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Evaluate the Efficacy and Safety of Goofice® (Elobixibat) in Patients With Chronic Constipation

Primary Purpose

Constipation

Status
Recruiting
Phase
Phase 3
Locations
Taiwan
Study Type
Interventional
Intervention
Goofice®
Goofice® Placebo
Sponsored by
Synmosa Biopharma Corp.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Constipation

Eligibility Criteria

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

Inclusion Criteria: - At provisional enrollment Men or women ≥ 20 years of age. Include 2 or more of the following during the last 3 months with symptom onset of at least 6 months: Straining during more than 25% of bowel movements (BMs);) Lumpy or hard stools in 25% of BMs; Sensation of incomplete evacuation in more than 25% of all BMs; Sensation of anorectal blockage or obstruction in more than 25% of BMs; Manual maneuvers required in more than 25% of BMs; Fewer than 3 BMs per week. In addition to having at least 2 of the above criteria, the following must also apply: a. Loose stools are rarely present without the use of laxatives; b. Insufficient criteria for irritable bowel syndrome (IBS). Ability to provide written consent. - At time of enrollment A total of SBM frequencies < 6 times during the 2-week screening period. Exclusion Criteria: At provisional enrollment Known or suspected allergy to components in elobixibat. Known or suspected organic constipation. Known or suspected symptomatic or drug-induced constipation. Known or suspected slow colon transit type constipation. Known or suspected excretory disorder constipation. Currently have or history of gastrointestinal obstruction. Currently have or history of abdominal hernia. History of laparotomy other than simple appendectomy. History of cholecystectomy or surgical or endoscopic intervention related to papillotomy. Subjects in whom the dosage regimens of medications, of which changing the dosage regimens is prohibited, will be changed after the day of informed consent. Cannot use the rescue medication (bisacodyl suppositories 10 mg). Pregnant, lactating or potentially pregnant women, women who wish to become pregnant from the time of the informed consent to the last observation/test point, or women who do not agree to use appropriate birth control methods. The acceptable effective contraception methods include: a. Male or female sterilization, implant, or intrauterine device; b. Injectable, pill, patch, ring plus one barrier method*; c. Two combined barrier methods*. Effective barrier methods are diaphragm, male or female condoms, sponge, or spermicides (creams or gels that contain a chemical to kill sperm). Anemia, defined as hemoglobin ≤ 10 g/dL. Concurrent serious renal disease (creatinine ≥ 2.00 mg/dL) or liver disease (total bilirubin ≥ 3.0 mg/dL, or aspartate aminotransferase(AST) or alanine transaminase(ALT) ≥ 100 U/L). Concurrent clinical significant heart disease, including uncontrolled hypertension, arrhythmia, or heart failure. History of serious drug-induced allergy needs emergent medical intervention, such as anaphylaxis, angioedema, generalized urticaria or bronchospasm. Subjects have a history of cancer (other than basal cell or squamous cell carcinoma of the skin) unless the malignancy has been in a complete remission without maintenance chemotherapy for ≥ 5 years prior to the Screening visit. Subjects who are taking part in another clinical study, or subjects who take part in another clinical study within 12 weeks prior to the day of informed consent. Loss of weight greater than 5 kg one month before screening visit. Determined by the investigator to be not suitable for the conduct of the study for any other reasons. Subjects have a barium enema within 7 days of the Screening Visit. At time of enrollment 22. Subjects have a clinically significant finding on colonoscopy performed as required in accordance with the American Gastroenterological Association (AGA) guidelines (within AGA time frames). If polyps are found and biopsied, pathology must be reviewed and must be negative for cancer before the subject may be enrolled in the study. 23. Used the rescue medication (bisacodyl suppositories 10 mg) at least 6 times during the 2-week screening period or subjects who used the rescue medication at least 3 times in Week -1 of the screening period. 24. Used the rescue medication for less than 72 hours after bowel movement during the 2-week screening period. 25. Mushy stool or watery stool (Bristol Stool Form Scale type 6 or 7) in SBM during the 2-week screening period. 26. Used prohibited medications/therapies during the 2-week screening period

Sites / Locations

  • National Taiwan University Hospital Clinical Trial CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Goofice®

Goofice® Placebo

Arm Description

Active ingredient: Elobixibat 5mg/tab Dosage and Frequency: Once daily before breakfast. The starting dose is total 10 mg of Goofice® (2 tablets). After 7 days of the start of the study treatment, the dosage may be adjusted according to symptoms among the dose levels of 5, 10, and 15 mg.However, the maximum daily dose is 15 mg (3 tablets).

Active ingredient/Excipients: The placebo drug is identical in appearance to the Goofice ® tablet with the same excipient ingredients, but without the active compound. Dosage and Frequency: Once daily before breakfast. The dosage and frequency is the same as active drug

Outcomes

Primary Outcome Measures

Overall Complete spontaneous bowel movement(CSBM) responder rate during 12 weeks treatment
An overall CSBM responder is a subject who is a weekly CSBM responder for at least 9 of the 12 treatment weeks, including at least 3 of the last 4 treatment weeks. A weekly CSBM responder will be defined as a subject with CSBM frequency of ≥ 3 times and CSBM frequency improved by ≥ 1 time from Week -1 of the screening period. SBM is defined as defecation without laxative drug/enema or stool extraction. CSBM is defined as SBM without sensation of incomplete evacuation. In this study, when subjects used laxative drug at the day before initiation of screening period or rescue medication after initiation of screening period, defecation within 24 hours after the use of these medications will be not deemed as SBM or CSBM.

Secondary Outcome Measures

Efficacy endpoint - Complete spontaneous bowel movement (CSBM) responder rate at Week 12
- A responder will be defined as a subject with weekly (Week 12) CSBM frequency of ≥ 3 times and weekly (Week 12) CSBM frequency improved by ≥ 1 time from Week -1 of the screening period.
Efficacy endpoint - Spontaneous bowel movement (SBM) responder rate at Week 12
- A responder will be defined as a subject with weekly (Week 12) SBM frequency of ≥3 times and weekly (Week 12) SBM frequency improved by ≥ 1 time from Week -1 of the screening period.
Efficacy endpoint - SBM and CSBM responder rate
- Changes of SBM and CSBM responder rate during follow-up period.
Efficacy endpoint - SBM frequency
- Changes in SBM frequency from screening period Week -1 at each week.
Efficacy endpoint - CSBM frequency
- Changes in CSBM frequency from screening period Week -1 at each week.
Efficacy endpoint - Mean stool consistency by Bristol Stool Form Scale
- The stool consistency is assessed based on the Bristol Stool Form Scale on a 7-grade scale. Grade / Interpretation / Separate hard lumps, like nuts (hard to pass) / Sausage shaped, but lumpy / Like a sausage, but with cracks on its surface / Like a sausage or snake, smooth and soft / Soft blobs with clear cut edges (passed easily) / Fluffy pieces with ragged edges, a mushy stool / Watery, no solid pieces, entirely liquid Mean stool consistency as measured at Week -1 and each treatment Week.
Exploratory endpoint - Patient Assessment of Constipation Quality of Life (PAC-QoL)
- Each item of the 28-item questionnaire (Appendix 1) is scored on a 5-point Likert-type scale from 0 to 4, with (0 = none/not at all, 1 = a little bit/a little bit of the time, 2 = moderately/some of the time, 3 = quite a bit/most of the time, 4 = extremely/all the time). Scores are reported overall and for each of the four subscales (physical discomfort, psychosocial discomfort, worries and concerns, and satisfaction). An improvement (reduction) of ≥1 point in PAC-QoL score are considered clinically significant based on previous validation studies.
Exploratory endpoint - Patient Assessment of Constipation Symptoms (PAC-SYM) scores
- Symptom scores are evaluated using the PAC-SYM questionnaire, a validated, 12-item, Patient-reported outcome (PRO) instrument with abdominal, stool and rectal symptom subscales. Each item of the PAC-SYM is scored on a 5-point Likert-type scale (0 = absent, 1 = mild, 2 = moderate, 3 = severe, 4 = very severe), with higher scores indicating greater symptom severity. An improvement (reduction) of ≥1 point in PAC-SYM score is considered clinically significant based on previous validation studies.

Full Information

First Posted
September 23, 2022
Last Updated
May 29, 2023
Sponsor
Synmosa Biopharma Corp.
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1. Study Identification

Unique Protocol Identification Number
NCT05895877
Brief Title
Evaluate the Efficacy and Safety of Goofice® (Elobixibat) in Patients With Chronic Constipation
Official Title
A Double-blind, Randomized, Placebo-controlled Trial to Evaluate the Efficacy and Safety of Goofice® in Patients With Chronic Constipation
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Recruiting
Study Start Date
December 21, 2021 (Actual)
Primary Completion Date
September 30, 2023 (Anticipated)
Study Completion Date
September 30, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Synmosa Biopharma Corp.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a double-blind, randomized, placebo-controlled trial to evaluate the efficacy and safety of Goofice® in patients with chronic constipation.
Detailed Description
In order to enroll appropriate patients with chronic constipation, a 2-week constipation-related symptom intensity screening period will be established to investigate the number of bowel movements just prior to the study drug treatment initiation. Eligible subjects who fulfill all selection criteria for enrollment will be randomly assigned to receive Goofice® or placebo drug with 2:1 allocation ratio. The study drug will be received once daily approximately 30 minutes before breakfast in the 12-week treatment period. The starting dosing of Goofice® / placebo will be 10 mg (2 tablets) in treatment period. It is allowed to adjust the dosage among 5, 10, and 15 mg after 7 days after treatment initiation, if the dose adjusting criteria are met depending on symptoms. After treatment period, subjects will be followed up for 4 weeks to observe the effect of discontinuing treatment.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
351 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Goofice®
Arm Type
Active Comparator
Arm Description
Active ingredient: Elobixibat 5mg/tab Dosage and Frequency: Once daily before breakfast. The starting dose is total 10 mg of Goofice® (2 tablets). After 7 days of the start of the study treatment, the dosage may be adjusted according to symptoms among the dose levels of 5, 10, and 15 mg.However, the maximum daily dose is 15 mg (3 tablets).
Arm Title
Goofice® Placebo
Arm Type
Placebo Comparator
Arm Description
Active ingredient/Excipients: The placebo drug is identical in appearance to the Goofice ® tablet with the same excipient ingredients, but without the active compound. Dosage and Frequency: Once daily before breakfast. The dosage and frequency is the same as active drug
Intervention Type
Drug
Intervention Name(s)
Goofice®
Intervention Description
Once daily before breakfast.
Intervention Type
Drug
Intervention Name(s)
Goofice® Placebo
Intervention Description
Once daily before breakfast.
Primary Outcome Measure Information:
Title
Overall Complete spontaneous bowel movement(CSBM) responder rate during 12 weeks treatment
Description
An overall CSBM responder is a subject who is a weekly CSBM responder for at least 9 of the 12 treatment weeks, including at least 3 of the last 4 treatment weeks. A weekly CSBM responder will be defined as a subject with CSBM frequency of ≥ 3 times and CSBM frequency improved by ≥ 1 time from Week -1 of the screening period. SBM is defined as defecation without laxative drug/enema or stool extraction. CSBM is defined as SBM without sensation of incomplete evacuation. In this study, when subjects used laxative drug at the day before initiation of screening period or rescue medication after initiation of screening period, defecation within 24 hours after the use of these medications will be not deemed as SBM or CSBM.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Efficacy endpoint - Complete spontaneous bowel movement (CSBM) responder rate at Week 12
Description
- A responder will be defined as a subject with weekly (Week 12) CSBM frequency of ≥ 3 times and weekly (Week 12) CSBM frequency improved by ≥ 1 time from Week -1 of the screening period.
Time Frame
12 weeks
Title
Efficacy endpoint - Spontaneous bowel movement (SBM) responder rate at Week 12
Description
- A responder will be defined as a subject with weekly (Week 12) SBM frequency of ≥3 times and weekly (Week 12) SBM frequency improved by ≥ 1 time from Week -1 of the screening period.
Time Frame
12 weeks
Title
Efficacy endpoint - SBM and CSBM responder rate
Description
- Changes of SBM and CSBM responder rate during follow-up period.
Time Frame
4 weeks
Title
Efficacy endpoint - SBM frequency
Description
- Changes in SBM frequency from screening period Week -1 at each week.
Time Frame
12 weeks
Title
Efficacy endpoint - CSBM frequency
Description
- Changes in CSBM frequency from screening period Week -1 at each week.
Time Frame
12 weeks
Title
Efficacy endpoint - Mean stool consistency by Bristol Stool Form Scale
Description
- The stool consistency is assessed based on the Bristol Stool Form Scale on a 7-grade scale. Grade / Interpretation / Separate hard lumps, like nuts (hard to pass) / Sausage shaped, but lumpy / Like a sausage, but with cracks on its surface / Like a sausage or snake, smooth and soft / Soft blobs with clear cut edges (passed easily) / Fluffy pieces with ragged edges, a mushy stool / Watery, no solid pieces, entirely liquid Mean stool consistency as measured at Week -1 and each treatment Week.
Time Frame
12 weeks
Title
Exploratory endpoint - Patient Assessment of Constipation Quality of Life (PAC-QoL)
Description
- Each item of the 28-item questionnaire (Appendix 1) is scored on a 5-point Likert-type scale from 0 to 4, with (0 = none/not at all, 1 = a little bit/a little bit of the time, 2 = moderately/some of the time, 3 = quite a bit/most of the time, 4 = extremely/all the time). Scores are reported overall and for each of the four subscales (physical discomfort, psychosocial discomfort, worries and concerns, and satisfaction). An improvement (reduction) of ≥1 point in PAC-QoL score are considered clinically significant based on previous validation studies.
Time Frame
12 weeks
Title
Exploratory endpoint - Patient Assessment of Constipation Symptoms (PAC-SYM) scores
Description
- Symptom scores are evaluated using the PAC-SYM questionnaire, a validated, 12-item, Patient-reported outcome (PRO) instrument with abdominal, stool and rectal symptom subscales. Each item of the PAC-SYM is scored on a 5-point Likert-type scale (0 = absent, 1 = mild, 2 = moderate, 3 = severe, 4 = very severe), with higher scores indicating greater symptom severity. An improvement (reduction) of ≥1 point in PAC-SYM score is considered clinically significant based on previous validation studies.
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
20 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: - At provisional enrollment Men or women ≥ 20 years of age. Include 2 or more of the following during the last 3 months with symptom onset of at least 6 months: Straining during more than 25% of bowel movements (BMs);) Lumpy or hard stools in 25% of BMs; Sensation of incomplete evacuation in more than 25% of all BMs; Sensation of anorectal blockage or obstruction in more than 25% of BMs; Manual maneuvers required in more than 25% of BMs; Fewer than 3 BMs per week. In addition to having at least 2 of the above criteria, the following must also apply: a. Loose stools are rarely present without the use of laxatives; b. Insufficient criteria for irritable bowel syndrome (IBS). Ability to provide written consent. - At time of enrollment A total of SBM frequencies < 6 times during the 2-week screening period. Exclusion Criteria: At provisional enrollment Known or suspected allergy to components in elobixibat. Known or suspected organic constipation. Known or suspected symptomatic or drug-induced constipation. Known or suspected slow colon transit type constipation. Known or suspected excretory disorder constipation. Currently have or history of gastrointestinal obstruction. Currently have or history of abdominal hernia. History of laparotomy other than simple appendectomy. History of cholecystectomy or surgical or endoscopic intervention related to papillotomy. Subjects in whom the dosage regimens of medications, of which changing the dosage regimens is prohibited, will be changed after the day of informed consent. Cannot use the rescue medication (bisacodyl suppositories 10 mg). Pregnant, lactating or potentially pregnant women, women who wish to become pregnant from the time of the informed consent to the last observation/test point, or women who do not agree to use appropriate birth control methods. The acceptable effective contraception methods include: a. Male or female sterilization, implant, or intrauterine device; b. Injectable, pill, patch, ring plus one barrier method*; c. Two combined barrier methods*. Effective barrier methods are diaphragm, male or female condoms, sponge, or spermicides (creams or gels that contain a chemical to kill sperm). Anemia, defined as hemoglobin ≤ 10 g/dL. Concurrent serious renal disease (creatinine ≥ 2.00 mg/dL) or liver disease (total bilirubin ≥ 3.0 mg/dL, or aspartate aminotransferase(AST) or alanine transaminase(ALT) ≥ 100 U/L). Concurrent clinical significant heart disease, including uncontrolled hypertension, arrhythmia, or heart failure. History of serious drug-induced allergy needs emergent medical intervention, such as anaphylaxis, angioedema, generalized urticaria or bronchospasm. Subjects have a history of cancer (other than basal cell or squamous cell carcinoma of the skin) unless the malignancy has been in a complete remission without maintenance chemotherapy for ≥ 5 years prior to the Screening visit. Subjects who are taking part in another clinical study, or subjects who take part in another clinical study within 12 weeks prior to the day of informed consent. Loss of weight greater than 5 kg one month before screening visit. Determined by the investigator to be not suitable for the conduct of the study for any other reasons. Subjects have a barium enema within 7 days of the Screening Visit. At time of enrollment 22. Subjects have a clinically significant finding on colonoscopy performed as required in accordance with the American Gastroenterological Association (AGA) guidelines (within AGA time frames). If polyps are found and biopsied, pathology must be reviewed and must be negative for cancer before the subject may be enrolled in the study. 23. Used the rescue medication (bisacodyl suppositories 10 mg) at least 6 times during the 2-week screening period or subjects who used the rescue medication at least 3 times in Week -1 of the screening period. 24. Used the rescue medication for less than 72 hours after bowel movement during the 2-week screening period. 25. Mushy stool or watery stool (Bristol Stool Form Scale type 6 or 7) in SBM during the 2-week screening period. 26. Used prohibited medications/therapies during the 2-week screening period
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yayoi Lai
Phone
886-2-87977100
Ext
513
Email
yayoi1413@synmosa.com.tw
First Name & Middle Initial & Last Name or Official Title & Degree
Vincent Hsieh
Phone
886-2-87977100
Ext
808
Email
vincent1132@synmosa.com.tw
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ming-Shiang Wu
Organizational Affiliation
National Taiwan University Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
National Taiwan University Hospital Clinical Trial Center
City
Taipei
Country
Taiwan
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
YiChi Tseng
Phone
+886-2-23123456
Ext
66.49
Email
yctseng0706@gmail.com
First Name & Middle Initial & Last Name & Degree
Yayoi Lai
Phone
+886-2-8797-7100
Ext
511
Email
yayoi1413@synmosa.com.tw

12. IPD Sharing Statement

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Evaluate the Efficacy and Safety of Goofice® (Elobixibat) in Patients With Chronic Constipation

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