Lubiprostone for Functional Constipation in the Under 18 Years Patients
- Conditions
- Clinical EfficacyTreatment EfficacyDrug Side Effect
- Interventions
- Registration Number
- NCT05144295
- Lead Sponsor
- Alexandria University
- Brief Summary
The investigators will enroll subjects 8 - \< 18 years of age, fulfilling Rome IV criteria for functional constipation.
Participants will be randomly assigned to either Lubiprostone treatment (study group), or the control group (will receive either lactulose or Bisacodyl tablets).
safety and efficacy will be assessed.
- Detailed Description
The investigators will enroll 274 subjects who will be randomly divided equally into interventional and control groups.
Participants and their parents/legal guardians will be instructed to administer the doses at least 5 hours apart with meals and a large volume of fluid.
The control group will receive lactulose 1 mL/kg, once or twice daily (maximum 60 mL/day or Bisacodyl tablet (5 mg/tablet) in a dose of 2 tab/day for \< 12 years or 3 tab/day for \> 12 years.
Both arms will receive the treatment for 12 weeks followed by 4 weeks follow-up after the end of treatment (week 16).
Participants (and their guardians) will be instructed to regularly document the number of spontaneous bowel motions/week and to define their Bristol chart category for every bowel motion. In addition, the participants will be encouraged to contact the trial team if any adverse events appeared. This is in addition to regular visits at 0, 2, 8, 12 weeks for assessment of safety (efficacy will be assessed at weeks 8, 12, and 16).
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 274
- Patients 8 - < 18 years of age who have a confirmed diagnosis of Pediatric functional constipation according to the Rome IV criteria, who give written informed consent personally or from their legal guardians.
- Discontinuation of any medication affecting gastrointestinal (GI) motility at least 2 weeks before starting the treatment allocation.
- Patient's daily diary that indicates an average of < 3 weekly spontaneous bowel movements (SBMs), with ≥ 25% of SBMs involving at least some straining and/or a 5-point modified Bristol Stool Form Scale type 1 or 2.
- Patients who completed the study protocol.
- If the patient's constipation is attributed to any of the following: physical, mental, or cognitive illness, inflammatory bowel disease, medication, anatomical, neurological, endocrine, or metabolic factors.
- If the patient is a candidate for or underwent abdominal surgery, or has any condition other than constipation that could affect gastrointestinal motility or defecation.
- Patients suffering from Hirschsprung's disease.
- Patients experiencing any alarming signs e.g. unexplained significant weight loss.
- Untreated fecal impaction at the time of enrollment.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Investigational Arm Lubiprostone Pill * Patients will receive lubiprostone capsules (Amiprostone 8 and 24 mcg, or Lubicont 8 mcg) * Patients weighing \<50 kg will be given lubiprostone at doses of 8 mcg/8 hours. * Patients weighing ≥ 50 kg will be given lubiprostone at doses of 24 mcg BID. * Patients and their parents/legal guardians will be instructed to administer the doses at least 5 hours apart with meals and a large volume of fluid. Control Arm Lactulose Oral Liquid Product Subjects will receive the conventional therapy (one or a combination of the following): * Lactulose " Lactulose, or Duphalac syrup" at a dose of 1 ml/kg once or twice daily (maximum 60 mL/day), * Bisacodyl tablets " Bisacodyl 5 mg/tablet" in a dose of 2 tab/day for \< 12 years or 3 tab/day for \> 12 years, or * Sodium Picosulfate 0.75% drops (Picolax drops) in a daily dose of 2.5-20 mg/day. Control Arm Bisacodyl 5 MG Subjects will receive the conventional therapy (one or a combination of the following): * Lactulose " Lactulose, or Duphalac syrup" at a dose of 1 ml/kg once or twice daily (maximum 60 mL/day), * Bisacodyl tablets " Bisacodyl 5 mg/tablet" in a dose of 2 tab/day for \< 12 years or 3 tab/day for \> 12 years, or * Sodium Picosulfate 0.75% drops (Picolax drops) in a daily dose of 2.5-20 mg/day. Control Arm Sodium Picosulfate Subjects will receive the conventional therapy (one or a combination of the following): * Lactulose " Lactulose, or Duphalac syrup" at a dose of 1 ml/kg once or twice daily (maximum 60 mL/day), * Bisacodyl tablets " Bisacodyl 5 mg/tablet" in a dose of 2 tab/day for \< 12 years or 3 tab/day for \> 12 years, or * Sodium Picosulfate 0.75% drops (Picolax drops) in a daily dose of 2.5-20 mg/day.
- Primary Outcome Measures
Name Time Method Primary outcome At study week 16. Spontaneous bowel motions (SBM) ≥ 1 SBM/week increase in the frequency compared with baseline, and ≥ 3 SBMs/week for at least 8 weeks, including the last 4 study weeks and the 4 weeks of follow-up.
- Secondary Outcome Measures
Name Time Method First dose response time 1st week of treatment The time between first dose of treatment and the first SBM.
Early spontaneous bowel motions First 48 hours after first drug dose. Number of participants who experienced first SBM within 48 hours after dose initiation.
Number of Spontaneous Bowel Motions/Week. At study week Week 8, 12. Number of Spontaneous Bowel Motions/Week.
Responders rate At study week Week 8, 12, 16. Responders rate at week 8, 12, 16.
Trial Locations
- Locations (2)
Faculty of Medicine
🇪🇬Alexandria, Egypt
Alexandria Main University Hospital
🇪🇬Alexandria, Egypt