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NCT02397460

Effect of Gefapixant (AF-219/MK-7264) on Cough Reflex Sensitivity (MK-7264-015)

Completed Phase 2 Results posted Last updated 12 February 2021
What this trial tests

Phase 2 trial testing Gefapixant in Refractory Chronic Cough in 50 participants. Completed in 16 May 2016.

Timeline
29 April 2015
Primary endpoint
22 April 2016
16 May 2016

Quick facts

Lead sponsorAfferent Pharmaceuticals, Inc., a subsidiary of Merck & Co., Inc. (Rahway, New Jersey USA)
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designcrossover
Maskingquadruple
Primary purposetreatment
Enrollment50
Start date29 April 2015
Primary completion22 April 2016
Estimated completion16 May 2016
Sites1 location across United Kingdom

Drugs / interventions tested

Conditions studied

Sponsor

Afferent Pharmaceuticals, Inc., a subsidiary of Merck & Co., Inc. (Rahway, New Jersey USA) — full company profile →

Who can join

Adults 18 to 80, any sex, with Refractory Chronic Cough. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Cough Reflex Sensitivity to Capsaicin Measured by Maximal Cough Response (Emax) Primary · 2 hours post-dose

The effect of single doses of 50 mg and 300 mg gefapixant on cough reflex sensitivity to challenge with capsaicin was assessed in male and female healthy participants and participants with chronic cough. Capsaicin-evoked cough challenge was performed 2 hours post-dose in Periods 1 and 2. The maximal cough response (Emax) to capsaicin was assessed. For capsaicin challenge, doubling concentrations from 0.49 μM to 1000 μM were prepared by dilution of stock solutions with saline, and were administered by inhalation. The number of explosive cough sounds occurring within the first 15 seconds after i

GroupValue95% CI
Placebo/Healthy Males4.14
Placebo/Chronic Cough Males4.14
Placebo/Chronic Cough Females7.57
Gefapixant 50 mg/Healthy Males3.66
Gefapixant 50 mg/Chronic Cough Males3.37
Gefapixant 50 mg/Chronic Cough Females6.17
Gefapixant 300 mg/Healthy Males3.66
Gefapixant 300 mg/Chronic Cough Males3.37
Gefapixant 300 mg/Chronic Cough Females6.17
Cough Reflex Sensitivity to Capsaicin Measured by the Tussive Concentration Required to Achieve 50% of Emax (ED50) Primary · 2 hours post-dose

The effect of single doses of 50 mg and 300 mg gefapixant on cough reflex sensitivity to challenge with capsaicin was assessed in male and female healthy participants and participants with chronic cough. Capsaicin-evoked cough challenge was performed 2 hours post-dose in Periods 1 and 2. The concentration of capsaicin required to induce 50% of the Emax (ED50) was assessed. For capsaicin challenge, doubling concentrations from 0.49 μM to 1000 μM were prepared by dilution of stock solutions with saline, and were administered by inhalation. Nonlinear mixed-effects modeling was used to estimate th

GroupValue95% CI
Placebo/Healthy Males33
Placebo/Chronic Cough Males33
Placebo/Chronic Cough Females9.56
Gefapixant 50 mg/Healthy Males33
Gefapixant 50 mg/Chronic Cough Males33
Gefapixant 50 mg/Chronic Cough Females9.56
Gefapixant 300 mg/Healthy Males33
Gefapixant 300 mg/Chronic Cough Males33
Gefapixant 300 mg/Chronic Cough Females9.56
Cough Reflex Sensitivity to Adenosine Triphosphate (ATP) Measured by Maximal Cough Response (Emax) Secondary · 2 hours post-dose

The effect of single doses of 50 mg and 300 mg gefapixant on cough reflex sensitivity to challenge with adenosine triphosphate (ATP) was assessed in male and female healthy participants and participants with chronic cough. ATP-evoked cough challenge was performed 2 hours post-dose in Periods 3 and 4. For ATP challenge, doubling concentrations from 0.227 μmol/mL to 929 μmol/mL were prepared from ATP powder dissolved in saline, and were administered by inhalation. The number of explosive cough sounds occurring within the first 15 seconds after inhalation were recorded. Nonlinear mixed-effects mo

GroupValue95% CI
Placebo/Healthy Males2.35
Placebo/Chronic Cough Males2.35
Placebo/Chronic Cough Females5.4
Gefapixant 50 mg/Healthy Males2.35
Gefapixant 50 mg/Chronic Cough Males2.35
Gefapixant 50 mg/Chronic Cough Females5.4
Gefapixant 300 mg/Healthy Males2.35
Gefapixant 300 mg/Chronic Cough Males2.35
Gefapixant 300 mg/Chronic Cough Females5.4
Cough Reflex Sensitivity to ATP Measured by the Tussive Concentration Required to Achieve 50% of Emax (ED50) Secondary · 2 hours post-dose

The effect of single doses of 50 mg and 300 mg gefapixant on cough reflex sensitivity to challenge with ATP was assessed in male and female healthy participants and participants with chronic cough. ATP-evoked cough challenge was performed 2 hours post-dose in Periods 3 and 4. The concentration of ATP required to induce 50% of the Emax (ED50) was assessed. For ATP challenge, doubling concentrations from 0.227 μmol/mL to 929 μmol/mL were prepared by dilution of stock solutions with saline, and were administered by inhalation. Nonlinear mixed-effects modeling was used to estimate the ED50. Popula

GroupValue95% CI
Placebo/Healthy Males54.9
Placebo/Chronic Cough Males54.9
Placebo/Chronic Cough Females8.63
Gefapixant 50 mg/Healthy Males119.13
Gefapixant 50 mg/Chronic Cough Males155.92
Gefapixant 50 mg/Chronic Cough Females24.51
Gefapixant 300 mg/Healthy Males119.13
Gefapixant 300 mg/Chronic Cough Males192.7
Gefapixant 300 mg/Chronic Cough Females30.29
Concentrations of Capsaicin Inducing 2 or More Coughs (C2) Secondary · 2 hours post-dose

The concentrations of capsaicin inducing 2 or more coughs (C2) in participants were assessed in Periods 1 and 2. For capsaicin challenge, doubling concentrations from 0.49 μM to 1000 μM were prepared by dilution of stock solutions with saline, and were administered by inhalation.

GroupValue95% CI
Cohort 1: Gefapixant 300 mg/Healthy31.254 – 1000
Cohort 1: Placebo/Healthy31.254 – 500
Cohort 1: Gefapixant 300 mg/Chronic Cough3.900 – 16
Cohort 1: Placebo/Chronic Cough7.810 – 31
Cohort 2: Gefapixant 50 mg/Healthy15.622 – 63
Cohort 2: Placebo/Healthy23.448 – 125
Cohort 2: Gefapixant 50 mg/Chronic Cough15.620 – 125
Cohort 2: Placebo/Chronic Cough5.860 – 250
Concentrations of Capsaicin Inducing 5 or More Coughs (C5) Secondary · 2 hours post-dose

The concentrations of capsaicin inducing 5 or more coughs (C5) in participants were assessed in Periods 1 and 2. For capsaicin challenge, doubling concentrations from 0.49 μM to 1000 μM were prepared by dilution of stock solutions with saline, and were administered by inhalation.

GroupValue95% CI
Cohort 1: Gefapixant 300 mg/Healthy31.2516 – 250
Cohort 1: Placebo/Healthy62.5016 – 1000
Cohort 1: Gefapixant 300 mg/Chronic Cough3.900 – 31
Cohort 1: Placebo/Chronic Cough11.720 – 125
Cohort 2: Gefapixant 50 mg/Healthy250.0063 – 500
Cohort 2: Placebo/Healthy125.0063 – 500
Cohort 2: Gefapixant 50 mg/Chronic Cough15.622 – 63
Cohort 2: Placebo/Chronic Cough5.860 – 31
Concentrations of ATP Inducing 2 or More Coughs (C2) Secondary · 2 hours post-dose

The concentrations of ATP inducing 2 or more coughs (C2) in participants were assessed in Periods 3 and 4. For ATP challenge, doubling concentrations from 0.227 to 929 μmol/mL were prepared from ATP powder, dissolved and diluted in saline, and administered by inhalation.

GroupValue95% CI
Cohort 1: Gefapixant 300 mg/Healthy192.008 – 256
Cohort 1: Placebo/Healthy64.001 – 512
Cohort 1: Gefapixant 300 mg/Chronic Cough8.000 – 64
Cohort 1: Placebo/Chronic Cough1.000 – 64
Cohort 2: Gefapixant 50 mg/Healthy16.008 – 256
Cohort 2: Placebo/Healthy24.002 – 512
Cohort 2: Gefapixant 50 mg/Chronic Cough4.250 – 512
Cohort 2: Placebo/Chronic Cough4.000 – 256
Concentrations of ATP Inducing 5 or More Coughs (C5) Secondary · 2 hours post-dose

The concentrations of ATP inducing 5 or more coughs (C5) in participants were assessed in Periods 3 and 4. For ATP challenge, doubling concentrations from 0.227 to 929 μmol/mL were prepared from ATP powder, dissolved and diluted in saline, and administered by inhalation.

GroupValue95% CI
Cohort 1: Gefapixant 300 mg/Healthy192.00128 – 256
Cohort 1: Placebo/Healthy128.0064 – 256
Cohort 1: Chronic Cough/Gefapixant 300 mg8.000 – 64
Cohort 1: Placebo/Chronic Cough16.500 – 512
Cohort 2: Gefapixant 50 mg/Healthy64.0032 – 256
Cohort 2: Placebo/Healthy32.002 – 32
Cohort 2: Gefapixant 50 mg/Chronic Cough128.008 – 512
Cohort 2: Placebo/Chronic Cough4.000 – 128
Urge-to-Cough in Response to Capsaicin Challenge (Chronic Cough Participants Only) Secondary · At the end of a 4-hour post-dose observation period on Day 1; at the end of a 24-hour observation period on Day 2

In response to capsaicin challenges in Periods 1 and 2, participants with chronic cough completed a visual analogue scale (VAS) at the end of a 4-hour post-dose observation period on Day 1; and at end of 24-hour observation period on Day 2. For both periods, participants were asked to mark on a 100 mm VAS the severity of their urge to cough between 0 mm (no urge-to-cough) and 100 mm (worst urge-to-cough).

Day 1
GroupValue95% CI
Cohort 1: Gefapixant 300 mg/Chronic Cough28.9± 29.79
Cohort 1: Placebo/Chronic Cough38.6± 26.82
Cohort 2: Gefapixant 50 mg/Chronic Cough36.6± 30.84
Cohort 2: Placebo/Chronic Cough20.5± 11.54
Day 2
GroupValue95% CI
Cohort 1: Gefapixant 300 mg/Chronic Cough28.2± 32.72
Cohort 1: Placebo/Chronic Cough46.7± 29.20
Cohort 2: Gefapixant 50 mg/Chronic Cough41.8± 31.02
Cohort 2: Placebo/Chronic Cough36.7± 23.28
Urge-to-Cough in Response to ATP Challenge (Chronic Cough Participants Only) Secondary · At the end of a 4-hour post-dose observation period on Day 1; at the end of a 24-hour observation period on Day 2

In response to ATP challenges in Periods 3 and 4, participants with chronic cough completed a VAS at the end of a 4-hour post-dose observation period on Day 1; and at end of 24-hour observation period on Day 2. For both periods, participants were asked to mark on a 100 mm VAS the severity of their urge to cough between 0 mm (no urge-to-cough) and 100 mm (worst urge-to-cough).

Day 1
GroupValue95% CI
Cohort 1: Gefapixant 300 mg/Chronic Cough19.8± 23.54
Cohort 1: Placebo/Chronic Cough34.4± 26.78
Cohort 2: Gefapixant 50 mg/Chronic Cough21.5± 22.45
Cohort 2: Placebo/Chronic Cough25.3± 19.69
Day 2
GroupValue95% CI
Cohort 1: Gefapixant 300 mg/Chronic Cough21.6± 20.65
Cohort 1: Placebo/Chronic Cough39.8± 26.51
Cohort 2: Gefapixant 50 mg/Chronic Cough27.5± 29.54
Cohort 2: Placebo/Chronic Cough37.5± 27.33
Cough Severity in Response to Capsaicin Challenge (Chronic Cough Participants Only) Secondary · At the end of a 4-hour post-dose observation period; at the end of a 24-hour observation period on Day 2

In response to capsaicin challenges in Periods 1 and 2, participants with chronic cough completed a VAS at the end of a 4-hour post-dose observation period on Day 1; and at end of 24-hour observation period on Day 2. For both periods, participants were asked to mark on a 100 mm VAS their cough severity between 0 mm (no cough) and 100 mm (worst cough).

Day 1
GroupValue95% CI
Cohort 1: Gefapixant 300 mg/Chronic Cough28.2± 30.71
Cohort 1: Placebo/Chronic Cough35.7± 24.32
Cohort 2: Gefapixant 50 mg/Chronic Cough30.9± 27.22
Cohort 2: Placebo/Chronic Cough20.5± 12.75
Day 2
GroupValue95% CI
Cohort 1: Gefapixant 300 mg/Chronic Cough25.8± 30.20
Cohort 1: Placebo/Chronic Cough44.3± 27.43
Cohort 2: Gefapixant 50 mg/Chronic Cough39.8± 28.97
Cohort 2: Placebo/Chronic Cough35.5± 22.25
Cough Severity in Response to ATP Challenge (Chronic Cough Participants Only) Secondary · At the end of a 4-hour post-dose observation period on Day 1; at the end of a 24-hour observation period on Day 2

In response to ATP challenge in Periods 3 and 4, participants with chronic cough completed a VAS at the end of a 4-hour post-dose observation period on Day 1; and at end of 24-hour observation period on Day 2. For both periods, participants were asked to mark on a 100 mm VAS their cough severity between 0 mm (no cough) and 100 mm (worst cough).

Day 1
GroupValue95% CI
Cohort 1: Gefapixant 300 mg/Chronic Cough21.5± 27.06
Cohort 1: Placebo/Chronic Cough32.7± 24.23
Cohort 2: Gefapixant 50 mg/Chronic Cough21.2± 21.04
Cohort 2: Placebo/Chronic Cough23.5± 16.02
Day 2
GroupValue95% CI
Cohort 1: Gefapixant 300 mg/Chronic Cough18.9± 18.29
Cohort 1: Placebo/Chronic Cough36.8± 26.50
Cohort 2: Gefapixant 50 mg/Chronic Cough27.5± 26.78
Cohort 2: Placebo/Chronic Cough35.5± 24.07

Adverse events — posted to ClinicalTrials.gov

Time frame: Up to Day 41. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Cohort 1: Gefapixant 300 mg/Healthy
Serious: 0/14 (0%)
Deaths: 0/14
Cohort 1: Placebo/Healthy
Serious: 0/14 (0%)
Deaths: 0/14
Cohort 1: Gefapixant 300 mg/Chronic Cough
Serious: 0/12 (0%)
Deaths: 0/12
Cohort 1: Placebo/Chronic Cough
Serious: 0/12 (0%)
Deaths: 0/12
Cohort 2: Gefapixant 50 mg/Healthy
Serious: 0/12 (0%)
Deaths: 0/12
Cohort 2: Placebo/Healthy
Serious: 0/12 (0%)
Deaths: 0/12
Cohort 2: Gefapixant 50 mg/Chronic Cough
Serious: 0/12 (0%)
Deaths: 0/12
Cohort 2: Placebo/Chronic Cough
Serious: 0/11 (0%)
Deaths: 0/11
Other adverse events (41 terms — click to expand)

ReactionSystemCohort 1: Gefapixant 300 m…Cohort 1: Placebo/HealthyCohort 1: Gefapixant 300 m…Cohort 1: Placebo/Chronic …Cohort 2: Gefapixant 50 mg…Cohort 2: Placebo/HealthyCohort 2: Gefapixant 50 mg…Cohort 2: Placebo/Chronic …
DysgeusiaNervous system disorders
HeadacheNervous system disorders
Paraesthesia oralGastrointestinal disorders
AgeusiaNervous system disorders
HypogeusiaNervous system disorders
CoughRespiratory, thoracic and mediastinal disorders
Pharyngeal hypoaesthesiaRespiratory, thoracic and mediastinal disorders
Ear painEar and labyrinth disorders
DiarrhoeaGastrointestinal disorders
Dry mouthGastrointestinal disorders
DyspepsiaGastrointestinal disorders
Hypoaesthesia oralGastrointestinal disorders
NauseaGastrointestinal disorders
Reflux gastritisGastrointestinal disorders
Salivary hypersecretionGastrointestinal disorders
Tongue coatedGastrointestinal disorders
Tooth depositGastrointestinal disorders
VomitingGastrointestinal disorders
Chest discomfortGeneral disorders
FatigueGeneral disorders
PainGeneral disorders
GastroenteritisInfections and infestations
Oral herpesInfections and infestations
RhinitisInfections and infestations
Upper respiratory tract infectionInfections and infestations
Arthropod biteInjury, poisoning and procedural complications
ExcoriationInjury, poisoning and procedural complications
ArthralgiaMusculoskeletal and connective tissue disorders
Musculoskeletal painMusculoskeletal and connective tissue disorders
Spinal osteoarthritisMusculoskeletal and connective tissue disorders
DizzinessNervous system disorders
VIIth Nerve ParalysisNervous system disorders
AnxietyPsychiatric disorders
Dry throatRespiratory, thoracic and mediastinal disorders
Oropharyngeal discomfortRespiratory, thoracic and mediastinal disorders
Oropharyngeal painRespiratory, thoracic and mediastinal disorders
Throat irritationRespiratory, thoracic and mediastinal disorders
WheezingRespiratory, thoracic and mediastinal disorders
ErythemaSkin and subcutaneous tissue disorders
Hot flushVascular disorders

Data from ClinicalTrials.gov NCT02397460 adverse events section.

Sponsor's own description

The primary objective of this double-blind crossover study is to assess the effect of single doses of 50 mg and 300 mg gefapixant (AF-219/MK-7264) on cough reflex sensitivity to capsaicin in both healthy participants and participants with chronic cough. This study will also assess the effect of single doses of gefapixant on cough reflex sensitivity to adenosine triphosphate (ATP) in healthy participants and participants with chronic cough.

Publications & conference data

3 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Basic/Translational Development of Forthcoming Opioid- and Nonopioid-Targeted Pain Therapeutics.
    Knezevic NN, Yekkirala A, Yaksh TL. · · 2017 · cited 24× · PMID 29049116 · DOI 10.1213/ane.0000000000002442
  2. Curbing the Cough: Multimodal Treatments for Neurogenic Cough: A Systematic Review and Meta-Analysis.
    Wamkpah NS, Peterson AM, Lee JJ, Jia L, et al · · 2022 · cited 19× · PMID 33085095 · DOI 10.1002/lary.29146
  3. Safety and efficacy of gefapixant, a novel drug for the treatment of chronic cough: A systematic review and meta-analysis of randomized controlled trials.
    Abu-Zaid A, Aljaili AK, Althaqib A, Adem F, et al · · 2021 · cited 12× · PMID 34012479 · DOI 10.4103/atm.atm_417_20

Verify or expand the search:

Other trials of Gefapixant

Trials testing the same drug.

Other recruiting trials for Refractory Chronic Cough

Currently open trials in the same condition.

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

Trials by the same sponsor.

Verify against primary sources

Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT02397460.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing