Comparison of Lubiprostone and Placebo for the Relief of Constipation From Constipating Medications

• ClinicalTrials.gov Identifier: NCT01096290
• Recruitment Status: Terminated
• First Posted: March 31, 2010
• Results First Posted: September 9, 2020
• Last Update Posted: November 20, 2020
• Sponsor: University of South Alabama
• Collaborators: Takeda; Sucampo Pharmaceuticals, Inc.
• Information provided by (Responsible Party): University of South Alabama

Study Description

Brief Summary:

Constipation from medications is a serious and common condition. Lubiprostone has properties that make it a candidate drug. One hundred volunteers with constipation who are taking medications known to cause constipation will be randomized to take lubiprostone or placebo for 28 days. Therapeutic outcome will be evaluated by investigator and study subject assessment.

Condition or disease	Intervention/treatment	Phase
Constipation	Drug: lubiprostone; Drug: Matched placebo	Phase 4

Detailed Description:

Lubiprostone is a novel chloride channel activator that increases intestinal fluid secretion and motility. It is FDA approved and indicated for treatment of chronic idiopathic constipation and recently, constipation-predominant irritable bowel syndrome.

The Physicians Desk Reference lists over 90 Brand medications with reported incidence associated with constipation over 3%. Little data are available about treatment responses. A recent publication by our group reported treatment success for medication constipation using polyethylene glycol. Since ongoing studies are addressing the role of lubiprostone in opioid constipation, this work will be enrolling medication constipation study subjects not using opioids.

In this study, patients who meet diagnostic criteria for constipation will be randomized to receive 28 days of treatment with lubiprostone 24mcg twice a day. Data will be collected to evaluate therapeutic outcome.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 23 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Double (Participant, Investigator)
• Primary Purpose: Treatment
• Official Title: Comparison of Lubiprostone and Placebo for the Relief of Constipation From Constipating Medications
• Study Start Date: April 2010
• Actual Primary Completion Date: September 2012
• Actual Study Completion Date: September 2012

Arms and Interventions

Arm	Intervention/treatment
Experimental: Lubiprostone 24mcg BID for 30 days; Active medication	Drug: lubiprostone; 24mcg BID, capsule, oral 30days; Other Name: Amitiza
Placebo Comparator: Placebo; Placebo, matched, blinded	Drug: Matched placebo; Twice daily for 30days, oral; Other Name: Placebo, sugar pill

Outcome Measures

Primary Outcome Measures :

1. Relief of Constipation Defined by Modified ROME Criteria [ Time Frame: 30 days ]
   Subjects will report symptoms by questionnaire

Secondary Outcome Measures :

1. Frequency [ Time Frame: 30 days ]
   Subjects will report stool frequency by questionnaire

Eligibility Criteria

• Ages Eligible for Study: 19 Years and older (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: Yes

Criteria

Inclusion Criteria:

• Adult male or female outpatient age 19 or older.

• Patients meet International Congress of Gastroenterology (ROME III) clinical criteria for constipation*:

  1. Must include two or more of the following:

     1. Straining in > 1/4 defecations;
     2. Lumpy or hard stools > 1/4 defecations;
     3. Sensation of incomplete evacuation in 1/4 defecations;
     4. Sensation of anorectal obstruction/blockage in > 1/4 defecations;
     5. <3 defecations/week.
  2. Loose stools are rarely present without the use of laxatives.
  3. There are insufficient criteria for irritable bowel syndrome. *Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis.
• Use of one or more of listed medications known to cause constipation.
• If female and of childbearing potential, patient must be surgically sterilized or using oral contraceptives, depot contraceptives, intrauterine device, or testifies that she is monogamous with a vasectomized partner, or practices abstinence and will continue to do so during the duration of study. Mandatory compliance is required. Serum pregnancy tests will be performed at screening and during needed follow-up. Negative results will be received before inclusion and administration of first study dose. If pregnancy occurs during the trial, the investigator is notified immediately resulting in prompt discontinuation.
• Study subjects must not have received lubiprostone for more than 72 hours.
• Written informed consent.

Exclusion Criteria:

• Known or suspected obstruction, gastric retention, ileus, perforation, fecal impaction or inflammatory bowel disease.
• Severe diarrhea.
• Prior small bowel or colonic resection or colostomy.
• Weight < 80 lbs.
• If the patient has constipation that according to the investigator's clinical judgment is not the result of constipating medications but is suffering from a secondary cause including but limited to factors that are dietary, neurologic, congenital, diabetic or hypothyroid.
• Positive stool hemoccult (Can be included if colonoscopic evaluation is subsequently negative).
• Significant cardiac, renal or hepatic insufficiency.
• Pregnant or expecting to become pregnant within 120 days of study enrollment.
• Lactating or breast feeding.
• Subjects using opioid medications.
• Subjects who in the opinion of the investigator would be unable to comply adequately with the study plan.
• Use of investigational drugs in the last 30 days.
• Patients with known allergy to lubiprostone.

Contacts and Locations

Locations

United States, Alabama

USA Pavilion at Infirmary West

Mobile, Alabama, United States, 36693

Sponsors and Collaborators

University of South Alabama

Takeda

Sucampo Pharmaceuticals, Inc.

Investigators

• Principal Investigator: Jack A DiPalma, M.D.; University of South Alabama College of Medicine

More Information

• Responsible Party: University of South Alabama
• ClinicalTrials.gov Identifier: NCT01096290
• Other Study ID Numbers: 09-250
• First Posted: March 31, 2010
• Results First Posted: September 9, 2020
• Last Update Posted: November 20, 2020
• Last Verified: November 2020

Keywords provided by University of South Alabama:

constipation; lubiprostone; healthy volunteers

Additional relevant MeSH terms:

Constipation; Signs and Symptoms, Digestive; Lubiprostone; Chloride Channel Agonists; Membrane Transport Modulators; Molecular Mechanisms of Pharmacological Action