E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Active Ulcerative Colitis |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 8.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10058816 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To confirm the efficacy and safety profile seen in the phase II study of 25 mg and 50 mg once daily OPC-6535 oral tablets in the treatment of active ulcerative colitis. |
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E.2.2 | Secondary objectives of the trial | |
E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
E.3 | Principal inclusion criteria |
1. Male or female subjects, 18 to 80 years of age, inclusive, who provide written, informed consent prior to any study-related procedures and who are, in the opinion of the Investigator, likely to comply with all the requirements of the study. 2. Subjects with established diagnosis of active ulcerative colitis, who have relapsed within 12 weeks before screening. All subjects must have had the diagnosis of ulcerative colitis established by colonoscopy prior to randomization. (Newly diagnosed subjects are also eligible.) Colonoscopy may be substituted for flexible sigmoidoscopy during Screening in order to meet this criteria. 3. Colonic involvement with ulcerative colitis beyond 15 cm of the anal verge. 4. Subjects with a score ³ 2 for rectal bleeding and a score ³ 2 on flexible sigmoidoscopy at the Screening/Baseline Visit, based on the DAI criteria. 5. Subjects who have been on a stable dose of oral 5-ASA for at least 14 days prior to the Screening/Baseline, OR subjects who have not been receiving treatment with 5-ASA for at least 14 days. 6. Female or male subjects who are surgically sterilized or who are prepared to and agree to practice a double-barrier form of birth control from the Screening/Baseline Visit through 30 (females) and 90 (males) days, respectively, from the last dose of study medication. Females who are more than 12 months post-menopausal (documented by FSH) are also eligible to participate in the study. [See Section 5.4 of the protocol for a description of acceptable forms of birth control.] |
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E.4 | Principal exclusion criteria |
1. Subjects who have severe disease, defined as a DAI of 12 at the Screening/Baseline Visit, and/or subjects whom the Investigator deems likely to require immunosuppressant therapy including corticosteroids and/or hospitalization during the period of study 2. Subjects who have any other clinically significant disease(s) or condition/procedure(s) which, in the opinion of the Investigator, could compromise the subject’s involvement in the study and/or interfere with the absorption of the study drug or the overall interpretation of the data 3. Subjects who have had major gastrointestinal surgery including, but not limited to, a colostomy, an ileostomy or previous colonic surgery other than appendectomy 4. Subjects who have used oral corticosteroids (including oral budesonide) within 30 days, or topical intrarectal agents (corticosteroid or 5-ASA enemas, suppositories, foams) within 7 days of Screening/Baseline [Topical dermatological corticosteroids are not excluded] 5. Subjects who have used immunosuppressants within 28 days or IL-10, IL-11, FK-506 [tacrolimus], mycophenolate, cyclosporin, anti-TNF-a or monoclonal antibody medications within 60 days of Screening/Baseline 6. Subjects who have a history of active malignancies within 5 years (surgically-treated basal cell, squamous cell, non-melanoma or in situ cervical carcinomas permissible), an intra-abdominal abscess, a toxic megacolon, or a clinical instability resulting from any other cause 7. Subjects with a known or suspected history of sclerosing cholangitis 8. Subjects with a known history of, or suspected, clinically relevant cardiac disease 9. Subjects with a positive stool culture for any enteric pathogens, pathogenic ova or parasites, or a positive assay for C. difficile toxin (a positive EIA that is subsequently confirmed by a positive cytoxin assay) 10. Subjects with partial bowel obstruction, as documented by proximal small bowel dilatation at Screening/Baseline 11. Female subjects who are pregnant or lactating 12. Female subjects who are likely to undergo an in vitro fertilization (IVF ) procedure from the Screening/Baseline Visit through 30 days after the last dose of study medication, OR male subjects likely to participate in an IVF procedure from the Screening/Baseline Visit through 90 days after the last dose of study medication 13. Subjects with compromised hepatic function, characterized by ALT and/or AST levels twice (2x) the upper normal limit and/or a serum bilirubin > 1.7 mg/dL (unless the subject has been diagnosed with Gilbert’s syndrome) based on clinical laboratory results 14. Subjects with compromised renal function, characterized by serum creatinine levels 1.5 times the upper normal limit 15. Subjects with a platelet count <100,000 or >750,000/mm3 based on clinical laboratory results 16. Subjects with severe anemia, defined as hemoglobin of <8.0 g/dL based on clinical laboratory results 17. Subjects with a serum albumin <2.5 g/dL based on clinical laboratory results 18. Subjects with a prothrombin time INR > 1.2 based on clinical laboratory results 19. Subjects with a neutrophil count of <2000/mm3 based on clinical laboratory results 20. Subjects taking ³ 325 mg aspirin/day or chronic (³ 7 consecutive days) NSAID use within 7 days of Screening/Baseline 21. Subjects who have used antibiotics, other than topical antibiotics for dermatological use, within 14 days of Screening/Baseline 22. Subjects taking warfarin within 7 days of the Screening/Baseline Visit, or who are likely to take warfarin during the study 23. Subjects taking CYP1A2 inducer medications (See Appendix 7 in the Protocol) 24. Subjects taking pharmaceutical nicotine within 14 days of Screening/Baseline, or who are likely to take pharmaceutical nicotine during the study 25. Subjects with a history of known or suspected alcohol or drug abuse within 6 months of Screening/Baseline 26. Subjects taking prescription or over-the-counter anti-diarrheal agents, such as Lomotil® or Imodium®, within 3 days of Screening/Baseline 27. Subjects who receive an experimental drug or procedure within 30 days of the Screening/Baseline Visit, or who are likely to receive an experimental drug or procedure during the study through the 30-day period after the final administration of study drug. [An experimental agent is defined as any compound assessed under an IND. All experimental agents with documented or potential immunosuppressive effects must be withdrawn 90 days prior to the first administration of study drug.] 28. Subjects considered inappropriate by the Investigator for any reason(s) 29. Subjects who have changed their 5-ASA dose or began taking 5-ASA within the 14 days prior to Screening/Baseline 30. Subjects with Crohn’s Disease 31. Subjects with previous exposure to OPC-6535 32. Subjects who have taken COX-2 inhibitor medications (i.e., Celebrex®, Vioxx®) for ³ 7 consecutive days within 7 days of Screening/Baseline |
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E.5 End points |
E.5.1 | Primary end point(s) |
Clinical improvement at week 8 based on the ITT population (denoted as clinical improvement (ITT)), with the restriction that subjects who drop out before completing the week 8 visit will be considered as not exhibiting clinical improvement, regardless of their Disease Activity Index (DAI) scores. Subjects who complete the Week 8 visit on or after day 52 from the date of randomisation (irrespective of whether or not they were still taking medication) and show clinical improvement (as defined below) will be counted as demonstrating clinical improvement (ITT). Clinical improvement is defined as a reduction from baseline in rectal bleading (RB) score of 2 or greater to a score of 0 or 1 plus an improvement of at least 1 point in one other subscale of the DAI: flexible sigmoidoscopy (FS), physician' global assessment (PGA), or stool frequency (SF). The primary efficacy comparisons are 25 mg OPC-6535 vs. placebo and 50 mg OPC-6535 vs. placebo stratified by 5-ASA (5-ASA users or non-users). |
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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 | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
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) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
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 | Yes |
E.8.1.7.1 | Other trial design description |
stratified by 5-ASA users and non-users |
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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
|
The end of study for each subject is the date on which the last evaluation (the follow-up phone call at Week 10) was performed or the attempt was made to contact the subject. |
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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 | 1 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 36 |