Constipation - Functional Clinical Trial
Official title:
A Randomized Double-blind Placebo-controlled Clinical Trial Assessing the Efficacy and Safety of Hépar® in Chronic Constipation
The study objectives are to evaluate the efficacy and safety of a 2-week daily intake of 1L Hépar® natural mineral water rich in magnesium sulphate compared to a control natural mineral water in the treatment of the constipation symptoms in women outpatients.
Healthy patients meeting all of the following criteria were included in the study: i) female
outpatient aged 18 to 60, ii) with a diagnosis of functional constipation according to the
Rome III criteria for 3 months or more, iii) without any laxative drug for 3 days prior to
inclusion, iv) having easy access to toilet, v) regularly eating vegetables and fruits, vi)
having physical activity, reasonable walking periods or exercise 2 or 3 times a week and vii)
drinking 1.5±0.5L of water /day. Patients who presented any of the following criteria were
excluded from the study: i) known unsatisfaction to Hépar, ii) concomitant treatment or
disease (current or past) likely to interfere with evaluation of the study parameters and
iii) documented pregnancy. The study was conducted by 28 city-based general practitioners
located throughout France.
After a screening visit, patients followed a washout during 7 to 9 days before inclusion.
Patients had to stop any drug treatment liable to interfere with transit and drink 1.5 litres
per day of a low-mineral spring water (Nestlé Purelife, Nestlé Waters, France). At the
inclusion visit, patients were randomized to the control or Hépar group according to the
chronological order of inclusion and to a predetermined randomization list in balanced blocks
of 4 treatment units (SAS® software). The randomization list was prepared in advance by the
statistician from the society in charge of the logistic of bottles, and secured in an
electronic file with restricted access. Two sets of sealed envelopes kept by the investigator
and the study manager in a secure and locked place were generated to contain the patient's
randomization number and allocated group. The investigator could break the blinding in case
of absolute emergency and in accordance with the sponsor. The follow-up visit was performed
15 to 17 days following inclusion.
Patients had to drink 1.5L per day from day 1 to day 14. Depending of the randomization, they
drank either 1.5L of low-mineral water (Vittel Bonne Source, control group) or 1L of Hépar +
0.5L of low-mineral water (Hépar group).
During the screening visit (V0), the physician collected sociodemographics, previous medical
history and history of the constipation episode (Rome III criteria), onset of symptoms,
abdominal pain on a 100 mm VAS, dietary habits, physical activities and previous and current
treatments. The patient was provided with a self-evaluation e-diary to collect: i) the number
and type of stools (Bristol Scale); ii) abdominal pain, iii) physical activity and iv) drug,
water, beverage and food consumption during washout.
At inclusion (V1), the physician collected: i) the weekly number and type of stools, ii) Rome
III criteria, iii) AEs, iv) ability to complete the e-diary, v) compliance to the washout
treatment (count of unused bottles), and vi) use of rescue medication over the past week.
During the final visit (V2), the physician collected: i) the weekly number and type of
stools, ii) Rome III criteria, iii) AEs, iv) compliance to the treatment (count of unused
bottles) and v) use of rescue medication over the past two weeks.
For the washout and the treatment periods, the type of stools was assessed directly by the
patient on the e-diary and secondarily by an independent expert, based on the photographs the
patient had to make of each of their stools.
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