CAPTURE: Clotrimazole Enemas for Pouchitis in Children and Adults

Sponsor

Paul Rufo (Other)

Overall Status

Terminated

CT.gov ID

NCT00061282

Collaborator

(none)

Enrollment

Location

Arms

218.1

Actual Duration (Months)

0.1

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Colectomy with creation of an ileal pouch (IPAA) is now the treatment of choice for patients with ulcerative colitis that is resistant to existing medical therapies. The development of inflammation in these ileal reservoirs, a clinical entity referred to as pouchitis, is the most common long-term complication of this procedure and can affect 50-60% of adults and children. We have previously demonstrated that clotrimazole (delivered as a rectal suppository) is generally safe, effective, and displays poor systemic absorption when used in pediatric and adults with active pouchitis. We saw clinical benefit in patients with pouch disease that had previously failed to respond to standard antibiotic, steroid, or immunosuppressive therapies. The clinical trial outlined here will define the effectiveness and safety of topical clotrimazole therapy (delivered as a rectal enema) in pediatric (aged greater than two years) and adult patients with pouchitis.

Subjects in this study will be randomly assigned to receive either placebo (no active drug, 4 subjects) or one of two clotrimazole therapy groups: 2500 mg/day (8 subjects) or 4000mg/day (8 subjects). No washout period is required, and subjects will be allowed to continue their existing anti-inflammatory medications during their participation in the study. Clotrimazole will be delivered nightly in the form of an enema. Subjects will undergo flexible sigmoidoscopy (pouchoscopy) prior to and again after completing one month of study therapy, and pouch disease activity will be graded at after each procedure using the Pouchitis Disease Activity Index (PDAI). Clinical improvement will be defined as a drop in PDAI score. If the drop in PDAI scores between placebo and either active clotrimazole treatment group is not significant, and no subject experiences what are determined to be study-related adverse effects, a second cohort of subjects will be recruited and studied after receiving one month of either placebo (4 subjects), 6000 mg/day clotrimazole (8 subjects), or 7500mg/day clotrimazole (8 subjects).

Subjects will be assessed for adverse effects at the midpoint of the study. Clotrimazole blood levels will be measured during the first and last day of study participation. In addition, adults will complete a health related quality of life assessment at baseline and after completing study drug therapy.

All subjects will be eligible for one month of open-label study drug therapy after completing one month of study drug therapy.

Condition or Disease	Intervention/Treatment	Phase
Ulcerative Colitis Pouchitis Ileitis Inflammatory Bowel Disease	Drug: Clotrimazole	Phase 1/Phase 2

Study Design

Study Type:

Interventional

Anticipated Enrollment :

18 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

Triple (Participant, Care Provider, Investigator)

Primary Purpose:

Treatment

Official Title:

Clotrimazole Enemas for Pouchitis in Children and Adults

Actual Study Start Date :

Sep 30, 2002

Actual Primary Completion Date :

Dec 1, 2020

Actual Study Completion Date :

Dec 1, 2020

Arms and Interventions

Arm	Intervention/Treatment
Placebo Comparator: 1	Drug: Clotrimazole One retention enema, administered nightly
Active Comparator: 2 Clotrimazole Therapy	Drug: Clotrimazole One retention enema, administered nightly
Active Comparator: 3 Clotrimazole Therapy	Drug: Clotrimazole One retention enema, administered nightly

Arm

Intervention/Treatment

Placebo Comparator: 1

Drug: Clotrimazole

One retention enema, administered nightly

Active Comparator: 2

Clotrimazole Therapy

Drug: Clotrimazole

One retention enema, administered nightly

Active Comparator: 3

Clotrimazole Therapy

Drug: Clotrimazole