The Efficacy Of Diclectin® For Nausea And Vomiting Of Pregnancy

NCT ID: NCT00614445

Last Updated: 2021-11-23

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

280 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-01-31

Study Completion Date

2009-12-31

Brief Summary

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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

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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.

Conditions

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Nausea and Vomiting of Pregnancy

Keywords

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Nausea Vomiting Pregnancy Hyperemesis gravidarum Pregnancy complications

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Diclectin®

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

Group Type EXPERIMENTAL

doxylamine succinate 10 mg/pyridoxine hydrochloride 10 mg

Intervention Type DRUG

up to 4 tablets daily, titrated according to the protocol

Placebo

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

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

2 to 4 tablets daily titrated according to the protocol

Interventions

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doxylamine succinate 10 mg/pyridoxine hydrochloride 10 mg

up to 4 tablets daily, titrated according to the protocol

Intervention Type DRUG

Placebo

2 to 4 tablets daily titrated according to the protocol

Intervention Type DRUG

Other Intervention Names

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Diclectin®

Eligibility Criteria

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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.
Minimum Eligible Age

18 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

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Premier Research Group plc

UNKNOWN

Sponsor Role collaborator

Duchesnay Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Liubov Gargaun, M.D.

Role: STUDY_DIRECTOR

Duchesnay Inc.

Gideon Koren, M.D.

Role: PRINCIPAL_INVESTIGATOR

Motherisk Program, University of Toronto

Gary Hankins, M.D.

Role: PRINCIPAL_INVESTIGATOR

University of Texas

Locations

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Washington Hospital Center Physicians

Washington D.C., District of Columbia, United States

Site Status

Georgetown University Hospital

Washington D.C., District of Columbia, United States

Site Status

National Naval Medical Center

Bethesda, Maryland, United States

Site Status

Magee-Womens Hospital of University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, United States

Site Status

University of Texas Medical Branch

Galveston, Texas, United States

Site Status

UTMB Pasadena Clinic

Pasadena, Texas, United States

Site Status

UTMB Regional Maternal & Child Health Program--Pearland Clinic

Pearland, Texas, United States

Site Status

Countries

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United States

References

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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.

Reference Type DERIVED
PMID: 29342163 (View on PubMed)

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.

Reference Type DERIVED
PMID: 27881103 (View on PubMed)

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.

Reference Type DERIVED
PMID: 26844757 (View on PubMed)

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.

Reference Type DERIVED
PMID: 25884778 (View on PubMed)

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.

Reference Type DERIVED
PMID: 25052410 (View on PubMed)

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.

Reference Type DERIVED
PMID: 22972538 (View on PubMed)

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.

Reference Type DERIVED
PMID: 20843504 (View on PubMed)

Other Identifiers

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DIC-301

Identifier Type: -

Identifier Source: org_study_id