Long-term Safety of Linaclotide in Pediatric Participants With FC or IBS-C
Irritable Bowel Syndrome With Constipation, Functional Constipation
About this trial
This is an interventional treatment trial for Irritable Bowel Syndrome With Constipation
Eligibility Criteria
Inclusion Criteria:
- Participant weighs ≥ 18 kg at the time the parent/guardian/LAR and/or caregiver has provided signed consent.
- Female participants who have had their first menstrual period and are sexually active must agree to use a reliable form of contraception.
- Participants must have completed study intervention in their lead-in study.
Inclusion Criteria for Phase 2 LIN-MD-62 or Phase 2 LIN-MD-63 and Phase 3 LIN-MD-64 completers who enroll in LIN-MD-66 after >28 days from last study intervention:
- Female participants of childbearing potential must have a negative serum pregnancy test at the Screening Visit (Visit 1) and negative urine pregnancy test prior to the first dose on the Day 1 Visit (Visit 2).
LIN-MD-63 completers only: Participants meet Rome III criteria for child/adolescent IBS: At least once per week for at least 2 months before the LIN-MD-66 Screening Visit (Visit 1), the participant has experienced abdominal discomfort (an uncomfortable sensation not described as pain) or pain associated with 2 or more of the following at least 25% of the time:
- a) Improvement with defecation
- b) Onset associated with a change in frequency of stool
- c) Onset associated with a change in form (appearance) of stool
Participants meet modified Rome III criteria for child/adolescent FC: For at least 2 months before the LIN-MD-66 Screening Visit (Visit 1), the participant has had 2 or fewer defecations (with each defecation occurring in the absence of any laxative, suppository, or enema use during the preceding 24 hours) in the toilet per week. In addition, at least once per week, participant meets 1 or more of the following:
- a) History of retentive posturing or excessive volitional stool retention
- b) History of painful or hard BMs
- c) Presence of a large fecal mass in the rectum
- d) History of large diameter stools that may obstruct the toilet
- e) At least 1 episode of fecal incontinence per week
Exclusion Criteria:
- Participant has a known allergy or sensitivity to the study intervention or its components or other medications in the same drug class.
- Participant received an investigational drug, other than linaclotide, during the 30 days before the Screening Visit (Visit 1) or is planning to receive an investigational drug (other than that administered during this study) or use an investigational device at any time during the study.
- Female participants who are currently pregnant or nursing, or plan to become pregnant or nurse during the clinical study.
- Participant has required manual disimpaction any time prior to study intervention or disimpaction during in-patient hospitalization within 1 year prior to study intervention.
Participant has any of the following conditions:
- a) Down's syndrome or any other chromosomal disorder
- b) Anatomic malformations (eg, imperforate anus, anal stenosis, anterior displaced anus)
- c) Intestinal nerve or muscle disorders (eg, Hirschprung disease, visceral myopathies, visceral neuropathies)
- d) Neuropathic conditions (eg, spinal cord abnormalities, neurofibromatosis, tethered cord, spinal cord trauma)
- e) Neurodevelopmental disabilities (early-onset, chronic disorders that share the essential feature of a predominant disturbance in the acquisition of cognitive, motor, language, or social skills, which has a significant and continuing impact on the developmental progress of an individual) producing a cognitive delay that precludes comprehension by the participant.
- Participant has a mechanical bowel obstruction or pseudo-obstruction.
- Participant currently has both unexplained and clinically significant alarm symptoms (lower GI bleeding [rectal bleeding or heme-positive stool], iron-deficiency anemia, or any unexplained anemia, or weight loss) and systemic signs of infection or colitis, or any neoplastic process.
- Participant has an active anal fissure (Note: history of anal fissure is not an exclusion).
Participant has had surgery that meets any of the following criteria:
- a) Bariatric surgery for treatment of obesity, or surgery to remove a segment of the GI tract at any time before the Screening Visit (Visit 1).
- b) Surgery of the abdomen, pelvis, or retroperitoneal structures during the 6 months before the Screening Visit (Visit 1)
- c) An appendectomy or cholecystectomy during the 60 days before the Screening Visit
- d) Other major surgery during the 30 days before the Screening Visit (Visit 1)
- Participant is receiving enteral tube feeding
- Participants who have positive urine drug screen results for cocaine, barbiturates, opiates, or cannabinoids will be excluded from study participation.
Exclusion Criteria for LIN-MD-62, LIN-MD-63 and LIN-MD-64 Completers Who Enroll in LIN-MD-66 > 28 Days From Last Study Intervention:
- Participant has a history of nonretentive fecal incontinence
- For LIN-MD-62 and LIN-MD-64 completers only:
Participant meets Rome III criteria for child/adolescent IBS: at least once per week for at least 2 months before Screening (Visit 1), the participant has experienced abdominal discomfort (an uncomfortable sensation not described as pain) or pain associated with 2 or more of the following at least 25% of the time:
- a) Improvement with defecation
- b) Onset associated with a change in the frequency of stool
c) Onset associated with a change in form (appearance) of stool
- Participant has a history of drug or alcohol abuse
- Participant has any of the following conditions:
- a) Celiac disease, or positive serological test for celiac disease and the condition has not been ruled out by endoscopic biopsy
- b) Cystic fibrosis
- c) Hypothyroidism that is untreated or treated with thyroid hormone at a dose that has not been stable for at least 3 months prior to the Screening (Visit 1)
- d) Lead toxicity, hypercalcemia
- e) Inflammatory bowel disease
- f) Childhood functional abdominal pain syndrome
- g) Childhood functional abdominal pain
- h) Poorly treated or poorly controlled psychiatric disorders that might influence his or her ability to participate in the study
- i) Lactose intolerance that is associated with abdominal pain or discomfort and could confound the assessments in this study
- j) History of cancer other than treated basal cell carcinoma of the skin. (Note: Participants with a history of cancer are allowed provided that the malignancy has been in a complete remission for at least 5 years before the Randomization Visit. A complete remission is defined as the disappearance of all signs of cancer in response to treatment.)
k) History of diabetic neuropathy
- Participants who have positive urine drug screen results for cocaine, barbiturates, opiates, or cannabinoids.
Sites / Locations
- Central Research Associates /ID# 237953
- G & L Research, LLC /ID# 238093
- The Center for Clinical Trials Inc. /ID# 234605
- HealthStar Research of Hot Springs PLLC /ID# 234608
- Preferred Research Partners /ID# 237109
- Applied Research Center of Arkansas /ID# 238069
- Advanced Research Center /ID# 237960
- Kindred Medical Institute, LLC /ID# 237367
- Center for Clinical Trials LLC /ID# 234629
- Medical Ctr for Clin Research /ID# 236911
- Lynn Institute of Denver /ID# 238086
- Children's National Medical Center /ID# 234417
- Prohealth Research Center /ID# 234659
- Dolphin Medical Research /ID# 234676
- Amedica Research Institute Inc /ID# 234666
- Nemours Childrens Specialty Care /ID# 237991
- Elite Clinical Research /ID# 234651
- My Preferred Research LLC /ID# 237943
- South Miami Medical & Research Group Inc. /ID# 234654
- Valencia Medical & Research Center /ID# 234671
- Advanced Research for Health Improvement /ID# 238253
- Pediatric & Adult Research Center /ID# 234681
- Nemours Children's Hospital /ID# 234429
- Oviedo Medical Research /ID# 234692
- Treken Primary Care /ID# 234645
- Children's Healthcare of Atlanta - Ferry Rd /ID# 237005
- Children's Ctr Digestive, US /ID# 237574
- River Birch Research Alliance /ID# 237963
- Clinical Research Institute /ID# 234702
- Sleep Care Research Institute d/b/a Clinical Research Institute /ID# 236342
- KU Wichita Center for Clinical Research /ID# 234500
- Michael W. Simon, MD, PSC /ID# 236516
- Virgo Carter Pediatrics /ID# 234518
- MNGI Digestive Health, P. A. /ID# 234437
- GI associates and Endoscopy Ce /ID# 237969
- David M. Headley, MD, P.A. /ID# 238216
- Private Practice - Dr. Craig Spiegel /ID# 234545
- Medclinical Research Partners LLC/ Foundation Pediatrics /ID# 234566
- University of New Mexico /ID# 236983
- Advantage Clinical Trials /ID# 237932
- Columbia University Medical Center and Morgan Stanley Children's Hospital of NY /ID# 235686
- East Carolina University Brody School of Medicine /ID# 237509
- PMG Research of Piedmont Healthcare-Statesville /ID# 238257
- Univ Oklahoma HSC /ID# 237546
- IPS Research Company /ID# 237669
- Frontier Clinical Research, LLC - Scottdale /ID# 238022
- Frontier Clinical Research /ID# 237923
- Rhode Island Hospital /ID# 237861
- Coastal Pediatric Research - West Ashley B /ID# 234678
- Coastal Pediatric Research - Summerville /ID# 234674
- The Jackson Clinic, PA /ID# 236772
- Accellacare of Knoxville /ID# 234462
- Cook Children's Med. Center /ID# 237536
- Valley Institute of Research /ID# 234475
- Vilo Research Group Inc /ID# 238228
- Cullen Research /ID# 234482
- Pioneer Research Solutions - Houston /ID# 236935
- AIM Trials /ID# 236364
- Sun Research Institute /ID# 236932
- ClinPoint Trials /ID# 236615
- Chrysalis Clinical Research /ID# 234515
- Office of Maria Ona /ID# 234539
- Health Research of Hampton Roads, Inc. (HRHR) /ID# 237252
- Clinical Research Partners, LLC /ID# 237158
- Multicare Institute for Research and Innovation /ID# 236979
- London Health Sciences Center /ID# 234309
- Bluewater Clinical Research Group Inc /ID# 234618
- Stouffville Medical Centre /ID# 234619
- The Chaim Sheba Medical Center /ID# 236760
- Hadassah Hebrew University Hospital - Ein Kerem /ID# 234735
- The Baruch Padeh Medical Center Poriya /ID# 234768
- Academisch Medisch Centrum /ID# 237116
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Active Comparator
Active Comparator
72 μg linaclotide
145 μg linaclotide
290 μg linaclotide
An oral capsule that is taken once daily. It may be taken whole or sprinkled into 1 teaspoonful of applesauce or 30mL of bottled water.
An oral capsule that is taken once daily. It may be taken whole or sprinkled into 1 teaspoonful of applesauce or 30mL of bottled water.
An oral capsule that is taken once daily. It may be taken whole or sprinkled into 1 teaspoonful of applesauce or 30mL of bottled water.