Irritable Bowel Syndrome Clinical Trial
Official title:
Dose Escalation Trial of Traditional Chinese Medicine for Irritable Bowel Syndrome(TCM- IBS)
To test the efficacy of Traditional Chinese Medicine in relieving symptoms and change of quality of life of patients with Irritable Bowel Syndrome.
Irritable bowel syndrome (IBS), characterized by abdominal pain/discomfort and disturbed
bowel frequency, is a common functional bowel disorder that accounts for a substantial
proportion of patients seen in primary care and secondary referral centers. The impact on
patients' quality of life and the economic burden on the community are considerable.
However, the outcome of conventional Western medicine in treating IBS has been
disappointing. Several potential new therapeutic agents have been withdrawn because of
serious adverse events. Traditional Chinese medicine (TCM) has been used in the treatment of
IBS for centuries in Asian countries but scientific evaluation of its therapeutic function
is scarce. A methodologically strong trial of a 20-herb formula has shown significant
benefit for IBS patients. However, the herbal formulation was inadequately characterized and
defined for repeated clinical studies.
Subsequent to complete chemical characterization, a randomized, placebo-controlled,
double-blind, phase II dose-escalation clinical trial will be conducted to find an optimally
safe and efficacious dosage of this standardized 20-herb preparation in 104 patients aged 18
to 75 with all types of IBS. At each of two dosage levels, 52 participants will be
randomized to treatment for 8 weeks with the herbal formula or placebo in a 1:1 allocation
ratio, and will be assessed at baseline, weeks 0, 2, 4, 8, and 12 for the clinically
important and reliable outcome of patient reported global symptom improvement. At the
conclusion of the 1st dosage level, safety will be assessed prior to using the higher dosage
in a new cohort of participants. We also will assess individual IBS symptoms, nature,
severity, duration, and frequency of adverse events, quality of life, concurrent IBS
medications and health care utilization, and will perform blood tests for safety purposes.
Adherence to study medication will be verified by dose counts. Results of this dose-ranging
study will help to identify the optimal dosage of the herbal formula to be used in future
randomized placebo-controlled trials and in head-to-head comparisons with conventional
pharmaceuticals.
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