Long-term Safety of Linaclotide in Pediatric Participants With FC or IBS-C

Phase 3

Active, not recruiting

• Conditions: Irritable Bowel Syndrome With Constipation; Functional Constipation
• Interventions: Drug: Irritable Bowel Syndrome with Constipation (IBS-C) participants (LIN-MD-63 completers); Drug: Functional Constipation (FC) participants (LIN-MD-62 and LIN-MD-64 completers)

• Registration Number: NCT04166058
• Lead Sponsor: AbbVie

Brief Summary

LIN-MD-66 is a Phase 3 open-label study with 24 weeks (Functional Constipation participants) or 52 weeks (Irritable bowel syndrome with constipation participants) of linaclotide exposure that will enroll pediatric participants (6-17 years of age) with FC or IBS-C who completed study intervention in studies LIN-MD-62, LIN-MD-63, orLIN-MD-64 based on the individual study criteria.

Detailed Description

Not available

Basic Information
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Recruitment & Eligibility
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Study & Design
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Trial Locations

Study Timeline

• Study First Submitted: 2019-11-11
• Study First Submitted QC: 2019-11-15
• Study First Posted: 2019-11-18
• Study Start: 2019-11-19
• Status Verified: 2024-06
• Last Update Submitted: 2024-06-18
• Last Update Posted: 2024-06-20
• Primary Completion: 2025-06-05
• Study Completion: 2025-06-05

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 389

Inclusion Criteria

• Participant weighs ≥ 18 kg at the time the parent/guardian/LAR and/or caregiver has provided signed consent.
• Female participants who have had their first menstrual period and are sexually active must agree to use a reliable form of contraception.
• Participants must have completed study intervention in their lead-in study.

Inclusion Criteria for Phase 2 LIN-MD-62 or Phase 2 LIN-MD-63 and Phase 3 LIN-MD-64 completers who enroll in LIN-MD-66 after >28 days from last study intervention:

• Female participants of childbearing potential must have a negative serum pregnancy test at the Screening Visit (Visit 1) and negative urine pregnancy test prior to the first dose on the Day 1 Visit (Visit 2).

• LIN-MD-63 completers only: Participants meet Rome III criteria for child/adolescent IBS: At least once per week for at least 2 months before the LIN-MD-66 Screening Visit (Visit 1), the participant has experienced abdominal discomfort (an uncomfortable sensation not described as pain) or pain associated with 2 or more of the following at least 25% of the time:

  • a) Improvement with defecation
  • b) Onset associated with a change in frequency of stool
  • c) Onset associated with a change in form (appearance) of stool

• Participants meet modified Rome III criteria for child/adolescent FC: For at least 2 months before the LIN-MD-66 Screening Visit (Visit 1), the participant has had 2 or fewer defecations (with each defecation occurring in the absence of any laxative, suppository, or enema use during the preceding 24 hours) in the toilet per week. In addition, at least once per week, participant meets 1 or more of the following:

  • a) History of retentive posturing or excessive volitional stool retention
  • b) History of painful or hard BMs
  • c) Presence of a large fecal mass in the rectum
  • d) History of large diameter stools that may obstruct the toilet
  • e) At least 1 episode of fecal incontinence per week

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Exclusion Criteria

• Participant has a known allergy or sensitivity to the study intervention or its components or other medications in the same drug class.

• Participant received an investigational drug, other than linaclotide, during the 30 days before the Screening Visit (Visit 1) or is planning to receive an investigational drug (other than that administered during this study) or use an investigational device at any time during the study.

• Female participants who are currently pregnant or nursing, or plan to become pregnant or nurse during the clinical study.

• Participant has required manual disimpaction any time prior to study intervention or disimpaction during in-patient hospitalization within 1 year prior to study intervention.

• Participant has any of the following conditions:

  • a) Down's syndrome or any other chromosomal disorder
  • b) Anatomic malformations (eg, imperforate anus, anal stenosis, anterior displaced anus)
  • c) Intestinal nerve or muscle disorders (eg, Hirschprung disease, visceral myopathies, visceral neuropathies)
  • d) Neuropathic conditions (eg, spinal cord abnormalities, neurofibromatosis, tethered cord, spinal cord trauma)
  • e) Neurodevelopmental disabilities (early-onset, chronic disorders that share the essential feature of a predominant disturbance in the acquisition of cognitive, motor, language, or social skills, which has a significant and continuing impact on the developmental progress of an individual) producing a cognitive delay that precludes comprehension by the participant.

• Participant has a mechanical bowel obstruction or pseudo-obstruction.

• Participant currently has both unexplained and clinically significant alarm symptoms (lower GI bleeding [rectal bleeding or heme-positive stool], iron-deficiency anemia, or any unexplained anemia, or weight loss) and systemic signs of infection or colitis, or any neoplastic process.

• Participant has an active anal fissure (Note: history of anal fissure is not an exclusion).

• Participant has had surgery that meets any of the following criteria:

  • a) Bariatric surgery for treatment of obesity, or surgery to remove a segment of the GI tract at any time before the Screening Visit (Visit 1).
  • b) Surgery of the abdomen, pelvis, or retroperitoneal structures during the 6 months before the Screening Visit (Visit 1)
  • c) An appendectomy or cholecystectomy during the 60 days before the Screening Visit
  • d) Other major surgery during the 30 days before the Screening Visit (Visit 1)

• Participant is receiving enteral tube feeding

• Participants who have positive urine drug screen results for cocaine, barbiturates, opiates, or cannabinoids will be excluded from study participation.

Exclusion Criteria for LIN-MD-62, LIN-MD-63 and LIN-MD-64 Completers Who Enroll in LIN-MD-66 > 28 Days From Last Study Intervention:

• Participant has a history of nonretentive fecal incontinence
• For LIN-MD-62 and LIN-MD-64 completers only:

Participant meets Rome III criteria for child/adolescent IBS: at least once per week for at least 2 months before Screening (Visit 1), the participant has experienced abdominal discomfort (an uncomfortable sensation not described as pain) or pain associated with 2 or more of the following at least 25% of the time:

• a) Improvement with defecation

• b) Onset associated with a change in the frequency of stool

• c) Onset associated with a change in form (appearance) of stool

  • Participant has a history of drug or alcohol abuse
  • Participant has any of the following conditions:

• a) Celiac disease, or positive serological test for celiac disease and the condition has not been ruled out by endoscopic biopsy

• b) Cystic fibrosis

• c) Hypothyroidism that is untreated or treated with thyroid hormone at a dose that has not been stable for at least 3 months prior to the Screening (Visit 1)

• d) Lead toxicity, hypercalcemia

• e) Inflammatory bowel disease

• f) Childhood functional abdominal pain syndrome

• g) Childhood functional abdominal pain

• h) Poorly treated or poorly controlled psychiatric disorders that might influence his or her ability to participate in the study

• i) Lactose intolerance that is associated with abdominal pain or discomfort and could confound the assessments in this study

• j) History of cancer other than treated basal cell carcinoma of the skin. (Note: Participants with a history of cancer are allowed provided that the malignancy has been in a complete remission for at least 5 years before the Randomization Visit. A complete remission is defined as the disappearance of all signs of cancer in response to treatment.)

• k) History of diabetic neuropathy

  • Participants who have positive urine drug screen results for cocaine, barbiturates, opiates, or cannabinoids.

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Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
72 μg linaclotide	Irritable Bowel Syndrome with Constipation (IBS-C) participants (LIN-MD-63 completers)	An oral capsule that is taken once daily. It may be taken whole or sprinkled into 1 teaspoonful of applesauce or 30mL of bottled water.
145 μg linaclotide	Functional Constipation (FC) participants (LIN-MD-62 and LIN-MD-64 completers)	An oral capsule that is taken once daily. It may be taken whole or sprinkled into 1 teaspoonful of applesauce or 30mL of bottled water.
145 μg linaclotide	Irritable Bowel Syndrome with Constipation (IBS-C) participants (LIN-MD-63 completers)	An oral capsule that is taken once daily. It may be taken whole or sprinkled into 1 teaspoonful of applesauce or 30mL of bottled water.
72 μg linaclotide	Functional Constipation (FC) participants (LIN-MD-62 and LIN-MD-64 completers)	An oral capsule that is taken once daily. It may be taken whole or sprinkled into 1 teaspoonful of applesauce or 30mL of bottled water.
290 μg linaclotide	Irritable Bowel Syndrome with Constipation (IBS-C) participants (LIN-MD-63 completers)	An oral capsule that is taken once daily. It may be taken whole or sprinkled into 1 teaspoonful of applesauce or 30mL of bottled water.

Primary Outcome Measures

Name	Time	Method
Incidence of Treatment Emergent Adverse Events	24 to 52 weeks	Number of Participants With Treatment-Emergent Adverse Events (TEAEs).

Trial Locations

Locations (72)

River Birch Research Alliance /ID# 237963; 🇺🇸 Blue Ridge, Georgia, United States

Advanced Research Center /ID# 237960; 🇺🇸 Anaheim, California, United States

Dolphin Medical Research /ID# 234676; 🇺🇸 Doral, Florida, United States

Amedica Research Institute Inc /ID# 234666; 🇺🇸 Hialeah, Florida, United States

Children's Ctr Digestive, US /ID# 237574; 🇺🇸 Atlanta, Georgia, United States

East Carolina University - Brody School of Medicine /ID# 237509; 🇺🇸 Greenville, North Carolina, United States

PMG Research of Piedmont Healthcare-Statesville /ID# 238257; 🇺🇸 Statesville, North Carolina, United States

Children's Healthcare of Atlanta - Ferry Rd /ID# 237005; 🇺🇸 Atlanta, Georgia, United States

AIM Trials /ID# 236364; 🇺🇸 Plano, Texas, United States

Medical Ctr for Clin Research /ID# 236911; 🇺🇸 San Diego, California, United States

Elite Clinical Research /ID# 234651; 🇺🇸 Miami, Florida, United States

My Preferred Research LLC /ID# 237943; 🇺🇸 Miami, Florida, United States

Valencia Medical & Research Center /ID# 234671; 🇺🇸 Miami, Florida, United States

South Miami Medical & Research Group Inc. /ID# 234654; 🇺🇸 Miami, Florida, United States

Vilo Research Group Inc /ID# 238228; 🇺🇸 Houston, Texas, United States

Cullen Research /ID# 234482; 🇺🇸 Houston, Texas, United States

Pioneer Research Solutions - Houston /ID# 236935; 🇺🇸 Houston, Texas, United States

KU Wichita Center for Clinical Research /ID# 234500; 🇺🇸 Wichita, Kansas, United States

Central Research Associates /ID# 237953; 🇺🇸 Birmingham, Alabama, United States

MNGI Digestive Health, P. A. /ID# 234437; 🇺🇸 Minneapolis, Minnesota, United States

Univ Oklahoma HSC /ID# 237546; 🇺🇸 Oklahoma City, Oklahoma, United States

IPS Research Company /ID# 237669; 🇺🇸 Oklahoma City, Oklahoma, United States

Sun Research Institute /ID# 236932; 🇺🇸 San Antonio, Texas, United States

GI associates and Endoscopy Ce /ID# 237969; 🇺🇸 Flowood, Mississippi, United States

Applied Research Center of Arkansas /ID# 238069; 🇺🇸 Little Rock, Arkansas, United States

Medclinical Research Partners LLC/ Foundation Pediatrics /ID# 234566; 🇺🇸 East Orange, New Jersey, United States

Accellacare of Knoxville /ID# 234462; 🇺🇸 Jefferson City, Tennessee, United States

The Baruch Padeh Medical Center Poriya /ID# 234768; 🇮🇱 Tiberias, HaTsafon, Israel

The Chaim Sheba Medical Center /ID# 236760; 🇮🇱 Ramat Gan, Tel-Aviv, Israel

Hadassah Hebrew University Hospital - Ein Kerem /ID# 234735; 🇮🇱 Jerusalem, Yerushalayim, Israel

Children's National Medical Center /ID# 234417; 🇺🇸 Washington, District of Columbia, United States

David M. Headley, MD, P.A. /ID# 238216; 🇺🇸 Port Gibson, Mississippi, United States

G & L Research, LLC /ID# 238093; 🇺🇸 Foley, Alabama, United States

The Center for Clinical Trials Inc. /ID# 234605; 🇺🇸 Saraland, Alabama, United States

HealthStar Research of Hot Springs PLLC /ID# 234608; 🇺🇸 Hot Springs, Arkansas, United States

Kindred Medical Institute, LLC /ID# 237367; 🇺🇸 Corona, California, United States

Center for Clinical Trials LLC /ID# 234629; 🇺🇸 Paramount, California, United States

Prohealth Research Center /ID# 234659; 🇺🇸 Doral, Florida, United States

Nemours Childrens Specialty Care /ID# 237991; 🇺🇸 Jacksonville, Florida, United States

Advanced Research for Health Improvement /ID# 238253; 🇺🇸 Naples, Florida, United States

Oviedo Medical Research /ID# 234692; 🇺🇸 Oviedo, Florida, United States

Treken Primary Care /ID# 234645; 🇺🇸 Atlanta, Georgia, United States

Clinical Research Institute /ID# 234702; 🇺🇸 Stockbridge, Georgia, United States

Sleep Care Research Institute d/b/a Clinical Research Institute /ID# 236342; 🇺🇸 Stockbridge, Georgia, United States

Virgo Carter Pediatrics /ID# 234518; 🇺🇸 Silver Spring, Maryland, United States

Private Practice - Dr. Craig Spiegel /ID# 234545; 🇺🇸 Bridgeton, Missouri, United States

University of New Mexico /ID# 236983; 🇺🇸 Albuquerque, New Mexico, United States

Columbia University Irving Medical Center /ID# 235686; 🇺🇸 New York, New York, United States

Frontier Clinical Research, LLC - Scottdale /ID# 238022; 🇺🇸 Scottdale, Pennsylvania, United States

Frontier Clinical Research /ID# 237923; 🇺🇸 Smithfield, Pennsylvania, United States

Coastal Pediatric Research - Summerville /ID# 234674; 🇺🇸 Summerville, South Carolina, United States

Rhode Island Hospital /ID# 237861; 🇺🇸 Providence, Rhode Island, United States

The Jackson Clinic, PA /ID# 236772; 🇺🇸 Jackson, Tennessee, United States

Cook Children's Med. Center /ID# 237536; 🇺🇸 Fort Worth, Texas, United States

Valley Institute of Research /ID# 234475; 🇺🇸 Harlingen, Texas, United States

ClinPoint Trials /ID# 236615; 🇺🇸 Waxahachie, Texas, United States

Office of Maria Ona /ID# 234539; 🇺🇸 Franklin, Virginia, United States

Chrysalis Clinical Research /ID# 234515; 🇺🇸 Saint George, Utah, United States

Duplicate_Multicare Institute for Research and Innovation /ID# 236979; 🇺🇸 Tacoma, Washington, United States

Health Research of Hampton Roads, Inc. (HRHR) /ID# 237252; 🇺🇸 Newport News, Virginia, United States

London Health Sciences Center- University Hospital /ID# 234309; 🇨🇦 London, Ontario, Canada

Bluewater Clinical Research Group Inc /ID# 234618; 🇨🇦 Sarnia, Ontario, Canada

Stouffville Medical Centre /ID# 234619; 🇨🇦 Stouffville, Ontario, Canada

Duplicate_Academisch Medisch Centrum /ID# 237116; 🇳🇱 Amsterdam, Noord-Holland, Netherlands

Lynn Institute of Denver /ID# 238086; 🇺🇸 Aurora, Colorado, United States

Pediatric & Adult Research Center /ID# 234681; 🇺🇸 Orlando, Florida, United States

Nemours Children's Hospital /ID# 234429; 🇺🇸 Orlando, Florida, United States

Michael W. Simon, MD, PSC /ID# 236516; 🇺🇸 Lexington, Kentucky, United States

Advantage Clinical Trials /ID# 237932; 🇺🇸 Bronx, New York, United States

Coastal Pediatric Research - West Ashley B /ID# 234678; 🇺🇸 Charleston, South Carolina, United States

Clinical Research Partners, LLC /ID# 237158; 🇺🇸 Richmond, Virginia, United States

Preferred Research Partners /ID# 237109; 🇺🇸 Little Rock, Arkansas, United States