A Phase 2a, Randomised, Double-Blind, Placebo-Controlled Study to Evaluate the Safety/Tolerability and Efficacy of TOP1288 200 mg Rectal Solution Once Daily for 4 Weeks in Symptomatic Ulcerative Colitis Patients with Moderate to Severe Disease Activity
TOP1288, the first in a new class of agents called narrow spectrum protein kinase inhibitors (NSKIs), is being developed as a novel, non-absorbed treatment for ulcerative colitis (UC). UC is a disease of unknown cause characterised by inflammation of the lining of the large intestine and manifesting with abdominal pain and bloody diarrhoea. TOP1288 given rectally has a local anti-inflammatory action in experimental models of UC. A Phase I placebo-controlled, single ascending dose (SAD) and multiple ascending dose (MAD) study of TOP1288 conducted in 61 healthy volunteers demonstrated that rectal administration of TOP1288 at doses up to 200 mg BID for 4 days was safe and well tolerated, with minimal systemic absorption. TOP1288 200 mg, administered once daily, therefore offers the potential for a safe and effective novel approach to treating patients with this serious condition. This Phase 2a proof-of-concept study will evaluate the 200 mg daily dose of TOP1288, based on its favourable tolerability in the Phase 1 study. It will be administered as TOP1288 200 mg Rectal Solution compared against Placebo Rectal Solution, which contains all non-active excipients present in the active solution. This is a randomised, double-blind, placebo-controlled multicentre study designed to evaluate the safety/tolerability and efficacy of TOP1288 200 mg Rectal Solution following once-daily bedtime treatment for 4 consecutive weeks. The study will include approximately 40 sites in Europe. Randomization to study treatment will be 2:1, with approximately 40 subjects randomised to TOP1288 and approximately 20 subjects randomised to placebo. The Screening period will be up to 28 days prior to the first day of dosing with double-blind study treatment (Visit 1). A central reading facility will be used to determine eligibility based upon the Screening flexible sigmoidoscopy. Visit 2 is scheduled for Day 7 of dosing, and Visit 3 for Day 29 of dosing. There will be a 1-week safety follow-up period after Visit 3. The total duration of study participation for a given subject will be up to \~65 days or 9 weeks
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
77
Unnamed facility
Plovdiv, Bulgaria
Unnamed facility
Sofia, Bulgaria
Efficacy as measured by the Mayo Clinic modified endoscopic subscore
Time frame: After 4 consecutive weeks of daily bedtime treatment
Safety as measured by adverse events
Time frame: To 1 week after the last dose
Safety as measured by vital signs
Time frame: To 1 week after the last dose
Safety as measured by ECGs
Time frame: To 1 week after the last dose
Safety as measured by clinical laboratory tests
Time frame: To 1 week after the last dose
Efficacy as measured by Ulcerative Colitis Endoscopic Index of Severity (UCEIS) score
Time frame: After 4 consecutive weeks of daily bedtime treatment
Efficacy as measured by Partial Mayo Clinic score (i.e., the sum of the endoscopic, rectal bleeding, and stool frequency subscores)
Time frame: After 4 consecutive weeks of daily bedtime treatment
Efficacy as measured by endoscopic healing (indicated by the Mayo Clinic modified endoscopic subscore)
Time frame: After 4 consecutive weeks of daily bedtime treatment
Efficacy as measured by rectal bleeding (indicated by the Mayo Clinic rectal bleeding subscore)
Time frame: After 4 consecutive weeks of daily bedtime treatment
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Unnamed facility
Brno, Czechia
Unnamed facility
Litoměřice, Czechia
Unnamed facility
Olomouc, Czechia
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Prague, Czechia
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Budapest, Hungary
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Gyöngyös, Hungary
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Győr, Hungary
Unnamed facility
Gyula, Hungary
...and 18 more locations