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Adacolumn in Refractory UC Patients Trial (ART)

Primary Purpose

Ulcerative Colitis, Active Moderate

Status
Completed
Phase
Phase 4
Locations
France
Study Type
Interventional
Intervention
(GMA) Adsorptive Apheresis
Sponsored by
Otsuka Pharmaceutical Europe Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ulcerative Colitis, Active Moderate

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patients enrolled into the study will be between 18 and 75 years old and have moderate to severe, steroid-dependent, active ulcerative colitis documented by clinical symptoms, endoscopic findings and histology. Patients will have an ulcerative colitis clinical activity (CAI) of ≥6 and an endoscopic activity index (EAI) of ≥4. Patients will have an insufficient response or intolerance to immunosuppressants and/or biological treatment agents. Patients are required to have adequate peripheral venous access to allow completion of apheresis treatment.

Exclusion Criteria:

- A patient will be excluded from the study if he/she meets any of the following criteria:

  1. Is febrile (body temperature >38ºC).
  2. Has evidence of toxic megacolon.
  3. Has known obstructive disease of the gastrointestinal system.
  4. Is anticipated to need surgery within the next 24 weeks.
  5. Has a history of hypersensitivity reaction associated with an apheresis procedure or an intolerance to apheresis procedures.
  6. Has proctocolectomy, total colectomy, ileostomy, stoma or ileal pouch-anal anastomosis.
  7. Has a history of allergic reaction to heparin or of heparin-induced thrombocytopenia.
  8. Has a known infection with enteric pathogens, pathogenic ova or parasites, or a positive test for cytomegalovirus.
  9. Has symptomatic hypotension.
  10. Has a history of physical findings consistent with a cerebrovascular accident.
  11. Has a history of myocardial infarction or unstable angina within the previous 6 months.
  12. Has undergone coronary artery bypass graft surgery or angioplasty within the previous 6 months.
  13. Has congestive heart failure (New York Heart Association Class III or IV).
  14. Has a prosthetic heart valve, pacemaker or other permanent implant.
  15. Has severe cardiovascular or peripheral vascular disease.
  16. Has liver disease defined as levels of aspartate aminotransferase (AST/SGOT), alanine aminotransferase (ALT/SGPT) or alkaline phosphatase of greater than 2.5 × the upper limit of the normal range for the laboratory performing the test.
  17. Has a history of cirrhosis.
  18. Has a known bleeding disorder (prothrombin time [PT] or partial thromboplastin time [PTT] greater than 1.5 × the upper limit of the normal range for the laboratory performing the test) or requires concomitant anticoagulant therapy for purposes other than apheresis treatment.
  19. Has a prior history suggestive of a hypercoagulable disorder, including 1 or more episodes of pulmonary embolism or deep vein thrombosis.
  20. Has a known infection with hepatitis B or C or human immunodeficiency virus.
  21. Has abnormal haematology parameters defined as severe anaemia with haemoglobin <8.5 g/dL, white blood cell count <3500/µL or granulocyte count <2000/µL.
  22. Has a fibrinogen level >700 mg/dL.
  23. Has renal insufficiency, defined as a serum creatinine level greater than 150% of the upper limit of the normal range for the laboratory performing the test.
  24. Has had major surgery within the previous 6 weeks.
  25. Has any of the following types of infection:

    • An active infection within 4 weeks of successful completion of antibiotic treatment for a bacterial infection.
    • Febrile viral infection within the 4 weeks prior to entry into the study.
    • Systemic fungal infection that required therapy which was completed within the 12 weeks prior to entry into the study.
  26. Current drug or alcohol abuse.
  27. Is pregnant, lactating or planning to become pregnant during the study.
  28. Has used an investigational medicinal product, biologic agent or device within the last 30 days.
  29. Adults lacking capacity who are unable to give consent by themselves due to physical and or mental incapacity.
  30. Prisoners and patients who have undergone psychiatric treatment.

Sites / Locations

  • Clinique Universitaire d'Hépato-Gastroentérologie

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Adacolumn

Arm Description

Outcomes

Primary Outcome Measures

The primary efficacy endpoint is the ulcerative colitis remission rate at Week 12, defined as a CAI (Rachmilewitz) score of ≤4.

Secondary Outcome Measures

Ulcerative colitis response rate at Week 12, with response defined as a reduction in CAI of ≥3.
Response and remission rates at Weeks 24 and 48
Change from Baseline in CAI at Weeks 12, 24 and 48
Change from Baseline in EAI at Week 12
Time to remission and response
The proportion of patients reaching steroid-free remission/steroid-free response at any visit and by visit at Weeks 12, 24 and 48.
Time to steroid-free remission and response.
Colectomy rate at Week 96
Change from Baseline in concomitant medication (steroid) dose at Weeks 12, 24 and 48.
Quality of life changes based on the Short Health Scale for ulcerative colitis at Weeks 5, 12, 24 and 48.

Full Information

First Posted
November 24, 2011
Last Updated
October 16, 2015
Sponsor
Otsuka Pharmaceutical Europe Ltd
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1. Study Identification

Unique Protocol Identification Number
NCT01481142
Brief Title
Adacolumn in Refractory UC Patients Trial
Acronym
ART
Official Title
Multicentre Investigation of the Efficacy and Safety of Adacolumn® GMA in Patients With Steroid-Dependent Active Ulcerative Colitis and Insufficient Response or Intolerance to Immunosuppressants and/or Biological Therapies
Study Type
Interventional

2. Study Status

Record Verification Date
October 2015
Overall Recruitment Status
Completed
Study Start Date
October 2011 (undefined)
Primary Completion Date
May 2015 (Actual)
Study Completion Date
July 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Otsuka Pharmaceutical Europe Ltd

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The objectives of the study are to observe and document the efficacy and safety of 5 or more Adacolumn treatments, administered once weekly over 5 or more weeks, in a specific subset of ulcerative colitis patients. The patient subset of interest is those with moderate/severe, steroid-dependent, active ulcerative colitis with insufficient response or intolerance to immunosuppressants and/or biological agents.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ulcerative Colitis, Active Moderate

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
100 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Adacolumn
Arm Type
Experimental
Intervention Type
Device
Intervention Name(s)
(GMA) Adsorptive Apheresis
Intervention Description
Patients will be treated with once-weekly Adacolumn® apheresis over 5 consecutive weeks; treatment can be extended to up to 10 treatments administered once weekly over 10 weeks.
Primary Outcome Measure Information:
Title
The primary efficacy endpoint is the ulcerative colitis remission rate at Week 12, defined as a CAI (Rachmilewitz) score of ≤4.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Ulcerative colitis response rate at Week 12, with response defined as a reduction in CAI of ≥3.
Time Frame
12 weeks
Title
Response and remission rates at Weeks 24 and 48
Time Frame
12 weeks
Title
Change from Baseline in CAI at Weeks 12, 24 and 48
Time Frame
12 weeks, 24 weeks and 48 weeks
Title
Change from Baseline in EAI at Week 12
Time Frame
12 weeks
Title
Time to remission and response
Time Frame
Baseline
Title
The proportion of patients reaching steroid-free remission/steroid-free response at any visit and by visit at Weeks 12, 24 and 48.
Time Frame
12 weeks, 24 weeks and 48 weeks
Title
Time to steroid-free remission and response.
Time Frame
Baseline
Title
Colectomy rate at Week 96
Time Frame
96 weeks
Title
Change from Baseline in concomitant medication (steroid) dose at Weeks 12, 24 and 48.
Time Frame
12 weeks, 24 weeks and 48 weeks
Title
Quality of life changes based on the Short Health Scale for ulcerative colitis at Weeks 5, 12, 24 and 48.
Time Frame
5 weeks, 12 weeks, 24 weeks and 48 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients enrolled into the study will be between 18 and 75 years old and have moderate to severe, steroid-dependent, active ulcerative colitis documented by clinical symptoms, endoscopic findings and histology. Patients will have an ulcerative colitis clinical activity (CAI) of ≥6 and an endoscopic activity index (EAI) of ≥4. Patients will have an insufficient response or intolerance to immunosuppressants and/or biological treatment agents. Patients are required to have adequate peripheral venous access to allow completion of apheresis treatment. Exclusion Criteria: - A patient will be excluded from the study if he/she meets any of the following criteria: Is febrile (body temperature >38ºC). Has evidence of toxic megacolon. Has known obstructive disease of the gastrointestinal system. Is anticipated to need surgery within the next 24 weeks. Has a history of hypersensitivity reaction associated with an apheresis procedure or an intolerance to apheresis procedures. Has proctocolectomy, total colectomy, ileostomy, stoma or ileal pouch-anal anastomosis. Has a history of allergic reaction to heparin or of heparin-induced thrombocytopenia. Has a known infection with enteric pathogens, pathogenic ova or parasites, or a positive test for cytomegalovirus. Has symptomatic hypotension. Has a history of physical findings consistent with a cerebrovascular accident. Has a history of myocardial infarction or unstable angina within the previous 6 months. Has undergone coronary artery bypass graft surgery or angioplasty within the previous 6 months. Has congestive heart failure (New York Heart Association Class III or IV). Has a prosthetic heart valve, pacemaker or other permanent implant. Has severe cardiovascular or peripheral vascular disease. Has liver disease defined as levels of aspartate aminotransferase (AST/SGOT), alanine aminotransferase (ALT/SGPT) or alkaline phosphatase of greater than 2.5 × the upper limit of the normal range for the laboratory performing the test. Has a history of cirrhosis. Has a known bleeding disorder (prothrombin time [PT] or partial thromboplastin time [PTT] greater than 1.5 × the upper limit of the normal range for the laboratory performing the test) or requires concomitant anticoagulant therapy for purposes other than apheresis treatment. Has a prior history suggestive of a hypercoagulable disorder, including 1 or more episodes of pulmonary embolism or deep vein thrombosis. Has a known infection with hepatitis B or C or human immunodeficiency virus. Has abnormal haematology parameters defined as severe anaemia with haemoglobin <8.5 g/dL, white blood cell count <3500/µL or granulocyte count <2000/µL. Has a fibrinogen level >700 mg/dL. Has renal insufficiency, defined as a serum creatinine level greater than 150% of the upper limit of the normal range for the laboratory performing the test. Has had major surgery within the previous 6 weeks. Has any of the following types of infection: An active infection within 4 weeks of successful completion of antibiotic treatment for a bacterial infection. Febrile viral infection within the 4 weeks prior to entry into the study. Systemic fungal infection that required therapy which was completed within the 12 weeks prior to entry into the study. Current drug or alcohol abuse. Is pregnant, lactating or planning to become pregnant during the study. Has used an investigational medicinal product, biologic agent or device within the last 30 days. Adults lacking capacity who are unable to give consent by themselves due to physical and or mental incapacity. Prisoners and patients who have undergone psychiatric treatment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Axel Dignass, Professor
Organizational Affiliation
Markus Krankenhaus
Official's Role
Principal Investigator
Facility Information:
Facility Name
Clinique Universitaire d'Hépato-Gastroentérologie
City
Grenoble cedex
ZIP/Postal Code
38 043
Country
France

12. IPD Sharing Statement

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Adacolumn in Refractory UC Patients Trial

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