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Safety and Preliminary Efficacy of BGP345A in Constipation Due to Opioid-based Medications (OIC1)

Primary Purpose

Opioid-Induced Constipation

Status
Recruiting
Phase
Phase 2
Locations
France
Study Type
Interventional
Intervention
Lactobacillus gasseri BGP345A
Placebo
Sponsored by
BioGaia Pharma AB
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Opioid-Induced Constipation

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

I1. Age over 18 years (limit included),

I2. Diagnosed with OIC according to the adapted ROME IV criteria (Mearin F et al, 2016) previously used in clinical evaluation of patients with OIC (Webster LR et al, 2017) and self-reported symptoms assessed by a physician (daily diary check at V1 visit):

  • Fewer than three (<3) spontaneous bowel movements (SBMs) per week. A SBM is defined as a bowel movement without the use of laxatives in the previous 24 hours as recorded in the daily diary.
  • And one or more of the following symptoms in at least 25% of bowel movements: straining, feeling of incomplete evacuation, and/or hard/small stools, defined as Bristol Stool Scale (BSS) score lower than 3 (<3).

I3. With chronic non-cancer pain since at least three months, including the following indications but not limited to: back-pain, rheumatisms and post-operative pain,

I4. Patients received opioids for chronic analgesia (intended treatment ≥6 Weeks) for 1 week or more prior to study start and a stable regimen of opioids for 3 or more days before study entry (V0 visit) and during the whole study ,

I5. Subjects must be willing to discontinue laxative use at screening and only use the rescue laxatives permitted throughout the study duration,

I6. For women:

  • Non menopausal with the same reliable contraception since at least 2 cycles before the beginning of the study and agreeing to keep it during the entire duration of the study (condom with spermicide gel, any oral contraceptive, intrauterine device, subcutaneous contraceptive implant, vaginal ring, surgical intervention (bilateral tubal ligation or ovariectomy or hysterectomy), ESSURE system),
  • Menopausal without or with hormone replacement therapy,

I7. Good general and mental health with in the opinion of the investigator: no clinically significant and relevant abnormalities of medical history or physical examination,

I8. Able and willing to participate to the study by complying with the protocol procedures as evidenced by his dated and signed informed consent form,

I9. Affiliated with a social security scheme.

Exclusion Criteria:

E1. Involvement in any investigational drug or device study within 30 days prior to this study,

E2. Unable to withdraw other OIC treatments (any kind of laxative other than provided in the study),

E3. History of chronic constipation prior to starting analgesic medication or any potential non-opioid cause of bowel dysfunction that may be a major contributor to the constipation upon investigator judgment,

E4. Surgery planned within the whole study period,

E5. Evidence of active medical diseases affecting bowel transit,

E6. Antibiotic treatment intake within the last month prior the study start (V0),

E7. Unwilling to withdraw probiotic supplements, yoghurts without supplemented bacteria are permitted,

E8. Any history of drug addiction in the past five years,

E9. Pregnant or lactating women or intending to become pregnant,

E10. Unwilling to maintain food habits and current physical activity for the whole study duration,

E11. With a personal history of anorexia nervosa, bulimia or significant eating disorders according to the investigator,

E12. Having a lifestyle deemed incompatible with the study according to the investigator including drug and alcohol abuse,

E13. Taking part in another clinical trial or being in the exclusion period of a previous clinical trial,

E14. Under legal protection (guardianship, wardship) or deprived from his rights following administrative or judicial decision,

E15. Presenting a psychological or linguistic incapability to sign the informed consent,

E16. Impossible to contact in case of emergency.

Sites / Locations

  • CHU d'AmiensRecruiting
  • CHU DE NANTES (Hôpital Nord Laennec)Recruiting
  • CH de Valenciennes

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Active arm

Placebo arm

Arm Description

Outcomes

Primary Outcome Measures

Change in the average weekly number of Spontaneous Bowel Movements (SBMs) (expressed in number of stools/week)
A SBM (Spontaneous Bowel Movement) is defined as a bowel movement without the use of laxatives in the previous 24 hours as recorded in the daily diary (Webster LR et al, 2017).

Secondary Outcome Measures

Percentage of responders over the 4-weeks of treatment period defined by subjects reporting an average weekly number of SBMs ≥ 3 and an increase of the average weekly number of SBM ≥1 from baseline
SBM responders
Change in the average weekly number of BMs (Bowel Movements)
BM (Bowel Movements) expressed in number of stools/week
Change in the average weekly number of CSBMs (Complete Spontaneous Bowel Movement)
CSBMs (Complete Spontaneous Bowel Movement) expressed in number of stools/week is defined by as a bowel movement without the use of laxatives in the previous 24 hours as recorded in the daily diary and the feeling of complete emptying after bowel movement.
Change in the average weekly number of SBMs
SBMs expressed in number of stools/week
Change in the average weekly number of SBMs with no straining (straining score 1)
SBMs expressed in number of stools/week
Time to first SBM and CSBM after the last recorded stool before the randomisation
Expressed in hours
Change in the number of days with presence of SBMs
SBMs expressed in days/week
Change in the number of days with presence of CSBMs
CSBMs expressed in days/week
Change in the average weekly number of SBMs rated 3 or 4 on the BSS (Bristol Stool Scale)
Expressed in stools/week
Change of stool consistency assessed by the BSS (Bristol Stool Scale)
Expressed in arbitrary units/stool from 1-7.
Change of the overall BFI (Bowel Function Index) score
Expressed in arbitrary units, range 0-100
Change in the average daily abdominal bloating score
Expressed in arbitrary units/day (this score will be assessed daily for the past 24hours and could range from 0 to 4, where 0 = absent or no bloating, 1 = mild, 2 = moderate, 3= severe, and 4 =very severe bloating)
Change in the average daily abdominal discomfort score
Expressed in arbitrary units/day (this score will be assessed daily for the past 24hours and could range from 0 to 4, where 0 = no abdominal discomfort, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe discomfort)
Change in average daily pain at defecation assessed by the Visual Analogic Scale for pain at defecation (VAS)
Expressed in arbitrary units/day with stool, range 0-100
Change in the weekly frequency of rescue laxative use assessed by the daily diary
expressed in average of days/week
Frequency of rescue laxative use assessed by the daily diary.
Expressed in number of laxative uses
General health state measuring vital parameters assessed - Body weight
Body weight (kg)
General health state measuring vital parameters assessed- Diastolic Blood Pressure
Diastolic Blood Pressure (mmHg)
General health state measuring vital parameters assessed- Systolic Blood Pressure
Systolic Blood Pressure (mmHg)
General health state measuring vital parameters assessed- Vital signs
Vital signs (BPM)
the frequency of adverse events (AE), serious adverse events (SAE), Treatment-Emergent Adverse events (TEAE), Serious treatment-emergent adverse events (STEAE)
Frequency and nature of events

Full Information

First Posted
October 26, 2021
Last Updated
September 7, 2023
Sponsor
BioGaia Pharma AB
Collaborators
BioFortis
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1. Study Identification

Unique Protocol Identification Number
NCT05133076
Brief Title
Safety and Preliminary Efficacy of BGP345A in Constipation Due to Opioid-based Medications
Acronym
OIC1
Official Title
A Randomized Placebo-controlled Study to Assess Safety and Preliminary Efficacy of BGP345A in Patients With Constipation Due to the Use of Opioid-based Medications for the Management of Chronic Non Cancer Pain
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 20, 2022 (Actual)
Primary Completion Date
December 2023 (Anticipated)
Study Completion Date
December 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
BioGaia Pharma AB
Collaborators
BioFortis

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to assess safety and preliminary efficacy of BGP345A in patients with constipation due to the use of opioid-based medications for the management of chronic non cancer pain.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Opioid-Induced Constipation

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Active arm
Arm Type
Active Comparator
Arm Title
Placebo arm
Arm Type
Placebo Comparator
Intervention Type
Biological
Intervention Name(s)
Lactobacillus gasseri BGP345A
Other Intervention Name(s)
BGP345A
Intervention Description
Active and placebo capsules for oral use
Intervention Type
Biological
Intervention Name(s)
Placebo
Intervention Description
Placebo
Primary Outcome Measure Information:
Title
Change in the average weekly number of Spontaneous Bowel Movements (SBMs) (expressed in number of stools/week)
Description
A SBM (Spontaneous Bowel Movement) is defined as a bowel movement without the use of laxatives in the previous 24 hours as recorded in the daily diary (Webster LR et al, 2017).
Time Frame
Over the 4 week treatment period
Secondary Outcome Measure Information:
Title
Percentage of responders over the 4-weeks of treatment period defined by subjects reporting an average weekly number of SBMs ≥ 3 and an increase of the average weekly number of SBM ≥1 from baseline
Description
SBM responders
Time Frame
Average over the last two weeks of treatment
Title
Change in the average weekly number of BMs (Bowel Movements)
Description
BM (Bowel Movements) expressed in number of stools/week
Time Frame
Over 4 week treatment period; during each week of the treatment period; and up to 8 weeks at study completion.
Title
Change in the average weekly number of CSBMs (Complete Spontaneous Bowel Movement)
Description
CSBMs (Complete Spontaneous Bowel Movement) expressed in number of stools/week is defined by as a bowel movement without the use of laxatives in the previous 24 hours as recorded in the daily diary and the feeling of complete emptying after bowel movement.
Time Frame
Over 4 week treatment period; during each week of the treatment period; and up to 8 weeks at study completion.
Title
Change in the average weekly number of SBMs
Description
SBMs expressed in number of stools/week
Time Frame
Over 4 week treatment period; during each week of the treatment period; and up to 8 weeks at study completion.
Title
Change in the average weekly number of SBMs with no straining (straining score 1)
Description
SBMs expressed in number of stools/week
Time Frame
Over 4 week treatment period; during each week of the treatment period; and up to 8 weeks at study completion.
Title
Time to first SBM and CSBM after the last recorded stool before the randomisation
Description
Expressed in hours
Time Frame
Over 4 week treatment period
Title
Change in the number of days with presence of SBMs
Description
SBMs expressed in days/week
Time Frame
Over 4 week treatment period; during each week of the treatment period; and up to 8 weeks at study completion.
Title
Change in the number of days with presence of CSBMs
Description
CSBMs expressed in days/week
Time Frame
Over 4 week treatment period; during each week of the treatment period; and up to 8 weeks at study completion.
Title
Change in the average weekly number of SBMs rated 3 or 4 on the BSS (Bristol Stool Scale)
Description
Expressed in stools/week
Time Frame
Over 4 week treatment period; during each week of the treatment period; and up to 8 weeks at study completion.
Title
Change of stool consistency assessed by the BSS (Bristol Stool Scale)
Description
Expressed in arbitrary units/stool from 1-7.
Time Frame
Over 4 week treatment period; during each week of the treatment period; and up to 8 weeks at study completion.
Title
Change of the overall BFI (Bowel Function Index) score
Description
Expressed in arbitrary units, range 0-100
Time Frame
Over 4 week treatment period
Title
Change in the average daily abdominal bloating score
Description
Expressed in arbitrary units/day (this score will be assessed daily for the past 24hours and could range from 0 to 4, where 0 = absent or no bloating, 1 = mild, 2 = moderate, 3= severe, and 4 =very severe bloating)
Time Frame
Over 4 week treatment period; during each week of the treatment period; and up to 8 weeks at study completion.
Title
Change in the average daily abdominal discomfort score
Description
Expressed in arbitrary units/day (this score will be assessed daily for the past 24hours and could range from 0 to 4, where 0 = no abdominal discomfort, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe discomfort)
Time Frame
Over 4 week treatment period; during each week of the treatment period; and up to 8 weeks at study completion.
Title
Change in average daily pain at defecation assessed by the Visual Analogic Scale for pain at defecation (VAS)
Description
Expressed in arbitrary units/day with stool, range 0-100
Time Frame
Over 4 week treatment period; during each week of the treatment period; and up to 8 weeks at study completion.
Title
Change in the weekly frequency of rescue laxative use assessed by the daily diary
Description
expressed in average of days/week
Time Frame
Over 4 week treatment period; during each week of the treatment period; and up to 8 weeks at study completion.
Title
Frequency of rescue laxative use assessed by the daily diary.
Description
Expressed in number of laxative uses
Time Frame
Over the 4 week treatment period
Title
General health state measuring vital parameters assessed - Body weight
Description
Body weight (kg)
Time Frame
Through study completion, 10 weeks
Title
General health state measuring vital parameters assessed- Diastolic Blood Pressure
Description
Diastolic Blood Pressure (mmHg)
Time Frame
Through study completion, 10 weeks
Title
General health state measuring vital parameters assessed- Systolic Blood Pressure
Description
Systolic Blood Pressure (mmHg)
Time Frame
Through study completion, 10 weeks
Title
General health state measuring vital parameters assessed- Vital signs
Description
Vital signs (BPM)
Time Frame
Through study completion, 10 weeks
Title
the frequency of adverse events (AE), serious adverse events (SAE), Treatment-Emergent Adverse events (TEAE), Serious treatment-emergent adverse events (STEAE)
Description
Frequency and nature of events
Time Frame
Through study completion, 10 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: I1. Age over 18 years (limit included), I2. Diagnosed with OIC according to the adapted ROME IV criteria (Mearin F et al, 2016) previously used in clinical evaluation of patients with OIC (Webster LR et al, 2017) and self-reported symptoms assessed by a physician (daily diary check at V1 visit): Fewer than three (<3) spontaneous bowel movements (SBMs) per week. A SBM is defined as a bowel movement without the use of laxatives in the previous 24 hours as recorded in the daily diary. And one or more of the following symptoms in at least 25% of bowel movements: straining, feeling of incomplete evacuation, and/or hard/small stools, defined as Bristol Stool Scale (BSS) score lower than 3 (<3). I3. With chronic non-cancer pain since at least three months, including the following indications but not limited to: back-pain, rheumatisms and post-operative pain, I4. Patients received opioids for chronic analgesia (intended treatment ≥6 Weeks) for 1 week or more prior to study start and a stable regimen of opioids for 3 or more days before study entry (V0 visit) and during the whole study , I5. Subjects must be willing to discontinue laxative use at screening and only use the rescue laxatives permitted throughout the study duration, I6. For women: Non menopausal with the same reliable contraception since at least 2 cycles before the beginning of the study and agreeing to keep it during the entire duration of the study (condom with spermicide gel, any oral contraceptive, intrauterine device, subcutaneous contraceptive implant, vaginal ring, surgical intervention (bilateral tubal ligation or ovariectomy or hysterectomy), ESSURE system), Menopausal without or with hormone replacement therapy, I7. Good general and mental health with in the opinion of the investigator: no clinically significant and relevant abnormalities of medical history or physical examination, I8. Able and willing to participate to the study by complying with the protocol procedures as evidenced by his dated and signed informed consent form, I9. Affiliated with a social security scheme. Exclusion Criteria: E1. Involvement in any investigational drug or device study within 30 days prior to this study, E2. Unable to withdraw other OIC treatments (any kind of laxative other than provided in the study), E3. History of chronic constipation prior to starting analgesic medication or any potential non-opioid cause of bowel dysfunction that may be a major contributor to the constipation upon investigator judgment, E4. Surgery planned within the whole study period, E5. Evidence of active medical diseases affecting bowel transit, E6. Antibiotic treatment intake within the last month prior the study start (V0), E7. Unwilling to withdraw probiotic supplements, yoghurts without supplemented bacteria are permitted, E8. Any history of drug addiction in the past five years, E9. Pregnant or lactating women or intending to become pregnant, E10. Unwilling to maintain food habits and current physical activity for the whole study duration, E11. With a personal history of anorexia nervosa, bulimia or significant eating disorders according to the investigator, E12. Having a lifestyle deemed incompatible with the study according to the investigator including drug and alcohol abuse, E13. Taking part in another clinical trial or being in the exclusion period of a previous clinical trial, E14. Under legal protection (guardianship, wardship) or deprived from his rights following administrative or judicial decision, E15. Presenting a psychological or linguistic incapability to sign the informed consent, E16. Impossible to contact in case of emergency.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Sonia Brinet
Phone
+33 (0)2 40 20 57 99
Email
sonia.brinet@biofortis.fr
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Petra J Lierud
Organizational Affiliation
BioGaia Pharma
Official's Role
Study Director
Facility Information:
Facility Name
CHU d'Amiens
City
Amiens
ZIP/Postal Code
80054
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sandrine Soriot-Thomas, Docteur
Facility Name
CHU DE NANTES (Hôpital Nord Laennec)
City
Saint- Herblain
ZIP/Postal Code
44800
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Julien Nizard, Professor
Facility Name
CH de Valenciennes
City
Valenciennes
ZIP/Postal Code
59322
Country
France
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Antoine Lemaire, Docteur

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Safety and Preliminary Efficacy of BGP345A in Constipation Due to Opioid-based Medications

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