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Effect of EPA-FFA on Polypectomy in Familial Adenomatous Polyposis

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT03806426
Recruitment Status : Recruiting
First Posted : January 16, 2019
Last Update Posted : June 18, 2019
Information provided by (Responsible Party):
S.L.A. Pharma AG

Brief Summary:
2 Year randomised, double-blind, placebo-controlled, parallel group study to determine the safety and efficacy of EPA-FFA gastro resistant capsules in FAP.

Condition or disease Intervention/treatment Phase
Familial Adenomatous Polyposis Drug: Eicosapentaenoic acid free fatty acid (EPA-FFA) Drug: Placebo Phase 3

Detailed Description:

The purpose of this Phase III study is to determine whether Eicosapentaenoic acid-free fatty acid is a safe and well tolerated treatment in reducing the number of polypectomies FAP patients with an APC gene mutation have over a 2 year treatment period and to assess the effect that this has on clinical disease progression. Planned Sample Size This study will enrol 204 subjects (102 subjects per treatment group). Primary Objective is to determine the efficacy of EPA-FFA gastro-resistant capsules in patients with FAP in reducing polypectomy.

Secondary objectives is to evaluate the clinical disease progression and the long-term safety and tolerability of EPA-FFA.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 204 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: Randomised, Double-blind, Placebo-controlled Study of the Efficacy, Safety and Tolerability of EPA-FFA Gastro-resistant Capsules, in Patients With Familial Adenomatous Polyposis (FAP)
Actual Study Start Date : December 5, 2018
Estimated Primary Completion Date : March 1, 2021
Estimated Study Completion Date : March 1, 2021

Arm Intervention/treatment
Experimental: Treatment Group A
Eicosapentaenoic acid free fatty acid (EPA-FFA) 500mg
Drug: Eicosapentaenoic acid free fatty acid (EPA-FFA)
500mg capsule, two 500mg capsules to be taken twice daily for 24 months
Other Name: ALFA

Placebo Comparator: Treatment Group B
Placebo 500mg
Drug: Placebo
500mg capsule, two 500mg capsules to be taken twice daily for 24 months

Primary Outcome Measures :
  1. Total Number of Polypectomies (polyps > 5mm in the rectum) conducted during the 24 months study period [ Time Frame: 24 months ]
    Proctectomy is indicated when polyp burden is frequently high in the remaining rectum, if large highly dysplastic polyps occur, or if frank malignancy develops. Proctocolectomy also significantly reduces the cancer risk with the removal of the colon and rectum.

Secondary Outcome Measures :
  1. Change in Polyp number at 24 months assessed by blinded review of video records [ Time Frame: 24 months ]
    Subsequent proctectomy is indicated when polyp burden is frequently high in the remaining rectum, if large highly dysplastic polyps occur, or if frank malignancy develops. Proctocolectomy also significantly reduces the cancer risk with the removal of the colon and rectum.

  2. Change in score on the InSIGHT Polyposis Staging System (IPSS) at 24 months [ Time Frame: 24 months ]

    Classified stage on InSiGHT Polyposis Staging System (IPSS). The subjects FAP will be classified in accordance with the IPSS.

    The IPSS classification will be verified by the Polyp Video Scoring committee

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria

  1. Must give written informed consent.
  2. Male or female subjects, 18 to 65 years of age.
  3. Known diagnosis of FAP defined as those with a pathogenic APC mutation and have had a previous colectomy with ileo-rectal anastomosis.
  4. Subjects must have a preserved rectum.
  5. Classified stage 1-3 on InSiGHT Polyposis Staging System (IPSS).
  6. Subjects must show a willingness to abstain from regular use of non-steroidal anti-inflammatory medication for the trial. A cardioprotective dose of aspirin (75mg-100mg) will be permitted.

Exclusion Criteria:

  1. In subjects with previous ileo-rectal anastomosis ≥ 20 polyps > 5mm in the rectum.
  2. Subjects with an ileo-anal pouch.
  3. Subjects unwilling to have regular endoscopic examination.
  4. Subjects who are due to undergo gastro-intestinal surgery related to FAP.
  5. History of invasive carcinoma in the past 3 years.
  6. History of pelvic radiation.
  7. Known allergic reaction or intolerant to fish or fish oils.
  8. Known allergic reaction to excipients of IMP and placebo.
  9. Subjects who are pregnant or breast-feeding at screening.
  10. Subjects taking aspirin or other non-steroidal anti-inflammatory drugs on a regular basis other than low dose (75mg-100mg) cardioprotective dose.
  11. Subjects taking NSAIDs regularly in the 3 months prior to entry (other than low dose aspirin).
  12. Subjects who are taking other fish-oil supplements (e.g. cod liver oil) who are unwilling to stop them for the duration of the study. Subjects previously taking fish oil must have a washout period of 2 months prior to study enrolment.
  13. Subjects who are taking warfarin or other anticoagulants.
  14. Experimental agents must have been discontinued at least 8 weeks prior to screening for a period equivalent to 5 half-lives of the agent (whichever is longer).
  15. Subjects suffering from known disorders of clotting and blood coagulation.
  16. Subjects who have significant abnormalities on their screening blood tests.
  17. Subjects with gastrointestinal malabsorptive disease.
  18. Subjects with uncontrolled hypercholesterolaemia.
  19. Subjects who are deemed mentally incompetent, or have a history of anorexia nervosa or bulimia.
  20. Subjects who will be unavailable for the duration of the trial, deemed unable to comply with the requirements of the study protocol, likely to be noncompliant with the protocol, or who are felt to be unsuitable by the Investigator for any other reason.
  21. Women of childbearing potential, defined as all women physiologically capable of becoming pregnant, unless surgically sterile must use effective contraception (either combined estrogen and progestogen containing hormonal contraception associated with inhibition of ovulation [oral, intravaginal, transdermal], progestogen only hormonal contraception associated with inhibition of ovulation [oral, injectable, implantable], intrauterine device [IUD], intrauterine hormone-releasing system [IUS], vasectomised partner, sexual abstinence (only considered an acceptable method of contraception when it is in line with the subjects' usual and preferred lifestyle), combination of male condom with either cap, diaphragm or sponge with spermicide [double barrier methods]), and willing and able to continue contraception for 1 month after the last administration of IMP. Women using oral contraception must have started using it at least 2 months prior to screening. Women are not considered to be of childbearing potential if they have had 12 months of natural (spontaneous) amenorrhea with an appropriate clinical profile (e.g. age appropriate, history of vasomotor symptoms) or six months of spontaneous amenorrhea with serum FSH levels that have been confirmed to be in the "postmenopausal range". Or have had a surgical bilateral oophorectomy (with or without hysterectomy) or bilateral tubal ligation at least six weeks before the screening visit. In case of oophorectomy alone, the reproductive status of the woman should have been confirmed by follow up hormone level assessment.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT03806426

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Contact: Justin Slagel, CEO +44 1923 681001

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University Hospital Brno Recruiting
Brno, Czechia, 625 00
Contact: Milan Dastych, RN   
University Hospital Hradec Kralove Recruiting
Hradec Králové, Czechia, 500 05
Contact: Veronika Knoblochova   
Mediendo Ltd Recruiting
Praha, Czechia, 186 00
Contact: Stepan Suchanek, Dr   
Hopital Avicenne Not yet recruiting
Bobigny, France, 93000
Hospices Civils de Lyon Not yet recruiting
Lyon, France, 69003
Saint-Antoine Hospital Not yet recruiting
Paris, France, 75012
Rambam Healthcare Campus Not yet recruiting
Haifa, Bat Galim, Israel, 3109601
Contact: Maza Itai, Dr    +972-4-777-1912      
Soroka Medical Center Not yet recruiting
Be'er Sheva, Israel, 84101
Tel Aviv Medical Center Not yet recruiting
Tel Aviv, Israel, 64239
Centro di Riferimento Oncologico di aviano Not yet recruiting
Aviano, Italy, 33081
University of Bologna and St.Orsola-Malpighi Hospital Not yet recruiting
Bologna, Italy, 40138
IRCCS de Bellis Not yet recruiting
Castellana Grotte, Italy, 70013
Istituto nazionale dei Tumori Not yet recruiting
Milan, Italy, 20133
Istituto Europeo di Oncologia Not yet recruiting
Milan, Italy, 20141
Istituto Nazionale Tumori Fondazione G.Pascale Recruiting
Napoli, Italy, 80131
Contact: Giovanni Battista Rossi   
Oncologic Institute of Rome Recruiting
Roma, Italy, 00165
Contact: Lupe Sanchez Mete   
Instituto Clinico humanitas Not yet recruiting
Rozzano, Italy, 20089
Ospedale Casa Sollievo della Sofferenza Recruiting
San Giovanni Rotondo, Italy, 71013
Contact: Marianna Nardella   
Ospedale Molinette Not yet recruiting
Turin, Italy, 10126
Academic Medical Centre Recruiting
Amsterdam, Netherlands, 1100 DE
Contact: Victorine Roos   
Radboud University Medical Center Recruiting
Nimega, Netherlands, 6525
Contact: Nicoline Hoogerbrugge   
Hospital General Universitario de Alicante Not yet recruiting
Alicante, Spain, 03010
Hospital Clinic Barcelona Recruiting
Barcelona, Spain, 08036
Contact: Rebeca Moreira   
Complexo Hospitalario de Ourense Not yet recruiting
Ourense, Spain, 32003
Clinica Universidad de Navarra Not yet recruiting
Pamplona, Spain, 31008
Complexo Hospitalario Universitario de Pontevedra Not yet recruiting
Pontevedra, Spain, 36071
Hospital Alvaro Cunqueiro Not yet recruiting
Pontevedra, Spain, 36312
Hospital Universitario de Canarias Not yet recruiting
Santa Cruz De Tenerife, Spain, 38320
Hospital Clinico Universitario Lozana Blesa Not yet recruiting
Zaragoza, Spain, 50009
Sponsors and Collaborators
S.L.A. Pharma AG
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Principal Investigator: Luigi Ricciardiello, MD Associate Professor of Gastroenterology, University of Bologna

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Responsible Party: S.L.A. Pharma AG Identifier: NCT03806426     History of Changes
Other Study ID Numbers: EPA-POL-04
First Posted: January 16, 2019    Key Record Dates
Last Update Posted: June 18, 2019
Last Verified: June 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by S.L.A. Pharma AG:
Eicosapentaenoic Acid
EPA 99%
Fatty Acid
Familial Adenomatous Polyposis
IRA (Ileo-rectal anastomosis)
PUFA (polyunsaturated fatty acid)

Additional relevant MeSH terms:
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Colorectal Neoplasms
Nasopharyngeal Neoplasms
Adenomatous Polyposis Coli
Intestinal Neoplasms
Gastrointestinal Neoplasms
Digestive System Neoplasms
Neoplasms by Site
Digestive System Diseases
Gastrointestinal Diseases
Colonic Diseases
Intestinal Diseases
Rectal Diseases
Pharyngeal Neoplasms
Otorhinolaryngologic Neoplasms
Head and Neck Neoplasms
Nasopharyngeal Diseases
Pharyngeal Diseases
Stomatognathic Diseases
Otorhinolaryngologic Diseases
Adenomatous Polyps
Neoplasms, Glandular and Epithelial
Neoplasms by Histologic Type
Neoplastic Syndromes, Hereditary
Intestinal Polyposis
Genetic Diseases, Inborn