SPH3127 for Ulcerative Colitis

No longer recruiting at 15 trial locations

Overseen By Dinah Jaunakais, MEd

Age: 18+

Sex: Any

Trial Phase: Phase 2

Sponsor: Shanghai Pharma Biotherapeutics USA Inc.

Must not be taking: Steroids, Immunosuppressants, Antihypertensives, others

Disqualifiers: Severe UC, Colectomy, Liver impairment, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Prior Safety Data This treatment has passed at least one previous human trial

Compensation: Varies

Number of Visits: 1

Duration: 8 weeks

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a new drug, SPH3127, to determine its safety and effectiveness for people with mild-to-moderate ulcerative colitis, a condition where the colon becomes inflamed. Researchers compare different doses of SPH3127 against a placebo to gather information on its effects. Participants will take either the drug or a placebo (a pill with no active ingredient) for eight weeks, with an option to continue treatment for up to 10 more months. This trial may suit individuals diagnosed with mild-to-moderate ulcerative colitis, experiencing symptoms like rectal bleeding, and not recently treated with certain medications. As a Phase 2 trial, the research focuses on measuring the treatment's effectiveness in an initial, smaller group of people.

Will I have to stop taking my current medications?

Yes, you may need to stop taking certain medications before joining the trial. Specifically, you cannot take oral mesalamine over 2.4 g/day, systemic or rectal steroids, certain immunomodulators, antibiotics, anti-diarrheals, and some blood pressure medications within a few weeks before starting the trial. Please consult with the trial team for specific guidance on your medications.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that SPH3127 underwent testing in earlier studies. One study found that SPH3127 successfully prevented colitis, a type of gut inflammation, in mice. This suggests potential safety for humans, but further research is necessary to confirm this. Another study on a similar treatment, IBD98-M, found that it was well-tolerated by patients.

The treatment is currently in the second phase of testing, indicating it has already passed initial safety tests in humans. This phase focuses on determining the right dose and further assessing its safety. Available information suggests SPH3127 could be safe, but it remains under careful evaluation. ^{1 2 3 4 5}

Why are researchers excited about this trial's treatment for ulcerative colitis?

Researchers are excited about SPH3127 for ulcerative colitis because it offers a potentially novel approach compared to standard treatments like mesalamine, corticosteroids, and immunosuppressants. Unlike these traditional options, SPH3127 may work by targeting specific pathways involved in inflammation with a focus on a unique mechanism of action not widely used in current therapies. Moreover, the treatment's flexible dosing options, including the possibility of a lower 50 mg dose, could allow for tailored treatment plans with fewer side effects. This new approach could provide better management of the condition and improve the quality of life for those affected.

What evidence suggests that SPH3127 might be an effective treatment for ulcerative colitis?

Research has shown that SPH3127 might help treat mild-to-moderate ulcerative colitis. In animal studies, SPH3127 prevented colitis from developing, suggesting it could work in humans as well. SPH3127 blocks renin, an enzyme that can cause inflammation in the gut. In this trial, participants will receive either SPH3127 at different dosages or a placebo. Although more studies with people are needed, early results are promising for this treatment. ^{1 3 4 5 6}

Who Is on the Research Team?

Kenneth W. Locke, PhD

Principal Investigator

Shanghai Pharma Biotherapeutics USA Inc.

Are You a Good Fit for This Trial?

Adults aged 18-70 with mild-to-moderate ulcerative colitis extending at least 15 cm from the anal verge, who are not pregnant or abusing drugs/alcohol, and agree to use birth control. Excluded are those with certain infections, organ dysfunction, recent blood donations/transfusions, other trial participation within 30 days or specific medication use prior to the study.

Inclusion Criteria

I am a man and will use birth control with my partner who can have children.

I am not pregnant and agree to use birth control during the study.

Rectal bleeding subscore ≥ 1

Exclusion Criteria

Clinically relevant abnormalities detected on vital signs

I have not taken certain medications recently.

Positive stool sample for enteric pathogens

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive daily oral administration of SPH3127 or placebo for 8 weeks

8 weeks

Visits on Day 1, 28, and 56

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Active-treatment extension (optional)

Participants may opt into continuation of treatment with SPH3127 for an additional 10 months

10 months

What Are the Treatments Tested in This Trial?

Interventions

• Placebo
• SPH3127

Trial Overview

The trial is testing SPH3127's safety and effectiveness against a placebo in treating ulcerative colitis. Participants will be randomly assigned to receive either SPH3127 or a placebo without knowing which one they're getting (double-blind).

How Is the Trial Designed?

Group I: SPH3127 50 mg Experimental Treatment 1 Intervention

1 50 mg SPH3127 tablet in the morning and 1 placebo tablet in the evening daily for 8 weeks. After 8 weeks, optional continuation of daily treatment for an additional 10 months.

Group II: SPH3127 100 mg Experimental Treatment 1 Intervention

1 50 mg SPH3127 tablet in the morning and 1 50 mg SPH3127 tablet in the evening daily for 8 weeks. After 8 weeks, optional continuation of daily treatment for an additional 10 months.

Group III: Placebo Experimental Treatment 1 Intervention

2 placebo tablets, 1 in the morning and 1 in the evening, daily for 8 weeks. After 8 weeks, optional randomization to 1 of 2 SPH3127 daily treatment arms for an additional 10 months

Who Is Running the Clinical Trial?

Shanghai Pharma Biotherapeutics USA Inc.

Lead Sponsor

Trials

2

Recruited

40+

Published Research Related to This Trial

5-Aminosalicylic acid (5-ASA) is more effective than placebo for treating active ulcerative colitis, with a significant dose-response effect observed in 16 trials involving various patient populations.

However, 5-ASA does not show superior efficacy compared to sulfasalazine for either treating active disease or maintaining remission, indicating that while it is beneficial, it may not replace sulfasalazine in treatment protocols.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Sulfasalazine revisited: a meta-analysis of 5-aminosalicylic acid in the treatment of ulcerative colitis. Sutherland, LR., May, GR., Shaffer, EA.[2019]

In a study of 287 patients with ulcerative proctitis and proctosigmoiditis, mesalamine enemas (1, 2, and 4 g) significantly improved symptoms and clinical outcomes compared to placebo, with 67% to 75% of patients showing marked improvement.

The safety profile of mesalamine enemas was comparable to that of placebo, indicating that they are a safe and effective treatment option for distal ulcerative colitis without a clear dose-response effect.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Dose-ranging study of mesalamine (PENTASA) enemas in the treatment of acute ulcerative proctosigmoiditis: results of a multicentered placebo-controlled trial. The U.S. PENTASA Enema Study Group. Hanauer, SB.[2019]

A longitudinal placebo response model was developed using data from five clinical trials involving patients with ulcerative colitis, which helps to better understand how the Mayo Clinical Score (MCS) changes over time in response to placebo treatments.

Prior exposure to TNF-α antagonists was found to significantly influence the rectal bleeding and stool frequency subscores, indicating that patients who had previously received these treatments experienced higher symptom scores compared to those who were treatment-naive.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A longitudinal model for the Mayo Clinical Score and its sub-components in patients with ulcerative colitis. Kawakatsu, S., Zhu, R., Zhang, W., et al.[2022]

In a review of 119 clinical trials for ulcerative colitis, the placebo rates for clinical remission during induction trials were found to be 11%, while maintenance trials showed higher rates of 18%, indicating variability based on trial phase.

Factors such as prior biologic therapy exposure and the number of follow-up visits significantly influenced placebo response rates, which can help in designing more effective clinical trials.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Systematic Review and Meta-Analysis: Clinical, Endoscopic, Histological and Safety Placebo Rates in Induction and Maintenance Trials of Ulcerative Colitis. Sedano, R., Hogan, M., Nguyen, TM., et al.[2023]

The newer formulations of 5-aminosalicylic acid (5-ASA) were found to be significantly more effective than placebo in maintaining remission in ulcerative colitis, with a Peto odds ratio of 0.47, indicating a lower risk of relapse or withdrawal due to treatment failure.

However, when compared to sulfasalazine (SASP), 5-ASA showed a statistically significant inferiority in effectiveness, suggesting that while 5-ASA is beneficial, SASP may be a more effective option for some patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Oral 5-aminosalicylic acid for maintaining remission in ulcerative colitis. Sutherland, L., Roth, D., Beck, P., et al.[2020]

The newer formulations of 5-aminosalicylic acid (5-ASA) were found to be significantly more effective than placebo in inducing remission in active ulcerative colitis, with a pooled odds ratio of 0.51, indicating a lower failure rate in achieving clinical improvement.

While 5-ASA showed a trend towards better outcomes compared to sulfasalazine (SASP), the difference was not statistically significant, and 5-ASA was better tolerated, suggesting it may be a preferable option despite potential cost considerations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Oral 5-aminosalicylic acid for inducing remission in ulcerative colitis. Sutherland, L., Roth, D., Beck, P., et al.[2018]

In a study of 51 patients with mild to moderate ulcerative colitis, IBD98-M (mesalamine) showed a higher clinical response rate at 31.3% for the 1.2 g/day dose compared to 16.7% for placebo, indicating potential efficacy in treating the condition.

IBD98-M was found to be safe and well tolerated, with no new safety concerns reported, suggesting it could be a viable treatment option for patients with ulcerative colitis.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Phase 2a, Multicenter, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Trial of IBD98-M Delayed-Release Capsules to Induce Remission in Patients with Active and Mild to Moderate Ulcerative Colitis. Fiorino, G., Sturniolo, GC., Bossa, F., et al.[2021]

In a post hoc analysis of pooled data from multiple clinical trials involving ulcerative colitis, it was found that patients with normal serum C-reactive protein and albumin levels had a significantly higher likelihood of achieving a clinical response to placebo treatment (16.3% vs. 7.4%).

Patients with a higher baseline endoscopic severity (Mayo endoscopic score of 3) were less likely to respond to placebo compared to those with a lower score (18.8% vs. 25.9%), indicating that baseline disease severity influences placebo response rates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Predictors of Placebo Induction Response and Remission in Ulcerative Colitis. Wong, ECL., Dulai, PS., Marshall, JK., et al.[2023]

Citations

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A Study of SPH3127 in the Treatment of Mild to Moderate ...

To preliminarily evaluate the clinical efficacy of the renin inhibitor SPH3127 Tablets in patients with mild to moderate ulcerative colitis with placebo as a ...

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Evaluation of SPH3127 in Patients With Mild-to-Moderate ...

SPH3127-US-01 is a multi-center, randomized, double-blind, placebo-controlled study to evaluate the safety, pharmacokinetics, and preliminary ...

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withpower.com/trial/phase-3-colitis-ulcerative-8-2021-ab68b

SPH3127 for Ulcerative Colitis · Info for Participants

In a study of 287 patients with ulcerative proctitis and proctosigmoiditis, mesalamine enemas (1, 2, and 4 g) significantly improved symptoms and clinical ...

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pmc.ncbi.nlm.nih.gov/articles/PMC11417464/

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This study demonstrates that etrasimod is effective in treating moderately to severely active ulcerative colitis with a favorable benefit-risk profile at week ...

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A Phase I, Randomized, Double-Blind, Placebo-Controlled ...

Conclusions These results demonstrate that SPH3127 is able to effectively block colitis development in mouse experimental colitis models.

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Evaluation of SPH3127 in Patients With Mild-to-Moderate ...

SPH3127-US-01 is a multi-center, randomized, double-blind, placebo-controlled study to evaluate the safety, pharmacokinetics, and preliminary ...