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A Study of Oral Dosing of ASP0456 in Patients With Chronic Constipation

Phase 3
Completed
Conditions
Chronic Constipation
Interventions
Drug: Placebo
Registration Number
NCT02809105
Lead Sponsor
Astellas Pharma Inc
Brief Summary

The objective of this study is to verify the efficacy and investigate the safety of the study drug when ASP0456 is administered orally for 4 weeks and 52 weeks.

Detailed Description

This study consists of two parts. In Part I, ASP0456 or placebo will be administered orally in a blind manner. In Part II, the long-term safety and efficacy of ASP0456 will be evaluated in patients who have participated in the study and completed the Part I.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
186
Inclusion Criteria
  • Patients with SBM frequency for < 3 times/week, since ≥ 6 months prior to preliminary enrollment
  • Patients with one or more related symptoms for ≥ 6 months prior to preliminary enrollment
  • Patients at whom loose (mushy) or watery stools are rarely present without the use of laxatives for ≥ 6 months prior to preliminary enrollment
  • Patients who underwent pancolonoscopy or contrast enema after development of the CC symptoms and within 5 years prior to preliminary enrollment, and in whom no organic change was observed which dose not influence on CC symptoms
  • Female patients must be either:

If of non-childbearing potential:

  • Post-menopausal at the preliminary enrollment, or documented surgically sterile Or, if of childbearing potential,

  • Agree not to try to become pregnant during the study and for 28 days after the final study drug administration

  • And have a negative urine pregnancy test at screening

  • And, if heterosexually active, agree to consistently use two forms of highly effective birth control throughout the study period and for 28 days after the final study drug administration

    • Female patients must agree not to breastfeed throughout the study period and for 28 days after the final study drug administration
    • Female patients must not donate ova starting throughout the study period and for 28 days after the final study drug administration
    • Male subject and their female spouse/partners who are of childbearing potential must be using two forms of highly effective form of birth control starting at Screening and continue throughout the study period, and for 28 days after the final study drug administration
    • Male subject must not donate sperm starting at Screening and throughout the study period and, for 28 days after the final study drug administration
Exclusion Criteria
  • Patients who have met the Rome III diagnostic criteria for IBS; with recurrent abdominal pain or discomfort for ≥ 3 days/month in the last 3 months prior to preliminary enrollment, associated with ≥ 2 of the 3 characteristics described below and with the symptoms (IBS symptoms) described above for ≥ 6 months prior to preliminary enrollment

    1. Improvement with defecation
    2. Onset associated with a change in frequency of stool
    3. Onset associated with a change in form (appearance) of stool
  • Patients with a history of surgical resection of the stomach, gallbladder, small intestine, or large intestine

  • Patients with a history or current evidence of inflammatory bowel disease or ischemic colitis

  • Patients with concurrent infectious enteritis, hyperthyroidism or hypothyroidism, constipation due to anorectal dysfunction, drug-induced constipation, constipation due to other organic diseases or active peptic ulcer

  • Patients with apparent mechanical obstruction

  • Patients with megacolon or megarectum

  • For female patients, patients with concurrent endometriosis or adenomyosis

  • Patients who are considered to have severe depression or a severe anxiety disorder that can affect the efficacy evaluation of the study drug

  • Patients with a history of abuse of drugs or alcohol, or current abuse of drugs or alcohol

  • Patients who used/underwent or are scheduled to use/undergo prohibited concomitant drugs or therapies, or in whom prohibited examinations were conducted or are scheduled to be conducted 3 days prior to the start of the bowel habit observation period

  • Patients with a history or current evidence of malignant tumors

  • Patients with concurrent serious cardiovascular diseases, respiratory diseases, renal diseases, hepatic diseases, gastrointestinal disorders, blood diseases, or neurological/psychiatric diseases

  • Patients with a history of drug allergies

  • Patients who have participated in the clinical trial of ASP0456 or have been administered ASP0456

  • Patients who have participated or are participating in another clinical trial or post-marketing clinical study of other ethical drugs or medical devices within 12 weeks prior to obtaining informed consent

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Part I PlaceboPlaceboPlacebo will be administered orally for 4 weeks.
Part I ASP0456linaclotideASP0456 will be administered orally for 4 weeks.
Part II ASP0456linaclotideASP0456 will be administered orally.
Primary Outcome Measures
NameTimeMethod
Change from baseline in weekly mean SBM frequency during one week of administration (Part I)Baseline and Week 1

SBM: Spontaneous bowel movement

Secondary Outcome Measures
NameTimeMethod
Time to first SBMUp to Week 4
Safety assessed by incidence of adverse eventsUp to Week 56
Change from baseline in weekly mean SBM frequencyBaseline and up to Week 56
Weekly responder rate of SBMBaseline and up to Week 56

The weekly average value of SBM frequency is more than 3 and over 1 more than the weekly mean value of SBM frequency in the bowel habit observation period.

Percentage of subjects with SBM within 24 hours after the start of the initial administrationUp to 24h
Change from baseline in weekly mean CSBM frequencyBaseline and up to Week 56

CSBM: SBM without a sensation of incomplete evacuation

Weekly responder rate of CSBMBaseline and up to Week 56

The weekly average value of CSBM frequency is more than 3 and over 1 more than the weekly mean value of CSBM frequency in the bowel habit observation period.

Percentage of subjects with CSBM within 24 hours after the start of the initial administrationUp to 24h
Change from baseline in weekly mean stool form scoreBaseline and up to Week 56

Stool form will be measured using seven-point Bristol Stool Form Scale.

Change from baseline in weekly mean abdominal bloating severity scoreBaseline and up to Week 56

Abdominal bloating severity will be measured using a five-point ordinal score.

Change from baseline in weekly mean abdominal pain/discomfort severity scoreBaseline and up to Week 56

Abdominal pain/discomfort severity will be measured using a five-point ordinal score.

Change from baseline in weekly mean straining severity scoreBaseline and up to Week 56

Straining severity will be measured using a five-point ordinal score.

Weekly responder rate of abnormal bowel habits improvement in CCUp to Week 56

Score of abdominal bowel habits improvement effect (7 scores: 1-7) is 1 or 2.

Number of participants with abnormal Vital signs and/or adverse events during treatment periodUp to Week 56
Number of participants with abnormal Laboratory values and/or adverse events during treatment periodUp to Week 56
Weekly responder rate of global assessment of relief of CC symptomsUp to Week 56

CC: chronic constipation; The weekly responder of the evaluation items shall be the subject satisfying the following at the time of evaluation in each week: Score of Global assessment of relief of chronic constipation symptoms (7 scores: 1-7) is 1 or 2.

Weekly responder rate of abdominal symptoms relief of CCUp to Week 56

Score of abdominal symptom improvement effect (7 scores: 1-7) is 1 or 2.

Change from baseline in IBS-QOL-J scoreBaseline and up to Week 56

IBS-QOL-J: Japanese version of Irritable Bowel Syndrome Quality of Life

Safety assessed by body weightUp to Week 56

Trial Locations

Locations (39)

Site JP00036

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Osaka, Japan

Site JP00011

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Tokyo, Japan

Site JP00013

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Tokyo, Japan

Site JP00039

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Hyogo, Japan

Site JP00018

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Kanagawa, Japan

Site JP00019

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Kanagawa, Japan

Site JP00035

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Osaka, Japan

Site JP00027

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Saitama, Japan

Site JP00015

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Tokyo, Japan

Site JP00020

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Kanagawa, Japan

Site JP00032

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Osaka, Japan

Site JP00008

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Tokyo, Japan

Site JP00009

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Tokyo, Japan

Site JP00038

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Hyogo, Japan

Site JP00025

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Saitama, Japan

Site JP00014

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Tokyo, Japan

Site JP00040

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Fukuoka, Japan

Site JP00034

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Osaka, Japan

Site JP00028

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Saitama, Japan

Site JP00004

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Tokyo, Japan

Site JP00006

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Tokyo, Japan

Site JP00007

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Tokyo, Japan

Site JP00010

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Tokyo, Japan

Site JP00012

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Tokyo, Japan

Site JP00030

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Aichi, Japan

Site JP00021

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Chiba, Japan

Site JP00024

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Chiba, Japan

Site JP00029

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Aichi, Japan

Site JP00037

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Hyogo, Japan

Site JP00017

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Kanagawa, Japan

Site JP00022

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Chiba, Japan

Site JP00023

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Chiba, Japan

Site JP00001

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Hokkaido, Japan

Site JP00002

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Hokkaido, Japan

Site JP00031

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Osaka, Japan

Site JP00033

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Osaka, Japan

Site JP00026

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Saitama, Japan

Site JP00003

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Tokyo, Japan

Site JP00005

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Tokyo, Japan

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