Effect of 2 Doses of EPA on Apoptosis and Cell Proliferation on Colon Mucosa

NCT ID: NCT00432913

Last Updated: 2008-10-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2/PHASE3

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-10-31

Study Completion Date

2008-06-30

Brief Summary

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The purpose of this study is to determine the effect of two doses purified EPA (an omega-3 fatty acid), on apoptosis (natural cell death) and cell proliferation (formation of new cells) in the lining of the colon for patients with a history of colonic polyps.

Detailed Description

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Colorectal cancer is generally accepted to develop from changes within colonic adenomatous polyps. More than 90% of new large bowel cancers arise sporadically. The molecular events leading to the development of colorectal cancer from polyps are characterised by an imbalance in cell proliferation (formation of new cells) and apoptosis (natural cell death) from changes in the genes involved in normal colon cells.

Recent work at St George's Hospital Medical School, London, has shown significant beneficial effects on cell proliferation and apoptosis rates in the lining of the colon in subjects with a history of colonic adenomas using a highly purified, free-fatty acid form of eicosapentaenoic acid (EPA).

Comparator(s): 2g EPA per day for 6 months and 1g EPA per day for 6 months will be compared against placebo for 6 months.

Conditions

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Adenomatous Polyps

Keywords

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Eicosapentaenoic acid EPA EPA 99% Fatty acid omega-3 apoptosis cell proliferation colonic mucosa polyps adenomatous polyps endoscopy PUFA

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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1g EPA per day

Group Type ACTIVE_COMPARATOR

Eicosapentaenoic Acid (EPA)

Intervention Type DRUG

Either 2 x 500mg EPA capsules in the morning and evening (2g per day EPA) or 1 x 500mg EPA and 1 x placebo in the morning and evening (1g per day EPA)

Endoscopy

Intervention Type PROCEDURE

At baseline, month 3 and month 6.

Biopsies taken

Intervention Type PROCEDURE

9 biopsies taken for measurement of apoptosis (3 biopsies), cell proliferation (3 biopsies) and fatty acid levels (3 biopsies) at baseline, month 3 and month 6.

Clinical chemistry

Intervention Type PROCEDURE

Full blood count at baseline, month 3 and month 6.

Haematology

Intervention Type PROCEDURE

Urea and electrolytes, liver function tests, clotting profile and CRP at baseline, month 3 and month 6.

Physical examination

Intervention Type PROCEDURE

Including cardio-respiratory and abdominal examination at baseline, month 3 and month 6.

Vital signs

Intervention Type PROCEDURE

Height, weight, heart rate, blood pressure and temperature at baseline, month 3 and month 6.

Urine pregnancy test

Intervention Type PROCEDURE

For subjects of child-bearing potential, urine pregnancy test at baseline, month 3 and month 6.

Completion of patient diary card

Intervention Type PROCEDURE

Subjects are requested to complete when study medication is taken and in any new or unusual symptoms are experienced on a daily basis for 6 months.

2g EPA per day

Group Type ACTIVE_COMPARATOR

Eicosapentaenoic Acid (EPA)

Intervention Type DRUG

Either 2 x 500mg EPA capsules in the morning and evening (2g per day EPA) or 1 x 500mg EPA and 1 x placebo in the morning and evening (1g per day EPA)

Endoscopy

Intervention Type PROCEDURE

At baseline, month 3 and month 6.

Biopsies taken

Intervention Type PROCEDURE

9 biopsies taken for measurement of apoptosis (3 biopsies), cell proliferation (3 biopsies) and fatty acid levels (3 biopsies) at baseline, month 3 and month 6.

Clinical chemistry

Intervention Type PROCEDURE

Full blood count at baseline, month 3 and month 6.

Haematology

Intervention Type PROCEDURE

Urea and electrolytes, liver function tests, clotting profile and CRP at baseline, month 3 and month 6.

Physical examination

Intervention Type PROCEDURE

Including cardio-respiratory and abdominal examination at baseline, month 3 and month 6.

Vital signs

Intervention Type PROCEDURE

Height, weight, heart rate, blood pressure and temperature at baseline, month 3 and month 6.

Urine pregnancy test

Intervention Type PROCEDURE

For subjects of child-bearing potential, urine pregnancy test at baseline, month 3 and month 6.

Completion of patient diary card

Intervention Type PROCEDURE

Subjects are requested to complete when study medication is taken and in any new or unusual symptoms are experienced on a daily basis for 6 months.

Placebo

Group Type PLACEBO_COMPARATOR

Endoscopy

Intervention Type PROCEDURE

At baseline, month 3 and month 6.

Biopsies taken

Intervention Type PROCEDURE

9 biopsies taken for measurement of apoptosis (3 biopsies), cell proliferation (3 biopsies) and fatty acid levels (3 biopsies) at baseline, month 3 and month 6.

Clinical chemistry

Intervention Type PROCEDURE

Full blood count at baseline, month 3 and month 6.

Haematology

Intervention Type PROCEDURE

Urea and electrolytes, liver function tests, clotting profile and CRP at baseline, month 3 and month 6.

Physical examination

Intervention Type PROCEDURE

Including cardio-respiratory and abdominal examination at baseline, month 3 and month 6.

Vital signs

Intervention Type PROCEDURE

Height, weight, heart rate, blood pressure and temperature at baseline, month 3 and month 6.

Urine pregnancy test

Intervention Type PROCEDURE

For subjects of child-bearing potential, urine pregnancy test at baseline, month 3 and month 6.

Completion of patient diary card

Intervention Type PROCEDURE

Subjects are requested to complete when study medication is taken and in any new or unusual symptoms are experienced on a daily basis for 6 months.

Interventions

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Eicosapentaenoic Acid (EPA)

Either 2 x 500mg EPA capsules in the morning and evening (2g per day EPA) or 1 x 500mg EPA and 1 x placebo in the morning and evening (1g per day EPA)

Intervention Type DRUG

Endoscopy

At baseline, month 3 and month 6.

Intervention Type PROCEDURE

Biopsies taken

9 biopsies taken for measurement of apoptosis (3 biopsies), cell proliferation (3 biopsies) and fatty acid levels (3 biopsies) at baseline, month 3 and month 6.

Intervention Type PROCEDURE

Clinical chemistry

Full blood count at baseline, month 3 and month 6.

Intervention Type PROCEDURE

Haematology

Urea and electrolytes, liver function tests, clotting profile and CRP at baseline, month 3 and month 6.

Intervention Type PROCEDURE

Physical examination

Including cardio-respiratory and abdominal examination at baseline, month 3 and month 6.

Intervention Type PROCEDURE

Vital signs

Height, weight, heart rate, blood pressure and temperature at baseline, month 3 and month 6.

Intervention Type PROCEDURE

Urine pregnancy test

For subjects of child-bearing potential, urine pregnancy test at baseline, month 3 and month 6.

Intervention Type PROCEDURE

Completion of patient diary card

Subjects are requested to complete when study medication is taken and in any new or unusual symptoms are experienced on a daily basis for 6 months.

Intervention Type PROCEDURE

Other Intervention Names

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ALFA Colonoscopy Flexible sigmoidoscopy

Eligibility Criteria

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Inclusion Criteria

* Males or females aged over 18
* Patients of child-bearing potential must demonstrate a negative pregnancy test at screening, and should use a reliable form of contraception during the trial and for 1 month afterwards, e.g:
* Oral contraceptive + condom
* Intra-uterine device (IUD)+ condom
* Diaphragm with spermicide + condom
* Male partners of women of child bearing potential should use a reliable form of contraception during the trial and for 1 month afterwards, e.g:
* Oral contraceptive + condom
* Intra-uterine device (IUD)+ condom
* Diaphragm with spermicide + condom
* Patients must have a known history of colorectal adenomata and be under clinical follow-up for these, or be found to have one or more of these at the time of colonoscopy
* Patients must have provided written informed consent to participate

Exclusion Criteria

* Patients who are allergic to fish
* Patients who have diabetes mellitus
* Patients who are pregnant or breast-feeding
* Patients taking aspirin or other non-steroidal anti-inflammatory drugs on a regular basis
* Patients who have aspirin-sensitive asthma
* Patients suffering from haemorrhagic disorders
* Patients who are taking warfarin or other anticoagulants
* Patients who have significant abnormalities on their screening blood tests
* Patients taking lipid lowering medication
* Patients with known inflammatory bowel disease (IBD), or previously unknown IBD until discovered at the time of their colonoscopy
* Patients with gastrointestinal malabsorptive disease
* Patients belonging to a known polyposis syndrome (e.g. FAP, HNPCC)
* Patients with a previous colonic resection for colorectal cancer
* Patients who are taking other fish-oil supplements (e.g. cod liver oil) who are unwilling to stop them for the duration of the study
* Patients who are deemed mentally incompetent, or have a history of anorexia nervosa or bulimia
* Patients with a history of alcohol or drug abuse, including laxative abuse
* Patients considered by their physician unlikely to be able to comply with the protocol.
* Patients who have taken part in an experimental drug study in the preceding 2 months.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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S.L.A. Pharma AG

INDUSTRY

Sponsor Role lead

Principal Investigators

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Nicholas J West, MB BS FRCS

Role: PRINCIPAL_INVESTIGATOR

St. George's Hospital Medical School, London

Locations

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S. Orsola Hospital

Bologna, , Italy

Site Status

St. George's Hospital Medical School

London, , United Kingdom

Site Status

Countries

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Italy United Kingdom

Other Identifiers

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EPA/POL/02

Identifier Type: -

Identifier Source: org_study_id