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Ulcerative ColitisPhase 3NCT01567956

Propionyl-L-Carnitine Hydrochloride in Patients With Mild Ulcerative Colitis; Efficacy, Safety and Tolerability Study

A Phase 3 study testing Propionyl-L-Carnitine in people with Ulcerative Colitis, run by sigma-tau i.f.r. S.p.A. at 58 sites in 8 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The aim of the trial is to test safety, tolerability and efficacy of Propionyl-L-carnitine modified release tablets 1g/die in reducing the symptoms of the disease with respect to the proportion of patients with disease remission at the end of the 8 weeks of treatment. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Ulcerative Colitis
What is being tested?
Propionyl-L-Carnitine
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
150 participants
Where
58 sitesin 8 countries
Study dates
Apr 2012to Jan 2014
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Have read the Information for the Patient and signed the Informed Consent Form.
  • Diagnosis of active ulcerative colitis since at least 4 weeks as confirmed endoscopically and histologically.
  • Disease Activity Index comprised between 3 and 6, inclusive (mild ulcerative colitis), with rectal bleeding sub-score of at least 1.
  • Stable background oral aminosalicylates (mesalazine, balsalazide, olsalazine) or sulfasalazine standard therapy for greater than or equal to 4 weeks prior to screening assessments.
  • If female, not pregnant or nursing. For women of childbearing potential, willingness to avoid a pregnancy during the treatment period and for at least 4 weeks from the last dose of drug and utilization of an efficient method of birth control for the entire duration of the trial and until the first menses after a 30-day period after the last dose of trial medication.

Who cannot join

  • Crohn's disease and indeterminate colitis.
  • Current or previous (in the last 10 days preceding the screening) use of systemic corticosteroids.
  • Use of systemic antibiotics in the last 10 days preceding the screening.
  • Use of systemic Nonsteroidal anti-inflammatory drugs on a repeat basis in the last 10 days preceding the screening.
  • Use of probiotics started within 10 days preceding the screening. A stable regimen from at least 10 days prior to screening is allowed but the patient must be willing to continue up to the end of the study.
  • Use of immunosuppressants or biological agents within the last 6 weeks preceding the screening.
Show all 18Show fewer
  • Treatment with L-carnitine or its esters derivatives within the last 3 months.
  • Stool culture positive for enteric pathogens (eg, Shigella, Salmonella, Yersinia, Campylobacter) or toxins (C.difficile).
  • Significantly impaired liver, renal, pulmonary or cardiovascular function as assessed by the investigator.
  • History of colon resection.
  • Diverticulitis, symptomatic diverticulosis.
  • Active peptic ulcer disease.
  • Proctitis (extent of inflammation < 15 cm from the anus).
  • Bleeding disorders
  • Rectal therapy with any therapeutic enemas or suppositories with the exception of those required for endoscopy during the 10 days preceding the screening.
  • Active or chronic infection(s) or malignancies.
  • Known hypersensitivity to the active ingredient and excipients of the study drug
  • Patients treated with L-Carnitine or its esters derivatives during the 3 months preceding the screening phase.

Trial locations and contacts

58 sites in 8 countries.

58 sites in 8 countries

Germany11 sites
  • Charité Universitätsmedizin Berlin Universitätsklinik Charité, Campus Mitte Medizinische Poliklinik

    Berlin, 10117

  • Saint Josef Hospital Ruhr Universitaet Bochum Gudrunstraße 56

    Bochum, 44791

  • Klinikum Braunschweig

    Braunschweig, 38126

  • Universitätsklinikum Dresden Medizinische Klinik und Poliklinik I

    Dresden, 01307

  • Universtätsklinikum Schleswig-Holstein Gastroenterologie

    Lübeck, 23538

  • Universitätsklinikum Magdeburg A.ö.R. Klinik für Gastroenterologie, Hepatologie und Infektiologie

    Magdeburg, 39120

  • Universitätsmedizin Mannheim II. Medizinische Klinik

    Mannheim, 68167

  • Praxis Prof. Dr. med. Herbert Kellner

    München, 80639

  • Universitätklinikum Münster Medizinische Klinik und Poliklinik für Innere Medizin

    Münster, 48149

  • Gastroenterologische Fachpraxis am Germania Campus

    Münster, 48159

  • Elbe Klinikum Stade Innere Medizin, Abteilung Gastroenterology

    Stade, 21682

Other trials in Germany

Hungary10 sites
  • Fovárosi Önkormányzat Péterfy Sándor Utcai Kórház

    Budapest, 1076

  • Semmelweis Egyetem 1st Internal Dept.

    Budapest, 1083

  • Pannónia Magánorvosi Centrum Kft.

    Budapest, 1136

  • Semmelweis Egyetem II. sz. Belgyógyászati Klinika

    Budapest, H-1088

  • Békés Megyei Képviselotestület Pándy Kálmán Kórháza Semmelweis ulica 1

    Gyula, 5700

  • Kaposi Mór Megyei Oktató Kórhaz Belgyógyászati Osztály

    Kaposvár, H-7400

  • Borsod Abaúj Zemplén Megyei Kórház és Egyetemi Oktató Kórház II. sz. Belgyógyászati Osztály

    Miskolc, 3526

  • Karolina Kórház Rendelointézet Belgyógyászat- Gasztroenterológiai Osztály

    Mosonmagyaróvar, 9200

  • Clinfan Kft. SMO

    Szekszárd, 7100

  • CRU Hungary Kft.

    Szikszó, 3800

Other trials in Hungary

France9 sites
  • Centre Hospitalier Intercommunal Créteil 40 avenue de Verdun

    Créteil, 94010

  • Centre Hospitalier Universitaire Hôpital Nord - Service D'Hépato-Gastro-Entérologie

    Marseille, 13015

  • Centre Hospitalier Universitaire Hotel Dieu Service d'hépato-gastroentérologie

    Nantes, 44000

  • Hôpital de I´Archet 2 Service d'Hépato-Gastroentérologie et de Nutrition Clinicque, Pôle Digestif

    Nice, 06202

  • Hôpital Nord - Dept. of Gastroenterology

    Picardie, 80 054

  • Hôpital Robert Debré Service et Consultation d'Hépato-Gastro-Entérologie

    Reims, 51092

  • Hopital Nord - CHU de Saint-Etienne Service de Gastro-Entérologie

    Saint-Etienne, 42270

  • Hôpital Rangueil Service de gastro-enterologie

    Toulouse, 31079

  • Hôpital Brabois Service de gastro-enterologie

    Vandœuvre-lès-Nancy, 54511

Other trials in France

Poland9 sites
  • Centrum Opieki Zdrowotnej Orkan-Med Stec-Michalska Sp.J

    Ksawerów, 95-054

  • SPZOZ Uniwersytecki Szpital Kliniczny Nr 1 im. Norberta Barlickiego Oddzial Gastroenterologii Ogólnej i Onkologicznej

    Lódz, 90-153

  • Wojewódzki Szpital Specjalistyczny w Olsztynie Oddzial Gastroenterologii

    Olsztyn, 10-561

  • Endoskopia Sp. z o.o.

    Sopot, 81-756

  • Nzoz Vivamed

    Warsaw, 03-580

  • Akademicki Szpital Kliniczny im. Jana Mikulicza-Radeckiego we Wroclawiu Klinika Gastroenterologii i Hepatologii

    Wroclaw, 50-556

  • Wojewodzki Szpital Specjalistyczny im. J. Gromkowskiego we Wroclawiu Oddzial Gastroenterologii

    Wroclaw, 51-149

  • LexMedica

    Wroclaw, 53-025

  • ARS MEDICA s.c., Rybak Maria, Rybak Zbigniew

    Wroclaw, 53-333

Other trials in Poland

Spain7 sites
  • Fundación Hospital de Alcorcón Servicio de Gastroenterología

    Alcorcón, 28922

  • Centro Medico Teknon Servicio de Aparato Disgestivo

    Barcelona, 08022

  • Hospital Universitario Virgen de la Arrixaca Servicio de Digestivo

    El Palmar, 30120

  • Hospital Universitario La Princesa Unidad de Hepatología, Servicio de Gastroenterologia

    Madrid, 28006

  • Hospital Universitario La Paz Servico de Gastroenterologia

    Madrid, 28046

  • Corporació Sanitaria Parc Taulí Servicio de Digestivo

    Sabadell, 08028

  • Hospital Universitario Marques de Valdecilla Servicio de Digestivo

    Santander, 39008

Other trials in Spain

Austria4 sites
  • Landeskrankenhaus-Universitätskliniken Innsbruck - Klinische Abteilung für Gastroenterologie und Hepatologie

    Innsbruck, 6020

  • Krankenhaus der Barmherzigen Brüder - Abteilung für Innere Medizin

    Salzburg, 5010

  • Allgemeines Krankenhaus Wien - Universitätsklinik Klinik für Innere Medizin III

    Vienna, 1090

  • Ordinationszentrum Döbling

    Vienna, 1190

Other trials in Austria

Latvia4 sites
  • Daugavpils Central Regional Hospital

    Daugavpils, LV-5400

  • Paula Stradina Clinical University Hospital Gastroenterology Centre

    Riga, LV-1002

  • Latvian Maritime Medicine Centre

    Riga, LV-1005

  • Digestive Disease Center GASTRO

    Riga, LV-1006

Other trials in Latvia

Lithuania4 sites
  • Lietuvos sveikatos mokslu universiteto ligonine VšI Kauno klinikos Gastroenterologijos skyrius

    Kaunas, LT-50009

  • Klaipedos jurininku ligonine Diagnostikos skyrius

    Klaipėda, LT-92288

  • VšI Mykolo Marcinkeviciaus ligonines

    Vilnius, LT-03215

  • Vilniaus universiteto ligonine Santariškiu klinikos Hepatologijos, gastroenterologijos ir dietologijos centras

    Vilnius, LT-08661

Other trials in Lithuania

About this study

Official title: Phase III Randomized Multicenter International Study to Investigate the Safety and Efficacy of Propionyl-L-Carnitine Hydrochloride Modified Release Tablets in Patients Affected by Mild Ulcerative Colitis Under Oral Stable Treatment

The aim of the trial is to test safety, tolerability and efficacy of Propionyl-L-carnitine modified release tablets 1g/die in reducing the symptoms of the disease with respect to the proportion of patients with disease remission at the end of the 8 weeks of treatment. It will also aim to investigate capability of the treatment in the maintenance of remission after four weeks of treatment interruption; histological changes will be also evaluated and finally, improvement in the overall quality of life as measured by the Short Inflammatory Bowel Disease Questionnaire (SIBDQ) will be investigated.

Read the detailed description

Although it seems clear that an abnormal function of the colonic epithelium is the central problem causing inflammation and the unusual immunological response to the normal gut flora in inflammatory bowel disease (IBD), the actual causes of these dysfunctions are still unknown. Short Chain Fatty Acids (SCFA) are the main fuel of the colonic epithelium, and are normally produced by the bacterial flora by fermentation of the complex carbohydrates forming non soluble fibers usually introduced with everyday diet. Butyrate alone contributes 70% of the normal colonocyte energy. Studies done using animal models and colonic mucosa biopsies from patients suffering form ulcerative colitis (UC) have consistently shown that a metabolic change occurs in diseased colonic mucosa, with an impairment of butyrate oxidation (and of beta-oxidation) and an energy shortage that is only incompletely compensated by oxidation of glucose and other substrates such as glutamine. It is also well known that matrix metalloproteases production is highly increased in IBD and that serum transglutaminase activity is significantly reduced in patients with IBD. Transglutaminases are enzymes contributing to the crosslinking of matrix proteins and the reduction seen in patients affected by IBD correlates well with the endoscopic and histopathologic grading in UC, meaning that part of the circulating enzyme is sequestered in the injured colonic tissue in the effort to re-build the extracellular matrix during the healing process. Propionyl-L-carnitine Hydrochloride (PLC) is a molecule that has already been shown to reduce membrane lipid peroxidation in endothelial cells from bovine aorta and coronary vessels, to reduce the effects of hypoxia in coronary endothelial cells, and to play a role in the cardiac metabolic abnormalities that contribute to the mechanical dysfunctions leading to heart failure. Given these properties of Propionyl-L-carnitine Hydrochloride (ST 261) and given the peroxidative damage suffered by colonocytes in UC together with their metabolic impairment, the use of this molecule for the treatment of UC seemed to be appropriate and sound, in particular as a carrier of a propionate moiety that, once transformed into succinate, enters the Kreb cycle, acting as an extra burst fuel improving the balance of energy production inside tissues. Previous clinical experience has shown that PLC promoted complete or nearly complete regression of cutaneous trophic ulcers in a large number of vasculopathic patients refractory to all other therapies. As far as the UC pathology is concerned, the effects of ST 261, given orally or intrarectally, were investigated at different dosages, in preclinical experimentation, either after a single trinitrobenzene sulphonic acid (TNBS) administration (acute colitis) or after repeated TNBS administrations (reactivated colitis). The results showed a reduction in the damaged colon area both in acute model and reactivated colitis, even if the beneficial effect of restoration of TNBS-induced alterations of tissue morphology is more evident in the reactivated colitis model, particularly after oral administration. Based on the above-described results a development plan in humans started to investigate the activity of PLC in the treatment of ulcerative colitis.

Being tested
Propionyl-L-Carnitine, Placebo
Keywords
Ulcerative colitis
Medical subject headings
Colitis, Ulcerative

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Propionyl-L-CarnitineDrug

    500 mg modified release tablets, 500 mg bid; treatment duration 8 weeks

  • PlaceboDrug

    500 mg inert substances modified release tablets, 500 mg bid; treatment duration 8 weeks

Study groups in NCT01567956
Study groupRoleWhat they receive
Propionyl-L-CarnitineExperimentalModified release tablets containing 500 mg of propionyl-L-carnitine
Receives: Drug: Propionyl-L-Carnitine
PlaceboPlacebo comparatorModified release tablets containing inert substances
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proportion of clinical/endoscopic remissions

    Remission will be defined according with the overall modified Mayo score (Disease Activity Index). A score ≤ 2 with rectal bleeding sub-score = 0 and no other individual sub-score >1 will be considered necessary to classify the patient in remission state.

    Measured: End of treatment (week 8)

Secondary outcomes (9)
  1. Change from baseline in Rectal bleeding evaluation

    Evaluation will be performed by means of Disease Activity Index (DAI) sub-score (from 0 to 3).

    Measured: At week 2, 6 and 8 of treatment and after 4 week follow-up

  2. Change from baseline in stool frequency evaluation

    Evaluations will be performed by means of Disease Activity Index (DAI) sub-score (from 0 to 3).

    Measured: At week 2, 6 and 8 of treatment and after 4 week follow-up

  3. Histological response to the treatment

    Evaluated as an improvement of the histological index of at least 1 point

    Measured: End of treatment (week 8)

  4. Change from baseline in C-reactive protein (CRP) and Fibrinogen

    Measured: End of the treatment (week 8) and after 4 week follow-up

  5. Improvement of patients quality of life

    A validated specific questionnaire, the SIBDQ by McMaster university will be administered to evaluate changes in patients' quality of life

    Measured: End of treatment period (week8) and after 4 week follow-up

  6. Haematology

    Haemoglobin, Haematocrit, RBC, WBC and differential count.

    Measured: Baseline and end of treatment (week8)

  7. Electrocardiogram

    Standard intervals (PR, RR, QRS, QT) will be collected plus all rhythm abnormalities

    Measured: At baseline and at the end of treatment period (week8)

  8. Adverse Events collection

    Measured: 12 weeks

  9. Serum Chemistry

    Standard evaluation including renal and liver function, electrolytes and blood glucose

    Measured: At baseline and at the end of treatment period (week8)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Mar 2012 (estimated)
  2. Study startApr 2012
  3. Primary completionOct 2013
  4. Study completionJan 2014

Why it stopped: Evidence of very low probability to success. No safety issues

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
150 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01567956
Sponsor's protocol ID
ST261DM11006
Other IDs
2011-004770-28
Status last verified
Apr 2014
First submitted
28 Mar 2012
Last updated
7 Nov 2016
Results posted
No
Data monitoring committee
Yes
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Propionyl-L-Carnitine in people with Ulcerative Colitis, run by sigma-tau i.f.r. S.p.A. at 58 sites in 8 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 18 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 7 Nov 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 58 sites in Germany, Hungary, France, Poland, Spain and 3 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was stopped early (reason given: Evidence of very low probability to success. No safety issues). Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of clinical/endoscopic remissions (time frame: End of treatment (week 8)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 7 Nov 2016.

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