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A Study to Evaluate LB1148 for Return of Gastrointestinal Function and Adhesions in Subjects Undergoing Bowel Resection

Phase 2
Completed
Conditions
Post-Operative Adhesions
Ileus
Interventions
Drug: Placebo
Registration Number
NCT02836470
Lead Sponsor
Palisade Bio
Brief Summary

The purpose of this study is to establish preliminary evidence of the efficacy, safety, and tolerability of LB1148 for the treatment of post-operative ileus and intra-abdominal adhesions in subjects undergoing elective bowel resection.

Detailed Description

This will be a multicenter, randomized, double-blind, parallel, placebo-controlled, proof-of-concept, adaptive design, Phase 2 study to evaluate LB1148 for return of gastrointestinal function and reduction of post-operative ileus and intra-abdominal adhesions in subjects undergoing elective bowel resection surgery with or without a planned stoma.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
112
Inclusion Criteria

Subjects will be eligible for participation in the study only if they meet ALL of the following inclusion criteria:

  1. Scheduled to undergo an elective (non-emergent) bowel resection with a planned stoma via laparotomy or minimally invasive technique. This includes any subject in which a resection of the small intestine, colon, or rectum is performed for any elected indication.
  2. Planned stoma takedown or other planned abdominal surgery within 8 months of the initial surgery.
  3. Willing to perform and comply with all study procedures including attending clinic visit as scheduled and completion of a second surgery for stoma takedown or other abdominal surgery and to determine the presence of intra-abdominal adhesions.
  4. Has been informed of the nature of the study (either the subject or their legal representative), agrees to its provisions, and has provided written informed consent.
Exclusion Criteria

Subjects will not be eligible for participation in the study if they meet ANY of the following exclusion criteria:

  1. <18 or >80 years of age.

  2. Requires emergency bowel surgery.

  3. Has had 1 or more abdominal surgeries, excluding the current, for inflammatory bowel disease, including, but not limited to, inflammatory bowel disease (IBD), Crohn's Disease, or ulcerative colitis.

    Note: This does not apply to previous surgery such as hernia repair unrelated to IBD.

  4. American Society of Anesthesiologists (ASA) Class 4 or 5.

  5. Known inability to take the study drug orally (i.e. complete small bowel obstruction).

  6. Has contraindications or potential risk factors to taking TXA. These include subjects with:

    1. Known sensitivity to TXA;
    2. Recent craniotomy (past 30 days);
    3. Active cerebrovascular bleed;
    4. Active thromboembolic disease (such as deep vein thrombosis, pulmonary embolism, cerebral thrombosis, ischemic stroke, or acute coronary syndrome);
    5. Acute promyelocytic leukemia taking all-trans retinoic acid for remission induction, or
    6. Continuing use of a combined hormonal contraceptive and or combined hormonal replacement therapy (including combined hormonal pill, patch, or vaginal ring).
  7. Has peritoneal carcinomatosis

  8. History of or current seizure disorder.

  9. Patients with myeloproliferative disorders.

  10. Any other condition that, in the opinion of the Investigator, would preclude the subject from being an appropriate candidate for the study, including severe renal or hepatic impairment.

  11. Planned treatment with alvimopan (Entereg®) during study participation period.

  12. Planned use of 4% icodextrin (Adept®) or SEPRAFILM during the first surgery.

  13. Received any other investigational therapy within 4 weeks prior to Randomization

  14. Female subjects of childbearing potential with a positive urine or serum pregnancy test or who are not taking (or not willing to take) acceptable birth control measures (abstinence, intrauterine devices, contraceptive implants or barrier methods) through Day 30. Additionally, those women who are lactating and insist on breast feeding within 5 days of the last dose of study drug.

  15. Known history of radiation enteritis.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboPlacebo
LB1148LB1148Active
Primary Outcome Measures
NameTimeMethod
Change From Baseline in Extent and Severity of Intra-abdominal Adhesions Among Subjects Treated With LB1148 or Placeboup to 8 months from the index surgery

Extent and severity of intra-abd. adhesions will be determined by the surgeon using the "Intra-Abdominal Adhesion Extent and Severity Assessment Worksheet" with a min. value of zero (0) (better) and a max. value of one hundred and eight (108) (worse). And which records four (4) Sub scores for nine (9) abd. regions which are all summed to make the Total Extent and severity score. Sub scores include: 1) Abd. Wall to Bowel Extent Score (0-3); 2) Abd. Wall to Bowl Severity Score (0-3); Bowel to Bowel (or Viscera) Extent Score (0-3); Bowel to Bowel (or Viscera) Severity Score (0-3); The nine (9) Abd. Regions include: Right upper; Epigastrium; Left upper; Left flank; Left lower; Pelvis; Right lower; Right flank; and Central. Each Sub score is scored with a min. value of zero (0) (better) and a max. value of three (3) (worse); 0=no adhesion; 1=min. (\<1/3 of the site is covered); 2=mod. (1/3 to 2/3 of the site is covered); 3=extensive (\>2/3 of the site is covered).

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (28)

Site 305

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Miami, Florida, United States

Site 311

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Houston, Texas, United States

Site 319

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Houston, Texas, United States

Site 321

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Baltimore, Maryland, United States

Site 331

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Miami, Florida, United States

Site 302

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Sylmar, California, United States

Site 315

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Mobile, Alabama, United States

Site 312

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Torrance, California, United States

Site 303

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Miami, Florida, United States

Site 324

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Burlington, Massachusetts, United States

Site 323

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New York, New York, United States

Site 329

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Irvine, California, United States

Sie 309

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Houston, Texas, United States

Site 310

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Pasadena, California, United States

Site 301

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Cleveland, Ohio, United States

Site 317

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New York, New York, United States

Site 320

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Dallas, Texas, United States

Site 325

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Rochester, Minnesota, United States

Site 322

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Pittsburgh, Pennsylvania, United States

Site 316

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Fort Worth, Texas, United States

Site 326

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Salt Lake City, Utah, United States

Site 306

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Clearwater, Florida, United States

Site 330

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Wynnewood, Pennsylvania, United States

Site 307

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Yuma, Arizona, United States

Site 308

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Orlando, Florida, United States

Site 328

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Louisville, Kentucky, United States

Site 318

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Chapel Hill, North Carolina, United States

Site 327

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Charleston, South Carolina, United States

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