Efficacy and Safety of DWJ1609 for Bowel Cleansing Before Colonoscopy;

Efficacy and Safety of DWJ1609 for Bowel Cleansing Before Colonoscopy; a Prospective, Randomized, Single-blinded (Investigator), Parallel, Multi-center, Active-control, Non-inferiority, Phase 3 Clinical Trial

Phase of Development : III

Sponsor : DAEWOONG PHARMACEUTICAL

Study Sites and Principal Investigator : Dong ll Park M.D. Ph.D , Gastroenterology Kangbuk Samsung Hospital and other 6 study sites

Study Period : From the protocol approval date (institutional review board, IRB) 24 Months

Investigational product :

Investigational Products DWJ1609 (sodium sulfate potassium sulfate, Magnesium Sulfate Anhydrous , simethicone, sodium picosulphate)

Control Products DWC202304 (sodium sulfate potassium sulfate, Magnesium Sulfate Anhydrous , simethicone)

Target Diseases : A person who needs treatment before colonoscopy (X-ray, endoscopy)

Number of Subjects : 214 Subjects in total (85 subjects per group, 2 groups in total, considering a 20% dropout rate)

Study Methodology :

Test subjects evaluated as suitable for participation in clinical trials are randomly assigned at a 1:1 ratio to the test group (DWJ1609) and the control group (DWC202304), and clinical trial drugs are distributed for each administration group.

Subjects take the distributed clinical trial drugs as split-dose in the early evening of the day before colonoscopy (Day 1) and in the morning of the day of examination (Day 2) Test subjects visit the clinical trial institution after completing all clinical trial drugs at least 2 hours before colonoscopy (Visit 2).

All test subjects undergo colonoscopy in the morning, and the tester takes an image of all colonoscopy processes according to a separate manual.

For safety evaluation, subjects will conduct a phone visit 2 days after colonoscopy (±1 day) (Visit 3) and a regular visit 7 days after (±1 day) (Visit 4). If additional confirmation is required in the electrocardiogram or laboratory test results at the discretion of the tester, a follow-up visit can be conducted after 28 days (±2 days) (Visit 5).

I

Inclusion Criteria:

1. Adult men and women 19 years of age or older as of the date of consent in writing
2. a prospective colonoscopy patient
3. 19 kg/㎡ ≤ BMI < 30 kg/㎡
4. A person who voluntarily agrees to participate in this clinical trial and signs a written agreement Abbreviation: BMI = body mass index

Exclusion Criteria:

1. A person who undergoes colonoscopy for the following therapeutic purposes (1) balloon dilatation of the stenosis area (2) non-toxic giant colon or decompression of the S-phase colitis (sigmoid volvulus) (3) Removal of foreign substances (4) Vascular dysplasia, ulcer, tumor and treatment of bleeding after polypectomy (5) Treatment for stenosis or tumor bleeding (palliative treatment)

2. A person whose past history has been confirmed during a screening visit (1) Severe heart disease (insecurity angina, acute myocardial infarction, acute heart failure, cardiomyopathy, etc.) or acute respiratory failure within 24 weeks prior to screening (2) Epilepsy or seizures within 96 weeks prior to screening (3) Clinically significant intestinal surgical history regardless of duration (e.g., colon premature surgery, colon resection, etc.)

   a. However, appendectomy and hemorrhoids are excluded

3. A person who has been identified or suspected of the following comorbidities during a screening visit (1) active intestinal hemorrhage (2) gastrointestinal obstruction (intestinal obstruction, gastrointestinal obstruction, etc.), gastrointestinal perforation, gastric discharge disorder (gastrointestinal paralysis, gastric congestion, etc.) (3) Inflammatory bowel disease (ulcerative colitis, Crohn's disease, toxic colitis, toxic colitis, etc.) (4) Gastrointestinal ulcers, colorectal mucosal ulcers, ischemic colitis (5) an acute abdominal condition requiring surgery (6) A person who has been identified with the following major cardiovascular diseases

   ① congestive heart failure

   ② NYHA functional classification III or IV

   ③ Clinically significant arrhythmia identified by ECG, QTcFb delay (Male > 450 msec, Female > 470 msec) etc.

   b. QTc interval corrected by Fridericia's formula (7) Despite adequate medication, uncontrolled hypertension (SBP > 170 mmHg and DBP > 100 mmHg) (8) Diabetes undergoing insulin treatment or in need of insulin treatment (9) Clinically significant electrolyte abnormalities (sodium, potassium, calcium, magnesium, chloride, bicarbonate, phosphate etc.) (10) Those who are at risk of dehydration (transverse fusion, ascites, etc.) (11) Severe renal impairment (eGFRc < 30 mL/min/1.73m2) c. MDRD-eGFR (mL/min/1.73m2) = 186 × (serum creatinine concentration)-1.154 × (age)-0.203 (× 0.742, Female) (12) Child-Pugh class B or C (13) ALT or AST > three times the normal upper limit of the trachea (14) Severe nausea or vomiting that makes it difficult to participate in clinical trials (15) Active infection or high fever above 38℃ (except acute upper respiratory tract infection or local skin infection) (16) Active hepatitis B or C d. Defined as HBsAg positive during screening e. Defined as HCV Ab positive during screening (17) Test results of HIV antibodies and antibody test results

4. A person who is administering the following drugs during a screening visit or is expected to be administered by the time of completion of a colonoscopy (Day 2; Visit 2) (1) Constipation patients who are regularly administered laxatives or gastrointestinal motility promoters within 12 weeks prior to screening (e.g., two to three times a week or more) (2) Administration of laxatives, enema, simethicone, 5HT4 receptor agonist, iron preparation, opioid excluding clinical trial drugs within 7 days of clinical trial drug administration (Day 1)

5. A person who is hypersensitive to the ingredients of a clinical trial drug

6. a pregnant woman or a lactating woman

7. Fertility women and men who have a pregnancy plan or do not agree to perform appropriate contraception during the clinical trial. Appropriate contraception in this trial is as follows

   • hormonal contraceptive
   • implantation of intrauterine device or intrauterine system
   • Infertility procedures/surgery (e.g., bilateral ovarian ligation, vasectomy)

8. A person who has participated in another clinical trial/medical device clinical trial within 4 weeks of screening and has received/treated clinical trial medication/medical device

9. For other reasons, the tester determines that he/she is unfit to be tested for this clinical trial (e.g., clinically significant blood coagulation disorder, mental illness, dementia, drug or alcohol abuse history, oral administration of clinical trial drugs)