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Chronic diffuse liver disease implies liver damage of various origin - viral hepatitis, the effect of xenobiotics (alcohol, drugs, medications, industrial toxins), metabolic disorders, non-alcoholic fatty liver disease. Intrahepatic cholestasis syndrome, or bile retention, occurs in 11-55% of cases of diffuse chronic liver diseases, usually leads to a worsening of the liver disease, a decrease in the effectiveness of treatment. The drug REMAXOL® is a solution for infusion, which has shown high effectiveness in the syndrome of intrahepatic cholestasis in cases of liver dysfunction due to acute or chronic damage. The study drug REMAXA® enteric-coated tablets is a hybrid drug which contains the same active metabolites as REMAXOL, i.e. inosine, methionine, nicotinamide, and succinic acid. The purpose of this study is to select the optimal dose and dosage regimen followed by evaluation safety and efficacy of REMAXA®, enteric-coated tablets, in comparison with REMAXOL®, solution for infusion, in patients who suffer from chronic diffuse liver diseases and have intrahepatic cholestasis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group I-1 | Experimental | Intake of REMAXA, enteric-coated tablets, 2 tablets 3 times a day for 10 days |
|
| Group I-2 | Experimental | Intake of REMAXA, enteric-coated tablets, 2 tablets 2 times a day for 10 days |
|
| Group I-3 | Experimental | Intake of REMAXA, enteric-coated tablets, 2 tablets once a day for 10 days |
|
| Group I-4 | Active Comparator | Infusions of REMAXOL, solution for infusion, by intravenous drip, 400 ml once a day for 10 days. |
|
| Group II-1 | Experimental | Intake of REMAXA, enteric-coated tablets, during 10 days according to optimal dosing regimen established during stage I. |
|
| Group II-2 | Active Comparator |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Remaxa, enteric-coated tablets | Drug | enteric-coated tablets |
|
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of responders to treatment in the study groups | The proportion of patients who responded to therapy, as indicated by any of the changes of laboratory parameters: a decrease in the level of gamma-glutamyltranspeptidase by at least 40% from the initial level and/or a decrease in the level of alkaline phosphatase by at least 30% from the initial level and/or a decrease in the level of total bilirubin not by less than 30% from the initial to the end of the therapeutic course in the REMAXA group compared to REMAXOL group. | 11 days |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Tatiana V Kharitonova, MD PhD | STPF POLYSAN | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Research Center for Eco-safety, Ltd. | Saint Petersburg | 196143 | Russia | |||
| City Hospital of the Holy Martyr Elizabeth |
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Multicenter prospective two-stage comparative randomized parallel group study with placebo control
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On stage 1, there will be no blinding (because REMAXOL is a solution for infusions). On stage 2, blinding will be ensured by placebo masking and drug assignment via IWRS.
Infusions of REMAXOL, solution for infusion, by intravenous drip, 400 ml once a day for 10 days. |
|
| Group II-3 | Placebo Comparator | Intake of Placebo, enteric-coated tablets, during 10 days, analogous to dosing regimen in Group II-1 |
|
| Remaxol | Drug | solution for infusions |
|
|
| Placebo | Drug | enteric-coated tablets |
|
| Saint Petersburg |
| 197706 |
| Russia |
| Medical Company "Hepatologist" Ltd. | Samara | 443063 | Russia |
| ID | Term |
|---|---|
| D002780 | Cholestasis, Intrahepatic |
| ID | Term |
|---|---|
| D002779 | Cholestasis |
| D001649 | Bile Duct Diseases |
| D001660 | Biliary Tract Diseases |
| D004066 | Digestive System Diseases |
| D008107 | Liver Diseases |
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| ID | Term |
|---|---|
| D007288 | Inosine |
| D008715 | Methionine |
| D009536 | Niacinamide |
| D019802 | Succinic Acid |
| C555877 | Remaxol |
| D008536 | Meglumine |
| ID | Term |
|---|---|
| D011684 | Purine Nucleosides |
| D011687 | Purines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
| D009705 | Nucleosides |
| D009706 | Nucleic Acids, Nucleotides, and Nucleosides |
| D012263 | Ribonucleosides |
| D000603 | Amino Acids, Sulfur |
| D013457 | Sulfur Compounds |
| D009930 | Organic Chemicals |
| D000601 | Amino Acids, Essential |
| D000596 | Amino Acids |
| D000602 | Amino Acids, Peptides, and Proteins |
| D021542 | Amino Acids, Neutral |
| D009539 | Nicotinic Acids |
| D000147 | Acids, Heterocyclic |
| D011725 | Pyridines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D013386 | Succinates |
| D003998 | Dicarboxylic Acids |
| D000144 | Acids, Acyclic |
| D002264 | Carboxylic Acids |
| D013012 | Sorbitol |
| D013402 | Sugar Alcohols |
| D000438 | Alcohols |
| D006595 | Hexosamines |
| D000606 | Amino Sugars |
| D002241 | Carbohydrates |
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