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Effects of EPA-FFA on polypectomy in familial adenomatous polyposis.

Phase 1
Conditions
Familial Adenomatous Polyposis (FAP)
MedDRA version: 20.1Level: LLTClassification code 10059327Term: Familial adenomatous polyposisSystem Organ Class: 100000004850
Therapeutic area: Diseases [C] - Digestive System Diseases [C06]
Registration Number
EUCTR2017-002809-34-DE
Lead Sponsor
SLA Pharma UK Ltd
Brief Summary

Not available

Detailed Description

Not available

Recruitment & Eligibility

Status
Authorised-recruitment may be ongoing or finished
Sex
All
Target Recruitment
204
Inclusion Criteria

1. Must give written informed consent
2. Male or female subjects, 18 to 65 years of age.
3. Known diagnosis of FAP defined as those with a pathogenic APC
mutation.
4. Patients have had a previous colectomy with an ileo-rectal
anastomosis or an ileal pouch- anal anastomosis with a rectal remnant of
= 2cm.
5. Classified stage 1-3 on InSiGHT Polyposis Staging System (IPSS).
6. Subjects must show a willingness to abstain from regular use of nonsteroidal anti-inflammatory medication for the trial. A cardio protective
dose of aspirin (75mg-100mg) will be permitted.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 204
F.1.3 Elderly (>=65 years) no
F.1.3.1 Number of subjects for this age range

Exclusion Criteria

1. Subjects with ileo-rectal anastomosis who have = 20 polyps which are
of >5mm that are not amendable to removal in the rectum.
2. Subjects unwilling to have regular sigmoidoscopy examination.
3. Subjects who are due to undergo gastro-intestinal surgery related to
FAP.
4. History of invasive carcinoma in the past 3 years.
5. History of pelvic radiation.
6. Known allergic reaction or intolerant to fish or fish oils.
7. Known allergic reaction to excipients of IMP and placebo.
8. Subjects who are pregnant or breast-feeding at screening.
9. Subjects taking aspirin, other than a low (75mg-100mg)
cardioprotective dose on a regular basis, or other non-steroidal antiinflammatory drugs (NSAIDs) on a regular basis. Regular use of other
NSAIDS is defined in this protocol as use greater than 14-day treatment
period, and one treatment per six months for the duration of the study.
10. Subjects taking NSAIDs regularly in the 3 months prior to entry
(other than low dose aspirin).
11. Subjects taking NSAID, 5-aminosalicylic acid (5-ASA or mesalamine).
12. Subjects who are taking other fish-oil supplements (e.g. cod liver oil)
who are unwilling to stop them for the duration of the study. Subjects
previously taking fish oil must have a washout period of 2 months prior
to study enrolment.
13. Subjects who are taking warfarin or other anticoagulants.
14. Experimental agents must have been discontinued at least 8 weeks
prior to screening or for a period equivalent to 5 half-lives of the agent
(whichever is longer).
15. Subjects suffering from known disorders of clotting and blood
coagulation
16. Subjects who have significant abnormalities on their screening blood
tests.
17. Subjects with gastrointestinal malabsorptive disease.
18. Subjects with uncontrolled hypercholesterolaemia.
19. Subjects who are deemed mentally incompetent or have a history of
anorexia nervosa or bulimia.
20. Subjects who will be unavailable for the duration of the trial, deemed
unable to comply with the requirements of the study protocol, likely to
be noncompliant with the protocol, or who are felt to be unsuitable by
the Investigator for any other reason.
21. Women of childbearing potential, defined as all women
physiologically capable of becoming pregnant (unless surgically sterile),
must use effective contraception (either combined estrogen and
progestogen containing hormonal contraception associated with
inhibition of ovulation [oral, intravaginal, transdermal], progestogen
only hormonal contraception associated with inhibition of ovulation
[oral, injectable, implantable], intrauterine device [IUD], intrauterine
hormone-releasing system [IUS], vasectomised partner, sexual
abstinence (only considered an acceptable method of contraception
when it is in line with the subject's usual and preferred lifestyle),
combination of male condom with either cap, diaphragm or sponge with
spermicide [double barrier methods]), and be willing to continue
contraception for 1 month after the last administration of IMP.
22. Women using oral contraception must have started using it at least 2
months prior to screening. Women are not considered to be of
childbearing potential if they have had 12 months of natural
(spontaneous) amenorrhea with an appropriate clinical profile (e.g. age
appropriate, history of vasomotor symptoms) or six months of
spontaneous amenorrhea with serum FSH levels that have been
confirmed to be in the postmenopausal range. Or have had a surgical
bilateral oophorectomy (with o

Study & Design

Study Type
Interventional clinical trial of medicinal product
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Main Objective: To determine the efficacy of EPA-FFA gastro-resistant capsules in patients with FAP in reducing polypectomy.;Secondary Objective: • Evaluate the clinical disease progression.<br>• Evaluate the long-term safety and tolerability of EPA-FFA.;Primary end point(s): Total number of polypectomies (polyps > 5mm in the rectum) conducted during the 24 months study period.;Timepoint(s) of evaluation of this end point: Study end.
Secondary Outcome Measures
NameTimeMethod
Secondary end point(s): •Change in polyp number at 24 months assessed by blinded review of video records. <br>•Change in score on the InSiGHT Polyposis Staging System (IPSS) at 24 months.<br>•Number of subjects requiring surgical intervention (not including polypectomies).<br>•Total number of polypectomies (polyps > 5mm in the rectum) conducted at 6 months, 12 months, 18 months.<br>•Change in polyp number at 6 months, 12 months, 18 months assessed by blinded review of video records. <br>•Change in score on the InSiGHT Polyposis Staging System (IPSS) at 6 months, 12 months, 18 months.<br>•Time to surgical intervention (not including polypectomies).<br>•Change in score on the Spigelman Classification of Duodenal Polyposis at 24 months.<br>•Patient’s Global Impression of Improvement (PGI-I) at Months 6, 12, 18 and 24.<br>;Timepoint(s) of evaluation of this end point: 6, 12, 18 and 24 months.
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