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The primary objective of the study is to determine the efficacy of Asacolâ„¢ 4.8 g/day (800 mg tablets) to induce clinical and endoscopic remission after 6 weeks of treatment compared to placebo in subjects with active ulcerative colitis (UC).
The 800 mg Asacolâ„¢ tablets from Tillotts Pharma AG are being marketed in over 30 countries, mainly in Europe and Asia. Approved dosages for the treatment of active UC are between 2.4 and 4.8 g/day in analogy to the approved 400 mg dosage form. The present trial is planned to generate efficacy data to support the safe use of a 4.8 g/day dose of the 800 mg dosage form in a well defined population of patients with mildly to moderately active UC. In keeping with the EMEA UC guideline the study will have a placebo-controlled 6 weeks induction treatment. After 6 weeks, treatment success will be evaluated using the modified UC disease activity index as primary efficacy measurement.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Mesalamin | Experimental | 4.8g Mesalamin (800mg tablet) |
|
| Placebo | Placebo Comparator | 4.8g Placebo to Mesalamin (800 mg tablet) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Mesalamin | Drug | 4.8g/day, 800 mg tablets |
|
| Measure | Description | Time Frame |
|---|---|---|
| To Achieve Clinical Remission in Subjects With Active Ulcerative Colitis (UC). | Clinical remission defined as stool frequency score of 0, rectal bleeding score of 0, no urgency | 6 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical Remission | Clinical remission defined as a score of 0 for stool frequency, 0 for rectal bleeding and no urgency | 10 weeks |
| Endoscopic Remission | Endoscopic remission is defined as a sigmoidoscopy score of 1 or less |
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Inclusion Criteria:
(1) Male or non-pregnant, non-lactating females, 18 years of age or older. (2) Documented diagnosis of UC with disease extending at least 15 cm from the anal verge.
(3) Active UC defined by:
(a) modified UC-DAI score of 4-10 with (b) sigmoidoscopy component score ≥ 2 and (c) rectal bleeding component score ≥ 1 (4) Ability of subject to participate fully in all aspects of this clinical trial.
(5) Written informed consent must be obtained and documented.
Exclusion Criteria:
Severe UC defined by the following criteria:
³6 bloody stools daily with one or more of the following:
Previously failed treatment with a mesalazine dose of > 2.0 g/day.
Current relapse lasting > 6 weeks in the opinion of the investigator.
Treatment with 5-ASA at a dose of >2.0g/day within 1 week prior to randomisation
Treatment with systemic or rectal steroids within 4 weeks prior to randomization.
Treatment with immunosuppressants within 6 weeks prior to randomization.
Treatment with infliximab or other biologics within 3 months prior to randomization.
Treatment with systemic antibiotics for UC within 7 days prior to randomization.
Treatment with probiotics within 7 days prior to randomization.
Treatment with anti-diarrheals within 7 days prior to randomization.
Treatment with nicotine patch within 7 days prior to randomization.
Received any investigational drug within 30 days prior to randomization.
History of colectomy or partial colectomy.
History of definite dysplasia in colonic biopsies.
Crohn's disease.
Known bleeding disorders.
Immediate or significant risk of toxic megacolon.
Hypersensitivity to salicylates, aspirin, sulfasalazine or 5-ASA.
Serum creatinine > 1.5 times the upper limit of the normal range.
AST, ALT, total bilirubin or alkaline phosphatase > 2 times the upper limit of the normal range.
Serious underlying disease other than UC which in the opinion of the investigator may interfere with the subject's ability to participate fully in the study.
History of alcohol or drug abuse which in the opinion of the investigator may interfere with the subject's ability to comply with the study procedures.
Stools positive for clostridium difficile.
Pregnant or lactating women.
Prior enrolment in the current study and had received study treatment.
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| Name | Affiliation | Role |
|---|---|---|
| Brian Feagan, MD | Alimentiv Inc. | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Gomel Regional Clinical Hospital, 9 | Homyel | 23602 | Belarus | |||
| City Clinical Hospital No.1 |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23528626 | Derived | Feagan BG, Sandborn WJ, D'Haens G, Pola S, McDonald JWD, Rutgeerts P, Munkholm P, Mittmann U, King D, Wong CJ, Zou G, Donner A, Shackelton LM, Gilgen D, Nelson S, Vandervoort MK, Fahmy M, Loftus EV Jr, Panaccione R, Travis SP, Van Assche GA, Vermeire S, Levesque BG. The role of centralized reading of endoscopy in a randomized controlled trial of mesalamine for ulcerative colitis. Gastroenterology. 2013 Jul;145(1):149-157.e2. doi: 10.1053/j.gastro.2013.03.025. Epub 2013 Mar 22. |
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Screen failures, not complying to inclusion and exclusion criteria
November 2009 - February 2011
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| ID | Title | Description |
|---|---|---|
| FG000 | Mesalamin | Mesalamin: 4.8g/day, 800 mg tablets |
| FG001 | Placebo | Placebo to Mesalamin: 4.8g/day, 800 mg tablets |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| 6 weeks |
| Endoscopic Remission | Endoscopic remission is defined as a sigmoidoscopy score of 1 or less | 10 weeks |
| Improvement | Improvement is defined as a reduction of at least 3 points from baseline in the modified UC-DAI score. (minumum 3, maximum 7, higher absolute UC-DAI scores indicate more severe disease) | 6 weeks |
| Improvement | Improvement is defined as a reduction of at least 3 points from baseline in the modified UC-DAI score. (minumum 3, maximum 7, higher absolute UC-DAI scores indicate more severe disease) | 10 weeks |
| Minsk |
| 220013 |
| Belarus |
| Minsk Regional Clinical Hospital, 41 | Minsk | 2230 | Belarus |
| City Clinical Hospital No. 2 | Minsk | Belarus |
| E.Klumov City Clinical Hospital No. 3 | Minsk | Belarus |
| Vitebsk Regional Clinical Hospital | Vitebsk | 210037 | Belarus |
| Medwin Hospital | Hyderabad | Andhrapradesh | 500 001 | India |
| Osmania General Hospital | Hyderabad | Andhrapradesh | 500 012 | India |
| M.S.Ramiah Hospital | Bangalore | Karnataka | 560 054 | India |
| Shree Gokulam Medical College and Research Foundation | Trivandrum | Kerala | 695 607 | India |
| S. R. Kalla Memorial Gastro and General Hospital | Jaipur | Rajasthan | 302 001 | India |
| Life Line Hospital | Chennai | Tamil Nadu | 600 096 | India |
| Maulana Azad Medical College and Associated Lok Nayak Hospital | New Delhi | 110 002 | India |
| Institute of liver and billiary sciences | New Delhi | 110 070 | India |
| Ankara University Medical Faculty Sihhiye | Ankara | 06100 | Turkey (Türkiye) |
| Hacettepe University Medical Faculty Sihhiye | Ankara | 06100 | Turkey (Türkiye) |
| Gazi University Medical Faculty Besevler | Ankara | 06500 | Turkey (Türkiye) |
| Dicle University Medical Faculty | Diyarbakır | 21280 | Turkey (Türkiye) |
| Trakya University Medical Faculty | Edirne | 22030 | Turkey (Türkiye) |
| Gaziantep University Medical Faculty Kampus Alani | Gaziantep | 27310 | Turkey (Türkiye) |
| Sisli Etfal Egitim ve Arastirma Hospital Sisli | Istanbul | 34360 | Turkey (Türkiye) |
| Dokuz Eylul University Medical Faculty Inciralti | Izmir | 35340 | Turkey (Türkiye) |
| Ataturk Egitim ve Arastirma Hospital Basin Sitesi | Izmir | 35360 | Turkey (Türkiye) |
| Dnipropetrovska derzhavna medychna akademiia, | Dnipropetrovsk | 4904 | Ukraine |
| Ivano-Frankivskyi natsionalnyi medychnyi universytet, | Ivano-Frankivsk | Ukraine |
| Miska klinichna likarnia 2, | Kharkiv | 61001 | Ukraine |
| Natsionalnyi medychnyi universytet im. Bogomoltsia, kafedra khirurgii 1 na bazi viddilennia proctologii Miskoi klinichnoi likarni 18, m.Kyiv | Kyiv | 01030 | Ukraine |
| Natsionalnyi medychnyi universytet im. O.O. Bogomoltsia, | Kyiv | 04053 | Ukraine |
| Natsionalna medychna akademia pisliadyplomnoi osvity im. P.L. Shupyk, | Kyiv | 04201 | Ukraine |
| Lvivskyi natsionalnyi medychnyi universytet imeni Danyla Galytskogo, | Lviv | Ukraine |
| Odeska oblasna klinichna likarnia, Oblasnyi tsentr gastroenterologii, | Odesa | 65039 | Ukraine |
| COMPLETED |
|
| NOT COMPLETED |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Mesalamin | Mesalamin: 4.8g/day, 800 mg tablets The study drug will be given for 10 weeks. All treatment regimens will be orally administered, with or without food. Subjects randomized to the Asacolâ„¢ 4.8 g/day treatment group will receive three 800 mg Asacolâ„¢ tablets in the morning and three 800 mg Asacolâ„¢ tablets in the evening. |
| BG001 | Placebo | Placebo to Mesalamin: 4.8g/day, 800 mg tablets The study drug will be given for 10 weeks. All treatment regimens will be orally administered, with or without food. Subjects randomized to the placebo treatment group will receive three placebo tablets in the morning and three placebo tablets in the evening. |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Race/Ethnicity, Customized | Number | participants |
| ||||||||||||||||
| Region of Enrollment | Number | participants |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | To Achieve Clinical Remission in Subjects With Active Ulcerative Colitis (UC). | Clinical remission defined as stool frequency score of 0, rectal bleeding score of 0, no urgency | ITT | Posted | Number | participants | 6 weeks |
|
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Clinical Remission | Clinical remission defined as a score of 0 for stool frequency, 0 for rectal bleeding and no urgency | ITT | Posted | Count of Participants | Participants | 10 weeks |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Endoscopic Remission | Endoscopic remission is defined as a sigmoidoscopy score of 1 or less | ITT | Posted | Count of Participants | Participants | 6 weeks |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Endoscopic Remission | Endoscopic remission is defined as a sigmoidoscopy score of 1 or less | ITT | Posted | Count of Participants | Participants | 10 weeks |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Improvement | Improvement is defined as a reduction of at least 3 points from baseline in the modified UC-DAI score. (minumum 3, maximum 7, higher absolute UC-DAI scores indicate more severe disease) | ITT | Posted | Count of Participants | Participants | 6 weeks |
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Improvement | Improvement is defined as a reduction of at least 3 points from baseline in the modified UC-DAI score. (minumum 3, maximum 7, higher absolute UC-DAI scores indicate more severe disease) | ITT | Posted | Count of Participants | Participants | 10 weeks |
|
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| Post-Hoc | To Achieve Clinical Remission in the Patient Population Confirmed by the Central Reader | Clinical Remission, defined as stool frequency score of 0, rectal bleeding score of 0 and absence of urgency in subjects with adequate disease extent at baseline confirmed by central reading. | modified ITT, eligibility confirmed by central reader | Posted | Count of Participants | Participants | 6 weeks |
|
|
19 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Mesalamin | Mesalamin: 4.8g/day, 800 mg tablets | 0 | 140 | 27 | 140 | ||
| EG001 | Placebo | Placebo to Mesalamin: 4.8g/day, 800 mg tablets | 3 | 141 | 47 | 141 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Colitis ulcerosa | Gastrointestinal disorders | MedRA 11.0 | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Monozytopenia | Investigations | MedRA 11.0 | Systematic Assessment |
| |
| Anaemia | Blood and lymphatic system disorders | MedRA 11.0 | Systematic Assessment |
| |
| Colitis ulcerosa | Gastrointestinal disorders | MedRA 11.0 | Systematic Assessment |
|
Investigator endoscopy scores resultet in 31% patients with insuficient disease severity at baseline. Central reader scores were used for a post hoc analysis of the primary endpoint, including patients with pre-specified disease severity only.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Brian G. Feagan et al | The Role of Centralized Reading of Endoscopy in a Randomized Controlled Trial of Mesalamine for Ulcertive Colitis | Gastroenterology 2013; 145: | 149-157 |
| ID | Term |
|---|---|
| D003093 | Colitis, Ulcerative |
| D000208 | Acute Disease |
| ID | Term |
|---|---|
| D003092 | Colitis |
| D005759 | Gastroenteritis |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D015212 | Inflammatory Bowel Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D019804 | Mesalamine |
| ID | Term |
|---|---|
| D062368 | meta-Aminobenzoates |
| D062365 | Aminobenzoates |
| D001565 | Benzoates |
| D000146 | Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
| D009930 | Organic Chemicals |
| D000636 | Aminosalicylic Acids |
| D012459 | Salicylates |
| D062385 | Hydroxybenzoates |
| D006880 | Hydroxy Acids |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D010636 | Phenols |
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| Male |
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| Asian |
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| Ukraine |
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| Belarus |
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| India |
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