search
Back to results

Study on Analgesia of GIC-1001 & GIC-1002 on Visceral Pain, Rectal Sensory Threshold Using the Barostat Method

Primary Purpose

Pain, Cancer, Colonic Disease

Status
Completed
Phase
Phase 1
Locations
Canada
Study Type
Interventional
Intervention
GIC-1001 375 mg TID
GIC-1001 500 mg TID
GIC-1002 345 mg TID (equimolar to GIC-1001 375 mg TID)
GIC-1002 460 mg (equimolar to GIC-1001 500 mg)
Placebo
Sponsored by
gicare Pharma Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pain focused on measuring rectal distension, rectal compliance, visceral pain, pain intensity, barostat, distender, VAS (Visual Analog Scale), rectal sensory threshold, analgesia, trimebutine, pain management, peripheral, colon cancer, H2S (hydrogen sulfide)

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Male or female volunteer
  • A female volunteer must meet one of the following criteria:

Participant is of childbearing potential and agrees to use one of the accepted contraceptive regimens from at least 28 days prior to the first dosing, during the study and for at least 30 days after the last dosing or participant is of non-childbearing potential, i.e. surgically sterile or menopausal (at least 1 year without menses)

  • Age between 18 to 65 years
  • 35.00 kg/m2 ≥ Body Mass Index ≤ 18.50 kg/m2
  • Light-, non- or ex-smokers. A light smoker is smoking 2 cigarettes or less per day for at least 3 months before Day 1. An ex-smoker is someone who completely stopped smoking for at least 6 months before Day 1
  • Barostat naive or no barostat experience in the year preceding screening
  • Clinical laboratory values within the laboratory's stated normal range; or without any clinical significance
  • Have no history of clinically significant diseases or evidence of clinically significant findings on physical exam and/or clinical laboratory tests
  • Have a normal anorectal area, confirmed by entry digital rectal exam (DRE) and
  • Signed dated informed consent form by subject

Exclusion Criteria:

  • Pregnant or lactating females
  • History of significant hypersensitivity to trimebutine, to sulfur-containing drugs or any related products (including excipients of the formulations) as well as severe hypersensitivity reactions (like angioedema) to any drugs
  • Presence of significant gastrointestinal, liver or kidney disease, or any other conditions known to interfere with the absorption, distribution, metabolism or excretion of drugs or known to potentiate or predispose undesired effects
  • Diagnosis of Inflammatory Bowel Disease or Irritable Bowel Syndrome
  • Criteria for functional bowel disorder (i.e. functional constipation, functional diarrhea and IBS) or abdominal pain, as reported by questionnaire
  • Known history of rectosigmoid disease
  • Abnormal anorectal findings during entry DRE
  • History of abdominal surgery (except appendectomy or cholecystectomy)
  • History of gastrointestinal obstruction, any rectal or colon surgery
  • Known presence of piles or fissures, peri-anal pathology or any other rectal abnormalities
  • Female subjects with history of gynecological surgery (˂ 10 years prior to screening or 1 year for tubal ligation or hysterectomy)
  • Known history of, or risk factors for pelvic floor injury
  • History of significant gastrointestinal, liver or kidney disease, or surgery
  • Presence of significant cardiovascular, pulmonary, hematologic, neurological, psychiatric, endocrine, immunologic or dermatologic disease
  • Suicidal tendency, history of or disposition to seizures, state of confusion, clinically relevant psychiatric diseases
  • Presence of out-of-range cardiac interval (PR < 110 msec, PR > 220 msec, QRS < 60 msec, QRS >119 msec and QTc > 450 msec for males and > 460 msec for females) on the screening elcetrocardiogram (ECG) or other clinically significant ECG abnormalities
  • Use of cysteine, methionine, and other sulfur-containing amino acid supplements in the previous 7 days before day 1 of this study;
  • Light-smoker who smokes cigar or is unable to refrain from smoking in the 7 days prior to the housing period and during the housing period of the study
  • Known presence of rare hereditary problems of galactose and/or lactose intolerance
  • Maintenance therapy with any drug or significant history of drug dependency or alcohol abuse (>3 units of alcohol per day, intake of excessive alcohol, acute or chronic)
  • Any clinically significant illness in the previous 28 days before day 1 of this study
  • Use of any enzyme-modifying drugs, including strong inhibitors of cytochrome P450 (CYP) enzymes and strong inducers of CYP enzymes in the previous 28 days before day 1 of this study;
  • Regular consumption of any supplement related to bowel movement in the previous 28 days before day 1 of this study
  • Positive urine screening of alcohol and/or drugs of abuse
  • Positive results to HIV Ag/Ab Combo, Hepatitis B surface Antigen (HBsAG (B) (hepatitis B)) or anti-Hepatitis C Virus (HCV (C)) tests
  • Females pregnant according to a positive serum pregnancy test;
  • Subjects treated with any Investigational Product in the previous 28 days before Day 1 or who have already participated in this clinical study;
  • Prior donation of 50 mL or more of blood in the previous 28 days before Day 1
  • Prior total donation of 500 mL or more of blood in the previous 56 days before Day 1

Sites / Locations

  • Algorithme Pharma Inc.

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Experimental

Experimental

Active Comparator

Active Comparator

Placebo Comparator

Arm Label

GIC-1001 mid-dose

GIC-1001 high-dose

GIC-1002 mid-dose

GIC-1002 high-dose

Placebo matching GIC-1001 and GIC-1002

Arm Description

GIC-1001 , 375 mg TID during 3 consecutive days + a 10th dose in the morning of day 4 (colonoscopy day)

GIC-1001 , 500 mg TID during 3 consecutive days + a 10th dose in the morning of day 4 (colonoscopy day)

GIC-1002 345 mg TID (equimolar to GIC-1001 375 mg) 345 mg TID during 3 consecutive days + a 10th dose in the morning of day 4 (colonoscopy day)

GIC-1002 460 mg (equimolar to GIC-1001 500 mg) 460 mg TID during 3 consecutive days + a 10th dose in the morning of day 4 (colonoscopy day)

Placebo matching GIC-1001 doses Placebo matching GIC-1002 doses Placebo, TID during 3 consecutive days, + a 10 th dose in the morning of day 4 (colonoscopy day)

Outcomes

Primary Outcome Measures

Mean visceral pain intensity score following dosing with GIC-1001 375 mg TID
Mean visceral pain intensity score in millimeters (mm) on a 100-mm Visual Analog Scale (VAS) based on 7 measurements collected at increasing rectal distension pressures from 24 to 60 mmHg following the oral administration of the GIC-1001 375 mg TID x 3 days regimen, and comparing it to placebo.

Secondary Outcome Measures

Mean visceral pain intensity score following dosing with GIC-1001 500 mg TID
Mean visceral pain intensity score in mm on a 100-mm VAS based on 7 measurements collected at increasing rectal distension pressures from 24 to 60 mmHg following the oral administration of the GIC-1001 500 mg TID x 3 days regimen, compared to placebo.
Mean visceral pain intensity score following dosing with GIC-1002 345 mg TID and GIC-1002 460 mg TID
Mean visceral pain intensity score in mm on a 100-mm VAS, based on 7 measurements collected at increasing rectal distension pressures from 24 to 60 mmHg following the oral administration of two doses of GIC-1002 (345 mg TID and 460 mg TID x 3 days regimen), compared to placebo.
Barostat pressure required to elicit pre-defined rectal sensory symptoms
Barostat intra-balloon pressure in mm Hg required to elicit pre-defined rectal sensory symptoms (i.e. first sensation, need to defecate, urgency to defecate and pain) following the oral administration of GIC-1001 or GIC 1002, respectively at two equimolar doses
Rectal sensory intensity score
Rectal sensory intensity score (i.e. first sensation, need to defecate, urgency to defecate and pain) in mm on a 100-mm VAS following the oral administration of GIC-1001 or GIC-1002, respectively at two equimolar doses.
Rectal compliance under increasing rectal distension
Rectal compliance in ml/mmHg under increased rectal distension following the oral administration of GIC-1001 or GIC-1002, respectively at two equimolar doses.
Contributing hydrogen sulfide analgesia as evaluated by comparing mean visceral pain intensity score differences
Contribution of H2S to GIC-1001 analgesic effects in terms of mean VAS scores differences between GIC-1001 and GIC-1002 at equimolar doses.
Steady state pharmacokinetic AUC (ng/ml/hour) for GIC-1001 and GIC-1002
Steady State pharmacokinetics of GIC-1001 and GIC-1002 at the end of their proposed dosing regimens at pre-dosing times on Treatment Days 1, 2, 3 and on Day 4 of the barostat procedure then 8 hours post-dose .
Number of participants with adverse events
Number of subjects reporting AEs during participation
Number of adverse events
Number of adverse events reported overall
ECG measures
Safety evaluation: Standard ECG measures
Normality of physical exam
Safety evaluation: Complete physical examination at both entry and exit
Normality of Proctoscopic examination
Safety evaluation: Evaluation of rectum
Standard laboratory measures (biochemistry, hematology, urinalysis)
Safety evaluation: comparative assessment with baseline for all components

Full Information

First Posted
October 20, 2014
Last Updated
August 8, 2016
Sponsor
gicare Pharma Inc.
Collaborators
Algorithme Pharma Inc
search

1. Study Identification

Unique Protocol Identification Number
NCT02276768
Brief Title
Study on Analgesia of GIC-1001 & GIC-1002 on Visceral Pain, Rectal Sensory Threshold Using the Barostat Method
Official Title
A Phase 1b Clinical Study on the Analgesic Effect of GIC-1001 and GIC-1002 on Visceral Pain Under Rectal Distension and Rectal Sensory Threshold Using the Barostat Method in Male and Female Healthy Volunteers.
Study Type
Interventional

2. Study Status

Record Verification Date
August 2016
Overall Recruitment Status
Completed
Study Start Date
October 2014 (undefined)
Primary Completion Date
December 2014 (Actual)
Study Completion Date
December 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
gicare Pharma Inc.
Collaborators
Algorithme Pharma Inc

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study evaluates colonic analgesia by comparing two novel formulations, GIC-1001 and GIC-1002 with placebo using a barostat distender. The healthy male and female volunteers randomized to one of 5 possible treatments will be exposed to rectal distension following a 3-day treatment TID. The barostat methodology is a well-established and validated way to assess visceral pain. Visceral pain will be evaluated during exposure to varying distender pressures using a visual analog scale.
Detailed Description
The objectives of this single center, randomized, double-blinded, placebo-controlled Phase I clinical study include the evaluation of visceral pain intensity under rectal distension following the oral administration of either of two doses of GIC-1001 or of either of two doses of GIC-1002, equimolar to the first formulation, or of placebo in 90 healthy subjects. The barostat intra-balloon pressure required to elicit pre-defined rectal sensory symptoms (i.e. first sensation, need to defecate, urgency to defecate and pain) will also be determined. Rectal sensory symptom ratings and rectal compliance under increased rectal distension will also be evaluated. The contribution of hydrogen sulphide (H2S) to the colonic analgesic activity of GIC-1001 by comparison to that of GIC-1002 will be evaluated following steady state pharmacokinetic analysis. To further comprehend the non-linear, U shape dose response curve observed with GIC-1001 in a previous Phase II a trial. Finally, the safety of GIC-1002 in healthy volunteers will also be evaluated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pain, Cancer, Colonic Disease
Keywords
rectal distension, rectal compliance, visceral pain, pain intensity, barostat, distender, VAS (Visual Analog Scale), rectal sensory threshold, analgesia, trimebutine, pain management, peripheral, colon cancer, H2S (hydrogen sulfide)

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
GIC-1001 mid-dose
Arm Type
Experimental
Arm Description
GIC-1001 , 375 mg TID during 3 consecutive days + a 10th dose in the morning of day 4 (colonoscopy day)
Arm Title
GIC-1001 high-dose
Arm Type
Experimental
Arm Description
GIC-1001 , 500 mg TID during 3 consecutive days + a 10th dose in the morning of day 4 (colonoscopy day)
Arm Title
GIC-1002 mid-dose
Arm Type
Active Comparator
Arm Description
GIC-1002 345 mg TID (equimolar to GIC-1001 375 mg) 345 mg TID during 3 consecutive days + a 10th dose in the morning of day 4 (colonoscopy day)
Arm Title
GIC-1002 high-dose
Arm Type
Active Comparator
Arm Description
GIC-1002 460 mg (equimolar to GIC-1001 500 mg) 460 mg TID during 3 consecutive days + a 10th dose in the morning of day 4 (colonoscopy day)
Arm Title
Placebo matching GIC-1001 and GIC-1002
Arm Type
Placebo Comparator
Arm Description
Placebo matching GIC-1001 doses Placebo matching GIC-1002 doses Placebo, TID during 3 consecutive days, + a 10 th dose in the morning of day 4 (colonoscopy day)
Intervention Type
Drug
Intervention Name(s)
GIC-1001 375 mg TID
Other Intervention Name(s)
trimebutine 3-thiocarbamoylbenzenesulfonate , TB-905-02
Intervention Description
GIC-1001 375 mg TID mid-dose, oral tablet, white-coated, to be taken with water
Intervention Type
Drug
Intervention Name(s)
GIC-1001 500 mg TID
Other Intervention Name(s)
trimebutine 3-thiocarbamoylbenzenesulfonate , TB-905-02
Intervention Description
GIC-1001 500 mg TID high-dose, oral tablet, white-coated, to be taken with water
Intervention Type
Drug
Intervention Name(s)
GIC-1002 345 mg TID (equimolar to GIC-1001 375 mg TID)
Other Intervention Name(s)
non-H2S releasing tosylate salt
Intervention Description
GIC-1002 345 mg TID mid-dose, oral tablet, white-coated, to be taken with water
Intervention Type
Drug
Intervention Name(s)
GIC-1002 460 mg (equimolar to GIC-1001 500 mg)
Other Intervention Name(s)
non-H2S releasing tosylate salt
Intervention Description
GIC-1002 460 mg TID high-dose, oral tablet, white-coated, to be taken with water
Intervention Type
Other
Intervention Name(s)
Placebo
Other Intervention Name(s)
sugar -pill
Intervention Description
Placebo identical and matching active drugs GIC-1001 and GIC-1001
Primary Outcome Measure Information:
Title
Mean visceral pain intensity score following dosing with GIC-1001 375 mg TID
Description
Mean visceral pain intensity score in millimeters (mm) on a 100-mm Visual Analog Scale (VAS) based on 7 measurements collected at increasing rectal distension pressures from 24 to 60 mmHg following the oral administration of the GIC-1001 375 mg TID x 3 days regimen, and comparing it to placebo.
Time Frame
Stage IV, test lasts approximately 20 min.VAS scores collected every 2 minutes at a colorectal distension pressures 6, 12, 18, 24, 30, 36, 42, 48, 54 and 60 mmHg in random order, each maintained for 1 minute.A 1-minute resting period follows between.
Secondary Outcome Measure Information:
Title
Mean visceral pain intensity score following dosing with GIC-1001 500 mg TID
Description
Mean visceral pain intensity score in mm on a 100-mm VAS based on 7 measurements collected at increasing rectal distension pressures from 24 to 60 mmHg following the oral administration of the GIC-1001 500 mg TID x 3 days regimen, compared to placebo.
Time Frame
Stage IV, test lasts approx. 20 min.VAS scores collected every 2 min. at colorectal distension pressures 6, 12, 18, 24, 30, 36, 42, 48, 54 and 60 mmHg in random order, each maintained for 1 minute. A 1-minute resting period follows VAS scoring..
Title
Mean visceral pain intensity score following dosing with GIC-1002 345 mg TID and GIC-1002 460 mg TID
Description
Mean visceral pain intensity score in mm on a 100-mm VAS, based on 7 measurements collected at increasing rectal distension pressures from 24 to 60 mmHg following the oral administration of two doses of GIC-1002 (345 mg TID and 460 mg TID x 3 days regimen), compared to placebo.
Time Frame
Stage IV, test lasts approx. 20 min.VAS scores collected every 2 min. at colorectal distension pressures 6, 12, 18, 24, 30, 36, 42, 48, 54 and 60 mmHg in random order, each maintained for 1 minute. A 1-minute resting period follows VAS scoring.
Title
Barostat pressure required to elicit pre-defined rectal sensory symptoms
Description
Barostat intra-balloon pressure in mm Hg required to elicit pre-defined rectal sensory symptoms (i.e. first sensation, need to defecate, urgency to defecate and pain) following the oral administration of GIC-1001 or GIC 1002, respectively at two equimolar doses
Time Frame
Stage III lasts about 15 min.VAS scores collected every 1 minute at increasing colorectal distension pressures: 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 52, 56 and 60 mmHg. Each pressure is held for 1 minute for VAS score report. No resting period.
Title
Rectal sensory intensity score
Description
Rectal sensory intensity score (i.e. first sensation, need to defecate, urgency to defecate and pain) in mm on a 100-mm VAS following the oral administration of GIC-1001 or GIC-1002, respectively at two equimolar doses.
Time Frame
Stage III lasts about 15 min.Intensity score recorded every minute at te same time as VAS for rectal sensory compliance...
Title
Rectal compliance under increasing rectal distension
Description
Rectal compliance in ml/mmHg under increased rectal distension following the oral administration of GIC-1001 or GIC-1002, respectively at two equimolar doses.
Time Frame
Stage III lasts about 15 min. Overall rectal compliance is calculated over a 15-minute period with pressure increasing sequentially from 4 to 60 mmHg.
Title
Contributing hydrogen sulfide analgesia as evaluated by comparing mean visceral pain intensity score differences
Description
Contribution of H2S to GIC-1001 analgesic effects in terms of mean VAS scores differences between GIC-1001 and GIC-1002 at equimolar doses.
Time Frame
Approx. 35 minutes, during total barostat testing period
Title
Steady state pharmacokinetic AUC (ng/ml/hour) for GIC-1001 and GIC-1002
Description
Steady State pharmacokinetics of GIC-1001 and GIC-1002 at the end of their proposed dosing regimens at pre-dosing times on Treatment Days 1, 2, 3 and on Day 4 of the barostat procedure then 8 hours post-dose .
Time Frame
Pre-dose, 0, 24, 36, 72, 80 hours post dose
Title
Number of participants with adverse events
Description
Number of subjects reporting AEs during participation
Time Frame
5 days, from Treatment Day 1 until 24 hours post-barostat distension
Title
Number of adverse events
Description
Number of adverse events reported overall
Time Frame
5 days, from Treatment Day 1 until 24 hours post-barostat distension
Title
ECG measures
Description
Safety evaluation: Standard ECG measures
Time Frame
At baseline and post-barostat Day 4
Title
Normality of physical exam
Description
Safety evaluation: Complete physical examination at both entry and exit
Time Frame
At baseline and post-barostat Day 4
Title
Normality of Proctoscopic examination
Description
Safety evaluation: Evaluation of rectum
Time Frame
On Day 4, prior and post barostat distension
Title
Standard laboratory measures (biochemistry, hematology, urinalysis)
Description
Safety evaluation: comparative assessment with baseline for all components
Time Frame
At screening, pre-dosing (baseline) and post-barostat Day 4

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Male or female volunteer A female volunteer must meet one of the following criteria: Participant is of childbearing potential and agrees to use one of the accepted contraceptive regimens from at least 28 days prior to the first dosing, during the study and for at least 30 days after the last dosing or participant is of non-childbearing potential, i.e. surgically sterile or menopausal (at least 1 year without menses) Age between 18 to 65 years 35.00 kg/m2 ≥ Body Mass Index ≤ 18.50 kg/m2 Light-, non- or ex-smokers. A light smoker is smoking 2 cigarettes or less per day for at least 3 months before Day 1. An ex-smoker is someone who completely stopped smoking for at least 6 months before Day 1 Barostat naive or no barostat experience in the year preceding screening Clinical laboratory values within the laboratory's stated normal range; or without any clinical significance Have no history of clinically significant diseases or evidence of clinically significant findings on physical exam and/or clinical laboratory tests Have a normal anorectal area, confirmed by entry digital rectal exam (DRE) and Signed dated informed consent form by subject Exclusion Criteria: Pregnant or lactating females History of significant hypersensitivity to trimebutine, to sulfur-containing drugs or any related products (including excipients of the formulations) as well as severe hypersensitivity reactions (like angioedema) to any drugs Presence of significant gastrointestinal, liver or kidney disease, or any other conditions known to interfere with the absorption, distribution, metabolism or excretion of drugs or known to potentiate or predispose undesired effects Diagnosis of Inflammatory Bowel Disease or Irritable Bowel Syndrome Criteria for functional bowel disorder (i.e. functional constipation, functional diarrhea and IBS) or abdominal pain, as reported by questionnaire Known history of rectosigmoid disease Abnormal anorectal findings during entry DRE History of abdominal surgery (except appendectomy or cholecystectomy) History of gastrointestinal obstruction, any rectal or colon surgery Known presence of piles or fissures, peri-anal pathology or any other rectal abnormalities Female subjects with history of gynecological surgery (˂ 10 years prior to screening or 1 year for tubal ligation or hysterectomy) Known history of, or risk factors for pelvic floor injury History of significant gastrointestinal, liver or kidney disease, or surgery Presence of significant cardiovascular, pulmonary, hematologic, neurological, psychiatric, endocrine, immunologic or dermatologic disease Suicidal tendency, history of or disposition to seizures, state of confusion, clinically relevant psychiatric diseases Presence of out-of-range cardiac interval (PR < 110 msec, PR > 220 msec, QRS < 60 msec, QRS >119 msec and QTc > 450 msec for males and > 460 msec for females) on the screening elcetrocardiogram (ECG) or other clinically significant ECG abnormalities Use of cysteine, methionine, and other sulfur-containing amino acid supplements in the previous 7 days before day 1 of this study; Light-smoker who smokes cigar or is unable to refrain from smoking in the 7 days prior to the housing period and during the housing period of the study Known presence of rare hereditary problems of galactose and/or lactose intolerance Maintenance therapy with any drug or significant history of drug dependency or alcohol abuse (>3 units of alcohol per day, intake of excessive alcohol, acute or chronic) Any clinically significant illness in the previous 28 days before day 1 of this study Use of any enzyme-modifying drugs, including strong inhibitors of cytochrome P450 (CYP) enzymes and strong inducers of CYP enzymes in the previous 28 days before day 1 of this study; Regular consumption of any supplement related to bowel movement in the previous 28 days before day 1 of this study Positive urine screening of alcohol and/or drugs of abuse Positive results to HIV Ag/Ab Combo, Hepatitis B surface Antigen (HBsAG (B) (hepatitis B)) or anti-Hepatitis C Virus (HCV (C)) tests Females pregnant according to a positive serum pregnancy test; Subjects treated with any Investigational Product in the previous 28 days before Day 1 or who have already participated in this clinical study; Prior donation of 50 mL or more of blood in the previous 28 days before Day 1 Prior total donation of 500 mL or more of blood in the previous 56 days before Day 1
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Eric Sicard, M.D.
Organizational Affiliation
Algorithme Pharma Inc
Official's Role
Principal Investigator
Facility Information:
Facility Name
Algorithme Pharma Inc.
City
Montreal
State/Province
Quebec
ZIP/Postal Code
H3P-3P1
Country
Canada

12. IPD Sharing Statement

Plan to Share IPD
Undecided

Learn more about this trial

Study on Analgesia of GIC-1001 & GIC-1002 on Visceral Pain, Rectal Sensory Threshold Using the Barostat Method

We'll reach out to this number within 24 hrs