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The Efficacy Of Diclectin® For Nausea And Vomiting Of Pregnancy

Primary Purpose

Nausea and Vomiting of Pregnancy

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
doxylamine succinate 10 mg/pyridoxine hydrochloride 10 mg
Placebo
Sponsored by
Duchesnay Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Nausea and Vomiting of Pregnancy focused on measuring Nausea, Vomiting, Pregnancy, Hyperemesis gravidarum, Pregnancy complications

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • The patient has signed a written informed consent to participate in the study and has agreed to follow dosing instructions and complete all required study visits.
  • The patient is a pregnant female age equal to or greater than 18 years old.
  • The patient's entry ultrasound indicates a viable pregnancy and confirms gestational age of the fetus is 7-14 weeks at the anticipated time of the first dose of study medication or placebo. If an ultrasound was done within 4 weeks of the admission visit, and results can be obtained, an additional ultrasound is not necessary.
  • The patient is suffering from NVP and has a Pregnancy Unique Quantification of Emesis (PUQE) score ≥6.
  • The patient has not responded to conservative management consisting of dietary/lifestyle advice according to the 2004 ACOG Practice Bulletin.
  • The patient agrees, if on a multivitamin, to continue on their current dose of multivitamin for the duration of the trial.
  • The patient does not plan termination of the pregnancy.

Exclusion Criteria:

  • The investigator confirms the patient's nausea and vomiting is of etiology other than Nausea and Vomiting of Pregnancy (NVP).
  • The patient has gestational trophoblastic disease or multifetal gestation.
  • The patient has a condition for which antihistamines, in the opinion of the investigator, are contraindicated (epilepsy, alcoholism, glaucoma, chronic lung disease, urinary retention, heart block, etc.).
  • The patient has used antihistamines, anticholinergics, dopamine antagonists, serotonin antagonists, ginger, or anti-emetic therapy (including acupressure, acupuncture, homeopathic remedies, medical hypnosis, relief bands etc) to treat NVP in the previous 48 hours or plans to do so during the study .
  • The patient is using drugs that have anticholinergic activity (e.g., tricyclic antidepressants).
  • The patient is taking multivitamins containing more than 10 mg of vitamin B6, or plans to do so during the study.
  • The patient is taking supplementary vitamin B6 in addition to any multivitamin preparation, or plans to do so during the study.
  • The patient is currently drinking any amount of alcohol.
  • The patient has any condition that might interfere with the conduct of the study.
  • The patient is likely to be unable to comply with study procedures because of inadequate cognitive skills.
  • The patient has received an investigational drug within 30 days before enrollment in this study or is scheduled to receive an investigational drug during the course of this study.

Sites / Locations

  • Washington Hospital Center Physicians
  • Georgetown University Hospital
  • National Naval Medical Center
  • Magee-Womens Hospital of University of Pittsburgh Medical Center
  • University of Texas Medical Branch
  • UTMB Pasadena Clinic
  • UTMB Regional Maternal & Child Health Program--Pearland Clinic

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Diclectin®

Placebo

Arm Description

Diclectin® (doxylamine succinate 10 mg and pyridoxine hydrochloride 10 mg) delayed release tablet

Placebo tablets identical in size, shape, taste, and color to the experimental treatment (Diclectin®)

Outcomes

Primary Outcome Measures

Diclectin Versus Placebo for Treatment of Nausea and Vomiting of Pregnancy (NVP) as Measured by the Change in Pregnancy Unique-Quantification of Emesis (PUQE) Overall Score of Symptoms From Baseline (Day 1) to End of Study Visit (Day 15).
The objective of this double-blind, randomized, placebo-controlled study was to assess the efficacy, safety, and tolerability of oral Diclectin® in the treatment of nausea and vomiting of pregnancy (NVP) as measured by the Pregnancy Unique-Quantification of Emesis (PUQE) overall score of symptoms from baseline (Day 1) to end of study visit (Day 15). The PUQE score measured hours of nausea, number of times vomiting, and number of times retching for a TOTAL overall score of symptoms on a scale rated from 3 (no symptoms) to 15 (most severe).

Secondary Outcome Measures

Full Information

First Posted
January 29, 2008
Last Updated
November 22, 2021
Sponsor
Duchesnay Inc.
Collaborators
Premier Research Group plc
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1. Study Identification

Unique Protocol Identification Number
NCT00614445
Brief Title
The Efficacy Of Diclectin® For Nausea And Vomiting Of Pregnancy
Official Title
A Double-Blind, Multicenter, Randomized, Placebo-Controlled Trial Of The Efficacy Of Diclectin® For Nausea And Vomiting Of Pregnancy
Study Type
Interventional

2. Study Status

Record Verification Date
August 2011
Overall Recruitment Status
Completed
Study Start Date
January 2008 (undefined)
Primary Completion Date
July 2009 (Actual)
Study Completion Date
December 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Duchesnay Inc.
Collaborators
Premier Research Group plc

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine whether Diclectin® (doxylamine succinate USP 10 mg and pyridoxine HCl 10 mg) is more effective at controlling the nausea and vomiting of pregnancy than a placebo.
Detailed Description
Nausea and vomiting of pregnancy (NVP), also known as "morning sickness," is a common condition that affects a large percentage of pregnant women. The symptoms can range from mild nausea to severe nausea and vomiting for which a woman may need to be hospitalized. Nausea and vomiting of pregnancy can affect a woman's quality of life and ability to conduct daily activities. Diclectin® is a combination of 10 mg doxylamine succinate (an antihistamine), and 10 mg pyridoxine hydrochloride (vitamin B6) in a delayed release tablet formulation. It has been commercially available in Canada for the management of NVP for over 25 years and has been prescribed to over 33 million pregnant women. Presently, there is no Food Drug and Administration (FDA) approved drug on the market to treat the symptoms of NVP. This study will test the efficacy of Diclectin® (doxylamine 10 mg, pyridoxine 10 mg in a delayed-release formulation) for NVP. Patients enrolled in the study will receive between 2 and 4 tablets of Diclectin® or placebo daily, depending on their symptoms for up to 14 days. Patients will assess their symptoms of nausea and vomiting daily using a standardized questionnaire.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nausea and Vomiting of Pregnancy
Keywords
Nausea, Vomiting, Pregnancy, Hyperemesis gravidarum, Pregnancy complications

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
280 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Diclectin®
Arm Type
Experimental
Arm Description
Diclectin® (doxylamine succinate 10 mg and pyridoxine hydrochloride 10 mg) delayed release tablet
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo tablets identical in size, shape, taste, and color to the experimental treatment (Diclectin®)
Intervention Type
Drug
Intervention Name(s)
doxylamine succinate 10 mg/pyridoxine hydrochloride 10 mg
Other Intervention Name(s)
Diclectin®
Intervention Description
up to 4 tablets daily, titrated according to the protocol
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
2 to 4 tablets daily titrated according to the protocol
Primary Outcome Measure Information:
Title
Diclectin Versus Placebo for Treatment of Nausea and Vomiting of Pregnancy (NVP) as Measured by the Change in Pregnancy Unique-Quantification of Emesis (PUQE) Overall Score of Symptoms From Baseline (Day 1) to End of Study Visit (Day 15).
Description
The objective of this double-blind, randomized, placebo-controlled study was to assess the efficacy, safety, and tolerability of oral Diclectin® in the treatment of nausea and vomiting of pregnancy (NVP) as measured by the Pregnancy Unique-Quantification of Emesis (PUQE) overall score of symptoms from baseline (Day 1) to end of study visit (Day 15). The PUQE score measured hours of nausea, number of times vomiting, and number of times retching for a TOTAL overall score of symptoms on a scale rated from 3 (no symptoms) to 15 (most severe).
Time Frame
Baseline (Day 1) to End of Study Visit Day 15 (± 1 day)

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The patient has signed a written informed consent to participate in the study and has agreed to follow dosing instructions and complete all required study visits. The patient is a pregnant female age equal to or greater than 18 years old. The patient's entry ultrasound indicates a viable pregnancy and confirms gestational age of the fetus is 7-14 weeks at the anticipated time of the first dose of study medication or placebo. If an ultrasound was done within 4 weeks of the admission visit, and results can be obtained, an additional ultrasound is not necessary. The patient is suffering from NVP and has a Pregnancy Unique Quantification of Emesis (PUQE) score ≥6. The patient has not responded to conservative management consisting of dietary/lifestyle advice according to the 2004 ACOG Practice Bulletin. The patient agrees, if on a multivitamin, to continue on their current dose of multivitamin for the duration of the trial. The patient does not plan termination of the pregnancy. Exclusion Criteria: The investigator confirms the patient's nausea and vomiting is of etiology other than Nausea and Vomiting of Pregnancy (NVP). The patient has gestational trophoblastic disease or multifetal gestation. The patient has a condition for which antihistamines, in the opinion of the investigator, are contraindicated (epilepsy, alcoholism, glaucoma, chronic lung disease, urinary retention, heart block, etc.). The patient has used antihistamines, anticholinergics, dopamine antagonists, serotonin antagonists, ginger, or anti-emetic therapy (including acupressure, acupuncture, homeopathic remedies, medical hypnosis, relief bands etc) to treat NVP in the previous 48 hours or plans to do so during the study . The patient is using drugs that have anticholinergic activity (e.g., tricyclic antidepressants). The patient is taking multivitamins containing more than 10 mg of vitamin B6, or plans to do so during the study. The patient is taking supplementary vitamin B6 in addition to any multivitamin preparation, or plans to do so during the study. The patient is currently drinking any amount of alcohol. The patient has any condition that might interfere with the conduct of the study. The patient is likely to be unable to comply with study procedures because of inadequate cognitive skills. The patient has received an investigational drug within 30 days before enrollment in this study or is scheduled to receive an investigational drug during the course of this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Liubov Gargaun, M.D.
Organizational Affiliation
Duchesnay Inc.
Official's Role
Study Director
First Name & Middle Initial & Last Name & Degree
Gideon Koren, M.D.
Organizational Affiliation
Motherisk Program, University of Toronto
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Gary Hankins, M.D.
Organizational Affiliation
University of Texas
Official's Role
Principal Investigator
Facility Information:
Facility Name
Washington Hospital Center Physicians
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20010
Country
United States
Facility Name
Georgetown University Hospital
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20057
Country
United States
Facility Name
National Naval Medical Center
City
Bethesda
State/Province
Maryland
ZIP/Postal Code
20889
Country
United States
Facility Name
Magee-Womens Hospital of University of Pittsburgh Medical Center
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15213
Country
United States
Facility Name
University of Texas Medical Branch
City
Galveston
State/Province
Texas
ZIP/Postal Code
77555-0587
Country
United States
Facility Name
UTMB Pasadena Clinic
City
Pasadena
State/Province
Texas
ZIP/Postal Code
77502
Country
United States
Facility Name
UTMB Regional Maternal & Child Health Program--Pearland Clinic
City
Pearland
State/Province
Texas
ZIP/Postal Code
77581
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
29342163
Citation
Persaud N, Meaney C, El-Emam K, Moineddin R, Thorpe K. Doxylamine-pyridoxine for nausea and vomiting of pregnancy randomized placebo controlled trial: Prespecified analyses and reanalysis. PLoS One. 2018 Jan 17;13(1):e0189978. doi: 10.1371/journal.pone.0189978. eCollection 2018.
Results Reference
derived
PubMed Identifier
27881103
Citation
Koren G, Clark S, Hankins GD, Caritis SN, Umans JG, Miodovnik M, Mattison DR, Matok I. Demonstration of early efficacy results of the delayed-release combination of doxylamine-pyridoxine for the treatment of nausea and vomiting of pregnancy. BMC Pregnancy Childbirth. 2016 Nov 24;16(1):371. doi: 10.1186/s12884-016-1172-9.
Results Reference
derived
PubMed Identifier
26844757
Citation
Koren G, Hankins GD, Clark S, Caritis SN, Miodovnik M, Umans JG, Mattison DR. Effectiveness of doxylamine-pyridoxine for morning sickness. Am J Obstet Gynecol. 2016 May;214(5):664-6. doi: 10.1016/j.ajog.2016.01.186. Epub 2016 Feb 1. No abstract available.
Results Reference
derived
PubMed Identifier
25884778
Citation
Koren G, Clark S, Hankins GD, Caritis SN, Umans JG, Miodovnik M, Mattison DR, Matok I. Maternal safety of the delayed-release doxylamine and pyridoxine combination for nausea and vomiting of pregnancy; a randomized placebo controlled trial. BMC Pregnancy Childbirth. 2015 Mar 18;15:59. doi: 10.1186/s12884-015-0488-1.
Results Reference
derived
PubMed Identifier
25052410
Citation
Matok I, Clark S, Caritis S, Miodovnik M, Umans JG, Hankins G, Mattison DR, Koren G. Studying the antiemetic effect of vitamin B6 for morning sickness: pyridoxine and pyridoxal are prodrugs. J Clin Pharmacol. 2014 Dec;54(12):1429-33. doi: 10.1002/jcph.369. Epub 2014 Aug 7.
Results Reference
derived
PubMed Identifier
22972538
Citation
Costantine MM, Matok I, Chiossi G, Clark S, Miodovnik M, Umans JG, Caritis S, Hankins GD, Koren G. Determinants of adherence to delayed-release doxylamine and pyridoxine in patients with nausea and vomiting of pregnancy. Ther Drug Monit. 2012 Oct;34(5):569-73. doi: 10.1097/FTD.0b013e31826e7997.
Results Reference
derived
PubMed Identifier
20843504
Citation
Koren G, Clark S, Hankins GD, Caritis SN, Miodovnik M, Umans JG, Mattison DR. Effectiveness of delayed-release doxylamine and pyridoxine for nausea and vomiting of pregnancy: a randomized placebo controlled trial. Am J Obstet Gynecol. 2010 Dec;203(6):571.e1-7. doi: 10.1016/j.ajog.2010.07.030. Epub 2010 Sep 16.
Results Reference
derived

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The Efficacy Of Diclectin® For Nausea And Vomiting Of Pregnancy

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