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Lumacaftor

Phase 3

Cystic Fibrosis | Small molecule | Respiratory |Vertex Pharmaceuticals Incorporated|Last Updated: Dec 6, 2017

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedDouble-BlindCONTROLLEDDMCBiomarker
Total Trials6
Total Enrollment728
FDA Designations
No designations recorded
Clinical Trials (6)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT02390219Study to Evaluate Lumacaftor and Ivacaftor Combination Therapy in Subjects 12 Years and Older With Advanced Lung DiseasePHASE3 COMPLETED 46Mar 1, 2015Oct 1, 2016Dec 6, 20176 United States
NCT01897233Study of Lumacaftor in Combination With Ivacaftor in Subjects 6 Through 11 Years of Age With Cystic Fibrosis, Homozygous for the F508del-CFTR MutationPHASE3 COMPLETED 62Jul 1, 2013Oct 1, 2015Jun 20, 201720 United States, Canada
NCT01225211Study of VX-809 Alone and in Combination With VX-770 in Cystic Fibrosis (CF) Patients Homozygous or Heterozygous for the F508del-CFTR MutationPHASE2 COMPLETED 312Oct 1, 2010Apr 1, 2014Oct 5, 201555 United States, Australia +5
NCT01899105A Phase 1 Study to Investigate the Food Effect of Lumacaftor in Combination With IvacaftorPHASE1 COMPLETED 28Jul 1, 2013Aug 1, 2013Apr 3, 20141 United States
NCT01910415Phase 1, QT/QTC Interval Study in Healthy SubjectsPHASE1 COMPLETED 200Jun 1, 2013Mar 1, 2014Aug 11, 20141 Netherlands
NCT01768663A Phase 1 Study to Examine the Drug-Drug Interaction of Ciprofloxacin, Itraconazole, and Rifampin on the Combination of Lumacaftor With Ivacaftor in Healthy Adult SubjectsPHASE1 COMPLETED 80Jan 1, 2013 -Nov 15, 20131 United States
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Study Endpoints
Primary Endpoints
Number of Participants With Treatment Emergent Adverse Events (AEs) or Serious Adverse Events (SAEs)
Day 1 up to Week 28

AE: any untoward medical occurrence in a participant during the study; event does not necessarily have a causal relationship with treatment. This includes any newly occurring event/previous condition that has increased in severity/frequency after informed consent form is signed. AE includes serious as well as non-serious AEs. SAE (subset of AE): medical event, which falls into any of the following categories, regardless of its relationship to study drug: death, life threatening adverse experience, in-patient hospitalization/prolongation of hospitalization, persistent/significant disability or incapacity, congenital anomaly/birth defect, important medical event. TEAEs: AEs that started/ worsened on/after the start of study drug through the Safety Follow up Visit (4 weeks after the last dose of study drug). Results were reported as planned, as a combined single LUM/IVA arm irrespective of permitted dose modification.

Part A: Observed Plasma Concentration of Lumacaftor (LUM) and Ivacaftor (IVA) at Hour 4 Post-dose (C4h) on Day 1
4 hours post-morning dose on Day 1
Part A: Observed Plasma Concentration of Lumacaftor (LUM) and Ivacaftor (IVA) at Hour 4 Post-dose (C4h) on Day 14
4 hours post-morning dose on Day 14
Part A: Area Under the Plasma Concentration-Time Curve From Time 0 to End of Dosing Interval (AUCtau) of Lumacaftor (LUM) and Ivacaftor (IVA)
Day 14 (pre-morning dose, 4, 6, 12, and 24 hours post-morning dose for LUM; pre-morning dose, 2, 4, 6, 12 hours post-morning dose for IVA)

The AUCtau is the area under the concentration versus time curve from time 0 to time tau, where tau is the time at the end of dosing interval.

Part B: Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)
Day 1 up to Week 26

AE: any untoward medical occurrence in a participant during the study; the event does not necessarily have a causal relationship with the treatment. This includes any newly occurring event or previous condition that has increased in severity or frequency after the informed consent form is signed. AE includes serious as well as non-serious AEs. SAE (subset of AE): medical event or condition, which falls into any of the following categories, regardless of its relationship to the study drug: death, life threatening adverse experience, inpatient hospitalization/prolongation of hospitalization, persistent/significant disability or incapacity, congenital anomaly/birth defect, important medical event. AEs with start date or increased severity on or after the first study drug dose to Week 26 were considered treatment-emergent.

Cohort 1: Safety and Tolerability Based on Adverse Events (AEs)
Cohort 1: Day 1 up to 28 days after last dose (Last dose = Day 21)

AE: any untoward medical occurrence in a participant during study; irrespective of relationship with treatment. This includes any newly occurring event or previous condition that has increased in severity or frequency after informed consent. AE includes serious AEs (SAEs) as well as Non-SAEs. SAE (subset of AE): medical event or condition, which falls into any of the following categories, regardless of its relationship to study drug: death, life threatening adverse experience, in-patient hospitalization/prolongation of hospitalization, persistent/significant disability or incapacity, congenital anomaly/birth defect, important medical event. Number of participants with AEs and SAEs are reported. AE that started at/after initial dosing of study drug, or increased in severity after initial dosing of study drug is considered treatment-emergent. Results are reported separately for monotherapy period (Period 1: Day 1 to Day 14) and combination therapy period (Period 2: Day 15 to Day 21).

Cohort 2 and 3: Safety and Tolerability Based on Adverse Events (AEs)
Cohort 2 and 3: Day 1 up to 28 days after last dose (Last dose = Day 56)

Detailed description is provided in Outcome Measure 1. Results are reported separately for monotherapy period (Period 1: Day 1 to Day 28) and combination therapy period (Period 2: Day 29 to Day 56).

Cohort 4: Safety and Tolerability Assessed by Number of Participants With AEs and SAEs
Cohort 4: Day 1 up to 28 days after last dose (Last dose = Day 56)

AEs and SAEs are defined in Outcome Measure 1.

Cohort 1: Absolute Change From Day 14 in Sweat Chloride at Day 21
Cohort 1: Day 14, Day 21
Cohort 2 And 3: Absolute Change From Day 28 in Sweat Chloride at Day 56
Cohort 2 and 3: Day 28, Day 56
Cohort 4: Absolute Change From Baseline in Percent Predicted Forced Expiratory Volume in 1 Second (ppFEV1) at Day 56
Cohort 4: Baseline, Day 56

FEV1 is the volume of air that can forcibly be blown out in one second, after full inspiration. ppFEV1 (predicted for age, gender, and height) was calculated using the Hankinson method.

Pharmacokinetic parameters of lumacaftor and ivacaftor, including Cmax, AUC0-tlast, and AUC0-∞
up to 5 days
(Part A) Safety and tolerability of lumacaftor as measured by standard 12-lead ECGs, adverse events (AEs), vital signs, spirometry, and clinically significant laboratory assessments
7 days
(Part B) Time matched, baseline-adjusted change in QTcF intervals obtained from a continuous ECG recording over a 24 hour interval after administration of a therapeutic and supratherapeutic dose of lumacaftor in combination with ivacaftor
7 days
Cohorts 1-3: PK parameters including Cmax, and AUC from time of dosing to time tau of lumacaftor and ivacaftor in the absence and presence of ciprofloxacin, itraconazole, and rifampin
up to 24 days
Cohort 4: Change in lung function from before treatment with lumacaftor/ivacaftor to after treatment with lumacaftor/ivacaftor.
up to 21 days
Secondary Endpoints
Absolute Change From Baseline in Percent Predicted Forced Expiratory Volume in 1 Second (FEV1) Up to Week 24
Baseline, Up to Week 24
Absolute Change From Baseline in Forced Expiratory Volume in 1 Second (FEV1) Up to Week 24
Baseline, Up to Week 24
Duration For Which Participants Received Intravenous (IV) Antibiotics
Baseline through Week 24
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Study Design & Arms
AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
Lumacaftor/Ivacaftor combinationEXPERIMENTALLumacaftor 400 milligram (mg) and ivacaftor 250 mg combination tablet orally twice daily for 24 weeks.
Lumacaftor/Ivacaftor (LUM/IVA)EXPERIMENTALPart A Cohort 1: Participants aged 6 through 8 years will receive LUM 200 milligram (mg) in fixed-dose combination with IVA 250 mg orally every 12 hours (q12h) for 14 days. Part A Cohort 2: Participants aged 9 through 11 years will receive LUM 200 mg in fixed-dose combination with IVA 250 mg orally q12h for 14 days. Part B: Participants aged 6 through 11 years will receive LUM 200 mg in fixed-dose combination with IVA 250 mg orally q12h for 24 weeks.
Cohort 1: PlaceboPLACEBO_COMPARATORParticipants homozygous (HO) for the F508del-CF transmembrane conductance regulator gene (CFTR) mutation received lumacaftor matched placebo once daily (qd) (Day 1 through Day 14), followed by lumacaftor matched placebo qd in combination with ivacaftor matched placebo every 12 hours (q12h) (Day 15 through Day 21).
Cohort 1: LUM 200 mg qd/LUM 200 mg qd+IVA 150 mg q12hEXPERIMENTALParticipants homozygous for the F508del-CFTR mutation received 200 milligram (mg) of lumacaftor (LUM) qd (Day 1 through Day 14), followed by 200 mg of lumacaftor qd in combination with 150 mg of ivacaftor (IVA) q12h (Day 15 through Day 21).
Cohort 1: LUM 200 mg qd/LUM 200 mg qd+IVA 250 mg q12hEXPERIMENTALParticipants homozygous for the F508del-CFTR mutation received 200 mg of lumacaftor alone qd (Day 1 through Day 14), followed by 200 mg of lumacaftor qd in combination with 250 mg of ivacaftor q12h (Day 15 through Day 21).
Cohort 2 and 3: Placebo (HO and HE)PLACEBO_COMPARATORParticipants homozygous or heterozygous for the F508del-CFTR mutation received lumacaftor matched placebo qd (Day 1 through Day 28), followed by lumacaftor matched placebo in combination with ivacaftor matched placebo q12h (Day 29 through Day 56).
Cohort 2: LUM 200 mg qd/LUM 200 mg qd+IVA 250 mg q12h (HO)EXPERIMENTALParticipants homozygous for the F508del-CFTR mutation received 200 mg of lumacaftor alone qd (Day 1 through Day 28), followed by 200 mg of lumacaftor qd in combination with 250 mg of ivacaftor q12h (Day 29 through Day 56).
Cohort 2: LUM 400 mg qd/LUM 400 mg qd+IVA 250 mg q12h (HO)EXPERIMENTALParticipants homozygous for the F508del-CFTR mutation received 400 mg of lumacaftor alone qd (Day 1 through Day 28), followed by 400 mg of lumacaftor qd in combination with 250 mg of ivacaftor q12h (Day 29 through Day 56).
Cohort 2: LUM 600 mg qd/LUM 600 mg qd+IVA 250 mg q12h (HO&HE)EXPERIMENTALParticipants homozygous or heterozygous for the F508del-CFTR mutation received 600 mg of lumacaftor alone qd (Day 1 through Day 28), followed by 600 mg of lumacaftor qd in combination with 250 mg of ivacaftor q12h (Day 29 through Day 56).
Cohort 3: LUM 400 mg q12h/LUM 400 mg q12h+IVA 250 mg q12h (HO)EXPERIMENTALParticipants homozygous for the F508del-CFTR mutation received 400 mg of lumacaftor alone q12h (Day 1 through Day 28), followed by 400 mg of lumacaftor q12h in combination with 250 mg of ivacaftor q12h (Day 29 through Day 56).
Cohort 4: PlaceboPLACEBO_COMPARATORParticipants heterozygous for the F508del-CFTR mutation received lumacaftor matched placebo in combination with ivacaftor matched placebo q12h (Day 1 through Day 56).
Cohort 4: LUM 400 mg q12h+IVA 250 mg q12hEXPERIMENTALParticipants heterozygous for the F508del-CFTR mutation received 400 mg of lumacaftor q12h in combination with 250 mg of ivacaftor q12h (Day 1 through Day 56).
Part AEXPERIMENTALA single dose of 2 fixed-dose combination tablets of 200mg lumacaftor/125mg ivacaftor (total of 400mg lumacaftor/250mg ivacaftor) in the fed state and fasted state with a 14 day washout period in between each dosing occasion
Part BEXPERIMENTALA single dose of 3 fixed-dose combination tablets of 200mg lumacaftor/83mg ivacaftor (total of 600mg lumacaftor and 250mg ivacaftor) in the fed with a 14 day washout period in between dosing occasions
Treatment Group (Cohort 1)EXPERIMENTALSubjects will take lumacaftor in combination with ivacaftor for 14 days. Beginning on Day 15, subjects will take lumacaftor in combination with ivacaftor and ciprofloxacin through Day 21.
Treatment Group (Cohort 2)EXPERIMENTALSubjects will take lumacaftor in combination with ivacaftor for 14 days. Beginning on Day 15, subjects will take lumacaftor in combination with ivacaftor and itraconazole through Day 21.
Treatment Group (Cohort 3)EXPERIMENTALSubjects will take lumacaftor in combination with ivacaftor for 14 days. Beginning on Day 15, subjects will take lumacaftor in combination with ivacaftor and rifampin through Day 24.
Treatment Group (Cohort 4)EXPERIMENTALSubjects will take a single dose of lumacaftor in combination with ivacaftor on 3 occasions separated by 7 days.
Interventions
NameTypeDescription
LumacaftorDRUG -
IvacaftorDRUG -
Lumacaftor PlaceboDRUGMatching placebo tablet.
Ivacaftor PlaceboDRUGMatching placebo tablet.
moxifloxacin hydrochlorideDRUG -
CiprofloxacinDRUG750 mg taken every 12 hours
ItraconazoleDRUG200mg taken once daily
RifampinDRUG600mg taken once daily
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Eligibility Criteria
Age Range12 Years — N/A
SexALL
Healthy VolunteersNo
Study Sites6

Inclusion Criteria: * Homozygous for the F508del-CFTR mutation; historical genotype must be documented in the participant's source documents. * Percent predicted FEV1 \<40 of adjusted for age, sex, and height at Screening Exclusion Criteria: * Participant currently receiving invasive mechanical v...

Countries:United StatesCanadaAustraliaBelgiumFranceGermanyNew ZealandUnited KingdomNetherlands
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