPERIMENTALParticipants received LCI699 1 mg capsules, orally, QD, with or without food for up to 1 week (Week 8 to Week 9).
Withdrawal Period: LCI699 1.0 mg QD PlaceboPLACEBO_COMPARATORParticipants received LCI699 matching placebo capsules, orally, QD, with or without food for up to 1 week (Week 8 to Week 9).
Withdrawal Period: LCI699 0.5 mg BIDEXPERIMENTALParticipants received LCI699 0.5 mg capsules, orally, BID, with or without food for up to 1 week (Week 8 to Week 9).
Withdrawal Period: LCI699 0.5 mg BID PlaceboPLACEBO_COMPARATORParticipants received LCI699 matching placebo capsules, orally, BID, with or without food for up to 1 week (Week 8 to Week 9).
Withdrawal Period: Eplerenone 50 mg BIDACTIVE_COMPARATORParticipants received eplerenone 50 mg capsules, orally, BID, with or without food for up to 1 week (Week 8 to Week 9).
Withdrawal Period: Eplerenone 50 mg BID PlaceboPLACEBO_COMPARATORParticipants received eplerenone matching placebo capsules, orally, BID, with or without food for up to 1 week (Week 8 to Week 9).
Withdrawal Period: PlaceboPLACEBO_COMPARATORParticipants received LCI699-matching placebo or eplerenone-matching placebo, capsules, orally, QD or BID, with or without food for up to 1 week (Week 8 to Week 9).
LCI696 1mg bidEXPERIMENTAL -

Interventions

NameTypeDescription
LCI699DRUGOsilodrostat 1 mg and 5 mg capsules, was prepared by Novartis and supplied to the Investigator. The capsule formulation of osilodrostat was later changed to tablets and this change was implemented in the study with Protocol amendment 6. Osilodrostat was open labeled 1 mg, 5 mg, 10 mg and 20 mg tablets.
LCI699-matching placeboDRUGLCI699-matching placebo oral capsules
EplerenoneDRUGEplerenone oral capsules
Eplerenone-matching PlaceboDRUGEplerenone-matching placebo oral capsules
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Eligibility Criteria

Age Range18 Years to 75 Years
SexALL
Healthy VolunteersNo
Study Sites10

Inclusion Criteria: * Patients with a confirmed diagnosis of Cushing's Disease (persistent or recurrent) as evidenced by increased 24-hour urine free cortisol (UFC), normal or increased morning plasma Adrenocorticotropic Hormone (ACTH), and pituitary origin of excess ACTH. * Patients with de novo C...

Countries:United StatesFranceItalyJapanIceland
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Frequently asked questions about LCI699

What is LCI699 used for?

LCI699 is an investigational small molecule being studied for Cushing's Disease, Essential Hypertension, Primary Hyperaldosteronism, and Hypertension. It is in Phase 2 clinical development and is not approved for any use.

What does LCI699 target?

LCI699 is an aldosterone synthase inhibitor. It works by inhibiting the enzyme aldosterone synthase, which is involved in the production of aldosterone, a hormone that regulates blood pressure and fluid balance.

Who makes LCI699?

LCI699 is being developed by Novartis AG, a multinational pharmaceutical company. Novartis is listed on the stock exchange under the ticker symbol NVS.

What phase is LCI699 in?

LCI699 is in Phase 2 clinical development. It has completed four Phase 2 trials, and all trials are completed. It is not FDA approved and remains an investigational drug.

What clinical trials is LCI699 in?

LCI699 has completed four Phase 2 trials. These include NCT00732771 in Primary Hyperaldosteronism, NCT00817414 and NCT00817635 in Hypertension, and NCT01331239 in Cushing's Disease. All trials are completed.

Is LCI699 the same as osilodrostat?

LCI699 is also known as osilodrostat. It is the same compound, and both names refer to the drug being developed by Novartis for endocrine conditions.