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Multicenter Randomized Parallel Group Phase III Study Comparing the Bowel Cleansing Efficacy, Safety and Tolerability of NER1006 Versus MOVIPREP® Using 2-Day Split-Dosing and 1-Day Morning Split-Dosing Regimen in Adults. (MORA)

Primary Purpose

Colorectal Cancer, Colorectal Carcinoma, Colon Cleansing

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
NER1006, 2-Day Split-Dosing
NER1006,1-Day Morning Split-Dosing
MOVIPREP, 2-Day Split-Dosing
Sponsored by
Norgine
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional screening trial for Colorectal Cancer

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients must provide written informed consent.
  • Male and female outpatients and inpatients aged: ≥18 to ≤85 years undergoing a screening, surveillance or diagnostic colonoscopy.
  • Females of child-bearing potential must have a negative pregnancy test at Screening and at Visit 2 and must be practising one of the following methods of birth control and agree to continue with the regimen throughout the study period (unless postmenopausal or surgically sterile, or whose sole sexual partner has had a successful vasectomy): Oral, implantable, or injectable contraceptives (for a minimum of three months before study entry) in combination with a condom; Intrauterine device in combination with a condom; Double barrier method (condom* and occlusive cap [diaphragm or cervical/vault caps] with spermicidal foam/gel/film/cream/suppository).
  • Willing and able to complete the entire study and to comply with instructions.

Exclusion Criteria:

  • Patients with past history within last 12 months or current episode of severe constipation (requiring repeated use of laxatives/enema or physical intervention before resolution), known or suspected ileus, gastrointestinal obstruction, gastric retention, bowel perforation, toxic colitis or megacolon.
  • Patients with ongoing severe acute Inflammatory Bowel Disease.
  • Patients who have had previous significant gastrointestinal surgeries, including colonic resection, sub-total colectomy, abdomino-perineal resection, de-functioning colostomy, Hartmann's procedure and de-functioning ileostomy or other similar surgeries involving structure and function of the small or large colon.
  • Regular use of laxatives or colon motility altering drugs in the last month (i.e. more than 2-3 times per week) and/or laxative use within 72 hours prior to administration of the preparation.
  • Patients with active intestinal bleeding episodes or with a clinically significant low hemoglobin level <9 g/dL for women and <11 g/dL for men at screening.
  • Known glucose-6-phosphate dehydrogenase (G6PD) deficiency.
  • Known phenylketonuria.
  • Known hypersensitivity to polyethylene glycols, ascorbic acid and sulfates (not including sulfa-based products) or any other component of the study drug or comparator
  • Past history within the last 12 months or evidence of any on-going clinically relevant electrocardiogram (ECG) abnormalities (e.g. arrhythmias).
  • History of uncontrolled hypertension with systolic blood pressure >170 mmHg and diastolic blood pressure >100 mmHg.
  • Patients with cardiac insufficiency NYHA grades III or IV.
  • Patients with severe renal insufficiency (i.e. with GFR, <30 mL/min/1.73m2).
  • Patient with serum albumin <3.4 g/dL.
  • Patients with liver disease of grades B and C according to the Child Pugh classification.
  • Patients suffering from dehydration at screening as evaluated by the Investigator from physical examination and laboratory investigations.
  • Patients with clinically significant electrolyte abnormalities, whether pre-existing or noted at screening, such as hypernatremia, hyponatremia, hyperphosphatemia, hypermagnesemia, hypokalemia, hypocalcaemia dehydration, or those secondary to the use of diuretics or angiotensin converting enzyme (ACE) inhibitors.
  • Patients with any other clinically significant hematological parameters including coagulation profile at screening.
  • Patients with impaired consciousness that might predispose them to pulmonary aspiration.
  • Patients undergoing colonoscopy for foreign body removal and/or decompression.
  • Patients who are pregnant or lactating, or intending to become pregnant during the study.
  • Clinically relevant findings on physical examination based on the Investigator's judgment.
  • History of drug or alcohol abuse within the 12 months prior to dosing.
  • Concurrent participation in an investigational drug or device study or participation within three months of study entry.
  • Patients who are ordered to live in an institution on court or authority order

Sites / Locations

  • AZ Sint-Lucas
  • UZ Ghent
  • UZ Leuven
  • CHC- Clinique Saint-Joseph
  • Hôpital Avicenne- Service de Gastro-Entérologie
  • Hôpital Hotel-Dieu
  • Kliniken Essen-Mitte; Abteilung für Gastroenterologie
  • Klinikum der Friedrich Schiller Universität Jena
  • Praxis für Innere Medizin, Gastroenterologie und Allg. Medizin
  • A.O.U. di Bologna - Policlinico S. Orsola-Malpighi
  • Ospedale Valduce U.O. Gastroenterologia e Endoscopia
  • P.O. Maresca OORR Area Vesuviana ASL
  • Centro di Riferimento Oncologico (C.R.O.) S.O.C Gastroenterologia
  • Pol. Univ. A. Gemelli U.O. di Endoscopia Digestiva Chirurgica
  • Uniwersytecki Szpital Kliniczny w Bialymstoku
  • Gabinet Internistyczny dr n. med. Krzysztof Janik
  • Centralny Szpital Kliniczny Ministerstwa Spraw Wewnetrznych
  • Robert Petryka Gabinet Internistyczny
  • Lexmedica Durbajlo Hanna
  • NZOZ Centrum Medyczne-Szpital Swietej Rodziny
  • Hospital General Universitario de Alicante
  • Hospital del Mar
  • Hospital Universitari Germans Trias i Pujol
  • Hospital Clínico San Carlos
  • Hospital Ramon y Cajal - Ctra. De Colmenar km. 9, 100
  • Lothian Health Board
  • Borders General Hospital
  • Royal Shrewsbury Hospital
  • Royal Albert Edward Infirmary Department

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Active Comparator

Arm Label

NER1006, 2-Day Split-Dosing

NER1006,1-Day Morning Split-Dosing

MOVIPREP, 2-Day Split-Dosing

Arm Description

NER1006: 2-Day Split-Dosing Regimen (to commence in the evening of the day before colonoscopy).

NER1006: 1-Day Morning Split-Dosing Regimen (to commence in the morning of the day of colonoscopy).

MOVIPREP®: 2-Day Split-Dosing Regimen (to commence in the evening of the day before colonoscopy).

Outcomes

Primary Outcome Measures

Number of Patients With Successful Bowel Cleansing (Overall Colon)
The overall quality of bowel cleansing was assessed by a blinded central reader (an experienced and trained colonoscopist) using the segmental scores of the Harefield Cleansing Scale (HCS). A final HCS grading of A, B, C or D was derived. Grades A and B are classified as successful (i.e. all mucosa could be visualized) and C and D are classified as unsuccessful. Comparison of overall success of cleansing with NER1006 2-Day and 1-Day versus MOVIPREP was evaluated using a non-inferiority study design.
Number of Patients With 'Excellent Plus Good' (Highly Effective) Bowel Cleansing (Colon Ascendens)
The overall quality of bowel cleansing was assessed by a blinded central reader (an experienced and trained colonoscopist) using the segmental scores of the Harefield Cleansing Scale (HCS). Highly effective cleansing in the colon ascendens corresponded to scores 3 (Good) or 4 (Excellent) of the HCS. Adequate plus failure of cleansing corresponded to score 0-2. Comparison of 'Excellent plus good' cleansing of the colon ascendens using NER1006 2-Day and 1-Day versus MOVIPREP was evaluated using a non-inferiority study design.

Secondary Outcome Measures

Adenoma Detection Rate (Colon Ascendens)
Comparison of the number of patients with at least one adenoma detected in the colon ascendens when NER1006 2-Day and 1-Day is used for bowel cleansing versus MOVIPREP. Adenoma detection rate (ADR) defined as the number of patients with at least one adenoma in the colon ascendens.
Adenoma Detection Rate (Overall Colon)
Comparison of the number of patients with at least one adenoma detected in the overall colon when NER1006 2-Day and 1-Day is used for bowel cleansing versus MOVIPREP. Adenoma detection rate (ADR) defined as the number of patients with at least one adenoma in the overall colon.
Polyp Detection Rate (Colon Ascendens)
Comparison of the number of patients with at least one polyp detected in the colon ascendens when NER1006 2-Day and 1-Day is used for bowel cleansing versus MOVIPREP. Polyp detection rate (PDR) defined as the number of patients with at least one polyp in the colon ascendens.
Polyp Detection Rate (Overall Colon)
Comparison of the number of patients with at least one polyp detected in the overall colon when NER1006 is used for bowel cleansing versus number detected when MOVIPREP is used. PDR defined as the number of patients with at least one polyp in the overall colon.

Full Information

First Posted
October 16, 2014
Last Updated
April 12, 2018
Sponsor
Norgine
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1. Study Identification

Unique Protocol Identification Number
NCT02273167
Brief Title
Multicenter Randomized Parallel Group Phase III Study Comparing the Bowel Cleansing Efficacy, Safety and Tolerability of NER1006 Versus MOVIPREP® Using 2-Day Split-Dosing and 1-Day Morning Split-Dosing Regimen in Adults.
Acronym
MORA
Official Title
A Multicenter Randomized Parallel Group Phase III Study Comparing the Bowel Cleansing Efficacy, Safety and Tolerability of NER1006 (a Low Volume Bowel Cleansing Solution) Versus MOVIPREP Using 2-Day Split-Dosing and 1-Day Morning Split-Dosing Regimen in Adults.
Study Type
Interventional

2. Study Status

Record Verification Date
April 2018
Overall Recruitment Status
Completed
Study Start Date
October 2014 (undefined)
Primary Completion Date
August 2015 (Actual)
Study Completion Date
August 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Norgine

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study evaluates the efficacy, safety and tolerability of NER1006 versus MOVIPREP in adult patients requiring bowel cleansing prior to any procedure that requires a clean bowel, using a 2-Day evening/morning Split-Dosing and 1-Day morning only Split-Dosing regimens. Approximately 810 patients will be randomised with the aim of achieving a minimum of 245 patients in each of the 3 groups.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colorectal Cancer, Colorectal Carcinoma, Colon Cleansing

7. Study Design

Primary Purpose
Screening
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
Investigator
Allocation
Randomized
Enrollment
849 (Actual)

8. Arms, Groups, and Interventions

Arm Title
NER1006, 2-Day Split-Dosing
Arm Type
Experimental
Arm Description
NER1006: 2-Day Split-Dosing Regimen (to commence in the evening of the day before colonoscopy).
Arm Title
NER1006,1-Day Morning Split-Dosing
Arm Type
Experimental
Arm Description
NER1006: 1-Day Morning Split-Dosing Regimen (to commence in the morning of the day of colonoscopy).
Arm Title
MOVIPREP, 2-Day Split-Dosing
Arm Type
Active Comparator
Arm Description
MOVIPREP®: 2-Day Split-Dosing Regimen (to commence in the evening of the day before colonoscopy).
Intervention Type
Drug
Intervention Name(s)
NER1006, 2-Day Split-Dosing
Intervention Description
The subject will self-administer the first dose of the assigned investigational product in the evening prior to the scheduled colonoscopy and take mandatory additional clear fluid. Subject will take the second dose together with mandatory additional clear fluids on the morning of the colonoscopy.
Intervention Type
Drug
Intervention Name(s)
NER1006,1-Day Morning Split-Dosing
Intervention Description
The subject will self-administer the first dose of the investigational product on the morning of the colonoscopy and take mandatory additional clear fluid. After a 1-2 hour break the subject will self-administer the second dose plus additional clear mandatory fluid.
Intervention Type
Drug
Intervention Name(s)
MOVIPREP, 2-Day Split-Dosing
Intervention Description
The subject will self-administer the first dose of the assigned investigational product in the evening prior to the scheduled colonoscopy and take recommended additional clear fluid. Subject will take the second dose together with recommended additional clear fluids on the morning of the colonoscopy.
Primary Outcome Measure Information:
Title
Number of Patients With Successful Bowel Cleansing (Overall Colon)
Description
The overall quality of bowel cleansing was assessed by a blinded central reader (an experienced and trained colonoscopist) using the segmental scores of the Harefield Cleansing Scale (HCS). A final HCS grading of A, B, C or D was derived. Grades A and B are classified as successful (i.e. all mucosa could be visualized) and C and D are classified as unsuccessful. Comparison of overall success of cleansing with NER1006 2-Day and 1-Day versus MOVIPREP was evaluated using a non-inferiority study design.
Time Frame
Up to 2 days (from day of first dosing to day of colonoscopy)
Title
Number of Patients With 'Excellent Plus Good' (Highly Effective) Bowel Cleansing (Colon Ascendens)
Description
The overall quality of bowel cleansing was assessed by a blinded central reader (an experienced and trained colonoscopist) using the segmental scores of the Harefield Cleansing Scale (HCS). Highly effective cleansing in the colon ascendens corresponded to scores 3 (Good) or 4 (Excellent) of the HCS. Adequate plus failure of cleansing corresponded to score 0-2. Comparison of 'Excellent plus good' cleansing of the colon ascendens using NER1006 2-Day and 1-Day versus MOVIPREP was evaluated using a non-inferiority study design.
Time Frame
Up to 2 days (from day of first dosing to day of colonoscopy)
Secondary Outcome Measure Information:
Title
Adenoma Detection Rate (Colon Ascendens)
Description
Comparison of the number of patients with at least one adenoma detected in the colon ascendens when NER1006 2-Day and 1-Day is used for bowel cleansing versus MOVIPREP. Adenoma detection rate (ADR) defined as the number of patients with at least one adenoma in the colon ascendens.
Time Frame
Up to 2 days (from day of first dosing to day of colonoscopy)
Title
Adenoma Detection Rate (Overall Colon)
Description
Comparison of the number of patients with at least one adenoma detected in the overall colon when NER1006 2-Day and 1-Day is used for bowel cleansing versus MOVIPREP. Adenoma detection rate (ADR) defined as the number of patients with at least one adenoma in the overall colon.
Time Frame
Up to 2 days (from day of first dosing to day of colonoscopy)
Title
Polyp Detection Rate (Colon Ascendens)
Description
Comparison of the number of patients with at least one polyp detected in the colon ascendens when NER1006 2-Day and 1-Day is used for bowel cleansing versus MOVIPREP. Polyp detection rate (PDR) defined as the number of patients with at least one polyp in the colon ascendens.
Time Frame
Up to 2 days (from day of first dosing to day of colonoscopy)
Title
Polyp Detection Rate (Overall Colon)
Description
Comparison of the number of patients with at least one polyp detected in the overall colon when NER1006 is used for bowel cleansing versus number detected when MOVIPREP is used. PDR defined as the number of patients with at least one polyp in the overall colon.
Time Frame
Up to 2 days (from day of first dosing to day of colonoscopy)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients must provide written informed consent. Male and female outpatients and inpatients aged: ≥18 to ≤85 years undergoing a screening, surveillance or diagnostic colonoscopy. Females of child-bearing potential must have a negative pregnancy test at Screening and at Visit 2 and must be practising one of the following methods of birth control and agree to continue with the regimen throughout the study period (unless postmenopausal or surgically sterile, or whose sole sexual partner has had a successful vasectomy): Oral, implantable, or injectable contraceptives (for a minimum of three months before study entry) in combination with a condom; Intrauterine device in combination with a condom; Double barrier method (condom* and occlusive cap [diaphragm or cervical/vault caps] with spermicidal foam/gel/film/cream/suppository). Willing and able to complete the entire study and to comply with instructions. Exclusion Criteria: Patients with past history within last 12 months or current episode of severe constipation (requiring repeated use of laxatives/enema or physical intervention before resolution), known or suspected ileus, gastrointestinal obstruction, gastric retention, bowel perforation, toxic colitis or megacolon. Patients with ongoing severe acute Inflammatory Bowel Disease. Patients who have had previous significant gastrointestinal surgeries, including colonic resection, sub-total colectomy, abdomino-perineal resection, de-functioning colostomy, Hartmann's procedure and de-functioning ileostomy or other similar surgeries involving structure and function of the small or large colon. Regular use of laxatives or colon motility altering drugs in the last month (i.e. more than 2-3 times per week) and/or laxative use within 72 hours prior to administration of the preparation. Patients with active intestinal bleeding episodes or with a clinically significant low hemoglobin level <9 g/dL for women and <11 g/dL for men at screening. Known glucose-6-phosphate dehydrogenase (G6PD) deficiency. Known phenylketonuria. Known hypersensitivity to polyethylene glycols, ascorbic acid and sulfates (not including sulfa-based products) or any other component of the study drug or comparator Past history within the last 12 months or evidence of any on-going clinically relevant electrocardiogram (ECG) abnormalities (e.g. arrhythmias). History of uncontrolled hypertension with systolic blood pressure >170 mmHg and diastolic blood pressure >100 mmHg. Patients with cardiac insufficiency NYHA grades III or IV. Patients with severe renal insufficiency (i.e. with GFR, <30 mL/min/1.73m2). Patient with serum albumin <3.4 g/dL. Patients with liver disease of grades B and C according to the Child Pugh classification. Patients suffering from dehydration at screening as evaluated by the Investigator from physical examination and laboratory investigations. Patients with clinically significant electrolyte abnormalities, whether pre-existing or noted at screening, such as hypernatremia, hyponatremia, hyperphosphatemia, hypermagnesemia, hypokalemia, hypocalcaemia dehydration, or those secondary to the use of diuretics or angiotensin converting enzyme (ACE) inhibitors. Patients with any other clinically significant hematological parameters including coagulation profile at screening. Patients with impaired consciousness that might predispose them to pulmonary aspiration. Patients undergoing colonoscopy for foreign body removal and/or decompression. Patients who are pregnant or lactating, or intending to become pregnant during the study. Clinically relevant findings on physical examination based on the Investigator's judgment. History of drug or alcohol abuse within the 12 months prior to dosing. Concurrent participation in an investigational drug or device study or participation within three months of study entry. Patients who are ordered to live in an institution on court or authority order
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Raf Bisschops, MD
Organizational Affiliation
UZ Leuven
Official's Role
Principal Investigator
Facility Information:
Facility Name
AZ Sint-Lucas
City
Brugge
Country
Belgium
Facility Name
UZ Ghent
City
Ghent
Country
Belgium
Facility Name
UZ Leuven
City
Leuven
ZIP/Postal Code
3000 Leuven
Country
Belgium
Facility Name
CHC- Clinique Saint-Joseph
City
Liège
Country
Belgium
Facility Name
Hôpital Avicenne- Service de Gastro-Entérologie
City
Bobigny
Country
France
Facility Name
Hôpital Hotel-Dieu
City
Nantes
Country
France
Facility Name
Kliniken Essen-Mitte; Abteilung für Gastroenterologie
City
Essen
Country
Germany
Facility Name
Klinikum der Friedrich Schiller Universität Jena
City
Jena
Country
Germany
Facility Name
Praxis für Innere Medizin, Gastroenterologie und Allg. Medizin
City
Ludwigshafen
Country
Germany
Facility Name
A.O.U. di Bologna - Policlinico S. Orsola-Malpighi
City
Bologna
Country
Italy
Facility Name
Ospedale Valduce U.O. Gastroenterologia e Endoscopia
City
Como
Country
Italy
Facility Name
P.O. Maresca OORR Area Vesuviana ASL
City
Naples
Country
Italy
Facility Name
Centro di Riferimento Oncologico (C.R.O.) S.O.C Gastroenterologia
City
Pordenone
Country
Italy
Facility Name
Pol. Univ. A. Gemelli U.O. di Endoscopia Digestiva Chirurgica
City
Roma
Country
Italy
Facility Name
Uniwersytecki Szpital Kliniczny w Bialymstoku
City
Białystok
Country
Poland
Facility Name
Gabinet Internistyczny dr n. med. Krzysztof Janik
City
Czestochowa
Country
Poland
Facility Name
Centralny Szpital Kliniczny Ministerstwa Spraw Wewnetrznych
City
Warsaw
Country
Poland
Facility Name
Robert Petryka Gabinet Internistyczny
City
Warsaw
Country
Poland
Facility Name
Lexmedica Durbajlo Hanna
City
Wrocław
Country
Poland
Facility Name
NZOZ Centrum Medyczne-Szpital Swietej Rodziny
City
Łódź
Country
Poland
Facility Name
Hospital General Universitario de Alicante
City
Alicante
Country
Spain
Facility Name
Hospital del Mar
City
Barcelona
Country
Spain
Facility Name
Hospital Universitari Germans Trias i Pujol
City
Barcelona
Country
Spain
Facility Name
Hospital Clínico San Carlos
City
Madrid
Country
Spain
Facility Name
Hospital Ramon y Cajal - Ctra. De Colmenar km. 9, 100
City
Madrid
Country
Spain
Facility Name
Lothian Health Board
City
Edinburgh
Country
United Kingdom
Facility Name
Borders General Hospital
City
Melrose
Country
United Kingdom
Facility Name
Royal Shrewsbury Hospital
City
Shrewsbury
Country
United Kingdom
Facility Name
Royal Albert Edward Infirmary Department
City
Wigan
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
36064325
Citation
Cash BD, Allen C, Poppers DM. Transient alterations in plasma sodium concentrations with NER1006 bowel preparation: an analysis of three phase III, randomized clinical trials. BMC Gastroenterol. 2022 Sep 5;22(1):412. doi: 10.1186/s12876-022-02484-7.
Results Reference
derived
PubMed Identifier
30025414
Citation
Bisschops R, Manning J, Clayton LB, Ng Kwet Shing R, Alvarez-Gonzalez M; MORA Study Group. Colon cleansing efficacy and safety with 1 L NER1006 versus 2 L polyethylene glycol + ascorbate: a randomized phase 3 trial. Endoscopy. 2019 Jan;51(1):60-72. doi: 10.1055/a-0638-8125. Epub 2018 Jul 19.
Results Reference
derived

Learn more about this trial

Multicenter Randomized Parallel Group Phase III Study Comparing the Bowel Cleansing Efficacy, Safety and Tolerability of NER1006 Versus MOVIPREP® Using 2-Day Split-Dosing and 1-Day Morning Split-Dosing Regimen in Adults.

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