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Safety and Efficacy of TU-100 as an Adjunct to an Enhanced Recovery After Surgery in Subjects Undergoing Bowel Resection

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.
 
ClinicalTrials.gov Identifier: NCT04742907
Recruitment Status : Recruiting
First Posted : February 8, 2021
Last Update Posted : March 9, 2023
Sponsor:
Information provided by (Responsible Party):
Tsumura USA

Brief Summary:
This multicenter, randomized, double-blinded, placebo-controlled study will evaluate the effect of TU-100 on resolution of postoperative ileus (POI) in subjects undergoing open or laparoscopic bowel resection (BR).

Condition or disease Intervention/treatment Phase
Enhanced Recovery After Surgery Drug: TU-100 Drug: Placebo Phase 2

Detailed Description:
Subjects will be screened up to 28 days before their planned surgery and will be randomized 1:1:1 (TU-100 15 g/day: TU-100 7.5 g/day: placebo) on postoperative Day 1 before the first dose of study medication. After randomization, subjects will receive a total daily dose of TU-100 15g, TU-100 7.5 g, or matching placebo (3 times per day (TID)) until hospital discharge or ≤ 10 days (whichever is earlier). All subjects will be treated with study medication as adjunct to an enhanced recovery (ERAS) pathway for gastrointestinal (GI) recovery.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 402 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: Randomized, Double-Blind, Placebo-Controlled
Masking: Double (Participant, Investigator)
Masking Description: Investigators, study staff, sponsor designees, and subjects will be blinded to randomized study treatment for the duration of the study. The pharmacist or designee performing the preparation and administration will also be blinded.
Primary Purpose: Treatment
Official Title: Randomized, Double-Blind, Placebo-Controlled, Phase 2 Trial to Evaluate the Safety and Efficacy of TU-100 as an Adjunct to an Enhanced Recovery After Surgery (ERAS) Protocol in Subjects Undergoing Bowel Resection
Actual Study Start Date : July 29, 2021
Estimated Primary Completion Date : February 2024
Estimated Study Completion Date : March 2024

Arm Intervention/treatment
Experimental: TU-100 15 g/day
Subjects will receive a total daily dose of TU-100 5 g TID until hospital discharge or ≤ 10 days (whichever is earlier).
Drug: TU-100
Treatment with investigational product
Other Name: Daikenchuto

Experimental: TU-100 7.5 g/day
Subjects will receive a total daily dose of TU-100 2.5 g TID until hospital discharge or ≤ 10 days (whichever is earlier).
Drug: TU-100
Treatment with investigational product
Other Name: Daikenchuto

Placebo Comparator: Placebo
Subjects will receive placebo TID until hospital discharge or ≤ 10 days (whichever is earlier).
Drug: Placebo
Treatment with placebo product




Primary Outcome Measures :
  1. Time to gastrointestinal recovery (GIR) [ Time Frame: From the day after surgery until hospital discharge or ≤ 10 days (whichever is earlier) ]
    Time to achieve recovery of GI motility as measured by a composite endpoint representing upper AND lower GI recovery


Secondary Outcome Measures :
  1. Time to GIR responses [ Time Frame: From the day after surgery until hospital discharge or ≤ 10 days (whichever is earlier) ]
    Time to first toleration of clear liquids, time to transition from clear liquids to next diet stage (full liquids or solids), time to toleration of solids, time to first bowel movement, and time to absence of distension and presence of bowel sounds and flatus

  2. GIR outcome related to length of hospitalization [ Time Frame: From surgery to hospital discharge based on GI recovery (up to 2 weeks) ]
    Total number of calendar days from surgery to ready for discharge based solely on GI recovery

  3. POI-related morbidity [ Time Frame: From the day after surgery to discharge follow-up visit (30 days (+ 7 days) after hospital discharge) ]
    Primary POI that is not secondary to surgical complication, such as anastomotic leak, abscess formation, or sepsis that requires readmission within 7 days of discharge, or need for postoperative nasal gastric tube insertion to manage symptoms of POI (vomiting/retching, abdominal distension)

  4. Safety of TU-100 [ Time Frame: From baseline to discharge follow-up visit (30 days (+ 7 days) after hospital discharge) ]
    Patient incidence of adverse events (AEs) observed following administration of TU-100.


Other Outcome Measures:
  1. Effects of TU-100 on early postoperative surgical outcomes related to mechanism of action [ Time Frame: From the day after surgery to discharge follow-up visit (30 days (+ 7 days) after hospital discharge) ]
    Subject-reported (electronic diary) for number of episodes of vomiting and/or retching per day and bothersome nausea and abdominal bloating by day, postoperative antiemetic rescue, and postoperative complications



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Male or female ≥ 18 years of age
  2. Women of childbearing potential (WOCBP) or men whose sexual partners are WOCBP; must be able and willing to use at least 1 highly effective method of contraception during the study and for 30 days after the last dose of study drug
  3. American Society of Anesthesiologists Physical Status Score of 1 to 3
  4. Scheduled for an elective BR via open or laparoscopic approach
  5. Ability to understand the study procedures, have agreed to participate in the study program, and have voluntarily provided informed consent

Exclusion Criteria:

  1. Scheduled for a BR that is not listed in this protocol
  2. Requires any additional resections beyond the intestine (eg, hepatectomy, distal pancreatectomy, pancreaticoduodenectomy, gastric resection, uterine resection), or concomitant surgeries (with the exception of biopsies)
  3. Requires the formation of a stoma (ileostomy or colostomy)
  4. History of surgeries, illness, or behavior (eg, depression, psychosis) that in the opinion of the investigator might confound the study results or pose additional risk in administering the study procedures
  5. Have a functional colostomy or ileostomy
  6. Diagnosed with advanced or metastatic colon cancer (Stage IV by tumor, node, and metastasis classification)
  7. Positive coronavirus disease 2019 (COVID-19) test
  8. Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection (including human immunodeficiency virus (HIV)), diabetes, symptomatic congestive heart failure and ejection fraction < 35%, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with protocol requirements
  9. Chronic pain syndrome unrelated to the planned surgery requiring consistent management with analgesics and/or other non-pharmacologic modalities
  10. Myocardial infarction within 3 months
  11. Corrected QT interval > 500 msec
  12. Diabetic gastroparesis
  13. Compromised immune system, either from treatment with corticosteroids or other immunosuppressive agent within 2 weeks of surgery or from immunosuppressive disease (HIV)
  14. Pregnant (identified by a positive serum pregnancy test) or lactating, or are not postmenopausal (no menses for at least 1 year) and are of childbearing potential and not using an accepted method of birth control (surgical sterilization, intrauterine contraceptive device, oral contraceptive, diaphragm, or condom in combination with contraceptive cream, jelly, or foam or abstinence)
  15. Participated in another investigational drug/biologic or medical device study within 30 days of surgery or will be enrolled in another investigational drug or medical device study, or any study in which active subject participation is required outside routine hospital data collection during the course of the study
  16. Illicit drug use or alcohol abuse based on medical history, or currently engaged in illicit drug use or alcohol abuse
  17. Uses of supplemental ginger, ginseng, or Zanthoxylum fruit within 72 hours before randomization
  18. Has a history of allergic reactions to ginseng, ginger, Zanthoxylum fruit, or lactose
  19. Has clinical symptoms of lactose intolerance after ingesting milk or milk-containing products (abdominal pain, flatulence, diarrhea)
  20. Unwilling or unable to comply with procedures described in this protocol or is otherwise unacceptable for enrollment in the opinion of the investigator
  21. Has a history of previous surgeries, illness (interstitial pneumonia), or behavior (depression, psychosis) that, in the opinion of the investigator, might confound the study results or pose additional risk in administering the study procedures

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 ClinicalTrials.gov identifier (NCT number): NCT04742907


Contacts
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Contact: Rebekah McLaughlin 919-341-3318 rebecca.mclaughlin@syneoshealth.com
Contact: Dana Kappel 919-745-2818 dana.kappel@syneoshealth.com

Locations
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Sponsors and Collaborators
Tsumura USA
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Responsible Party: Tsumura USA
ClinicalTrials.gov Identifier: NCT04742907    
Other Study ID Numbers: TU100P2T4
First Posted: February 8, 2021    Key Record Dates
Last Update Posted: March 9, 2023
Last Verified: March 2023

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