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Study Comparing the Bowel Cleansing Efficacy of PLENVU® Versus SELG-ESSE® Using a 2-Day Split Dosing Regimen.

Primary Purpose

Colon Polyp, Colon Adenoma, Colon Lesion

Status
Completed
Phase
Phase 4
Locations
Italy
Study Type
Interventional
Intervention
PEG3350
Macrogol 4000
Sponsored by
Istituto Clinico Humanitas
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Colon Polyp

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients must provide written informed consent.
  2. Male and female outpatients and inpatients aged: ≥18 to ≤85 years undergoing a screening, surveillance or diagnostic colonoscopy.
  3. 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:

    • 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); *A female condom and a male condom should not be used together as friction between the two can result in either product failing.

    If any female patient has a positive pregnancy test at Visit 2, they will be excluded from further participation in the study for the efficacy evaluation, i.e. they will not undergo the colonoscopy procedure. The Investigator will be required to arrange a colonoscopy procedure outside of the study.

    Note: The above birth control methods do not apply to females who are postmenopausal or surgically sterile i.e. 12 months of natural (spontaneous) amenorrhea or 6 weeks' post-surgical bilateral oophorectomy with or without hysterectomy or hysterectomy, or whose sole sexual partner has had a vasectomy and has received medical assessment of the surgical success.

  4. Willing, able and competent to complete the entire study and to comply with instructions.

Exclusion Criteria:

  1. 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.
  2. Patients with ongoing severe acute Inflammatory Bowel Disease (IBD).
  3. Patients who have had previous significant gastrointestinal surgeries, including colonic resection, sub-total colectomy, abdomino-perineal resection, de-functioning colostomy, Hartmann's procedure and defunctioning ileostomy or other similar surgeries involving structure and function of the small or large colon.
  4. Regular use of laxatives or colon motility altering drugs (i.e. more than 2-3 times per week) in the last 28 days prior to the Screening Visit and/or laxative use within 72 hours prior to administration of the preparation.
  5. Patients with active intestinal bleeding episodes
  6. Known glucose-6-phosphate dehydrogenase (G6PD) deficiency.
  7. Known phenylketonuria.
  8. Known hypersensitivity to polyethylene glycols, ascorbic acid and sulfates (not including sulfa-based products) or any other component of the investigational product or comparator.
  9. Past history within the last 12 months or evidence of any on-going clinically relevant electrocardiogram (ECG) abnormalities (e.g. arrhythmias).
  10. History of uncontrolled hypertension with systolic blood pressure >170 mmHg and diastolic blood pressure >100 mmHg.
  11. Patients with cardiac insufficiency NYHA grades III or IV.
  12. Patients with severe renal insufficiency.
  13. Patients with known liver disease of grades B and C according to the Child Pugh classification.
  14. Patients suffering from dehydration at screening as evaluated by the Investigator from physical examination.
  15. Patients with pre-existing clinically significant electrolyte abnormalities, or dehydration.
  16. Patients with impaired consciousness that might predispose them to pulmonary aspiration.
  17. Patients undergoing colonoscopy for foreign body removal and/or decompression.
  18. Patients who are pregnant or lactating, or intending to become pregnant during the study.
  19. Clinically relevant findings on physical examination based on the Investigator's judgment.
  20. History of drug or alcohol abuse within the 12 months prior to dosing.
  21. Concurrent participation in an investigational drug or device study or participation within three months of study entry.
  22. Patients who, in the opinion of the Investigator, should not be included in the study for any reason, including inability to follow study procedures, e.g. cognitively impaired, debilitated or fragile patients.
  23. Patients who are ordered to live in an institution on court or authority order.

Sites / Locations

  • Centro di Riferimento Oncologico
  • Fondazione Poliambulanza
  • Nuovo Regina Margherita Hospital
  • ISMETT
  • Humanitas Research Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

PLENVU

SELG-ESSE

Arm Description

PLENVU® supplied as two powder-for-oral-solution formulations. One formulation contains PEG3350, sodium sulphate and electrolytes, and the second formulation contains PEG3350, sodium ascorbate, ascorbic acid, and electrolytes.

SELG-ESSE® supplied as powder-for-oral-solution containing PEG4000, simethicone, sodium sulphate and sodium bicarbonate, and electrolytes.

Outcomes

Primary Outcome Measures

Bowel cleansing efficacy
To evaluate the overall bowel cleansing efficacy of 2-day split-dosing with PLENVU compared to a 2-day split-dosing regimen with SELG-ESSE®, graded according to the Boston Bowel Preparation Scale (BBPS) in patients undergoing screening, surveillance or diagnostic colonoscopy.

Secondary Outcome Measures

Polip Detection Rate
To assess the overall Polip Detection Rate with PLENVU compared to SELG-ESSE
Adenoma Detection Rate
To assess the overall Adenoma Detection Rate with PLENVU compared to SELG-ESSE;
Adverse events
To assess the incidence of adverse events in PLENVU group comparing SELG-ESSE arm

Full Information

First Posted
November 13, 2018
Last Updated
August 26, 2020
Sponsor
Istituto Clinico Humanitas
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1. Study Identification

Unique Protocol Identification Number
NCT03742232
Brief Title
Study Comparing the Bowel Cleansing Efficacy of PLENVU® Versus SELG-ESSE® Using a 2-Day Split Dosing Regimen.
Official Title
A Multicentre Randomized Parallel Group Phase IV Study Comparing the Bowel Cleansing Efficacy, Safety and Tolerability of PLENVU® Versus SELG-ESSE® Using a 2-Day Split Dosing Regimen.
Study Type
Interventional

2. Study Status

Record Verification Date
August 2020
Overall Recruitment Status
Completed
Study Start Date
October 31, 2018 (Actual)
Primary Completion Date
March 31, 2020 (Actual)
Study Completion Date
March 31, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Istituto Clinico Humanitas

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is a multicentre randomized parallel group phase IV study comparing the bowel cleansing efficacy, safety and tolerability of PLENVU® (a 1 litre PEG Bowel Cleansing Solution) versus SELG-ESSE® (a 4 litre PEG Bowel Cleansing Solution) using a 2-Day Split Dosing Regimen.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Colon Polyp, Colon Adenoma, Colon Lesion

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
399 (Actual)

8. Arms, Groups, and Interventions

Arm Title
PLENVU
Arm Type
Experimental
Arm Description
PLENVU® supplied as two powder-for-oral-solution formulations. One formulation contains PEG3350, sodium sulphate and electrolytes, and the second formulation contains PEG3350, sodium ascorbate, ascorbic acid, and electrolytes.
Arm Title
SELG-ESSE
Arm Type
Active Comparator
Arm Description
SELG-ESSE® supplied as powder-for-oral-solution containing PEG4000, simethicone, sodium sulphate and sodium bicarbonate, and electrolytes.
Intervention Type
Drug
Intervention Name(s)
PEG3350
Intervention Description
PLENVU® supplied as two powder-for-oral-solution formulations. One formulation contains PEG3350, sodium sulphate and electrolytes, and the second formulation contains PEG3350, sodium ascorbate, ascorbic acid, and electrolytes. PLENVU® Administration: 2-Day Split-Dosing Regimen (to commence in the evening of the day before colonoscopy).
Intervention Type
Drug
Intervention Name(s)
Macrogol 4000
Intervention Description
SELG-ESSE® supplied as powder-for-oral-solution containing PEG4000, simethicone, sodium sulphate and sodium bicarbonate, and electrolytes. SELG-ESSE® Administration: 2-Day Split-Dosing Regimen (to commence in the evening of the day before colonoscopy).
Primary Outcome Measure Information:
Title
Bowel cleansing efficacy
Description
To evaluate the overall bowel cleansing efficacy of 2-day split-dosing with PLENVU compared to a 2-day split-dosing regimen with SELG-ESSE®, graded according to the Boston Bowel Preparation Scale (BBPS) in patients undergoing screening, surveillance or diagnostic colonoscopy.
Time Frame
1 Day of colonoscopy
Secondary Outcome Measure Information:
Title
Polip Detection Rate
Description
To assess the overall Polip Detection Rate with PLENVU compared to SELG-ESSE
Time Frame
1 Day of colonoscopy
Title
Adenoma Detection Rate
Description
To assess the overall Adenoma Detection Rate with PLENVU compared to SELG-ESSE;
Time Frame
1 Day of colonoscopy
Title
Adverse events
Description
To assess the incidence of adverse events in PLENVU group comparing SELG-ESSE arm
Time Frame
4 days after colonscopy

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 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: 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); *A female condom and a male condom should not be used together as friction between the two can result in either product failing. If any female patient has a positive pregnancy test at Visit 2, they will be excluded from further participation in the study for the efficacy evaluation, i.e. they will not undergo the colonoscopy procedure. The Investigator will be required to arrange a colonoscopy procedure outside of the study. Note: The above birth control methods do not apply to females who are postmenopausal or surgically sterile i.e. 12 months of natural (spontaneous) amenorrhea or 6 weeks' post-surgical bilateral oophorectomy with or without hysterectomy or hysterectomy, or whose sole sexual partner has had a vasectomy and has received medical assessment of the surgical success. Willing, able and competent 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 (IBD). Patients who have had previous significant gastrointestinal surgeries, including colonic resection, sub-total colectomy, abdomino-perineal resection, de-functioning colostomy, Hartmann's procedure and defunctioning ileostomy or other similar surgeries involving structure and function of the small or large colon. Regular use of laxatives or colon motility altering drugs (i.e. more than 2-3 times per week) in the last 28 days prior to the Screening Visit and/or laxative use within 72 hours prior to administration of the preparation. Patients with active intestinal bleeding episodes 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 investigational product 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. Patients with known 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. Patients with pre-existing clinically significant electrolyte abnormalities, or dehydration. 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, in the opinion of the Investigator, should not be included in the study for any reason, including inability to follow study procedures, e.g. cognitively impaired, debilitated or fragile patients. Patients who are ordered to live in an institution on court or authority order.
Facility Information:
Facility Name
Centro di Riferimento Oncologico
City
Aviano
State/Province
Italia
Country
Italy
Facility Name
Fondazione Poliambulanza
City
Brescia
State/Province
Italia
Country
Italy
Facility Name
Nuovo Regina Margherita Hospital
City
Roma
State/Province
Italia
Country
Italy
Facility Name
ISMETT
City
Palermo
Country
Italy
Facility Name
Humanitas Research Hospital
City
Rozzano
ZIP/Postal Code
20089
Country
Italy

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
33940043
Citation
Repici A, Spada C, Cannizzaro R, Traina M, Maselli R, Maiero S, Galtieri A, Guarnieri G, Di Leo M, Lorenzetti R, Capogreco A, Spadaccini M, Antonelli G, Zullo A, Amata M, Ferrara E, Correale L, Granata A, Cesaro P, Radaelli F, Minelli Grazioli L, Anderloni A, Fugazza A, Finati E, Pellegatta G, Carrara S, Occhipinti P, Buda A, Fuccio L, Manno M, Hassan C. Novel 1-L polyethylene glycol + ascorbate versus high-volume polyethylene glycol regimen for colonoscopy cleansing: a multicenter, randomized, phase IV study. Gastrointest Endosc. 2021 Oct;94(4):823-831.e9. doi: 10.1016/j.gie.2021.04.020. Epub 2021 Apr 30.
Results Reference
derived

Learn more about this trial

Study Comparing the Bowel Cleansing Efficacy of PLENVU® Versus SELG-ESSE® Using a 2-Day Split Dosing Regimen.

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