Tepilta® Versus Oxetacaine, Antacids and Placebo

Brief Summary

Official Title: “Clinical Trial to Assess the Efficacy of Fixed Combination Product Tepilta® in the Treatment of Radiation-induced Oesophagitis Compared to Its Active Ingredients Oxetacaine and Antacids, and to Placebo”

This is a randomised, double-blind, placebo-controlled, therapeutic confirmatory multicentre trial with 4 parallel treatment groups. The design is adaptive group-sequential with two interim analyses, possible sample size re-estimation after the first or second interim analysis and drop-the-loser approach. The study design was primarily chosen to show superior efficacy of Tepilta® compared to the single components and to placebo. Evaluation of safety is a secondary objective.

  • Study Type: Interventional
  • Study Design: Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
  • Study Primary Completion Date: September 2016

Detailed Clinical Trial Description

Tepilta® Suspension is indicated for treatment of pain in the upper digestive system induced by radiation therapy, in particular for radiation-induced oesophagitis.

Interventions Used in this Clinical Trial

  • Drug: oxetacaine, aluminium and magnesium hydroxide
    • 20mg/10ml oxetacaine, 196mg/10ml magnesium hydroxide, 582mg/10ml aluminium hydroxide. Suspension for oral intake 3-6 times per day for a maximum of 11 weeks.
  • Drug: oxetacaine
    • 20mg/10ml oxetacaine. Suspension for oral intake 3-6 times per day for a maximum of 11 weeks.
  • Drug: magnesium and aluminium hydroxide
    • 196mg/10ml magnesium hydroxide, 582mg/10ml aluminium hydroxide. Suspension for oral intake 3-6 times per day for a maximum of 11 weeks.
  • Other: Vehicle
    • Placebo suspension for oral intake 3-6 times per day for a maximum of 11 weeks.

Arms, Groups and Cohorts in this Clinical Trial

  • Experimental: Tepilta®
  • Active Comparator: Oxetacaine
  • Active Comparator: Antacids
  • Placebo Comparator: Placebo

Outcome Measures for this Clinical Trial

Primary Measures

  • Time from randomisation to requirement of additional systemic pain medication for oesophagitis (ASPO).
    • Time Frame: up to 11 weeks
      Safety Issue?: No

Secondary Measures

  • ASPO: WHO analgesic pain ladder
    • Time Frame: up to 11 weeks
      Safety Issue?: No
  • Pain intensity recorded on NRS with scores 0-10
    • Time Frame: up to 11 weeks
      Safety Issue?: No
  • Swallowing disorder recorded on NRS with scores 0-10
    • Time Frame: up to 11 weeks
      Safety Issue?: No
  • Adapted CTCAE grade
    • Time Frame: up to 11 weeks
      Safety Issue?: No
  • Incidence of artificial nutrition due to radiation-induced oesophagitis
    • Time Frame: up to 11 weeks
      Safety Issue?: No
  • Incidence of interruptions of radiation therapy due to radiation-induced oesophagitis
    • Time Frame: up to 11 weeks
      Safety Issue?: No
  • Duration of pain medication intake after the end of Radiation Therapy
    • Time Frame: up to 11 weeks
      Safety Issue?: No
  • Loss of body weight
    • Time Frame: up to 11 weeks
      Safety Issue?: No

Criteria for Participation in this Clinical Trial

Inclusion Criteria

1. Male or female ≥ 18 years.

2. Score = 0 on NRS for oesophageal pain.

3. Radiotherapy (RT) or combined radio-chemotherapy (RCT) of a solid tumour in head/neck/thorax region. A minimum length of 5 cm of the oesophagus must be included in high-dose radiation field.

4. Duration of RT 5 to 8 weeks.

5. Single radiation dosage of fractionated RT 1.8 to 2.0 Gy/day, of intensity-modulated RT (IMRT) 1.5 to 2.3 Gy/day, each for 5 days a week (single frequency deviations are allowed presuming that intended duration of RT remains 5 to 8 weeks).

6. First radiation in the intended radiation area.

7. Written informed consent.

Randomisation criteria:

8. Appearance of oesophageal pain as follows: Score ≥ 2 on Numeric Rating Scale (NRS) for pain during main daily meals is reached at least once.

9. At least 20 Gy of the dose of radiation therapy in oesophageal area remaining.

10. Oesophageal symptoms of grade ≤ 2a according to the adapted Common Terminology Criteria for Adverse Events CTCAE.

Exclusion Criteria

1. History of allergic reaction to the study medication or its excipients (i.e. aluminium or magnesium hydroxide, oxetacaine, any other ingredient of study medication).

2. Pregnancy, breast-feeding or planned pregnancy during the study.

3. Known hypermagnesaemia.

4. Known hypophosphataemia.

5. Clinically significant obstipation, as judged by the investigator.

6. Acute appendicitis.

7. Total intended radiation dose at lips and the anterior oral cavity > 60% of total intended radiation dose at the swallowing process (pharynx, oesophagus).

8. Hyper-fractionated RT.

9. Intended naso-gastral tubes.

10. Primary tumour of the cranial base, brain, oral cavity, lips, naso-pharynx, para-nasal sinuses.

11. Known bone metastases.

12. Reflux oesophagitis 3 months prior to the study.

13. Continuous systemic pain treatment at the beginning of RT. Systemic pain medication for oesophagitis prior to randomisation must not be taken.

14. Concomitant treatment with gastric acid inhibitors (such as H2-receptor-blockers, proton inhibitors, bismuth salts or antacids other than those used as study medication), tetracyclines, cinolone derivatives (ciprofloxacin, ofloxacin, enoxacin, norfloxacin), cheno-desoxycholic acid, sodium fluoride, local anaesthetics (other than those used as study medication).

15. Patients relying on levothyroxine after resection of thyroid carcinoma being hypothyroid and patients relying on levothyroxine due to other reasons not being euthyroid.

16. Artificial nutrition at the beginning of radiation.

17. Drug (licit and illicit) or alcohol abuse which would interfere with the patient's proper completion of the study.

18. Exposure to an investigational product within the last 4 weeks, simultaneous exposure to another investigational product.

19. Lack of ability or willingness to give informed consent.

20. Anticipated non-availability for study visits / procedures.

21. Lack of ability or willingness to keep patient's diary.

22. Lack of willingness to have personal study related data collected, archived or transmitted according to the protocol.

23. Vulnerable subjects.

Gender Eligibility for this Clinical Trial: Both

Minimum Age for this Clinical Trial: 18 Years

Maximum Age for this Clinical Trial: N/A

Are Healthy Volunteers Accepted for this Clinical Trial: No

Clinical Trial Investigator Information

  • Lead Sponsor
    • MEDA Pharma GmbH & Co. KG
  • Collaborator
    • Trium Analysis Online GmbH
  • Provider of Information About this Clinical Study
    • Sponsor
  • Overall Official(s)
    • Frank Bruns, Dr. med., Principal Investigator, Hannover Medical School
    • Ursula Petzold, PhD, Study Chair, MEDA Pharma GmbH & Co. KG
  • Overall Contact(s)
    • Ingrid Schwienhorst, Dr., +49 6172 888, ingrid.schwienhorst@medapharma.de

Source

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The URL of this page is:
http://clinicaltrialsfeeds.org/clinical-trials/show/NCT01336530