Clinical Trial Results:
Double-blind, randomised, placebo-controlled, parallel group study to evaluate the efficacy and safety of oral administration of Nepadutant in infant colic
Summary
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EudraCT number |
2009-018218-21 |
Trial protocol |
DE SE |
Global end of trial date |
28 Dec 2013
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Results information
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Results version number |
v1(current) |
This version publication date |
04 Nov 2018
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First version publication date |
04 Nov 2018
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
NIC-03
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT01258153 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Menarini Ricerche S.p.A.
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Sponsor organisation address |
Via Sette Santi 1, Florence, Italy, 50131
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Public contact |
Angela Capriati, Menarini Ricerche S.p.A., +39 05556809990, acapriati@menarini-ricerche.it
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Scientific contact |
Angela Capriati, Menarini Ricerche S.p.A., +39 05556809990, acapriati@menarini-ricerche.it
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
31 Oct 2014
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
28 Dec 2013
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
Efficacy of oral Nepadutant treatment given once daily at two doses in comparison to placebo
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Protection of trial subjects |
Parents could withdraw consent for their baby participation in the study at any time without
prejudice. The investigator could withdraw a subject if, in his/her clinical judgment, it was in the
best interest of the subject or if the subject could not comply with the protocol.
The subject underwent to a final study visit (FU visit) after withdrawal, the cause of which had to
be recorded in detail on the CRF/eCRF. If the withdrawal of a subject resulted from an adverse
event, this was documented in accordance with procedures described under section “Adverse
Event”.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
04 Nov 2010
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Long term follow-up planned |
Yes
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Long term follow-up rationale |
Safety | ||
Long term follow-up duration |
1 Months | ||
Independent data monitoring committee (IDMC) involvement? |
No
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Poland: 2
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Country: Number of subjects enrolled |
Sweden: 1
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Country: Number of subjects enrolled |
Germany: 1
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Country: Number of subjects enrolled |
United States: 2
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Country: Number of subjects enrolled |
Russian Federation: 109
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Worldwide total number of subjects |
115
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EEA total number of subjects |
4
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
115
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
0
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From 65 to 84 years |
0
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85 years and over |
0
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Recruitment
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Recruitment details |
Screened patients were 130, of these, 15 were screening failures. Subjects randomised therefore were 115. Two patients were excluded from ITT population (n=113) due to: withdrawal of consent after 1st intake (1) and after 1 day with 0 intake. | ||||||||||||
Pre-assignment
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Screening details |
Healthy infants(age >4 weeks and <20 weeks),breast-fed,mixed fed or formula fed with a stable dietary regimen,normal growth,infant colic as per modified Wessel criteria.At randomization,eligibility was confirmed by total of crying and/or fussing time lasting at least 6h during the last 3days screening SF:15;Main SF reason: I/E criteria not met(10) | ||||||||||||
Period 1
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Period 1 title |
Treatment (overall period)
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Is this the baseline period? |
Yes | ||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | ||||||||||||
Roles blinded |
Investigator, Monitor, Data analyst, Carer, Assessor, Subject | ||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Nepadutant low dose | ||||||||||||
Arm description |
Nepadutant oral solution 0.1 mg/kg for oral administration once daily for 7 days | ||||||||||||
Arm type |
Experimental | ||||||||||||
Investigational medicinal product name |
Nepadutant
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Oral solution
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Routes of administration |
Oral use
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Dosage and administration details |
Nepadutant oral solution 0.1 mg/kg for oral administration once daily for 7 days
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Arm title
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Nepadutant high dose | ||||||||||||
Arm description |
Nepadutant oral solution 0.5 mg/kg for oral administration once daily for 7 days | ||||||||||||
Arm type |
Experimental | ||||||||||||
Investigational medicinal product name |
Nepadutant oral solution 0.5 mg/kg
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Oral solution
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Routes of administration |
Oral use
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Dosage and administration details |
Nepadutant oral solution 0.5 mg/kg for oral administration once daily for 7 days
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Arm title
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Placebo | ||||||||||||
Arm description |
Placebo matching Nepadutant oral solution for oral administration once daily for 7 days | ||||||||||||
Arm type |
Placebo | ||||||||||||
Investigational medicinal product name |
placebo
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Oral solution
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Routes of administration |
Oral use
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Dosage and administration details |
once daily for 7 days
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Notes [1] - The number of subjects reported to be in the baseline period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same. Justification: Two patients withdraw the consent: a total of 113 patients were considered in the ITT population and 114 for the safety population. For the efficacy analysis 112 patients were considered, as one patient had no baseline recorded data. |
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Baseline characteristics reporting groups
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Reporting group title |
Nepadutant low dose
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Reporting group description |
Nepadutant oral solution 0.1 mg/kg for oral administration once daily for 7 days | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Nepadutant high dose
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Reporting group description |
Nepadutant oral solution 0.5 mg/kg for oral administration once daily for 7 days | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
Placebo matching Nepadutant oral solution for oral administration once daily for 7 days | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Nepadutant low dose
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Reporting group description |
Nepadutant oral solution 0.1 mg/kg for oral administration once daily for 7 days | ||
Reporting group title |
Nepadutant high dose
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Reporting group description |
Nepadutant oral solution 0.5 mg/kg for oral administration once daily for 7 days | ||
Reporting group title |
Placebo
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Reporting group description |
Placebo matching Nepadutant oral solution for oral administration once daily for 7 days |
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End point title |
Absolute Change of the Mean Daily Crying and Fussing Time for Three Consecutive Days While on Treatment Versus Baseline. | ||||||||||||||||
End point description |
Efficacy assessment to be measured through “baby’s day” diary recorded for three consecutive days while on treatment (i.e. starting from 6 pm on Day 4 and continued for 72 hours) vs baseline (i.e. starting from 6 pm on Day -4 until 1st treatment administration).
Analysis population: 112 instead of 113, because 1 subject had no records at baseline and therefore the outcome could not be measured
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End point type |
Primary
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End point timeframe |
Baseline and one week
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Statistical analysis title |
ANCOVA | ||||||||||||||||
Comparison groups |
Nepadutant high dose v Placebo v Nepadutant low dose
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Number of subjects included in analysis |
112
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Analysis specification |
Pre-specified
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Analysis type |
other | ||||||||||||||||
P-value |
= 0.04 | ||||||||||||||||
Method |
ANCOVA | ||||||||||||||||
Confidence interval |
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End point title |
Absolute Change in the Overall Parental Judgment After the First Dose of Treatment Versus Baseline | ||||||||||||||||
End point description |
On a daily basis parents expressed an overall judgement on the study treatment effect based on a 6 rate categorical scale from 0 to 5 (where 0 is for "Not at all" and 5 is "Extremely".
The question was "How frustrating to you was your baby's crying today?"
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End point type |
Secondary
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End point timeframe |
1 day
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No statistical analyses for this end point |
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End point title |
Absolute Change in the Overall Parental Judgment at the End of Treatment Versus Baseline | ||||||||||||||||
End point description |
On a daily basis parents expressed an overall judgement on the study treatment effect based on a 6 rate categorical scale from 0 to 5 (where 0 is for "Not at all" and 5 is "Extremely".
The question was "How frustrating to you was your baby's crying today?"
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End point type |
Secondary
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End point timeframe |
1 week
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No statistical analyses for this end point |
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End point title |
Absolute Change in the Overall Parental Judgment After Treatment Discontinuation Versus Baseline | ||||||||||||||||
End point description |
On a daily basis parents expressed an overall judgement on the study treatment effect based on a 6 rate categorical scale from 0 to 5 (where 0 is for "Not at all" and 5 is "Extremely".
The question was "How frustrating to you was your baby's crying today?"
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End point type |
Secondary
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End point timeframe |
10 days
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No statistical analyses for this end point |
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End point title |
Percentage of 'Responder' Babies at the End of Treatment Period. | ||||||||||||
End point description |
Response is defined as a decrease of at least 50% of crying and fussing time during the last 3 days on treatment vs baseline.
Analysis population: 112 instead of 113, because 1 subject had no records at baseline and therefore the outcome could not be measured
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End point type |
Secondary
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End point timeframe |
baseline and one week
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No statistical analyses for this end point |
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Adverse events information
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Timeframe for reporting adverse events |
up to 4 weeks after the first drug intake
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
14.1
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Reporting groups
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Reporting group title |
Nepadutant low dose
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Reporting group description |
Nepadutant oral solution 0.1 mg/kg for oral administration once daily for 7 days | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Nepadutant high dose
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Reporting group description |
Nepadutant oral solution 0.5 mg/kg for oral administration once daily for 7 days | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
Placebo matching Nepadutant oral solution for oral administration once daily for 7 days | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 2% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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26 Apr 2011 |
Harmonisation of the slightly different protocol versions which are in force in three participating Countries as consequence of the country specific Amendments implemented in response to Regulatory Authorities (RAs), Ethical Committees (ECs)
and Institutional Review Boards.
Enlargement of the inclusion to infants who are fed with mixed milk or formula milk,
provided that the following specifications on infant’s dietary regimen are met:
a) stable and well tolerated dietary regimen
b) no change in the dietary regimen until the end of the 7 day treatment period
c) cow milk allergy must be excluded
d) complementary food not allowed
• Deletion of faecal analysis which was intended to be performed as sub-study in Finnish
sites, no longer participating to the study.
• Update on the Project Responsible Person appointed by the CRO. |
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21 Dec 2011 |
Main changes:
The age range of eligible patients has been extended by increasing the age upper limit to
< 20 weeks at screening visit. The allowed PCA (post-conceptual age) at screening visit has been
decreased from >44 to >40 weeks.
• Revision of the inclusion criteria specifically pertaining the diagnosis of colic has been
made so that a total of 6 hours crying and/or fussing time over a three days screening
period is now considered adequate to reflect the Wessel criteria based on a weekly
observation time (“paroxysm of irritability, fussing or crying that start and stop without
obvious cause for >3h/day, >3 days/week for at least one week”).
• Study procedures have been reviewed to avoid unnecessary restriction and therefore to
facilitate the inclusion of patients. In particular:
- the start of the wash-out period for the exclusion of any pharmacological treatment
has been shortened to 24 h before starting the “baby’s day” diary recording at
screening (i.e. the day before Day -4) instead of 1 week prior randomisation. As the
minimum screening period is 4 days, the wash-out period was at least of 5 days
before starting the study treatment.
- no change in probiotics and herbal tea intake is required, from 24 h before starting
recording the “baby’s day” diary up to completion of post treatment period.
• to remove the PK sampling scheduled at visit 3 in order to further reduce any patient discomfort.
The “baby’s day” diary has been simplified
Administrative changes: number of sites, CRO name, |
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29 Oct 2012 |
New sites in Asia and Australia have been included and ClinActis Ltd is the CRO in charge to manage the Asian and Australian sites. The contact details of the CRO have been added to the protocol.
• The “Study Responsibility” section has been updated.
• Exclusion criterion 5 clarifies that the daily infant’s habits should not be changed during
the study conduct, including the use of probiotics, herbal tea and other home remedy.
• Paper CRF was replaced by electronic CRF.
• Other minor rewording and typos have been included in the protocol review |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |