Outcome
Type |
Measure |
Description |
Time frame |
Safety issue |
Primary |
Percentage of Primary Efficacy Responder at Week 34 by Randomized Treatment and Strata |
To compare the complete response rate at the end of the 8-week period of randomized withdrawal between randomized patients.A primary efficacy responder is defined as a randomized patient who has mUFC = ULN at Week 34 and who was neither discontinued (study or RW treatment) nor had osilodrostat dose increase above the level at Week 26 during the RW Period of the study. mUFC: mean urinary free cortisol; ULN: Upper Limit of Normal |
Week 34 (8 weeks) |
|
Secondary |
Percentage of Secondary Efficacy Responder at Week 24 (Key Secondary Endpoint) |
To assess the complete response rate at the end of individual dose-titration and treatment with LCI699 in the initial single-arm, open label period. A Key secondary efficacy responder is defined as a patient in FAS who has mUFC = ULN at Week 24 and the dose of osilodrostat during Study Period 2 (Weeks 13-24) was not increased above the level established at the end of Study Period 1 (Week 12). Patients who had missing mUFC assessment at Week 24 will be counted as non-responders for the key secondary endpoint. |
Week 24 |
|
Secondary |
Time-to-loss of Control of Mean Urinary Free Cortisol (mUFC) by Randomized Treatment Group |
Time-to-loss of control of mUFC during the RW Period, defined as the time (in days) from randomization to the first evidence of loss of control (defined as mUFC assessment >1.5 ULN based on central laboratory result & at least 2 of the associated individual urine samples showing UFC >1.5×ULN) within the RW period. A patient without evidence of loss of control was censored at the date of the last assessment with mUFC = 1.5 ULN. If a patient discontinued randomized treatment without having a UFC assessment, they were censored at the date of randomization. The measure type (number) refers to an Event probability estimate 8 weeks after randomization. |
8 weeks after randomization |
|
Secondary |
Complete Response Rate (CRR) |
Complete response rate is defined as percentage of enrolled participants with mUFC = ULN |
Week 12, Week 24, Week 48, Week 72, last observed value |
|
Secondary |
Actual Change From Baseline in mUFC |
Actual change in mUFC from baseline. |
Weeks 12, 24, 48, 72, last available assessment |
|
Secondary |
Actual Change From Baseline in Cardiovascular-related Parameter Associated With Cushing's Disease: Fasting Glucose |
Actual change in fasting glucose from baseline. |
Baseline, Weeks 48, 72, last available assessment |
|
Secondary |
Actual Change From Baseline in Cardiovascular-related Parameter Associated With Cushing's Disease: Hemoglobin A1C (HbA1C) |
Actual change in glycosylated hemoglobin (HbA1c) from baseline. |
Baseline, Weeks 48, 72, last available assessment |
|
Secondary |
Actual Change From Baseline in Cardiovascular-related Parameter Associated With Cushing's Disease: Cholesterol, LDL Cholesterol, HDL Cholesterol & Triglyceride |
Actual change in Cholesterol, LDL Cholesterol, HDL Cholesterol & Triglyceride from baseline. |
Baseline, Weeks 48, 72, last available assessment |
|
Secondary |
Actual Change From Baseline in Cardiovascular-related Parameter Associated With Cushing's Disease: Sitting Systolic Blood Pressure (SBP) & Sitting Diastolic Blood Pressure (DBP) |
Actual change in sitting SBP & DBP from baseline. |
Baseline, Weeks 48, 72, last available assessment |
|
Secondary |
Actual Change From Baseline in Cardiovascular-related Parameter Associated With Cushing's Disease: Weight |
Actual change in weight from baseline. |
Baseline, Weeks 48, 72, last available assessment |
|
Secondary |
Actual Change From Baseline in Cardiovascular-related Parameter Associated With Cushing's Disease: Body Mass Index (BMI) |
Actual change in BMI from baseline. |
Baseline, Weeks 48, 72, last available assessment |
|
Secondary |
Actual Change From Baseline in Cardiovascular-related Parameter Associated With Cushing's Disease: Waist Circumference |
Actual change in waist circumference from baseline. |
Baseline, Weeks 48, 72, last available assessment |
|
Secondary |
Actual Change From Baseline in Patient-Reported Outcomes (Cushing's Health-Related Quality of Life (QoL)) - Total Score |
Cushing's Disease Health-Related Quality of Life Questionnaire was developed to evaluate quality of life in patients with Cushing's syndrome. It is comprised of 12 items that capture patient responses on 7 concepts: daily activities, healing & pain, mood & self-confidence, social concerns, physical appearance, memory & concern about the future. These items are measured on a 5- point Likert-type scale assessing how often or how much each item has been related to the patient's Cushing's disease in the previous 4 weeks. The raw score is calculated by summing the individual item scores prior to being standardized so that the total score ranges from 0 to 100. Content reliability, sensitivity to change & psychometric properties have been validated in patients with Cushing's disease. Patients were asked to complete the questionnaire prior to clinical assessments being undertaken. Increases from baseline are indicative of an improvement. |
Baseline, Week (W) 48, W72, Last available assessment |
|
Secondary |
Actual Change From Baseline in Patient-Reported Outcomes: Beck Depression Inventory-II (BDI-II) |
BDI-II is a patient-reported instrument developed to measure the severity of depression in adults & adolescents aged 13 years & older. It is designed to be completed by the patient on paper & takes approximately 5 minutes to complete. The BDI-II consists of 21 items designed to assess the intensity of depression in clinical & normal patients in the preceding 2 weeks. Items are rated on a 4-point severity scale of 0 ('not at all') to 3 ('extreme' form of each symptom) with differing response options for each item. A global score ranging from 0 to 63 is calculated with a higher score representing a greater level of depression. The following scoring guidelines for interpretation of BDI-II have been suggested (Smarr, 2011): Minimal range =0-13, Mild depression =14-19, Moderate depression =20-28 and Severe depression = 29-63. Patients were asked to complete the questionnaire prior to clinical assessments being undertaken. A reduction from baseline in BDI-II is indicative of an improvement. |
Baseline, W48, W72, Last available assessment |
|
Secondary |
Actual Change in Patient-Reported Outcomes: EQ-5D-5L Utility Index |
The EQ-5D-5L questionnaire is a standardized measure of health status developed by the EuroQol Group in order to provide a simple, generic measure of health for clinical and economic appraisal. It is cognitively undemanding, taking only a few minutes to complete. Instructions to respondents are included in the questionnaire. The EQ-5D-5L measures 5 items on mobility, self-care, usual activities, pain/discomfort, anxiety/depression, measured on 5 levels: no problems, slight problems, moderate problems, severe problems, & extreme problems. A utility index can be computed from the EQ 5D-5L descriptive system with utility scores ranging from -0.281 (worst imaginable health state) to 1 (best imaginable health state), with -0.281 representing an "unconscious" health state. A single index value is analyzed for the EQ-5D-5L score. An increase from baseline in the EQ-ED-5L utility index is indicative of an improvement. |
Baseline, W48, W72, Last available assessment |
|
Secondary |
Actual Change in Patient-Reported Outcomes: EQ-5D-5L Vascular Analog Scale (VAS) |
The EQ-5D-5L also includes a 20 cm vertical, VAS (visual analogue scale) with on a scale of 0-100, with endpoints labeled 100 = 'the best health you can imagine' and 0 = 'the worst health you can imagine'. A single index value is analyzed for the VAS score. An increase from baseline in the EQ-ED-5L VAS is indicative of an improvement. |
Baseline, W48, W72, Last available assessment |
|
Secondary |
Change From Baseline in the Physical Features of Cushing's Disease by Photography |
Improvement from baseline to Weeks 48, 72 and End of Treatment (Extension period) in each of the following clinical signs of Cushing's disease by photography: facial rubor, hirsutism, striae, supraclavicular fat pad, dorsal fat pad, proximal muscle wasting (atrophy), central (abdominal) obesity, and ecchymoses (bruises). |
Week 48, Week 72, Last available assessment |
|
Secondary |
Change From Baseline in Bone Mineral Density - All Participants |
Actual change from baseline to Week 48 and the LOV in bone mineral density as measured by DXA scan at the lumbar spine and total hip. An increase in bone mineral density is indicative of an improvement.. |
Baseline, Week 48, Last observed value (LOV) |
|
Secondary |
Time-to-escape |
Escape was defined as the time (in days) from the first mUFC = ULN to the first mUFC results > 1.5 x ULN with at least 2 individual UFC results > 1.5 x ULN the loss happened beyond 12-week dose titration period. Participants randomized to placebo were not included in the analysis. |
From the first mUFC = ULN to the first mUFC results > 1.5 x ULN with at least 2 individual UFC results > 1.5 x ULN |
|
Secondary |
LCI699 Exposures |
To evaluate exposures of LCI699 in patients with Cushing's disease. Plasma concentrations (predose, 0.75 h, 1.5 h, and 4 h post-dose) of LCI699. These are the maximum number of PAS subjects analyzed for each incident dose. |
from week 2 to 10 at Predose, 0.75h, 1.5h, and 4h post-dose |
|
Secondary |
Percentage of Participants With Complete Response Rate (CRR) |
Complete response rate is defined as percentage of enrolled participants with mUFC = ULN. |
Week 12, Week 24, Week 48, Week 72, last available assessment |
|
Secondary |
Percentage of Participants With Partial Response Rate (PRR) |
Partial response rate is defined as percentage of enrolled participants with = 50% reduction from baseline in mUFC, but mUFC>ULN) |
Week 12, Week 24, Week 48, Week 72, last available assessment |
|
Secondary |
Percentage of Participants With Overall Response Rate (ORR) |
Overall response rate is defined as percentage of enrolled participants with mUFC = ULN or at least 50% reduction from baseline. |
Week 12, Week 24, Week 48, Week 72, last available assessment |
|