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Lubiprostone for Chronic Idiopathic Constipation Treatment

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT02729909
Recruitment Status : Completed
First Posted : April 6, 2016
Results First Posted : April 1, 2019
Last Update Posted : April 1, 2019
Sponsor:
Information provided by (Responsible Party):
Takeda

Brief Summary:
The purpose of this study is to evaluate the efficacy and safety of oral administration of 24 ug of lubiprostone twice daily (BID) for 4 weeks in participants with chronic idiopathic constipation (CIC) compared with placebo.

Condition or disease Intervention/treatment Phase
Constipation Drug: Lubiprostone Drug: Placebo Phase 3

Detailed Description:

The drug being tested in this study is called lubiprostone. Lubiprostone is being tested to treat people who have chronic idiopathic constipation. This study will look at the frequency of spontaneous bowel movements (SBMs) in people who take lubiprostone compared to placebo.

The study will enroll approximately 211 participants. Participants will be randomly assigned (by chance, like flipping a coin) equally to one of the two treatment groups, which will remain undisclosed to the participant and study doctor during the study (unless there is an urgent medical need):

  • Lubiprostone 24 μg
  • Placebo (dummy inactive pill) - this is a capsule that looks like the study drug but has no active ingredient

All participants will be asked to take one capsule with breakfast and one capsule with dinner each day throughout the study. All participants will be asked to record each time they have a SBM and all details of each SBM (including the consistency of the stool and the difficulty they have in passing it) in a diary.

This multi-center trial will be conducted in Mexico. The overall time to participate in this study is 8 weeks. Participants will make multiple visits to the clinic, and will be contacted by telephone 14 days after last dose of study drug for a follow-up assessment.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 211 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase 3, Multicenter, Randomized, Double-Blind, Parallel-Group, Placebo-Controlled Study to Evaluate the Efficacy and Safety of Lubiprostone for the Treatment of Chronic Idiopathic Constipation
Actual Study Start Date : May 11, 2016
Actual Primary Completion Date : April 28, 2017
Actual Study Completion Date : June 5, 2017

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Constipation

Arm Intervention/treatment
Experimental: Lubiprostone 24 μg
Lubiprostone 24 μg, capsules, orally, twice daily, under fed conditions, for 4 weeks.
Drug: Lubiprostone
Lubiprostone capsules
Other Name: AMITIZA

Placebo Comparator: Placebo
Lubiprostone placebo-matching capsules, orally, twice daily, under fed conditions, for 4 weeks.
Drug: Placebo
Lubiprostone placebo-matching capsules




Primary Outcome Measures :
  1. Spontaneous Bowel Movement (SBM) Frequency at Week 1 of Administration [ Time Frame: Week 1 ]
    A SBM is defined as any bowel movement (BM) that does not occur within 24 hours after rescue medication use (laxative, suppository, or enema). Participants were given a diary to complete at home where they have recorded all details of each SBM including the consistency of the stool and the difficulty they have in passing it.


Secondary Outcome Measures :
  1. SBM Frequency at Weeks 2, 3 and 4 [ Time Frame: Weeks 2, 3 and 4 ]
    A SBM is defined as any BM that does not occur within 24 hours after rescue medication use (laxative, suppository, or enema). Participants were given a diary to complete at home where they have recorded all details of each SBM including the consistency of the stool and the difficulty they have in passing it.

  2. Percentage of Participants Who Have a SBM Within 24 Hours After First Dose of Study Medication [ Time Frame: Up to 24 hours after the first dose of study medication ]
    A SBM is defined as any BM that does not occur within 24 hours after rescue medication use. Percentage of participants who have an SBM within 24 hours after the first dose was assessed and derived from the data on SBMs collected in the participant diary.

  3. Mean Degree of Straining Score [ Time Frame: Weeks 1, 2, 3 and 4 ]
    For each participant, the mean degree of straining was averaged for all SBMs in a given week. The degree of straining for each SBM was collected in the participant diary. The degree of straining was scored on a 5-point scale where: 0=No straining, 1=Mild straining, 2=Moderate straining, 3=Strong straining or 4=Very strong straining with higher scores indicating more severe straining.

  4. Mean Degree of Stool Consistency [ Time Frame: Weeks 1, 2, 3 and 4 ]
    For each participant, the mean stool consistency score was averaged for all SBMs in a given week. The mean degree of stool consistency for each SBM was collected in the participant diary based on the Bristol Stool Chart. The Bristol Stool Chart is a medical aid designed to classify the form of human feces into seven categories where: 1=Hard and round (difficult-to-pass), 2=Sausage-shaped but hard stool, 3=Sausage-shaped stool with cracks on the surface, 4=Sausage-shaped, soft stool with smooth surface, or coiled stool, 5=Soft, half-solid (and easy-to-pass) stool with clear crease, 6=Unshaped, loose stool with small, irregular-shaped pieces, or mushy stool or 7=Watery stool without solid pieces (entirely liquid).

  5. Weekly Abdominal Symptoms Score [ Time Frame: Weeks 1, 2, 3 and 4 ]
    Weekly abdominal symptoms of bloating and discomfort upon waking in the morning was scored weekly on a 5-point scale where: 0=None, 1=Mild, 2=Moderate, 3=Severe or 4=Very severe, with a higher score indicating more severe symptoms. Assessment of weekly abdominal symptoms were recorded in the participant in the diary.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. In the opinion of the investigator, is capable of understanding and complying with protocol requirements.
  2. The participant or, when applicable, the participant's legally acceptable representative signs and dates a written, informed consent form and any required privacy authorization prior to the initiation of any study procedures.
  3. Has a history of constipation defined as having spontaneous bowel movement (SBM) frequency of less than 3 times per week on average for 6 months or longer and for whom the same SBM frequency is observed during the Screening Period.
  4. Has had 1 or more of the symptoms associated with SBM (described below) for 6months or longer at the start of Screening:

    1. Scybalum stool or hard feces in at least 1 out of every 4 bowel movements.
    2. Sensation of incomplete evacuation in at least 1 out of every 4 bowel movements.
    3. Straining in at least 1 out of every 4 bowel movements.
  5. Rarely has loose stools without the use of laxatives.
  6. Is willing and able to keep a diary on his/her own and willing and able to complete a questionnaire.
  7. Is male or female and aged 18 years or older, at the time of signing an informed consent.
  8. A female participant of childbearing potential who is sexually active agrees to use routinely adequate contraception from signing of informed consent throughout the duration of the study and 14 days after the last dose of study drug.

Exclusion Criteria:

  1. Has received any investigational compound within 30 days prior to Screening.
  2. Has received lubiprostone in a previous clinical study or as a therapeutic agent.
  3. Is an immediate family member, study site employee, or is in a dependent relationship with a study site employee who is involved in conduct of this study (eg, spouse, parent, child, sibling) or may consent under duress.
  4. Has, in the judgment of the investigator, clinically significant abnormal hematological parameters of hemoglobin, hematocrit, or erythrocytes at Screening.
  5. Has a history or clinical manifestations of significant mechanical obstruction (intestinal obstruction due to tumor, hernia etc).
  6. Has a history of hypersensitivity or allergies to lubiprostone or any of its excipients.
  7. Has a history of drug abuse (defined as any illicit drug use) or a history of alcohol abuse within 1 year prior to the Screening Visit.
  8. Is required to take excluded medications.
  9. If female, is pregnant or lactating or intending to become pregnant before, during, or within 1 month after participating in this study; or intending to donate ova during such time period.
  10. Participant whose constipation is considered to be due to drugs or to whom a prohibited concomitant medication has been administered.
  11. Is having chronic constipation due to a secondary cause (medications, diabetes mellitus, hypothyroidism, depression, etc.)
  12. Has sufficient criteria for irritable bowel syndrome (IBS) or functional defecation disorder.
  13. SBM frequency is 3 or more per week.
  14. SBM frequency has been less than 3 times per week for less than 6 months in duration or whose symptoms associated with SBM have been present for less than 6 months (hard feces, sensation of incomplete evacuation, or straining).
  15. Has received treatment with a rescue medication within 24 hours prior to the first dose on the morning of Day1: bisacodyl suppository, which is a standard laxative, glycerin enema, or any other rescue medication.
  16. Has megacolon/megarectum or has received a diagnosis of intestinal pseudo-obstruction.
  17. Has confirmed or suspected organic disorders of the large intestine (obstruction, stenosis, carcinoma, or inflammatory bowel disease). Organic disorders of the large intestine can be confirmed or ruled out using the results of enema X-ray examination or total colonoscopy performed in the previous 2 years. If the participant has no history or shows no current evidence of weight loss, anemia, or rectal bleeding, organic disorders may be ruled out based on the results of such testing performed in the past 3 years. Any participant in whom total colonoscopy has detected a polyp requiring treatment is excluded from this study .Note: Participant should not be screened unless at least 7 days have passed since an enema X-ray examination, total colonoscopy or sigmoidoscopy have been performed.
  18. Has been hospitalized for gastrointestinal or abdominal surgery within 3 months prior to Screening.
  19. Has a significant cardiovascular, liver, lung, kidney, neurological, or mental disease (including existing alcohol or drug abuse problem) or a systemic disease.
  20. Has significant clinical findings or in whom a significant abnormality has been found in hematology test, serum chemistry, or urinalysis.
  21. Participant in whom noncompliance with the study protocol (administration schedule, visit schedule, diary completion or other study procedure) is expected.
  22. Has a history of malignant disease (except basal cell carcinoma) within 5 years prior to Screening.
  23. Has any screening abnormal laboratory value that suggests a clinically significant underlying disease or condition that may prevent the participant from entering the study; or the participant has: creatinine >1.5 mg/dL, alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) >2 times the upper limit of normal (ULN), or total bilirubin >2.0 mg/dL with AST/ALT elevated above the limits of normal values.
  24. Participant who the investigator/subinvestigator has determined ineligible to participate in this study for any reason other than the above.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02729909


Locations
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Mexico
Mexicali, Baja California Norte, Mexico
Mexico, Distrito Federal, Mexico
Cuautitlan Izcalli, Estado De Mexico, Mexico
Tlalnepantla, Estado De Mexico, Mexico
Leon, Guanajuato, Mexico
Morelia, Michoacan, Mexico
Monterrey, Nuevo Le0n, Mexico
Culiacan, Sinaloa, Mexico
Chihuahua, Mexico
Durango, Mexico
Sponsors and Collaborators
Takeda
Investigators
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Study Director: Medical Director Clinical Science Takeda
  Study Documents (Full-Text)

Documents provided by Takeda:
Study Protocol  [PDF] May 18, 2015
Statistical Analysis Plan  [PDF] June 29, 2017

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Responsible Party: Takeda
ClinicalTrials.gov Identifier: NCT02729909    
Other Study ID Numbers: Lubiprostone-3003
U1111-1168-6358 ( Registry Identifier: WHO )
153300410A0196 ( Registry Identifier: RNEC )
First Posted: April 6, 2016    Key Record Dates
Results First Posted: April 1, 2019
Last Update Posted: April 1, 2019
Last Verified: January 2019

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Takeda:
Drug therapy
Additional relevant MeSH terms:
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Constipation
Signs and Symptoms, Digestive
Lubiprostone
Chloride Channel Agonists
Membrane Transport Modulators
Molecular Mechanisms of Pharmacological Action