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26 Week Efficacy and Safety Trial for Patients With Chronic Idiopathic Constipation

Phase 3
Terminated
Conditions
Chronic Idiopathic Constipation
Interventions
Registration Number
NCT01827592
Lead Sponsor
Ferring Pharmaceuticals
Brief Summary

Efficacy and Safety Trial of elobixibat in Patients with Chronic Idiopathic Constipation treated for 26 Weeks.

Detailed Description

The present trial was designed to determine the efficacy and safety of elobixibat treatment (at both doses of 5 mg and 10 mg/day) compared to placebo treatment for 26-week Treatment Period in patients with chronic idiopathic constipation. Patients were followed-up for 2 weeks after end of the Treatment Period.

The assessment of primary and key secondary end points was done for patients who completed the first 12 weeks of Treatment Period. Incidence of Adverse Events (AEs) were reported till 2 weeks after end of the treatment.

The trial was early terminated due to a distribution issue with the trial medication.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
376
Inclusion Criteria
  • Body mass index (BMI) ≥18.5 but <35.0 kg/m^2

  • Male or female ≥18 years of age

  • Reports <3 spontaneous Bowel movements (BM) per week and reports one or more of the following symptoms for the last 3 months with symptom onset at least 6 months before the Screening Visit or before starting chronic therapy with any laxative:

    1. Straining during at least 25% of defecations
    2. Lumpy or hard stools during at least 25% of defecations
    3. Sensation of incomplete evacuation during at least 25% of defecations
  • Is ambulatory and community dwelling

  • An initial colonoscopy is required if recommended by national guidelines

Exclusion Criteria
  • Reports loose (mushy) or watery stools in the absence of any laxative intake in the form of a tablet, a suppository or an enema, or prohibited medicine for >25% of BMs
  • The patient reports a BSFS of 6 or 7 during the Pretreatment Period
  • Has irritable bowel syndrome (IBS) with pain/discomfort as predominant symptoms
  • Has a structural abnormality of the GI tract or a disease or condition that can affect Gastrointestinal (GI) motility
  • Has a history of diverticulitis, chronic pancreatitis, active peptic ulcer disease (PUD) not adequately treated, ischaemic colitis, inflammatory bowel disease, laxative abuse, faecal impaction that required hospitalization or emergency treatment, pseudo-obstruction, megacolon, megarectum, bowel obstruction, descending perineum syndrome, ovarian cysts, endometriosis, solitary rectal ulcer syndrome, systemic sclerosis, pre-malignant colonic disease (e.g., familial adenomatous polyposis or hereditary non-polyposis colorectal cancer) or other forms of familial colorectal cancer.
  • Has unexplained and clinically significant GI alarm signals (e.g., lower GI bleeding or heme-positive stool in the absence of known internal or external haemorrhoids, iron-deficiency anaemia, unexplained weight loss) or systemic signs of infection or colitis
  • Has a potential central nervous system (CNS) cause of constipation (e.g., Parkinson's disease, spinal cord injury, multiple sclerosis)
  • Has intestinal/rectal prolapse or other known pelvic floor dysfunction
  • Commonly uses digital manoeuvres (perianal pressure or digital disimpaction) or vaginal splinting to facilitate the passage of a bowel movement
  • Has a history of diabetic neuropathy
  • Has a history of bariatric surgery for treatment of obesity; surgery to remove a segment of the GI tract; or surgery of the abdomen, pelvic or retroperitoneal area during the 6 months prior to Screening; or appendectomy or cholecystectomy 3 months prior to screening; or other major surgery 1 month prior to Screening
  • Has a history of cancer with last date of proven disease activity/presence of malignancy within 5 years, except for adequately treated basal cell carcinoma of the skin, cervical dysplasia, or carcinoma in situ of the skin or the cervix
  • Known human immunodeficiency virus (HIV) or Hepatitis B/C (HBV/HCV) infection
  • Has a history of hospitalization for any psychiatric disorder, or any suicide attempt in the 2 years prior to Screening
  • Is actively abusing alcohol or drugs or has a history of alcohol or drug abuse during the 6 months prior to Screening
  • Is being treated for hypothyroidism, but the dose of medication has not been stable for at least 3 months at the time of Screening
  • Is a pregnant, breast-feeding, or lactating woman

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
EBX 5Elobixibat 5 mgElobixibat 5 mg/day
EBX 10Elobixibat 10 mgElobixibat 10 mg/day
PLCBOPlaceboPlacebo
Primary Outcome Measures
NameTimeMethod
Overall Complete Spontaneous Bowel Movement (CSBM) ResponseDuring the first 12 weeks

This outcome measured the percentage of patients who were CSBM responders. A CSBM responder was defined as a patient with ≥3 CSBMs per week and an increase of ≥1 CSBM per week from Baseline, for at least 9 of the 12 weeks in the 12-week Treatment Period, including at least 3 weeks during Weeks 9-12.

Secondary Outcome Measures
NameTimeMethod
Occurrence of CSBM ResponseWithin the first 24 hours of treatment initiation

This outcome measured the percentage of patients who had a CSBM within 24 hours after the first dose of treatment. A CSBM was defined as a spontaneous (occurring without laxative within the preceding 24 hours, including no rescue medication within the preceding 24 hours) bowel movement (as interpreted by the patient, with a beginning and an end, including single or multiple stools), accompanied by a patient reported sense of complete evacuation ('complete').

Change From Baseline in Weekly Frequency of Spontaneous Bowel Movements (SBMs)From Baseline (2-week Pretreatment Period) to overall first 12-weeks of Treatment Period

The change from Baseline for the continuous variable was estimated using a repeated measures analysis of covariance (ANCOVA) model.

Change From Baseline in Weekly Stool Consistency of SBMsFrom Baseline (2-week Pretreatment Period) to overall first 12-weeks of Treatment Period

The stool consistency is measured using the seven-point ordinal Bristol Stool Form Scale (BSFS) score. The BSFS classifies human stool into seven types and points them accordingly.

Type 1: Separate hard lumps, like nuts (hard to pass) Type 2: Sausage-shaped, but lumpy Type 3: Like a sausage but with cracks on its surface Type 4: Like a sausage or snake, smooth and soft Type 5: Soft blobs with clear cut edges (passed easily) Type 6: Fluffy pieces with ragged edges, a mushy stool Type 7: Watery, no solid pieces, entirely liquid Types 1 and 2 indicate constipation, with 3 and 4 represents the ideal stool form (especially the latter), and 5, 6 and 7 tends towards diarrhoea .

For a given assessment week, the weekly stool consistency was defined as the sum of non-missing stool consistency score for SBMs during that week divided by the number of non-missing stool consistency score for SBMs during that week. The parameter was analysed using repeated measures ANCOVA model.

Total Patient Assessment of Constipation - Quality of Life (PAC-QOL) Score ResponderAt 12 weeks

This outcome measured the percentage of patients who were PAC-QOL score responder at 12-week of Treatment Period. A PAC-QOL score responder was defined as a patient with ≥50% reduction in total PAC-QOL score from Baseline at Week 12.

PAC-QOL is a 28-item questionnaire for psychometric assessment of disease-specific quality of life. The questionnaire is based on 5-point Likert scale; ranging from 0 \[none of the time or not at all\] to 4 \[all of the time or extremely\]). A lower score indicates a better Quality of Life. The PAC-QOL questionnaire is developed specifically for patients with constipation.

Total PAC-QOL score was averaged from the individual item score.

Change From Baseline in Weekly Degree of Straining of SBMsFrom Baseline (2-week Pretreatment Period) to overall first 12-weeks of Treatment Period

The degree of straining was measured using the five-point ordinal scale (1=Not at all, 2=A little bit, 3=A moderate amount, 4=A great deal, and 5=An extreme amount).

For a given assessment week, the weekly degree of straining was defined as the sum of non-missing straining score for SBMs during that week divided by the number of non-missing straining score for SBMs during that week. The parameter was analysed using repeated measures ANCOVA model.

Change From Baseline in Weekly Abdominal Bloating ScoreFrom Baseline (2-week Pretreatment Period) to overall first 12-weeks of Treatment Period

The abdominal bloating score was measured using the five-point ordinal scale (1=None, 2=Mild, 3=Moderate, 4=Severe, and 5=Very severe).

For a given assessment week, the weekly abdominal bloating score was defined as the sum of non-missing abdominal bloating score for SBMs during that week divided by the number of non-missing abdominal bloating score for SBMs during that week. The parameter was analysed using repeated measures ANCOVA model.

Change From Baseline in Weekly Abdominal Discomfort ScoreFrom Baseline (2-week Pretreatment Period) to overall first 12-weeks of Treatment Period

The abdominal discomfort score was measured using the five-point ordinal scale (1=None, 2=Mild, 3=Moderate, 4=Severe, and 5=Very severe).

For a given assessment week, the weekly abdominal discomfort score was defined as the sum of non-missing abdominal discomfort score for SBMs during that week divided by the number of non-missing abdominal discomfort score for SBMs during that week. The parameter was analysed using repeated measures ANCOVA model.

Trial Locations

Locations (90)

Alabama Clinical Therapeutics

🇺🇸

Birmingham, Alabama, United States

G and L Research, LLC

🇺🇸

Foley, Alabama, United States

Adobe Gastroenterology Research, LLC

🇺🇸

Tucson, Arizona, United States

Skyline Research LLC

🇺🇸

Cerritos, California, United States

GW Research, Inc.

🇺🇸

Chula Vista, California, United States

Paradigm Clinical, Inc.

🇺🇸

Garden Grove, California, United States

Providence Clinical Research

🇺🇸

North Hollywood, California, United States

Stamford Therapeutics Consortium

🇺🇸

Stamford, Connecticut, United States

Pulmonary Associates of Brandon

🇺🇸

Brandon, Florida, United States

In Vivo Clinical Research, Inc.

🇺🇸

Hialeah, Florida, United States

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Alabama Clinical Therapeutics
🇺🇸Birmingham, Alabama, United States

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