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Rifaximin Delayed Release for the Prevention of Recurrent Acute Diverticulitis and Diverticular Complications.

Phase 2
Terminated
Conditions
Diverticulitis
Interventions
Registration Number
NCT03469050
Lead Sponsor
Alfasigma S.p.A.
Brief Summary

Colonic microbiota changes may play a key role in the pathogenesis of acute diverticulitis. A previous proof-of-concept study suggests that rifaximin, a low-absorbable oral antibiotic, may be beneficial for prevention of acute diverticulitis recurrence by modulating the gut microflora.

The main objective of this study is to evaluate the safety and efficacy of two different doses of a delayed release formulation of rifaximin, versus placebo, for the prevention of recurrence of acute diverticulitis and diverticular complications in patients with a recent episode of acute diverticulitis.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
193
Inclusion Criteria
  • Men and women aged 18-80 years at screening.
  • Female participants must be either of non-childbearing potential or of childbearing potential with a negative pregnancy test result at screening and randomization AND agreeing to use a highly effective method of contraception.
  • A previous documented episode of diverticulitis between 30 and 180 days prior to screening.
  • Clinical remission from acute diverticulitis at screening

Key

Exclusion Criteria
  • History of two or more acute diverticulitis episodes or history of any diverticular complication.
  • Any documented current organic disease of the gastrointestinal tract other than diverticulosis
  • Laboratory signs of clinically significant acute inflammation or signs/symptoms of diverticular complications.
  • Diagnosis or history of inflammatory bowel disease (or other conditions associated with ulcerative lesions of the intestinal tract).
  • Patients with positive Clostridium difficile toxin stool assay.
  • Use of marketed rifaximin (or neomycin or other low-absorbable oral antibiotics) during or after the previous episode of acute diverticulitis.
  • Severe hepatic impairment
  • Severe kidney impairment
  • Any other current significant health condition that in the Investigator's judgement may: i) jeopardize the patient's safe participation in the trial or ii) make unlikely the patient's completion of the study or iii) make unlikely the patient's compliance with the study procedures.
  • History of hypersensitivity to rifaximin, rifamycin-derivatives or any of the rifaximin delayed release or placebo excipients.

NOTE: Other protocol defined Inclusion/Exclusion criteria apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Rifaximin delayed released 400 mg b.i.dRifaximin delayed released 400mg Tablet(i.e. 1x400 mg tablet plus 1 placebo tablet twice a day; total daily dose: 800 mg) for 10 consecutive days a month, for 12 months
Rifaximin delayed released 400 mg b.i.dPlacebo(i.e. 1x400 mg tablet plus 1 placebo tablet twice a day; total daily dose: 800 mg) for 10 consecutive days a month, for 12 months
Placebo b.i.d.Placebo(i.e. 2 x placebo tablets twice a day) for 10 consecutive days a month, for 12 months.
Rifaximin delayed released 800 mg b.i.d.Rifaximin delayed released 400mg Tablet(i.e. 2 x 400 mg tablet twice a day; total daily dose: 1600 mg) for 10 consecutive days a month, for 12 months
Primary Outcome Measures
NameTimeMethod
Rate of patients with recurrence of diverticulitis and/or diverticular complications over the 12-month treatment period.12-month treatment period
Secondary Outcome Measures
NameTimeMethod
Number of weeks in a year with bloating12-month treatment period
Change in bowel habits12-month treatment period

Evaluated by Bristol Stool Scale

Rate of any hospitalization for diverticulitis12-month treatment period
Rate of hospitalization for diverticulitis without surgery12-month treatment period
Rate of elective surgery for diverticulitis12-month treatment period
Rate of emergency surgery for diverticulitis12-month treatment period
Change in Quality of Life12-month treatment period

Evaluated by SF36 Quality of Life Questionnaire

Rate of patients with an acute episode of prolonged (≥24 hours) left-lower quadrant abdominal pain plus leukocytosis/elevation of CRP [Time Frame: 12-month treatment period]12-month treatment period
Time to diverticulitis recurrence or complication12-month treatment period
Rate of patients with diverticulitis-associated fever12-month treatment period
Left-lower quadrant abdominal pain intensity12-month treatment period
Left-lower quadrant abdominal pain duration12-month treatment period
Number of days in a year with left-lower quadrant abdominal pain12-month treatment period
Number of weeks in a year with episodes of prolonged (≥24 hours) left-lower quadrant abdominal pain12-month treatment period
Number of days in a year with any abdominal pain12-month treatment period

Trial Locations

Locations (64)

Hôpital Avicenne Service Gastro-entérologie

🇫🇷

Bobigny, France

Cabinet Médical

🇫🇷

Lille, France

Centre Hospitalier Regional Universitaire Claude Huriez Service de Chirurgie Digestive et Générale

🇫🇷

Lille, France

Hôpital Saint-Joseph Service Hépato-Gastroentérologie

🇫🇷

Marseille, France

CHU Nantes, Hôtel Dieu Clinique de Chirurgie digestive et endocrinienne (CCDE) Institut des maladies de l'Appareil Digestif (IMAD)

🇫🇷

Nantes, France

Hôpital Charles Nicolle - CHU Rouen Service Hépato-Gastroentérologie

🇫🇷

Rouen, France

Centre Hospitalier Universitaire (CHU) de Strasbourg Service de Chirurgie Digestive et Endocrinienne

🇫🇷

Strasbourg, France

Gemeinschaftspraxis - Praxis Überruhr

🇩🇪

Essen, Germany

Medamed GmbH Studienambulanz Leipzig

🇩🇪

Leipzig, Germany

MVZ Dres. Eisenbach, Simon, Schwarz

🇩🇪

Leverkusen, Germany

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Hôpital Avicenne Service Gastro-entérologie
🇫🇷Bobigny, France

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