E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Ileal pouch anal anastomosis (IPAA)-related faecal incontinence |
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10016092 |
E.1.2 | Term | Faecal incontinence |
E.1.2 | System Organ Class | 10017947 - Gastrointestinal disorders |
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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 |
The primary objective is to determine the effect of 10% phenylephrine hydrochloride gel, applied three times a day, on the change from baseline to the end of study in the faecal incontinence score (St Mark’s) in subjects with IPAA-related faecal incontinence, compared with placebo. |
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E.2.2 | Secondary objectives of the trial |
The secondary objectives are to determine the effect of topical phenylephrine, compared with placebo, on:-
• Number of daytime faecal incontinence episodes of liquid/mucus and solid stool • Number of nights with nocturnal incontinence episodes of liquid/mucus and solid stool • Number of incontinence episodes of gas • Faecal incontinence quality of life scale • Subject satisfaction with treatment • Subject assessment of overall change from baseline • Loperamide or other constipating agent usage • Anal manometry measurements • Safety and tolerability will be assessed by physical examination, biochemical and haematological markers and the incidence of adverse events
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
A subject will be considered eligible for this study only if all of the following criteria apply:
• Incontinence of solid or liquid stool/mucus following ileo-anal pouch construction, at least once per week over the last month • At least six months must have elapsed since IPAA surgery or six months since closure of a loop ileostomy created during IPAA surgery, whichever is the later • Aged 18 years or over • If female, the subject must not be lactating and must be (a) post-menopausal, (b) surgically sterilised, or (c) have a negative pregnancy test result prior to entry into the study and will use adequate contraception for the duration of the study • Written informed consent to participate has been provided
NB: Seepage, leakage, soiling of faecal material is regarded as incontinence.
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E.4 | Principal exclusion criteria |
A subject will not be eligible for inclusion in this study if any of the following criteria apply:
• A history of surgery to the anal sphincter complex • Active pouchitis (determined by clinical examination and macroscopic inflammation on endoscopy. Patients on maintenance antibiotics need not be excluded but their antibiotic dose should remain the same throughout the study) • Undergone pelvic radiotherapy at any time • Cardiac or cardiovascular disease, including ischaemic heart disease, history of stroke, cerebral arteriosclerosis, aneurysm, tachycardia or hypertension • Hyperthyroidism or diabetes mellitus • Crohn’s disease (indeterminate colitis is not an exclusion criterion) • The use of α- or β-adrenoceptor agonists (other than inhaled β-adrenoceptor agonists) or antagonists, other sympathomimetics or any cardiovascular drugs during the study (including eyedrops, nasal drops and OTC cold cures containing phenylephrine or pseudoephedrine) • The use of mono-amine oxidase inhibitors or tricyclic antidepressants in the 4 weeks prior to the first dose of study medication or during the study • Any mental or other impairment which, in the investigator’s opinion, would render them unlikely to be able to comply with the requirements of the study • Considered by their physician unlikely to be able to comply with the protocol • Participation in a clinical trial within the past three months • Known hypersensitivity to phenylephrine or excipients • History of drug or alcohol abuse
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy variable will be the change from baseline to the end of study in the faecal incontinence score (St Mark’s). |
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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 | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
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 | No |
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 | 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
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | No |
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 | 1 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |