52-Week Efficacy and Safety Study of Ibodutant in Women With Irritable Bowel Syndrome With Diarrhea (IBS-D)

Irritable Bowel Syndrome With Diarrhea Clinical Trial

— IRIS-4  

Official title:

A 52-Week, Double-blind, Randomised, Placebo-controlled, Parallel-group Phase III Study With Re-randomisations at Week 25 to Evaluate the Efficacy and Safety of Oral Ibodutant 10 mg Once Daily in Female Patients With Irritable Bowel Syndrome With Diarrhoea (IBS-D)

Clinical Trial Details — Status: Terminated

Administrative data

• NCT number: NCT02120027
• Other study ID #: NAK-07
• Secondary ID: 2013-000895-14
• Status: Terminated
• Phase: Phase 3
• First received: April 17, 2014
• Last updated: May 18, 2016
• Start date: March 2014
• Est. completion date: November 2015

Study information

• Verified date: May 2016
• Source: Menarini Group
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Food and Drug AdministrationCzech Republic: State Institute for Drug ControlHungary: Ministry of Health, Social and Family AffairsLatvia: State Agency of MedicinesSlovakia: State Institute for Drug ControlSweden: Medical Products AgencyUnited Kingdom: Medicines and Healthcare Products Regulatory AgencyGermany: Federal Institute for Drugs and Medical DevicesPoland: Office for Registration of Medicinal Products, Medical Devices and Biocidal Products
• Study type: Interventional

Clinical Trial Summary

Irritable Bowel Syndrome with diarrhoea (IBS-D) is a functional gastrointestinal disorder characterised by chronic or recurrent abdominal pain or discomfort and diarrhoea. This trial aims at the evaluation of the efficacy and safety of oral ibodutant 10 mg once daily as compared to placebo in women with IBS-D over a 24-week treatment period

Description:

The study evaluates the efficacy and safety of ibodutant 10 mg, given once daily for 24 weeks in comparison with placebo in female IBS-D patients. Randomisation to ibodutant and placebo will be 1:1. Efficacy is evaluated in terms of weekly response for abdominal pain intensity and stool consistency over 24 weeks of treatment in at least 50% of the weeks of treatment.

The clinical phase of the study comprises up to 2 weeks of screening for patient's eligibility, a 2-week run-in period (treatment-free) for IBS severity assessment, a first 24-week double-blind treatment period, a second 26-week re-randomised treatment period period and a 2-week safety follow-up, resulting in a maximum 58-week overall duration of the study for each patient.

Patients report their IBS-related symptoms daily in a telephone-based electronic diary from run-in until end of treatment.

Recruitment information / eligibility

• Status: Terminated
• Enrollment: 500
• Est. completion date: November 2015
• Est. primary completion date: October 2015
• Accepts healthy volunteers: No
• Gender: Female
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• At screening:

• Female patients aged 18 years or older.

• Clinical diagnosis of IBS-D according to the following symptoms-based criteria as per Rome III modular questionnaire criteria:

1. Recurrent abdominal pain or discomfort for at least 3 days per month in the last 3 months associated with at least 2 of the following characteristics: a) improvement with defecation; b) onset associated with a change in the frequency of stool; c) onset associated with a change in form (appearance) of stool.

2. Symptom-onset at least 6 months prior to diagnosis.

3. Loose or watery stools at least 25% of the time in the last 3 months AND hard or lumpy stools less than 25% of the time in the last 3 months.

4. Additional criterion: more than 3 bowel movements per day at least 25% of the time in the last 3 months.

• For patients older than 50 years OR patients with a positive family history of colorectal cancer: normal results from colonoscopy/flexible sigmoidoscopy performed within the last 5 years.

• For patients aged 65 years or older: absence of ischaemic colitis, microscopy colitis or any other organic gastrointestinal disease as evidenced by the results of a colonoscopy/flexible sigmoidoscopy with biopsy performed within 6 months.

• For women of childbearing potential: Use of a highly effective contraceptive method with a failure rate <1% per year throughout the entire study period.

• Physical examination without clinically relevant abnormalities during screening.

• No clinically relevant abnormalities in 12-Lead ECG or in laboratory findings.

• Mentally competent, able to give written informed consent, and compliant to undergo all visits and procedures.

• Unrestricted access to a touch-tone telephone.

• Willingness to refrain from using loperamide within 3 days prior to run-in visit and during the run-in period.

Additional criteria at randomisation:

• During both weeks of the run-in period:

1. A weekly average of worst abdominal pain in the past 24 hours with a score of =3.0 on a 0 to 10 point scale.

2. At least one bowel movement on each day.

3. A weekly average of at least 3 bowel movements per day.

4. At least one stool with a consistency of Type 6 or Type 7 according to the Bristol Stool Scale (BSS) on at least 2 days per week.

5. Less than 2 bowel movements with a consistency of Type 1 or Type 2 according to the BSS per week.

• Adequate compliance with the e-diary recording procedure defined as at least 11 of 14 days (=75%) of the nominal daily data entry.

Exclusion Criteria:

• Male gender.

• Diagnosis of IBS with a subtype of constipation, mixed IBS, or un-subtyped IBS.

• Colonic or major abdominal surgery, any other major abdominal surgery or elective major surgery planned or expected during the study.

• History of organic GI abnormalities, inflammatory bowel diseases, complicated diverticulosis, ischaemic colitis, microscopic colitis.

• History of pancreatitis, active biliary duct disease, cholecystitis or symptomatic gallbladder stone disease in the previous 6 months.

• History of gluten enteropathy or lactose intolerance.

• Current or previous diagnosis of neoplasia.

• History of endometriosis.

• History of positive tests for ova or parasites, or clostridium difficile toxin or occult blood in the stool in the previous 6 months.

• History of human immunodeficiency virus infection.

• History of major cardiovascular events in the previous 6 months.

• Uncontrolled hypertension, insulin-dependent diabetes mellitus or abnormal thyroid function.

• Major psychiatric or neurological disorders or unstable medical condition which may compromise the efficacy and safety assessments.

• Evidence of clinically significant hepatic disease, severe renal insufficiency or anemia.

• Relevant changes in dietary habits, lifestyle, or exercise regimen in the previous 2 months.

• Use of prohibited concurrent medication within the previous month such as antibiotics, antimuscarinic drugs, drugs enhancing GI motility and analgesics.

• Pregnancy or breastfeeding.

• Inability to understand or collaborate throughout the study.

• Participation in other clinical studies in the previous 4 weeks or concurrent enrollment in a clinical study.

• Any condition that would compromise the well-being of the patient.

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment

Related Conditions & MeSH terms

• Diarrhea
• Irritable Bowel Syndrome
• Irritable Bowel Syndrome With Diarrhea
• Syndrome

Intervention

Drug:
• Ibodutant 10 mg
Oral tablet, to be given once daily.
• Placebo
Oral tablet, (identical in appearance and weight to ibodutant tablets), to be given once daily.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
Menarini Group

Countries where clinical trial is conducted

United States,  Czech Republic,  Germany,  Hungary,  Latvia,  Poland,  Slovakia,  Sweden,  United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Weekly response for abdominal pain intensity AND stool consistency over the first 24 weeks of treatment in at least 50% of the weeks of treatment (12 out of 24 weeks).	The patient will be considered a weekly responder if she meets both of the following criteria in the same week: Abdominal pain response: decrease in weekly average of worst abdominal pain score in the past 24 hours of at least 30% compared with baseline; Stool consistency response: decrease of at least 50% in the number of days per week with at least one stool that has a consistency of Type 6 or 7 compared with baseline.	24 weeks	No
Secondary	Weekly response for abdominal pain intensity over the first 24 weeks of treatment in at least 50% of the weeks of treatment (12 out of 24 weeks).	The patient will be considered a weekly abdominal pain responder if she meets the following criterion: Decrease in weekly average of worst abdominal pain score in the past 24 hours of at least 30% compared with baseline.	24 weeks	No
Secondary	Weekly response for stool consistency over the first 24 weeks of treatment in at least 50% of the weeks of treatment (12 out of 24 weeks).	The patient will be considered a weekly stool consistency responder is she meets the following criterion: Decrease of at least 50% in the number of days per week with at least one stool that has a consistency of Type 6 or 7 compared with baseline.	24 weeks	No
Secondary	Weekly response for relief of overall IBS signs and symptoms over the first 24 weeks of treatment in at least 50% of the weeks (12 out of 24)	The patient will be considered a weekly responder if she has an IBS degree-of-relief equal to "completely relieved/improved" or "considerably relieved/improved".	24 weeks	No
Secondary	Sustained efficacy	Weekly response for abdominal pain intensity AND stool consistency over the first 24 weeks of treatment applying the 50% rule with at least 2 weeks of response in the last 4 weeks of treatment (week 21 to 24). The patient will be considered a weekly responder as defined for the primary endpoint.	24 weeks	No