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Study to Evaluate Safety and Efficacy of Rifamycin SV Multi-Matrix System (MMX) for the Treatment of Traveler's Diarrhea (TD)

Primary Purpose

Traveler's Diarrhea

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Placebo
Rifamycin SV MMX
Sponsored by
Cosmo Technologies Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Traveler's Diarrhea focused on measuring traveler's, diarrhea, Rifamycin SV MMX, Rifamycin, MMX, Traveler's Diarrhea

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria

Patients were enrolled in the study only if they met all of the following criteria:

  1. Male and female patients 18 years of age or older
  2. Female and male patients of childbearing potential must have agreed to use an effective method of birth control (this method must have been approved by the investigator and may have included total abstinence from sexual intercourse) during the treatment and follow-up study periods; female patients of childbearing potential must have had a negative pregnancy test in the 72 hours before randomization; female patients who abstained totally from sexual intercourse were not required to take the pregnancy test
  3. Recent travel (i.e., must be within 30 days of randomization) from an industrialized country
  4. Experiencing signs or symptoms indicative of acute bacterial diarrhea (TD), defined as at least three unformed, watery or soft, stools within the 24 hours preceding randomization and the duration of illness 72 hours before randomization, and able to provide an unformed stool sample during Screening (the latter can be the third unformed stool passed by the patient within the 24 hours preceding randomization); the bacterial cause of diarrhea was confirmed by microbiology analysis of the stool sample
  5. Experiencing one or more signs or symptoms of enteric infection (moderate to severe gas/flatulence, nausea, vomiting, abdominal cramps or pain, rectal tenesmus, or defecation urgency)
  6. Capable of and willing to give informed consent

Exclusion Criteria

Patients were excluded from the study if they met any of the following criteria:

  1. Fever (> 100.4F or 38C) or presence of signs and symptoms of systemic infection Note: antipyretic medication should not have been administered in the 6 hours before this assessment
  2. Known or suspected infection with non-bacterial pathogen before randomization
  3. Presence of diarrhea for > 72 hours duration
  4. Presence of grossly bloody stool
  5. Presence of moderate to severe dehydration (i.e., presence of orthostatic hypotension and/or dehydration requiring treatment with intravenous fluids)
  6. History of ulcerative colitis, diarrhea-predominant irritable bowel syndrome, Crohn's disease, celiac sprue (gluten-enteropathy), chronic pancreatitis, malabsorption, or any other gastrointestinal disease associated with diarrhea. Note: lactose intolerance treated with lactase supplements or a lactose-free diet were not excluded if these regimens were maintained during the study.
  7. Receiving more than two doses of an antidiarrheal medication (e.g., antimotility, absorbent, adsorbent, antisecretory, or probiotics) within 24 hours before randomization
  8. Receiving one or more of the following antibiotics, which are active against gram negative bacteria TMP-SMX, fluorquinolone, azithromycin or rifaximin within 7 days before randomization
  9. Females pregnant or breast feeding or not using adequate birth control
  10. Known intolerance/hypersensitivity/resistance to rifamycin or rifamycin-related antibiotics or to any excipient included in the study medications
  11. Patients unable or unwilling to comply with study protocol (e.g., alcoholism, mental illness, travel schedule)
  12. Participation in a clinical study with another investigational drug in the 30 days prior to randomization or while participating in this study
  13. Previous participation in this study

Sites / Locations

  • Santarus Investigational Site 03
  • Santarus Investigational Site 14
  • Santarus Investigational Site 04
  • Santarus Investigational Site 05
  • Santarus Investigational Site 06
  • Santarus Investigational Site 12
  • Santarus Investigational Site 10
  • Santarus Investigational Site 07
  • Santarus Investigational Site 08
  • Santarus Investigational Site 09
  • Santarus Investigational Site 11
  • Santarus Investigational Site 13

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Placebo

Rifamycin SV MMX

Arm Description

Placebo (two matching tablets) orally twice daily for 3 days (72 hours)

Rifamycin SV MMX® 400 mg (two 200 mg tablets) orally twice daily for 3 days (72 hours).

Outcomes

Primary Outcome Measures

Time to Last Unformed Stool (TLUS)
The primary endpoint is TLUS defined as the interval in hours between the first dose of study drug and the last unformed stool passed just before the start of Clinical Cure. An unformed stool is defined as either a soft or watery stool. TLUS will be calculated for each patient in the following manner: Step 1: Identify when the patient achieves Clinical Cure. Step 2: Moving backwards from this time, identify the time of the last unformed stool. Step 3: The TLUS equals the time from the first dose of study drug to the time of the last unformed stool identified in Step 2.

Secondary Outcome Measures

Clinical Cure
Clinical Cure is defined as either of the following: Passage of two or fewer soft stools and no watery stools, no fever (>100.4 ºF or 38 ºC), and no signs or symptoms of enteric infection (other than mild excess gas/flatulence) during a 24 hour interval in the 120-hr data collection period after the first dose of study drug Passage of no stools or only formed stools and no fever during a 48-hour interval in the 120-hr data collection period after the first dose of study drug, with or without other signs or symptoms of enteric infection

Full Information

First Posted
June 9, 2010
Last Updated
May 10, 2018
Sponsor
Cosmo Technologies Ltd
Collaborators
Bausch Health Americas, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01142089
Brief Title
Study to Evaluate Safety and Efficacy of Rifamycin SV Multi-Matrix System (MMX) for the Treatment of Traveler's Diarrhea (TD)
Official Title
A Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Safety and Efficacy of Rifamycin SV MMX for the Treatment of Traveler's Diarrhea
Study Type
Interventional

2. Study Status

Record Verification Date
April 2018
Overall Recruitment Status
Completed
Study Start Date
May 27, 2010 (undefined)
Primary Completion Date
June 2012 (Actual)
Study Completion Date
June 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Cosmo Technologies Ltd
Collaborators
Bausch Health Americas, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine whether Rifamycin SV MMX is a safe and effective treatment for Traveler's Diarrhea.
Detailed Description
This is a multicenter, randomized, double-blind, placebo-controlled efficacy and safety study conducted in patients traveling to developing regions with a known high incidence of TD. Eligibility will be based on a symptom complex that is highly indicative of enteric acute bacterial infection without indication of systemic infection. Approximately 262 patients will be enrolled in the study and randomized at a 3:1 ratio to receive Rifamycin SV MMX® 400 mg or placebo orally twice daily for 3 days (72 hours). Treatment will be initiated on the day of Screening (Visit 1, Day 1), within 72 hours of onset of diarrhea. Daily doses of study drug will be taken at breakfast time and dinner time with a glass of liquid. Safety and efficacy will be assessed. Blood samples for routine safety tests (chemistry and hematology) will be collected at Visit 1 and at Visit 3 and sent to a local laboratory for analysis and reporting to the Investigator for safety monitoring. Urine samples for routine urinalysis (dipstick only) will be collected at Visits 1 and 3, and the results will be used by the Investigator for safety monitoring. If a patient's diarrhea and/or signs or symptoms of enteric infection worsen in a 24 hour interval of time during the treatment period or if the enteric illness fails to improve after 24 hours or more of therapy, the patient may receive Rescue Therapy. Rescue Therapy will be prescribed by the Investigator using local standard empiric therapy and/or guided by pathogen identification.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Traveler's Diarrhea
Keywords
traveler's, diarrhea, Rifamycin SV MMX, Rifamycin, MMX, Traveler's Diarrhea

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
264 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo (two matching tablets) orally twice daily for 3 days (72 hours)
Arm Title
Rifamycin SV MMX
Arm Type
Experimental
Arm Description
Rifamycin SV MMX® 400 mg (two 200 mg tablets) orally twice daily for 3 days (72 hours).
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo (two matching tablets) orally twice daily for 3 days (72 hours).
Intervention Type
Drug
Intervention Name(s)
Rifamycin SV MMX
Intervention Description
Rifamycin SV MMX® 400 mg (two 200 mg tablets) orally twice daily for 3 days (72 hours).
Primary Outcome Measure Information:
Title
Time to Last Unformed Stool (TLUS)
Description
The primary endpoint is TLUS defined as the interval in hours between the first dose of study drug and the last unformed stool passed just before the start of Clinical Cure. An unformed stool is defined as either a soft or watery stool. TLUS will be calculated for each patient in the following manner: Step 1: Identify when the patient achieves Clinical Cure. Step 2: Moving backwards from this time, identify the time of the last unformed stool. Step 3: The TLUS equals the time from the first dose of study drug to the time of the last unformed stool identified in Step 2.
Time Frame
24 hours
Secondary Outcome Measure Information:
Title
Clinical Cure
Description
Clinical Cure is defined as either of the following: Passage of two or fewer soft stools and no watery stools, no fever (>100.4 ºF or 38 ºC), and no signs or symptoms of enteric infection (other than mild excess gas/flatulence) during a 24 hour interval in the 120-hr data collection period after the first dose of study drug Passage of no stools or only formed stools and no fever during a 48-hour interval in the 120-hr data collection period after the first dose of study drug, with or without other signs or symptoms of enteric infection
Time Frame
24 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Patients were enrolled in the study only if they met all of the following criteria: Male and female patients 18 years of age or older Female and male patients of childbearing potential must have agreed to use an effective method of birth control (this method must have been approved by the investigator and may have included total abstinence from sexual intercourse) during the treatment and follow-up study periods; female patients of childbearing potential must have had a negative pregnancy test in the 72 hours before randomization; female patients who abstained totally from sexual intercourse were not required to take the pregnancy test Recent travel (i.e., must be within 30 days of randomization) from an industrialized country Experiencing signs or symptoms indicative of acute bacterial diarrhea (TD), defined as at least three unformed, watery or soft, stools within the 24 hours preceding randomization and the duration of illness 72 hours before randomization, and able to provide an unformed stool sample during Screening (the latter can be the third unformed stool passed by the patient within the 24 hours preceding randomization); the bacterial cause of diarrhea was confirmed by microbiology analysis of the stool sample Experiencing one or more signs or symptoms of enteric infection (moderate to severe gas/flatulence, nausea, vomiting, abdominal cramps or pain, rectal tenesmus, or defecation urgency) Capable of and willing to give informed consent Exclusion Criteria Patients were excluded from the study if they met any of the following criteria: Fever (> 100.4F or 38C) or presence of signs and symptoms of systemic infection Note: antipyretic medication should not have been administered in the 6 hours before this assessment Known or suspected infection with non-bacterial pathogen before randomization Presence of diarrhea for > 72 hours duration Presence of grossly bloody stool Presence of moderate to severe dehydration (i.e., presence of orthostatic hypotension and/or dehydration requiring treatment with intravenous fluids) History of ulcerative colitis, diarrhea-predominant irritable bowel syndrome, Crohn's disease, celiac sprue (gluten-enteropathy), chronic pancreatitis, malabsorption, or any other gastrointestinal disease associated with diarrhea. Note: lactose intolerance treated with lactase supplements or a lactose-free diet were not excluded if these regimens were maintained during the study. Receiving more than two doses of an antidiarrheal medication (e.g., antimotility, absorbent, adsorbent, antisecretory, or probiotics) within 24 hours before randomization Receiving one or more of the following antibiotics, which are active against gram negative bacteria TMP-SMX, fluorquinolone, azithromycin or rifaximin within 7 days before randomization Females pregnant or breast feeding or not using adequate birth control Known intolerance/hypersensitivity/resistance to rifamycin or rifamycin-related antibiotics or to any excipient included in the study medications Patients unable or unwilling to comply with study protocol (e.g., alcoholism, mental illness, travel schedule) Participation in a clinical study with another investigational drug in the 30 days prior to randomization or while participating in this study Previous participation in this study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Herbert DuPont, MD
Organizational Affiliation
Bausch Health Americas, Inc.
Official's Role
Principal Investigator
Facility Information:
Facility Name
Santarus Investigational Site 03
City
Antigua
ZIP/Postal Code
03001
Country
Guatemala
Facility Name
Santarus Investigational Site 14
City
Antigua
Country
Guatemala
Facility Name
Santarus Investigational Site 04
City
Quetzaltenango
ZIP/Postal Code
09001
Country
Guatemala
Facility Name
Santarus Investigational Site 05
City
Guadalajara
State/Province
Jalisco
ZIP/Postal Code
42670
Country
Mexico
Facility Name
Santarus Investigational Site 06
City
Cuernavaca
State/Province
Morelos
ZIP/Postal Code
62240
Country
Mexico
Facility Name
Santarus Investigational Site 12
City
Cabo San Lucas
ZIP/Postal Code
23440
Country
Mexico
Facility Name
Santarus Investigational Site 10
City
Cancun
ZIP/Postal Code
77500
Country
Mexico
Facility Name
Santarus Investigational Site 07
City
Oaxaca
ZIP/Postal Code
6800
Country
Mexico
Facility Name
Santarus Investigational Site 08
City
Puebla
ZIP/Postal Code
72197
Country
Mexico
Facility Name
Santarus Investigational Site 09
City
Puerto Escondido
ZIP/Postal Code
71980
Country
Mexico
Facility Name
Santarus Investigational Site 11
City
Puerto Vallarta
ZIP/Postal Code
48330
Country
Mexico
Facility Name
Santarus Investigational Site 13
City
Tulum
ZIP/Postal Code
77760
Country
Mexico

12. IPD Sharing Statement

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Study to Evaluate Safety and Efficacy of Rifamycin SV Multi-Matrix System (MMX) for the Treatment of Traveler's Diarrhea (TD)

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