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ivacaftor

Phase 3

Cystic Fibrosis | Small molecule | Respiratory |Vertex Pharmaceuticals Incorporated|Last Updated: Feb 26, 2020

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-BlindACTIVE_CONTROLLEDDMCBiomarker
Total Trials15
Total Enrollment1,027
FDA Designations
No designations recorded
Clinical Trials (15)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT02934698An Efficacy and Safety Study of Ivacaftor in Patients With Cystic Fibrosis and Two Splicing MutationsPHASE3 COMPLETED 2Nov 1, 2016May 1, 2018Aug 6, 2018 -
NCT03068312A Study to Evaluate Efficacy of Ivacaftor in Subjects With Cystic Fibrosis Who Have a 3849 + 10KB C→T or D1152H CFTR MutationPHASE3 COMPLETED 38Jul 18, 2017Dec 18, 2018Feb 26, 20201 Israel
NCT02412111A Phase 3 Study of Tezacaftor (VX-661) in Combination With Ivacaftor (VX-770) in Subjects Aged 12 Years and Older With Cystic Fibrosis (CF), Who Have One F508del-CFTR Mutation and a Second Mutation That Has Been Demonstrated to be Clinically Responsive to IvacaftorPHASE3 COMPLETED 156Jun 1, 2015Sep 1, 2017Jan 8, 201968 United States, Australia +8
NCT01946412Roll-Over Study of Ivacaftor in Cystic Fibrosis Pediatric Subjects With a CF Transmembrane Conductance Regulator Gene (CFTR) Gating MutationPHASE3 COMPLETED 33Dec 1, 2013Dec 1, 2015Feb 1, 201716 United States, Canada +1
NCT01707290Rollover Study of Ivacaftor in Subjects With Cystic Fibrosis and a Non G551D CFTR MutationPHASE3 COMPLETED 125Feb 1, 2013Apr 1, 2016May 12, 201738 United States, Belgium +2
NCT01705145Study of Ivacaftor in Cystic Fibrosis Subjects 2 Through 5 Years of Age With a CFTR Gating MutationPHASE3 COMPLETED 35Jan 1, 2013Mar 1, 2014Apr 5, 201620 United States, Canada +1
NCT01614457Study of Ivacaftor in Subjects With Cystic Fibrosis (CF) Who Have the R117H-CF Transmembrane Conductance Regulator (CFTR) Mutation (KONDUCT)PHASE3 COMPLETED 70Jul 1, 2012Oct 1, 2013Feb 12, 201531 United States, United Kingdom
NCT01614470Study of Ivacaftor in Subjects With Cystic Fibrosis (CF) Who Have a Non-G551D CF Transmembrane Conductance Regulator (CFTR) Gating MutationPHASE3 COMPLETED 39Jul 1, 2012Oct 1, 2013Oct 29, 201412 United States, Belgium +1
NCT01117012Rollover Study of VX-770 in Cystic Fibrosis SubjectsPHASE3 COMPLETED 192Jul 1, 2010May 1, 2014Jul 7, 201558 United States, Australia +6
NCT00909727Study of Ivacaftor in Cystic Fibrosis Subjects Aged 6 to 11 Years With the G551D MutationPHASE3 COMPLETED 52Aug 1, 2009Apr 1, 2011Aug 21, 201229 United States, Australia +5
NCT00909532Study of Ivacaftor in Cystic Fibrosis Subjects Aged 12 Years and Older With the G551D MutationPHASE3 COMPLETED 167Jun 1, 2009Nov 1, 2012Jan 18, 201365 United States, Australia +6
NCT01685801Pilot Study Testing the Effect of Ivacaftor on Lung Function in Subjects With Cystic Fibrosis and Residual CFTR FunctionPHASE2 COMPLETED 24Sep 1, 2012Apr 1, 2014May 19, 20151 United States
NCT01262352Study of the Effect of Ivacaftor on Lung Clearance Index in Subjects With Cystic Fibrosis and the G551D MutationPHASE2 COMPLETED 21Jan 1, 2011Nov 1, 2011Feb 11, 20138 United States, Canada +1
NCT00457821Safety Study of Ivacaftor in Subjects With Cystic FibrosisPHASE2 COMPLETED 39May 1, 2007Aug 1, 2008Oct 5, 201215 United States, Canada +1
NCT02015507An Open-Label, Phase 1 Study in Healthy Adult Subjects to Examine the Effects of Multiple-Dose Ciprofloxacin on Ivacaftor and VX-661 in Combination With IvacaftorPHASE1 COMPLETED 34Jan 1, 2014Feb 1, 2014Mar 26, 2014 -
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Study Endpoints
Primary Endpoints
Forced Expiratory Volume
24 weeks

Absolute change in percent predicted in 1 second FEV1 from baseline through week 24

Change in Lung Clearance Index 2.5 (LCI2.5)
From baseline through 8 weeks

LCI2.5 represents the number of lung turnovers required to reduce the end tidal inert gas concentration to 1/40th of its starting value.

Absolute Change From Baseline in Percent Predicted Forced Expiratory Volume in 1 Second (FEV1) Through Week 8
Baseline, Through Week 8

FEV1 is the volume of air that can forcibly be blown out in one second, after full inspiration.

Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs)
Day 1 up to Week 97 (for participants who completed study drug dosing); Day 1 up to 24 weeks after the last dose (up to Week 108, for participants who prematurely discontinued study drug dosing)

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 dose of study drug through the end of study participation was considered treatment-emergent.

Number of Participants With Treatment Emergent Adverse Events (TEAEs) or Serious Adverse Events (SAEs) in Ivacaftor Arm
Day 1 up to Week 108 (Study 112)

AE: any untoward medical occurrence in a participants 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 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, In-patient hospitalization/prolongation of hospitalization, persistent/significant disability or incapacity, congenital anomaly/birth defect, important medical event. TEAEs were defined as adverse events with start date or increased severity on and after the first dose of study drug through Week 108.

Part A: Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs) and Related AEs
Part A: Up to 93 Days

AE: any adverse change from participant's baseline (pre-treatment) condition, including any adverse experience, abnormal recording/clinical laboratory assessment which occurs during course of study, whether it is considered related to study drug or not. SAE: medical event or condition, which falls into any of following categories, regardless of its relationship to the study drug: death, life threatening adverse experience, in-patient hospitalization/prolonged hospitalization, persistent/significant disability/incapacity, congenital anomaly/birth defect, important medical event. Related AEs includes all AEs for which the causality was either related to study drug or possibly related to study drug. Data was reported as per the dose received and for overall participants.

Part B: Number of Participants With Adverse Events (AEs), Serious Adverse Events (SAEs) and Related AEs
Part B: Up to 28 Weeks

AE: any adverse change from participant's baseline (pre-treatment) condition, including any adverse experience, abnormal recording/clinical laboratory assessment which occurs during course of study, whether it is considered related to study drug or not. AE includes both serious and non-serious AE. SAE: medical event or condition, which falls into any of following categories, regardless of its relationship to the study drug: death, life threatening adverse experience, in-patient hospitalization/prolonged hospitalization, persistent/significant disability/incapacity, congenital anomaly/birth defect, important medical event. Related AEs includes all AEs for which the causality was either related to study drug or possibly related to study drug. Data was reported as per the dose received.

Part A: Plasma Concentration of Ivacaftor and Its Metabolites
Part A: up to 24 hours post-dose on Day 4

Plasma concentration was reported for ivacaftor and its metabolites (hydroxymethyl ivacaftor \[M1\] and ivacaftor carboxylate \[M6\]) up to 24 hours post-dose on Day 4 (Hour 0 \[pre-dose\] on Day 1 and Day 4; 2, 3, 6, 24 hours post-dose on Day 4). Data was planned to be reported for overall participants in the period.

Absolute Change From Baseline in Percent Predicted Forced Expiratory Volume in 1 Second (FEV1) Through Week 24
Baseline, Week 24

FEV1 is the volume of air that can forcibly be blown out in one second, after full inspiration. Hankinson and Wang standards were used to calculate percent predicted FEV1 (for age, gender, and height). The Hankinson standard was used for male subjects 18 years and older and female subjects 16 years and older. The Wang standard was used for male subjects aged 6 to 17 years and for female subjects aged 6 to 15 years.

Part 1: Absolute Change From Baseline in Percent Predicted Forced Expiratory Volume in 1 Second (FEV1) Through Week 8
Part 1: Baseline (pre-dose Day 1), Week 8

FEV1 is the volume of air that can forcibly be blown out in one second, after full inspiration. Hankinson and Wang standards were used to calculate percent predicted FEV1 (for age, gender, and height). The Hankinson standard was used for male subjects 18 years and older and female subjects 16 years and older. The Wang standard was used for male subjects aged 6 to 17 years and for female subjects aged 6 to 15 years. Baseline was defined as the most recent non-missing measurement collected before initial administration of study drug during study Part 1.

Part 2: Absolute Change From Baseline in Percent Predicted Forced Expiratory Volume in 1 Second (FEV1) Through 24 Weeks of Treatment (Week 36 Visit)
Baseline (pre-dose Week 12), Week 36

FEV1 is the volume of air that can forcibly be blown out in one second, after full inspiration. Hankinson and Wang standards were used to calculate percent predicted FEV1 (for age, gender, and height). The Hankinson standard was used for male subjects 18 years and older and female subjects 16 years and older. The Wang standard was used for male subjects aged 6 to 17 years and for female subjects aged 6 to 15 years. Absolute change in percent predicted FEV1 over 24 weeks of ivacaftor treatment (from Week 12 \[Part 1: Treatment Period 2\] through Week 36 \[Part 2\]) was reported for subjects who received ivacaftor in Part 1: Treatment Period 2, as per planned analysis. Baseline was defined as the most recent non-missing measurement collected before initial administration of study drug during Part 1: Treatment Period 2.

Number of Participants With Non-Serious Adverse Events (AEs) and Serious Adverse Events (SAEs)
Study 105: Day 1 up to Week 168

Adverse Event: any untoward medical occurrence in a participant during the study, including any unfavorable and unintended sign, symptom, or disease whether or not it was considered to be study drug related. This included any newly occurring event or previous condition that increased in severity or frequency after obtaining informed consent and assent (where applicable). SAE: medical event or condition, which resulted in any of following, regardless of its relationship to the study drug: death, life threatening adverse experience, in-patient hospitalization/prolonged hospitalization, persistent/significant disability/incapacity, congenital anomaly/birth defect, important medical event. Non-Serious AEs included all AEs except SAEs.

Absolute Mean Change From Baseline in Percent Predicted Forced Expiratory Volume in 1 Second (FEV1) Through Week 24
baseline through 24 weeks

Spirometry (as measured by FEV1) is a standardized assessment to evaluate lung function that is the most widely used endpoint in cystic fibrosis studies.

Cycle 1 and Cycle 2: Absolute Change From Cycle Baseline In Percent Predicted Forced Expiratory Volume In 1 Second (FEV1) After 2 Weeks of Treatment
Cycle 1 baseline, Cycle 1 Day 15 (for Cycle 1 reporting arms); Cycle 2 baseline, Cycle 2 Day 15 (for Cycle 2 reporting arms)

FEV1 is the volume of air that can forcibly be blown out in one second, after full inspiration. Hankinson and Wang standards were used to calculate percent predicted FEV1 (for age, gender, and height). The Hankinson standard was used for male participants 18 years and older and female participants 16 years and older. The Wang standard was used for male participants aged 12 to 17 years and for female participants aged 12 to 15 years. Data was to be reported for each cycle (Cycle 1 and Cycle 2) and as per drug treatment, for overall participants and as per genotype (residual function mutation and mRNA splice site mutation).

Absolute Change From Baseline in Lung Clearance Index (LCI)
Baseline through Day 29

Lung clearance index (LCI) is a measure of ventilation inhomogeneity that is derived from a multiple-breath washout test. The LCI was calculated as the number of lung volume turnovers (cumulative expired volume divided by the functional residual capacity \[FRC\]) required to reduce end-tidal SF6 concentration to 1/40th of the starting value.

Number of Subjects With Adverse Events (Combined Part 1 and Part 2)
Baseline to Follow-up

Adverse event data were collected up to the follow-up visit (5 to 9 days after last dose of study drug). Serious adverse events that were ongoing at the follow-up visit were followed until the event resolved, returned to baseline, or was determined to be a stable or chronic condition.

Number of Adverse Events (Combined Part 1 and Part 2)
Baseline to Follow-up

Adverse event data were collected up to the follow-up visit (5 to 9 days after last dose of study drug). Serious adverse events that were ongoing at the follow-up visit were followed until the event resolved, returned to baseline, or was determined to be a stable or chronic condition.

PK parameters of ivacaftor and metabolites following concomitant dosing with ciprofloxacin relative to ivacaftor administered alone
Day 7, Day 14

PK Parameters - maximum observed plasma concentrations (Cmax) and area under the concentration versus time curve (AUC),

PK parameters of VX-661 and metabolites when dosed in combination with ivacaftor and concomitant ciprofloxacin relative to VX-661 administered in combination with ivacaftor
Day 10, Day 20

PK parameters - maximum observed plasma concentrations (Cmax) and area under the concentration versus time curve (AUC),

Secondary Endpoints
Sputum Results
24 weeks
Sweat Chloride
24 Weeks
Relative Change From Baseline in Percent Predicted Forced Expiratory Volume in 1 Second (FEV1) Through Week 8
Baseline, Through Week 8
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Study Design & Arms
AllocationNA
MaskingNONE
ModelSINGLE_GROUP
PurposeTREATMENT
Treatment Arms
ArmTypeDescription
IvacaftorEXPERIMENTALThere is only one arm to this study. The two sisters with Cystic Fibrosis will both receive Ivacaftor for 6 months for their treatment.
Sequence 1: First Ivacaftor (IVA) Then PlaceboEXPERIMENTALParticipants received IVA 150 milligram (mg) every 12 hours (q12h) for 8 weeks in treatment period 1 followed by placebo matched to IVA for 8 weeks in treatment period 2. A washout period of 8 weeks was maintained between the 2 treatment periods.
Sequence 2: First Placebo Then IVAEXPERIMENTALParticipants received placebo matched to IVA for 8 weeks in treatment period 1 followed by IVA 150 mg q12h for 8 weeks in treatment period 2. A washout period of 8 weeks was maintained between the 2 treatment periods.
Ivacaftor (Run-in Period)EXPERIMENTALIvacaftor 150 milligram (mg) tablet orally every 12 hours for 4 weeks.
VX-661 + Ivacaftor (Active comparator period)EXPERIMENTALVX-661 100 mg and ivacaftor 150 mg fixed-dose combination tablet orally once daily in the morning and ivacaftor 150 mg tablet orally once daily in the evening for 8 weeks.
Ivacaftor monotherapy (Active comparator period)ACTIVE_COMPARATORIvacaftor 150 mg tablet orally every 12 hours as monotherapy for 8 weeks.
Observational ArmNO_INTERVENTION -
ObservationalNO_INTERVENTIONParticipants who received Ivacaftor 150 mg tablet and/or Placebo matched to Ivacaftor tablet, orally, q12h in the previous Study 110 (NCT01614457) or Study 111 (NCT01614470), were observed (did not receive study drug) in this Study 112 (NCT01707290) for up to 2 years.
PlaceboPLACEBO_COMPARATORPlacebo matched to Ivacaftor tablet orally twice daily for 24 weeks.
Part 1: Ivacaftor First, Then PlaceboEXPERIMENTALIvacaftor 150 milligram (mg) tablet orally twice daily for 8 weeks in treatment period 1 followed by placebo matched to ivacaftor tablet orally twice daily for 8 weeks in treatment period 2. Washout out period of 4 to 8 weeks was maintained between each treatment period.
Part 1: Placebo First, Then IvacaftorEXPERIMENTALPlacebo matched to ivacaftor tablet orally twice daily for 8 weeks in treatment period 1 followed by ivacaftor 150 mg tablet orally twice daily for 8 weeks in treatment period 2. Washout out period of 4 to 8 weeks was maintained between each treatment period.
Part 2: IvacaftorEXPERIMENTALIvacaftor 150 mg tablet orally twice daily for 16 weeks.
VX-770EXPERIMENTALVX-770 (ivacaftor) 150 milligram (mg) tablet orally twice daily (q12h).
150 mg Ivacaftor q12hEXPERIMENTALSubjects who received 150 mg of ivacaftor q12h for up to 48 weeks.
Ivacaftor, Placebo, Ivacaftor, Placebo (IPIP)EXPERIMENTALDuring the Crossover Period, study drug was administered in 2-week alternating cycles with a minimum of 4-week washout period between Cycle 1 \[(Period 1 - Day 1 to 14) (Period 2 - Day 15 to 29)\] and Cycle 2 \[(Period 1 - Day 1 to 14) (Period 2 - Day 15 to 29)\] and between Cycle 2 and the Open-label Period (Day 1 to 57). During the Open-label Period, all participants received ivacaftor.
Ivacaftor, Placebo, Placebo, Ivacaftor (IPPI)EXPERIMENTALDuring the Crossover Period, study drug was administered in 2-week alternating cycles with a minimum of 4-week washout period between Cycle 1 \[(Period 1 - Day 1 to 14) (Period 2 - Day 15 to 29)\] and Cycle 2 \[(Period 1 - Day 1 to 14) (Period 2 - Day 15 to 29)\] and between Cycle 2 and the Open-label Period (Day 1 to 57). During the Open-label Period, all participants received ivacaftor.
Placebo, Ivacaftor, Ivacaftor, Placebo (PIIP)EXPERIMENTALDuring the Crossover Period, study drug was administered in 2-week alternating cycles with a minimum of 4-week washout period between Cycle 1 \[(Period 1 - Day 1 to 14) (Period 2 - Day 15 to 29)\] and Cycle 2 \[(Period 1 - Day 1 to 14) (Period 2 - Day 15 to 29)\] and between Cycle 2 and the Open-label Period (Day 1 to 57). During the Open-label Period, all participants received ivacaftor.
Placebo, Ivacaftor, Placebo, Ivacaftor (PIPI)EXPERIMENTALDuring the Crossover Period, study drug was administered in 2-week alternating cycles with a minimum of 4-week washout period between Cycle 1 \[(Period 1 - Day 1 to 14) (Period 2 - Day 15 to 29)\] and Cycle 2 \[(Period 1 - Day 1 to 14) (Period 2 - Day 15 to 29)\] and between Cycle 2 and the Open-label Period (Day 1 to 57). During the Open-label Period, all participants received ivacaftor.
Treatment Sequence 1EXPERIMENTALIvacaftor administered in Treatment Period 1 and placebo administered in Treatment Period 2.
Treatment Sequence 2EXPERIMENTALPlacebo administered in Treatment Period 1 and ivacaftor administered in Treatment Sequence 2.
Ivacaftor Group AEXPERIMENTALSubjects in Part 1 who first received 25 mg or 75 mg of ivacaftor every 12 hours (q12h) for 14 days, then crossed over to receive the alternate dose for another 14 days.
Ivacaftor Group BEXPERIMENTALSubjects in Part 1 who first received 75 mg or 150 mg of ivacaftor q12h for 14 days then crossed over to receive the alternate dose for another 14 days.
Ivacaftor Group CEXPERIMENTALSubjects in Part 2 who received 150 mg or 250 mg of ivacaftor q12h for 28 days.
Cohort 1ACTIVE_COMPARATORparticipants in Cohort 1 will be administered ivacaftor alone followed by ivacaftor with concomitant ciprofloxacin.
Cohort 2EXPERIMENTALParticipants in Cohort 2 will be administered VX-661 in combination with ivacaftor followed by VX-661 in combination with ivacaftor and concomitant ciprofloxacin
Interventions
NameTypeDescription
IvacaftorDRUGSubjects will be treated with ivacaftor for 6 months and followed for 7 months and will undergo assessments along the way to measure sweat chloride and sputum amounts.
PlaceboDRUGPlacebo matched to IVA tablet.
Tezacaftor/IvacaftorDRUG -
Placebo-matched-to-ivacaftor tabletDRUGOrally every 12 hours up to 4 weeks.
Ivacaftor 25 mg/75 mgDRUG25 mg or 75 mg q12h for a total of 28 days (Part 1)
Ivacaftor 75 mg/150 mgDRUG75 mg or 150 mg q12h for a total of 28 days (Part 1)
Ivacaftor 150 mg or 250 mgDRUG150 mg or 250 mg of ivacaftor q12h for 28 days (Part 2)
VX-661DRUG -
ciprofloxacinDRUG -
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Eligibility Criteria
Age Range18 Years — N/A
SexFEMALE
Healthy VolunteersNo

Inclusion Criteria: * Subjects are \>18 years of age and able to provide informed consent. * Subjects reside in the US and are willing to be treated with ivacaftor. * Subjects have the splicing mutation of interest. * Subjects are willing and able to perform requirements of the study. Exclusion Cr...

Countries:IsraelUnited StatesAustraliaAustriaBelgiumCanadaFranceGermanyIrelandItalyUnited KingdomCzechia
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