Efficacy and Safety of CB-01-11 200mg Tablets in Infectious Diarrhoea

Efficacy and Safety of CB-01-11 200mg Tablets in Infectious Diarrhoea. A Pilot, Dose Finding, Double-blind, Randomized, Multicentre Study

To assess the safety and the preliminary efficacy data on the three doses of the new Cosmo Technologies oral rifamycin SV colon-release 200 mg tablets manufactured according to MMX technology (CB-01-11) in the treatment of infectious diarrhoea.

Study Overview

• Status: Completed
• Conditions: Infectious Diarrhoea
• Intervention / Treatment: Drug: 400 mg Rifamycin SV dosage; Drug: 800 mg Rifamycin SV dosage; Drug: 1200 mg Rifamycin SV dosage

Detailed Description

To assess the safety and the preliminary efficacy data on the three doses of the new Cosmo Technologies oral rifamycin SV colon-release 200 mg tablets manufactured according to MMXTM technology (CB-01-11) in the treatment of infectious diarrhoea.

Primary end points to determine:

• The safety and preliminary efficacy data of the three doses of the new rifamycin SV formulation tested based upon the time elapsed from the ingestion of the 1st dose of study medication to the passage of the last unformed stool (TLUS), in compliance with the relevant guidelines

Secondary end-points to determine:

• The number of patients showing improvement in diarrhoea during a 24-h interval, i.e. >50 % reduction of bowel movements.
• The number of unformed stools passed per 24-h interval, after dosing.
• The number of patients who are declared to be "well". Wellness is defined as the patient having 48 hours with no unformed stools, a maximum of two soft stools and no clinical symptoms of infectious diarrhoea.
• The number of treatment failures. A treatment failure is defined as clinical deterioration or worsening of symptoms or illness continuing after 120 h following the first dose.
• The number and percentage of patients recovered from diarrhoea. Patients were considered to have recovered if fewer than three unformed stools were passed in the previous 24 hours and no symptom of enteric infection were present.

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Phase 2

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 65 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

Patients had to meet all of the following inclusion criteria:

• Male and female patients aged 18-65 years inclusive on the date of screening.
• Patients with infectious diarrhoea (ID) in the active phase of no more than 72-h duration. Criteria for diagnosis of ID were: three or more unformed stools in the preceding 24 hours, and at least one symptom of enteric infection e.g. abdominal cramps/pain, tenesmus, urgency, an excess of gas/flatulence, nausea, vomiting.
• If female, and of child-bearing potential, use of an effective contraceptive method. (Oral contraceptives, injectable hormonal contraceptives, double-barrier method (condom/diaphragm with spermicide) and intra-uterine devices, according to the definition of Note 3 of ICH M3(M) Guideline. Females were considered not to be of child-bearing potential, if they were at least 12 months post-menopausal.
• Ability, in the investigator's opinion to comprehend the full nature and purpose of the study, including the possible risks and side effects, and willing to comply with the requirements of the study.
• Patients who have voluntarily signed and dated the informed consent document for screening and study specific procedures.
• Patients must be sufficiently literate to be able to complete a diary card.

Exclusion Criteria:

Patients had not to have had of any of the following:

• Females of child-bearing potential not using an effective contraceptive method.
• Pregnant or lactating females.
• Fever (defined as a body (axillary) temperature ≥ 38° C) present either at the screening visit or in the previous 24 hours.
• Visible presence of blood in the stool at baseline.
• Patients with any history or evidence on examination, of clinically significant gastrointestinal (in particular intestinal obstruction and severe intestinal ulcerative lesions), renal, hepatic, endocrine, respiratory, cardiovascular, dermatological or haematological disease, which in the opinion of the investigator could affect the interpretation of the efficacy and safety data.
• Patients with moderate or severe dehydration (see Appendix 2 of the protocol, for definitions of clinical symptoms).
• Prohibited previous and concomitant medication (see relevant section of the protocol).
• History of recent gastrointestinal malignancy (within 6 months).
• Allergy: presumptive or ascertained hypersensitivity to the study drug, history of anaphylaxis or allergic reactions in general.
• History of, or current misuse of alcohol, drugs or abuse of medication.
• Participation in another study with any investigational product within 3 months before screening.
• Patients who, in the opinion of the investigator, could be un-cooperative and/or non-compliant and should not therefore participate in the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: 400 mg Rifamycin SV dosage; Two enteric coated, modified release tablets, each containing 200 mg Rifamycin SV, taken three times daily. Four of the six daily tablet taken in this group were placebos.	Drug: 400 mg Rifamycin SV dosage
Active Comparator: 800 mg Rifamycin SV dosage; Two enteric coated, modified release tablets, each containing 200 mg Rifamycin SV, taken three times daily. Two of the six daily tablet taken in this group were placebos.	Drug: 800 mg Rifamycin SV dosage
Active Comparator: 1200 mg Rifamycin SV dosage; Two enteric coated, modified release tablets, each containing 200 mg Rifamycin SV, taken three times daily. None of the six daily tablet taken in this group were placebos.	Drug: 1200 mg Rifamycin SV dosage

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time to Last Unformed Stool (TLUS)	The safety and preliminary efficacy data of the three doses of the new rifamycin SV formulation tested based upon the time elapsed from the ingestion of the 1st dose of study medication to the passage of the last unformed stool (TLUS)	Up to 7 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The Number of Patients Showing Improvement in Diarrhoea During a 48h Interval	The evaluation of improvement in diarrhoea during a 48 hour interval is defined as a >50% reduction of bowel movements versus the baseline value	48 hours
The Number of Unformed Stools Passed Per 24-h Interval	The number of unformed stools passed per 24-h interval, after dosing	192 hours
The Number of Patients Who Are Declared to be "Well"	The patient having must meet all of the following criteria in order to be classified as "well": 48 hours with no unformed stools with a maximum of two soft stools and no clinical symptoms of infectious diarrhoea.	48 hours
Number of Participants With Treatment Failure	A treatment failure is defined as clinical deterioration or worsening of symptoms or illness continuing after 120 h following the first dose.	120 hours
The Number of Patients Recovered From Diarrhoea	Patients were considered to have recovered if fewer than three unformed stools were passed in the previous 24 hours and no symptom of enteric infection were present.	24 hours

Collaborators and Investigators

• Sponsor: Cosmo Technologies Ltd
• Investigators: Principal Investigator: Manuel Mancera Reyes, HOSPITAL CENTRAL DE ORIENTE; Principal Investigator: Can Polat Eyigün, Gülhane Military Medical Academy

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2008
• Primary Completion (Actual): July 1, 2008
• Study Completion (Actual): July 1, 2008

Study Registration Dates

• First Submitted: February 9, 2018
• First Submitted That Met QC Criteria: February 21, 2018
• First Posted (Actual): February 27, 2018

Study Record Updates

• Last Update Posted (Actual): February 18, 2020
• Last Update Submitted That Met QC Criteria: February 5, 2020
• Last Verified: February 1, 2020

More Information

Terms related to this study

• Keywords: Infectious diarrhoea; MMX; rifamycin SV; rifamycin SV MMX
• Additional Relevant MeSH Terms: Digestive System Diseases; Pathologic Processes; Disease Attributes; Signs and Symptoms, Digestive; Gastrointestinal Diseases; Gastroenteritis; Intestinal Diseases; Infections; Communicable Diseases; Diarrhea; Dysentery; Anti-Infective Agents; Antirheumatic Agents; Anti-Bacterial Agents; Rifamycins; Rifamycin SV
• Other Study ID Numbers: CB-01-11/03

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: None. IPD not to be shared.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No