Title

Safety and Efficacy of Two Different Doses of Asacol in the Treatment of Moderately Active Ulcerative Colitis
A Double-Blind, Randomized, 6-Week, Parallel-Group Design Clinical Trial to Assess Safety and Efficacy of Asacol 4.8 g/Day (800 mg Tablet) Versus Asacol 2.4 g/Day (400 mg Tablet) for the Treatment of Moderately Active Ulcerative Colitis
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Intervention/Treatment

    mesalamine ...
  • Study Participants

    386
This study is a prospective clinical study to evaluate the safety and efficacy of two different doses of Asacol for the treatment of moderately active ulcerative colitis. In addition, a new tablet formulation will be evaluated at one of the two doses.
Study Started
Sep 30
2000
Primary Completion
Sep 30
2003
Study Completion
Sep 30
2003
Results Posted
Jul 28
2011
Estimate
Last Update
Jun 29
2015
Estimate

Drug Asacol 800 mg (mesalamine)

tablets, 4.8 g/day for 6 weeks, 2 - 800 mg Asacol tablets and 2 placebo tablets 3 times daily

Drug Asacol 400 mg (mesalamine)

tablets, 2.4 g/day for 6 weeks, 2 - 400 mg Asacol tablets and 2 placebo tablets 3 times daily

Asacol 2.4 g/day Active Comparator

Asacol (2.4 g/day)

Asacol 4.8 g/day Experimental

Asacol (4.8 g/day)

Criteria

Inclusion Criteria:

male or female between 18 and 75 years of age;
have a confirmed diagnosis of ulcerative colitis with the extent varying from proctitis to pancolitis;
currently demonstrating moderately active disease

Exclusion Criteria:

Patients will be excluded from admission to the study if they have/are:

a history of allergy or hypersensitivity to salicylates or aminosalicylates;
a history of extensive small bowel resection (>1/2 the length of the small intestine) causing short bowel syndrome;
current renal or hepatic disease;
participated in any drug or device clinical study within 30 days of entry;
currently enrolled in any other clinical study;
received any oral, intravenous, intramuscular, or rectally administered corticosteroids within 1 month prior to the Baseline Visit;
received any other topical rectal therapy during the week prior to the Screening Visit;
received immunomodulatory therapy including, but not limited to, 6-mercaptopurine, azathioprine, cyclosporine, or methotrexate within 3 months prior to the Baseline Visit;
received a dose of mesalamine-containing compound by any route from which more than 1.6 g/day of mesalamine was available within 1 week prior to the Screening Visit (NOTE: 4 g/day of sulfasalazine and 4.5 g/day of balsalazide are equivalent to 1.6 g/day of mesalamine);
received antibiotics, other than topical antibiotics, within 1 week prior to the Screening Visit;
received aspirin (except for cardioprotective reasons up to a maximum dose of 325 mg/day) or NSAIDs within 1 week prior to the Baseline Visit;
if female, positive pregnancy test, or lactating.

Summary

Asacol 2.4 g/Day

Asacol 4.8 g/Day

All Events

Event Type Organ System Event Term Asacol 2.4 g/Day Asacol 4.8 g/Day

Percentage of Treatment Success Patients at Week 6, ITT (Intent to Treat) Population

Treatment success defined as complete response (PGA score 0 and complete resolution of stool frequency, rectal bleeding, PFA (patient's functional assessment), normal sigmoidoscopy) or partial response (improvement from baseline PGA and improvement in 1 clinical assessment [stool frequency, rectal bleeding, PFA, sigmoidoscopy] and no worsening in any other clinical assessments)

Asacol 2.4 g/Day

59.2
Percentage of Participants

Asacol 4.8 g/Day

71.8
Percentage of Participants

Change From Baseline in Ulcerative Colitis Disease Activity Index (UCDAI) at Week 6, ITT Population

UCDAI - sum of clinical assessment scores (stool frequency score [0=normal, 1=1-2 stools > normal/day, 2=3-4 stools > normal/day, 3=5 or more stools > normal/day], rectal bleeding score [0=no blood seen, 1=streaks of blood with stool less than half of the time, 2=obvious blood with stool most of the time, 3=blood alone passed and PGA score [0=quiescent disease, 1=mild, 2=moderate, 3=severe]) and sigmoidoscopy score [0=normal, 1=mild, 2=moderate, 3=severe]

Asacol 2.4 g/Day

-3.2
Scores on a Scale (Mean)
Standard Error: 0.27

Asacol 4.8 g/Day

-3.7
Scores on a Scale (Mean)
Standard Error: 0.27

Percentage of Participants Whose Rectal Bleeding & Sigmoidoscopy Score Both Improved From Baseline to Week 6, ITT Population

Rectal Bleeding - 0=no blood seen, 1=streaks of blood w/stool less than half of the time, 2=obvious blood w/stool most of the time, 3=blood alone passed Sigmoidoscopy Assessment Score - 0=normal (intact vascular pattern, no friability or granularity), 1=mild (erythema, diminished or absent vascular markings; mild granularity; friability), 2=moderate (marked erythema, granularity; absent vascular markings; bleeds with minimal trauma; no ulcerations) 3=severe (spontaneous bleeding, ulcerations)

Asacol 2.4 g/Day

59.8
Percentage of Participants

Asacol 4.8 g/Day

63.6
Percentage of Participants

Percentage of Patients Whose Sigmoidoscopy Score Improved From Baseline to Week 6, ITT Population

Sigmoidoscopy Assessment Score (0=normal intact vascular pattern, no friability or granularity, 1=mild erythema; diminished or absent vascular markings; mild granularity; friability, 2=moderate marked erythema, granularity; absent vascular markings; bleeds with minimal trauma; no ulcerations, 3=severe spontaneous bleeding, ulcerations)

Asacol 2.4 g/Day

69.0
Percentage of Participants

Asacol 4.8 g/Day

75.2
Percentage of Participants

Percentage of Patients With an Improvement in Stool Frequency, ITT Population, Week 6

0=Normal stool frequency per day, 1=1-2 stools greater than normal per day, 2=3-4 stools greater than normal per day, 3=5 or more stools greater than normal per day

Asacol 2.4 g/Day

71.3
Percentage of Participants

Asacol 4.8 g/Day

74.0
Percentage of Participants

Percentage of Patients With Improvement in Rectal Bleeding, ITT Population, Week 6

Rectal Bleeding (0=no blood seen, 1=streaks of blood with stool less than half of the time, 2=obvious blood with stool most of the time, 3=blood alone passed)

Asacol 2.4 g/Day

77.5
Percentage of Participants

Asacol 4.8 g/Day

78.5
Percentage of Participants

Percentage of Patients With Improvement in Patient's Functional Assessment (PFA), ITT Population, Week 6

PFA - 0=generally well, 1=fair, 2=poor, 3=terrible

Asacol 2.4 g/Day

70.5
Percentage of Participants

Asacol 4.8 g/Day

69.6
Percentage of Participants

Percentage of Patients With Improvement in Physician Global Assessment (PGA)Score, ITT Population, Week 6

PGA -Physician's Global Assessment - 0=quiescent disease (all parameters 0), 1=mild disease (parameters mostly 1's) 2=moderate (parameters mostly 2's), 3=severe (parameters mostly 3's) [parameters: combination of stool frequency, rectal bleeding, PFA & sigmoidoscopy findings] If scoring equal default to physician judgement.

Asacol 2.4 g/Day

73.5
Percentage of Participants

Asacol 4.8 g/Day

83.2
Percentage of Participants

Mean Change From Baseline in Total Inflammatory Bowel Disease Questionnaire (IBDQ) at Week 3, All Randomized Patients

IBDQ-32 questions divided into 4 categories: bowel, systemic, emotional and social. Each question graded with the following responses: 1-more than ever before, 2-extremely frequently, 3-very frequently, 4-moderate increase in frequency, 5-some increase in frequency, 6-slight increase in frequency or 7-not at all/normal; 1/worst thru 7/best. Scoring 32 - 224 - higher score better.

Asacol 2.4 g/Day

30.4
Scores on a Scale (Mean)
Standard Error: 2.84

Asacol 4.8 g/Day

29.8
Scores on a Scale (Mean)
Standard Error: 2.60

Mean Change From Baseline in Total Inflammatory Bowel Disease Questionnaire (IBDQ) at Week 6, All Randomized Patients

IBDQ-32 questions divided into 4 categories: bowel, systemic, emotional and social. Each question graded with the following responses: 1-more than ever before, 2-extremely frequently, 3-very frequently, 4-moderate increase in frequency, 5-some increase in frequency, 6-slight increase in frequency or 7-not at all/normal; 1/worst thru 7/best. Scoring 32-224 - higher score better.

Asacol 2.4 g/Day

43.1
Scores on a Scale (Mean)
Standard Error: 3.5

Asacol 4.8 g/Day

40.4
Scores on a Scale (Mean)
Standard Error: 3.08

Percentage of Patients With Moderate, Left-Sided Disease at Baseline Classified as Treatment Success at Week 6, All Randomized Patients

Treatment success defined as complete response (PGA score 0 and complete resolution of stool frequency, rectal bleeding, PFA (patient's functional assessment), normal sigmoidoscopy) or partial response (improvement from baseline PGA and improvement in 1 clinical assessment [stool frequency, rectal bleeding, PFA, sigmoidoscopy] and no worsening in any other clinical assessments)

Asacol 2.4 g/Day

60.0
Percentage of Participants

Asacol 4.8 g/Day

71.1
Percentage of Participants

Percentage of Treatment Success Patients at Week 3, ITT Population

Treatment success defined as complete response (PGA score 0 and complete resolution of stool frequency, rectal bleeding, PFA (patient's functional assessment), normal sigmoidoscopy) or partial response (improvement from baseline PGA and improvement in 1 clinical assessment [stool frequency, rectal bleeding, PFA, sigmoidoscopy] and no worsening in any other clinical assessments)

Asacol 2.4 g/Day

51.5
Percentage of Participants

Asacol 4.8 g/Day

61.3
Percentage of Participants

Total

268
Participants

Age, Customized

Race/Ethnicity, Customized

Sex: Female, Male

Overall Study

Asacol 2.4 g/Day

Asacol 4.8 g/Day

Drop/Withdrawal Reasons

Asacol 2.4 g/Day

Asacol 4.8 g/Day