Safety, Efficacy and Cost-effectiveness of Racecadotril in Children With Acute Diarrhea in Mexico

NCT ID: NCT01153854

Last Updated: 2010-06-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

454 participants

Study Classification

INTERVENTIONAL

Study Start Date

2007-01-31

Study Completion Date

2009-12-31

Brief Summary

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Rationale: Acute diarrhea (AD) is still a significant morbidity-mortality problem worldwide. Although oral rehydration therapy is the cornerstone, its anti-diarrheal effect is a controversial subject. Since ten years ago, Racecadotrilo´s safety and efficacy had been proved. However, a pharmacoeconomics analysis on this therapeutics has not been published yet.

Objective: Evaluate the efficacy, safety, tolerability and costs associated with Racecadotril administration in comparison to a placebo in infants up to 24 months of age with AD in a hospital (mildly or moderately dehydrated) and ambulatory (no dehydrated) settings at the National Institute of Pediatrics in Mexico.

Material and Methods: Randomized, double-blind, placebo controlled, clinical trial (RDBCCT) with pharmacoeconomics analysis (cost minimization) to realize in 454 infants with AD (270 hospitalized and 184 outpatients), 1 to 24 months of age who concomitantly will receive ORT and Racecadotril (1.5mg./Kg./t.i.d. doe 5 days) (ORT-Rac Group) or placebo (ORT-Placebo Group). The clinical outcomes in the hospitalized infants to measure will be a) Stool output rate at 48hs. and at the end of the study; b) duration of diarrhea; c) percentage of intravenous (IV) needs and d) percentage of adverse events. The outcome variables in outpatient infants to measure will be a) total liquid and semi-liquid bowel movements during the study; b) duration of diarrhea and c) percentage of adverse events. The pharmacoeconomics analysis will involve a cost minimization analysis (CMA). Results will be analyzed through bi and multivariate analysis using STATA 11.0 for Mac, considering a p value \< 0.05 as significant. The pharmacoeconomics model will made through decisions trees using TreAge Pro Healthcare v 1.2.0, 2009.

Detailed Description

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Conditions

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Diarrhea

Keywords

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acute diarrhea Acute diarrhea (three or more watery or semi-watery bowel movements for at least one day lasting no more than 5 days before being admitted)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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ORS-Raceca In hospital Group

This group included 135 dehydrated patients which need an oral rehydration therapy in hospital and were assigned to received oral rehydration solution and racecadotril (1.5mg./Kg./t.i.d. doe 5 days) in double blind assigned.

Group Type EXPERIMENTAL

Racecadotril

Intervention Type DRUG

oral racecadotril (1.5mg./Kg./t.i.d. doe 5 days) in double blind assigned.

ORS-Placebo in hospital group

This group included 135 dehydrated patients which need an oral rehydration therapy in hospital and were assigned to received oral rehydration solution and placebo in double blind assigned.

Group Type PLACEBO_COMPARATOR

Placebo groups

Intervention Type DRUG

Placebo with feature color, appearance and tase similar to racecadotril t.i.d. for 5 days

ORS-Placebo ambulatory group

This group included 92 non dehydrated patients which were assigned to received oral rehydration solution and placebo in double blind assigned and ambulatory (in home) bases.

Group Type PLACEBO_COMPARATOR

Placebo groups

Intervention Type DRUG

Placebo with feature color, appearance and tase similar to racecadotril t.i.d. for 5 days

ORS-Raceca ambulatory group

This group included 92 non dehydrated patients which were assigned to received oral rehydration solution and racecadotril (1.5mg./Kg./t.i.d. doe 5 days) in double blind assigned and ambulatory (in home) bases.

Group Type EXPERIMENTAL

Racecadotril

Intervention Type DRUG

oral racecadotril (1.5mg./Kg./t.i.d. doe 5 days) in double blind assigned.

Interventions

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Racecadotril

oral racecadotril (1.5mg./Kg./t.i.d. doe 5 days) in double blind assigned.

Intervention Type DRUG

Placebo groups

Placebo with feature color, appearance and tase similar to racecadotril t.i.d. for 5 days

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* children ≥ 1 month of age and ≤ 24 months of age
* Acute diarrhea (defined as three or more watery or semi-watery bowel movements for at least one day lasting no more than 5 days before being admitted)
* For in hospital group: mild or moderate dehydration
* Signed informed consent letter

Exclusion Criteria

* previous use of oral antibiotics for more than 48 hours (during the two weeks before the trial
* previous use of anti-diarrheal medication (e.g.: bismuth subsalicylate, adsorbents, Loperamide, combinations)
* chronic pathologies (e.g.: cardiopathies, nephropathies, chronic gastrointestinal pathologies, endocrinopathies)
Minimum Eligible Age

1 Month

Maximum Eligible Age

24 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ferrer Laboratories

UNKNOWN

Sponsor Role collaborator

National Institute of Pediatrics, Mexico

OTHER_GOV

Sponsor Role lead

Responsible Party

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National Pediatric Institute

Principal Investigators

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Pedro Gutierrez-Castrellon, MD, MSc, DSc

Role: PRINCIPAL_INVESTIGATOR

National Pediatric Institute

Locations

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National Pediatric Institute

Mexico City, Mexico City, Mexico

Site Status

Countries

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Mexico

References

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Szajewska H, Ruszczynski M, Chmielewska A, Wieczorek J. Systematic review: racecadotril in the treatment of acute diarrhoea in children. Aliment Pharmacol Ther. 2007 Sep 15;26(6):807-13. doi: 10.1111/j.1365-2036.2007.03444.x.

Reference Type BACKGROUND
PMID: 17767464 (View on PubMed)

Cezard JP, Salazar-Lindo E. Racecadotril in acute diarrhea. Indian Pediatr. 2005 May;42(5):502-3; author reply 503. No abstract available.

Reference Type BACKGROUND
PMID: 15923708 (View on PubMed)

Rao SG. Racecadotril (acetorphan) in the treatment of acute watery diarrhoea in children. J Indian Med Assoc. 2002 Aug;100(8):530. No abstract available.

Reference Type BACKGROUND
PMID: 12675192 (View on PubMed)

Cojocaru B, Bocquet N, Timsit S, Wille C, Boursiquot C, Marcombes F, Garel D, Sannier N, Cheron G. [Effect of racecadotril in the management of acute diarrhea in infants and children]. Arch Pediatr. 2002 Aug;9(8):774-9. doi: 10.1016/s0929-693x(01)00988-5. French.

Reference Type BACKGROUND
PMID: 12205786 (View on PubMed)

Cezard JP, Duhamel JF, Meyer M, Pharaon I, Bellaiche M, Maurage C, Ginies JL, Vaillant JM, Girardet JP, Lamireau T, Poujol A, Morali A, Sarles J, Olives JP, Whately-Smith C, Audrain S, Lecomte JM. Efficacy and tolerability of racecadotril in acute diarrhea in children. Gastroenterology. 2001 Mar;120(4):799-805. doi: 10.1053/gast.2001.22544.

Reference Type BACKGROUND
PMID: 11231932 (View on PubMed)

Salazar-Lindo E, Santisteban-Ponce J, Chea-Woo E, Gutierrez M. Racecadotril in the treatment of acute watery diarrhea in children. N Engl J Med. 2000 Aug 17;343(7):463-7. doi: 10.1056/NEJM200008173430703.

Reference Type BACKGROUND
PMID: 10944563 (View on PubMed)

Other Identifiers

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INP14/2005-Raceca-001

Identifier Type: -

Identifier Source: org_study_id