search
Back to results

Effect of TU-100 on Rectal Compliance, Rectal Sensation and Small Bowel and Colonic Transit in Females With Constipation

Primary Purpose

Functional Constipation, Gastric Emptying, Whole Gut Transit

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Daikenchuto (TU-100)
Daikenchuto (TU-100)
Placebo
Sponsored by
Tsumura USA
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Functional Constipation focused on measuring Digestive system diseases, Gastrointestinal diseases, Intestinal diseases, Colonic inertia

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Meet Rome III criteria for functional constipation
  2. Willing and able to provide written informed consent
  3. Females, not pregnant or not breast-feeding

    • Females of childbearing potential must use an acceptable form of contraception during the study and for 30 days after the last dose. Acceptable methods include surgical sterilization, hormonal contraceptives (such as oral contraceptives, Depo-Provera, Nuva Ring, condoms used with a spermicide, an IUD or abstinence.
    • Females are not considered to be of childbearing potential if they are postmenopausal for at least two years or have been surgically sterilized.
  4. Ages 18 to 65 years old inclusive
  5. A body mass index (BMI) between 18 and 40 kg/m2 inclusive
  6. A negative urine drug screen at Visit 1
  7. Normal or not clinically significant laboratory results as reviewed by the study physicians
  8. A normal rectal exam result on file within the past 2 years or performed at Visit 1 in order to exclude the possibility of an evacuation disorder. Examination must exclude findings suggestive of an evacuation disorder such as high sphincter tone at rest, failure of perineal descent and spasm, tenderness or paradoxical contraction of the puborectalis muscles.
  9. Do not have sufficient criteria for irritable bowel syndrome (IBS)

Exclusion Criteria:

  1. Structural or metabolic diseases/conditions that affect the gastrointestinal system or functional gastrointestinal disorders other than constipation.
  2. Taking any medication that in the opinion of the principal investigator has a potential to alter GI transit. This includes but is not limited to osmotic or stimulant laxatives, magnesium or aluminum-containing antacids, prokinetics, erythromycin, narcotics, anticholinergics, selective norepinephrine reuptake inhibitors (SNRIs), opiates, GABAergic agents and benzodiazepines.

    • Note: Tricyclic antidepressants are permissible at doses equal to or less than 25 mg daily; selective serotonin reuptake inhibitor (SSRI) antidepressants are permissible at low, stable doses. Analgesics such as Tylenol, ibuprofen, naproxen and aspirin are permissible. All medications shall be reviewed by the principal investigator on a case by case basis.
    • Rescue medications: Rescue medications shall be reviewed and approved as necessary for exacerbation of constipation as the study medication treatment period is lengthy, about 28 days total. The patient will contact the study staff to request review and approval of the use of a rescue medication by the principal investigator. The use of the rescue medication will be documented by the patient in the bowel pattern diary. Rescue medications are not allowed within 7 days of the abbreviated baseline or the full transit scintigraphy to ensure data integrity.
  3. Clinical evidence, including but not limited to a clinically significant abnormal physical exam or laboratory test result or a past event documented in the past medical record, or current clinically significant abnormal physical exam or laboratory test result that could indicate significant cardiovascular, respiratory, renal, hepatic, gastrointestinal, hematological, neurological, psychiatric or other diseases that interfere with the objectives of the study. If a laboratory test result is abnormal and clinically significant, it may be repeated once at the discretion of the principal investigator. If the laboratory test result remains abnormal and clinically significant, the patient will be discontinued from the study and referred to a primary care physician for evaluation.
  4. Patients who are considered to be alcoholics not in remission or known substance abusers.
  5. Patients who have participated in another clinical study in the past 30 days.
  6. Patients who have a history of allergic reactions to egg, ginseng, ginger or Sichuan pepper
  7. Patients who are clinically lactose intolerant
  8. Patients must agree to avoid alcohol during the days of Visits 5, 6 and 7 to avoid corrupting the data from the anorectal manometry and rectal barostat tests.

Sites / Locations

  • Mayo Clinic, Rochester Methodist CRU

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Daikenchuto (TU-100) 7.5g/day

Daikenchuto (TU-100) 15g/day

Placebo

Arm Description

Daikenchuto (TU-100) 2.5g TID (7.5g/day)

Daikenchuto (TU-100) 5g TID (15g/day)

Placebo TID

Outcomes

Primary Outcome Measures

Colonic geometric center at 24 hours measured by scintigraphy
T1/2 of ascending colon emptying as measured by scintigraphy

Secondary Outcome Measures

Colonic geometric center at 4 hours and 48 hours
Colonic filling at 6 hours
t1/2 of gastric emptying of solid
Rectal Compliance Pr1/2
Rectal sensation thresholds (gas, urgency to defecate, and pain)
Anal sphincter pressure at rest
Anal sphincter pressure during squeeze
Recto-anal pressure difference during straining to simulate defecation
Stool frequency
Stool consistency
PAC-QOL (Patient Assessment of Constipation Quality of Life) score

Full Information

First Posted
June 3, 2010
Last Updated
January 8, 2013
Sponsor
Tsumura USA
Collaborators
Cato Research
search

1. Study Identification

Unique Protocol Identification Number
NCT01139216
Brief Title
Effect of TU-100 on Rectal Compliance, Rectal Sensation and Small Bowel and Colonic Transit in Females With Constipation
Official Title
Effect of DAIKENCHUTO (TU-100), a Gastrointestinal Nerve Modulator, on Rectal Compliance, Rectal Sensation and Small Bowel and Colonic Transit in Female Patients With Functional Constipation
Study Type
Interventional

2. Study Status

Record Verification Date
January 2013
Overall Recruitment Status
Completed
Study Start Date
August 2010 (undefined)
Primary Completion Date
November 2012 (Actual)
Study Completion Date
November 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tsumura USA
Collaborators
Cato Research

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to assess the dose-related effects of TU-100, a botanical agent that modulates gastrointestinal nerves, on rectal compliance, rectal sensation thresholds and small bowel and colonic transit in female patients with functional constipation as compared to placebo.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Functional Constipation, Gastric Emptying, Whole Gut Transit, Small Bowel Transit, Colonic Transit, Rectal Compliance, Rectal Sensation
Keywords
Digestive system diseases, Gastrointestinal diseases, Intestinal diseases, Colonic inertia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
45 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Daikenchuto (TU-100) 7.5g/day
Arm Type
Experimental
Arm Description
Daikenchuto (TU-100) 2.5g TID (7.5g/day)
Arm Title
Daikenchuto (TU-100) 15g/day
Arm Type
Experimental
Arm Description
Daikenchuto (TU-100) 5g TID (15g/day)
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo TID
Intervention Type
Drug
Intervention Name(s)
Daikenchuto (TU-100)
Intervention Description
Subjects will receive 2.5g TID (7.5g/day) of TU-100. Dosage form is granule. Subject will take a daily dose divided 3 times per day for 4 weeks.
Intervention Type
Drug
Intervention Name(s)
Daikenchuto (TU-100)
Intervention Description
Subjects will receive 5g TID (15g/day) of TU-100. Dosage form is granule. Subject will take a daily dose divided 3 times per day for 4 weeks.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Subjects will receive daily dose of TU-100 placebo. Dosage form is granule. Subject will take a daily dose divided 3 times per day for 4 weeks.
Primary Outcome Measure Information:
Title
Colonic geometric center at 24 hours measured by scintigraphy
Time Frame
Up to 48 hours
Title
T1/2 of ascending colon emptying as measured by scintigraphy
Time Frame
Up to 48 hours
Secondary Outcome Measure Information:
Title
Colonic geometric center at 4 hours and 48 hours
Time Frame
Up to 48 hours
Title
Colonic filling at 6 hours
Time Frame
Up to 48 hours
Title
t1/2 of gastric emptying of solid
Time Frame
Up to 48 hours
Title
Rectal Compliance Pr1/2
Time Frame
Up to 3 hours
Title
Rectal sensation thresholds (gas, urgency to defecate, and pain)
Time Frame
Up to 3 hours
Title
Anal sphincter pressure at rest
Time Frame
Up to 3 hours
Title
Anal sphincter pressure during squeeze
Time Frame
Up to 3 hours
Title
Recto-anal pressure difference during straining to simulate defecation
Time Frame
Up to 3 hours
Title
Stool frequency
Time Frame
6 weeks
Title
Stool consistency
Time Frame
6 weeks
Title
PAC-QOL (Patient Assessment of Constipation Quality of Life) score
Time Frame
6 weeks

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Meet Rome III criteria for functional constipation Willing and able to provide written informed consent Females, not pregnant or not breast-feeding Females of childbearing potential must use an acceptable form of contraception during the study and for 30 days after the last dose. Acceptable methods include surgical sterilization, hormonal contraceptives (such as oral contraceptives, Depo-Provera, Nuva Ring, condoms used with a spermicide, an IUD or abstinence. Females are not considered to be of childbearing potential if they are postmenopausal for at least two years or have been surgically sterilized. Ages 18 to 65 years old inclusive A body mass index (BMI) between 18 and 40 kg/m2 inclusive A negative urine drug screen at Visit 1 Normal or not clinically significant laboratory results as reviewed by the study physicians A normal rectal exam result on file within the past 2 years or performed at Visit 1 in order to exclude the possibility of an evacuation disorder. Examination must exclude findings suggestive of an evacuation disorder such as high sphincter tone at rest, failure of perineal descent and spasm, tenderness or paradoxical contraction of the puborectalis muscles. Do not have sufficient criteria for irritable bowel syndrome (IBS) Exclusion Criteria: Structural or metabolic diseases/conditions that affect the gastrointestinal system or functional gastrointestinal disorders other than constipation. Taking any medication that in the opinion of the principal investigator has a potential to alter GI transit. This includes but is not limited to osmotic or stimulant laxatives, magnesium or aluminum-containing antacids, prokinetics, erythromycin, narcotics, anticholinergics, selective norepinephrine reuptake inhibitors (SNRIs), opiates, GABAergic agents and benzodiazepines. Note: Tricyclic antidepressants are permissible at doses equal to or less than 25 mg daily; selective serotonin reuptake inhibitor (SSRI) antidepressants are permissible at low, stable doses. Analgesics such as Tylenol, ibuprofen, naproxen and aspirin are permissible. All medications shall be reviewed by the principal investigator on a case by case basis. Rescue medications: Rescue medications shall be reviewed and approved as necessary for exacerbation of constipation as the study medication treatment period is lengthy, about 28 days total. The patient will contact the study staff to request review and approval of the use of a rescue medication by the principal investigator. The use of the rescue medication will be documented by the patient in the bowel pattern diary. Rescue medications are not allowed within 7 days of the abbreviated baseline or the full transit scintigraphy to ensure data integrity. Clinical evidence, including but not limited to a clinically significant abnormal physical exam or laboratory test result or a past event documented in the past medical record, or current clinically significant abnormal physical exam or laboratory test result that could indicate significant cardiovascular, respiratory, renal, hepatic, gastrointestinal, hematological, neurological, psychiatric or other diseases that interfere with the objectives of the study. If a laboratory test result is abnormal and clinically significant, it may be repeated once at the discretion of the principal investigator. If the laboratory test result remains abnormal and clinically significant, the patient will be discontinued from the study and referred to a primary care physician for evaluation. Patients who are considered to be alcoholics not in remission or known substance abusers. Patients who have participated in another clinical study in the past 30 days. Patients who have a history of allergic reactions to egg, ginseng, ginger or Sichuan pepper Patients who are clinically lactose intolerant Patients must agree to avoid alcohol during the days of Visits 5, 6 and 7 to avoid corrupting the data from the anorectal manometry and rectal barostat tests.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Camilleri, MD
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic, Rochester Methodist CRU
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
23451764
Citation
Iturrino J, Camilleri M, Wong BS, Linker Nord SJ, Burton D, Zinsmeister AR. Randomised clinical trial: the effects of daikenchuto, TU-100, on gastrointestinal and colonic transit, anorectal and bowel function in female patients with functional constipation. Aliment Pharmacol Ther. 2013 Apr;37(8):776-85. doi: 10.1111/apt.12264. Epub 2013 Mar 4.
Results Reference
derived

Learn more about this trial

Effect of TU-100 on Rectal Compliance, Rectal Sensation and Small Bowel and Colonic Transit in Females With Constipation

We'll reach out to this number within 24 hrs