Effect and Tolerance of Botulinum A Toxin Rectal Injections on Fecal Incontinence

NCT ID: NCT02414425

Last Updated: 2016-12-07

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

200 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-12-31

Study Completion Date

2019-07-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Fecal incontinence is a frequent pathology which concerns 10% of the general population and severely alters patients quality of life. The cost of urinary and faecal incontinence has been estimated to be $16 billions a year. Several treatments exist depending on the aetiology of the faecal incontinence: medical treatments, biofeedback and sacral nerve stimulation. Nevertheless, these treatments are not always effective (50-70% of success) and are not without side effects, particularly the sacral nerve stimulation (pain, infection, electrode displacement..).

The intravesical injections of botulinum toxin have been used for several years for the treatment of urinary incontinence with overactive bladder. Several randomized trials have demonstrated the efficacy of these injections in patients with neurological disorders and overactive bladder, as well as in idiopathic overactive bladder. The toxin injections in the detrusor muscle increase the compliance and the bladder capacity and delay the initial appearance of detrusor uninhibited contraction. Furthermore, botulinum toxin decreases the urinary urgency. It maybe secondary to the reduction of the amplitude of the detrusor uninhibited contraction as well as to a direct effect of toxin on sensory pelvic nerve afferents.

The botulinum toxin should play a role on motor afferents as well as on the sensory function of efferent nerves.

The hypothesis is to demonstrate a decrease of active faecal incontinence and/or urgency episodes with improvement in quality of life, without any major side effects, in the patients included in this study. Nevertheless, the benefit of toxin injections are known to be temporary because of nerve re-growth. If we obtain similar results for fecal incontinence, it would be possible to schedule one to two injections a year because of the limited side-effects and invasiveness of the rectal injections.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Fecal Incontinence

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Fecal Incontinence Botulinum Toxin A Rectal injection

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Rectal Injection of Botulinum toxin A

Botulinum toxin A will be injected during rectoscopy for patient with rectal incontinence.

Anorectal manometry will be performed for evaluation of efficacy of experimental drug

Group Type EXPERIMENTAL

Rectoscopy

Intervention Type PROCEDURE

A rectoscopy will be performed for Botulinum toxin A or physiologic serum injection

Anorectal manometry

Intervention Type PROCEDURE

Anorectal manometry will be performed to evaluate efficacy of Botulinum toxin A or physiologic serum rectal injection

Botulinum toxin A or physiologic serum injection

Intervention Type DRUG

Botulinum toxin A or physiologic serum injection is performed during rectoscopy

Rectal Injection of physiologic serum

physiologic serum will be injected during rectoscopy for patient with rectal incontinence.

Anorectal manometry will be performed for evaluation of efficacy of placebo

Group Type PLACEBO_COMPARATOR

Rectoscopy

Intervention Type PROCEDURE

A rectoscopy will be performed for Botulinum toxin A or physiologic serum injection

Anorectal manometry

Intervention Type PROCEDURE

Anorectal manometry will be performed to evaluate efficacy of Botulinum toxin A or physiologic serum rectal injection

Botulinum toxin A or physiologic serum injection

Intervention Type DRUG

Botulinum toxin A or physiologic serum injection is performed during rectoscopy

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Rectoscopy

A rectoscopy will be performed for Botulinum toxin A or physiologic serum injection

Intervention Type PROCEDURE

Anorectal manometry

Anorectal manometry will be performed to evaluate efficacy of Botulinum toxin A or physiologic serum rectal injection

Intervention Type PROCEDURE

Botulinum toxin A or physiologic serum injection

Botulinum toxin A or physiologic serum injection is performed during rectoscopy

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Patients with at least one episode of active Fecal Incontinence and /or urgency per week;
* Patients with Fecal Incontinence for at least 3 months;
* Patients with Fecal Incontinence refractory to conventional treatment (medical and biofeedback);
* Patients having read the information letter and signed informed consent;
* Patients with medical insurance.

Exclusion Criteria

* Patients younger than 18 years old;
* Pregnant or breast-feeding women or women without effective contraception and of age to procreate;
* Exclusive passive Fecal Incontinence;
* Fecal Incontinence secondary to anorectal malformation, post-surgery, anorectal organic disease (cancer, inflammatory bowel disease, post-radiotherapy etc.), constipation, an anal sphincter lesion which could be repaired as a first step, a rectal prolapse (the inclusion in the study is possible if Fecal Incontinence persists after rectopexy, a neurological disease with rapid progress ( stable neurological status is needed for at least 6 months);
* Patients under guardianship.
* Known Hypersensibility to botulinum toxin;
* Neuromuscular junction pathology (myasthenia, Lambert-Eaton syndrome);
* Anesthesia performed less than 1 month previously;
* Association with antibiotics
* Neurological pathology such as polyradiculoneuropathy;
* Dysphagia, pneumopathy secondary to dysphagia;
* Botulinum toxin injections during the 3 months before the beginning of the study;
* Known Hypersensitivity to albumin;
* History of inhalation pneumopathy.
* Rectoscopy impossible (anal stenosis for example);
* Anti-coagulant or anti-platelet drug or hemostasis disorders.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

University Hospital, Rouen

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Anne-Marie LEROI, Pr

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Rouen

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Bordeaux University Hospital

Bordeaux, , France

Site Status RECRUITING

Clinique des Cèdres

Cornebarrieu, , France

Site Status RECRUITING

Hospices Civils de Lyon

Lyon, , France

Site Status RECRUITING

AP-HM Hôpital Nord

Marseille, , France

Site Status RECRUITING

AP-HP Hôpital Tenon

Paris, , France

Site Status RECRUITING

Hôpital des Diaconesses

Paris, , France

Site Status RECRUITING

Rennes University Hospital

Rennes, , France

Site Status RECRUITING

Rouen University Hospital

Rouen, , France

Site Status RECRUITING

Countries

Review the countries where the study has at least one active or historical site.

France

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Anne-Marie LEROI, Pr

Role: CONTACT

Email: [email protected]

Julien BLOT

Role: CONTACT

Email: [email protected]

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Franck ZERBIB, Pr

Role: primary

Michel QUERALTO, MD

Role: primary

François MION, Pr

Role: primary

Véronique VITTON, MD

Role: primary

Gérard AMARENCO, Pr

Role: primary

Isabelle ETIENNEY, MD

Role: primary

Laurent SIPROUDHIS, Pr

Role: primary

Anne-Marie LEROI, Pr

Role: primary

References

Explore related publications, articles, or registry entries linked to this study.

Leroi AM, Queralto M, Zerbib F, Siproudhis L, Vitton V, Amarenco G, Etienney I, Mion F, Bridoux V, Philip J, Brochard C, Damon H, Lacroix E, Gillibert A, Gourcerol G. Intrarectal injections of botulinum toxin versus placebo for the treatment of urge faecal incontinence in adults (FI-Toxin): a double-blind, multicentre, randomised, controlled phase 3 study. Lancet Gastroenterol Hepatol. 2024 Feb;9(2):147-158. doi: 10.1016/S2468-1253(23)00332-1. Epub 2023 Dec 18.

Reference Type DERIVED
PMID: 38128556 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

2014-003650-14

Identifier Type: EUDRACT_NUMBER

Identifier Source: secondary_id

2014/008/HP

Identifier Type: -

Identifier Source: org_study_id