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Idiopathic Pulmonary FibrosisPhase 2CORALNCT05964335

Cough Reduction in IPF With Nalbuphine ER

A Phase 2 study testing NAL ER in people with Idiopathic Pulmonary Fibrosis, run by Trevi Therapeutics at 59 sites in 10 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The main purpose of the study is to evaluate the effect of NAL ER on 24-hour cough frequency using objective digital cough monitoring and to assess safety and tolerability of NAL ER. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Idiopathic Pulmonary Fibrosis
What is being tested?
NAL ER
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
165 participants
Where
59 sitesin 10 countries
Study dates
6 Feb 2024to 24 Apr 2025
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Diagnosis of IPF as determined by the Principal Investigator based on ATS/ERS/JRS/ALAT guidelines.
  • Cough Severity Score ≥ 4 on CS-NRS (Cough Severity Numerical Rating Scale) during the Screening period and Baseline.
  • History of chronic cough for at least 8 weeks before screening.
  • SpO2 ≥ 92%, taken after at least 5 minutes in a sitting position, undisturbed and non-stimulated (Saturation of Hemoglobin with Oxygen as Measured by Pulse Oximetry).
  • FVC ≥ 40% predicted of normal - Forced Vital Capacity, as determined by spirometry adhering to ATS/ERS guidelines.
  • DLCO ≥ 25% predicted of normal - Diffusing capacity of the lung for carbon monoxide corrected for hemoglobin, assessed within the last 12 weeks, or at the time of screening.

Who cannot join

  • Currently on continuous oxygen therapy for longer than 16 hours at any level or delivered by any modality. Intermittent oxygen use of any duration over any given 24-hour period is allowed.
  • Inadequate swallow reflex as assessed by the ability to sip 3 fluid oz (or 89 mL) of water without coughing or choking.
  • Upper or lower respiratory tract infection in the last 8 weeks prior to the baseline visit.
  • Clinical history of aspiration pneumonitis.
  • Diagnosis of sleep apnea.
  • Abnormal kidney or liver functions based on Screening lab results.
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  • Known hypersensitivity to nalbuphine or to NAL ER excipients
  • History of major psychiatric disorder.
  • History of substance abuse.
  • Significant medical condition or other factors that may interfere with the participant's ability to successfully complete the study.
  • Pregnant or lactating female participant.
  • Known intolerance (gastrointestinal, central nervous system symptoms), hypersensitivity, drug allergy following the use of an opioid drug.
  • Use of opiates is prohibited within 14 days prior to the baseline visit.
  • Use of benzodiazepines are prohibited within 14 days prior to the baseline visit and for the duration of the study.
  • Monoamine oxidase inhibitors (MAOIs) including methylene blue (methylthioninium chloride) and the antibiotic linezolid are prohibited within 14 days prior to the baseline visit and for the duration of the study.
  • Use of oral corticosteroid cough treatment is prohibited within 4 weeks prior to the baseline visit and for the duration of the study.
  • Exposure to any investigational medication, including placebo, is prohibited within 4 weeks prior to the baseline visit and for the duration of the study.
  • Medications prescribed as cough suppressants are prohibited unless on a stable dose 14-days prior to the baseline visit and are expected to remain on that dose for the duration of the study.
  • Use of medications that affect serotonergic neurotransmission and that when used concomitantly with opioids can increase the risk of serotonin syndrome are prohibited unless on a stable dose 14-days prior to the baseline visit and are expected to remain on that dose for the duration of the study.
  • Anti-fibrotic medications are prohibited unless on a stable dose for 8 weeks prior to the baseline visit and are expected to remain on that dose for the duration of the study.
  • Strong inhibitors/inducers of the P450 Isozymes are prohibited unless on a stable dose for 14-days prior to baseline visit and are expected to remain on that dose for the duration of the study.
  • Use of a medication having a "known risk" of Torsade de Pointes (categorized as "KR" on the Credible Meds® website.) 4 weeks prior to Baseline.
  • Use of unstable doses of medications associated with a potential risk of QT prolongation but not clearly associated with Torsade de Pointes within 4 weeks of screening.
  • Other protocol defined inclusion/exclusion criteria may apply.

Trial locations and contacts

59 sites in 10 countries.

59 sites in 10 countries

United Kingdom13 sites
  • Queen Elizabeth Hospital Birmingham - University Hospitals Birmingham NHS Foundation Trust

    Birmingham, B15 2GW

  • Royal Papworth Hospital

    Cambridge, CB2 0AY

  • Hull and East Yorkshire - Castle Hill Hospital

    Cottingham, HU16 5JQ

  • Royal Infirmary Of Edinburgh

    Edinburgh, EH16 4SA

  • University College London

    London, NW1 2PG

  • Royal Brompton Hospital

    London, SW3 6NP

  • Altnagelvin Area Hospital

    Londonderry, BT47 6SB

  • Wythenshawe Hospital

    Manchester, M23 9LT

  • Norfolk and Norwich University Hospital

    Norwich, NR4 7UY

  • Nottingham City Hospital

    Nottingham, NG5 1PB

  • Churchill Hospital

    Oxford, OX3 7LE

  • Southern Health & Social Care Trust, Craigavon Area Hospital

    Portadown, BT63 5QQ

  • Southampton General Hospital

    Southampton, SO16 6YD

Other trials in United Kingdom

Germany7 sites
  • Universitatsklinik Ruhrlandklinik, Westdeutsches Lungenzentrum

    Essen, 45239

  • IKF Institut fuer klinische Forschung Frankfurt

    Frankfurt am Main, 60596

  • Medizinische Hochschule Hannover, Hannover Medical School

    Hanover, 30625

  • University Hospital of Leipzig

    Leipzig, 04103

  • IKF Pneumologie Mainz, Helix Medical Excellence Center Mainz

    Mainz, 55128

  • University Medical Center of Johannes Gutenberg-University Mainz

    Mainz, 55131

  • Krankenhaus Bethanien

    Solingen, 42699

Other trials in Germany

Australia6 sites
  • Eastern Health-Box Hill Hospital

    Box Hill, 3128

  • Concord Repatriation General Hospital

    Concord, 2139

  • Austin Hospital

    Heidelberg, 3084

  • Respiratory Clinical Trials Pty Ltd

    Kent Town, 5067

  • TrialsWest Pty Ltd

    Spearwood, 6163

  • Westmead Hospital

    Westmead, 2145

Other trials in Australia

Chile6 sites
  • Hospital Clinico Regional Dr. Guillermo Grant Benavente

    Concepción, 4040324

  • Centro Respiratorio Integral Ltda

    Quillota, 2260877

  • Clinica Universidad de los Andes

    Santiago, 7620157

  • Centro de Investigacion del Maule

    Talca, 3467384

  • Hospital Carlos Van Buren

    Valparaíso, 2352499

  • Centro de Investigaciones de Enfermedades Respiratorias e Immunologic Limitada

    Villa Del Mar, 2520598

Other trials in Chile

Turkey (Türkiye)6 sites
  • Gulhane Askeri Tip Akademisi (GATA) - Gulhane Askeri Tip Fakultesi (Gulhane Military Medical Academy and Medical School)

    Ankara, 06010

  • Akdeniz University Faculty of Medicine

    Antalya, 7070

  • Canakkale Onsekiz Mart Universitesi (COMU) - Tip Fakultesi Hastanesi

    Çanakkale, 17020

  • Sureyyapasa Gogus Hastaliklari ve Gogus Cerrahisi Egitim ve Arastirma Hastanesi

    Istanbul, 34854

  • Ege University Medical Faculty

    Izmir, 35100

  • Selcuk Universty Medical Faculty

    Konya, 42130

Other trials in Turkey (Türkiye)

Italy5 sites
  • Azienda Ospedaliero - Universitaria Policlinico - Vittorio Emanuele- Ospedale Gaspare Rodolico

    Catania, 95123

  • Azienda Ospedaliero Universitaria Ospedali Riuniti Di Foggia

    Foggia, 71122

  • Azienda Ospedaliera San Gerardo di Monza

    Monza, 20900

  • Azienda Ospedaliera di Padova

    Padua, 35128

  • Fondazione Policlinico Universitario Agostino Gemelli IRCCS

    Rome, 00168

Other trials in Italy

Canada4 sites
  • Dynamic Drug Advancement

    Ajax, L1S 2J5

  • CIC Mauricie Inc.

    Trois-Rivières, Quebec, G8T 7A1

  • Centre for Lung Health Clinic

    Vancouver, V5Z 1M9

  • The Pacific Lung Health Centre - St. Pauls Hospital

    Vancouver, V6Z 1Y6

Other trials in Canada

Netherlands4 sites
  • Jeroen Bosch Ziekenhuis

    's-Hertogenbosch, 5223 GZ

  • Martini Ziekenhuis

    Groningen, 9728 NT

  • Erasmus Medisch Centrum 1

    Rotterdam, 3015 GD

  • HMC (Haaglanden Medisch Centrum) Bronovo

    The Hague, 2512 VA

Other trials in Netherlands

Poland4 sites
  • Uniwersyteckie Centrum Kliniczne (UCK)

    Gdansk, 80-214

  • Uniwersytecki Szpital Kliniczny nr 1 im. N. Barlickiego

    Lodz, 90-153

  • Warminsko Mazurskie Centrum Chorob Pluc w Olsztynie

    Olsztyn, 10-357

  • Samodzielny Publiczny Wojewodzki Szpital Zespolony w Szczecinie

    Szczecin, 70-891

Other trials in Poland

Spain4 sites
  • Clinica Mi Tres Torres Barcelona

    Barcelona, 08017

  • Hospital Universitari de Bellvitge

    Barcelona, 08907

  • Hospital La Milagrosa

    Madrid, 28010

  • HUMV

    Santander, 39008

Other trials in Spain

About this study

Official title: A Randomized, Double-Blind, Placebo-Controlled, Parallel, 4-Arm Dose Ranging Study of the Safety and Efficacy of Nalbuphine Extended-Release Tablets (NAL ER) for the Treatment of Cough in Idiopathic Pulmonary Fibrosis (IPF)

The main purpose of the study is to evaluate the effect of NAL ER on 24-hour cough frequency using objective digital cough monitoring and to assess safety and tolerability of NAL ER.

Being tested
NAL ER, Placebo
Keywords
Cough, Nalbuphine
Medical subject headings
Idiopathic Pulmonary Fibrosis, Cough

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • NAL ERDrug

    Also called Nalbuphine

    Oral tablets

  • PlaceboDrug

    Oral tablets

  • NAL ERDrug

    Also called Nalbuphine

    Oral Tablets

  • NAL ERDrug

    Also called Nalbuphine

    Oral tablets

Study groups in NCT05964335
Study groupRoleWhat they receive
NAL ER 27 mgExperimentalParticipants were titrated over 2 weeks to NAL ER 27 mg BID, then maintained at the fixed dose for 4 weeks (total 6 weeks of treatment).
Receives: Drug: NAL ER
NAL ER 54 mgExperimentalParticipants were titrated over 2 weeks to NAL ER 54 mg BID, then maintained at the fixed dose for 4 weeks (total 6 weeks of treatment).
Receives: Drug: NAL ER
NAL ER 108 mgExperimentalParticipants were titrated over 2 weeks to NAL ER 108 mg BID, then maintained at the fixed dose for 4 weeks (total 6 weeks of treatment).
Receives: Drug: NAL ER
PlaceboPlacebo comparatorParticipants received a matching placebo BID, using the same 2-week blinded titration schedule and 4-week fixed-dose period as the active treatment arms (6 weeks total).
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Relative Change From Baseline in 24-hour Cough Frequency at Week 6

    Relative change in 24-hour (combined daytime and nighttime) cough frequency (coughs per hour) from baseline was assessed. Assessment was done using objective digital cough monitoring. The relative change from baseline = [ (Post-baseline - Baseline) / Baseline] × 100. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

Secondary outcomes (44)
  1. Relative Change From Baseline in Evaluating Respiratory Symptoms in Idiopathic Pulmonary Fibrosis (E-RS:IPF) Cough Subscale at Week 6

    The E-RS:IPF is a respiratory symptom subscale of the exacerbation of chronic pulmonary disease tool (EXACT) and consists of 11 items and was developed for use in IPF. The Cough subscale includes a single item (item 2: How often did you cough today?). The possible score range is 0 (not at all) to 4 (almost constantly). Higher scores indicate more severe symptoms. The relative change from baseline values is presented below. The relative change from baseline = [ (Post-baseline - Baseline) / Baseline] × 100. A positive change from baseline indicates worsening. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  2. Number of Participants Who Experienced at Least One Treatment Emergent Adverse Events (TEAEs)

    An adverse event (AE) was defined as any untoward medical occurrence in a participant or clinical investigation participant administered a pharmaceutical product and which does not necessarily have to have a causal relationship with the treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding, for example), symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. A TEAE was defined as any AE that occurs after the first dose of study drug. TEAEs included both serious and non-serious TEAEs.

    Measured: Up to Week 12

  3. Relative Change From Baseline in 24-hour Cough Frequency at Week 6

    Relative change in 24-hour (combined daytime and nighttime) cough frequency (coughs per hour) from baseline was assessed. Assessment was done using objective digital cough monitoring. The relative change from baseline = [ (Post-baseline - Baseline) / Baseline] × 100. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Weeks 6

  4. Percentage of Responders With ≥30%, ≥50% and ≥75% Reduction in the 24-Hour Cough Frequency at Week 6

    Responders were defined as those with ≥30%, ≥50%, or ≥75% reduction in 24-hour cough frequency from Baseline at Week 6. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  5. Relative Change From Baseline in Awake Cough Frequency at Week 6

    Awake cough was defined as cough that occurs between the time that the participant is awaken 24 hours after the digital cough monitor was applied for use. Assessment was done using objective digital cough monitoring. The relative change from baseline = [ (Post-baseline - Baseline) / Baseline] × 100. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  6. Relative Change From Baseline in Sleep Cough Frequency at Week 6

    Sleep cough frequency was intended as the average coughs per hour while the participant was flagged as being asleep. Assessment was done using objective digital cough monitoring. Percent change in cough frequency (coughs per hour) from baseline was assessed. The relative change from baseline = [ (Post-baseline - Baseline) / Baseline] × 100. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  7. Relative Change From Baseline in E-RS: IPF Cough Subscale at Week 6

    The E-RS:IPF is a respiratory symptom subscale of the EXACT and consists of 11 items and was developed for use in IPF. The Cough subscale includes a single item (item 2: How often did you cough today?) with a score range of 0 (not at all) to 4 (almost constantly). The relative change from baseline values is presented below. The relative change from baseline = [ (Post-baseline - Baseline) / Baseline] × 100. A positive change from baseline indicates worsening. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  8. Percentage of E-RS: IPF Cough Subscale Responders With At Least One Category Improvement at Week 6

    The E-RS:IPF is a respiratory symptom subscale of the EXACT and consists of 11 items and was developed for use in IPF. The Cough subscale includes a single item (item 2) with a score range of 0 (not at all) to 4 (almost constantly). Responders are defined as those with at least one category reduction (improvement) by ≥1 point at Week 6. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  9. Change From Baseline in E-RS:IPF Total Score at Week 6

    The Total E-RS:IPF includes all 11 items from the scale and was developed for use in IPF. Items assignments to domains of the E-RS:IPF are as follows: the RS-Breathlessness domain (Items 7-11) has a score range of 0-23; the IPF-Chest domain (Items 1, 5, and 6) has a score range of 0-12; the IPF-Cough domain (Item 2) has a score range of 0-4; the IPF-Sputum domain (Items 3 and 4) has a score range of 0-8; and the E-RS:IPF total score (Items 1-11) ranges from 0-47. For each day, the sum of the item-level raw scores forms the E-RS:IPF total score. Higher scores indicate more severe symptoms. A negative change from Baseline indicates improvement. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  10. Change From Baseline in IPF-Breathlessness Subdomain Score at Week 6

    The E-RS:IPF consists of a subset of 11 items from the EXACT and was developed for use in IPF. The Breathlessness subdomain score includes 5 items (Item 7: Were you breathless today, Item 8: Describe how breathless you were today, Item 9: Were you short of breath today when performing your usual personal care activities like washing or dressing, Item 10: Were you short of breath today when performing your usual indoor activities like cleaning or household work, Item 11: Were you short of breath today when performing your usual activities outside the home such as yard work or errands), all of which required the participant to report the effect of activities on shortness of breath. The possible score range is 0 to 23. A negative change from Baseline indicates improvement. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study. A higher score indicates more severe symptoms.

    Measured: Baseline, Week 6

  11. Change From Baseline in IPF-Cough Subdomain Score at Week 6

    The E-RS:IPF is a respiratory symptom subscale of the EXACT and consists of 11 items and was developed for use in IPF. The Cough subdomain score includes single item (item 2: How often did you cough today?) The possible score range is 0 (not at all) to 4 (almost constantly). A higher score indicates more severe symptoms. A negative change from baseline indicates improvement. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  12. Change From Baseline in IPF-Sputum Subdomain Score at Week 6

    The E-RS:IPF is a respiratory symptom subscale of the EXACT and consists of 11 items and was developed for use in IPF. The Sputum subdomain score includes 2 items (Item 3: How much mucus (phlegm) did you bring up when coughing today? and Item 4: How difficult was it to bring up mucus (phlegm) today?), which ask about quantity and difficulty in bringing up phlegm. The possible score range is 0-8. Higher score indicates more severe symptoms. A negative change from baseline indicates improvement. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  13. Change From Baseline in IPF-Chest Subdomain Score at Week 6

    The E-RS:IPF is a respiratory symptom subscale of the EXACT and consists of 11 items and was developed for use in IPF. The Chest subdomain score includes 3 items (Item 1: (Did your chest feel congested today?), Item 5: (Did you have chest discomfort today?), and Item 6: (Did your chest feel tight today?)). These questions solicited information on chest congestion, discomfort, and tightness. The possible score range is 0-12. A higher score indicates more severe symptoms. A negative change from baseline indicates improvement. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  14. Change From Baseline in Cough Severity Numerical Rating Scale (CS-NRS) at Week 6

    The CS-NRS is a single item scale in which participants described the severity of their cough in the past 24 hours on a scale of 0 (no cough) to 10 (worst possible cough). A negative change from Baseline indicates improvement. A higher score indicates more severe symptoms. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  15. Change From Baseline in Leicester Cough Questionnaire (LCQ) Total Score at Week 6

    LCQ is a self-reporting quality of life measure of chronic cough. It consists of 19 items with a 7-point Likert response scale ranging from 1 to 7. The responses are as follows: 1 = all of the time, 2 = most of the time, 3 = a good bit of the time, 4 = some of the time, 5 = a little of the time, 6 = hardly any of the time, and 7 = none of the time. Each item is designed to assess cough symptoms and the impact of cough across three main domains, physical (8 items), psychological (7 items), and social (4 items). Domain scores are calculated as the total score from items in the domain divided by the number of items in the domain and range from 1 to 7. The LCQ total score is calculated by summing the individual domain scores and ranges from 3 to 21, with higher scores indicating better health status. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  16. Percentage of LCQ Total Score Responders With 1.3-Point Increase Response at Week 6

    LCQ is a self-reporting quality of life measure of chronic cough. It consists of 19 items with a 7-point Likert response scale ranging from 1 to 7. The responses are as follows: 1 = all of the time, 2 = most of the time, 3 = a good bit of the time, 4 = some of the time, 5 = a little of the time, 6 = hardly any of the time, and 7 = none of the time. Each item is designed to assess cough symptoms and the impact of cough across three main domains, physical (8 items), psychological (7 items), and social (4 items). Domain scores are calculated as the total score from items in the domain divided by the number of items in the domain and range from 1 to 7. The LCQ total score is calculated by summing the individual domain scores and ranges from 3 to 21, with higher scores indicating better health status. Percentage of LCQ Total Score responders are presented in this outcome measure. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  17. Change From Baseline in LCQ Domains at Week 6

    LCQ is a self-reporting quality of life measure of chronic cough. It consists of 19 items with a 7-point Likert response scale ranging from 1 to 7. The responses are as follows: 1 = all of the time, 2 = most of the time, 3 = a good bit of the time, 4 = some of the time, 5 = a little of the time, 6 = hardly any of the time, and 7 = none of the time. Each item is designed to assess cough symptoms and the impact of cough across three main domains, physical (8 items), psychological (7 items), and social (4 items). Domain scores are calculated as the total score from items in the domain divided by the number of items in the domain and each domain score ranges from 1 to 7. Higher scores indicate better physical, psychological, and social status respectively. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  18. Change From Baseline in Living With Pulmonary Fibrosis Impacts Questionnaire (L-IPF©) Impacts Raw Sum Score at Week 6

    The L-IPF questionnaire is a 35-item questionnaire with two modules: symptoms (15 items) and impacts (20 items). The Impacts module yields a single Impacts score that is presented in this outcome measure. Each item's score ranges from 0-3. The score range for the L-IPF overall impacts raw sum score is 0-60, with higher scores indicating severe adverse impact. A negative change from Baseline indicates improvement. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  19. Change From Baseline in L-IPF Symptoms Domain Scores at Week 6

    The L-IPF questionnaire is a 35-item questionnaire with two modules: symptoms (15 items) and impacts (20 items). The L-IPF Symptoms module measures the various symptoms associated with IPF. The module contains 15 items that fall into 3 domains: Dyspnea, Cough, and Energy. Each item consists of a 0-3 score range. Dyspnea consists of 7 items and has a raw sum score range of 0-21 with higher scores indicating worsening dyspnea symptoms, Cough consists of 5 items and has a raw sum score range of 0-15 with higher scores indicating worsening cough symptoms, and Energy consists of 3 items and has a raw sum score range of 0-9 with higher scores indicating worsening energy. A negative change from Baseline indicates improvement. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  20. Number of Participants With Shift From Baseline in European Quality of Life 5 Dimensions 5 Level (EQ-5D-5L™) at Week 6

    The EQ-5D-5L is a participant reported outcome and comprises of a descriptive system with 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression). The recall period was the day that the questions were being completed. Each of the 5 dimensions in the descriptive system had 5 levels: 1 = no problems, 2 = slight problems, 3 = moderate problems, 4 = severe problems, and 5 = extreme problems. Higher scores indicate worsening. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  21. Change From Baseline in Patient Global Impression of Severity (PGI-S) Cough Score at Week 6

    The PGI-S cough scale is a self-reported, single-item categorical scale used for assessing chronic cough. Participants rated the severity of their cough in the last week with a 4-point Likert scale (0-3: 0 = No Cough, 1 = Mild, 2 = Moderate, or 3 = Severe). Higher scores indicate worsening. A negative change from Baseline indicates improvement. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  22. Patient Global Impression of Change (PGI-C) Cough Score at Week 6

    The PGI-C cough is a self-reported single-item 7-point scale that assesses participants' ratings of cough over the past 7 days. Participants rated their change as -3 = much better, -2 = moderately better, -1 = a little better, 0 = no change, 1 = a little worse, 2 = moderately worse, or 3 = much worse. Higher scores indicate worsening. A negative change from Baseline indicates improvement.

    Measured: At Week 6

  23. Percentage of Participants With Improvement by ≥1 and ≥ 2 on PGI-C Cough

    The PGI-C cough is a self-reported single-item 7-point scale that assesses participants' ratings of cough over the past 7 days. Participants rated their change as -3 = much better, -2 = moderately better, -1 = a little better, 0 = no change, 1= a little worse, 2 = moderately worse, or 3 = much worse. Higher scores indicate worsening. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  24. Percentage of Participants With Worsening by ≥1 and ≥2 on PGI-C Cough

    The PGI-C cough is a self-reported single-item 7-point scale that assesses participants' ratings of cough over the past 7 days. Participants rated their change as -3 = much better, -2 = moderately better, -1 = a little better, 0 = no change, 1= a little worse, 2 = moderately worse, or 3 = much worse. Higher scores indicate worsening. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  25. Percentage of Participants With no Change on PGI-C Cough

    The PGI-C cough is a self-reported single-item 7-point scale that assesses participants' ratings of cough over the past 7 days. Participants rated their change as -3 = much better, -2 = moderately better, -1 = a little better, 0 = no change, 1= a little worse, 2 = moderately worse, or 3=much worse. Higher scores indicate worsening. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  26. Percentage of Participants With Improvement by ≥1 and ≥2 on PGI-S Cough

    The PGI-S cough scale is a self-reported, single-item categorical scale used for assessing chronic cough. Participants rated the severity of their cough in the last week with a 4-point Likert scale (0-3: 0 = No Cough, 1 = Mild, 2 = Moderate, or 3 = Severe). Higher scores indicate worsening. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  27. Percentage of Participants With Worsening by ≥1 and ≥2 and PGI-S Cough

    The PGI-S cough scale is a self-reported, single-item categorical scale used for assessing chronic cough. Participants rated the severity of their cough in the last week with a 4-point Likert scale (0-3: 0 = No Cough, 1 = Mild, 2 = Moderate, or 3 = Severe). Higher scores indicate worsening. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  28. Percentage of Participants With no Change on PGI-S Cough

    The PGI-S cough scale is a self-reported, single-item categorical scale used for assessing chronic cough. Participants rated the severity of their cough in the last week with a 4-point Likert scale (0-3: 0 = No Cough, 1 = Mild, 2 = Moderate, or 3 = Severe). Higher scores indicate worsening. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  29. Change From Baseline in PGI-S IPF at Week 6

    PGI-S IPF scale is a self-reported, single-item categorical scale that was used to assess symptoms of IPF. Participants rated the symptoms of IPF in the last week with a 4-point Likert scale (0-3: 0 = No symptoms, 1 = Mild, 2 = Moderate, or 3 = Severe). Higher scores indicate worsening. A negative change from Baseline indicates improvement. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  30. PGI-C IPF Score at Week 6

    The PGI-C IPF is a self-reported, single-item 7-point scale assessing a participant's rating of cough over the past 7 days. Participants rated their change as -3 = much better, -2 = moderately better, -1 = a little better, 0 = no change, 1 = a little worse, 2 = moderately worse, or 3 = much worse. Higher scores indicate worsening. A negative change from Baseline indicates improvement.

    Measured: At Week 6

  31. Percentage of Participants With Improvement by ≥1 and ≥2 on PGI-C IPF

    The PGI-C IPF is a self-reported, single-item 7-point scale assessing a participant's rating of cough over the past 7 days. Participants rated their change as -3 = much better, -2 = moderately better, -1 = a little better, 0 = no change, 1= a little worse, 2 = moderately worse, or 3 = much worse. Higher scores indicate worsening. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  32. Percentage of Participants With Worsening by ≥1 and ≥2 on PGI-C IPF

    The PGI-C IPF is a self-reported, single-item 7-point scale assessing a participant's rating of cough over the past 7 days. Participants rated their change as -3 = much better, -2 = moderately better, -1= a little better, 0 = no change, 1= a little worse, 2 = moderately worse, or 3 = much worse. Higher scores indicate worsening. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  33. Percentage of Participants With no Change on PGI-C IPF

    The PGI-C IPF is a self-reported, single-item 7-point scale assessing a participant's rating of cough over the past 7 days. Participants rated their change as -3 = much better, -2 = moderately better, -1= a little better, 0 = no change, 1= a little worse, 2 = moderately worse, or 3 = much worse. Higher scores indicate worsening. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  34. Percentage of Participants With Improvement by ≥1 and ≥2 on PGI-S-IPF

    PGI-S IPF scale is a self-reported, single-item categorical scale that was used to assess symptoms of IPF. Participants rated the symptoms of IPF in the last week with a 4-point Likert scale (0-3: 0 = No symptoms, 1 = Mild, 2 = Moderate, or 3 = Severe). Higher scores indicate worsening. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  35. Percentage of Participants With Worsening by ≥1 and ≥2 on PGI-S-IPF

    PGI-S IPF scale is a self-reported, single-item categorical scale that was used to assess symptoms of IPF. Participants rated the symptoms of IPF in the last week with a 4-point Likert scale (0-3: 0 = No symptoms, 1 = Mild, 2 = Moderate, or 3 = Severe). Higher scores indicate worsening. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  36. Percentage of Participants With no Change on PGI-S-IPF

    PGI-S IPF scale is a self-reported, single-item categorical scale that was used to assess symptoms of IPF. Participants rated the symptoms of IPF in the last week with a 4-point Likert scale (0-3: 0 = No symptoms, 1 = Mild, 2 = Moderate, or 3 = Severe). Higher scores indicate worsening. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  37. Change From Baseline in Clinicians Global Impression of Severity (CGI-S) Score at Week 6

    The CGI-S is a single-item measure on which the clinician rates the participant's cough. CGI-S have score range of 0-3. (0 = no cough, 1 = mild, 2 = moderate, 3 = severe). Higher scores indicate greater severity of cough. A negative change from Baseline indicates improvement. The baseline value was defined as the last non-missing observation prior to the date of the first dose of study.

    Measured: Baseline, Week 6

  38. CGI-C IPF Score at Week 6

    The CGI-C is a one-item measure evaluating change from the initiation of treatment on a seven-point scale. CGI-C have score range 1-7 (1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse. Higher scores indicate greater severity of cough.

    Measured: At Week 6

  39. Percentage of Participants With Improvement by ≥1 and ≥2 on the Clinicians Global Impression of Change (CGI-C) at Week 6

    The CGI-C is a one-item measure evaluating change from the initiation of treatment on a seven-point scale. CGI-C have score range 1-7 (1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse. Higher scores indicate greater severity of cough. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  40. Percentage of Participants With Worsening by ≥1 and ≥2 on the CGI-C at Week 6

    The CGI-C is a one-item measure evaluating change from the initiation of treatment on a seven-point scale. CGI-C have score range 1-7 (1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse. Higher scores indicate greater severity of cough. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  41. Percentage of Participants With no Change on the CGI-C at Week 6

    The CGI-C is a one-item measure evaluating change from the initiation of treatment on a seven-point scale. CGI-C have score range 1-7 (1 = Very much improved, 2 = Much improved, 3 = Minimally improved, 4 = No change, 5 = Minimally worse, 6 = Much worse, 7 = Very much worse. Higher scores indicate greater severity of cough. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  42. Percentage of Participants With Improvement by ≥1 and ≥2 on the Clinicians Global Impression of Severity (CGI-S) at Week 6

    The CGI-S is a single-item measure on which the clinician rates the participant's cough. CGI-S have score range 0-3 (0 = no cough, 1= mild, 2 = moderate, 3 = severe). Higher scores indicate greater severity of cough. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  43. Percentage of Participants With Worsening by ≥1 and ≥2 on the CGI-S at Week 6

    The CGI-S is a single-item measure on which the clinician rates the participant's cough. CGI-S have score range 0-3 (0 = no cough, 1= mild, 2 = moderate, 3 = severe). Higher scores indicate greater severity of cough. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

  44. Percentage of Participants With no Change on the CGI-S at Week 6

    The CGI-S is a single-item measure on which the clinician rates the participant's cough. CGI-S have score range 0-3 (0 = no cough, 1= mild, 2 = moderate, 3 = severe). Higher scores indicate greater severity of cough. Percentages were rounded off to the nearest decimal.

    Measured: At Week 6

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Jul 2023
  2. Study start6 Feb 2024
  3. Primary completion24 Apr 2025
  4. Study completion24 Apr 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
165 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05964335
Sponsor's protocol ID
NAL03-202
Acronym
CORAL
Status last verified
Jun 2026
First submitted
7 Jul 2023
Last updated
26 Jun 2026
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Molyneaux PL, Mogulkoc N, Gunen H, Doboszynska A, Kreuter M, Neustifter B, Mathur V, Cassella J; CORAL Study Group. Oral Nalbuphine in Idiopathic Pulmonary Fibrosis-Associated Cough: The CORAL Randomized Clinical Trial. JAMA. 2026 Mar 24;335(12):1050-1059. doi: 10.1001/jama.2025.26179.

    PubMed 41569557

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing NAL ER in people with Idiopathic Pulmonary Fibrosis, run by Trevi Therapeutics at 59 sites in 10 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 24 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 26 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 59 sites in United Kingdom, Germany, Australia, Chile, Turkey (Türkiye) and 5 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 26 Jun 2026). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Relative Change From Baseline in 24-hour Cough Frequency at Week 6 (time frame: Baseline, Week 6). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05964335, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Jun 2026.

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