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    Clinical Trial Results:
    An open, randomized, controlled, single centre trial to evaluate CT image quality and diagnostic feasibility of Lumentin® 44, a new egg albumen based oral bowel filling agent, in comparison with diluted Omnipaque® and Movprep®, two commonly used agents in subjects referred for abdominal CT-examination.

    Summary
    EudraCT number
    2017-002368-42
    Trial protocol
    SE  
    Global end of trial date
    14 Feb 2019

    Results information
    Results version number
    v2(current)
    This version publication date
    02 Dec 2020
    First version publication date
    20 Mar 2020
    Other versions
    v1
    Version creation reason
    • Correction of full data set
    Previously, the sec. endpoints bowel filling properties (extension and distension) and diagnostic ability were not presented as described in the protocol but by alternative methods of calculation. In this version, the calculation methods in the trial Protocol were used. i.e. sum of the both assessors’ gradings of all small bowel sub-segments and the sum of the both assessors’ gradings of all selected organs. The method of calculation did not have any impact on the interpretation of the results.

    Trial information

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    Trial identification
    Sponsor protocol code
    LUM-001
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03326518
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Lument AB
    Sponsor organisation address
    Scheelevägen 22, LUND, Sweden, 223 63
    Public contact
    CEO, Lument AB, olof.book@lumentab.com
    Scientific contact
    CEO, Lument AB, olof.book@lumentab.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    02 Mar 2020
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    14 Feb 2019
    Global end of trial reached?
    Yes
    Global end of trial date
    14 Feb 2019
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    To compare the mean difference in contrast density shown on abdominal CT-images when using the contrast agent Lumentin® 44, with abdominal CT-images using diluted Omnipaque® and with abdominal CT-images using Movprep® General information: This was an open, randomized, controlled, single centre Phase II trial of Lumentin® 44 in comparison with diluted Omnipaque® and Movprep® in subjects referred to CT-examination of the abdomen. Eligible subjects were randomized to Lumentin® 44 (Lumentin 44 Arm), diluted Omnipaque® (diluted Omnipaque Arm), or Movprep® (movprep Arm) in a 2:1:1 ratio. Lumentin was given in volumes of 750 mL to 1200 mL and Omnipaque and Movprep were given according to the general praxis of care at the clinical site. The difference in contrast density between lumen and wall (mucosal lining) in CT-images was measured in 9 locations of the small bowel: 2 locations in each of the duodenum, jejunum, proximal ileum and distal ileum and in 1 location in the terminal ileum
    Protection of trial subjects
    The trial was conducted in compliance with the protocol, the International Conference on Harmonisation (ICH) guidelines on good clinical practice (GCP), the applicable European Directives and local legal requirements, and the ethical principles of the latest revision of the Declaration of Helsinki as adopted by the World Medical Association. All information containing personal data were handled in accordance with Swedish data protection legislation and with the EU Data Protection Directive (95/46/EC). In accordance with the legislation, the data does not identify any persons taking part in the trial.
    Background therapy
    No background therapy was given.
    Evidence for comparator
    The comparators, Omnipaque® and Movprep® used in the trial are both standard of care treatment, commonly used as contrast agents, in patients referred to abdominal CT-examinations. Abbreviations used: Abd-CT: Abdominal-CT AE: Adverse events CT: Computed tomography FA: Full analysis HU: Hounsfield units IMP: Investigational medical product ROI: Region of interest SAE: Serious adverse events vs.: versus
    Actual start date of recruitment
    28 Nov 2017
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Sweden: 45
    Worldwide total number of subjects
    45
    EEA total number of subjects
    45
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    19
    From 65 to 84 years
    25
    85 years and over
    1

    Subject disposition

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    Recruitment
    Recruitment details
    Subjects referred for abdominal or thoracoabdominal CT-examination at the clinical site were informed of the trial by a letter added to the referral letter informing them on date and time for the CT-examination, and by advertising posters at referring clinics. Subjects who had received an invitation letter were contacted by phone.

    Pre-assignment
    Screening details
    Subjects who were interested in participating in the trial, were sent full subject information and were asked to read it before the CT-examination visit.

    Period 1
    Period 1 title
    Overall Trial Period (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded
    Blinding implementation details
    Eligible subjects were to be randomized in a 2:1:1 ratio to Lumentin 44, Omnipaque or Movprep

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Lumentin 44
    Arm description
    Before CT-examination, subjects received Lumentin 44 in volumes of 750 mL to 1200 mL, which should be taken orally within 1 hour.
    Arm type
    Experimental

    Investigational medicinal product name
    Lumentin 44
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Oral liquid
    Routes of administration
    Oral use
    Dosage and administration details
    pg28 Lumentin 44 was provided as an aqueous dispersion, which was whipped to a foam at the clinical site. The foam contained 44% of air, which was the radiological key ingredient that caused the agent's contrast properties.

    Arm title
    Diluted Omnipaque
    Arm description
    Before CT-examination, subjects received diluted Omnipaque in volumes according to standard of care praxis at the study site (target volume 1000 mL). The diluted Omnipaque should be taken orally within 1 hour.
    Arm type
    Active comparator

    Investigational medicinal product name
    Diluted Omnipaque
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Oral use
    Dosage and administration details
    Before oral administration, 30 mL of Omnipaque 240 mg I/mL was mixed with 970 mL of water.

    Arm title
    Movprep
    Arm description
    Before CT-examination, subjects received Movprep in volumes according to standard of care praxis at the study site (target volume 1000 mL). The Movprep solution should be taken orally within 1 hour.
    Arm type
    Active comparator

    Investigational medicinal product name
    Movprep
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Powder for oral solution
    Routes of administration
    Oral use
    Dosage and administration details
    Before oral administration, the Movprep dose Units A and B were dissolved in 1000 mL of water.

    Number of subjects in period 1
    Lumentin 44 Diluted Omnipaque Movprep
    Started
    19
    12
    14
    Completed
    16
    12
    13
    Not completed
    3
    0
    1
         Consent withdrawn by subject
    1
    -
    -
         Lost to follow-up
    1
    -
    1
         Protocol deviation
    1
    -
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Lumentin 44
    Reporting group description
    Before CT-examination, subjects received Lumentin 44 in volumes of 750 mL to 1200 mL, which should be taken orally within 1 hour.

    Reporting group title
    Diluted Omnipaque
    Reporting group description
    Before CT-examination, subjects received diluted Omnipaque in volumes according to standard of care praxis at the study site (target volume 1000 mL). The diluted Omnipaque should be taken orally within 1 hour.

    Reporting group title
    Movprep
    Reporting group description
    Before CT-examination, subjects received Movprep in volumes according to standard of care praxis at the study site (target volume 1000 mL). The Movprep solution should be taken orally within 1 hour.

    Reporting group values
    Lumentin 44 Diluted Omnipaque Movprep Total
    Number of subjects
    19 12 14 45
    Age categorical
    Note: Age categorical is given for all 45 subjects who were enrolled in the trial.
    Units: Subjects
        In utero
    0 0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0 0
        Newborns (0-27 days)
    0 0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0 0
        Children (2-11 years)
    0 0 0 0
        Adolescents (12-17 years)
    0 0 0 0
        Adults (18-64 years)
    6 5 8 19
        From 65-84 years
    13 6 6 25
        85 years and over
    0 1 0 1
    Age continuous
    Note: 45 subjects were enrolled but mean age values are shown for the FA set only. 2 subjects in the Lumentin 44 group were not included in th FA set: 1 female (75 years), who did not fulfill eligibility criteria and was not treated, and 1 female (75 years), who was unable to drink Lumentin 44 and withdrew consent.
    Units: years
        arithmetic mean (standard deviation)
    64.7 ( 16.2 ) 64.9 ( 14.1 ) 59.4 ( 15.8 ) -
    Gender categorical
    Gender categorical is given for all 45 subjects who were included in the trial.
    Units: Subjects
        Female
    11 8 8 27
        Male
    8 4 6 18
    Subject analysis sets

    Subject analysis set title
    Safety set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All subjects who drank at least some part of the stipulated dose of contrast agent (Lumentin 44, diluted Omnipaque, or Movprep) were included in the Safety Data Set of the trial. The subjects were included in the analysis according to the treatment actually received. 18 (94.7%) out of the 19 randomised subjects in Lumentin 44 group, 12 out of 12 (100%) of the randomised subjects in the Omnipaque group, and 14 out of 14 (100%) of the randomised subjects in the Movprep group were included in the Safety population.

    Subject analysis set title
    Full Analysis (FA) Set
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All correctly included and randomised subjects who received at least some portion of the contrast agents (Lumentin 44, diluted Omnipaque, or Movprep) and for whom a CT-examination was performed. All subjects were included in the group according to the intention based on the randomisation. 17 (89.5%) out of the 19 randomised subjects in Lumentin 44 group, 12 out of 12 (100%) of the randomised subjects in the Omnipaque group, and 14 out of 14 (100%) of the randomised subjects in the Movprep group were included in the FA population.

    Subject analysis sets values
    Safety set Full Analysis (FA) Set
    Number of subjects
    44
    43
    Age categorical
    Note: Age categorical is given for all 45 subjects who were enrolled in the trial.
    Units: Subjects
        In utero
    0
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
    0
        Newborns (0-27 days)
    0
    0
        Infants and toddlers (28 days-23 months)
    0
    0
        Children (2-11 years)
    0
    0
        Adolescents (12-17 years)
    0
    0
        Adults (18-64 years)
    19
    19
        From 65-84 years
    24
    23
        85 years and over
    1
    1
    Age continuous
    Note: 45 subjects were enrolled but mean age values are shown for the FA set only. 2 subjects in the Lumentin 44 group were not included in th FA set: 1 female (75 years), who did not fulfill eligibility criteria and was not treated, and 1 female (75 years), who was unable to drink Lumentin 44 and withdrew consent.
    Units: years
        arithmetic mean (standard deviation)
    ( )
    ( )
    Gender categorical
    Gender categorical is given for all 45 subjects who were included in the trial.
    Units: Subjects
        Female
    26
    25
        Male
    18
    18

    End points

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    End points reporting groups
    Reporting group title
    Lumentin 44
    Reporting group description
    Before CT-examination, subjects received Lumentin 44 in volumes of 750 mL to 1200 mL, which should be taken orally within 1 hour.

    Reporting group title
    Diluted Omnipaque
    Reporting group description
    Before CT-examination, subjects received diluted Omnipaque in volumes according to standard of care praxis at the study site (target volume 1000 mL). The diluted Omnipaque should be taken orally within 1 hour.

    Reporting group title
    Movprep
    Reporting group description
    Before CT-examination, subjects received Movprep in volumes according to standard of care praxis at the study site (target volume 1000 mL). The Movprep solution should be taken orally within 1 hour.

    Subject analysis set title
    Safety set
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All subjects who drank at least some part of the stipulated dose of contrast agent (Lumentin 44, diluted Omnipaque, or Movprep) were included in the Safety Data Set of the trial. The subjects were included in the analysis according to the treatment actually received. 18 (94.7%) out of the 19 randomised subjects in Lumentin 44 group, 12 out of 12 (100%) of the randomised subjects in the Omnipaque group, and 14 out of 14 (100%) of the randomised subjects in the Movprep group were included in the Safety population.

    Subject analysis set title
    Full Analysis (FA) Set
    Subject analysis set type
    Full analysis
    Subject analysis set description
    All correctly included and randomised subjects who received at least some portion of the contrast agents (Lumentin 44, diluted Omnipaque, or Movprep) and for whom a CT-examination was performed. All subjects were included in the group according to the intention based on the randomisation. 17 (89.5%) out of the 19 randomised subjects in Lumentin 44 group, 12 out of 12 (100%) of the randomised subjects in the Omnipaque group, and 14 out of 14 (100%) of the randomised subjects in the Movprep group were included in the FA population.

    Primary: Difference in Contrast Density

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    End point title
    Difference in Contrast Density
    End point description
    The difference in contrast density was measured indepentently by 2 investigators in 2 locations in each of the 4 defined sub-segments: duodenum, jejunum, proximal ileum, and distal ileum, and in 1 location of the terminal ileum. Regions of interest (ROI) measuring 6 mm in diameter were selected in the lumen of each location. The ROIs were placed where the lumen was best shown in the CT-image. The CT-scan software provided a mean HU measurement of each of the selected ROIs and the values were recorded by the Investigators. The HU of the wall was set to +80HU as a standard for all measurements. It was not possible to discriminate between the lumen and the wall for Movprep and Diluted Omnipaque as they have a contrast similar to the wall contrast. The difference in contrast density between bowel lumen and wall were calculated by subtracting the pinpoint HU value(s) of the wall (+80HU) from the mean ROI HU value(s) of the lumen, and the absolute value was presented.
    End point type
    Primary
    End point timeframe
    CT-examination, Day 1
    End point values
    Lumentin 44 Diluted Omnipaque Movprep
    Number of subjects analysed
    17
    12
    14
    Units: HU (Hounsfield Units)
        arithmetic mean (standard deviation)
    484.0 ( 192.4 )
    122.1 ( 81.4 )
    64.5 ( 15.9 )
    Statistical analysis title
    Wilcoxon rank sum test
    Statistical analysis description
    The null-hypothesis that the primary efficacy variable is equal in the groups was tested by means of the Wilcoxon rank sum test. In each of these analyses a 2-sided p-value less than 5% was considered statistically significant.
    Comparison groups
    Diluted Omnipaque v Movprep v Lumentin 44
    Number of subjects included in analysis
    43
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    < 0.0001 [1]
    Method
    Wilcoxon (Mann-Whitney)
    Confidence interval
    Notes
    [1] - Analysis of Lumentin 44 vs. diluted Omnipaque: P-value <0.0001 Analysis of Lumentin 44 vs. Movprep: P-value <0.0001

    Secondary: Bowel Filling Properties, Extension

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    End point title
    Bowel Filling Properties, Extension
    End point description
    The bowel filling agent was distributed along the length of small bowel, i.e. the extension. The filling of each of the 5 selected sub-segments of the small bowel in terms of extension was examined on the CT-scan by 2 investigators, independently of each other, and graded using Likert scales between 1 and 9. Extension scale: 1. No sign of contrast agent 2. Trace of contrast agent filling 3. Segment filled to ca. 25% 4. Segment filled to >25% but <50% 5. Filled to segment filled to 50% 6. Segment filled > 50% but <75% 7. Segment filled to ca. 75% 8. Segment filled to >75% but <100% 9. Segment filled to 100% The Extension score is the sum of the grades of both assessors and in each sub-segment and hence range from 10 to 90.
    End point type
    Secondary
    End point timeframe
    CT-examination, Day 1
    End point values
    Lumentin 44 Diluted Omnipaque Movprep
    Number of subjects analysed
    17
    12
    14
    Units: Likert Scale (1-9)
        arithmetic mean (standard deviation)
    63.0 ( 21.7 )
    61.2 ( 15.9 )
    71.8 ( 10.6 )
    Statistical analysis title
    Wilcoxon rank sum test
    Statistical analysis description
    The null-hypothesis that the primary efficacy variable is equal in the groups was tested by means of the Wilcoxon rank sum test. In each of these analyses a 2-sided p-value less than 5% was considered statistically significant.
    Comparison groups
    Lumentin 44 v Diluted Omnipaque v Movprep
    Number of subjects included in analysis
    43
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.8419 [2]
    Method
    Wilcoxon (Mann-Whitney)
    Confidence interval
    Notes
    [2] - Analysis of Lumentin 44 vs. diluted Omnipaque: P-value =0.8419 Analysis of Lumentin 44 vs. Movprep: P-value =0.3305

    Secondary: Bowel filling properties, Distension

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    End point title
    Bowel filling properties, Distension
    End point description
    The bowel filling agent caused a local widening of the bowel loop, distension. The filling of each of the 5 selected sub-segments of the small bowel in terms of distension was examined on the CT-scan by both the 2 investigators independently of each other, and graded using Likert scales between 1 and 9. Distension scale: 1. No identifiable contrast agent 2. A minimal amount of contrast agent is identified 3. Small amount of contrast agent, insufficient for placing a ROI of 6 mm 4. Amount of contrast agent just allowing for a ROI of 6 mm 5. Medium filled bowel loop 6. Slightly better than grade 5 7. Good filling 8. Optimal filling 9. Excellent or almost over distended The Distension score is the sum of the grades of both assessors and in each sub-segment and range from 10 to 90.
    End point type
    Secondary
    End point timeframe
    CT-examination, Day 1
    End point values
    Lumentin 44 Diluted Omnipaque Movprep
    Number of subjects analysed
    17
    12
    14
    Units: Likert Scale (1-9)
        arithmetic mean (standard deviation)
    48.1 ( 18.1 )
    47.0 ( 12.2 )
    54.7 ( 8.6 )
    Statistical analysis title
    Wilcoxon rank sum test
    Statistical analysis description
    The null-hypothesis that the primary efficacy variable is equal in the groups was tested by means of the Wilcoxon rank sum test. In each of these analyses a 2-sided p-value less than 5% was considered statistically significant.
    Comparison groups
    Lumentin 44 v Diluted Omnipaque v Movprep
    Number of subjects included in analysis
    43
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.9823 [3]
    Method
    Wilcoxon (Mann-Whitney)
    Confidence interval
    Notes
    [3] - Analysis of Lumentin 44 vs. diluted Omnipaque: P-value =0.9823 Analysis of Lumentin 44 vs. Movprep: P-value =0.2333

    Secondary: Diagnostic Ability when Examining Abdominal CT

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    End point title
    Diagnostic Ability when Examining Abdominal CT
    End point description
    Diagnostic ability when examining Abd-CT was assessed on the CT-scan by the 2 investigators independently of each other. The following features were assessed: • Small bowel appearance • Parenchymal organs, i.e. Pancreas, ovaries, urinary bladder • Mesenterium and omentum using a Likert scales of 1-9 ranging, where: 1. Impossible to observe details 5. Medium 9. Excellent resolution The Diagnostic ability score was the sum of the scores from both assessors and ranged from 6 to 54.
    End point type
    Secondary
    End point timeframe
    CT-examination, Day 1
    End point values
    Lumentin 44 Diluted Omnipaque Movprep
    Number of subjects analysed
    17
    12
    14
    Units: Likert Scale (1-9)
        arithmetic mean (standard deviation)
    43.1 ( 4.8 )
    39.9 ( 5.9 )
    41.4 ( 4.4 )
    Statistical analysis title
    Wilcoxon rank sum test
    Statistical analysis description
    The null-hypothesis that the primary efficacy variable is equal in the groups was tested by means of the Wilcoxon rank sum test. In each of these analyses a 2-sided p-value less than 5% was considered statistically significant.
    Comparison groups
    Lumentin 44 v Diluted Omnipaque v Movprep
    Number of subjects included in analysis
    43
    Analysis specification
    Pre-specified
    Analysis type
    equivalence
    P-value
    = 0.1755 [4]
    Method
    Wilcoxon (Mann-Whitney)
    Confidence interval
    Notes
    [4] - Analysis of Lumentin 44 vs. diluted Omnipaque: P-value =0.1755 Analysis of Lumentin 44 vs. Movprep: P-value =0.3284

    Secondary: Degradation of Contrast Agent (Lumentin® 44)

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    End point title
    Degradation of Contrast Agent (Lumentin® 44) [5]
    End point description
    Degradation of Lumentin 44 was founded on the 2 characteristics; coalescence and syneresis or drainage. Coalescence: 0. No bubbles visually detectable at the CT-scan 1. Bubbles visually detectable at the CT-scan Syneresis or drainage: 0. No syneresis or drainage, i.e. separation of air and liquid phases, observed 1. Syneresis or drainage observed Signs of degradation were assessed on the CT-scan, by both Investigator and Sub-Investigator, independently of each other, in each of the 5 selected sub-segments of the small bowel. The degradation of contrast agents score is the sum of the scores from both assessors and in each sub-segment and range from 0 to 20.
    End point type
    Secondary
    End point timeframe
    CT-Examination, Day 1
    Notes
    [5] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Lumentin 44 is a foam containing air, and it could be suspected that the air bubbles would not withstand the condition in the stomach or the intestines. Therefore, the end point Degradation of Contrast Agent was only valid for Lumentin 44 and it was included to prove the resisting power of Lumentin 44 and not to compare the IMP with Omnipaque or Movprep.
    End point values
    Lumentin 44
    Number of subjects analysed
    17
    Units: Score (1-20)
        arithmetic mean (standard deviation)
    0.647 ( 0.996 )
    No statistical analyses for this end point

    Secondary: Subjects' Assessment of Taste of the Contrast Agent

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    End point title
    Subjects' Assessment of Taste of the Contrast Agent
    End point description
    The subjects assessed taste on a five degree-scale: 1. Very negative 2. Negative 3. Neutral 4. Positive 5. Very positive
    End point type
    Secondary
    End point timeframe
    Day 1
    End point values
    Lumentin 44 Diluted Omnipaque Movprep
    Number of subjects analysed
    17
    12
    14
    Units: Score (1-5)
        median (full range (min-max))
    4.0 (3.0 to 5.0)
    4.0 (3.0 to 5.0)
    2.5 (1.0 to 4.0)
    No statistical analyses for this end point

    Secondary: Subjects' Assessment of Smell of the Contrast Agent

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    End point title
    Subjects' Assessment of Smell of the Contrast Agent
    End point description
    The subjects assessed smell on a five degree-scale: 1. Very negative 2. Negative 3. Neutral 4. Positive 5. Very positive
    End point type
    Secondary
    End point timeframe
    Day 1
    End point values
    Lumentin 44 Diluted Omnipaque Movprep
    Number of subjects analysed
    17
    12
    14
    Units: Score (1-5)
        median (full range (min-max))
    4.0 (3.0 to 5.0)
    4.0 (3.0 to 5.0)
    3.0 (2.0 to 5.0)
    No statistical analyses for this end point

    Secondary: Subjects' Assessment of Consistency of the Contrast Agent

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    End point title
    Subjects' Assessment of Consistency of the Contrast Agent
    End point description
    The subjects assessed consistency on a five degree-scale: 1. Very negative 2. Negative 3. Neutral 4. Positive 5. Very positive
    End point type
    Secondary
    End point timeframe
    Day 1
    End point values
    Lumentin 44 Diluted Omnipaque Movprep
    Number of subjects analysed
    17
    12
    14
    Units: Score (1-5)
        median (full range (min-max))
    3.0 (2.0 to 4.0)
    4.0 (3.0 to 5.0)
    3.0 (2.0 to 4.0)
    No statistical analyses for this end point

    Secondary: Subjects' Assessment of Ability to Swallow the Contrast Agent

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    End point title
    Subjects' Assessment of Ability to Swallow the Contrast Agent
    End point description
    The subjects assessed ability to swallow on a five degree-scale: 1. Very difficult 2. Difficult 3. Medium 4. Easy 5. Very easy
    End point type
    Secondary
    End point timeframe
    Day 1
    End point values
    Lumentin 44 Diluted Omnipaque Movprep
    Number of subjects analysed
    17
    12
    14
    Units: Score (1-5)
        median (full range (min-max))
    3.0 (2.0 to 4.0)
    5.0 (2.0 to 5.0)
    3.0 (1.0 to 5.0)
    No statistical analyses for this end point

    Secondary: Subjects' Assessment of Fullness after Drinking the Contrast Agent

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    End point title
    Subjects' Assessment of Fullness after Drinking the Contrast Agent
    End point description
    The subjects assessed fullness on a five degree-scale: 1. Very full 2. Full 3. Medium full 4. Barely full 5. Not at all full.
    End point type
    Secondary
    End point timeframe
    Day 1
    End point values
    Lumentin 44 Diluted Omnipaque Movprep
    Number of subjects analysed
    17
    12
    14
    Units: Score (1-5)
        median (full range (min-max))
    2.0 (1.0 to 4.0)
    3.0 (2.0 to 4.0)
    3.0 (1.0 to 5.0)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    AEs were reported from start of intake of the study drug and until a telephone interview, taking place 12–48 hours after the CT-examination.
    Adverse event reporting additional description
    AEs were collected using non-leading questions, observed, or spontaneously volunteered by subjects. Especially solicited AEs were: Stomach ache, Burping, Letting of wind, Nausea, Sensation of fullness. Solicited AEs and abnormal clinical significant laboratory values were also to be included in "all AEs".
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    19.0
    Reporting groups
    Reporting group title
    Lumentin 44
    Reporting group description
    Before CT-scan, subjects received Lumentin 44 in volumes of 750 mL to 1200 mL, which should be taken within 1 hour. All AEs reported (including solicited AEs) are presented.

    Reporting group title
    Diluted Omnipaque
    Reporting group description
    Before CT-scan, subjects received Omnipaque in volumes according to standard of care (target volume 1000 mL), which should be taken within 1 hour. All AEs reported (including solicited AEs) are presented.

    Reporting group title
    Movprep
    Reporting group description
    Before CT-scan, subjects received Movprep in volumes according to standard of care (target volume 1000 mL), which should be taken within 1 hour. All AEs reported (including solicited AEs) are presented.

    Serious adverse events
    Lumentin 44 Diluted Omnipaque Movprep
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 18 (0.00%)
    0 / 12 (0.00%)
    0 / 14 (0.00%)
         number of deaths (all causes)
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Lumentin 44 Diluted Omnipaque Movprep
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    7 / 18 (38.89%)
    7 / 12 (58.33%)
    8 / 14 (57.14%)
    General disorders and administration site conditions
    Chills
    Additional description: Not solicited event.
         subjects affected / exposed
    0 / 18 (0.00%)
    1 / 12 (8.33%)
    0 / 14 (0.00%)
         occurrences all number
    0
    1
    0
    Gastrointestinal disorders
    Abdominal distension
    Additional description: Solicited AE: Sensation of fullness
         subjects affected / exposed
    1 / 18 (5.56%)
    1 / 12 (8.33%)
    1 / 14 (7.14%)
         occurrences all number
    1
    1
    1
    Abdominal pain upper
    Additional description: Solicited AE: Stomach ache
         subjects affected / exposed
    1 / 18 (5.56%)
    3 / 12 (25.00%)
    3 / 14 (21.43%)
         occurrences all number
    1
    3
    3
    Diarrhoea
    Additional description: Not solicited event.
         subjects affected / exposed
    0 / 18 (0.00%)
    3 / 12 (25.00%)
    6 / 14 (42.86%)
         occurrences all number
    0
    3
    6
    Eructation
    Additional description: Solicited AE: Burping
         subjects affected / exposed
    1 / 18 (5.56%)
    0 / 12 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0
    Flatulence
    Additional description: Solicited AE: Letting of wind
         subjects affected / exposed
    4 / 18 (22.22%)
    4 / 12 (33.33%)
    3 / 14 (21.43%)
         occurrences all number
    4
    4
    3
    Nausea
    Additional description: Solicited event: Nausea
         subjects affected / exposed
    2 / 18 (11.11%)
    2 / 12 (16.67%)
    1 / 14 (7.14%)
         occurrences all number
    2
    2
    1
    Rectal haemorrhage
    Additional description: Not solicited event.
         subjects affected / exposed
    1 / 18 (5.56%)
    0 / 12 (0.00%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    11 Nov 2017
    Amendment No. 1 was implemented before start of enrollment. • The minimum volumes of diluted Omnipaque and Movprep required to be taken by the subject were adjusted to comply with the general praxis of care at the Department of Imaging and Function, Skåne University Hospital. • The dose for the intravenous contrast agent, Omnipaque® 350 mg I/mL, which in error was stated as 60 to 90 mL, was corrected to the dose range according to the standard procedure: 60 to 115 mL. • The exclusion criterion, prohibiting the inclusion of subjects participating in other clinical studies, was revised to allow participating in an oncology clinical trial if the subject was in the follow-up phase of the trial or had been on reduced maintenance treatment for at least the last 6 weeks.
    05 Jul 2018
    • The assessment of the primary objective in the trial was changed to directly measure the mean difference in contrast density between the lumen and the wall of the intestine instead of relating it to the contrast density of the stomach. The reason for the change was that the main objective of the trial was to show differences between the 3 contrast agents. The patients came to the CT-examination fasted which led to that the density of the stomach was on par with the bowel. The difference between the contrast agents might therefore be obscured by relating the contrast density within patients to the contrast density of the stomach. • The total number of subjects to be recruited was lowered from 114 to 80 evaluable subjects. The number of subjects in the Lumentin 44 arm would be 40 and in the 2 comparator arms the numbers were set to 20. Because of this change, the power of the trial was lowered from 90% to 78% (with a maintained 2-sided p-value less than 0.0500) in the previous version of the protocol. • To facilitate recruitment, posters were placed at the oncology departments at Skåne University Hospital and invitation letters were handed out to those interested. • The inclusion criteria were changed so fasting for 4 hours was required before intake of contrast agent for patients coming for CT-examination. This change was made to ensure that the contrast agents reached the terminal sections of the bowel. • For diluted Omnipaque, one of the standard oral contrast agents, the addition of 30 mL 70% Sorbitol was omitted. The reason was that some patients were reluctant to take this contrast agent due to undesirable side effects of the Sorbitol additive. General praxis of care at the Department of Imaging and Function, Skåne University Hospital, includes dilution of Omnipaque both with and without Sorbitol addition. Omission of Sorbitol in this trial was therefore not considered to have any negative effect on neither subject safety nor evaluation of the trial.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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