AzTrials
AzTrials

Colorectal PolypsNCT07448129

Clinical Trial to Evaluate the Efficacy and Safety of SUBMO® as a Submucosal Injection Agent in Endoscopic Resection of Superficial Gastrointestinal Lesions.

A study testing SUBMO® Submucosal Injection and Normal Saline (0.9% Sodium Chloride) with Surface Dye Injection in people with Colorectal Polyps, run by i+Med S.Coop. at 4 sites in Spain.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

The SUBMO-PIC01-2025 study evaluates whether SUBMO®, a submucosal injection hydrogel composed of high-molecular weight hyaluronic acid and methylene blue, is as effective and safe as normal saline for endoscopic resection of superficial colorectal lesions larger than 10 mm. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Colorectal Polyps
What is being tested?
SUBMO® Submucosal Injection and Normal Saline (0.9% Sodium Chloride) with Surface Dye Injection
Could I receive a placebo?
No, everyone receives an active treatment
How many people
300 participants
Where
4 sitesSpain
Study dates
29 Apr 2026to Mar 2027
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Subjects >18 years old.
  • Presence of a colorectal lesion larger than 10 mm, confirmed through colonoscopy.
  • The lesion must be considered technically resectable using either Endoscopic Mucosal Resection (RME) or Endoscopic Submucosal Dissection (DSE).
  • The participant must be willing and able to comply with all required study visits and procedures, according to the protocol.
  • The participant must understand, sign, and date the written informed consent form before undergoing any study-specific procedures.

Who cannot join

  • Severe comorbidities according to clinical judgment, including patients classified as ASA IV or ASA V, except those ASA IV cases explicitly approved as clinically safe by the center's Anesthesiology Service (using the ASA anesthetic classification).
  • Patients presenting some coagulopathy that prevents safe endoscopic resection.
  • Lesions that are suspicious endoscopic invasive cancer.
  • Any medical condition that, in the investigator's opinion, could compromise patient safety or protocol adherence.
  • Known allergy or hypersensitivity to any component of the investigational product, including hyaluronic acid, methylene blue, or any excipients.
  • Contraindications to colonoscopy or to the administration of sedation/anesthesia.
  • Current participation in another clinical investigation with an investigational product, or participation in any clinical study (with tested or untested products) within the previous 30 days prior to randomization.
  • Pregnant or breastfeeding women.

Trial locations and contacts

4 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Josune Torrecilla contact

+34945561134

jtorrecilla@imasmed.com

Spain4 sites, 4 recruiting
  • Hospital Universitario de la Santa Creu i Sant Pau

    Barcelona, Barcelona, 08026

    Jorge Gordillo, Ábalos, 935 565 920, JGordillo@santpau.cat

    Recruiting
  • Hospital Universitario Basurto

    Bilbao, Bizkaia, 48013

    Ángel Calderón, Dr, 944 00 60 00, angeljose.calderongarcia@osakidetza.eus

    Recruiting
  • Hospital de Cruces

    Bilbao, Bizkaia, 48903

    David Coto, Dr, 946 00 60 00, david.cotougarte@osakidetza.eus

    Recruiting
  • Hospital Althaia

    Manresa, Barcelona, 08243

    Marco Antonio Álvarez, Dr, 938 759 300, marcoalgo@gmail.com

    Recruiting

Other trials in Spain

About this study

Official title: Randomized Clinical Trial to Evaluate the Efficacy and Safety of the Use of a Medical Device (SUBMO®) for Submucosal Injection in Endoscopic Resection Techniques of Superficial Gastrointestinal Lesions.

The SUBMO-PIC01-2025 study evaluates whether SUBMO®, a submucosal injection hydrogel composed of high-molecular weight hyaluronic acid and methylene blue, is as effective and safe as normal saline for endoscopic resection of superficial colorectal lesions larger than 10 mm. Its primary aim is to determine non-inferiority in complete resection rates, whether en bloc or fragmented, and to assess safety through the systematic identification of serious adverse events. Secondary aims include analysing the total volume of product needed, the number of injections required, the maintenance of the submucosal cushion, the duration of the procedure, the ease of resection, the subjective evaluation of endoscopists, and the appearance of additional adverse events related to the intervention such as intraprocedural bleeding, fever, significant post-procedure pain, post-coagulation syndrome or immediate or delayed perforation.

Eligible participants are adults aged 18 or older with a confirmed colorectal lesion greater than 10 mm that is technically resectable using EMR or ESD, who are capable and willing to follow the study procedures and who have signed informed consent prior to any protocol-specific action. Exclusion criteria include severe comorbidities corresponding to ASA IV or V unless specifically authorised by anaesthesia, coagulopathies that prevent endoscopic resection, endoscopic suspicion of invasive cancer, any condition deemed by investigators to compromise safety or adherence, known allergy to hyaluronic acid, methylene blue or excipients, contraindications to colonoscopy or sedation, participation in another clinical investigation within the previous 30 days, and pregnancy or breastfeeding. Participants may be withdrawn due to voluntary consent withdrawal, safety concerns, protocol deviations that affect data integrity or patient safety, loss to follow-up or pregnancy discovered during the study.

The main efficacy variable is the technical success of resection as judged immediately by the endoscopist, while the main safety variable is the incidence of serious adverse events and their causal relationship with the investigational product. Exploratory variables include baseline demographics such as age, sex, ethnic origin and body mass index, anticoagulant or antiplatelet medication, and comorbidities including endoscopic history, obesity, hypertension, cardiovascular disease, haematologic disorders such as von Willebrand disease or haemophilia, and chronic liver disease. Baseline variables also include ASA classification and lifestyle habits. Polyp-related variables include size, number, anatomical location in the colon or rectum, LST subtype and JNET classification. Resection-related variables capture the technique used (EMR or ESD), whether the resection is en bloc or piecemeal, the number of fragments for calculating the Sydney Resection Quotient, the DMI score and any closure technique or complications. Treatment-related variables include total and per-surface area injection volume, number of submucosal injections needed, macroscopic evaluation of cushion maintenance, total procedure time, ease of resection using a visual analogue scale from 0 to 100, a usability questionnaire completed by the endoscopists and a detailed record of all adverse events including bleeding, fever, pain, post-coagulation syndrome and perforation.

Being tested
SUBMO® Submucosal Injection, Normal Saline (0.9% Sodium Chloride) with Surface Dye Injection
Keywords
Submucosal injection, endoscopic resection, hyaluronic acid hydrogel

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • SUBMO® Submucosal InjectionDevice

    Participants randomized to this arm undergo endoscopic resection (EMR or ESD) in which the submucosal injection is performed using SUBMO®, a high-viscosity hydrogel composed of high-molecular-weight hyaluronic acid and methylene blue. SUBMO® is administered through a standard injection needle to create and maintain a stable submucosal cushion that facilitates safe and complete resection of colorectal lesions. Its integrated dye enhances visualization of the submucosal layer. All other aspects of the procedure follow routine clinical practice.

  • Normal Saline (0.9% Sodium Chloride) with Surface Dye InjectionDevice

    Participants in this arm undergo endoscopic resection using normal saline as the submucosal injection solution, combined with surface dye staining (methylene blue or indigo carmine) prepared as customary in hospital practice, ensuring visibility equivalent to that of the experimental product. Saline is injected to raise the mucosa and allow resection, following standard EMR or ESD clinical techniques. This arm represents the current standard of care for submucosal injection in colorectal lesion resection.

Study groups in NCT07448129
Study groupRoleWhat they receive
SUBMO® Submucosal InjectionExperimentalSUBMO® is a sterile, pyrogen-free hydrogel composed of high-molecular-weight sodium hyaluronate combined with methylene blue and buffered salts in an isotonic, physiological-pH solution. It is designed to act as a submucosal filler, creating a stable and long-lasting elevation between mucosal and muscular layers. The formulation provides structural support due to its viscosity and enhances visualization through integrated methylene blue. SUBMO® is supplied in 10 mL prefilled borosilicate glass syringes and is classified as a Class III medical device without CE marking.
Receives: Device: SUBMO® Submucosal Injection
Normal Saline (0.9% Sodium Chloride) with Surface Dye InjectionActive comparatorThe control product is 0.9% sodium chloride solution (normal saline), used as a standard, low-viscosity submucosal injection fluid. To ensure visualization comparable to the experimental product, a non-infused surface dye such as methylene blue or indigo carmine is added according to routine hospital practice. Saline provides a short-lasting mucosal lift and does not contain structural polymers or integrated colorants. It represents the current reference solution widely used for submucosal elevation.
Receives: Device: Normal Saline (0.9% Sodium Chloride) with Surface Dye Injection

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Resection (RME / ESD) Technical Success

    Resection technical success represents the immediate procedural success of the endoscopist in achieving a complete resection of the target lesion. Assessment is based on the endoscopist's expert judgement of whether the entire lesion has been removed, following either EMR (Endoscopic Mucosal Resection) or ESD (Endoscopic Submucosal Dissection). The result is recorded dichotomously (success / no success). At the end of the study, this outcome will be expressed as the percentage of patients in each treatment arm who achieved complete resection.

    Measured: Immediatly after procedure (day 0)

  2. Incidence and Characterisation of Serious Adverse Events (SAEs)

    This is the primary safety outcome and includes all serious adverse events occurring from the moment a patient receives the investigational or control product until the end of follow-up.

    Measured: Throughout the study (from day 0 to 1 month)

Secondary outcomes (11)
  1. Total size of the lesion (mm)

    Measurement of the total size of the lesion (the largest lesion will be used as reference in the measurement) (measured in millimeters).

    Measured: During intervention (day 0)

  2. Number of lesions (>10 mm)

    Measurement of the number of lesions larger than 10 mm.

    Measured: During intervention (day 0)

  3. Anatomical location of the lesion

    Description of the anatomical location within the colon or rectum (right colon, transverse colon, left colon, or rectum).

    Measured: During intervention (day 0)

  4. LST (Lateral Spreading Tumor) classification

    Classification of the polyps that spread laterally across de mucosa, it predicts the risk of the submucosa infiltration.

    The classification will be divided into two groups: Granular polyps (LST-G) and Non-Granular polyps (LST-NG)

    Measured: During intervention (day 0)

  5. JNET (Japanese NBI Expert Team) classification

    Classification that divides NICE 2 lesions into 2 groups: 2A (low grade adenomas) and 2B (high grade adenomas, incorporating the cancers that infiltrate the submucosa superficially)

    Measured: During intervention (day 0)

  6. Resection Technique

    Resection technique used (EMR vs. ESD).

    Fragmentation data are used to calculate the Sydney Resection Quotient, a metric reflecting resection efficiency and difficulty (lesion size divided by number of fragments).

    Measured: During intervention (Day 0)

  7. Analysis of lesion removal (single piece removal vs. multiple fragments removal)

    Analysis of the outcome of the resection measure as wether the lesion was removed in a single piece or multiple fragments.

    Sydney Resection Quotient is calculated for the multiple fragment removal, a metric reflecting resection efficiency and difficulty (lesion size divided by number of fragments).

    Measured: During intervention (Day 0)

  8. Number of Fragments collected

    Analysis of the number of fragments collected when piecemeal resection occurs.

    Fragmentation data are used to calculate the Sydney Resection Quotient, a metric reflecting resection efficiency and difficulty (lesion size divided by number of fragments).

    Measured: During intervention (Day 0)

  9. Sydney Deep Mural Injury Score (DMI)

    Analysis of the Sydney Deep Mural Injury (DMI) score (0 to IV points), which assesses the depth of tissue injury (0-Normal defect; IV-actual hole with a white cautery ring).

    Measured: During intervention (Day 0)

  10. Closure Techniques vs. Hemostatic measures

    Documentation of whether closure techniques or hemostatic measures were applied (such as clipping, coagulation, or other methods).

    Measured: During intervention (Day 0)

  11. Intra-procedural complications

    Data on intra-procedural complications, whether minor or significant, are recorded.

    Measured: During intervention (Day 0)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Mar 2026
  2. Study start29 Apr 2026
  3. Primary completionMar 2027 (estimated)
  4. Study completionMar 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
300 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07448129
Sponsor's protocol ID
SUBMO-PIC01-2025
Status last verified
Jul 2026
First submitted
26 Feb 2026
Last updated
9 Jul 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A study testing SUBMO® Submucosal Injection and Normal Saline (0.9% Sodium Chloride) with Surface Dye Injection in people with Colorectal Polyps, run by i+Med S.Coop. at 4 sites in Spain.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 9 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in Spain. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Josune Torrecilla (+34945561134, jtorrecilla@imasmed.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Resection (RME / ESD) Technical Success (time frame: Immediatly after procedure (day 0)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 Jul 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in