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Trial of Linaclotide in Patients With Chronic Constipation

This study has been completed.
Forest Laboratories
Information provided by (Responsible Party):
Ironwood Pharmaceuticals, Inc. Identifier:
First received: August 5, 2008
Last updated: December 19, 2012
Last verified: December 2012
The objective of this trial is to determine the efficacy and safety of linaclotide administered to patients with chronic constipation (CC). The primary efficacy parameter is the percentage of patients in each dosing group that meet the protocol definition for Complete Spontaneous Bowel Movement (CSBM) Overall Responder.

Condition Intervention Phase
Chronic Constipation
Drug: Matching Placebo
Drug: Linaclotide
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double Blind (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase 3, Randomized, Double-blind, Placebo-controlled, Parallel-group Trial of Linaclotide Administered Orally for 12 Weeks Followed by a 4-Week Randomized Withdrawal Period in Patients With Chronic Constipation

Resource links provided by NLM:

Further study details as provided by Ironwood Pharmaceuticals, Inc.:

Primary Outcome Measures:
  • Complete Spontaneous Bowel Movement (CSBM) Overall Responder [ Time Frame: Change from Baseline to Week 12 ]

    A 12-week CSBM Overall Responder was defined as a patient who for at least 9 of the 12 weeks of the treatment period had a CSBM weekly frequency rate that was 3 or greater and increased by 1 or more from baseline. A CSBM was defined as a spontaneous bowel movement (SBM) that was associated with a sense of complete evacuation.

    An SBM was defined as a bowel movement (BM) that occurred in the absence of laxative, enema, or suppository use on either the calendar day of the BM or the calendar day before the BM.

Secondary Outcome Measures:
  • 12-Week Complete Spontaneous Bowel Movement (CSBM) Frequency [ Time Frame: Change from Baseline to Week 12 ]
    The number of CSBMs per week.

  • 12-Week Spontaneous Bowl Movement (SBM) Frequency [ Time Frame: Change from Baseline to Week 12 ]
    The number of SBMs per week.

  • 12-week Change in Stool Consistency [ Time Frame: Change from Baseline to Week 12 ]

    The consistency of each BM was assessed using the 7-point Bristol Stool Form Scale:

    1. = separate hard lumps like nuts [difficult to pass]
    2. = sausage shaped but lumpy
    3. = like a sausage but with cracks on surface
    4. = like a sausage or snake, smooth and soft
    5. = soft blobs with clear-cut edges [passed easily]
    6. = fluffy pieces with ragged edges, a mushy stool
    7. = watery, no solid pieces [entirely liquid]

  • 12-week Change in Severity of Straining [ Time Frame: Change from Baseline to Week 12 ]
    Severity of Straining is measured on a 5-point scale, where a value of 1 is "not at all" and a value of 5 is "an extreme amount".

  • 12-week Change in Abdominal Discomfort [ Time Frame: Change from Baseline to Week 12 ]
    Abdominal discomfort is based on a 5-point scale where a value of l is "none" and a value of 5 is "very severe."

  • 12-week Change in Bloating [ Time Frame: Change from Baseline to Week 12 ]
    Bloating was based on a 5-point scale where a value of l is "none" and a value of 5 is "very severe".

  • 12-week Change in Constipation Severity [ Time Frame: Change from Baseline to Week 12 ]
    Constipation severity was based on a 5-point ordinal scale where a value of l is "none" and a value of 5 is "very severe".

Enrollment: 643
Study Start Date: August 2008
Study Completion Date: October 2009
Primary Completion Date: August 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: 145 μg linaclotide Drug: Linaclotide
Oral, once daily
Experimental: 290 μg linaclotide Drug: Linaclotide
Oral, once daily
Placebo Comparator: Matching Placebo Drug: Matching Placebo
Oral, once daily


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

Inclusion Criteria:

  • Patient has completed a colonoscopy according to the AGA criteria, with no clinically significant findings
  • Patient has successfully completed protocol procedures (with no clinically significant findings): physical exam, 12-lead ECG, or clinical laboratory tests
  • Patient meets protocol criteria for CC: reports < 3 bowel movements per week and reports straining, lumpy or hard stools, and/or sensation of incomplete evacuation during > 25% of BMs
  • Patient demonstrates continued chronic constipation through Pretreatment Period
  • Patient is compliant with IVRS

Exclusion Criteria:

  • Patient has history of loose or watery stools
  • Patient has symptoms of or been diagnosed with Irritable Bowel Syndrome (IBS)
  • Patient has a structural abnormality of the gastrointestinal (GI) tract or a disease or condition that can affect GI motility
  • Patient has any protocol-excluded or clinically significant medical or surgical history that could confound the study assessments
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Please refer to this study by its identifier: NCT00730015

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Sponsors and Collaborators
Ironwood Pharmaceuticals, Inc.
Forest Laboratories
Study Chair: Jeffrey M. Johnston, MD, FACP Ironwood Pharmaceuticals, Inc.
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