A Study to Evaluate Topical Phenylephrine Gel in the Management of Faecal Incontinence

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. Identifier: NCT00420797
Recruitment Status : Withdrawn (Terminated, new protocol to be developed)
First Posted : January 11, 2007
Last Update Posted : May 19, 2015
Information provided by:
S.L.A. Pharma AG

Brief Summary:
The aim of the study is to test the hypothesis that topical application of phenylephrine improves faecal continence and quality of life in subjects with passive faecal incontinence after ileo-anal pouch construction.

Condition or disease Intervention/treatment Phase
Faecal Incontinence Drug: 10% Phenylephrine hydrochloride gel Phase 3

Detailed Description:

Faecal seepage and even frank incontinence at night can be a problem for approximately 30% of patients who have undergone ileal pouch anal anastomosis (IPAA). Nocturnal seepage may be a problem in patients who do not have gross incontinence, or who may even have no incontinence during the day. Although baseline continence during the day is maintained by involuntary control of the internal anal sphincter, this can be supplemented by voluntary contraction of the external sphincter. While sleeping, this supplementary external sphincter effect is lost and internal anal sphincter tone is reduced, leading to seepage. This is obviously distressing and leads some patients to wear a pad to reduce the soiling that may occur.

The primary objective is to determine the effect of 10% phenylephrine hydrochloride gel, applied three times a day, on the change from baseline to the end of study (8 weeks)in the faecal incontinence score (St Mark's) with passive faecal incontinence after ileo-anal pouch construction, compared with placebo.

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 0 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Double-blind, Randomised, Placebo-controlled Study to Evaluate Topical 10% Phenylephrine Gel in the Management of Ileal Pouch Anal Anastomosis (IPAA)-Related Faecal Incontinence
Study Start Date : February 2007
Actual Study Completion Date : November 2007

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Bowel Movement

Primary Outcome Measures :
  1. The primary efficacy variable will be the change from baseline to the end of study in the faecal incontinence score (St Mark's)

Secondary Outcome Measures :
  1. Efficacy:
  2. Number of daytime faecal incontinence episodes of liquid/mucus and solid stool
  3. Number of nights with nocturnal incontinence episodes of liquid/mucus and solid stool
  4. Number of incontinence episodes of gas
  5. Faecal incontinence quality of life scale
  6. Subject satisfaction with treatment
  7. Subject assessment of overall change from baseline
  8. Loperamide or other constipating agent usage
  9. Anal manometry measurements
  10. Safety:
  11. AEs
  12. Blood pressure
  13. Pulse rate
  14. Changes in other physical examination findings
  15. Changes in biochemical or haematological markers

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

Inclusion Criteria:

  • Incontinence of solid or liquid stool/mucus following ileo-anal pouch construction, at least once per week over the last month
  • At least six months must have elapsed since IPAA surgery or six months since closure of a loop ileostomy created during IPAA surgery, whichever is the later
  • Aged 18 years or over
  • If female, the subject must not be lactating and must be (a) post-menopausal, (b) surgically sterilised, or (c) have a negative pregnancy test result prior to entry into the study and will use adequate contraception for the duration of the study (sterilization of partner, abstinence, an intra-uterine device (IUD), double barrier method or oral hormonal contraception).
  • Written informed consent to participate has been provided

NB: Seepage, leakage, soiling of faecal material is regarded as incontinence.

Exclusion Criteria:

  • A history of surgery to the anal sphincter complex
  • Active pouchitis (determined by clinical examination and macroscopic inflammation on endoscopy. Patients on maintenance antibiotics need not be excluded but their antibiotic dose should remain the same throughout the study)
  • Undergone pelvic radiotherapy at any time
  • Cardiac or cardiovascular disease, including ischaemic heart disease, history of stroke, cerebral arteriosclerosis, aneurysm, tachycardia or hypertension
  • Hyperthyroidism or diabetes mellitus
  • Crohn's disease (indeterminate colitis is not an exclusion criterion)
  • The use of α- or β-adrenoceptor agonists (other than inhaled β-adrenoceptor agonists) or antagonists, other sympathomimetics or any cardiovascular drugs during the study (including eyedrops, nasal drops and OTC cold cures containing phenylephrine or pseudoephedrine)
  • The use of mono-amine oxidase inhibitors or tricyclic antidepressants in the 4 weeks prior to the first dose of study medication or during the study
  • Any mental or other impairment which, in the investigator's opinion, would render them unlikely to be able to comply with the requirements of the study
  • Considered by their physician unlikely to be able to comply with the protocol
  • Participation in a clinical trial within the past three months
  • Known hypersensitivity to phenylephrine or excipients
  • History of drug or alcohol abuse

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 identifier (NCT number): NCT00420797

United Kingdom
St Mark's Hospital
Harrow, Middlesex, United Kingdom, HA1 3UJ
Sponsors and Collaborators
S.L.A. Pharma AG
Principal Investigator: Susan Clark, MD FRCS St Mark's Hospital, The North West London Hospitals NHS Trust Identifier: NCT00420797     History of Changes
Other Study ID Numbers: P/PFI/01
First Posted: January 11, 2007    Key Record Dates
Last Update Posted: May 19, 2015
Last Verified: November 2007

Keywords provided by S.L.A. Pharma AG:
Faecal seepage
ileal pouch anal anastomosis (IPAA)
quality of life
faecal incontinence
ileo-anal pouch construction
phenylephrine hydrochloride gel
IPAA-related faecal incontinence

Additional relevant MeSH terms:
Fecal Incontinence
Rectal Diseases
Intestinal Diseases
Gastrointestinal Diseases
Digestive System Diseases
Cardiotonic Agents
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Vasoconstrictor Agents
Nasal Decongestants
Respiratory System Agents
Adrenergic alpha-1 Receptor Agonists
Adrenergic alpha-Agonists
Adrenergic Agonists
Adrenergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Protective Agents