CClinicalTrials.gg
CompletedNCT02232425Updated Aug 17, 2020Results posted

IX-01 Effect on Intravaginal Ejaculatory Latency Time (IELT) and Patient Reported Outcomes in Men With Premature Ejaculation (PE)

A Phase 2 interventional study of IX-01 and Placebo in Premature Ejaculation, sponsored by Ixchelsis Limited. Completed at 10 sites in 2 countries. Open to male participants aged 18 Years to 60 Years. Per ClinicalTrials.gov, last updated 2020-08-17.

Sponsored by Ixchelsis Limited · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
88
Allocation
Randomized
Ages
18 Years to 60 Years
Sex
Male
01

Study summary

The purpose of this study is to determine the effectiveness of IX-01 in men with lifelong premature ejaculation.

02

Conditions studied

  • Premature Ejaculation
03

Who can participate

Ages eligible
18 Years to 60 Years
Sexes eligible
Male
Accepts healthy volunteers
No

Inclusion criteria

  • In stable (≥ 6 months) heterosexual relationship
  • Have life-long (primary) premature ejaculation
  • Have premature ejaculation confirmed by Intravaginal Ejaculatory Latency Time (IELT) less than or equal to (≤) 1 minute on ≥ 75% attempts at sexual intercourse
  • Meet other aspects of the International Society for Sexual Medicine (ISSM) definition for lifelong premature ejaculation (PE), including inability to delay ejaculation on all or nearly all vaginal penetrations and negative personal consequences such as distress, bother and frustration
  • Willing to attempt intercourse at least 4 times during run-in period and at least 8 more times during double-blind part of the study
  • Not planning pregnancy with his partner and he is willing to use contraception (unless not of child-bearing potential, e.g., surgically sterilised)
  • Willing to limit use of alcohol on days in which they take study drug (not more than three drinks, where one drink is defined as a 12 ounce (oz), 360 milliliter (mL) bottle of beer, a 5 oz (150 mL) glass of wine, or a 1½ oz (45 mL distilled spirits)
  • Capable of giving written informed consent

Exclusion criteria

Exclusion Criteria:

  • An Intravaginal Ejaculatory Latency Time (IELT) value ≥ 2 minutes during run-in period
  • Less than (\<) 4 attempts at sexual intercourse during run-in (screening may be extended or patient may be rescreened if there are extenuating circumstances)
  • A rating of control of ejaculation as fair, good, or very good on the Premature Ejaculation Profile (PEP) questionnaire prior to study
  • Co-existing Erectile Dysfunction - International Index of Erectile Dysfunction (IIEF) erectile function domain \< 22 during run-in
  • Concomitant use of Phosphodiesterase 5 (PDE5) inhibitors, intracavernosal injections, penile implants, Selective Serotonin Reuptake Inhibitors (SSRI's) or Serotonin-Norepinephrine Reuptake Inhibitors (SSNRI's), tricyclic antidepressants (for example (e.g.) clomipramine), monoamine oxidase inhibitors, alpha blockers, 5 alpha reductase inhibitors (including propecia for hair loss), topical anaesthetics, and/or tramadol
  • History (last 6 months) of use of Botox or similar product to treat premature ejaculation
  • Unwilling to stop other treatments for premature ejaculation (including but not limited to pharmacological, herbal, multiple condoms, psychosexual treatment, prior masturbation)
  • Other sexual disorder of patient or partner that could interfere with results
  • Current active sexually transmitted disease
  • Major medical condition of patient that could interfere with ability to have sexual activity and or require hospital treatment
  • Body Mass Index (BMI) > 40 kg/m2
  • Participation in a clinical drug trial anytime during the 30 days prior to screening
  • Human Immunodeficiency Virus (HIV) or hepatitis B
  • History of clinically significant prostate disease
  • History of myocardial infarction, coronary bypass surgery, coronary artery angioplasty, unstable angina, clinically evident congestive heart failure, cardiac pacemaker, or cerebrovascular accident
  • Cardiac arrhythmia: significant cardiac arrhythmia shown on Electrocardiogram (ECG), or a known or suspected history of significant cardiac arrhythmias within last six months
  • History of congenital QT prolongation and/ corrected QT (QTc) interval > 450 milliseconds (msec) using the Bazett formula
  • Mean systolic cuff blood pressure (BP) > 140 millimeter of mercury (mmHg), as assessed by up to three measurements taken in sequence within 5-10 minutes of last measure
  • Mean diastolic cuff BP > 90 mmHg, as assessed by up to three measurements taken in sequence within 5-10 minutes of the last measure
  • Major psychiatric disease or risk of suicidal tendency as assessed by clinical evaluation and Patient Health Questionnaire (PHQ)-9 and Columbia Suicide Assessment
  • PHQ-9 questionnaire total score > 9 and/or score > 0 for question 9 of PHQ-9, and/or suicidal ideation or behavior as assessed by Columbia Suicide Assessment
  • Clinically significant abnormal laboratory function test results (including liver enzymes > 2 x Upper Limit of Normal (ULN) or bilirubin > 1.5 x ULN)
  • Taking Cytochrome P450 3A4 (CYP3A4) inducers, or moderate and potent CYP3A4 inhibitors
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Investigator)
Enrollment
88 participants (actual)

Study arms

  • Experimental
    Drug: IX-01

    Two to four 200 mg capsules administered orally, 1-6 hours prior to sexual activity

    Drug: IX-01

  • Placebo comparator
    Placebo

    Two to four capsules administered orally, 1-6 hours prior to sexual activity

    Drug: Placebo

Interventions

  • DrugIX-01
  • DrugPlacebo
05

What researchers measure

Primary outcomes

  1. Mean Fold Change in Geometric Mean Intravaginal Ejaculatory Latency Time (IELT)

    IX-01 versus placebo. Intravaginal ejaculatory latency time (IELT) was defined as the time from the initiation of sexual intercourse (penetration) until ejaculation occurred

    Time frame: Last 4 weeks of treatment compared to baseline

Secondary outcomes

  1. Proportion of Participants Rating Their PE as Better or Much Better, on the Clinical Global Impression of Change (CGIC) Scale

    7 point scale ranging from much worse (-3) to much better (3). The proportion refers to the proportion of patients who had the best 2 possible responses \[better(2) or much better (3)\] on this 7 point scale

    Time frame: Baseline to the end of treatment (approximately 8 weeks)

  2. Proportion of Participants With Greater Than or Equal to (≥) 2.5 Fold Increase in Intravaginal Ejaculatory Latency Time (IELT)

    Intravaginal ejaculatory latency time (IELT) was defined as the time from the initiation of sexual intercourse (penetration) until ejaculation occurred. Outcome measured proportion of patients with at least a 2.5-fold increase in geometric mean IELT over the last 4 weeks of treatment as compared to baseline. Proportion of participants adjusted for baseline IELT, country and site

    Time frame: Last 4 weeks of treatment compared to baseline

  3. Mean Fold Change in Arithmetic IELT (Intravaginal Ejaculatory Latency Time)

    IX-01 versus placebo

    Time frame: Last 4 weeks of treatment compared to baseline

  4. Mean Change in Score on Control of Timing of Ejaculation

    Reported in electronic diary and based on the Premature Ejaculation Profile (PEP). PEP question on control of timing is scored on a 5 point scale with the scores ranging from very poor (this is the worst answer) scored as 0 to very good (this is the best answer scored as 4)

    Time frame: Last 4 weeks of treatment compared to baseline

  5. Mean Change in Score on Ejaculation-related Personal Distress

    Based on Premature Ejaculation Profile (PEP). Scale ranges from 'extremely' (0) to 'not at all' (4). An increase in score from baseline indicates improvement.

    Time frame: Last 4 weeks of treatment compared to baseline

  6. Proportion of Participants With ≥ 1 Category of Improvement in Satisfaction With Sexual Intercourse, on the Premature Ejaculation Profile (PEP) Questionnaire

    Based on Premature Ejaculation Profile (PEP) 5 point scale with the scores ranging from 0 (worse answer) to 4 (best answer).

    Time frame: Baseline to 8 weeks

  7. Proportion of Participants With ≥ 1 Category of Improvement in Control Over Ejaculation During Sexual Intercourse on the Premature Ejaculation Profile (PEP) Questionnaire

    Reported in electronic diary and based on the Premature Ejaculation Profile (PEP). PEP is scored on a 5 point scale with the scores ranging from 0 (worst answer) to 4 (best answer)

    Time frame: Baseline to 8 weeks

  8. Proportion of Participants With ≥ 1 Category of Improvement in Ejaculation-related Distress on the Premature Ejaculation Profile ( PEP) Questionnaire

    Reported in e-diary. Based on Premature Ejaculation Profile (PEP). Scale ranges from 'extremely' (0) to 'not at all' (4). An increase in score from baseline indicates improvement.

    Time frame: Baseline to 8 weeks

  9. Proportion of Participants With ≥ 1 Category of Improvement in Ejaculation-related Interpersonal Difficulty on the Premature Ejaculation Profile (PEP) Questionnaire

    Reported in e-diary. Based on Premature Ejaculation Profile (PEP). Scale ranges from 'extremely' (0) to 'not at all' (4). An increase in score from baseline indicates improvement.

    Time frame: Baseline to 8 weeks

  10. Proportion of Participants With ≥ 2 Category Increase in Control and ≥ 1 Category Decrease in Personal Distress on a Patient Reported Outcome (PRO) Measure

    Reported in e-diary. Based on Premature Ejaculation Profile (PEP). Each of the PEP questions is scored on a 5 point scale with the scores ranging from 0 (worst answer) to 4 (best answer)

    Time frame: Baseline to 8 weeks

  11. Change in Percentage of Intercourse Attempts Lasting Longer Than 1 Minute From Baseline to Last 4 Weeks on Treatment

    'Baseline' time period defined as Day -28 - Day 0. 'Last 4 Weeks' time period defined as the 28 days prior to last time subject took study drug and after Day 14. Analysis excludes two subjects from ITT population: #010-012 (placebo) and #888-018 (active). Adjusted for treatment, baseline IELT, baseline percentage, country and site.

    Time frame: Baseline to last 4 weeks on treatment

  12. Incidence of Treatment-emergent Adverse Events

    Number of participants with at least one treatment-emergent adverse event

    Time frame: Start of Treatment to end of study (approximately 10 weeks)

06

Results

Posted Jan 24, 2019

Participant flow

Participant flow — Overall Study
MilestoneDrug: IX-01Placebo
Started5830
Completed4422
Not completed148
Withdrew: Lost to follow-up62
Withdrew: Adverse event20
Withdrew: Withdrawal by subject56
Withdrew: Lack of efficacy10

Outcome measures

PrimaryMean Fold Change in Geometric Mean Intravaginal Ejaculatory Latency Time (IELT)

IX-01 versus placebo. Intravaginal ejaculatory latency time (IELT) was defined as the time from the initiation of sexual intercourse (penetration) until ejaculation occurred

Time frame:
Last 4 weeks of treatment compared to baseline
Reported as:
Geometric mean · No units for fold change
Mean Fold Change in Geometric Mean Intravaginal Ejaculatory Latency Time (IELT)
No units for fold changeDrug: IX-01Placebo
Mean Fold Change in Geometric Mean Intravaginal Ejaculatory Latency Time (IELT)2.1 (1.5 to 3.1)1.1 (0.7 to 1.8)
SecondaryProportion of Participants Rating Their PE as Better or Much Better, on the Clinical Global Impression of Change (CGIC) Scale

7 point scale ranging from much worse (-3) to much better (3). The proportion refers to the proportion of patients who had the best 2 possible responses \[better(2) or much better (3)\] on this 7 point scale

Time frame:
Baseline to the end of treatment (approximately 8 weeks)
Reported as:
Number · proportion of participants
Proportion of Participants Rating Their PE as Better or Much Better, on the Clinical Global Impression of Change (CGIC) Scale
proportion of participantsDrug: IX-01Placebo
Better/Much Better0.170
Any Improvement0.440.13
SecondaryProportion of Participants With Greater Than or Equal to (≥) 2.5 Fold Increase in Intravaginal Ejaculatory Latency Time (IELT)

Intravaginal ejaculatory latency time (IELT) was defined as the time from the initiation of sexual intercourse (penetration) until ejaculation occurred. Outcome measured proportion of patients with at least a 2.5-fold increase in geometric mean IELT over the last 4 weeks of treatment as compared to baseline. Proportion of participants adjusted for baseline IELT, country and site

Time frame:
Last 4 weeks of treatment compared to baseline
Reported as:
Number · Proportion of participants
Proportion of Participants With Greater Than or Equal to (≥) 2.5 Fold Increase in Intravaginal Ejaculatory Latency Time (IELT)
Proportion of participantsDrug: IX-01Placebo
Proportion of Participants With Greater Than or Equal to (≥) 2.5 Fold Increase in Intravaginal Ejaculatory Latency Time (IELT)0.31 (0.14 to 0.54)0.07 (0.01 to 0.32)
SecondaryMean Fold Change in Arithmetic IELT (Intravaginal Ejaculatory Latency Time)

IX-01 versus placebo

Time frame:
Last 4 weeks of treatment compared to baseline
Reported as:
Mean · No units for fold change
Mean Fold Change in Arithmetic IELT (Intravaginal Ejaculatory Latency Time)
No units for fold changeDrug: IX-01Placebo
Mean Fold Change in Arithmetic IELT (Intravaginal Ejaculatory Latency Time)3.6 (2.2 to 5.0)1.8 (0.9 to 2.7)
SecondaryMean Change in Score on Control of Timing of Ejaculation

Reported in electronic diary and based on the Premature Ejaculation Profile (PEP). PEP question on control of timing is scored on a 5 point scale with the scores ranging from very poor (this is the worst answer) scored as 0 to very good (this is the best answer scored as 4)

Time frame:
Last 4 weeks of treatment compared to baseline
Reported as:
Mean · units on a scale
Mean Change in Score on Control of Timing of Ejaculation
units on a scaleDrug: IX-01Placebo
Mean Change in Score on Control of Timing of Ejaculation0.42 (-0.08 to 0.93)-0.03 (-0.59 to 0.53)
SecondaryMean Change in Score on Ejaculation-related Personal Distress

Based on Premature Ejaculation Profile (PEP). Scale ranges from 'extremely' (0) to 'not at all' (4). An increase in score from baseline indicates improvement.

Time frame:
Last 4 weeks of treatment compared to baseline
Reported as:
Mean · units on a scale
Mean Change in Score on Ejaculation-related Personal Distress
units on a scaleDrug: IX-01Placebo
Mean Change in Score on Ejaculation-related Personal Distress0.63 (0.37 to 0.88)0.03 (-0.34 to 0.40)
SecondaryProportion of Participants With ≥ 1 Category of Improvement in Satisfaction With Sexual Intercourse, on the Premature Ejaculation Profile (PEP) Questionnaire

Based on Premature Ejaculation Profile (PEP) 5 point scale with the scores ranging from 0 (worse answer) to 4 (best answer).

Time frame:
Baseline to 8 weeks
Reported as:
Number · adjusted proportion of participants
Proportion of Participants With ≥ 1 Category of Improvement in Satisfaction With Sexual Intercourse, on the Premature Ejaculation Profile (PEP) Questionnaire
adjusted proportion of participantsDrug: IX-01Placebo
Proportion of Participants With ≥ 1 Category of Improvement in Satisfaction With Sexual Intercourse, on the Premature Ejaculation Profile (PEP) Questionnaire0.53 (0.33 to 0.72)0.30 (0.13 to 0.56)
SecondaryProportion of Participants With ≥ 1 Category of Improvement in Control Over Ejaculation During Sexual Intercourse on the Premature Ejaculation Profile (PEP) Questionnaire

Reported in electronic diary and based on the Premature Ejaculation Profile (PEP). PEP is scored on a 5 point scale with the scores ranging from 0 (worst answer) to 4 (best answer)

Time frame:
Baseline to 8 weeks
Reported as:
Number · adjusted proportion of participants
Proportion of Participants With ≥ 1 Category of Improvement in Control Over Ejaculation During Sexual Intercourse on the Premature Ejaculation Profile (PEP) Questionnaire
adjusted proportion of participantsDrug: IX-01Placebo
Proportion of Participants With ≥ 1 Category of Improvement in Control Over Ejaculation During Sexual Intercourse on the Premature Ejaculation Profile (PEP) Questionnaire0.56 (0.42 to 0.69)0.36 (0.19 to 0.58)
SecondaryProportion of Participants With ≥ 1 Category of Improvement in Ejaculation-related Distress on the Premature Ejaculation Profile ( PEP) Questionnaire

Reported in e-diary. Based on Premature Ejaculation Profile (PEP). Scale ranges from 'extremely' (0) to 'not at all' (4). An increase in score from baseline indicates improvement.

Time frame:
Baseline to 8 weeks
Reported as:
Number · adjusted proportion of participants
Proportion of Participants With ≥ 1 Category of Improvement in Ejaculation-related Distress on the Premature Ejaculation Profile ( PEP) Questionnaire
adjusted proportion of participantsDrug: IX-01Placebo
Proportion of Participants With ≥ 1 Category of Improvement in Ejaculation-related Distress on the Premature Ejaculation Profile ( PEP) Questionnaire0.60 (0.46 to 0.73)0.36 (0.19 to 0.57)
SecondaryProportion of Participants With ≥ 1 Category of Improvement in Ejaculation-related Interpersonal Difficulty on the Premature Ejaculation Profile (PEP) Questionnaire

Reported in e-diary. Based on Premature Ejaculation Profile (PEP). Scale ranges from 'extremely' (0) to 'not at all' (4). An increase in score from baseline indicates improvement.

Time frame:
Baseline to 8 weeks
Reported as:
Number · adjusted proportion of participants
Proportion of Participants With ≥ 1 Category of Improvement in Ejaculation-related Interpersonal Difficulty on the Premature Ejaculation Profile (PEP) Questionnaire
adjusted proportion of participantsDrug: IX-01Placebo
Proportion of Participants With ≥ 1 Category of Improvement in Ejaculation-related Interpersonal Difficulty on the Premature Ejaculation Profile (PEP) Questionnaire0.60 (0.45 to 0.72)0.48 (0.29 to 0.68)
SecondaryProportion of Participants With ≥ 2 Category Increase in Control and ≥ 1 Category Decrease in Personal Distress on a Patient Reported Outcome (PRO) Measure

Reported in e-diary. Based on Premature Ejaculation Profile (PEP). Each of the PEP questions is scored on a 5 point scale with the scores ranging from 0 (worst answer) to 4 (best answer)

Time frame:
Baseline to 8 weeks
Reported as:
Number · proportion of participants
Proportion of Participants With ≥ 2 Category Increase in Control and ≥ 1 Category Decrease in Personal Distress on a Patient Reported Outcome (PRO) Measure
proportion of participantsDrug: IX-01Placebo
Proportion of Participants With ≥ 2 Category Increase in Control and ≥ 1 Category Decrease in Personal Distress on a Patient Reported Outcome (PRO) Measure0.170
SecondaryChange in Percentage of Intercourse Attempts Lasting Longer Than 1 Minute From Baseline to Last 4 Weeks on Treatment

'Baseline' time period defined as Day -28 - Day 0. 'Last 4 Weeks' time period defined as the 28 days prior to last time subject took study drug and after Day 14. Analysis excludes two subjects from ITT population: #010-012 (placebo) and #888-018 (active). Adjusted for treatment, baseline IELT, baseline percentage, country and site.

Time frame:
Baseline to last 4 weeks on treatment
Reported as:
Mean · percentage of attempts
Change in Percentage of Intercourse Attempts Lasting Longer Than 1 Minute From Baseline to Last 4 Weeks on Treatment
percentage of attemptsDrug: IX-01Placebo
Change in Percentage of Intercourse Attempts Lasting Longer Than 1 Minute From Baseline to Last 4 Weeks on Treatment37.6 (17.8 to 57.3)13.5 (-9.1 to 36.2)
SecondaryIncidence of Treatment-emergent Adverse Events

Number of participants with at least one treatment-emergent adverse event

Time frame:
Start of Treatment to end of study (approximately 10 weeks)
Reported as:
Number · participants
Incidence of Treatment-emergent Adverse Events
participantsDrug: IX-01Placebo
Incidence of Treatment-emergent Adverse Events129

Adverse events

Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Drug: IX-01—0/56 (0%)12/56 (21.4%)
Placebo—0/30 (0%)9/30 (30%)
Most frequent other events
Showing 10 of 24
Most frequent other events
EventDrug: IX-01Placebo
Upper respiratory tract infectionInfections and infestations1/562/30
NauseaGastrointestinal disorders2/561/30
Ear PainEar and labyrinth disorders0/561/30
Dry MouthGastrointestinal disorders1/561/30
DyspepsiaGastrointestinal disorders0/561/30
HemorrhoidsGastrointestinal disorders0/561/30
Feeling jitteryGeneral disorders0/561/30
Lower respiratory tract infectionInfections and infestations0/561/30
Tooth abscessInfections and infestations0/561/30
LacerationsInjury, poisoning and procedural complications0/561/30

Baseline characteristics

Age, Continuous
Age, Continuous(years)Drug: IX-01PlaceboTotal
Mean42 ± 943 ± 843 ± 9
Sex: Female, Male
Sex: Female, Male(Participants)Drug: IX-01PlaceboTotal
Female000
Male583088
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Drug: IX-01PlaceboTotal
Hispanic or Latino10212
Not Hispanic or Latino482876
Unknown or Not Reported000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Drug: IX-01PlaceboTotal
American Indian or Alaska Native000
Asian426
Native Hawaiian or Other Pacific Islander000
Black or African American6511
White482169
More than one race011
Unknown or Not Reported011
Region of Enrollment
Region of Enrollment(participants)Drug: IX-01PlaceboTotal
United States472370
Australia11718
07

Study locations

10 sites
  • San Diego Sexual Medicine
    San Diego, California 92120, United States
  • South Florida Medical Research Inc.
    Aventura, Florida 33180, United States
  • Center for Marital and Sexual Health of South Florida
    West Palm Beach, Florida 33401, United States
  • Tulane University School of Medicine
    New Orleans, Louisiana 70112, United States
  • Cooper Research Institute
    Camden, New Jersey 08103, United States
  • Manhattan Medical Research
    New York, New York 10016, United States
  • Urologic Consultants of Southeastern Pennsylvania
    Bala-Cynwyd, Pennsylvania 19004, United States
  • Miriam Hospital / The Men's Health Center
    Providence, Rhode Island 02906, United States
  • Australian Centre for Sexual Health
    Saint Leonards, New South Wales 2065, Australia
  • Keogh Institute for Medical Research
    Nedlands, Western Australia 6009, Australia
08

References and documents

Publications

  • McMahon C, Althof S, Rosen R, Giuliano F, Miner M, Osterloh IH, Muirhead GJ, Harty B; PEPIX Multi-Centre Study Group. The Oxytocin Antagonist Cligosiban Prolongs Intravaginal Ejaculatory Latency and Improves Patient-Reported Outcomes in Men with Lifelong Premature Ejaculation: Results of a Randomized, Double-Blind, Placebo-Controlled Proof-of-Concept Trial (PEPIX). J Sex Med. 2019 Aug;16(8):1178-1187. doi: 10.1016/j.jsxm.2019.05.016. PubMed 31351659 ↗
09

Registry details

Key details

Study ID
NCT02232425
Lead sponsor
Ixchelsis Limited
Collaborators
Carelon Research, Novotech (Australia) Pty Limited, ICON plc, PHT Corporation
Responsible party
Sponsor
First posted
Sep 5, 2014
Start date
Sep 2014
Primary completion
Oct 2015
Completion
Oct 2015
Results posted
Jan 24, 2019
Last update
Aug 17, 2020

Study contacts

Email Katie.George@Ixchelsis.com
study director · Ixchelsis Limited

Oversight

Data monitoring committee
No
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