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Effect of TU-100 in Patients With Irritable Bowel Syndrome (IBS)

Primary Purpose

Irritable Bowel Syndrome, Digestive System Diseases, Gastrointestinal Diseases

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
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 Irritable Bowel Syndrome focused on measuring Rectal Compliance, Rectal Sensation, Rectal Tone

Eligibility Criteria

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

Inclusion Criteria:

  1. Meet Rome III criteria for IBS.
  2. Willing and able to provide written informed consent.
  3. If a female of childbearing potential, must be using 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, NuvaRing), condoms used with a spermicide, an IUD [Intrauterine device] or abstinence.

    Females are not considered to be of childbearing potential if they are postmenopausal for at least 2 years or have been surgically sterilized.

  4. Aged 18 to 65 years, inclusive.
  5. Have a body mass index (BMI) between 18 and 40 kg/m2, inclusive.
  6. Have a negative urine drug screening at Visit 1.
  7. Have normal or not clinically significant laboratory results as reviewed by the study physicians.
  8. Have a normal rectal examination 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. Agree to avoid alcohol during the entire study to avoid corrupting the data from the rectal barostat tests.

Exclusion Criteria:

  1. Have a structural or metabolic diseases or conditions that affect the GI system.
  2. Be 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, gabapentin, pregabalin, narcotics, anticholinergics, antidepressants [including selective norepinephrine reuptake inhibitors], antipsychotics, opiates, GABAergic agents and benzodiazepines).

    Note: Tricyclic antidepressants are permissible at doses equal to or less than 25 mg daily; selective serotonin reuptake inhibitor antidepressants are permissible at low, stable doses. Analgesics such as Tylenol, ibuprofen, naproxen and aspirin are not permissible during Visits 2 and 3 to avoid corrupting data from the rectal barostat tests. All medications will be reviewed by the principal investigator on a case by case basis.

    Rescue medications: Rescue medications will be reviewed and approved as necessary for exacerbation of constipation or diarrhea since the study medication treatment period is about 14 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, bloating and pain diary. Rescue medications are not allowed within 7 days of the rectal sensation studies to ensure data integrity.

  3. Have clinical evidence, including but not limited to, of a clinically significant abnormal physical examination or laboratory value or of a past event documented in the past medical record, or current clinically significant abnormal physical examination or laboratory value that could indicate significant cardiovascular, respiratory, renal, hepatic, GI, hematological, neurological, psychiatric or other diseases that interfere with the objectives of the study. If a laboratory test value falls outside of the reference range and is considered 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. Be a known substance abuser or be considered to be an alcoholic not in remission.
  5. Have participated in another clinical study in the past 30 days.
  6. Have a history of allergic reactions to egg, ginseng, ginger or Sichuan pepper.
  7. Be clinically lactose intolerant.

Sites / Locations

  • Mayo Clinic, Rochester Methodist CRU

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Daikenchuto (TU-100) 15g/day

Placebo

Arm Description

Daikenchuto (TU-100) 5g TID/3 times per day (15g/day)

Placebo TID

Outcomes

Primary Outcome Measures

Sensation rating of urgency to defecate in response to 32 mmHg distension of rectum on a 100 mm VAS
Sensation threshold for pain in response to distention of the rectum

Secondary Outcome Measures

Rectal compliance at half-maximum pressure (Pr1/2)
Rectal sensation thresholds (gas, urgency to defecate, first sensation)
Rectal sensation ratings (pain, gas) in response to 32 mmHg distension of the rectum
Rectal tone response to feeding 1,000 kcal meal
Stool frequency
Stool consistency as measured by the Bristol stool scale
Daily average severity of abdominal pain on 100mm VAS
Worst severity of abdominal pain each day measured on 100mm VAS scale
Daily average severity of bloating on 100mm VAS scale
IBS-QOL (Quality of Life) score
Ease of bowel movements
Completeness of evacuation

Full Information

First Posted
June 27, 2013
Last Updated
June 9, 2016
Sponsor
Tsumura USA
Collaborators
Cato Research
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1. Study Identification

Unique Protocol Identification Number
NCT01890837
Brief Title
Effect of TU-100 in Patients With Irritable Bowel Syndrome (IBS)
Official Title
Effect of Daikenchuto (TU-100), a Gastrointestinal Nerve Modulator, on Rectal Sensation in Patients With Irritable Bowel Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
June 2016
Overall Recruitment Status
Completed
Study Start Date
August 2013 (undefined)
Primary Completion Date
March 2015 (Actual)
Study Completion Date
March 2015 (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 compare the effects of 5g of Daikenchuto (TU-100) three times per day (Daikenchuto [TU-100] is a botanical agent that modulates gastrointestinal nerves), and placebo on rectal sensation (sensation ratings of urgency to defecate and sensation threshold for pain) in response to rectal balloon distension by barostat in patients with IBS.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Irritable Bowel Syndrome, Digestive System Diseases, Gastrointestinal Diseases, Intestinal Diseases, Abdominal Pain
Keywords
Rectal Compliance, Rectal Sensation, Rectal Tone

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Daikenchuto (TU-100) 15g/day
Arm Type
Experimental
Arm Description
Daikenchuto (TU-100) 5g TID/3 times per day (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 5g TID (15g/day) of TU-100. Dosage form is granule. Subject will take a daily dose divided 3 times per day for 2 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 2 weeks.
Primary Outcome Measure Information:
Title
Sensation rating of urgency to defecate in response to 32 mmHg distension of rectum on a 100 mm VAS
Time Frame
14 days
Title
Sensation threshold for pain in response to distention of the rectum
Time Frame
14 days
Secondary Outcome Measure Information:
Title
Rectal compliance at half-maximum pressure (Pr1/2)
Time Frame
14 days
Title
Rectal sensation thresholds (gas, urgency to defecate, first sensation)
Time Frame
14 days
Title
Rectal sensation ratings (pain, gas) in response to 32 mmHg distension of the rectum
Time Frame
14 days
Title
Rectal tone response to feeding 1,000 kcal meal
Time Frame
14 days
Title
Stool frequency
Time Frame
21 days
Title
Stool consistency as measured by the Bristol stool scale
Time Frame
21 days
Title
Daily average severity of abdominal pain on 100mm VAS
Time Frame
21 days
Title
Worst severity of abdominal pain each day measured on 100mm VAS scale
Time Frame
21 days
Title
Daily average severity of bloating on 100mm VAS scale
Time Frame
21 days
Title
IBS-QOL (Quality of Life) score
Time Frame
14 days
Title
Ease of bowel movements
Time Frame
21 days
Title
Completeness of evacuation
Time Frame
21 days

10. Eligibility

Sex
All
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 IBS. Willing and able to provide written informed consent. If a female of childbearing potential, must be using 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, NuvaRing), condoms used with a spermicide, an IUD [Intrauterine device] or abstinence. Females are not considered to be of childbearing potential if they are postmenopausal for at least 2 years or have been surgically sterilized. Aged 18 to 65 years, inclusive. Have a body mass index (BMI) between 18 and 40 kg/m2, inclusive. Have a negative urine drug screening at Visit 1. Have normal or not clinically significant laboratory results as reviewed by the study physicians. Have a normal rectal examination 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). Agree to avoid alcohol during the entire study to avoid corrupting the data from the rectal barostat tests. Exclusion Criteria: Have a structural or metabolic diseases or conditions that affect the GI system. Be 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, gabapentin, pregabalin, narcotics, anticholinergics, antidepressants [including selective norepinephrine reuptake inhibitors], antipsychotics, opiates, GABAergic agents and benzodiazepines). Note: Tricyclic antidepressants are permissible at doses equal to or less than 25 mg daily; selective serotonin reuptake inhibitor antidepressants are permissible at low, stable doses. Analgesics such as Tylenol, ibuprofen, naproxen and aspirin are not permissible during Visits 2 and 3 to avoid corrupting data from the rectal barostat tests. All medications will be reviewed by the principal investigator on a case by case basis. Rescue medications: Rescue medications will be reviewed and approved as necessary for exacerbation of constipation or diarrhea since the study medication treatment period is about 14 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, bloating and pain diary. Rescue medications are not allowed within 7 days of the rectal sensation studies to ensure data integrity. Have clinical evidence, including but not limited to, of a clinically significant abnormal physical examination or laboratory value or of a past event documented in the past medical record, or current clinically significant abnormal physical examination or laboratory value that could indicate significant cardiovascular, respiratory, renal, hepatic, GI, hematological, neurological, psychiatric or other diseases that interfere with the objectives of the study. If a laboratory test value falls outside of the reference range and is considered 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. Be a known substance abuser or be considered to be an alcoholic not in remission. Have participated in another clinical study in the past 30 days. Have a history of allergic reactions to egg, ginseng, ginger or Sichuan pepper. Be clinically lactose intolerant.
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

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Effect of TU-100 in Patients With Irritable Bowel Syndrome (IBS)

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