Trial Outcomes & Findings for Amitiza® Plus GoLYTELY® (PEG) Versus Placebo Plus GoLYTELY® for Outpatient Colonoscopy Preparation (NCT NCT00645801)

NCT ID: NCT00645801

Last Updated: 2023-06-01

Results Overview

Endoscopists evaluated the quality of the colonoscopy preparation based on Ottawa bowel preparation scale. . The total score ranges from 0-14; score of 0 being perfect and score of 14 indicating solid stool in each colon segment and lot of fluid. Before using the scale for this trial, the endoscopists participated in a calibration exercise that involved 20 patients to ensure that they concurred on their interpretation of the scale.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

158 participants

Primary outcome timeframe

within 12 hours of completing bowel prep

Results posted on

2023-06-01

Participant Flow

Two hundred patients were planned to enroll in the study; however, the study was discontinued by the sponsor before the enrollment goal was completed because of slow enrollment. Of the 157 patients who volunteered for the study, only 123 patients who actually did the bowel preparation. Patients were recruited from the gastroenterology clinic at the main hospital and at the satellite clinic in the suburbs of Detroit.

Exclusion criteria included serum creatinine greater than 1.4, type I diabetes, CHF, pre-existing electrolyte abnormalities, inflammatory bowel disease, no spontaneous bowel movement every 48 hours, more than 3 bowel movements daily and previous colon resection.

Participant milestones

Participant milestones
Measure
1 Patient Received Both Lubiprostone in 4 Divided Doses and Golytely.
First dose of lubiprostone was administered 2 nights before colonoscopy and subsequent doses at breakfast, lunch, and dinner on the day before the procedure. Patients were instructed to initiate drinking PEG (immediately after the last dose of lubiprostone) at 6 PM the evening before the colonoscopy and continued drinking the solution until at least 2 bowel movements were clear yellow or green. After completing the preparation but before colonoscopy, patients were also required to fill a questionnaire to assess the tolerability of tablets and solution. This was measured on a 1-5 rating Likert scale 1) Easy, up to 5) Unable to Finish. In addition, the presence of symptoms of nausea, vomiting, abdominal pain, chest pain, dizziness, and bloating was also noted. All colonoscopies were performed by 3 endoscopists (with 85% of the procedures performed by principal investigator of the study, A.L.S.). Endoscopists evaluated the quality of the colonoscopy preparation based on the Ottawa bowel preparation scale. This scale rates 3 sections of colon, rectosigmoid, mid, and right colon, on a 5-point scale (0-4) and a global 3-point rating (0-2) for overall colonic fluid. The total score ranges from 0-14; score of 0 being perfect and score of 14 indicating solid stool in each colon segment and lot of fluid. All patients were contacted by telephone the day after the procedure to determine if they were experiencing any adverse reactions.
2 Look Alike Placebo in 4 Divided Doses Plus PEG and Electrolytes.
group 2 ingested 4 tablets of placebo (in divided doses) + 1 gallon of PEG. First dose of placebo was administered 2 nights before colonoscopy and subsequent doses at breakfast, lunch, and dinner on the day before the procedure. Patients were instructed to initiate drinking PEG (immediately after the last dose of lubiprostone) at 6 PM the evening before the colonoscopy and continue drinking the solution until at least 2 bowel movements were clear yellow or green. Patients evaluated the prep on a 1-5 rating Likert scale 1)Easy, to 5) Unable to Finish In addition, the presence of symptoms of nausea, vomiting, abdominal pain, chest pain, dizziness, and bloating were also recorded.All colonoscopies were performed by 3 endoscopists (with 85% of the procedures performed by principal investigator of the study, A.L.S.). Endoscopists evaluated the quality of the colonoscopy preparation based on the Ottawa bowel preparation scale. This scale rates 3 sections of colon, rectosigmoid, mid, and right colon, on a 5-point scale (0-4) and a global 3-point rating (0-2) for overall colonic fluid. The total score ranges from 0-14; score of 0 being perfect and score of 14 indicating solid stool in each colon segment and lot of fluid. All patients were contacted by telephone the day after the procedure to determine if they were experiencing any adverse reactions.
Overall Study
STARTED
77
81
Overall Study
COMPLETED
57
66
Overall Study
NOT COMPLETED
20
15

Reasons for withdrawal

Reasons for withdrawal
Measure
1 Patient Received Both Lubiprostone in 4 Divided Doses and Golytely.
First dose of lubiprostone was administered 2 nights before colonoscopy and subsequent doses at breakfast, lunch, and dinner on the day before the procedure. Patients were instructed to initiate drinking PEG (immediately after the last dose of lubiprostone) at 6 PM the evening before the colonoscopy and continued drinking the solution until at least 2 bowel movements were clear yellow or green. After completing the preparation but before colonoscopy, patients were also required to fill a questionnaire to assess the tolerability of tablets and solution. This was measured on a 1-5 rating Likert scale 1) Easy, up to 5) Unable to Finish. In addition, the presence of symptoms of nausea, vomiting, abdominal pain, chest pain, dizziness, and bloating was also noted. All colonoscopies were performed by 3 endoscopists (with 85% of the procedures performed by principal investigator of the study, A.L.S.). Endoscopists evaluated the quality of the colonoscopy preparation based on the Ottawa bowel preparation scale. This scale rates 3 sections of colon, rectosigmoid, mid, and right colon, on a 5-point scale (0-4) and a global 3-point rating (0-2) for overall colonic fluid. The total score ranges from 0-14; score of 0 being perfect and score of 14 indicating solid stool in each colon segment and lot of fluid. All patients were contacted by telephone the day after the procedure to determine if they were experiencing any adverse reactions.
2 Look Alike Placebo in 4 Divided Doses Plus PEG and Electrolytes.
group 2 ingested 4 tablets of placebo (in divided doses) + 1 gallon of PEG. First dose of placebo was administered 2 nights before colonoscopy and subsequent doses at breakfast, lunch, and dinner on the day before the procedure. Patients were instructed to initiate drinking PEG (immediately after the last dose of lubiprostone) at 6 PM the evening before the colonoscopy and continue drinking the solution until at least 2 bowel movements were clear yellow or green. Patients evaluated the prep on a 1-5 rating Likert scale 1)Easy, to 5) Unable to Finish In addition, the presence of symptoms of nausea, vomiting, abdominal pain, chest pain, dizziness, and bloating were also recorded.All colonoscopies were performed by 3 endoscopists (with 85% of the procedures performed by principal investigator of the study, A.L.S.). Endoscopists evaluated the quality of the colonoscopy preparation based on the Ottawa bowel preparation scale. This scale rates 3 sections of colon, rectosigmoid, mid, and right colon, on a 5-point scale (0-4) and a global 3-point rating (0-2) for overall colonic fluid. The total score ranges from 0-14; score of 0 being perfect and score of 14 indicating solid stool in each colon segment and lot of fluid. All patients were contacted by telephone the day after the procedure to determine if they were experiencing any adverse reactions.
Overall Study
unclear if patient took all the medication.
1
0
Overall Study
Lost to Follow-up
19
15

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
2 Look Alike Placebo in 4 Divided Doses Plus PEG and Electrolytes.
n=66 Participants
group 2 ingested 4 tablets of placebo (in divided doses) + 1 gallon of PEG. First dose of placebo was administered 2 nights before colonoscopy and subsequent doses at breakfast, lunch, and dinner on the day before the procedure. Patients were instructed to initiate drinking PEG (immediately after the last dose of lubiprostone) at 6 PM the evening before the colonoscopy and continue drinking the solution until at least 2 bowel movements were clear yellow or green. Patients evaluated the prep on a 1-5 rating Likert scale 1)Easy, to 5) Unable to Finish In addition, the presence of symptoms of nausea, vomiting, abdominal pain, chest pain, dizziness, and bloating were also recorded.All colonoscopies were performed by 3 endoscopists (with 85% of the procedures performed by principal investigator of the study, A.L.S.). Endoscopists evaluated the quality of the colonoscopy preparation based on the Ottawa bowel preparation scale. This scale rates 3 sections of colon, rectosigmoid, mid, and right colon, on a 5-point scale (0-4) and a global 3-point rating (0-2) for overall colonic fluid. The total score ranges from 0-14; score of 0 being perfect and score of 14 indicating solid stool in each colon segment and lot of fluid. All patients were contacted by telephone the day after the procedure to determine if they were experiencing any adverse reactions.
1 Patient Received Both Lubiprostone in 4 Divided Doses and Golytely.
n=57 Participants
First dose of lubiprostone was administered 2 nights before colonoscopy and subsequent doses at breakfast, lunch, and dinner on the day before the procedure. Patients were instructed to initiate drinking PEG (immediately after the last dose of lubiprostone) at 6 PM the evening before the colonoscopy and continued drinking the solution until at least 2 bowel movements were clear yellow or green. After completing the preparation but before colonoscopy, patients were also required to fill a questionnaire to assess the tolerability of tablets and solution. This was measured on a 1-5 rating Likert scale 1) Easy, up to 5) Unable to Finish. In addition, the presence of symptoms of nausea, vomiting, abdominal pain, chest pain, dizziness, and bloating was also noted. All colonoscopies were performed by 3 endoscopists (with 85% of the procedures performed by principal investigator of the study, A.L.S.). Endoscopists evaluated the quality of the colonoscopy preparation based on the Ottawa bowel preparation scale. This scale rates 3 sections of colon, rectosigmoid, mid, and right colon, on a 5-point scale (0-4) and a global 3-point rating (0-2) for overall colonic fluid. The total score ranges from 0-14; score of 0 being perfect and score of 14 indicating solid stool in each colon segment and lot of fluid. All patients were contacted by telephone the day after the procedure to determine if they were experiencing any adverse reactions.
Total
n=123 Participants
Total of all reporting groups
Age, Continuous
age
56.1 years
STANDARD_DEVIATION 9.1 • n=66 Participants
55.8 years
STANDARD_DEVIATION 9.4 • n=57 Participants
56.0 years
STANDARD_DEVIATION 9.2 • n=123 Participants
Sex: Female, Male
Female
41 Participants
n=66 Participants
35 Participants
n=57 Participants
76 Participants
n=123 Participants
Sex: Female, Male
Male
25 Participants
n=66 Participants
22 Participants
n=57 Participants
47 Participants
n=123 Participants
Race and Ethnicity Not Collected
0 Participants
Race and Ethnicity were not collected from any participant.
Region of Enrollment
United States
66 participants
n=66 Participants
57 participants
n=57 Participants
123 participants
n=123 Participants

PRIMARY outcome

Timeframe: within 12 hours of completing bowel prep

Endoscopists evaluated the quality of the colonoscopy preparation based on Ottawa bowel preparation scale. . The total score ranges from 0-14; score of 0 being perfect and score of 14 indicating solid stool in each colon segment and lot of fluid. Before using the scale for this trial, the endoscopists participated in a calibration exercise that involved 20 patients to ensure that they concurred on their interpretation of the scale.

Outcome measures

Outcome measures
Measure
Look Alike Placebo in 4 Divided Doses Plus PEG and Electrolytes.
n=66 Participants
group 2 ingested 4 tablets of placebo (in divided doses) + 1 gallon of PEG. First dose of placebo was administered 2 nights before colonoscopy and subsequent doses at breakfast, lunch, and dinner on the day before the procedure. Patients were instructed to initiate drinking PEG (immediately after the last dose of lubiprostone) at 6 PM the evening before the colonoscopy and continue drinking the solution until at least 2 bowel movements were clear yellow or green. Patients evaluated the prep on a 1-5 rating Likert scale 1)Easy, to 5) Unable to Finish In addition, the presence of symptoms of nausea, vomiting, abdominal pain, chest pain, dizziness, and bloating were also recorded.All colonoscopies were performed by 3 endoscopists (with 85% of the procedures performed by principal investigator of the study, A.L.S.). Endoscopists evaluated the quality of the colonoscopy preparation based on the Ottawa bowel preparation scale. This scale rates 3 sections of colon, rectosigmoid, mid, and right colon, on a 5-point scale (0-4) and a global 3-point rating (0-2) for overall colonic fluid. The total score ranges from 0-14; score of 0 being perfect and score of 14 indicating solid stool in each colon segment and lot of fluid. All patients were contacted by telephone the day after the procedure to determine if they were experiencing any adverse reactions.
Patient Received Both Lubiprostone in 4 Divided Doses and Golytely.
n=57 Participants
First dose of lubiprostone was administered 2 nights before colonoscopy and subsequent doses at breakfast, lunch, and dinner on the day before the procedure. Patients were instructed to initiate drinking PEG (immediately after the last dose of lubiprostone) at 6 PM the evening before the colonoscopy and continued drinking the solution until at least 2 bowel movements were clear yellow or green. After completing the preparation but before colonoscopy, patients were also required to fill a questionnaire to assess the tolerability of tablets and solution. This was measured on a 1-5 rating Likert scale 1) Easy, up to 5) Unable to Finish. In addition, the presence of symptoms of nausea, vomiting, abdominal pain, chest pain, dizziness, and bloating was also noted. All colonoscopies were performed by 3 endoscopists (with 85% of the procedures performed by principal investigator of the study, A.L.S.). Endoscopists evaluated the quality of the colonoscopy preparation based on the Ottawa bowel preparation scale. This scale rates 3 sections of colon, rectosigmoid, mid, and right colon, on a 5-point scale (0-4) and a global 3-point rating (0-2) for overall colonic fluid. The total score ranges from 0-14; score of 0 being perfect and score of 14 indicating solid stool in each colon segment and lot of fluid. All patients were contacted by telephone the day after the procedure to determine if they were experiencing any adverse reactions.
Endoscopist Evaluation of Colon Cleanliness in the Lubiprostone Group vs the Placebo Group
1.38 score on a scale
Standard Deviation 0.49
1.24 score on a scale
Standard Deviation 0.59

SECONDARY outcome

Timeframe: done at the time of colonoscopy

Population: Patients completed the drug or placebo with PEG and completed a questionnaire on the day of of the colonoscopy

After completing the colonoscopy prep patients were asked to assess tolerability of the prep using a 5 point Likert scale with 1 being easy and 5 being unable to complete the prep

Outcome measures

Outcome measures
Measure
Look Alike Placebo in 4 Divided Doses Plus PEG and Electrolytes.
n=52 Participants
group 2 ingested 4 tablets of placebo (in divided doses) + 1 gallon of PEG. First dose of placebo was administered 2 nights before colonoscopy and subsequent doses at breakfast, lunch, and dinner on the day before the procedure. Patients were instructed to initiate drinking PEG (immediately after the last dose of lubiprostone) at 6 PM the evening before the colonoscopy and continue drinking the solution until at least 2 bowel movements were clear yellow or green. Patients evaluated the prep on a 1-5 rating Likert scale 1)Easy, to 5) Unable to Finish In addition, the presence of symptoms of nausea, vomiting, abdominal pain, chest pain, dizziness, and bloating were also recorded.All colonoscopies were performed by 3 endoscopists (with 85% of the procedures performed by principal investigator of the study, A.L.S.). Endoscopists evaluated the quality of the colonoscopy preparation based on the Ottawa bowel preparation scale. This scale rates 3 sections of colon, rectosigmoid, mid, and right colon, on a 5-point scale (0-4) and a global 3-point rating (0-2) for overall colonic fluid. The total score ranges from 0-14; score of 0 being perfect and score of 14 indicating solid stool in each colon segment and lot of fluid. All patients were contacted by telephone the day after the procedure to determine if they were experiencing any adverse reactions.
Patient Received Both Lubiprostone in 4 Divided Doses and Golytely.
n=64 Participants
First dose of lubiprostone was administered 2 nights before colonoscopy and subsequent doses at breakfast, lunch, and dinner on the day before the procedure. Patients were instructed to initiate drinking PEG (immediately after the last dose of lubiprostone) at 6 PM the evening before the colonoscopy and continued drinking the solution until at least 2 bowel movements were clear yellow or green. After completing the preparation but before colonoscopy, patients were also required to fill a questionnaire to assess the tolerability of tablets and solution. This was measured on a 1-5 rating Likert scale 1) Easy, up to 5) Unable to Finish. In addition, the presence of symptoms of nausea, vomiting, abdominal pain, chest pain, dizziness, and bloating was also noted. All colonoscopies were performed by 3 endoscopists (with 85% of the procedures performed by principal investigator of the study, A.L.S.). Endoscopists evaluated the quality of the colonoscopy preparation based on the Ottawa bowel preparation scale. This scale rates 3 sections of colon, rectosigmoid, mid, and right colon, on a 5-point scale (0-4) and a global 3-point rating (0-2) for overall colonic fluid. The total score ranges from 0-14; score of 0 being perfect and score of 14 indicating solid stool in each colon segment and lot of fluid. All patients were contacted by telephone the day after the procedure to determine if they were experiencing any adverse reactions.
Tolerability of the Colon Cleansing Group in the Lubiprostone Group vs the Placebo Group
easy
6 participants
4 participants
Tolerability of the Colon Cleansing Group in the Lubiprostone Group vs the Placebo Group
Tolerable
15 participants
14 participants
Tolerability of the Colon Cleansing Group in the Lubiprostone Group vs the Placebo Group
slightly difficult
18 participants
25 participants
Tolerability of the Colon Cleansing Group in the Lubiprostone Group vs the Placebo Group
extremely difficult
6 participants
15 participants
Tolerability of the Colon Cleansing Group in the Lubiprostone Group vs the Placebo Group
unable to finish
7 participants
6 participants

SECONDARY outcome

Timeframe: amount of PEG at start of the study and that measured when the patient presented for their procedure.

Patients in the lubiprostone group and the placebo returned unused PEG after completing the prep for the colonoscopy. This was measured in liters and recorded.

Outcome measures

Outcome measures
Measure
Look Alike Placebo in 4 Divided Doses Plus PEG and Electrolytes.
n=57 Participants
group 2 ingested 4 tablets of placebo (in divided doses) + 1 gallon of PEG. First dose of placebo was administered 2 nights before colonoscopy and subsequent doses at breakfast, lunch, and dinner on the day before the procedure. Patients were instructed to initiate drinking PEG (immediately after the last dose of lubiprostone) at 6 PM the evening before the colonoscopy and continue drinking the solution until at least 2 bowel movements were clear yellow or green. Patients evaluated the prep on a 1-5 rating Likert scale 1)Easy, to 5) Unable to Finish In addition, the presence of symptoms of nausea, vomiting, abdominal pain, chest pain, dizziness, and bloating were also recorded.All colonoscopies were performed by 3 endoscopists (with 85% of the procedures performed by principal investigator of the study, A.L.S.). Endoscopists evaluated the quality of the colonoscopy preparation based on the Ottawa bowel preparation scale. This scale rates 3 sections of colon, rectosigmoid, mid, and right colon, on a 5-point scale (0-4) and a global 3-point rating (0-2) for overall colonic fluid. The total score ranges from 0-14; score of 0 being perfect and score of 14 indicating solid stool in each colon segment and lot of fluid. All patients were contacted by telephone the day after the procedure to determine if they were experiencing any adverse reactions.
Patient Received Both Lubiprostone in 4 Divided Doses and Golytely.
n=66 Participants
First dose of lubiprostone was administered 2 nights before colonoscopy and subsequent doses at breakfast, lunch, and dinner on the day before the procedure. Patients were instructed to initiate drinking PEG (immediately after the last dose of lubiprostone) at 6 PM the evening before the colonoscopy and continued drinking the solution until at least 2 bowel movements were clear yellow or green. After completing the preparation but before colonoscopy, patients were also required to fill a questionnaire to assess the tolerability of tablets and solution. This was measured on a 1-5 rating Likert scale 1) Easy, up to 5) Unable to Finish. In addition, the presence of symptoms of nausea, vomiting, abdominal pain, chest pain, dizziness, and bloating was also noted. All colonoscopies were performed by 3 endoscopists (with 85% of the procedures performed by principal investigator of the study, A.L.S.). Endoscopists evaluated the quality of the colonoscopy preparation based on the Ottawa bowel preparation scale. This scale rates 3 sections of colon, rectosigmoid, mid, and right colon, on a 5-point scale (0-4) and a global 3-point rating (0-2) for overall colonic fluid. The total score ranges from 0-14; score of 0 being perfect and score of 14 indicating solid stool in each colon segment and lot of fluid. All patients were contacted by telephone the day after the procedure to determine if they were experiencing any adverse reactions.
Change in Volume of PEG From Beginning of Bowel Prep to That at Completion of the Colonoscopy Preparation in the Two Groups
0.79 liters
Standard Deviation 0.97
1.36 liters
Standard Deviation 1.04

Adverse Events

Ingested 4 Tablets of Lubiprostone in Divided Doses + 1 Gallon of Polyethylene Glycol

Serious events: 0 serious events
Other events: 41 other events
Deaths: 0 deaths

Ingested 4 Tablets of Placebo in Divided Doses + 1 Gallon of Polyethylene Glycol

Serious events: 0 serious events
Other events: 46 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Ingested 4 Tablets of Lubiprostone in Divided Doses + 1 Gallon of Polyethylene Glycol
n=57 participants at risk
lubiprostone (Amitiza): 24 mcg administered 4 times over the two days of the colon preparation with PEG plus electrolytes before the colonoscopy. 96 mcg total lubiprostone
Ingested 4 Tablets of Placebo in Divided Doses + 1 Gallon of Polyethylene Glycol
n=66 participants at risk
Placebo: Amitiza Placebo 4 times over the two days of the colon preparation in divided doses with PEG plus electrolytes before the colonoscopy.
Gastrointestinal disorders
nausea
36.8%
21/57 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep
37.9%
25/66 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep
Gastrointestinal disorders
bloating
15.8%
9/57 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep
19.7%
13/66 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep
Nervous system disorders
headache
10.5%
6/57 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep
4.5%
3/66 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep
Gastrointestinal disorders
abdominal pain
0.00%
0/57 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep
4.5%
3/66 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep
Gastrointestinal disorders
flatulence
0.00%
0/57 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep
3.0%
2/66 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep
Nervous system disorders
Tingling of extremities
1.8%
1/57 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep
1.5%
1/66 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep
Gastrointestinal disorders
anal irritation
1.8%
1/57 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep
0.00%
0/66 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep
Nervous system disorders
Dizziness
5.3%
3/57 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep
3.0%
2/66 • Adverse events were collected over the 2 days that the patients took lubiprostone or placebo.
Patients were asked to describe any symptoms during colonoscopy prep

Additional Information

Director of Gastrointestinal Research

retired

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place