Efficacy and safety of levoketoconazole in the treatment of endogenous Cushing's syndrome (SONICS): a phase 3, multicentre, open-label, single-arm trial

Publication date: Available online 18 September 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Maria Fleseriu, Rosario Pivonello, Atanaska Elenkova, Roberto Salvatori, Richard J Auchus, Richard A Feelders, Eliza B Geer, Yona Greenman, Przemyslaw Witek, Fredric Cohen, Beverly M K BillerSummaryBackgroundLevoketoconazole is a ketoconazole stereoisomer in development for treatment of Cushing's syndrome and has not been assessed previously in a clinical trial in patients with Cushing's syndrome. We aimed to investigate the efficacy and safety of levoketoconazole in patients with endogenous Cushing's syndrome.MethodsSONICS is a phase 3, multicentre, open-label, non-randomised, single-arm study in which we recruited adults (≥18 years) with confirmed Cushing's syndrome and a mean 24-h urinary free cortisol (mUFC) of at least 1·5 times the upper limit of normal from 60 hospital and community sites in 19 countries (15 countries in Europe, and Canada, Israel, Turkey, and the USA). Patients were treated with oral levoketoconazole in a 2–21 week incremental dose-titration phase starting at 150 mg twice daily (150 mg increments until mUFC normalisation, maximum 600 mg twice daily) and a 6-month maintenance phase. The primary outcome was the proportion of patients with mUFC normalisation at end of maintenance, without dose increase during the maintenance phase (in the intention-to-treat population). Prespecified adverse events of special interest were potential liver toxicit...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research