E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Mildly-to-Moderately Active Ulcerative Colitis in Children and Adolescents |
|
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 11.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10045365 |
E.1.2 | Term | <Manually entered code. Term in E.1.1> |
|
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 |
The overall objective of this study is to assess the safety and efficacy of high dose and low dose Asacol administered as 400 mg delayed-release tablets given every 12 hours for 6 weeks to children and adolescents with mildly-to-moderately active ulcerative colitis. The primary efficacy objective is to assess the proportion of patients that achieve treatment success using the validated Pediatric Ulcerative Colitis Activity Index (PUCAI). |
|
E.2.2 | Secondary objectives of the trial |
The secondary efficacy objectives are to assess the following: • PUCAI Complete Response; • PUCAI Partial Response; • PUCAI Treatment Failure; • Truncated Mayo Treatment Success; • Truncated Mayo Complete Response; • Truncated Mayo Partial Response; • Truncated Mayo Treatment Failure. To assess biomarker resolution in Asacol treated pediatric patients with mildly-to-moderately active UC, secondary objectives will include assessment of biomarker endpoints as follows: • the proportion of patients who show reduction from Baseline in the fecal and serum lactoferrin and calprotectin biomarkers; • the proportion of patients who achieve a specified cutoff level in fecal lactoferrin and calprotectin biomarkers; • the change in lactoferrin and calprotectin biomarkers from Baseline to Week 6. |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Patients are eligible to participate in the study if they: a. are male or female between the ages of 5 and 17 years, inclusive, at the time of the first dose of study medication, with a history of biopsy and endoscopy confirmed UC; b. have mildly-to-moderately active UC (either newly diagnosed or that has relapsed) as defined clinically by a Pediatric UC Activity Index (PUCAI) score ≥ 10 and ≤ 55, and, in the opinion of the Investigator, the patient does not require steroids c. have baseline scores of at least 1 for both rectal bleeding (Streaks of blood with stool less than half of the time) and stool frequency (1-2 stools greater than normal per day) as defined by the TM-Mayo Score d. are generally in good health (other than the diagnosis of UC), based on medical history, physical examination, and screening laboratory results; e. are able to swallow Asacol tablets (400 mg marketed US formulation); f. have a body weight no less than 17 kg and no more than 90 kg; g. are female patients who are pre-menarchal or have a negative urine pregnancy test and, if sexually active, practice acceptable contraception (e.g., abstinence; oral, intramuscular, or implanted hormonal contraception [at least 3 months prior to enrollment]; 2-barrier methods [e.g., condom, diaphragm, or spermicide]; intrauterine device or verbal report of partner with history of non-reversed vasectomy). All female patients of childbearing potential will undergo urine pregnancy testing at Screening and must not be lactating; and h. are able and willing to participate in the study and follow study procedures, as evidenced by the child providing assent and the parent/guardian signing a written informed consent.
|
|
E.4 | Principal exclusion criteria |
Patients will be excluded from admission to the study if they: a. have a history of allergy or hypersensitivity to salicylates, aminosalicylates, or any component of the Asacol tablet; b. have a history or presence of any condition causing malabsorption or an effect on gastrointestinal motility or history of extensive small bowel resection (greater than one half the length of the small intestine) causing short bowel syndrome; c. are current abuser of drugs or alcohol; d. have a history of HIV infection or AIDS; e. have a significant co-existing illness or other condition(s), including but not limited to cancer or significant organic or psychiatric disease on medical history or physical examination, that, in the judgment of the Investigator, contraindicate(s) administration of the study drug and/or any study procedures; f. have current renal disease, or a screening blood urea nitrogen (BUN) or creatinine value that is > 1.5 times the upper limit of the age appropriate normal; g. have a documented history of or current hepatic disease, or liver function tests (ALT, AST, T Bili) that are > 2 times the upper limit of normal; h. have a history of pancreatitis; i. have any other screening laboratory test values that the Investigator or Sponsor considers clinically significant that would impact the outcome of the study or the safety of the patient; j. previously participated in this study; k. participated in any other drug or device clinical study within 30 days prior to the Screening visit; l. are currently participating in any other clinical study; m. have undergone treatment with any oral, intravenous, intramuscular, or rectally administered corticosteroids (including budesonide) within 30 days prior to the Screening visit; n. have undergone treatment with any other topical (non-oral) mesalamine therapy within 7 days prior to the Screening visit; o. have undergone treatment with immunomodulatory therapy including, but not limited to: rosiglitazone, 6-mercaptopurine or azathioprine, cyclosporine, or methotrexate within 90 days prior to Screening visit; p. have undergone treatment with biologic therapy including, but not limited to: infliximab, certolizumab, adalimumab or other biologic treatment of UC within 90 days prior to Screening visit; q. have undergone treatment with antibiotics (other than topical antibiotics) including metronidazole within 7 days prior to the Screening visit; r. have undergone treatment with aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) within 7 days prior to the Screening visit; s. have undergone treatment with any antidiarrheals and/or antispasmodics within 3 days of the Screening visit; or t. have a stool examination positive for Clostridium difficile (C. difficile), bacterial pathogens, or ova and parasites. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy endpoint is the proportion of patients that achieve PUCAI-TS |
|
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 | 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 | Information not present in EudraCT |
E.7.1.2 | Bioequivalence study | Information not present in EudraCT |
E.7.1.3 | Other | Information not present in EudraCT |
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 | 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 | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 9 |
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 |
|
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
| |
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
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 years | 2 |