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CTRI Number  CTRI/2013/01/003288 [Registered on: 07/01/2013] Trial Registered Prospectively
Last Modified On: 22/01/2013
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Drug 
Study Design  Randomized, Parallel Group, Active Controlled Trial 
Public Title of Study   Clotrimazole 500 mg Vaginal Tablet Therapeutic Equivalence Clinical Trial 
Scientific Title of Study   “An Active Control, Open label, Randomized, Parallel Group, Single Dose Clinical Study to Evaluate the Therapeutic Equivalence of Clotrimazole 500 mg Vaginal Tablet of Actor Pharma, South Africa Versus Canesten® (Containing Clotrimazole 500 mg) Vaginal Tablet of Bayer, South Africa in Healthy Adult Females with Vulvovaginal Candidiasis.”  
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
NEX/CLZ/TE-6001/17/09/2011   Protocol Number 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr Prema Prabhudev 
Designation  Principal Investigator 
Affiliation  S . S . Institute of Medical Sciences & Research Centre 
Address  S . S . Institute of Medical Sciences & Research Centre, NH4 Bypass road, Davangere - 577005, Karnataka

Davanagere
KARNATAKA
577005
India 
Phone  9902063706  
Fax    
Email  drpremaprabhudev@gmail.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr Amit Bhatt 
Designation  President & CEO 
Affiliation  NEXUS CLINICAL RESEARCH (INDIA) LTD. 
Address  32 A Nexus Center For Clinical Excellence Sector 1, Shiravane Road, Service Industry, Nerul (E), New Mumbai- 400 706 Maharashtra - India

Raigarh
MAHARASHTRA
400706
India 
Phone  02227714204  
Fax    
Email  dramit.bhatt@gmail.com  
 
Details of Contact Person
Public Query
 
Name  Dr Amit Bhatt 
Designation  President & CEO 
Affiliation  NEXUS CLINICAL RESEARCH (INDIA) LTD. 
Address  32 A Nexus Center For Clinical Excellence Sector 1, Shiravane Road, Service Industry, Nerul (E), New Mumbai- 400 706 Maharashtra - India

Raigarh
MAHARASHTRA
400706
India 
Phone  02227714204  
Fax    
Email  dramit.bhatt@gmail.com  
 
Source of Monetary or Material Support  
Actor Pharma (Pty) Ltd.,South Africa. 
 
Primary Sponsor  
Name  ACTOR PHARMA PTY LTD 
Address  Unit 7, Royal Palm Business Estate, 646 Washington Street, Halfway House, Midrand 1685. South Africa. 
Type of Sponsor  Pharmaceutical industry-Global 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 5  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Neha Lad  Dr. Lads Navjeevan Hospital Pvt. Ltd (Department of gynaecology)  Dr. Lads Navjeevan Hospital Pvt. Ltd.,Near Mahamarg Bus Stand, Holkar road, Tidke Colony-422002, Nashik, Maharashtra.
Nashik
MAHARASHTRA 
9225100643

lad.nitin@yahoo.com 
Dr Minal Wairagade  Family Multispeciality Hospital, Nursing Home and Research Centre (Department of gynaecology)  Family Multispeciality Hospital, Nursing Home and Research Centre, 214,SaiShradha Appt., Nehru Nagar Square, Nandanvan Main Road, Nagpur-440009
Nagpur
MAHARASHTRA 
9326007188

minalrk2008@india.com 
Dr Prema Prabhudev  S.S.Institute of Medical Sciences & Research Centre (Department of gynaecology)  S.S.Institute of Medical Sciences & Research Centre, NH4 Bypass Road, Davangere-577005
Davanagere
KARNATAKA 
9902063706

drpremaprabhudev@gmail.com 
Dr Mamta Bhomia   Sanjivani Super Speciality Hospital Pvt. Ltd. (Department of gynaecology)  Sanjivani Super Speciality Hospital, 1, Uday Park Society, Near Sunrise park, Vastrapur, Ahmedabad-380015
Ahmadabad
GUJARAT 
9909390010

vgb.sanjivani@gmail.com 
Dr Chitra Saxena  Sharda General Hospital (Department of gynaecology)  Sharda General Hospital, Madhyam Marg, Agarwal Farm, 112/15, Mansarover, Jaipur - 302020
Jaipur
RAJASTHAN 
9414716655

drchitrasaxena@yahoo.co.in 
 
Details of Ethics Committee  
No of Ethics Committees= 5  
Name of Committee  Approval Status 
Institutional Ethics Committee, Davangere  Approved 
Magna Care Ethics Committee, Nashik  Approved 
Midcity Independent Ethics Committee, Nagpur  Approved 
Sanjivani Hospital Ethics Committee, Ahmadabad  Approved 
Swastik Ethics Committee, Jaipur  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Not Applicable 
 
Health Condition / Problems Studied  
Health Type  Condition 
Healthy Human Volunteers  Healthy Adult Females with Vulvovaginal Candidiasis 
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  Canesten® (Containing Clotrimazole 500 mg) Vaginal Tablet of Bayer, South Africa   Single dose will be administered by inserting one tablet into the vagina (Intra vaginal) at bedtime on Day 0. 
Intervention  Clotrimazole 500 mg Vaginal Tablet of Actor Pharma, South Africa   Single dose will be administered by inserting one tablet into the vagina (Intra vaginal) at bedtime on Day 0. 
 
Inclusion Criteria  
Age From  18.00 Year(s)
Age To  45.00 Year(s)
Gender  Female 
Details  Female patients aged between 18 to 45 years.
Patient has a primary diagnosis of Vulvovaginal Candidiasis (VVC).
Patient willing to give their informed consent.
Postmenarcheal females with a diagnosis of VVC will be included based on the criteria listed below.
To be clinically evaluable, Patient should have a clinical diagnosis of VVC based on history and physical examination (including vaginal examination). Signs and symptoms to be evaluated include: itching, burning, irritation, edema, erythema and/or excoriation of the vagina/vulva. Each evaluated signs and/or symptoms should be given a numerical rating based on severity
Documented Papanicolaou (Pap) test at baseline or during the previous 12 months reported as either “negative for intraepithelial lesion or malignancy” or “ASCUS-atypical squamous cells of undetermined significance.”
At baseline, ≥ 50% of the patient should have at least moderate severity of VVC, defined as having a minimum composite Vulvovaginal signs and symptoms score of 2.
Presence of at least one Vulvovaginal symptom (Vulvovaginal itching, burning, or irritation) as assessed by the investigator at baseline.
Presence of at least one Vulvovaginal sign (Vulvovaginal erythema, edema, or excoriation) as assessed by the investigator at baseline
Clinical diagnosis of symptomatic Vulvovaginal Candidiasis (VVC) confirmed at baseline by positive KOH wet mount test (i.e., when examined microscopically, vaginal secretions obtained by swab of the vaginal mucosa, placed on a slide and diluted with 10% room temperature potassium hydroxide (KOH) reveal filamentous hyphae/ pseudohyphae and/or budding yeast cells). 
 
ExclusionCriteria 
Details  Pregnant or nursing women.
Patient has Menstruation at the time of diagnosis.
Diabetes mellitus [NOTE: If diabetic women are enrolled, it is important that their diabetes be
controlled (Fasting blood glucose should be <200 mg/dl) and the proportion of diabetic patient
be similar among all treatment groups, because cure rates might differ in diabetic versus non-diabetic women].
Insufficiency of liver and/or of kidney (Creatinine > 2.0 mg/dl).
Use of systemic, topical (applied to the vulva) or vaginal antibiotics, antifungals or anti-trichomonals within 7 days prior to randomization.
Use of any systemic corticosteroid, immunosuppressive, or immune-stimulating drug within 3
months prior to randomization.
Presence of concomitant vulvovaginitis caused by other infections (e.g., bacterial vaginosis,
Trichomonas vaginalis, Chlamydia trachomatis or Neisseria gonorrhoeae).
Patient with other infectious causes of vulvovaginitis (e.g., bacterial vaginosis, Trichomonas
vaginalis, Chlamydia trachomatis, Neisseria gonorrhoeae, Herpes simplex, or human papilloma
virus).
Sexual intercourse 24 hours before the KOH mount test.
Presence of another vaginal or vulvar condition that would confound the interpretation of
clinical response.
Women who will be under treatment or surgery during the study period for cervical
intraepithelial neoplasia (CIN) or cervical carcinoma.
History of allergy or sensitivity to clotrimazole, related compounds or any component of the
formulation.
HSV-II–Tzanck Smear positive patient. 
 
Method of Generating Random Sequence   Permuted block randomization, fixed 
Method of Concealment   An Open list of random numbers 
Blinding/Masking   Open Label 
Primary Outcome  
Outcome  TimePoints 
Primary endpoint of the study is the proportion of patient with therapeutic cure, defined as both
mycological cure and clinical cure, at the test-of-cure visits conducted on study days  
Visit 1 (Day -2)
Visit 2 (Day 0)
Visit 3 (Day 3±1)
Visit 4 (Day 14±2)



 
 
Secondary Outcome  
Outcome  TimePoints 
The type of AE(s), number of AE(s), frequency of AE(s) and proportion of patients with AE(s).
The severity, seriousness and the relationship of AE to the treatment.
Vital signs (sitting blood pressure, oral temperature, radial pulse rate and respiratory rate) will be measured at enrolment, prior to dosing (at the time of Check-in), 30 minutes after post dose, at the time of discharge and at follow up visit i.e. visit 3 and visit 4
 
Visit 2(Day 0),Visit 3(Day 3±1) 
 
Target Sample Size   Total Sample Size="80"
Sample Size from India="80" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 4 
Date of First Enrollment (India)   07/01/2013 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="0"
Months="3"
Days="0" 
Recruitment Status of Trial (Global)
Modification(s)  
Not Applicable 
Recruitment Status of Trial (India)  Open to Recruitment 
Publication Details    
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Brief Summary  

This is a multi-centric, open label, randomized, parallel group, Single Dose Clinical Study to Evaluate the Therapeutic Equivalence of Clotrimazole 500 mg Vaginal Tablet of Actor Pharma, South Africa.

The study will be conducted at 5 sites in India only.

Approximately 100  healthy adult females suffering from Vulvovaginal Candidiasis (50 per arm) will be enrolled in the study (Including dropouts/withdrawals). 80 completed patients excluding screen failures, drop-outs and withdrawals will be considered for data analysis..

The primary objective is to evaluate and compare the therapeutic cure rates defined as clinical cure (resolution of clinical signs and symptoms) and mycological cure (negative microscopy and negative culture) at 3±1 days and 14±2 days of Clotrimazole 500 mg Vaginal Tablet versus Canesten® (Containing Clotrimazole 500 mg) Vaginal Tablet in healthy adult females suffering from Vulvovaginal Candidiasis.

.Secondary objective is to monitor the adverse events and to ensure the safety of patient.

 

The main inclusion criteria for the study are Female patients should be of age between 18 to 45 years.and should have a primary diagnosis of Vulvovaginal Candidiasis (VVC).

The test drug used will be Clotrimazole 500 mg Vaginal Tablet of Actor Pharma, South Africa whereas the reference drug is Canesten® (Containing Clotrimazole 500 mg) Vaginal Tablet of Bayer, South Africa

Enrolled patients will receive single dose of either test drug or reference drug, the drug will be administered by inserting one tablet into the vagina (Intra vaginal) at bedtime on Day 0 as per the computer generated randomization sequence.

Duration of Protocol Therapy is 1 day and duration of patient participation is approximately 16±2 days [dosing (Day 0) and Follow-up at 3±1 days and 14±2 days after administration of the vaginal tablet.]

Patients fulfilling inclusion/exclusion criteria at the time of screening would be subjected to medical screening (Day-2). Screening will include, clinical evaluation and history of medication used in last 1 year. The Patient physical examination will be performed including vaginal pH, speculum examination of the vagina, KOH preparation and it will be evaluated by investigators. A vaginal specimen will be obtained for culture and susceptibility testing results. Blood and urine samples will be collected for baseline chemistry, hematology and urinalysis tests. All the results from these procedures will be documented in e-CRF. During treatment visit 2 (Day 0) Vital signs, General examination and AE monitoring will be done on visit 2. Symptoms Relief Card will be filled by investigator. Patient Diary will be provided to patient. All the data from Patient Diary will be recorded in e-CRF in every visit by the investigator. The follow up visit ( post-treatment contact) will be initiated by the investigator at 2, 4, 6 and 8 days after the beginning of treatment. The Follow-up Visit 3 & 4 (Test-of-Cure Visit) will start at 3±1 days after post dose, this will be the First Test-of-Cure visit and second Test-of-Cure visit will be at 14±2 days after post dose. At all these visits clinical examination, vaginal examination and a vaginal semi-quantitative culture will be recorded by the investigators. Speciation and susceptibility testing will be done on all positive cultures.

Primary  endpoint  of  the  study  is  the  proportion  of  patient  with  therapeutic  cure,  defined  as  both  mycological cure and clinical cure, at the test-of-cure visits conducted on study days and Secondary endpoints will be monitored as safety outcomes. Safety assessments can be limited to local description of toxicity.  However, where appreciable systemic absorption occurs, hematology, chemistry, and urine laboratory testing will be performed as per investigators discretion.

 
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