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Evaluation of Topical 10% Metronidazole Ointment for the Treatment of Active Perianal Crohn's Disease

Information source: S.L.A. Pharma AG
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Crohn's Disease

Intervention: 10% Metronidazole Ointment (Drug)

Phase: Phase 3

Status: Completed

Sponsored by: S.L.A. Pharma AG

Official(s) and/or principal investigator(s):
Emin Carapeti, BSc,MBBS,MD,, Principal Investigator, Affiliation: St Thomas Hospital, London


The purpose of this study is to compare changes in Perianal Crohn's Disease following use of locally applied 10% metronidazole ointment and a placebo.

Clinical Details

Official title: Phase III Study to Evaluate the Effect of 10% Metronidazole Ointment, Applied Topically Three Times a Day in and Around the Anus and the Change in Perianal Crohn's Disease Activity

Study design: Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Primary outcome: To evaluate the effect of 10% metronidazole ointment, applied topically three times a day, in and around the anus, on the change in perianal Crohn's disease activity.

Secondary outcome:

To evaluate and compare the relief of perianal pain and discomfort associated with Crohn's disease, against placebo.

To evaluate and compare Patient Global Impression of Improvement

To compare visual improvement (using photographic documentation assessed by a blinded independent observer)

To compare Quality of Life assessments

To evaluate and compare the number of analgesics required prior to treatment and to that required by the treatment and placebo group

To evaluate and compare fistula healing

Detailed description: Anorectal Crohn's disease is one of the most problematic and debilitating conditions encountered in colorectal practise. The condition is usually chronic, debilitating, and frequently refractory to current medications. Failure to respond to medical therapy may ultimately result in proctocolectomy and ileostomy, even in the absence of more proximal colonic disease. Isolated anorectal Crohn's disease is reported in 3 to 5% of Crohn's patients. In Crohn's patients as a whole, anorectal involvement is reported in up to one third to one half of patients, in addition to either colonic or enteric Crohn's disease. In spite of the previously reported painless nature of anorectal Crohn's disease, it is the author's experience that the condition can be inordinately painful due to deeply eroding fissures, oedematous skin tags, and painful induration of the perianal region.


Minimum age: 18 Years. Maximum age: N/A. Gender(s): Both.


Inclusion Criteria:

- Have Crohn's disease (diagnosed by radiology, endoscopy and pathology), with

anorectal involvement.

- Have had perianal symptoms for longer than 3 months

- Have a PCDAI of 5 or above at baseline

- Subjects can be on concomitant medication. Acceptable regimes are:-

- Aminosalicylates at a dosage that has been stable for more than 4 weeks before


- Oral corticosteroids <40mg per day that has been stable for more than 3 weeks;

- Methotrexate given for at least 3 months that has been stable for more than 4 weeks;

Azathioprine or mercaptopurine given for at least 6 months at dosage that has been stable for more than 8 weeks;

- Antibiotics at a dosage that has been stable for 4 weeks (subjects may be on oral

metronidazole but on a dose not more than 750mg per day),

- Cycolsporin for more than 3 months and on a stable dose for more than 4 weeks;

- Patients who have been treated with Infliximab must have received their initial dose

3 months before starting study medication and their most recent dose at least 8 weeks before starting study medication and not receive an infusion whilst in the double-blind treatment phase of the study for 4 weeks. During the second 4 week open stage of the study patients can commence again a maintenance regime with Infliximab treatment if deemed necessary

- Any patients not on concurrent medication must have been off medication for at least

4 weeks before screening.

- If patients have Setons these must have been in place for at least 4 weeks prior to


- Subjects must be aged 18 years or over and of the legal age of consent.

- If female, the subject must not be lactating and must be (a) post- menopausal,

(b) surgically sterilised, or (c) have a negative pregnancy test result prior to entry into the study and will use double- barrier methods of contraception (two separate methods of birthcontrol one of which may include oral contraception) for the duration of the study.

- Must have provided written informed consent to participate.

Exclusion Criteria:

- They have had surgery to the anus or rectum in the past 4 weeks;

- They have a perianal abscess requiring incision and drainage;

- They have a stoma of less than 6 months duration;

- Allergic to metronidazole;

- Are taking any prohibited medication.

- Deemed mentally incompetent.

- Considered by their physician unlikely to be able to comply with the protocol.

- Taken part in an experimental drug study in the preceding three months.

Locations and Contacts

Monklands Hospital, Airdrie ML6 0JS, United Kingdom

Birmingham Heartlands Hospital, Birmingham B9 5SS, United Kingdom

Bristol Royal Infirmary, Bristol BS1 3NU, United Kingdom

University Hospital of Wales, Cardiff CF14 4XW, United Kingdom

University Hospital of Warwick and Coventry, Coventry CV2 2DX, United Kingdom

St Marks Hospital, Harrow HA1 3UJ, United Kingdom

St Thomas Hospital, London SE1 &EH, United Kingdom

Peterborough District Hospital, Peterborough PE3 6DA, United Kingdom

Derby City General Hospital, Derby, Derbyshire DE22 3NE, United Kingdom

Leicester General Hospital, Leicester, Leicestershire LE5 4PW, United Kingdom

Washington University School of Medicine, St Louis, Missouri M 63110, United States

Additional Information

Starting date: May 2005
Last updated: December 12, 2012

Page last updated: August 23, 2015

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