Efficacy and Safety of ME-015 (Suplatast Tosilate) in Cough Related to Idiopathic Pulmonary Fibrosis (COSMIC-IPF)

Study Purpose

Orally administered ME-015 (Suplatast Tosilate) has been available on the market as a prescription drug for allergy-related conditions in Japan since 1995 with a good safety and tolerability profile. There is preclinical and exploratory clinical evidence suggesting that ME-015 may be effective in treating cough caused by idiopathic pulmonary fibrosis (IPF cough). 80% of patients with idiopathic pulmonary fibrosis (IPF) are affected by a devastating dry cough that is often not responsive to standard cough treatments and causes significant psychological and physiological suffering as well as reduced quality of life. As of November 2024, there is no approved treatment for IPF cough. There is an enormous unmet clinical need for an effective, safe and well-tolerated oral treatment; particularly as approved antifibrotic treatments (pirfenidone and nintedanib) have not been shown to reduce cough in controlled clinical trials. The COSMIC-IPF Phase 2a trial is the first clinical trial assessing ME-015 (an NCE outside of Japan) for the treatment of IPF cough and aims to generate clinical proof-of-concept results regarding the safety and efficacy of ME-015 in this condition.

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 18 Years and Over
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

1. Diagnosis of IPF according to 2018 ATS/ERS/JRS/ALAT guidelines, confirmed by high-resolution computed tomography (HRCT) chest scan taken < 2 years ago. 2. Age ≥ 18 years. 3. Cough attributed to IPF unresponsive to standard anti-tussive treatment and present for > 8 weeks. 4. Arithmetic mean of ≥ 10 coughs/hour during waking hours. 5. Ability to read, comprehend, and complete the ICF and all questionnaires in the study without help. 6. Cough severity score of ≥ 40 mm on a 0-to-100 mm Visual Analogue Scale (VAS) 7. Willing and able to comply with the protocol. 8. Life expectancy > 6 months. 9. Stable medical condition: stable treatment for > 12 weeks and absence of acute exacerbations for > 4 weeks. 10. FVC ≥ 40% predicted. 11. FEV1 / FVC ≥ 65% 12. Women of childbearing potential must agree to use a highly effective method of contraception. 13. Male partner must agree to use a condom during the study, unless they had a vasectomy > 6 months prior to first study drug administration.

Exclusion Criteria:

1. Likely need for lung transplantation in next 12 months. 2. Permanent long-term oxygen therapy. 3. Use of high-dose corticosteroids or cytotoxic medications. 4. History of unstable or deteriorating cardiac or pulmonary disease in the preceding 6 months. 5. Current smoking, vaping, or tobacco chewing. 6. Treatment with an ACE inhibitor or sitagliptin. 7. Any antitussive treatment, including opioid-based and OTC, for treatment of cough within 4 weeks of Screening or at any point during the study. 8. BMI < 18 kg/m2 or ≥ 40 kg/m2. 9. Suspected acute infection, including COVID-19 or influenza or any upper respiratory tract infection. 10. History of malignancy within the last 2 years. 11. History of drug/ alcohol dependency/ abuse within the last 2 years. 12. Condition that could affect drug absorption. 13. Recent history of stroke or TIA. 14. Resting blood pressure > 160/90 mmHg. 15. Pregnant/lactating women. 16. Investigational drug or biologic within the last 2 months. 17. Blood donation within the last 56 days or plasma donation within the last 7 days. 18. Severe medical/ psychiatric condition posing risk to trial participation

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT05983471
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 2
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

Melius Pharma AB
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

N/A
Principal Investigator Affiliation N/A
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Industry
Overall Status Active, not recruiting
Countries India
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Idiopathic Pulmonary Fibrosis, Cough, IPF, Fibrotic Lung Disease, Chronic Cough, Coughing
Study Website: View Trial Website
Additional Details

This quadruple blinded, cross-over, placebo-controlled clinical trial will randomize patients with stable idiopathic pulmonary fibrosis (IPF) and cough related to IPF (IPF cough) in a 1:1 fashion to one of two treatment sequences: active treatment followed by placebo, or placebo followed by active treatment. Each 14-day active/placebo treatment phase is preceded by a wash out period. The treatment sequences are followed by an observational 7-day follow-up period without medication. All subjects in the trial receive standard-of-care antifibrotic treatment for IPF. There is a single-blinded placebo run-in period before randomization to create a stable baseline and adjust for the anticipated placebo effect at study entry. Treatment assignment is blinded to patients, investigators, site personnel, data analysts and Sponsor. The active treatment is ME-015 (Suplatast Tosilate) 200 mg t.i.d. (three times per day) administered as oral capsules. The placebo treatment consists of identical capsules without the active component. The primary efficacy endpoint is the effect on awake time cough frequency measured objectively with the VitaloJak device over a 24-hour period. VitaloJak recordings are analysed using a blinded, independent, central review and validation process. The study is conducted as a single-country, multi-centre clinical trial in India with Melius Pharma AB as the Sponsor. External central adjudication of HRCT images by a UK-based KOL ensures guideline-based diagnoses of IPF. Treatment needs to follow international guideline-based standard of care for IPF, and all Indian sites have been chosen to reflect a similar standard of care as practiced in Europe and the U.S. Only literate patients are enrolled into the trial and all patient-facing material is made available in English and all common local languages.

Arms & Interventions

Arms

Experimental: Treatment Arm 1

2 weeks of blinded active treatment, followed by 2 weeks of blinded placebo treatment (wash-out), followed by 2 weeks of blinded placebo treatment, followed by 1 week of follow-up with neither active nor placebo treatment

Experimental: Treatment Arm 2

2 weeks of blinded placebo treatment, followed by 2 weeks of blinded placebo treatment (wash-out), followed by 2 weeks of blinded active treatment, followed by 1 week of follow-up with neither active nor placebo treatment

Interventions

Drug: - ME-015 (Suplatast Tosilate)

Oral capsule form, 200 mg t.i.d. (total 600 mg per 24 hours)

Other: - Identical placebo

Without active component

Contact a Trial Team

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International Sites

Aditya Multi Specialty Hospital, Guntur, Andhra Pradesh, India

Status

Address

Aditya Multi Specialty Hospital

Guntur, Andhra Pradesh, 522001

Belgaum, Karnataka, India

Status

Address

KLE's Dr Prabhakar Kore Hospital & Medical Research Centre

Belgaum, Karnataka, 590010

ACE Hospital and Research Centre, Pune, Maharashtra, India

Status

Address

ACE Hospital and Research Centre

Pune, Maharashtra, 411004

Hindusthan Hospital, Coimbatore, Tamil Nadu, India

Status

Address

Hindusthan Hospital

Coimbatore, Tamil Nadu, 641028

Kanpur, UP, India

Status

Address

GSVM Medical College, Murari Lal Chest Hospital

Kanpur, UP, 208002

Health Point Hospital, Kolkata, West Bengal, India

Status

Address

Health Point Hospital

Kolkata, West Bengal, 700025

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