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A Study to Evaluate Dose Responses of Efficacy and Safety of ASP0456 in Patient With Chronic Constipation

Primary Purpose

Chronic Constipation

Status
Completed
Phase
Phase 2
Locations
Japan
Study Type
Interventional
Intervention
ASP0456
Placebo
Sponsored by
Astellas Pharma Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Constipation focused on measuring linaclotide, ASP0456, chronic constipation

Eligibility Criteria

20 Years - 79 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Patient who had SBM* (Spontaneous bowel movement) less than 3 times per week, more than six months prior to the provisional registration

    • *Defecation without procedure of laxative, suppository, enema, or stool extraction on the day or preceding day of the defecation
  • Patient who was affected with one or more following symptoms before more than six months of provisional registration:

    • Straining during at least 25% of defecations
    • Lumpy or hard stools in at least 25% of defecations
    • Sensation of incomplete evacuation for at least 25% of defecations
  • Loose stools are rarely present without the use of laxatives more than six months prior to the provisional registration.
  • Patients who had pancolonoscopy or contrast enema (or sigmoidoscopy) after the onset of chronic constipation symptom and had no organic changes

Exclusion Criteria:

  • Patient who has met IBS-C diagnostic criteria from Rome III more than six months prior to provisional registration. Meaning that patient who had recurrent abdominal pain or discomfort at least 3 days/month in last 3 months associated with two or more of the following, and patient who was affected with following IBS symptoms more than six months prior to the provisional registration:

    • Improvement with defecation
    • Onset associated with a change in frequency of stool
    • Onset associated with a change in form (appearance) of stool
  • Patient with history of surgical resection of stomach, gallbladder, small intestine, or large intestine (excluding resection of appendicitis and benign polyp)
  • Patient with history or current evidence of inflammatory bowel disease (Crohn's disease or ulcerative colitis)
  • Patient with history or current evidence of ischemic colitis
  • Patient currently affected by infectious enteritis
  • Patient currently affected by hyperthyroidism or hypothyroidism
  • Patient with apparent mechanical obstruction (i.e. patient with ileus caused by hernia)
  • Patient with mega colon or mega rectum
  • Patient currently affected by constipation due to anorectal dysfunction
  • Patient currently affected by drug induced constipation.
  • Patient with constipation due to other organic disease
  • Patient currently affected by active peptic ulcer
  • In the case of a female, the one currently affected by endometriosis or uterine adenomyosis
  • Patient with high depression or anxiety considered to influence drug evaluation
  • Patient with history of abuse of drug or alcohol within a year before consent acquisition, or with current abuse
  • Patient who used or underwent or will use or undergo drug/therapy/test prohibited to combine 3 days before the start of bowel habit observation period (Day -17) or thereafter (however, patient who used or underwent restricted drug/therapy according to Protocol may be enrolled provisionally)
  • Patient with history or current evidence of malignant tumor
  • Patient currently affected by serious cardiovascular disease, respiratory disease, kidney disease, hepatic disease, gastrointestinal disease (excluding CC), hemorrhagic disease, or neural/mental disease
  • Patient with history of drug allergy

Sites / Locations

  • Site: 35
  • Site: 36
  • Site: 27
  • Site: 28
  • Site: 29
  • Site: 30
  • Site: 48
  • Site: 49
  • Site: 50
  • Site: 1
  • Site: 2
  • Site: 45
  • Site: 46
  • Site: 47
  • Site: 22
  • Site: 23
  • Site: 24
  • Site: 25
  • Site: 26
  • Site: 44
  • Site: 37
  • Site: 38
  • Site: 39
  • Site: 40
  • Site: 41
  • Site: 42
  • Site: 43
  • Site: 31
  • Site: 32
  • Site: 33
  • Site: 34
  • Site: 10
  • Site: 11
  • Site: 12
  • Site: 13
  • Site: 14
  • Site: 15
  • Site: 16
  • Site: 17
  • Site: 18
  • Site: 19
  • Site: 20
  • Site: 21
  • Site: 3
  • Site: 4
  • Site: 5
  • Site: 6
  • Site: 7
  • Site: 8
  • Site: 9

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

ASP0456 0.0625mg

ASP0456 0.125mg

ASP0456 0.25mg

ASP0456 0.5mg

Placebo group

Arm Description

oral

oral

oral

oral

oral

Outcomes

Primary Outcome Measures

Change in weekly average of SBM frequency
SBM: Spontaneous Bowel Movement. SBM means the defecation without procedure of laxative, suppository, enema, or stool extraction on the day or preceding day of the defecation. SBM frequency is calculated as follows: (the week total number of SBM )/ (the total number of days on which the frequency of SBM is evaluable) x7

Secondary Outcome Measures

Weekly responder rate for SBM
The weekly average value of SBM frequency is more than 3 and over 1 more than the weekly mean value of SBM frequency in the bowel habit observation period
Weekly responder rate for CSBM
The weekly average value of CSBM frequency is more than 3 and over 1 more than the weekly mean value of CSBM frequency in the bowel habit observation period
Percentage of subjects with SBM within 24 hours after the start of initial treatment
Change in weekly average of CSBM frequency
Proportion of subjects with CSBM within 24 hours after the start of initial treatment
Weekly responder rate of the global assessment of relief of chronic constipation.
The weekly responder of the evaluation items shall be the subject satisfying the following at the time of evaluation in each week: Score of Global assessment of relief of chronic constipation symptoms (7 scores: 1-7) is 1 or 2
Weekly responder rate of the abdominal bowel habits improvement in chronic constipation.
Score of abdominal bowel habits improvement effect (7 scores: 1-7) is 1 or 2
Weekly responder rate of abdominal symptom relief of chronic constipation.
Score of abdominal symptom improvement effect (7 scores: 1-7) is 1 or 2
Score of the global assessment of relief of chronic constipation
Scores will be measured using a seven-point ordinal score
Changes in IBS-QOL-J scores (entire scores or scores on the sub-scales)
IBS-QOL-J: Irritable bowel syndrome quality of life Japanese version
Changes in weekly average of SBM frequency
SBM: Spontaneous Bowel Movement
Changes in weekly average of CSBM frequency
CSBM: Complete Spontaneous Bowel Movement
Changes in weekly average of stool form
Stool form will be measured using seven-point Bristol Stool Form Scale
Changes in weekly average of abdominal bloating severity scores
Abdominal bloating severity will be measured using a five-point ordinal score
Changes in weekly average of abdominal pain/discomfort severity scores
Abdominal pain/discomfort severity will be measured using a five-point ordinal score
Changes in weekly average of straining severity scores
Straining severity will be measured using a five-point ordinal score
Score of the abdominal bowel habits improvement in chronic constipation
Scores will be measured using a seven-point ordinal score
Score of the abdominal symptom relief of chronic constipation
Scores will be measured using a seven-point ordinal score
Safety assessed by development of incidence of adverse events, vital signs, clinical laboratory tests and body weight

Full Information

First Posted
April 7, 2015
Last Updated
December 10, 2018
Sponsor
Astellas Pharma Inc
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1. Study Identification

Unique Protocol Identification Number
NCT02425722
Brief Title
A Study to Evaluate Dose Responses of Efficacy and Safety of ASP0456 in Patient With Chronic Constipation
Official Title
Phase II Study of ASP0456 - A Double-blind, Placebo-controlled, Parallel-group, Comparative Study in Patients With Chronic Constipation (Not Including Constipation Due to Organic Diseases)
Study Type
Interventional

2. Study Status

Record Verification Date
December 2018
Overall Recruitment Status
Completed
Study Start Date
April 13, 2015 (Actual)
Primary Completion Date
October 31, 2015 (Actual)
Study Completion Date
October 31, 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Astellas Pharma Inc

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The objective of this study is to investigate dose-responses of efficacy and safety of ASP0456 in patients with chronic constipation (diagnosed by Rome III criteria of functional constipation (FC), not including constipation due to organic diseases) compared to placebo and to find the appropriate dose for P3 study.
Detailed Description
To determine optimum dose of ASP0456 for the patients with chronic constipation (not including constipation due to organic diseases) in Japan based on its efficacy and safety, multicentered, placebo-controlled, double-blind, parallel group comparative study will be conducted. After two-week observation period, the patient who meets the primary registration criteria will be randomized to the one from five groups and will start treatment period. The patients will take once daily orally before the breakfast for two weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Constipation
Keywords
linaclotide, ASP0456, chronic constipation

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
ASP0456 0.0625mg
Arm Type
Experimental
Arm Description
oral
Arm Title
ASP0456 0.125mg
Arm Type
Experimental
Arm Description
oral
Arm Title
ASP0456 0.25mg
Arm Type
Experimental
Arm Description
oral
Arm Title
ASP0456 0.5mg
Arm Type
Experimental
Arm Description
oral
Arm Title
Placebo group
Arm Type
Placebo Comparator
Arm Description
oral
Intervention Type
Drug
Intervention Name(s)
ASP0456
Other Intervention Name(s)
Linaclotide
Intervention Description
oral
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
oral
Primary Outcome Measure Information:
Title
Change in weekly average of SBM frequency
Description
SBM: Spontaneous Bowel Movement. SBM means the defecation without procedure of laxative, suppository, enema, or stool extraction on the day or preceding day of the defecation. SBM frequency is calculated as follows: (the week total number of SBM )/ (the total number of days on which the frequency of SBM is evaluable) x7
Time Frame
From baseline to week 1
Secondary Outcome Measure Information:
Title
Weekly responder rate for SBM
Description
The weekly average value of SBM frequency is more than 3 and over 1 more than the weekly mean value of SBM frequency in the bowel habit observation period
Time Frame
up to 2 weeks
Title
Weekly responder rate for CSBM
Description
The weekly average value of CSBM frequency is more than 3 and over 1 more than the weekly mean value of CSBM frequency in the bowel habit observation period
Time Frame
up to 2 weeks
Title
Percentage of subjects with SBM within 24 hours after the start of initial treatment
Time Frame
up to 24 hours
Title
Change in weekly average of CSBM frequency
Time Frame
From baseline to week 1
Title
Proportion of subjects with CSBM within 24 hours after the start of initial treatment
Time Frame
up to 24 hours
Title
Weekly responder rate of the global assessment of relief of chronic constipation.
Description
The weekly responder of the evaluation items shall be the subject satisfying the following at the time of evaluation in each week: Score of Global assessment of relief of chronic constipation symptoms (7 scores: 1-7) is 1 or 2
Time Frame
up to 2 weeks
Title
Weekly responder rate of the abdominal bowel habits improvement in chronic constipation.
Description
Score of abdominal bowel habits improvement effect (7 scores: 1-7) is 1 or 2
Time Frame
up to 2 weeks
Title
Weekly responder rate of abdominal symptom relief of chronic constipation.
Description
Score of abdominal symptom improvement effect (7 scores: 1-7) is 1 or 2
Time Frame
up to 2 weeks
Title
Score of the global assessment of relief of chronic constipation
Description
Scores will be measured using a seven-point ordinal score
Time Frame
up to 2 weeks
Title
Changes in IBS-QOL-J scores (entire scores or scores on the sub-scales)
Description
IBS-QOL-J: Irritable bowel syndrome quality of life Japanese version
Time Frame
Week 0, and 2
Title
Changes in weekly average of SBM frequency
Description
SBM: Spontaneous Bowel Movement
Time Frame
From baseline to every week until 2 weeks
Title
Changes in weekly average of CSBM frequency
Description
CSBM: Complete Spontaneous Bowel Movement
Time Frame
From baseline to every week until 2 weeks
Title
Changes in weekly average of stool form
Description
Stool form will be measured using seven-point Bristol Stool Form Scale
Time Frame
From baseline to every week until 2 weeks
Title
Changes in weekly average of abdominal bloating severity scores
Description
Abdominal bloating severity will be measured using a five-point ordinal score
Time Frame
From baseline to every week until 2 weeks
Title
Changes in weekly average of abdominal pain/discomfort severity scores
Description
Abdominal pain/discomfort severity will be measured using a five-point ordinal score
Time Frame
From baseline to every week until 2 weeks
Title
Changes in weekly average of straining severity scores
Description
Straining severity will be measured using a five-point ordinal score
Time Frame
From baseline to every week until 2 weeks
Title
Score of the abdominal bowel habits improvement in chronic constipation
Description
Scores will be measured using a seven-point ordinal score
Time Frame
up to 2 weeks
Title
Score of the abdominal symptom relief of chronic constipation
Description
Scores will be measured using a seven-point ordinal score
Time Frame
up to 2 weeks
Title
Safety assessed by development of incidence of adverse events, vital signs, clinical laboratory tests and body weight
Time Frame
up to 2 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Maximum Age & Unit of Time
79 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient who had SBM* (Spontaneous bowel movement) less than 3 times per week, more than six months prior to the provisional registration *Defecation without procedure of laxative, suppository, enema, or stool extraction on the day or preceding day of the defecation Patient who was affected with one or more following symptoms before more than six months of provisional registration: Straining during at least 25% of defecations Lumpy or hard stools in at least 25% of defecations Sensation of incomplete evacuation for at least 25% of defecations Loose stools are rarely present without the use of laxatives more than six months prior to the provisional registration. Patients who had pancolonoscopy or contrast enema (or sigmoidoscopy) after the onset of chronic constipation symptom and had no organic changes Exclusion Criteria: Patient who has met IBS-C diagnostic criteria from Rome III more than six months prior to provisional registration. Meaning that patient who had recurrent abdominal pain or discomfort at least 3 days/month in last 3 months associated with two or more of the following, and patient who was affected with following IBS symptoms more than six months prior to the provisional registration: Improvement with defecation Onset associated with a change in frequency of stool Onset associated with a change in form (appearance) of stool Patient with history of surgical resection of stomach, gallbladder, small intestine, or large intestine (excluding resection of appendicitis and benign polyp) Patient with history or current evidence of inflammatory bowel disease (Crohn's disease or ulcerative colitis) Patient with history or current evidence of ischemic colitis Patient currently affected by infectious enteritis Patient currently affected by hyperthyroidism or hypothyroidism Patient with apparent mechanical obstruction (i.e. patient with ileus caused by hernia) Patient with mega colon or mega rectum Patient currently affected by constipation due to anorectal dysfunction Patient currently affected by drug induced constipation. Patient with constipation due to other organic disease Patient currently affected by active peptic ulcer In the case of a female, the one currently affected by endometriosis or uterine adenomyosis Patient with high depression or anxiety considered to influence drug evaluation Patient with history of abuse of drug or alcohol within a year before consent acquisition, or with current abuse Patient who used or underwent or will use or undergo drug/therapy/test prohibited to combine 3 days before the start of bowel habit observation period (Day -17) or thereafter (however, patient who used or underwent restricted drug/therapy according to Protocol may be enrolled provisionally) Patient with history or current evidence of malignant tumor Patient currently affected by serious cardiovascular disease, respiratory disease, kidney disease, hepatic disease, gastrointestinal disease (excluding CC), hemorrhagic disease, or neural/mental disease Patient with history of drug allergy
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Director
Organizational Affiliation
Astellas Pharma Inc
Official's Role
Study Director
Facility Information:
Facility Name
Site: 35
City
Aichi
Country
Japan
Facility Name
Site: 36
City
Aichi
Country
Japan
Facility Name
Site: 27
City
Chiba
Country
Japan
Facility Name
Site: 28
City
Chiba
Country
Japan
Facility Name
Site: 29
City
Chiba
Country
Japan
Facility Name
Site: 30
City
Chiba
Country
Japan
Facility Name
Site: 48
City
Fukuoka
Country
Japan
Facility Name
Site: 49
City
Fukuoka
Country
Japan
Facility Name
Site: 50
City
Fukuoka
Country
Japan
Facility Name
Site: 1
City
Hokkaido
Country
Japan
Facility Name
Site: 2
City
Hokkaido
Country
Japan
Facility Name
Site: 45
City
Hyogo
Country
Japan
Facility Name
Site: 46
City
Hyogo
Country
Japan
Facility Name
Site: 47
City
Hyogo
Country
Japan
Facility Name
Site: 22
City
Kanagawa
Country
Japan
Facility Name
Site: 23
City
Kanagawa
Country
Japan
Facility Name
Site: 24
City
Kanagawa
Country
Japan
Facility Name
Site: 25
City
Kanagawa
Country
Japan
Facility Name
Site: 26
City
Kanagawa
Country
Japan
Facility Name
Site: 44
City
Kyoto
Country
Japan
Facility Name
Site: 37
City
Osaka
Country
Japan
Facility Name
Site: 38
City
Osaka
Country
Japan
Facility Name
Site: 39
City
Osaka
Country
Japan
Facility Name
Site: 40
City
Osaka
Country
Japan
Facility Name
Site: 41
City
Osaka
Country
Japan
Facility Name
Site: 42
City
Osaka
Country
Japan
Facility Name
Site: 43
City
Osaka
Country
Japan
Facility Name
Site: 31
City
Saitama
Country
Japan
Facility Name
Site: 32
City
Saitama
Country
Japan
Facility Name
Site: 33
City
Saitama
Country
Japan
Facility Name
Site: 34
City
Saitama
Country
Japan
Facility Name
Site: 10
City
Tokyo
Country
Japan
Facility Name
Site: 11
City
Tokyo
Country
Japan
Facility Name
Site: 12
City
Tokyo
Country
Japan
Facility Name
Site: 13
City
Tokyo
Country
Japan
Facility Name
Site: 14
City
Tokyo
Country
Japan
Facility Name
Site: 15
City
Tokyo
Country
Japan
Facility Name
Site: 16
City
Tokyo
Country
Japan
Facility Name
Site: 17
City
Tokyo
Country
Japan
Facility Name
Site: 18
City
Tokyo
Country
Japan
Facility Name
Site: 19
City
Tokyo
Country
Japan
Facility Name
Site: 20
City
Tokyo
Country
Japan
Facility Name
Site: 21
City
Tokyo
Country
Japan
Facility Name
Site: 3
City
Tokyo
Country
Japan
Facility Name
Site: 4
City
Tokyo
Country
Japan
Facility Name
Site: 5
City
Tokyo
Country
Japan
Facility Name
Site: 6
City
Tokyo
Country
Japan
Facility Name
Site: 7
City
Tokyo
Country
Japan
Facility Name
Site: 8
City
Tokyo
Country
Japan
Facility Name
Site: 9
City
Tokyo
Country
Japan

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Access to anonymized individual participant level data collected during the trial, in addition to study-related supporting documentation, is planned for trials conducted with approved product indications and formulations, as well as compounds terminated during development. Conditions and exceptions are described under the Sponsor Specific Details for Astellas on www.clinicalstudydatarequest.com.
IPD Sharing Time Frame
Access to participant level data is offered to researchers after publication of the primary manuscript (if applicable) and is available as long as Astellas has legal authority to provide the data.
IPD Sharing Access Criteria
Researchers must submit a proposal to conduct a scientifically relevant analysis of the study data. The research proposal is reviewed by an Independent Research Panel. If the proposal is approved, access to the study data is provided in a secure data sharing environment after receipt of a signed Data Sharing Agreement.
IPD Sharing URL
https://www.clinicalstudydatarequest.com
Citations:
PubMed Identifier
30084233
Citation
Fukudo S, Miwa H, Nakajima A, Kinoshita Y, Kosako M, Nakagawa A, Akiho H, Kuroishi K, Johnston JM, Currie M, Ohkusa T. Dose-finding study of linaclotide in Japanese patients with chronic constipation: A phase II randomized, double-blind, and placebo-controlled study. Neurogastroenterol Motil. 2018 Dec;30(12):e13442. doi: 10.1111/nmo.13442. Epub 2018 Aug 7.
Results Reference
derived
Links:
URL
https://astellasclinicalstudyresults.com/study.aspx?ID=279
Description
Link to results on the Astellas Clinical Study Results website

Learn more about this trial

A Study to Evaluate Dose Responses of Efficacy and Safety of ASP0456 in Patient With Chronic Constipation

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