Clinical trial • Gastroenterology

MOXIFLOXACIN for Uncomplicated acute appendicitis

Clinical trial of MOXIFLOXACIN for Uncomplicated acute appendicitis.

Overview

Trial Therapeutic Area
Gastroenterology
Trial Disease
Uncomplicated acute appendicitis
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
22-10-2024
First CTIS Authorization Date
20-11-2024

Trial design

Randomised, open-label, comparators: levofloxacin (oral; max daily dose 500 mg; max total dose 2500 mg), metronidazole (oral; max daily dose 1500 mg; max total dose 7500 mg), ertapenem (solution for infusion; iv infusion; max daily dose 1 g; max total dose 2 g). test product: moxifloxacin (oral; max daily dose 400 mg; max total dose 2800 mg; max treatment period 7 days).-controlled trial in Finland.

Randomised
Yes
Open Label
Yes
Comparator
Comparators: LEVOFLOXACIN (oral; max daily dose 500 mg; max total dose 2500 mg), METRONIDAZOLE (oral; max daily dose 1500 mg; max total dose 7500 mg), ERTAPENEM (solution for infusion; IV infusion; max daily dose 1 g; max total dose 2 g). Test product: MOXIFLOXACIN (oral; max daily dose 400 mg; max total dose 2800 mg; max treatment period 7 days).
Target Sample Size
599
Trial Duration For Participant
365

Eligibility

Recruits 599 Vulnerable population not selected. Participants must be able to co-operate and give informed consent; 'Inability to co-operate and give informed consent' is an exclusion criterion. Subject information and informed consent forms are provided (documents listed in the submission: 'APPAC II potilassuostumus', 'Potilastiedote APPAC II 310516 final', 'Potilastiedote APPAC II poissulkeutuneet'). No assent process for minors is described (trial enrols adults 18–60 years)..

Pregnancy Exclusion
2) Pregnancy or lactation,
Vulnerable Population
Vulnerable population not selected. Participants must be able to co-operate and give informed consent; 'Inability to co-operate and give informed consent' is an exclusion criterion. Subject information and informed consent forms are provided (documents listed in the submission: 'APPAC II potilassuostumus', 'Potilastiedote APPAC II 310516 final', 'Potilastiedote APPAC II poissulkeutuneet'). No assent process for minors is described (trial enrols adults 18–60 years).

Inclusion criteria

  • {"criterion_text":"- 1) Age 18–60 years"}
  • {"criterion_text":"- 2) Diagnosis of uncomplicated acute appendicitis confirmed by CT scan defined by the following criteria: appendiceal diameter exceeding 6 mm with thickened and enhancing wall and periappendiceal edema and /or minor fluid collection, and the absence of the criteria of complicated appendicitis. The CT findings will be evaluated using a standardised CT scan report sheet"}

Exclusion criteria

  • {"criterion_text":"- 1) Age under 18 or over 60 years"}
  • {"criterion_text":"- 2) Pregnancy or lactation,"}
  • {"criterion_text":"- 3) Allergy to contrast media or iodine,"}
  • {"criterion_text":"- 4) Allergy or contraindication to antibiotic therapy,"}
  • {"criterion_text":"- 5) Renal insufficiency or serum creatinine value exceeding the upper reference limit,"}
  • {"criterion_text":"- 6) Type 2 diabetes mellitus and metformine medication,"}
  • {"criterion_text":"- 7) Severe systemic illness (for example malignancy, medical condition requiring immunosuppressant medication),"}
  • {"criterion_text":"- 8) Inability to co-operate and give informed consent, and"}
  • {"criterion_text":"- 9) Complicated acute appendicitis in the CT scan."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- The primary endpoint of the APPAC II trial is defined as the success of the randomised treatment at one-year follow-up (treatment efficacy). Treatment success in both groups is defined as the resolution of acute appendicitis with antibiotic treatment resulting in discharge from the hospital without the need for surgical intervention and no recurrent appendicitis during a follow-up of one year.","definition_or_measurement_approach":"Treatment success defined as resolution of acute appendicitis with antibiotic treatment resulting in discharge from hospital without need for surgical intervention and no recurrent appendicitis during one-year follow-up."}

Secondary endpoints

  • {"endpoint_text":"- post-intervention complications (possible postoperative complications classified using the Clavien-Dindo classification)","definition_or_measurement_approach":"Classified using the Clavien-Dindo classification."}
  • {"endpoint_text":"- late recurrence (after one year) of acute appendicitis after antibiotic treatment","definition_or_measurement_approach":"Occurrence of recurrent appendicitis after one year following antibiotic treatment."}
  • {"endpoint_text":"- duration of hospital stay","definition_or_measurement_approach":"Measured as length of inpatient stay (days)."}
  • {"endpoint_text":"- VAS scores","definition_or_measurement_approach":"Pain assessed using Visual Analogue Scale (VAS)."}
  • {"endpoint_text":"- quality of life (QOL, using for example 5D or 15D validated QOL questionnaire)","definition_or_measurement_approach":"Quality of life measured using validated QOL questionnaires such as 5D or 15D."}
  • {"endpoint_text":"- length of sick leave","definition_or_measurement_approach":"Measured as duration of sick leave (days)."}
  • {"endpoint_text":"- treatment costs","definition_or_measurement_approach":"Health economic assessment of treatment-related costs."}

Recruitment

Planned Sample Size
599
Recruitment Window Months
244
Consent Approach
Participants must be able to co-operate and provide informed consent; inability to co-operate and give informed consent is an exclusion criterion. Subject information and informed consent forms are included in the submission (documents: 'APPAC II potilassuostumus', 'Potilastiedote APPAC II 310516 final', 'Potilastiedote APPAC II poissulkeutuneet'). No age-specific assent process is described (trial enrols adults 18–60 years).

Geography

Total Number Of Sites
9
Total Number Of Participants
599

Finland

Earliest CTIS Part Ii Submission Date
15-11-2024
Latest Decision Or Authorization Date
20-11-2024
Processing Time Days
5
Number Of Sites
9
Number Of Participants
599

Sites

Site Name
Mikkeli Central Hospital
Department Name
Surgery
Contact Person Name
Imre Ilves
Contact Person Email
imre.ilves@utu.fi
Site Name
Seinäjoki Central Hospital
Department Name
Surgery
Contact Person Name
Tarja Pinta
Contact Person Email
tarja.pinta@utu.fi
Site Name
Tampere University Hospital
Department Name
Surgery
Contact Person Name
Pia Nordström
Contact Person Email
pia.nordstrom@pirha.fi
Site Name
Oulu University Hospital
Department Name
Surgery
Contact Person Name
Tero Rautio
Contact Person Email
tero.rautio@oulu.fi
Site Name
Kuopio University Hospital
Department Name
Surgery
Contact Person Name
Tuomo Rantanen
Contact Person Email
tuomo.rantanen@kuh.fi
Site Name
Lapland Central Hospital
Department Name
Surgery
Contact Person Name
Jukka Rintala
Contact Person Email
Jukka.rintala@pohde.fi
Site Name
Turku University Hospital
Department Name
Surgery
Contact Person Name
Paulina Salminen
Contact Person Email
paulina.salminen@tyks.fi
Site Name
Central Finland Hospital District Central Finland Hospital Nova
Department Name
Surgery
Contact Person Name
Anne Mattila
Contact Person Email
anne.mattila@ksshp.fi
Site Name
Pori Central Hospital
Department Name
Surgery
Contact Person Name
Eeva-Liisa Sävelä
Contact Person Email
eeva-liisa.savela@utu.fi

Sponsor

Primary sponsor

Full Name
Turku University Hospital
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
Finland

Investigational products

Investigational Product Name
MOXIFLOXACIN
Active Substance
MOXIFLOXACIN
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
prodAuthStatus 2; marketingAuthNumber -
Maximum Dose
400 mg milligram(s) per day
Investigational Product Name
LEVOFLOXACIN
Active Substance
LEVOFLOXACIN
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
prodAuthStatus 2; marketingAuthNumber -
Maximum Dose
500 mg milligram(s) per day
Investigational Product Name
METRONIDAZOLE
Active Substance
METRONIDAZOLE
Modality
Small molecule
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
prodAuthStatus 2; marketingAuthNumber -
Maximum Dose
1500 mg milligram(s) per day
Investigational Product Name
ERTAPENEM
Active Substance
ERTAPENEM
Modality
Small molecule
Routes Of Administration
IV INFUSION
Route
IV INFUSION
Authorisation Status
prodAuthStatus 2; marketingAuthNumber -
Maximum Dose
1 g gram(s) per day
Combination Treatment
Yes

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