Efficacy and Safety Study to Treat Subjects With Symptomatic Internal Hemorrhoids

NCT ID: NCT01355874

Last Updated: 2014-01-28

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

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

403 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-07-31

Study Completion Date

2012-06-30

Brief Summary

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Primary Objective:

To evaluate the effect of iferanserin ointment on cessation of bleeding when administered intra-anally twice daily (BID) for 7 or 14 days in subjects with symptomatic internal hemorrhoids.

Methodology:

Double-Blind: Phase 3, multicenter, double-blind, randomized, parallel group, placebo-controlled part of the study. Extension: Multicenter, open-label part of the study.

Study Treatment Duration:

Double-Blind: 28 days (14-day treatment period and a 14-day follow-up period). Extension: 12 months (open-label part of the study in which there will be a scheduled visit every three months. Subjects who have recurrence(s) of their symptomatic internal hemorrhoids will be treated with open-label iferanserin for 7 days followed by a 21-day follow-up period).

Criteria for Evaluation:

Primary Endpoint:

The primary endpoint is the cessation of bleeding by the end of Day 7 that persists for the remainder of the treatment period (through Day 14).

Detailed Description

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Primary Objective:

To evaluate the effect of iferanserin ointment on cessation of bleeding when administered intra-anally twice daily (BID) for 7 or 14 days in subjects with symptomatic internal hemorrhoids. Safety Secondary Objective To determine the safety of iferanserin ointment administered intra-anally BID for 7 or 14 days in subjects with symptomatic internal hemorrhoids.

Exploratory Objectives:

To evaluate the frequency of recurrence of bleeding in subjects with symptomatic internal hemorrhoids. To evaluate time to bleeding recurrence in subjects with symptomatic internal hemorrhoids. To evaluate efficacy of iferanserin ointment in the treatment of recurrence when administered intra-anally BID for 7 days in subjects with symptomatic internal hemorrhoids. To evaluate the parameters of the Symptom Satisfaction Questionnaire

Methodology:

Double-Blind: Phase 3, multicenter, double-blind, randomized, parallel group, placebo-controlled part of the study. Extension: Multicenter, open-label part of the study.

Criteria for Evaluation:

Primary Endpoint:

The primary endpoint is the cessation of bleeding by the end of Day 7 that persists for the remainder of the treatment period (through Day 14).

Secondary Endpoints:

Key Secondary Endpoints Cessation of itching by the end of Day 7 that persists for the remainder of the treatment period (through Day 14). Cessation of pain by the end of Day 7 that persists for the remainder of the treatment period (through Day 14). Safety Secondary Endpoints Adverse events (AEs). Serious Adverse events (SAEs). Physical examination. Hematology, serum chemistry, and urinalysis. Vital signs. Electrocardiogram.

Exploratory Endpoints:

Bleeding recurrence rate of symptomatic internal hemorrhoids. Time to bleeding recurrence of symptomatic internal hemorrhoids. Response to open-label iferanserin ointment in the treatment of recurrence of symptomatic internal hemorrhoids. Overall improvement score for the parameters of the Symptom Satisfaction Questionnaire.

Conditions

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Internal Hemorrhoids

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Iferanserin

Group Type EXPERIMENTAL

Iferanserin

Intervention Type DRUG

0.5% iferanserin ointment (containing 10 mg of iferanserin) BID for 14 days during double blind.

Placebo

Group Type EXPERIMENTAL

Placebo

Intervention Type DRUG

Placebo ointment BID for 14 days during double blind.

Iferanserin + Placebo

Group Type EXPERIMENTAL

Iferanserin + Placebo

Intervention Type DRUG

0.5% iferanserin ointment (containing 10 mg of iferanserin) BID for 7 days followed by placebo ointment BID for 7 days during the double blind.

Interventions

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Iferanserin

0.5% iferanserin ointment (containing 10 mg of iferanserin) BID for 14 days during double blind.

Intervention Type DRUG

Placebo

Placebo ointment BID for 14 days during double blind.

Intervention Type DRUG

Iferanserin + Placebo

0.5% iferanserin ointment (containing 10 mg of iferanserin) BID for 7 days followed by placebo ointment BID for 7 days during the double blind.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Males or non-pregnant females, aged ≥ 18 to ≤ 75 years.
2. Symptomatic internal hemorrhoids, Grades I-III by direct anoscopic visualization (anoscopic visualization not required if Grade determined by colonoscopy within 28 days prior to Day 1).
3. Bleeding from hemorrhoids for two consecutive days prior to randomization (Day 1).

4. Itching OR pain for two consecutive days prior to randomization (Day 1).
5. Able to attempt bowel movements daily (defined as trying to have a bowel movement while sitting on the toilet for at least a few minutes, at least once daily, whether or not you feel the need to have a bowel movement that day).
6. Body mass index of ≥ 18.5 to ≤ 36 kg/m2.
7. Female of non-childbearing potential, including any female who: a) has had a hysterectomy, b) has had a bilateral oophorectomy, c) has had a bilateral tubal ligation or d) is post menopausal (demonstration of total cessation of menses for ≥ 1 year from the date of the screening visit).
8. Females of child bearing potential who agree to use two forms of contraception, one of which must be a barrier method, during the full duration of the study.
9. Able to communicate adequately with the investigator and to comply with the requirements for the entire study.
10. Capable of using the IVRS and adequately communicate comprehension of IVRS questions to the investigator.
11. Capable of and freely willing to provide written informed consent prior to participating in the study.

Exclusion Criteria

1. Grade IV internal hemorrhoids.
2. Age ≥ 40 years, with no complete colon evaluation within three years.
3. Age \< 40 years, with no sigmoidoscopy or complete colon evaluation within three years.
4. Age \< 40 years, with any of the following and no complete colon evaluation within two years; or age ≥ 40 years, with any of the following and no complete colon evaluation within one year:

* History of adenomatous polyps.
* Family history of either colorectal cancer or colorectal adenomas diagnosed in a first-degree relative before age 60.
* Family history or genetic testing indicating the presence of one of two hereditary syndromes.
5. Malignancy within 5 years prior to Day 1(with the exception of treated basal cell/squamous cell carcinoma of the skin).
6. History of inflammatory bowel disease.
7. History of irritable bowel syndrome with constipation or diarrhea.
8. Previous surgical or instrumental treatment of internal hemorrhoids.
9. Clinical evidence or history of fecal incontinence.
10. Current thrombosed internal or external hemorrhoid(s).
11. Clinical evidence or history of anal fissure.
12. Clinical evidence or history of anal fistula.
13. AST/ALT \> 3x ULN.
14. Hemoglobin \< 10.0 g/dL.
15. Selective serotonin reuptake inhibitors within 28 days prior to Day 1.
16. Tamoxifen within 28 days prior to Day 1.
17. Laxatives (unless maintained on a stable dose of the medication for ≥ 60 days prior to Day 1).
18. Anticoagulants (e.g., coumadin, heparinoids, dabigatran) within 90 days prior to Day 1.
19. Anti-platelet agents or low dose aspirin (unless maintained on the medication for ≥ 90 days prior to Day 1).
20. Over the counter or prescription anti-hemorrhoid agents (including herbal supplements) within 14 days prior to Day 1.
21. Topical anesthetics within 14 days prior to Day 1.
22. Chronic use of analgesics (e.g., opioids, acetaminophen, aspirin, NSAIDS, cox-2 inhibitors, etc).
23. Any investigational agents within 28 days prior to Day 1 (with the exception of iferanserin for recurrence).
24. Anti-TNF agents within 6 months prior to Day 1.
25. Oral or parenteral steroids within 28 days prior to Day 1.
26. Use of anal, intra-anal, or intra-rectal steroids within 28 days prior to Day 1.
27. Expected to have a planned interventional and/or surgical procedure that requires hospitalization, colonoscopy, or sigmoidoscopy (colonoscopy or sigmoidoscopy during the screening period is acceptable).
28. Following concomitant disease state:

* Clinical evidence or history of significant cardiovascular disease including arrhythmias, clinically significant ECG abnormalities, myocardial infarction, stroke, congestive heart failure (greater than class II), and valve disease or abnormalities.
* Asthma currently requiring treatment (with the exception of infrequent use of rescue inhaler).
* Clinical evidence or history of chronic renal failure (greater than Stage III).
* Clinical evidence or history of gastric ulcer, duodenal ulcer, or pancreatitis.
* Clinical evidence or history of hematological disease.
* Clinical evidence or history of neurological disease.
* Acute infection currently requiring treatment.
* Clinical evidence or history of chronic infectious disease.
29. Major organ transplant.
30. Any disease or prior surgery that may interfere with the subject successfully completing the study.
31. History of any prior anal or rectal surgery (hemorrhoid banding with the 5 years of Day 1).
32. Psychosis, schizophrenia, mania, depressive disorders, history of suicide attempt or suicidal ideation, or any other psychiatric illness (with the exception of intermittent anxiety).
33. Known sensitivity to investigational product(s) or class of investigational product(s).
34. Drug or alcohol abuse within 12 months of Day 1.
35. Currently using narcotic(s) chronically.
36. Breast-feeding females.
37. Females on their menstrual cycle who cannot discern whether the bleeding is rectal bleeding or vaginal bleeding from menstruation.
38. Employees, family members, or students of the investigator or clinical site.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ventrus Biosciences, Inc

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Cleveland Clinic

Role: PRINCIPAL_INVESTIGATOR

Cleveland Clinic Weston, FL

Locations

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Digestive Health

Dothan, Alabama, United States

Site Status

Clinical Research Associates

Huntsville, Alabama, United States

Site Status

Comprehensive Health Services

Phoenix, Arizona, United States

Site Status

Adobe

Tucson, Arizona, United States

Site Status

Desert Sun Clin Res

Tucson, Arizona, United States

Site Status

AR Gastro

Sherwood, Arkansas, United States

Site Status

ACRI

Anaheim, California, United States

Site Status

Providence Clin Res

Burbank, California, United States

Site Status

Med Center

Carmichael, California, United States

Site Status

South Orange County Surgical Group

Laguna Hills, California, United States

Site Status

Torrence C. R.

Lomita, California, United States

Site Status

Premiere Clin Res

Long Beach, California, United States

Site Status

Facey Med Foundation

Mission Hills, California, United States

Site Status

Futura Research

Montebello, California, United States

Site Status

Community Clin Trials

Orange, California, United States

Site Status

Del Carmen Med Center

Reseda, California, United States

Site Status

MARG

San Diego, California, United States

Site Status

Med Center for Clinical Research

San Diego, California, United States

Site Status

Westlake Res

Westlake Village, California, United States

Site Status

Colorado Research

Salida, Colorado, United States

Site Status

Innovative

Clearwater, Florida, United States

Site Status

Avail Clin Res

DeLand, Florida, United States

Site Status

Eastern

Hilieah, Florida, United States

Site Status

Center for GI Disorders

Hollywood, Florida, United States

Site Status

Nature Coast Clin Res

Inverness, Florida, United States

Site Status

Jupiter Research

Jupiter, Florida, United States

Site Status

Aplusresearch

Miami, Florida, United States

Site Status

Kendall

Miami, Florida, United States

Site Status

MRA

Miami, Florida, United States

Site Status

Advanced Gastro Assoc

Palm Harbor, Florida, United States

Site Status

ICR

Sanford, Florida, United States

Site Status

Cleveland Clinic Florida

Weston, Florida, United States

Site Status

Southeast REgional Research Group

Columbus, Georgia, United States

Site Status

Tri County

Hartwell, Georgia, United States

Site Status

Southeast Regional Research Group

Savannah, Georgia, United States

Site Status

Pinnacle Med Inst

Overland, Kansas, United States

Site Status

Kentucy med Center

Lexington, Kentucky, United States

Site Status

Praetorian Pharmaceutical Res

Marrerro, Louisiana, United States

Site Status

Clinical Trials Mgmt

Metarie, Louisiana, United States

Site Status

Delta Research

Monroe, Louisiana, United States

Site Status

Women Under Study

New Orleans, Louisiana, United States

Site Status

Capital Digestive

Chevy Chase, Maryland, United States

Site Status

Meritus Center for Clin Res

Hagerstown, Maryland, United States

Site Status

Mid Atlantic Res Center

Hollywood, Maryland, United States

Site Status

Saginaw Med Res

Saginaw, Michigan, United States

Site Status

Gastro Assoc Western Michigan

Wyoming, Michigan, United States

Site Status

Gastrointestinal Associates

Jackson, Mississippi, United States

Site Status

Midwest Center for Clin Res

Lee's Summitt, Missouri, United States

Site Status

Center for Digestive & Liver Diseases

Mexico, Missouri, United States

Site Status

Clin Res Nevada

Las Vegas, Nevada, United States

Site Status

S. Jersey Gastro

Marlton, New Jersey, United States

Site Status

Long Island GI Group

Great Neck, New York, United States

Site Status

MRA NY

New York, New York, United States

Site Status

Ashville Gastro

Asheville, North Carolina, United States

Site Status

Carolinas Res Ass

Davidson, North Carolina, United States

Site Status

Vital

Greenboro, North Carolina, United States

Site Status

Carolinas Research

Harrisburg, North Carolina, United States

Site Status

Wake Res

Raleigh, North Carolina, United States

Site Status

Trial Management Associates

Wilmington, North Carolina, United States

Site Status

Hightop Med Res

Cincinnati, Ohio, United States

Site Status

Dayton Gastro

Dayton, Ohio, United States

Site Status

Great Lakes Gastro

Mentor, Ohio, United States

Site Status

Central Sooner

Norman, Oklahoma, United States

Site Status

Clinsearch

Chattanooga, Tennessee, United States

Site Status

Memphis Gastro

Germantown, Tennessee, United States

Site Status

Assoc of Gastro

Hermitage, Tennessee, United States

Site Status

Dial Research

Nashville, Tennessee, United States

Site Status

First Clinic

Nashville, Tennessee, United States

Site Status

Texas Health Research

Fort Worth, Texas, United States

Site Status

Amcare Research

Houston, Texas, United States

Site Status

Houston Gastro

Houston, Texas, United States

Site Status

Permian

Odessa, Texas, United States

Site Status

Pioneer Research

Sugarland, Texas, United States

Site Status

ARI

Ogden, Utah, United States

Site Status

ARI

Sandy City, Utah, United States

Site Status

New River Valley Res

Christianburg, Virginia, United States

Site Status

Blue Ridge Medical Center

Lyncburg, Virginia, United States

Site Status

Countries

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United States

Other Identifiers

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VEN 309-Hem-SE3-001

Identifier Type: -

Identifier Source: org_study_id

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