Fast-Track Therapeutic Model in Complicated Acute Appendicitis

2025-520777-39-00 Protocol IIBSP-FAS-2020-120 Therapeutic use (Phase IV) Ongoing, recruiting

Start 29 Jan 2025 · Status Ongoing, recruiting · 1 EU/EEA countries · 12 sites · Protocol IIBSP-FAS-2020-120

Overview

Sponsor-declared trial summary

Phase Therapeutic use (Phase IV)
Status Ongoing, recruiting
Participants planned 772
Countries 1
Sites 12

Complicated acute appendicitis

To evaluate whether a postoperative therapeutic strategy, Fast Track, aimed at shortening hospital stay in pediatric patients undergoing laparoscopic appendectomy for complicated acute appendicitis, yields outcomes that are not inferior to the standard therapeutic model in terms of the combined variable of adverse even…

Key facts

Sponsor
Fundacio Institut De Recerca De L'Hospital De La Santa Creu I Sant Pau
Participant type
Pediatric, Patients
Age range
0-17 years
Gender
Male and Female
Therapeutic area
Diseases [C] - Pathological Conditions, Signs and Symptoms [C23], Analytical,Diagnostic,Therapeutic Techniques and Equipment [E]-Surgical Procedures, Operative [E04], Diseases [C] - Bacterial Infections and Mycoses [C01]
Trial duration
29 Jan 2025 → ongoing
Decision date (initial)
2025-01-29
Transition trial
Yes
Low-intervention
Yes
Rare-disease indication
No
Vulnerable population
No

External identifiers

EU CT number
2025-520777-39-00
EudraCT number
2020-004460-25

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Efficacy

To evaluate whether a postoperative therapeutic strategy, Fast Track, aimed at shortening hospital stay in pediatric patients undergoing laparoscopic appendectomy for complicated acute appendicitis, yields outcomes that are not inferior to the standard therapeutic model in terms of the combined variable of adverse events within 30 days postoperatively (including postoperative abdominal abscess, peritonitis, surgical wound complications, reintervention, sepsis, or death).

Secondary objectives 8

  1. Evaluate individually the incidence of postoperative abdominal abscess, peritonitis, surgical wound complications, reintervention, sepsis, and death.
  2. Compare hospital readmission rates between both study arms during the first postoperative month following appendectomy.
  3. Determine changes in procalcitonin levels at 6-10 hours postoperatively in cases of complicated appendicitis and evaluate its application as a criterion for early discharge (only in centers that choose to participate).
  4. Describe the pathogens causing appendicitis and their antibiotic sensitivity (only in centers that choose to participate).
  5. Compare patient and family satisfaction between the standard strategy and the Fast Track therapeutic model, using the CSQ-18 questionnaire.
  6. Evaluate adverse reactions associated with antibiotic treatment.
  7. Assess the quality of life of patients under the Fast Track therapeutic strategy using the EQ-5D-5Y questionnaire in comparison with the standard strategy.
  8. Quantify the cost of implementing the Fast Track therapeutic strategy and compare it to the cost of the standard strategy.

Conditions and MedDRA coding

Complicated acute appendicitis

VersionLevelCodeTermSystem organ class
21.1 LLT 10003008 Appendectomy 10042613
20.0 PT 10064736 Antibiotic prophylaxis 100000004865

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 4

  1. Age: 2 to 17 years.
  2. Intraoperative diagnosis of complicated appendicitis.
  3. Undergoing appendectomy via laparoscopic approach.
  4. Agreement to participate in the study with signed informed consent.

Exclusion criteria 5

  1. Patients requiring ICU admission with vasoactive support
  2. Catarrhal or phlegmonous appendicitis.
  3. History of cystic fibrosis, Crohn's disease, or transplant that may interfere with the usual postoperative course of laparoscopic appendectomy.
  4. Contraindication to the administration of amoxicillin-clavulanic acid (allergy or intolerance).
  5. Refusal to participate in the study by parents/legal guardians.

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. The primary outcome measure will be the composite variable "adverse events" occurring within the first 30 postoperative days, defined as the occurrence of any of the following events: intra-abdominal abscess, peritonitis, surgical wound complications, reoperation, sepsis, or death.

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Amoxicilina/Ácido clavulánico NORMON 875 mg/125 mg comprimidos recubiertos con película EFG

PRD11918358 · Product

Active substance
Amoxicillin
Substance synonyms
AMOXICILLINE, AMOXICILLINUM
Pharmaceutical form
FILM-COATED TABLET
Route of administration
ORAL
Max daily dose
70 mg/kg milligram(s)/kilogram
Max total dose
35 mg/kg milligram(s)/kilogram
Max treatment duration
3 Day(s)
Authorisation status
Authorised
ATC code
J01CR02 — AMOXICILLIN AND ENZYME INHIBITOR
Marketing authorisation
70.188
MA holder
LABORATORIOS NORMON, S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Comparator 1

Amoxicilina/Ácido clavulánico NORMON 1.000 mg/200 mg polvo para solución inyectable y para perfusión EFG

PRD11782266 · Product

Active substance
Amoxicillin
Substance synonyms
AMOXICILLINE, AMOXICILLINUM
Pharmaceutical form
SOLUTION FOR INJECTION/INFUSION
Route of administration
ORAL
Max daily dose
105 mg/kg milligram(s)/kilogram
Max total dose
35 mg/kg milligram(s)/kilogram
Max treatment duration
5 Day(s)
Authorisation status
Authorised
ATC code
J01CR02 — AMOXICILLIN AND ENZYME INHIBITOR
Marketing authorisation
66425
MA holder
LABORATORIOS NORMON, S.A.
MA country
Spain
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Fundacio Institut De Recerca De L'Hospital De La Santa Creu I Sant Pau

Sponsor organisation
Fundacio Institut De Recerca De L'Hospital De La Santa Creu I Sant Pau
Address
Calle Sant Quinti 77-79
City
Barcelona
Postcode
08041
Country
Spain

Scientific contact point

Organisation
Fundacio Institut De Recerca De L'Hospital De La Santa Creu I Sant Pau
Contact name
Alejandra Espinosa

Public contact point

Organisation
Fundacio Institut De Recerca De L'Hospital De La Santa Creu I Sant Pau
Contact name
Alejandra Espinosa

Locations

1 EU/EEA country · 12 investigational sites

By country

CountryMS statusPlanned subjectsSites
Spain Ongoing, recruiting 772 12
Rest of world 0

Investigational sites

Spain

12 sites · Ongoing, recruiting
Hospital Universitari De Girona Doctor Josep Trueta
Pediatric Surgery, Avinguda De Franca S/n, 17007, Girona
Complexo Hospitalario Universitario De Santiago
Pediatric Surgery, Calle Choupana Da S/n, 15706, Santiago De Compostela
Hospital Universitari Joan XXIII De Tarragona
Pediatric Surgery, Calle Del Doctor Mallafre Guasch 4, 43005, Tarragona
Hospital Sant Joan De Deu Barcelona
Pediatric Surgery, Passeig De Sant Joan De Deu 2, 08950, Esplugues De Llobregat
Hospital Germans Trias I Pujol
Pediatric Surgery, Carretera Canyet 1a Planta, 08916, Badalona
Hospital De La Santa Creu I Sant Pau
Epidemiología, Calle De San Antonio Maria Claret 167, 08025, Barcelona
Consorci Mar Parc De Salut De Barcelona
Pediatric Surgery, Passeig Maritim De La Barceloneta 25-29, 08003, Barcelona
Hospital Universitario Reina Sofia
Pediatric Surgery, Avenida Menendez Pidal S/n, 14004, Cordoba
Hospital Universitario 12 De Octubre
Pediatric Surgery, Avenida De Cordoba Sn, 28041, Madrid
Hospital Clinico San Carlos
Pediatric Surgery, Calle De Martin Fierro Sn, 28040, Madrid
Hospital Royo Villanova
Pediatric Surgery, Avenida De San Gregorio 30, 50015, Zaragoza
University Hospital Virgen Del Rocio S.L.
Pediatric Surgery, Avenida De Manuel Siurot S/n, 41013, Sevilla

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Spain 2025-01-29 2025-01-29

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 7 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_Protocol 2025-520777-39-00 pub 4
Recruitment arrangements (for publication) K1_Recruitment arrangements pub 1
Subject information and informed consent form (for publication) L1_SIS and ICF 6 years 2
Subject information and informed consent form (for publication) L1_SIS and ICF parents pub 3
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC Amoxicilina 1
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC Amoxicilina 1
Synopsis of the protocol (for publication) D1_Protocol synopsis MS_ 2025-520777-39-00 FP 4

Application history

2 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2025-01-22 Spain Acceptable with conditions
2025-01-29
2025-01-29
2 SUBSTANTIAL MODIFICATION SM-1 2026-03-25 Spain Acceptable
2026-05-07
2026-05-12