A Safety and Efficacy Study of a Range of Linaclotide Doses Administered Orally to Children Ages 7-17 Years, With Irritable Bowel Syndrome With Constipation

NCT ID: NCT02559817

Last Updated: 2020-12-28

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE2

Total Enrollment

101 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-11-01

Study Completion Date

2019-08-30

Brief Summary

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The purpose of this study is to evaluate the safety and efficacy of linaclotide for the treatment of Irritable Bowel syndrome with Constipation (IBS-C), in children age 7-17 years.

This study includes up to a 4-week Screening Period, and a 2 to 3-week Pretreatment Period. Patients age 7-11 will receive oral liquid or oral solid capsule and patients 12-17 will receive solid oral capsule formulation. Children ages 7-11 years meeting the entry criteria will be randomized to 1 of 3 doses of linaclotide or placebo for 4 weeks. Children ages 12-17 years meeting the entry criteria will be randomized to 1 of 4 doses of linaclotide or placebo for 4 weeks.

This 4-week study will assess the effects of linaclotide on bowel movement frequency, as well as other bowel symptoms of IBS-C.

Detailed Description

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Conditions

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Irritable Bowel Syndrome With Constipation

Keywords

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Irritable Bowel Syndrome with Constipation in children Linzess

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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Linaclotide Dose A

Taken once daily each morning at least 30 minutes before breakfast, with the exception of the first Treatment Period dose which will be taken at the study center, after at least a 2-hour fast.

Dose A: 18 micrograms liquid oral solution or solid oral capsule in children 7-11 years of age with weight 18 to \<35 kg

Dose A: 36 micrograms liquid oral solution or solid oral capsule in children 7-11 years of age with weight ≥ 35 kg

Dose A: 36 micrograms solid oral capsule in children 12-17 years of age

Group Type EXPERIMENTAL

Linaclotide Dose A

Intervention Type DRUG

Linaclotide Dose B

Taken once daily each morning at least 30 minutes before breakfast, with the exception of the first Treatment Period dose which will be taken at the study center, after at least a 2-hour fast.

Dose B: 36 micrograms liquid oral solution or solid oral capsule in children 7-11 years of age with weight 18 to \<35 kg

Dose B: 72 micrograms liquid oral solution or solid oral capsule in children 7-11 years of age with weight ≥ 35 kg

Dose B: 72 micrograms solid oral capsule in children 12-17 years of age

Group Type EXPERIMENTAL

Linaclotide Dose B

Intervention Type DRUG

Linaclotide Dose C

Taken once daily each morning at least 30 minutes before breakfast, with the exception of the first Treatment Period dose which will be taken at the study center, after at least a 2-hour fast.

Dose C: 72 micrograms liquid oral solution or solid oral capsule in children 7-11 years of age with weight 18 to \<35 kg

Dose C: 145 micrograms liquid oral solution or solid oral capsule in children 7-11 years of age with weight ≥ 35 kg

Dose C: 145 micrograms solid oral capsule in children 12-17 years of age

Group Type EXPERIMENTAL

Linaclotide Dose C

Intervention Type DRUG

Linaclotide Approved Adult Dose

Taken once daily each morning at least 30 minutes before breakfast, with the exception of the first Treatment Period dose which will be taken at the study center, after at least a 2-hour fast.

Approved Adult Dose: 290 micrograms solid oral capsule in children 12-17 years of age

Group Type EXPERIMENTAL

Linaclotide Approved Adult Dose

Intervention Type DRUG

Matching Placebo

Taken once daily each morning at least 30 minutes before breakfast, with the exception of the first Treatment Period dose which will be taken at the study center, after at least a 2-hour fast

Placebo liquid oral solution or placebo solid oral capsule in children 7-11 years of age

Placebo solid oral capsule in children 12-17 years of age

Group Type PLACEBO_COMPARATOR

Matching Placebo

Intervention Type DRUG

Interventions

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Linaclotide Dose A

Intervention Type DRUG

Linaclotide Dose B

Intervention Type DRUG

Linaclotide Dose C

Intervention Type DRUG

Linaclotide Approved Adult Dose

Intervention Type DRUG

Matching Placebo

Intervention Type DRUG

Other Intervention Names

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Linzess Linzess Linzess Linzess Linzess

Eligibility Criteria

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Inclusion Criteria

* Patient weighs at least 18 kg (39.7 lbs)
* Patient meets Rome III criteria for child/adolescent IBS: at least once per week for at least 2 months before Screening Visit, the patient experienced abdominal discomfort (an uncomfortable sensation not described as pain) or pain associated with 2 or more of the following at least 25% of the time:
* a) Improvement with defecation
* b) Onset associated with a change in frequency of stool
* c) Onset associated with a change in form (appearance) of stool
* Patient meets modified Rome III criteria for child/adolescent Functional Constipation (FC): For at least 2 months before the Screening Visit, the patient has had 2 or fewer defecations (with each defecation occurring in the absence of any laxative, suppository, or enema use during the preceding 24 hours) in the toilet per week. In addition, at least once per week, patient meets 1 or more of the following:
* a) History of retentive posturing or excessive volitional stool retention
* b) History of painful or hard bowel movements (BMs)
* c) Presence of a large fecal mass in the rectum
* d) History of large diameter stools that may obstruct the toilet
* Patient is willing to discontinue any laxatives used before the Pretreatment Visit in favor of the protocol-permitted rescue medicine
* Patient has an average of fewer than 3 spontaneous BMs (SBMs) per week during the 14 days before the randomization day and up to the randomization. An SBM is defined as a BM that occurs in the absence of laxative, enema, or suppository use on the calendar day of the BM or the calendar day before the BM
* Patient or parent/guardian/LAR or caregiver is compliant with eDiary by completing both the morning and evening assessments for 10 out of the 14 days immediately preceding the Randomization Visit

Exclusion Criteria

* Patient reports having more than 1 loose, mushy stool (eDiary-recorded stool consistency of 6 on the Pediatric Bristol Stool Form Scale \[p-BSFS\]) or any watery stool (eDiary-recorded stool consistency of 7 on the p-BSFS) with any SBM that occurred in the absence of laxative use on the calendar day of the BM or the calendar day before the BM during the 14 days before the randomization day and up to the randomization
* Select medical history or conditions that may be related to other causes of constipation or may interfere with safety and efficacy analyses
* Patient has required manual disimpaction anytime prior to randomization or disimpaction during in-patient hospitalization within one year prior to randomization
* Patient is unable to tolerate the placebo during rhe Screening Period
Minimum Eligible Age

7 Years

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ironwood Pharmaceuticals, Inc.

INDUSTRY

Sponsor Role collaborator

Forest Laboratories

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Anna Muslin

Role: STUDY_CHAIR

Forest Laboratories, LLC, an Allergan Affiliate

Locations

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HealthStar Research, LLC

Hot Springs, Arkansas, United States

Site Status

Applied Research Center of Arkansas

Little Rock, Arkansas, United States

Site Status

Advanced Research Center - Site 069

Anaheim, California, United States

Site Status

Kindred Medical Institute for Clinical Trials, LLC

Corona, California, United States

Site Status

WCCT Global, LLC

Costa Mesa, California, United States

Site Status

ACTCA, Inc

Los Angeles, California, United States

Site Status

Children's Hospital Los Angeles

Los Angeles, California, United States

Site Status

Center for Clinical Trials, LLC

Paramount, California, United States

Site Status

University of California at San Francisco

San Francisco, California, United States

Site Status

Advanced Medical Research Center

Miami, Florida, United States

Site Status

Children's Center for Digestive Health Care LLC

Atlanta, Georgia, United States

Site Status

Sleepcare Clinical Research Institute

Stockbridge, Georgia, United States

Site Status

Methodist Medical Center

Peoria, Illinois, United States

Site Status

Riley Hospital for Children at Indiana University Health

Indianapolis, Indiana, United States

Site Status

Heartland Research Associates, LLC

Wichita, Kansas, United States

Site Status

Willis-Knighton Physician Network

Shreveport, Louisiana, United States

Site Status

Certified Research Consultants Virgo/Carter Pediatrics

Silver Spring, Maryland, United States

Site Status

GI Associates and Endoscopy Center

Jackson, Mississippi, United States

Site Status

Children's Mercy Hospital

Kansas City, Missouri, United States

Site Status

Boys Town National Research Hospital

Boys Town, Nebraska, United States

Site Status

Midwest Children Health Research Institute

Lincoln, Nebraska, United States

Site Status

Midwest Children Health Research Institute

Lincoln, Nebraska, United States

Site Status

Goryeb Children's Hospital

Morristown, New Jersey, United States

Site Status

Columbia University Medical Center and Morgan Stanley Children's Hospital of New York

New York, New York, United States

Site Status

Asheboro Research Associates - Site 022

Asheboro, North Carolina, United States

Site Status

Capital Pediatrics and Adolescent Center PLLC

Raleigh, North Carolina, United States

Site Status

Cincinnati Children's Hospital Medical Center

Cincinnati, Ohio, United States

Site Status

Ohio Pediatric Research Association

Dayton, Ohio, United States

Site Status

IPS Research Company

Oklahoma City, Oklahoma, United States

Site Status

St. Christopher's Hospital for Children

Philadelphia, Pennsylvania, United States

Site Status

Children's Hospital of Pittsburgh of UPMC

Pittsburgh, Pennsylvania, United States

Site Status

Preferred Primary Care Physicians, Inc.

Pittsburgh, Pennsylvania, United States

Site Status

Frontier Clinical Research, LLC

Scottdale, Pennsylvania, United States

Site Status

Montgomery Medical Inc.

Smithfield, Pennsylvania, United States

Site Status

Rhode Island Hospital

Providence, Rhode Island, United States

Site Status

Coastal Pediatric Research

Charleston, South Carolina, United States

Site Status

Coastal Pediatrics Associates

Mt. Pleasant, South Carolina, United States

Site Status

Cook Children's Medical Center

Fort Worth, Texas, United States

Site Status

Texas Children's Hospital/Baylor College Medicine

Houston, Texas, United States

Site Status

Houston Clinical Research Associates

Houston, Texas, United States

Site Status

Sun Research Institute

San Antonio, Texas, United States

Site Status

ClinPoint Trials

Waxahachie, Texas, United States

Site Status

Children's Hospital of The King's Daughters

Norfolk, Virginia, United States

Site Status

Virginia Tech Carilion School of Medicine Pediatric Gastroenterology

Roanoke, Virginia, United States

Site Status

MultiCare Institute for Research and Innovation

Tacoma, Washington, United States

Site Status

Aurora Health Care, Aurora Medical Center in Summit

Summit, Wisconsin, United States

Site Status

Children's Hospital of Western Ontario

London, Ontario, Canada

Site Status

Physician's Clinical Research Inc.

Vaughan, Ontario, Canada

Site Status

Countries

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United States Canada

References

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Di Lorenzo C, Nurko S, Hyams JS, Rodriguez-Araujo G, Shakhnovich V, Saps M, Simon M. Safety and efficacy of linaclotide in children aged 7-17 years with irritable bowel syndrome with constipation. J Pediatr Gastroenterol Nutr. 2024 Mar;78(3):539-547. doi: 10.1002/jpn3.12103. Epub 2023 Dec 28.

Reference Type DERIVED
PMID: 38504394 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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LIN-MD-63

Identifier Type: -

Identifier Source: org_study_id