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| ID | Type | Description | Link |
|---|---|---|---|
| 29672 | Other Identifier | Quorum Review IRB |
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This study evaluates the efficacy, safety and tolerability of NER1006 versus Trisulfate Solution (TS) in adult patients requiring bowel cleansing prior to any procedure that requires a clean bowel, using a 2-Day evening/morning Split-Dosing regimen. Approximately 540 patients will be randomised with the aim of achieving a minimum of 245 patients in each of the 2 groups.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NER1006, 2-Day Split-Dosing | Experimental | NER1006:2-Day Split-Dosing Regimen (to commence in the evening of the day before the colonoscopy) |
|
| Trisulfate Solution, 2-Day Split-Dosing | Active Comparator | Trisulfate Solution 2-Day Split-Dosing Regimen (to commence in the evening of the day before the colonoscopy) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| NER1006 | Drug | The subject will self-administer the first dose of the assigned investigational product in the evening prior to the scheduled colonoscopy and take mandatory additional clear fluid. Subject will take the second dose together with mandatory additional clear fluids on the morning of the colonoscopy. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Patients With Successful Bowel Cleansing (Overall Colon) | The overall quality of bowel cleansing was assessed by a blinded central reader (an experienced and trained colonoscopist) using the segmental scores of the Harefield Cleansing Scale (HCS). A final HCS grading of A, B, C or D was derived. Grades A and B are classified as successful (i.e., all mucosa could be visualised) and C and D are classified as unsuccessful. Comparison of overall success of cleansing with NER1006 versus Trisulfate solution was evaluated using a non-inferiority study design. | Two days (from day of first dosing to day of colonoscopy) |
| Number of Patients With 'Excellent Plus Good' (Highly Effective) Bowel Cleansing (Colon Ascendens) | The overall quality of bowel cleansing was assessed by a blinded central reader (an experienced and trained colonoscopist) using the segmental scores of the Harefield Cleansing Scale (HCS). Highly effective cleansing in the colon ascendens corresponded to scores 3 (Good) or 4 (Excellent) of the HCS. Adequate plus failure of cleansing corresponded to score 0-2. Comparison of 'Excellent plus good' cleansing of the colon ascendens using NER1006 versus Trisulfate Solution was evaluated using a non-inferiority study design. | Two days (from day of first dosing to day of colonoscopy) |
| Measure | Description | Time Frame |
|---|---|---|
| Adenoma Detection Rate (Colon Ascendens) | Comparison of the number of patients with at least one adenoma detected in the colon ascendens when NER1006 is used for bowel cleansing versus Trisulfate Solution. Adenoma detection rate (ADR) defined as the number of patients with at least one adenoma in the colon ascendens. | Two days (from day of first dosing to day of colonoscopy) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Michael Demicco | Anaheim Clinical Trials, CA | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Anaheim Clinical Trials | Anaheim | California | 92801 | United States | ||
| Investigative Clinical Research |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28803744 | Background | DeMicco MP, Clayton LB, Pilot J, Epstein MS; NOCT Study Group. Novel 1 L polyethylene glycol-based bowel preparation NER1006 for overall and right-sided colon cleansing: a randomized controlled phase 3 trial versus trisulfate. Gastrointest Endosc. 2018 Mar;87(3):677-687.e3. doi: 10.1016/j.gie.2017.07.047. Epub 2017 Aug 10. | |
| 36064325 |
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The trial recruited out/in-patients at 12 medical centres in the USA, from September 2014 to May 2015.
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| ID | Title | Description |
|---|---|---|
| FG000 | Trisulfate Solution 2-Day Split-Dosing | Trisulfate solution: Trisulfate solution 2-Day Split-Dosing Regimen (to commence in the evening of the day before the colonoscopy) |
| FG001 | NER1006 2-Day Split-Dosing |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Trisulfate solution | Drug | The subject will self-administer the first dose of the assigned investigational product in the evening prior to the scheduled colonoscopy and take mandatory additional clear fluid. Subject will take the second dose together with mandatory additional clear fluids on the morning of the colonoscopy. |
|
| Adenoma Detection Rate (Overall Colon) | Comparison of the number of patients with at least one adenoma detected in the overall colon when NER1006 is used for bowel cleansing versus Trisulfate Solution. ADR defined as the number of patients with at least one adenoma in the overall colon. | Two days (from day of first dosing to day of colonoscopy) |
| Polyp Detection Rate (Colon Ascendens) | Comparison of the number of patients with at least one polyp detected in the colon ascendens when NER1006 is used for bowel cleansing versus Trisulfate Solution. Polyp detection rate (PDR) defined as the number of patients with at least one polyp in the colon ascendens. | Two days (from day of first dosing to day of colonoscopy) |
| Polyp Detection Rate (Overall Colon) | Comparison of the number of patients with at least one polyp detected in the overall colon when NER1006 is used for bowel cleansing versus Trisulfate Solution. PDR defined as the number of patients with at least one polyp in the overall colon. | Two days (from day of first dosing to day of colonoscopy) |
| Annapolis |
| Maryland |
| 21401 |
| United States |
| MGG Group Co., Inc., Chevy Chase Clinical | Chevy Chase | Maryland | 20815 | United States |
| Clinical Research Institute of Michigan, LLC | Chesterfield | Michigan | 48047 | United States |
| Long Island Gastrointestinal Research Group, LLP | Great Neck | New York | 11023 | United States |
| Cumberland Research Associates, LLC | Fayetteville | North Carolina | 28304 | United States |
| Peters Medical Research | High Point | North Carolina | 27262 | United States |
| Wake Research Associates, LLC | Raleigh | North Carolina | 27612 | United States |
| Trial Management Associates, LLC | Wilmington | North Carolina | 24803 | United States |
| Consultants for Clinical Research | Cincinnati | Ohio | 45219 | United States |
| Investigative Clinical Research, LLC | Mentor | Ohio | 44060 | United States |
| Advanced Research Institute | Ogden | Utah | 84405 | United States |
| Cash BD, Allen C, Poppers DM. Transient alterations in plasma sodium concentrations with NER1006 bowel preparation: an analysis of three phase III, randomized clinical trials. BMC Gastroenterol. 2022 Sep 5;22(1):412. doi: 10.1186/s12876-022-02484-7. |
NER1006: NER1006 2-Day Split-Dosing Regimen (to commence in the evening of the day before the colonoscopy)
| COMPLETED |
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| NOT COMPLETED |
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The number of participants for analysis, 245 per arm, was based on assumed overall cleansing success rates of 90% for both Trisulfate Solution (TS) and NER1006, a non-inferiority (NI) margin of 10%, and at least 90% power to demonstrate NI. The overall number of participants analyzed was based on the modified full analysis set (mFAS).
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| ID | Title | Description |
|---|---|---|
| BG000 | Trisulfate Solution 2-Day Split-Dosing | Trisulfate solution: Trisulfate solution 2-Day Split-Dosing Regimen (to commence in the evening of the day before the colonoscopy) |
| BG001 | NER1006 2-Day Split-Dosing | NER1006: NER1006 2-Day Split-Dosing Regimen (to commence in the evening of the day before the colonoscopy) |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
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| Age, Continuous | Mean | Standard Deviation | Years |
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| Sex: Female, Male | Count of Participants | Participants |
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| 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 | Number of Patients With Successful Bowel Cleansing (Overall Colon) | The overall quality of bowel cleansing was assessed by a blinded central reader (an experienced and trained colonoscopist) using the segmental scores of the Harefield Cleansing Scale (HCS). A final HCS grading of A, B, C or D was derived. Grades A and B are classified as successful (i.e., all mucosa could be visualised) and C and D are classified as unsuccessful. Comparison of overall success of cleansing with NER1006 versus Trisulfate solution was evaluated using a non-inferiority study design. | The overall number of participants analyzed was based on the mFAS. This included all randomized patients, except any patient who (i) was randomized but subsequently failed to meet entry criteria and (ii) in whom it was confirmed (from their patient diary) that the same patient did not receive any study drug. | Posted | Count of Participants | Participants | Two days (from day of first dosing to day of colonoscopy) |
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| Primary | Number of Patients With 'Excellent Plus Good' (Highly Effective) Bowel Cleansing (Colon Ascendens) | The overall quality of bowel cleansing was assessed by a blinded central reader (an experienced and trained colonoscopist) using the segmental scores of the Harefield Cleansing Scale (HCS). Highly effective cleansing in the colon ascendens corresponded to scores 3 (Good) or 4 (Excellent) of the HCS. Adequate plus failure of cleansing corresponded to score 0-2. Comparison of 'Excellent plus good' cleansing of the colon ascendens using NER1006 versus Trisulfate Solution was evaluated using a non-inferiority study design. | The overall number of participants analyzed was based on the mFAS. This included all randomized patients, except any patient who (i) was randomized but subsequently failed to meet entry criteria and (ii) in whom it was confirmed (from their patient diary) that the same patient did not receive any study drug. | Posted | Count of Participants | Participants | Two days (from day of first dosing to day of colonoscopy) |
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| Secondary | Adenoma Detection Rate (Colon Ascendens) | Comparison of the number of patients with at least one adenoma detected in the colon ascendens when NER1006 is used for bowel cleansing versus Trisulfate Solution. Adenoma detection rate (ADR) defined as the number of patients with at least one adenoma in the colon ascendens. | The overall number of participants analyzed was based on the mFAS. This included all randomized patients, except any patient who (i) was randomized but subsequently failed to meet entry criteria and (ii) in whom it was confirmed (from their patient diary) that the same patient did not receive any study drug | Posted | Count of Participants | Participants | Two days (from day of first dosing to day of colonoscopy) |
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| Secondary | Adenoma Detection Rate (Overall Colon) | Comparison of the number of patients with at least one adenoma detected in the overall colon when NER1006 is used for bowel cleansing versus Trisulfate Solution. ADR defined as the number of patients with at least one adenoma in the overall colon. | The overall number of participants analyzed was based on the mFAS. This included all randomized patients, except any patient who (i) was randomized but subsequently failed to meet entry criteria and (ii) in whom it was confirmed (from their patient diary) that the same patient did not receive any study drug. | Posted | Count of Participants | Participants | Two days (from day of first dosing to day of colonoscopy) |
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| Secondary | Polyp Detection Rate (Colon Ascendens) | Comparison of the number of patients with at least one polyp detected in the colon ascendens when NER1006 is used for bowel cleansing versus Trisulfate Solution. Polyp detection rate (PDR) defined as the number of patients with at least one polyp in the colon ascendens. | The overall number of participants analyzed was based on the mFAS. This included all randomized patients, except any patient who (i) was randomized but subsequently failed to meet entry criteria and (ii) in whom it was confirmed (from their patient diary) that the same patient did not receive any study drug. | Posted | Count of Participants | Participants | Two days (from day of first dosing to day of colonoscopy) |
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| Secondary | Polyp Detection Rate (Overall Colon) | Comparison of the number of patients with at least one polyp detected in the overall colon when NER1006 is used for bowel cleansing versus Trisulfate Solution. PDR defined as the number of patients with at least one polyp in the overall colon. | The overall number of participants analyzed was based on the mFAS. This included all randomized patients, except any patient who (i) was randomized but subsequently failed to meet entry criteria and (ii) in whom it was confirmed (from their patient diary) that the same patient did not receive any study drug. | Posted | Count of Participants | Participants | Two days (from day of first dosing to day of colonoscopy) |
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Afternoon of Day 1 (first dose) to Day 9 (final clinic visit)
Safety analyses were based on the safety population which included all randomized patients for whom it could not be ruled out (from their patient diary) that they received study drug at least once (n=527). The analyses are based on treatment emergent adverse events (TEAEs). There were no deaths and neither of the serious TEAEs was related to treatment.
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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 | Trisulfate Solution 2-Day Split-Dosing | Trisulfate solution: Trisulfate solution 2-Day Split-Dosing Regimen (to commence in the evening of the day before the colonoscopy) | 0 | 265 | 1 | 265 | 32 | 265 |
| EG001 | NER1006 2-Day Split-Dosing | NER1006: NER1006 2-Day Split-Dosing Regimen (to commence in the evening of the day before the colonoscopy) | 0 | 262 | 1 | 262 | 73 | 262 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Gastrintestinal haemorrhage | Gastrointestinal disorders | MedDRA 18.0 | Non-systematic Assessment |
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| Ileus | Gastrointestinal disorders | MedDRA 18.0 | Non-systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abdominal Distension | Gastrointestinal disorders | MedDRA 18.0 | Non-systematic Assessment |
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| Abdominal Tenderness | Gastrointestinal disorders | MedDRA 18.0 | Non-systematic Assessment |
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| Gastritis | Gastrointestinal disorders | MedDRA 18.0 | Non-systematic Assessment |
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| Hiatus hernia | Gastrointestinal disorders | MedDRA 18.0 | Non-systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA 18.0 | Non-systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA 18.0 | Non-systematic Assessment |
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| Glomerular filtration rate decreased | Investigations | MedDRA 18.0 | Non-systematic Assessment |
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| Dehydration | Metabolism and nutrition disorders | MedDRA 18.0 | Non-systematic Assessment |
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| Headache | Nervous system disorders | MedDRA 18.0 | Non-systematic Assessment |
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| Nasopharyngitis | Infections and infestations | MedDRA 18.0 | Non-systematic Assessment |
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| Fatigue | General disorders | MedDRA 18.0 | Non-systematic Assessment |
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Imputation of failure occurred in 7% of patients. This strict analytical approach reduced the cleansing success rates for both treatments.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Lucy Clayton | Norgine Ltd | +44-1895-826669 | lclayton@norgine.com |
| ID | Term |
|---|---|
| D003110 | Colonic Neoplasms |
| D015179 | Colorectal Neoplasms |
| ID | Term |
|---|---|
| D007414 | Intestinal Neoplasms |
| D005770 | Gastrointestinal Neoplasms |
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004066 | Digestive System Diseases |
| D005767 | Gastrointestinal Diseases |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D012002 | Rectal Diseases |
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| >=65 years |
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| Male |
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| Non-Inferiority or Equivalence |
The confidence limits were adjusted for multiple comparisons (two alternative primary endpoints): To be declared non-inferior, the primary endpoint must show a difference in success rates of no greater than 10% in favor of Trisulfate Solution using lower 1-sided 97.5% confidence limits. Calculated using exact Clopper-Pearson confidence limits. |
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