| E.1 Medical condition or disease under investigation |
| E.1.1 | Medical condition(s) being investigated |
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| E.1.1.1 | Medical condition in easily understood language |
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| E.1.1.2 | Therapeutic area | Diseases [C] - Digestive System Diseases [C06] |
| MedDRA Classification |
| E.1.2 Medical condition or disease under investigation |
| E.1.2 | Version | 20.1 |
| E.1.2 | Level | LLT |
| E.1.2 | Classification code | 10045365 |
| E.1.2 | Term | Ulcerative colitis |
| E.1.2 | System Organ Class | 100000004856 |
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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 evaluate the beneficial and harmful effects of low dose azathioprine and allopurinol versus standard azathioprine monotherapy for patients with ulcerative colitis |
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| E.2.2 | Secondary objectives of the trial |
• Time to remission (defined as described above) • Clinical response after 52 weeks (defined as a Mayo score between ≤1 to < 3) • Endoscopic remission after 52 weeks (defined as a Mayo subscore of 0) • Fecal calprotectin levels after 52 weeks. • Quality of life after 26 and 52 weeks using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ) and short health scale (SHS). • Correlation between E-6TGN and clinical, laboratory, endoscopic and histological indices. • Histological mucosal healing after 52 weeks. • Adverse events
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| E.2.3 | Trial contains a sub-study | No |
| E.3 | Principal inclusion criteria |
• Age 18 - 80 years at the time of inclusion • Willing to comply with all trial procedures and available for the duration of the trial. • Clinically and histologically verified ulcerative colitis eligible for treatment with thiopurines due to steroid dependence (failure to taper steroid or starting a second course of systemic steroids within 1 year) or patients with the need for rescue therapy with anti-TNFα. • A sigmoidoscopy showing active inflammation in the present disease flare • Negative stool test for pathogen bacteria incl. C. difficile • Willing to give informed consent; • Normal TPMT genotype. TPMT can be measured as genotype or phenotype. A normal TPMT genotype is ‘wild type’. A normal TPMT phenotype is > 14 U/ml ery • Oral 5-ASA dose stable for two weeks
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| E.4 | Principal exclusion criteria |
• Kidney disease with a GRF < 50. • Persistent alanine aminotransferase (ALT) twice above upper limit of the normal range; • Infectious diarrhoea. • Participation in other interventional clinical trials. • Pregnancy or breastfeeding • Previous or current treatment with other biologics than anti-TNFα • Not being able to comply with the study, assessed by investigator |
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| E.5 End points |
| E.5.1 | Primary end point(s) |
| Steroid and biologic treatment free remission defined as total Mayo score ≤1without rectal bleeding |
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| E.5.1.1 | Timepoint(s) of evaluation of this end point |
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| E.5.2 | Secondary end point(s) |
• Time to remission (defined as described above) • Clinical response after 52 weeks (defined as a Mayo score between ≤1 to < 3) • Endoscopic remission after 52 weeks (defined as a Mayo subscore of 0) • Fecal calprotectin levels after 52 weeks. • Quality of life after 26 and 52 weeks. We will assess the quality of life using the Short Inflammatory Bowel Disease Questionnaire (SIBDQ) and short health scale (SHS) • Histological mucosal healing after 52 weeks. • Correlation between E-6TGN and clinical, laboratory, endoscopic and histological indices after 52 weeks • Adverse events |
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| E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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) | 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 | 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 | Yes |
| E.8.1.7.1 | Other trial design description |
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| 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.8.2.4 | Number of treatment arms in the trial | 2 |
| 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 | 9 |
| 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 | No |
| 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 | 4 |
| E.8.9.1 | In the Member State concerned months | |
| E.8.9.1 | In the Member State concerned days | |