Title

Efficacy of Alicaforsen in Pouchitis Patients Who Have Failed to Respond to at Least One Course of Antibiotics
A Randomized, Double-Blind, Placebo-Controlled Trial of the Safety and Efficacy of Topical Alicaforsen Enema in Subjects With Active, Chronic, Antibiotic Refractory Primary Idiopathic Pouchitis
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Intervention/Treatment

    alicaforsen ...
  • Study Participants

    138
A Phase III, multi-centre, double-blind randomised controlled trial in subjects with chronic antibiotic refractory pouchitis.

Subjects will undertake a <2 week screening period to provide baseline data and be assessed for eligibility. At the Baseline visit (Day 1) eligible subjects will be randomised on a 1:1 basis to either a) 240 mg alicaforsen enema or b) matching placebo.

Study drug will be administered once nightly (on going to bed) up to and including week 6. Following the Day 1 Visit, subjects will return to the clinic for safety and efficacy assessments at Week 3, 6, 10, 18 and 26.

Subjects may receive certain permitted medications as per Entry Criteria, which must remain at stable doses throughout the trial. Introduction of any new medication for pouchitis, or a dose change to an existing concomitant medication for pouchitis, other than those detailed in the protocol, will not be permitted.

Clinical symptoms associated with pouchitis will be recorded daily by the patient in a diary card.

Subjects will undergo endoscopic examination of their pouch (during Screening, and at Weeks 6 and 10). Where technically feasible, each endoscopy will provide at least one biopsy sample for histopathology.

In addition to endoscopic, histopathologic and symptomatic assessments, Quality of Life will be assessed.

Bloods for routine assessment, including haematology and biochemistry will be taken. Bloods and stool samples will be collected to evaluate relevant biomarkers.
Study Started
Dec 03
2015
Primary Completion
Jul 09
2018
Study Completion
Oct 29
2018
Results Posted
Feb 25
2020
Last Update
Feb 25
2020

Drug Alicaforsen

Drug Placebo

Alicaforsen Experimental

Alicaforsen enema, 240mg once daily for 6 weeks

Placebo Placebo Comparator

Placebo enema, once daily for 6 weeks

Criteria

Inclusion Criteria:

Written informed consent;
Male or female subjects, 18 years of age who have undergone an IPAA for UC
History of pouchitis
Overall PDAI score > 7
Must have Chronic Antibiotic Refractory Pouchitis

Exclusion Criteria:

Lack of effective contraception
Women who are pregnant or breastfeeding;
Strong analgesia NSAID use
Change in dose of the following permitted meds during screening and study: oral 5-aminosalicylate (5 ASA), Oral steroids,, Immunosuppressant therapy.
Rectal products
Biological agents: Anti-tumour necrosis factor (anti - TNF) therapy and / or vedolizumab; are not permitted within 8 weeks of the Screening Visit.
All other agents targeted to pouchitis, including experimental agents, must have been discontinued at least 8 weeks prior to the Screening Visit, or for a period equivalent to 5 half-lives (t½) of the agent (whichever is longer)
Anal sphincter dysfunction
Infections to cytomegalovirus or Clostridium Difficile
Other GI pathology (inc. intestinal malabsorption, pancreatic maldigestion etc) and differential diagnoses
Clinically significant and/or persistent illness; which in the investigators opinion, would exclude entry into the trial

Summary

Alicaforsen

Placebo

All Events

Event Type Organ System Event Term Alicaforsen Placebo

Proportion of Patients With Endoscopic Remission

The group of patients with an improvement in their endoscopic score between screening and week 10 as shown by an reduced modified MAYO score. Remission is defined as absence of friability and ulceration, represented by a score of ≤1.

Alicaforsen

Placebo

Proportion of Patients With a Reduction in Relative Stool Frequency

Group of patients with a lowering of stool frequency from baseline to week 10, where the subject's stool frequency is represented by a MAYO subscore of ≤1 at week 10.

Alicaforsen

Placebo

Total

138
Participants

Age, Categorical

Race (NIH/OMB)

Sex: Female, Male

Overall Study

Alicaforsen

Placebo