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.
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).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
75
2 x 10 mg placebo capsules administered orally with water, b.i.d.
10 mg Natura-alpha capsule and 10 mg placebo capsule administered orally with water, b.i.d.
2 x 10mg Natura-alpha capsules administered orally with water, b.i.d.
Advanced Clinical Research Institute
Anaheim, California, United States
Chevy Chase Clinical Research
Chevy Chase, Maryland, United States
Kansas City Gastroenterology and Hepatology
Kansas City, Missouri, United States
AGA Medical Research Associates, LLC
Egg Harbor, New Jersey, United States
Long Island Clinical Research Associates, LLP
Great Neck, New York, United States
Premier Medical Group of the Hudson Valley
Poughkeepsie, New York, United States
Consultants for Clinical Research
Cincinnati, Ohio, United States
Consultants for Clinical Research
Fairfield, Ohio, United States
Nashville Medical Research Institute
Nashville, Tennessee, United States
Wisconsin Center for Advanced Research, LLC
Milwaukee, Wisconsin, United States
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.
Time frame: Day 28 after the treatment
Physician's Global Assessment (PGA)
The proportion of patients in all treatment groups who achieve clinical remission at Day 28
Time frame: Day 28 after the treatment
Physician's Global Assessment (PGA)
The proportion of patients in all treatment groups who demonstrate clinical response
Time frame: Day 7
Physician's Global Assessment (PGA)
The proportion of patients in all treatment groups who demonstrate clinical response
Time frame: 14
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
Time frame: Day 28
Safety
adverse events, changes in physical examination findings, vital signs, concomitant medications, and laboratory test results
Time frame: Day 28
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