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Efficacy and Safety of Ultrase® MT20 in Improving the Coefficient of Fat Absorption (CFA) in Children With Cystic Fibrosis (CF) and Pancreatic Insufficiency (PI)

Primary Purpose

Cystic Fibrosis, Pancreatic Insufficiency

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Ultrase® MT20
Sponsored by
Forest Laboratories
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Cystic Fibrosis focused on measuring Cystic Fibrosis, Pancreatic insufficiency, Steatorrhea, Children 7 to 11 years, Pancreatic enzyme

Eligibility Criteria

7 Years - 11 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • After a full explanation of the study, participants or their legally authorized representative must have signed the informed consent or assent form along with a parental form
  • Participants must have a confirmed diagnosis of CF based on one or more clinical features consistent with the CF phenotype, and one of the following:

    • A genotype with two identifiable mutations consistent with CF
    • A sweat chloride test greater that 60 millimole per liter (mmol/L) by quantitative pilocarpine iontophoresis
  • Participants must have PI as demonstrated by a fecal elastase-1 (FE-1) concentration less than 100 microgram per gram (mcg/g) of stools (ScheBo test) and requiring pancreatic enzyme supplementation
  • Participants must be clinically stable according to the physician's judgment by:

    • Medical and medication history
    • Baseline physical examination including vital signs and laboratory analyses
  • Participants must be 7 to 11 years of age
  • Participants must have an adequate nutritional status based on body mass index (BMI) greater than or equal to fifth percentile
  • Participants must be on an optimal clinical dose of pancreatic enzymes (Ultrase® MT12 , MT18 or MT20 or other pancreatic enzyme preparations) prior to entry in the study and must tolerate this medication in the opinion of the investigator
  • Participants must be able to be able to swallow capsules and eat a high-fat diet calculated as 2 gram fat per kilogram (g fat/kg) of body weight per day
  • Participants must be, in the opinion of the investigator, able and willing to complete the study
  • Female participants should be premenarcheal. Otherwise, a female participant of childbearing potential (WOCBP) must not be pregnant and must have practiced an acceptable method of contraception for at least 1 month prior to the study entry

Exclusion Criteria:

  • Participants with a known contraindication, sensitivity or hypersensitivity to Ultrase® MT20 or any porcine protein
  • Participants with a known allergy to the food, drug and cosmetic (FD&C) Blue No. 2 dye indicator (stool marker)
  • Participants who are not willing to stop the prohibited medications or products at study entry and throughout the study
  • Participants who use narcotics chronically and bowel stimulants and/or laxatives on a regular basis
  • Participants with acute pancreatitis or acute exacerbation of chronic pancreatic disease
  • Participants with an acute pulmonary infection
  • Participants with a history of bowel resection
  • Participants suffering from any dysmotility disorders
  • Participants with chronic or severe abdominal pain
  • Participants receiving enteral tube feeding and not willing to stop during the course of the study
  • Participants with a significant medical disease that would compromise their welfare or confound the study results
  • Participants with a history of or a current diagnosis of clinically significant portal hypertension
  • Participants who have a condition known to increase fecal fat loss including celiac's disease, biliary cancer, biliary stricture, cholelithiasis, Crohn's disease, ulcerative colitis, pancreas cancer, radiation enteritis, tropical sprue, Whipple's disease, lactose intolerance, pseudomembranous colitis
  • Participants with a current diagnosis or a history of complete distal intestinal obstruction syndrome (DIOS) in the past 6 months; or, participants who had 2 or more episodes of DIOS in the past year
  • Participants with poorly controlled diabetes according to the investigator's opinion
  • Female participants who are pregnant or lactating
  • Participants who received an investigational drug within 30 days prior to entry into the study

Sites / Locations

  • University of Michigan Health System Cystic Fibrosis Center
  • Cystic Fibrosis Center Rainbow Babies and Children's HospitalDivision
  • Pennsylvania State University And the Milton S. Hershey Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Ultrase® MT20

Arm Description

Outcomes

Primary Outcome Measures

Percent Coefficient of Fat Absorption (CFA)
Percent CFA was calculated as ([fat intake - fat excretion]/fat intake)*100, determined by the stools collected during the 72-hour period in either washout phase or treatment phase. Mean percent CFA was calculated for Day 3 to Day 5 or Day 6 of the respective phase.

Secondary Outcome Measures

Percent Coefficient of Nitrogen Absorption (CNA)
Percent CNA was calculated as [(nitrogen intake-nitrogen excretion)/nitrogen intake]*100, determined by the stools collected during the 72- hour period in either washout phase or treatment phase. Nitrogen intake was calculated as protein intake/6.25. Nitrogen excretion was measured as total fecal nitrogen. Mean percent CNA was calculated for Day 3 to Day 5 or Day 6 of the respective phase.

Full Information

First Posted
August 7, 2007
Last Updated
February 7, 2017
Sponsor
Forest Laboratories
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1. Study Identification

Unique Protocol Identification Number
NCT00513682
Brief Title
Efficacy and Safety of Ultrase® MT20 in Improving the Coefficient of Fat Absorption (CFA) in Children With Cystic Fibrosis (CF) and Pancreatic Insufficiency (PI)
Official Title
Efficacy and Safety of Ultrase® MT20 in Improving the Coefficient of Fat Absorption (CFA%) in Children With Cystic Fibrosis (CF) and Pancreatic Insufficiency (PI)
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Completed
Study Start Date
July 2007 (undefined)
Primary Completion Date
March 2008 (Actual)
Study Completion Date
April 2008 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Forest Laboratories

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a Phase III, multicenter, open-label study, that will evaluate the improvement of nutrient absorption when participants will receive Ultrase® MT20. This study is sponsored by Aptalis (formerly Axcan). This study is performed in children from 7 to 11 years old.
Detailed Description
This is a Phase III, multicenter, open-label study, which will quantify the improvement of nutrient absorption when participants are receiving Ultrase® MT20. The improvement will be demonstrated by comparing the CFA percent (%) and CNA% obtained during a washout of enzyme with the CFA% and CNA% obtained during a period of treatment with Ultrase® MT20. The study is also designed to obtain safety data in CF children suffering also from PI taking Ultrase® MT20. The total duration for the participation of children in this study will be approximately up to 38 days and will include 3 phases: screening phase, the washout phase and treatment phase. Screening phase: this phase will last 15 days and all participants will take Ultrase® MT20 as per investigator's discretion during this period. During the last 4 days, participants will be stabilized on a high fat diet and with Ultrase® MT20. The individual 'stabilized dose' of Ultrase® MT20 capsules will be determined for each participant based on the average number of capsules of Ultrase® MT20 taken during last 4 days. Washout phase: this phase will last 6 to 7 days. The participants will continue the high-fat diet but will refrain from taking Ultrase® MT20 or any other enzymes. A 72-hour stool collection will be performed and all food consumed by the participants will be recorded to assess the CFA% and CNA%. Treatment phase: this phase will last 7 to 11 days. The participants will continue the high-fat diet and will take the 'stabilized dose' of Ultrase® MT20 established during screening. Another 72-hour stool collection will be performed and all food consumed by the participants will be recorded to assess the CFA% and CNA%.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Cystic Fibrosis, Pancreatic Insufficiency
Keywords
Cystic Fibrosis, Pancreatic insufficiency, Steatorrhea, Children 7 to 11 years, Pancreatic enzyme

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
9 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Ultrase® MT20
Arm Type
Experimental
Intervention Type
Drug
Intervention Name(s)
Ultrase® MT20
Intervention Description
Ultrase® MT20 capsules will be administered orally with each meal during Day 1 to 15 in screening phase at a dose based on investigator's discretion. During Day 12 to 15, participants will receive high-fat diet and Ultrase® MT20 dose will be adjusted depending on symptoms of steatorrhea. This will be followed by a washout phase of 6 to 7 days, in which participants will receive only high-fat diet; then stabilized dose of Ultrase® MT20 capsule (as identified during screening phase) will be administered orally for 7 to 11 days during treatment phase. The stabilized dose should not to exceed 2500 lipase units per kilogram body weight per meal (lipase units/kg/meal).
Primary Outcome Measure Information:
Title
Percent Coefficient of Fat Absorption (CFA)
Description
Percent CFA was calculated as ([fat intake - fat excretion]/fat intake)*100, determined by the stools collected during the 72-hour period in either washout phase or treatment phase. Mean percent CFA was calculated for Day 3 to Day 5 or Day 6 of the respective phase.
Time Frame
Day 3 to Day 5 or Day 6 during washout phase and treatment phase
Secondary Outcome Measure Information:
Title
Percent Coefficient of Nitrogen Absorption (CNA)
Description
Percent CNA was calculated as [(nitrogen intake-nitrogen excretion)/nitrogen intake]*100, determined by the stools collected during the 72- hour period in either washout phase or treatment phase. Nitrogen intake was calculated as protein intake/6.25. Nitrogen excretion was measured as total fecal nitrogen. Mean percent CNA was calculated for Day 3 to Day 5 or Day 6 of the respective phase.
Time Frame
Day 3 to Day 5 or Day 6 during washout phase and treatment phase

10. Eligibility

Sex
All
Minimum Age & Unit of Time
7 Years
Maximum Age & Unit of Time
11 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: After a full explanation of the study, participants or their legally authorized representative must have signed the informed consent or assent form along with a parental form Participants must have a confirmed diagnosis of CF based on one or more clinical features consistent with the CF phenotype, and one of the following: A genotype with two identifiable mutations consistent with CF A sweat chloride test greater that 60 millimole per liter (mmol/L) by quantitative pilocarpine iontophoresis Participants must have PI as demonstrated by a fecal elastase-1 (FE-1) concentration less than 100 microgram per gram (mcg/g) of stools (ScheBo test) and requiring pancreatic enzyme supplementation Participants must be clinically stable according to the physician's judgment by: Medical and medication history Baseline physical examination including vital signs and laboratory analyses Participants must be 7 to 11 years of age Participants must have an adequate nutritional status based on body mass index (BMI) greater than or equal to fifth percentile Participants must be on an optimal clinical dose of pancreatic enzymes (Ultrase® MT12 , MT18 or MT20 or other pancreatic enzyme preparations) prior to entry in the study and must tolerate this medication in the opinion of the investigator Participants must be able to be able to swallow capsules and eat a high-fat diet calculated as 2 gram fat per kilogram (g fat/kg) of body weight per day Participants must be, in the opinion of the investigator, able and willing to complete the study Female participants should be premenarcheal. Otherwise, a female participant of childbearing potential (WOCBP) must not be pregnant and must have practiced an acceptable method of contraception for at least 1 month prior to the study entry Exclusion Criteria: Participants with a known contraindication, sensitivity or hypersensitivity to Ultrase® MT20 or any porcine protein Participants with a known allergy to the food, drug and cosmetic (FD&C) Blue No. 2 dye indicator (stool marker) Participants who are not willing to stop the prohibited medications or products at study entry and throughout the study Participants who use narcotics chronically and bowel stimulants and/or laxatives on a regular basis Participants with acute pancreatitis or acute exacerbation of chronic pancreatic disease Participants with an acute pulmonary infection Participants with a history of bowel resection Participants suffering from any dysmotility disorders Participants with chronic or severe abdominal pain Participants receiving enteral tube feeding and not willing to stop during the course of the study Participants with a significant medical disease that would compromise their welfare or confound the study results Participants with a history of or a current diagnosis of clinically significant portal hypertension Participants who have a condition known to increase fecal fat loss including celiac's disease, biliary cancer, biliary stricture, cholelithiasis, Crohn's disease, ulcerative colitis, pancreas cancer, radiation enteritis, tropical sprue, Whipple's disease, lactose intolerance, pseudomembranous colitis Participants with a current diagnosis or a history of complete distal intestinal obstruction syndrome (DIOS) in the past 6 months; or, participants who had 2 or more episodes of DIOS in the past year Participants with poorly controlled diabetes according to the investigator's opinion Female participants who are pregnant or lactating Participants who received an investigational drug within 30 days prior to entry into the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Aptalis Medical Information
Organizational Affiliation
Forest Laboratories
Official's Role
Study Director
Facility Information:
Facility Name
University of Michigan Health System Cystic Fibrosis Center
City
Ann Arbor
State/Province
Michigan
ZIP/Postal Code
48109-0212
Country
United States
Facility Name
Cystic Fibrosis Center Rainbow Babies and Children's HospitalDivision
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44106
Country
United States
Facility Name
Pennsylvania State University And the Milton S. Hershey Medical Center
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033
Country
United States

12. IPD Sharing Statement

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Efficacy and Safety of Ultrase® MT20 in Improving the Coefficient of Fat Absorption (CFA) in Children With Cystic Fibrosis (CF) and Pancreatic Insufficiency (PI)

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