Efficacy and Tolerability Study of Natura-Alpha in the Treatment of Patients With Active Ulcerative Colitis
Primary Purpose
Ulcerative Colitis
Status
Unknown status
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
placebo capsule
10 mg Natura-alpha capsule and 10 mg placebo capsule
2 x 10 mg Natura-alpha capsules
Sponsored by
About this trial
This is an interventional treatment trial for Ulcerative Colitis focused on measuring Natura-alpha, ulcerative colitis, cytokines, Th1, Th17
Eligibility Criteria
Inclusion Criteria:
- Females must be of non-childbearing potential evidenced by being surgically sterile, postmenopausal for at least 12 months or be using acceptable contraception methods.
Subject is require to meet one of the following criteria:
- Newly diagnosed patients with moderate to severe ulcerative colitis evidenced by endoscopy and histopathology, who have never been medically treated for ulcerative colitis, or
- Patients with moderate to severe disease, as defined by a Disease Activity Index (DAI) score of 6-10 (inclusive) at the Baseline Visit (assessed at screening and verified at Day 1), with a negative evaluation of the terminal ileum within 3 years of the screening visit, or
- Patients with active ulcerative colitis who are refractory or intolerant to therapies of 5-ASA, steroids, immunosuppressants or anti-TNF-alpha.
- Endoscopic evidence of active mucosal disease as assessed by flexible sigmoidoscopy, with a DAI mucosal appearance sub score ≥ 2.
- DAI rectal bleeding sub score of ≥ 1.
- Physician's Global Assessment (PGA) DAI sub score ≥ 2.
- Ability to adhere to the study visit schedule and other protocol requirements.
- Ability to provide voluntary written informed consent.
- Adequate cardiac, renal and hepatic function as determined by site principal investigator and demonstrated by screening laboratory evaluations, and questionnaires, and physical examination results that are within normal limits.
Exclusion Criteria:
- History of colonic or rectal surgery.
- Pregnant or breast-feeding.
- Diagnosis of diabetes, heart failure, unstable angina, hepatic cirrhosis, kidney failure, or any other unstable medical condition.
- Known hypersensitivity to Natura alpha or any of the drug excipients.
- Active and chronic infections.
- Severe ulcerative colitis indicated by Disease Activity Index score > 10.
- Patients with ulcerative proctitis (disease limited to less than 15 cm from the anal verge).
- Use of any vaccine or any other immunostimulator within 4 weeks prior to the screening visit. .
- Use of > 2.4 gm mesalamine or equivalent within 2 weeks prior to the screening visit.
- Use of oral corticosteroids for more than 3 days during the two weeks prior to the screening visit.
- Use of corticosteroid or 5-ASA enemas, foams, or suppositories at any time within two weeks prior to the screening visit. .
- Use of TNF-alpha antibody or any other biologic therapy within 2 months prior to the screening visit. .
- Use of immunosuppressive drugs at any time within four weeks prior to the screening visit. .
- Use of oral or parenteral antibiotics at any time within two weeks prior to the screening visit.
- Diagnosis of Crohn's disease.
- Diagnosis of indeterminate colitis (inability to distinguish between ulcerative colitis and Crohn's disease).
- Diagnosis of microscopic colitis (collagenous or lymphocytic colitis).
- Diagnosis of ischemic, infectious (e.g., salmonella, shigella, etc.), or amebic colitis, or gonococcal proctitis.
- Diagnosis of Clostridium difficile colitis.
- History of positive serology to hepatitis B or C or human immunodeficiency virus (HIV) infection.
- Active alcohol or drug abuse.
- Known malignancy or history of malignancy that would reduce life expectancy.
- Current smoker, or has been a smoker within 6 months prior to the screening visit.
Sites / Locations
- Advanced Clinical Research Institute
- Chevy Chase Clinical Research
- Kansas City Gastroenterology and Hepatology
- AGA Medical Research Associates, LLC
- Long Island Clinical Research Associates, LLP
- Premier Medical Group of the Hudson Valley
- Consultants for Clinical Research
- Consultants for Clinical Research
- Nashville Medical Research Institute
- Wisconsin Center for Advanced Research, LLC
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Placebo Comparator
Experimental
Experimental
Arm Label
2 x 10 mg placebo capsule
10mg Natura-alpha + 10 mg placebo
2 x 10 mg Natura-alpha capsules
Arm Description
2 x 10 mg placebo capsules, administered orally with water, b.i.d.
10 mg Natura-alpha capsule + 10 mg placebo capsule administered orally with water, b.i.d.
2 x 10mg Natura-alpha capsules administered orally with water, b.i.d.
Outcomes
Primary Outcome Measures
Physician's Global Assessment(PGA)
The primary efficacy endpoint will be the proportion of patients in all treatment groups with clinical response (improvement) at Day 28.
Secondary Outcome Measures
Physician's Global Assessment (PGA)
The proportion of patients in all treatment groups who achieve clinical remission at Day 28
Physician's Global Assessment (PGA)
The proportion of patients in all treatment groups who demonstrate clinical response
Physician's Global Assessment (PGA)
The proportion of patients in all treatment groups who demonstrate clinical response
Physician's Global Assessment (PGA)
The proportion of patients in all treatment groups who demonstrate clinical response who were previously corticosteroid, 5-aminosalicylic acid (5-ASA), immunosuppresant, TNF-alpha antibody therapy-refractory or intolerant
Safety
adverse events, changes in physical examination findings, vital signs, concomitant medications, and laboratory test results
Full Information
NCT ID
NCT01216280
First Posted
September 2, 2010
Last Updated
June 24, 2011
Sponsor
Natrogen Therapeutics International, Inc
1. Study Identification
Unique Protocol Identification Number
NCT01216280
Brief Title
Efficacy and Tolerability Study of Natura-Alpha in the Treatment of Patients With Active Ulcerative Colitis
Official Title
Efficacy and Tolerability Study of Natura-Alpha in the Treatment of Patients With Active Ulcerative Colitis
Study Type
Interventional
2. Study Status
Record Verification Date
July 2010
Overall Recruitment Status
Unknown status
Study Start Date
July 2010 (undefined)
Primary Completion Date
July 2011 (Anticipated)
Study Completion Date
September 2011 (Anticipated)
3. Sponsor/Collaborators
Name of the Sponsor
Natrogen Therapeutics International, Inc
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study is to evaluate the efficacy and tolerability of multiple oral doses of Natura-alpha capsule administered to patients with active ulcerative colitis. This will be a randomized, double-blind, placebo-controlled, parallel-design study. Up to 75 patients will complete this study (20 to 25 patients per treatment group) at approximately 10-12 clinical sites in the Unites States. Patients will be assigned at a 1:1:1 ratio to receive placebo, Natura-alpha 10 mg or Natura-alpha 20 mg, b.i.d. Replacement patients may be added, pending Sponsor approval, if it appears that less than 60 patients will complete the study.
Detailed Description
This will be a randomized, double-blind, placebo-controlled, parallel-design study. Eligible patients will have moderate to severe ulcerative colitis, defined as:
A Disease Activity Index (DAI) score of 6 to 10 (inclusive);
Endoscopic evidence of active ulcerative colitis (DAI mucosal appearance sub score of ≥2) as assessed by flexible sigmoidoscopy unless colonoscopy is clinically indicated;
Rectal bleeding (DAI sub score of ≥1);
Physician's Global Assessment (PGA) of moderate disease (DAI sub score ≥2). Patients will be randomized to receive placebo, 10 mg Natura-alpha or 20 mg Natura-alpha. Patients will self-administer their assigned dose orally for 28 consecutive days, twice per day (b.i.d) at approximately 8:00 am and 8:00 pm.
The effectiveness and safety of Natura-alpha will be evaluated at baseline, and after 7, 14 and 28 days of treatment. Additional follow-up measurements will take place 7 and 28 days post cessation of treatment (Day 35 and Day 56, respectively). Stool samples for fecal calprotectin (FC) tests and optional blood samples (15 ml) for cytokine tests will be collected and analyzed at sponsor-selected sites and lab for exploratory analyses to be performed at a later date.
Clinical response will be assessed by the Physician's Global Assessment (PGA) on the basis of sigmoidoscopy (Walkiewicz, Werlin et al. 2008) and mucosal appearance (DAI category). Sigmoidoscopy including histopathological examination to assess disease severity and changes in tissue inflammation will be conducted before and after treatment (Day 1, Day 28) by the same endoscopist at each site and read by one sponsor selected central pathologist. Truelove-Richards histological grading system will be applied for disease histological scoring (Pullan, Rhodes et al. 1994; Zhong, Huang et al. 2005; Liang and Ouyang 2008). Safety labs and adverse events (AEs) will be monitored for the duration of the study (including the 7 day follow up visit).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ulcerative Colitis
Keywords
Natura-alpha, ulcerative colitis, cytokines, Th1, Th17
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
75 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
2 x 10 mg placebo capsule
Arm Type
Placebo Comparator
Arm Description
2 x 10 mg placebo capsules, administered orally with water, b.i.d.
Arm Title
10mg Natura-alpha + 10 mg placebo
Arm Type
Experimental
Arm Description
10 mg Natura-alpha capsule + 10 mg placebo capsule administered orally with water, b.i.d.
Arm Title
2 x 10 mg Natura-alpha capsules
Arm Type
Experimental
Arm Description
2 x 10mg Natura-alpha capsules administered orally with water, b.i.d.
Intervention Type
Drug
Intervention Name(s)
placebo capsule
Other Intervention Name(s)
Group 1
Intervention Description
2 x 10 mg placebo capsules administered orally with water, b.i.d.
Intervention Type
Drug
Intervention Name(s)
10 mg Natura-alpha capsule and 10 mg placebo capsule
Other Intervention Name(s)
Group 2
Intervention Description
10 mg Natura-alpha capsule and 10 mg placebo capsule administered orally with water, b.i.d.
Intervention Type
Drug
Intervention Name(s)
2 x 10 mg Natura-alpha capsules
Other Intervention Name(s)
Group 3
Intervention Description
2 x 10mg Natura-alpha capsules administered orally with water, b.i.d.
Primary Outcome Measure Information:
Title
Physician's Global Assessment(PGA)
Description
The primary efficacy endpoint will be the proportion of patients in all treatment groups with clinical response (improvement) at Day 28.
Time Frame
Day 28 after the treatment
Secondary Outcome Measure Information:
Title
Physician's Global Assessment (PGA)
Description
The proportion of patients in all treatment groups who achieve clinical remission at Day 28
Time Frame
Day 28 after the treatment
Title
Physician's Global Assessment (PGA)
Description
The proportion of patients in all treatment groups who demonstrate clinical response
Time Frame
Day 7
Title
Physician's Global Assessment (PGA)
Description
The proportion of patients in all treatment groups who demonstrate clinical response
Time Frame
14
Title
Physician's Global Assessment (PGA)
Description
The proportion of patients in all treatment groups who demonstrate clinical response who were previously corticosteroid, 5-aminosalicylic acid (5-ASA), immunosuppresant, TNF-alpha antibody therapy-refractory or intolerant
Time Frame
Day 28
Title
Safety
Description
adverse events, changes in physical examination findings, vital signs, concomitant medications, and laboratory test results
Time Frame
Day 28
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Females must be of non-childbearing potential evidenced by being surgically sterile, postmenopausal for at least 12 months or be using acceptable contraception methods.
Subject is require to meet one of the following criteria:
Newly diagnosed patients with moderate to severe ulcerative colitis evidenced by endoscopy and histopathology, who have never been medically treated for ulcerative colitis, or
Patients with moderate to severe disease, as defined by a Disease Activity Index (DAI) score of 6-10 (inclusive) at the Baseline Visit (assessed at screening and verified at Day 1), with a negative evaluation of the terminal ileum within 3 years of the screening visit, or
Patients with active ulcerative colitis who are refractory or intolerant to therapies of 5-ASA, steroids, immunosuppressants or anti-TNF-alpha.
Endoscopic evidence of active mucosal disease as assessed by flexible sigmoidoscopy, with a DAI mucosal appearance sub score ≥ 2.
DAI rectal bleeding sub score of ≥ 1.
Physician's Global Assessment (PGA) DAI sub score ≥ 2.
Ability to adhere to the study visit schedule and other protocol requirements.
Ability to provide voluntary written informed consent.
Adequate cardiac, renal and hepatic function as determined by site principal investigator and demonstrated by screening laboratory evaluations, and questionnaires, and physical examination results that are within normal limits.
Exclusion Criteria:
History of colonic or rectal surgery.
Pregnant or breast-feeding.
Diagnosis of diabetes, heart failure, unstable angina, hepatic cirrhosis, kidney failure, or any other unstable medical condition.
Known hypersensitivity to Natura alpha or any of the drug excipients.
Active and chronic infections.
Severe ulcerative colitis indicated by Disease Activity Index score > 10.
Patients with ulcerative proctitis (disease limited to less than 15 cm from the anal verge).
Use of any vaccine or any other immunostimulator within 4 weeks prior to the screening visit. .
Use of > 2.4 gm mesalamine or equivalent within 2 weeks prior to the screening visit.
Use of oral corticosteroids for more than 3 days during the two weeks prior to the screening visit.
Use of corticosteroid or 5-ASA enemas, foams, or suppositories at any time within two weeks prior to the screening visit. .
Use of TNF-alpha antibody or any other biologic therapy within 2 months prior to the screening visit. .
Use of immunosuppressive drugs at any time within four weeks prior to the screening visit. .
Use of oral or parenteral antibiotics at any time within two weeks prior to the screening visit.
Diagnosis of Crohn's disease.
Diagnosis of indeterminate colitis (inability to distinguish between ulcerative colitis and Crohn's disease).
Diagnosis of microscopic colitis (collagenous or lymphocytic colitis).
Diagnosis of ischemic, infectious (e.g., salmonella, shigella, etc.), or amebic colitis, or gonococcal proctitis.
Diagnosis of Clostridium difficile colitis.
History of positive serology to hepatitis B or C or human immunodeficiency virus (HIV) infection.
Active alcohol or drug abuse.
Known malignancy or history of malignancy that would reduce life expectancy.
Current smoker, or has been a smoker within 6 months prior to the screening visit.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Longgui Wang, MD
Organizational Affiliation
Natrogen Therapeutics International, Inc
Official's Role
Study Director
Facility Information:
Facility Name
Advanced Clinical Research Institute
City
Anaheim
State/Province
California
ZIP/Postal Code
92801
Country
United States
Facility Name
Chevy Chase Clinical Research
City
Chevy Chase
State/Province
Maryland
ZIP/Postal Code
20814
Country
United States
Facility Name
Kansas City Gastroenterology and Hepatology
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
64131
Country
United States
Facility Name
AGA Medical Research Associates, LLC
City
Egg Harbor
State/Province
New Jersey
ZIP/Postal Code
08324
Country
United States
Facility Name
Long Island Clinical Research Associates, LLP
City
Great Neck
State/Province
New York
ZIP/Postal Code
11021
Country
United States
Facility Name
Premier Medical Group of the Hudson Valley
City
Poughkeepsie
State/Province
New York
ZIP/Postal Code
12601
Country
United States
Facility Name
Consultants for Clinical Research
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States
Facility Name
Consultants for Clinical Research
City
Fairfield
State/Province
Ohio
ZIP/Postal Code
45014
Country
United States
Facility Name
Nashville Medical Research Institute
City
Nashville
State/Province
Tennessee
ZIP/Postal Code
37205
Country
United States
Facility Name
Wisconsin Center for Advanced Research, LLC
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53215
Country
United States
12. IPD Sharing Statement
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Efficacy and Tolerability Study of Natura-Alpha in the Treatment of Patients With Active Ulcerative Colitis
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