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The Safety and Efficacy of Gefapixant (AF-219/MK-7264) in Female Participants With Interstitial Cystitis /Bladder Pain Syndrome (MK-7264-005)

A Four-Week, Double-Blind, Placebo-Controlled, Randomized, Multicenter Study Evaluating the Safety and Efficacy of AF-219 in Female Subjects With Interstitial Cystitis/Bladder Pain Syndrome (IC/BPS)

Status
Terminated
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01569438
Enrollment
107
Registered
2012-04-03
Start date
2012-04-13
Completion date
2014-05-14
Last updated
2020-08-17

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Bladder Pain Syndrome

Brief summary

The purpose of this study is to assess the efficacy of gefapixant (AF-219/MK-7264) in female participants with moderate to severe pain associated with interstitial cystitis/bladder pain syndrome (IC/BPS) after 4 weeks of treatment.

Detailed description

This study is a double-blind, placebo-controlled, randomized trial designed to assess the efficacy and safety of gefapixant in female participants with moderate to severe pain associated with IC/BPS. The study will consist of 4 phases: Screening, Baseline, Treatment, and Follow-up.

Interventions

DRUGGefapixant

50 or 300 mg tablets for a total daily dose of 50, 100, 150, 200, 250 or 300 mg BID, orally with food for 4 weeks

DRUGPlacebo

Dose matched placebo tablets, BID, orally, with food for 4 weeks

Sponsors

Afferent Pharmaceuticals, Inc., a subsidiary of Merck & Co., Inc. (Rahway, New Jersey USA)
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Masking description

Double Blind

Eligibility

Sex/Gender
FEMALE
Age
18 Years to 80 Years
Healthy volunteers
No

Inclusion criteria

* Women * Women of child bearing potential must not be pregnant during the study and must use two forms of birth control * Clinical evidence of Interstitial Cystitis /Bladder Pain Syndrome (IC/BPS) * Have provided written informed consent

Exclusion criteria

* History of diseases that can be confused for IC/BPS * Unable to void spontaneously * Immunosuppressant, intravesicular, nerve stimulator or opioid treatment for certain periods prior to start of the study * Changes to doses of Elmiron®, antidepressant, alpha-adrenergic antagonist, H1 antagonist, or anti-muscarinic treatment within a certain period prior to the start of the study

Design outcomes

Primary

MeasureTime frameDescription
Change From Baseline in the Average Mean Numeric Pain Rating Scale (NPRS) Score at Week 4Baseline and Week 4The bladder pain severity was measured using 0-10 NPRS, with 0 representing 'no pain' and 10 representing 'the worst pain possible'. Participants were asked to select a number on the scale that best described the severity of bladder pain during past 24 hours over telephone using an interactive voice response system (IVRS) every evening at bedtime during the baseline assessment phase and treatment phase (up to 4 weeks). The primary analysis was conducted using a Mixed Model with Repeated Measures (MMRM) approach to calculate the Least Squares (LS) mean change from baseline in NPRS score and associated Standard Error (SE) at Week 4 for each treatment arm. Negative values indicate decrease in bladder pain severity.

Secondary

MeasureTime frameDescription
Change From Baseline in Painful Bladder/Interstitial Cystitis Symptom Diary (PBIC-SD) Score at Week 4Baseline and Week 4To assess the severity of bladder pain syndrome (BPS), an 8-item participant self-report PBIC-SD measure was used. Participants were asked to select a number on the scale that best described the severity of bladder pain over telephone using an IVRS each evening on the three consecutive days (during the Baseline Assessment Phase and during each Treatment Week up to 4 weeks). Each item was graded on a scale from 0 (good condition) to 4 (poor condition) with a total score range 0-32. Higher scores indicate more severe BPS. The analysis was conducted using a MMRM approach to calculate the LS mean change from baseline PBIC-SD total score and associated SE at Week 4 for each treatment arm. Negative values indicate decrease in severity of BPS.
Change From Baseline in O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI) Score at Week 4Baseline and Week 4To measure the severity of BPS (urgency and frequency of urination, nighttime urination, and pain or burning) over past month, a 4-item self-report ICSI measure was used. Participants were asked to select a number on the scale that best described the severity of symptoms over telephone using an IVRS every evening at bedtime during the baseline assessment phase and treatment phase (up to 4 weeks). The ICSI score range from 0 (Not at all) to 5 (Almost always) for the first 3 items and a score of 0 (Not at all) to 4 (Almost always) for the last item, with an index score range of 0-19. Higher scores indicate more severe BPS. The analysis was conducted using one-way ANCOVA model to calculate the LS mean change from baseline ICSI total score and associated SE at Week 4 for each treatment arm. Negative values indicate decrease in severity of BPS.
Change From Baseline in Genitourinary Pain Index (GUPI) Score at Week 4Baseline and Week 4To measure the degree of genitourinary pain symptoms, an 8-item self-report GUPI measure was used. Participants were asked to select a number on the scale that best described the severity of symptoms over telephone using an IVRS every evening at bedtime during the baseline assessment phase and treatment phase (up to 4 weeks). The GUPI instrument yields a total score of 0-45 and 3 subscales: pain (score = 0-23), urinary (score = 0-10), and quality of life (score = 0-12). Higher scores indicate more severe symptoms. The analysis was conducted using one-way ANCOVA model to calculate the LS mean change from baseline GUPI total score and associated SE at Week 4 for each treatment arm. Negative values indicate decrease in degree of genitourinary pain symptoms.

Countries

United States

Participant flow

Recruitment details

Overall, 107 participants were randomized (55 in Gefapixant intervention group, and 52 in Placebo group).

Pre-assignment details

Of 107 participants randomized to the study, 105 received at least one dose of study treatment (All Treated Population) and were evaluable for all safety analysis.

Participants by arm

ArmCount
Gefapixant
Female participants receive gefapixant, a total dose titrated from 50 mg to highest tolerated dose (maximum of 300 mg) twice daily (BID), orally over a period of 6 days with food depending on safety and tolerability, and then maintain that dose for the course of a 4-week treatment period. Participants were allowed to decrease the dose if tolerability issues occurred.
55
Placebo
Female participants receive dose matched placebo tablets, twice daily (BID), orally, with food for 4 weeks.
52
Total107

Withdrawals & dropouts

PeriodReasonFG000FG001
Overall StudyAdverse Event215
Overall StudyDecrease of GFR greater than 30 ml/min10
Overall StudyLack of Efficacy12
Overall StudyProtocol Violation20
Overall StudySponsor/Physician decision11
Overall StudyUnable to adhere to study schedule01
Overall StudyWithdrawal by Subject03

Baseline characteristics

CharacteristicGefapixantPlaceboTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
5 Participants0 Participants5 Participants
Age, Categorical
Between 18 and 65 years
50 Participants52 Participants102 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants0 Participants3 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
52 Participants52 Participants104 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Numeric Pain Rating Scale (NPRS) Score6.20 Score on a scale
STANDARD_DEVIATION 1.41
6.53 Score on a scale
STANDARD_DEVIATION 1.23
6.36 Score on a scale
STANDARD_DEVIATION 1.33
Race (NIH/OMB)
American Indian or Alaska Native
2 Participants0 Participants2 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
5 Participants6 Participants11 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants0 Participants2 Participants
Race (NIH/OMB)
White
46 Participants46 Participants92 Participants
Region of Enrollment
United States
55 Participants52 Participants107 Participants
Sex: Female, Male
Female
55 Participants52 Participants107 Participants
Sex: Female, Male
Male
0 Participants0 Participants0 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 520 / 55
other
Total, other adverse events
36 / 5153 / 54
serious
Total, serious adverse events
0 / 510 / 54

Outcome results

Primary

Change From Baseline in the Average Mean Numeric Pain Rating Scale (NPRS) Score at Week 4

The bladder pain severity was measured using 0-10 NPRS, with 0 representing 'no pain' and 10 representing 'the worst pain possible'. Participants were asked to select a number on the scale that best described the severity of bladder pain during past 24 hours over telephone using an interactive voice response system (IVRS) every evening at bedtime during the baseline assessment phase and treatment phase (up to 4 weeks). The primary analysis was conducted using a Mixed Model with Repeated Measures (MMRM) approach to calculate the Least Squares (LS) mean change from baseline in NPRS score and associated Standard Error (SE) at Week 4 for each treatment arm. Negative values indicate decrease in bladder pain severity.

Time frame: Baseline and Week 4

Population: Titration Completers Population - defined as participants who received at least 1 dose of drug, had at least 1 post-baseline NPRS Score, who titrated the dose in Week 1 of the treatment phase, and who completed the 4-week treatment phase

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
GefapixantChange From Baseline in the Average Mean Numeric Pain Rating Scale (NPRS) Score at Week 4-2.6 Score on a scaleStandard Error 0.34
PlaceboChange From Baseline in the Average Mean Numeric Pain Rating Scale (NPRS) Score at Week 4-1.9 Score on a scaleStandard Error 0.31
Comparison: MMRM approach was used to model the change from baseline as a function of treatment, week, treatment by week interaction, baseline score, and baseline score by week interaction.p-value: 0.073490% CI: [-1.6, 0.2]Mixed Model with Repeated Measures
Secondary

Change From Baseline in Genitourinary Pain Index (GUPI) Score at Week 4

To measure the degree of genitourinary pain symptoms, an 8-item self-report GUPI measure was used. Participants were asked to select a number on the scale that best described the severity of symptoms over telephone using an IVRS every evening at bedtime during the baseline assessment phase and treatment phase (up to 4 weeks). The GUPI instrument yields a total score of 0-45 and 3 subscales: pain (score = 0-23), urinary (score = 0-10), and quality of life (score = 0-12). Higher scores indicate more severe symptoms. The analysis was conducted using one-way ANCOVA model to calculate the LS mean change from baseline GUPI total score and associated SE at Week 4 for each treatment arm. Negative values indicate decrease in degree of genitourinary pain symptoms.

Time frame: Baseline and Week 4

Population: Titration Completers Population - defined as participants who received at least 1 dose of drug, had at least 1 post-baseline GUPI Score, who titrated the dose in Week 1 of the treatment phase, and who completed the 4-week treatment phase.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
GefapixantChange From Baseline in Genitourinary Pain Index (GUPI) Score at Week 4-5.1 Score on a scaleStandard Error 0.88
PlaceboChange From Baseline in Genitourinary Pain Index (GUPI) Score at Week 4-3.7 Score on a scaleStandard Error 0.86
Comparison: The one-way ANCOVA model was used to calculate change from baseline as a function of treatment and baseline score.p-value: 0.118390% CI: [-3.5, 0.6]ANCOVA
Secondary

Change From Baseline in O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI) Score at Week 4

To measure the severity of BPS (urgency and frequency of urination, nighttime urination, and pain or burning) over past month, a 4-item self-report ICSI measure was used. Participants were asked to select a number on the scale that best described the severity of symptoms over telephone using an IVRS every evening at bedtime during the baseline assessment phase and treatment phase (up to 4 weeks). The ICSI score range from 0 (Not at all) to 5 (Almost always) for the first 3 items and a score of 0 (Not at all) to 4 (Almost always) for the last item, with an index score range of 0-19. Higher scores indicate more severe BPS. The analysis was conducted using one-way ANCOVA model to calculate the LS mean change from baseline ICSI total score and associated SE at Week 4 for each treatment arm. Negative values indicate decrease in severity of BPS.

Time frame: Baseline and Week 4

Population: Titration Completers Population - defined as participants who received at least 1 dose of drug, had at least 1 post-baseline ICSI Score, who titrated the dose in Week 1 of the treatment phase, and who completed the 4-week treatment phase.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
GefapixantChange From Baseline in O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI) Score at Week 4-3.8 Score on a scaleStandard Error 0.62
PlaceboChange From Baseline in O'Leary-Sant Interstitial Cystitis Symptom Index (ICSI) Score at Week 4-3.4 Score on a scaleStandard Error 0.6
Comparison: The one-way ANCOVA model was used to calculate change from baseline as a function of treatment and baseline score.p-value: 0.360390% CI: [-1.7, 1.1]ANCOVA
Secondary

Change From Baseline in Painful Bladder/Interstitial Cystitis Symptom Diary (PBIC-SD) Score at Week 4

To assess the severity of bladder pain syndrome (BPS), an 8-item participant self-report PBIC-SD measure was used. Participants were asked to select a number on the scale that best described the severity of bladder pain over telephone using an IVRS each evening on the three consecutive days (during the Baseline Assessment Phase and during each Treatment Week up to 4 weeks). Each item was graded on a scale from 0 (good condition) to 4 (poor condition) with a total score range 0-32. Higher scores indicate more severe BPS. The analysis was conducted using a MMRM approach to calculate the LS mean change from baseline PBIC-SD total score and associated SE at Week 4 for each treatment arm. Negative values indicate decrease in severity of BPS.

Time frame: Baseline and Week 4

Population: Titration Completers Population - defined as participants who received at least 1 dose of drug, had at least 1 post-baseline PBIC-SD Score, who titrated the dose in Week 1 of the treatment phase, and who completed the 4-week treatment phase.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
GefapixantChange From Baseline in Painful Bladder/Interstitial Cystitis Symptom Diary (PBIC-SD) Score at Week 4-7.8 Score on a scaleStandard Error 1.29
PlaceboChange From Baseline in Painful Bladder/Interstitial Cystitis Symptom Diary (PBIC-SD) Score at Week 4-6.7 Score on a scaleStandard Error 1.15
Comparison: MMRM approach was used to model the change from baseline as a function of treatment, week, treatment by week interaction, baseline score, and baseline score by week interaction.p-value: 0.272690% CI: [-3.9, 1.8]Mixed Model With Repeated Measures

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026