E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
- Diagnosis of UC according to Lennard-Jones criteria - Endoscopically demonstrated colorectal lesions localized above the anal margin and extending at least up to 15cm proximally. - Severe acute flare of UC with a Lichtiger Index score > 10. - Refractoriness to high dose intravenous steroid therapy (≥ 0.8 mg/kg/d of methylprednisolone or equivalent) given for at least 5 days.
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MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 9.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10045282 |
E.1.2 | Term | UC |
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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 |
This randomized, open-label, multicenter trial aims to demonstrate that cyclosporine is more efficacious than infliximab to induce short-term response in steroid-refractory severe attacks of ulcerative colitis.
PRIMARY END POINT •Percentage of patients with success, defined as: clinical response at D7 (Lichtiger Index score<10 for two consecutive days with a decrease of at least 3 points compared with the baseline score AND remission at D98 (Mayo Disease Activity Index (DAI) score2 without a subscore>1) (Appendix 4), without steroids.
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E.2.2 | Secondary objectives of the trial |
- Percentage of patients in clinical response at D14, D28, D42 and D98 defined as Lichtiger Index score<10 with a decrease of at least 3 points compared with the baseline score. - Percentage of patients in remission at D7, D42 and D98 defined as Mayo Disease - Activity Index score2 without a subscore>1. - Lichtiger Index score at D7, D14, D28, D42, D98. - Mayo Disease Activity Index score at D7, D14, D42. - Time to discharge. - Endoscopic response (using the subscore of the Mayo DAI) at D7, D42 and D98. - Colectomy rate at D98. - Steroid dosage at D7, D14, D28, D42, and D98 - Number of adverse events (see below) - CMV infection will be assessed at D7 and D98 After D98, patients will be followed up at least every 6 months until the end of the study to describe: - Relapse rate (during the follow-up, relapse will be defined as the need of a new course of UC treatment, including steroids, cyclosporine or infliximab) - Colectomy rate - Adverse events
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Age > 18 years. - Diagnosis of UC according to Lennard-Jones criteria (Appendix 1). - Endoscopically demonstrated colorectal lesions localized above the anal margin and extending at least up to 15cm proximally. - Severe acute flare of UC with a Lichtiger Index score > 10 (Appendix 2). - Refractoriness to high dose intravenous steroid therapy (≥ 0.8 mg/kg/d of methylprednisolone or equivalent) given for at least 5 days. - Adequate contraception for male or female subjects of childbearing potential, which will be continued throughout the study and at least 3 months after study termination.
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E.4 | Principal exclusion criteria |
- Pregnant or breast-feeding woman. - Previous treatment with cyclosporine or infliximab. - Azathioprine or 6-mercaptopurine treatment initiated more than 4 weeks before inclusion. - Indication for immediate surgery. - History of colorectal dysplasia. - Diagnosis of Crohn's disease. - Positive stool tests for amoebiasis and/or positive bacteriological culture for Salmonella, Shigella, Yersinia and Campylobacter and/or presence of Clostridium difficile B toxin in the stools. - Renal failure (creatininemia > upper limit of normal laboratory value). - Uncontrolled high blood pressure. - HIV, HBV viral infection (except the presence of positive anti-HBs antibodies) with serology not older than 3 months. - Uncontrolled bacterial or active viral infection. - Past medical history of malignant condition in the last 5 years (including leukaemia, lymphoma and myelodysplasia) except for baso-cellular cutaneous cancers. - Past medical history of myocardial infarction or heart failure. - Intradermal reaction to Tuberculin (Tubertest® 5 units) > 5mm. - Active tuberculosis - Untreated latent tuberculosis (see national recommendations. Appendix 3). - Abnormal blood count with polynuclear neutrophils < 1,500 G/L or white cells < 3,000, or platelets < 100,000 G/L. - Unexplained rise higher than 3 times the normal level for transaminases, alkaline phosphatases and/or higher than twice the normal level for bilirubin. - Non-compliant subjects. - Participation in another therapeutic study.
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E.5 End points |
E.5.1 | Primary end point(s) |
• Percentage of patients with success, defined as: clinical response at D7 (Lichtiger Index score<10 for two consecutive days with a decrease of at least 3 points compared with the baseline score) AND remission at D98 (Mayo Disease Activity Index (DAI) score2 without a subscore>1) , without steroids.
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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 | 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) | 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 | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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) | Yes |
E.8.2.2 | Placebo | No |
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.8.4.1 | Number of sites anticipated in Member State concerned | 1 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 2 |
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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INCLUSION PERIOD: 24 months.
STUDY DURATION: 27 months.
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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 | |
E.8.9.1 | In the Member State concerned months | 51 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 51 |