A Phase 3 interventional study of Blood sampling, endoscopy and Budesonide MMX® 6 mg in Ulcerative Colitis, sponsored by Bausch Health Americas, Inc.. Completed at 71 sites in 15 countries. Open to participants aged 18 Years to 75 Years. Per ClinicalTrials.gov, last updated 2019-12-10.
Sponsored by Bausch Health Americas, Inc. · Phase 3, Interventional, and Treatment
This will be a multicentre, randomised, double-blind, double-dummy, parallel group comparative study in patients with mild or moderate, active ulcerative colitis. The study will compare budesonide-MMX™ 6 mg and budesonide-MMX™ 9 mg tablets to placebo and to Entocort® 3 x 3 mg capsules, in four parallel groups of patients over an 8 week treatment period.
After the screening visit, patients will enter a washout period of 2 days, then they will be randomised to the following four treatment groups: budesonide-MMX™ tablets (6 mg), budesonide-MMX™ tablets (9 mg), Entocort® capsules (3 x 3 mg) and placebo (tablets and capsules), all administered once a day after breakfast. Hence, each patient will receive, in the morning after breakfast, either one budesonide-MMX™ 6 mg or budesonide MMX™ 9 mg tablet and 3 placebo Entocort® matching capsules, or three Entocort® 3 mg capsules and one placebo budesonide-MMX™ matching tablet, or one placebo budesonide-MMX™ matching tablet and three placebo Entocort® matching capsules.
Each patient will receive one of the following regimens in the morning after breakfast:
Hence, each patient is to take four tablets/capsules per day of active or placebo study medication as per the randomization schedule. Placebo tablets of Budesonide MMX® and placebo overencapsulated capsules of Entocort EC® will be used to maintain the study blind using a double-dummy technique.
During the study, five visits to the clinical center are scheduled: one at Screening and three in the double-blind treatment period (Day 1, Day 14, Day 28 and Day 56). A safety follow-up visit will take place about 2 weeks after the final study visit. If a patient is withdrawn from the study before Day 56, they will be asked to attend the study center as soon as possible thereafter so that the Final visit assessments can be conducted.
1,073 studies on the registry are indexed under Colitis; 131 are open to participants now.
This study's enrollment of 514 is above the median of 60 across 771 interventional studies indexed under Colitis.
Browse Colitis studies →Bausch Health Americas, Inc. is the lead sponsor of 209 studies on the registry; 9 are open to participants now.
Of its 23 completed or terminated interventional studies of FDA-regulated products, 16 (70%) have results posted.
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Patients fulfilling the following criteria at the screening visit are eligible for participation in the study:
Exclusion Criteria:
Patients who meet any of the following criteria at screening visit are to be excluded from study participation:
One budesonide-MMX® 6 mg plus three placebo Entocort EC® overencapsulated capsules daily in the morning after breakfast.
Procedure: Blood sampling, endoscopy · Drug: Budesonide MMX® 6 mg
One budesonide-MMX® 9 mg plus three placebo Entocort EC® overencapsulated capsules daily in the morning after breakfast.
Procedure: Blood sampling, endoscopy · Drug: Budesonide MMX® 9 mg
Three Entocort EC® 3 mg overencapsulated capsules plus one placebo budesonide MMX® tablet daily in the morning after breakfast.
Procedure: Blood sampling, endoscopy · Drug: Entocort EC® 3 mg
Three placebo Entocort EC® overencapsulated capsules plus one placebo Budesonide MMX® tablet daily in the morning after breakfast.
Procedure: Blood sampling, endoscopy · Drug: Placebo
Blood sampling for hematology and biochemistry and endoscopy with biopsy for histological and endoscopic assessment scores
6 mg/day, 6 mg tablets
9 mg/day, 9 mg tablets
9 mg/day, 3 mg tablets
Placebo
Clinical and Endoscopic Remission.
Clinical and endoscopic remission defined as an Ulcerative Colitis Disease Activity Index (UCDAI) score ≤ 1, with subscores of 0 for rectal bleeding, stool frequency, and mucosal appearance and with a ≥ 1 point reduction in the endoscopic index score.
Time frame: 8 weeks
Clinical Improvement.
Clinical improvement, defined as a ≥ 3-point improvement in UCDAI from baseline to the end of Week 8.
Time frame: 8 weeks
Endoscopic Improvement.
Greater or equal to a 1 point improvement in the mucosal appearance subscore of the UCDAI, from baseline to week 8. As per the hierarchical testing procedure for secondary endpoints, because clinical improvement was not statistically significant in the ITT population, formal statistical comparisons for endoscopic improvement between the 2 budesonide MMX groups and placebo were not conducted.
Time frame: 8 weeks
Recruited from July 2008 to February 2010.
| Milestone | 1: Budesonide-MMX® 6 mg | 2: Budesonide-MMX® 9 mg | 3: Entocort EC® 3 mg | 4: Placebo |
|---|---|---|---|---|
| Started | 109 | 109 | 103 | 89 |
| Completed | 67 | 76 | 68 | 61 |
| Not completed | 42 | 33 | 35 | 28 |
Clinical and endoscopic remission defined as an Ulcerative Colitis Disease Activity Index (UCDAI) score ≤ 1, with subscores of 0 for rectal bleeding, stool frequency, and mucosal appearance and with a ≥ 1 point reduction in the endoscopic index score.
| percentage of patients | 1: Budesonide-MMX® 6 mg | 2: Budesonide-MMX® 9 mg | 3: Entocort EC® 3 mg | 4: Placebo |
|---|---|---|---|---|
| Clinical and Endoscopic Remission. | 8.3 (3.1 to 13.4) | 17.4 (10.3 to 24.6) | 12.6 (6.2 to 19.0) | 4.5 (0.2 to 8.8) |
Clinical improvement, defined as a ≥ 3-point improvement in UCDAI from baseline to the end of Week 8.
| percentage of patients | 1: Budesonide-MMX® 6 mg | 2: Budesonide-MMX® 9 mg | 3: Entocort EC® 3 mg | 4: Placebo |
|---|---|---|---|---|
| Clinical Improvement. | 25.7 (17.5 to 33.9) | 42.2 (32.9 to 51.5) | 33.0 (23.9 to 42.1) | 33.7 (23.9 to 43.5) |
Greater or equal to a 1 point improvement in the mucosal appearance subscore of the UCDAI, from baseline to week 8. As per the hierarchical testing procedure for secondary endpoints, because clinical improvement was not statistically significant in the ITT population, formal statistical comparisons for endoscopic improvement between the 2 budesonide MMX groups and placebo were not conducted.
| percentage of patients | 1: Budesonide-MMX® 6 mg | 2: Budesonide-MMX® 9 mg | 3: Entocort EC® 3 mg | 4: Placebo |
|---|---|---|---|---|
| Endoscopic Improvement. | 25.7 (17.5 to 33.9) | 42.2 (32.9 to 51.5) | 36.9 (27.6 to 46.2) | 31.5 (21.8 to 41.1) |
Collected over 56 day ± 2 day (study duration) + 30 day safety followup period.. Non-serious events are listed at a 2% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| 1: Budesonide-MMX® 6 mg | — | 3/128 (2.3%) | 77/128 (60.2%) |
| 2: Budesonide-MMX® 9 mg | — | 4/128 (3.1%) | 67/128 (52.3%) |
| 3: Entocort EC® 3 mg | — | 1/126 (0.8%) | 68/126 (54%) |
| 4: Placebo | — | 5/129 (3.9%) | 52/129 (40.3%) |
| Event | 1: Budesonide-MMX® 6 mg | 2: Budesonide-MMX® 9 mg | 3: Entocort EC® 3 mg | 4: Placebo |
|---|---|---|---|---|
| Colitis ulcerativeGastrointestinal disorders | 1/128 | 1/128 | 1/126 | 3/129 |
| Treatment failureGeneral disorders | 2/128 | 0/128 | 0/126 | 0/129 |
| Gastric ulcerGastrointestinal disorders | 0/128 | 0/128 | 1/126 | 0/129 |
| EnterocolitisGastrointestinal disorders | 0/128 | 1/128 | 0/126 | 0/129 |
| NauseaGastrointestinal disorders | 0/128 | 1/128 | 0/126 | 0/129 |
| Colon cancerNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 1/128 | 0/128 | 0/126 | 0/129 |
| Urge incontinenceRenal and urinary disorders | 0/128 | 1/128 | 0/126 | 0/129 |
| Signet-ring cell carcinomaNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/128 | 0/128 | 0/126 | 1/129 |
| Personality disorderPsychiatric disorders | 0/128 | 0/128 | 0/126 | 1/129 |
| Event | 1: Budesonide-MMX® 6 mg | 2: Budesonide-MMX® 9 mg | 3: Entocort EC® 3 mg | 4: Placebo |
|---|---|---|---|---|
| Colitis ulcerativeGastrointestinal disorders | 20/128 | 26/128 | 15/126 | 14/129 |
| HeadacheNervous system disorders | 21/128 | 20/128 | 9/126 | 8/129 |
| NauseaGastrointestinal disorders | 8/128 | 6/128 | 3/126 | 3/129 |
| NasopharyngitisInfections and infestations | 1/128 | 8/128 | 6/126 | 2/129 |
| Abdominal painGastrointestinal disorders | 3/128 | 5/128 | 7/126 | 7/129 |
| FlatulenceGastrointestinal disorders | 5/128 | 7/128 | 7/126 | 3/129 |
| Blood cortisol decreasedInvestigations | 7/128 | 3/128 | 4/126 | 1/129 |
| AnaemiaBlood and lymphatic system disorders | 5/128 | 3/128 | 0/126 | 1/129 |
| Abdominal pain upperGastrointestinal disorders | 5/128 | 3/128 | 2/126 | 3/129 |
| CushingoidEndocrine disorders | 2/128 | 1/128 | 2/126 | 5/129 |
Baseline characteristics were analyzed with the ITT population, defined as randomized patients who received study drug, had no entry criteria/GCP violation, and had abnormal mucosal histology at baseline. ITT population=410 patients: 511 - 101 patients who were not randomized, had entry criteria/GCP violation, or had normal histology at baseline.
| Age, Categorical(Participants) | 1: Budesonide-MMX® 6 mg | 2: Budesonide-MMX® 9 mg | 3: Entocort EC® 3 mg | 4: Placebo | Total |
|---|---|---|---|---|---|
| <=18 years | 0 | 0 | 0 | 0 | 0 |
| Between 18 and 65 years | 102 | 107 | 97 | 82 | 388 |
| >=65 years | 7 | 2 | 6 | 7 | 22 |
| Age, Continuous(years) | 1: Budesonide-MMX® 6 mg | 2: Budesonide-MMX® 9 mg | 3: Entocort EC® 3 mg | 4: Placebo | Total |
|---|---|---|---|---|---|
| Mean | 43.6 ± 13.6 | 42.8 ± 13.9 | 43.4 ± 14.0 | 44.8 ± 13.0 | 43.6 ± 13.6 |
| Sex: Female, Male(Participants) | 1: Budesonide-MMX® 6 mg | 2: Budesonide-MMX® 9 mg | 3: Entocort EC® 3 mg | 4: Placebo | Total |
|---|---|---|---|---|---|
| Female | 52 | 45 | 48 | 32 | 177 |
| Male | 57 | 64 | 55 | 57 | 233 |
| Region of Enrollment(participants) | 1: Budesonide-MMX® 6 mg | 2: Budesonide-MMX® 9 mg | 3: Entocort EC® 3 mg | 4: Placebo | Total |
|---|---|---|---|---|---|
| Estonia | 11 | 6 | 6 | 5 | 28 |
| Slovakia | 10 | 5 | 5 | 7 | 27 |
| Ukraine | 7 | 6 | 7 | 5 | 25 |
| Lithuania | 19 | 17 | 11 | 12 | 59 |
| Russian Federation | 24 | 35 | 34 | 28 | 121 |
| United Kingdom | 2 | 4 | 3 | 0 | 9 |
| Italy | 18 | 12 | 18 | 13 | 61 |
| France | 0 | 1 | 1 | 1 | 3 |
| Poland | 7 | 14 | 13 | 9 | 43 |
| Belgium | 2 | 0 | 0 | 0 | 2 |
| Romania | 2 | 5 | 1 | 3 | 11 |
| Australia | 1 | 1 | 3 | 2 | 7 |
| Latvia | 2 | 2 | 0 | 2 | 6 |
| Sweden | 3 | 1 | 0 | 2 | 6 |
| Israel | 1 | 0 | 1 | 0 | 2 |
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Bausch Health Americas, Inc.