The Effect of CSP01 on Chronic Idiopathic Constipation and Irritable Bowel Syndrome With Constipation
Constipation, Chronic Idiopathic Constipation, Irritable Bowel Syndrome With Constipation
About this trial
This is an interventional treatment trial for Constipation
Eligibility Criteria
Inclusion Criteria:
- Age 22-70 years old
- BMI >18.5 and <35 kg/m2
- Rome III criteria for functional constipation or IBS-C
- Continued IBS-C or CIC throughout Run-in period
- Compliant with reporting during Run-in (confirm the presence of constipation during the 7-day Run-in baseline period; patients are required to report an average of <3 continuous spontaneous bowel movements [CSBMs] and ≤6 spontaneous bowel movements [SBMs] per week via the interactive web response system).
- Ability to follow verbal and written instructions
- Ability to record daily bowel habits, including frequency, stool consistency (BSFS), straining (EoPS), completeness of evacuation, and Patient Reported Outcomes (PROs) (abdominal discomfort, severity of constipation, bloating, overall relief)
- Informed consent form signed by the subjects
Exclusion Criteria:
- History of loose stools
- History of irritable bowel syndrome with diarrhea (IBS-D) or mixed irritable bowel syndrome (IBS-M)
- Non-compliance with reporting during Run-in
- Patients reporting laxative, enema, and/or suppository usage for >2 days or any usage of a prohibited medication during the Run-in period
- Patients reporting watery stools for any SBM (Type 7 on the Bristol Stool Form Scale [BSFS]) or loose (mushy) stools for >1 SBM (Type 6 on the BSFS) in the absence of laxatives during Run-in
- GI motility obstruction or GI tract structural abnormality
- Current use of prescribed or illicit opioids
- History of pelvic floor dysfunction
- Need for manual maneuvers in order to achieve a BM
- History of GI lumen surgery at any time or other GI or abdominal operations within 60 days prior to entry into the study
- History of high-dose stimulative or cathartic laxative abuse as judged by investigator team
- Neurological disorders, metabolic disorders, or other significant disease that would impair their ability to participate in the study
- Cardiovascular disease, diabetes, cancer, Crohn's disease, ulcerative colitis
- BMI of <18.5 or >35 kg/m2
- Pregnancy (or positive serum or urine pregnancy test(s) in females of childbearing potential) or lactation
- Absence of contraception in females of childbearing potential
- History of allergic reaction to carboxymethylcellulose, citric acid, sodium stearyl fumarate, raw cane sugar, gelatin, or titanium dioxide
- Administration of investigational products within 1 month prior to Screening Visit
- Exclusion of colonic inertia with symptoms of < 1 BM per 2 weeks
- Subjects anticipating surgical intervention during the study
- Known history of diabetes (type 1 or 2)
- History of eating disorders including binge eating (except mild binge eater)
- Supine SBP > 160 mm Hg and/or supine DBP > 95 mm Hg (mean of two consecutive readings)
- Angina, coronary bypass, or myocardial infarction within 6 months prior to Screening Visit
- History of swallowing disorders
- Esophageal anatomic abnormalities (e.g., webs, diverticuli, rings)
- History of gastric bypass or any other gastric surgery
- History of small bowel resection (except if related to appendectomy)
- History of gastric or duodenal ulcer
- History of gastroparesis
- History of abdominal radiation treatment
- History of pancreatitis
- History of intestinal stricture (e.g., Crohn's disease)
- History of intestinal obstruction or subjects at high risk of intestinal obstruction including suspected small bowel adhesions
- History of malabsorption
- History of sucrose intolerance
- History of hepatitis B or C
- History of human immunodeficiency virus
- History of cancer within the past 5 years (except adequately-treated localized basal cell skin cancer or in situ uterine cervical cancer)
- Any other clinically significant disease interfering with the assessments of Gelesis100, according to the Investigator (e.g., disease requiring corrective treatment, potentially leading to study discontinuation)
- HbA1c > 8.5% (> 69 mmol/mol)
- Positive test for drugs in the urine
- Any relevant biochemical abnormality interfering with the assessments of Gelesis100, according to the Investigator
- Antidiabetic medications within 1 month prior to Screening Visit (except stable dose of metformin, ≤ 1500 mg/day, for at least 1 month in subjects with type 2 diabetes)
- Medications requiring mandatory administration with meal at lunch or dinner
- Anticipated requirement for use of prohibited concomitant medications
- Implanted or externally worn medical device such as, but not limited to, a pacemaker, infusion pump, or insulin pump
Sites / Locations
- Massachusetts General Hospital
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Active Comparator
Placebo Comparator
CSP01
Carboxymethylcellulose (CMC)
Placebo
Subjects in the experimental group will receive CSP01, a non-systemic, orally administered hydrogel capsule, twice a day. CSP01 capsules are taken prior to a meal with water, after which the small particles within the capsules hydrate and expand in the stomach and small intestine. By acting as a bulking agent and possibly reducing colonic transit time through increase of colonic water content, CSP01 may contribute to constipation relief.
Subjects in the active control group will receive orally administered 3 capsules of carboxymethylcellulose (CMC) capsules twice a day.
Matching placebo consists of an inert mixture supplied by Gelesis Inc. in identical-appearing capsules.Subjects in the placebo group will be administered 3 capsules of placebo twice a day.