E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
severe acute necrotisng pancreatitis |
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MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Main objective : To determine if prophylactic intravenous antibiotic therapy with meropenem prevents the development of pancreatic or peripancreatic infection in subjects with non-infected necrotizing pancreatitis. |
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E.2.2 | Secondary objectives of the trial |
Secondary objectives : To evaluate subsidiary outcomes of prophylactic intravenous antibiotic therapy in subjects with non-infectednecrotizing pancreatitis. These outcomes to be: time to onset of pancreatic/peripancreatic infection, subject mortality, changes in organ dysfunction, requirement for operative or interventional radiological drainage techniques and incidence of non-pancreatic infections |
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E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
E.3 | Principal inclusion criteria |
Provision of written informed consentSubjects male or female, 18 years of age or older. Diagnosis of necrotizing pancreatitis within 120 hours * following onset of symptoms/ first reported symptoms. Primary diagnosis to be confirmed by contrast-enhanced CT evidence of ³ 30% necrosis of the pancreas.Or if ³ 30% necrosis is not present or cannot be confirmed, a contrast-enhanced CT scan showing extensive or multiple peripancreatic fluid collections and pancreatic edema (Balthazar grade E) with either C-reactive protein (CRP).120 mg/L or a MOD score of >2 is acceptable.Or where a subject is, in the clinical judgement of the investigator, unsuitable for a contrast-enhanced CT scan, the following may be accepted for inclusion:A non enhanced CT scan showing extensive or multiple peripancreatic fluid collections and pancreatic edema (Balthazar grade E) with either C-reactive protein (CRP).120 mg/L or a MOD score of >2 is acceptable. This option is particularly recommended for subjects with pre-existing renal impairment, with creatinine>180μmol?l (2mg/dL)*Randomisation, and receipt of first study drug, should also be within 120 hours of onset of symptoms of pancreatitis. It is therefore recommended that diagnosis of pancreatitis is confirmed within sufficient time after start of symptoms to allow completion screening assessments prior to randomisation within the 120 hour post-onset period. |
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E.4 | Principal exclusion criteria |
The clinical management plan of the primary care team includes peritoneal lavage for treatment of pancreatitis. A confirmed diagnosis of necrotizing pancreatitis will not be possible within 120 hours of onset of symptoms of pancreatitis.The subject has received an investigational drug or device within 30 days prior to study entry.The subject has received >48 hours of antibiotic therapy between onset of symptoms of pancreatitis and diagnosis of necrotizing pancreatitis.The subject will require continuation of non-protocolled antibiotic therapy after randomisation. The subject has known or suspected anaphylactic or other type 1 (immediate) hypersensitivity reactions to cephalosporins, penicillins or carbapenems. The subject is receiving, or will require, probenecid therapy (see section 3.4.4).The subject has a rapidly progressing underlying disease or marked immunosuppression that would preclude evaluation of therapy. The criteria to be employed include: pre-morbid malignancy metastatic to brain, peritoneum (if ascites present), lung, or liver; a haematological malignancy; AIDS; immunosuppression for maintenance of an organ transplant. The subject is neutropenic (absolute neutrophil count < 1000/mm3). The subject has cirrhosis, severity of Child’s grade C. There is not a commitment on the part of the clinical care team, the subject, or the subject’s family to full, aggressive support including operative intervention if needed. The subject is a pregnant and/or nursing female (a serum or urine gonadotropin pregnancy test will be obtained on all premenopausal women prior to study drug administration). The subject was previously enrolled in this study.
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E.5 End points |
E.5.1 | Primary end point(s) |
Efficacy: Development of pancreatic or peripancreatic infection within 42 days following the day of randomisation. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | Yes |
E.6.3 | Therapy | No |
E.6.4 | Safety | No |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
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E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 3 |