An Open-Label, Long-term Study to Assess the Immunogenicity of LINZESS® (Linaclotide) Administered Orally to Adult Participants With Irritable Bowel Syndrome With Constipation or Chronic Idiopathic Constipation

NCT ID: NCT02590432

Last Updated: 2019-08-22

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

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

828 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-11-01

Study Completion Date

2018-02-05

Brief Summary

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The primary objective of this study is to assess the potential of LINZESS® (linaclotide) treatment to induce the development of anti-drug antibodies (ADAs). The secondary objectives are to provide additional evidence supporting the long-term safety and efficacy of linaclotide in adult irritable bowel syndrome with constipation (IBS-C) and chronic idiopathic constipation (CIC) participants and to evaluate lower doses of linaclotide.

Detailed Description

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This study includes up to a 3-week Screening Period, followed by a 52-week treatment period. Participants with CIC meeting the entry criteria received linaclotide 145 μg capsules, orally, once daily and participants with IBS-C meeting the entry criteria received linaclotide 290 μg capsules, orally, once daily. Participants with intolerable Adverse Events (AEs), following resolution of the AEs, could be randomized to receive 290 μg, 145 μg, or the lower dose of 72 μg linaclotide oral capsules for IBS-C; and 145 μg or 72 μg for CIC. Participants who experienced further intolerable AEs after the randomization could be transitioned to open-label 72 μg linaclotide.

Conditions

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Irritable Bowel Syndrome With Constipation Chronic Idiopathic Constipation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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LINZESS® 145 μg (CIC, Open Label)

LINZESS® (linaclotide) 145 μg capsules, orally, once daily for up to 52 weeks for participants with CIC. If an intolerable AE occurred participants could be randomized to the Double-blind Treatment Period.

Group Type EXPERIMENTAL

Linaclotide

Intervention Type DRUG

Linaclotide capsules, orally, once daily.

LINZESS® 290 μg (IBS-C, Open Label)

LINZESS® 290 μg capsules, orally, once daily for up to 52 weeks for participants with IBS-C. If an intolerable AE occurred participants could be randomized to the Double-blind Treatment Period.

Group Type EXPERIMENTAL

Linaclotide

Intervention Type DRUG

Linaclotide capsules, orally, once daily.

LINZESS® 290 μg (IBS-C, Double Blind)

Following participation in the Open Label Treatment Period, LINZESS® 290 μg capsules, orally, once daily from double-blind randomization up to Week 52 for participants with IBS-C. If an intolerable AE occurred, dose was reduced to Open Label 72 μg, if applicable.

Group Type EXPERIMENTAL

Linaclotide

Intervention Type DRUG

Linaclotide capsules, orally, once daily.

LINZESS® 145 μg (IBS-C, Double Blind)

Following participation in the Open Label Treatment Period, LINZESS® 145 μg capsules, orally, once daily from double-blind randomization up to Week 52 for participants with IBS-C. If an intolerable AE occurred, dose was reduced to Open Label 72 μg, if applicable.

Group Type EXPERIMENTAL

Linaclotide

Intervention Type DRUG

Linaclotide capsules, orally, once daily.

LINZESS® 72 μg (IBS-C, Double Blind)

Following participation in the Open Label Treatment Period, LINZESS® 72 μg capsules, orally, once daily from double-blind randomization up to Week 52 for participants with IBS-C. If an intolerable AE occurred, dose was maintained at Open Label 72 μg, if applicable.

Group Type EXPERIMENTAL

Linaclotide

Intervention Type DRUG

Linaclotide capsules, orally, once daily.

LINZESS® 145 μg (CIC, Double Blind)

Following participation in the Open Label Treatment Period, LINZESS® 145 μg capsules, orally, once daily from double-blind randomization up to Week 52 for participants with CIC. If an intolerable AE occurred, dose was reduced to 72 μg, if applicable.

Group Type EXPERIMENTAL

Linaclotide

Intervention Type DRUG

Linaclotide capsules, orally, once daily.

LINZESS® 72 μg (CIC, Double Blind)

Following participation in the Open Label Treatment Period, LINZESS® 72 μg capsules, orally, once daily from double-blind randomization up to Week 52 for participants with CIC. If an intolerable AE occurred, dose was maintained at Open Label 72 μg, if applicable.

Group Type EXPERIMENTAL

Linaclotide

Intervention Type DRUG

Linaclotide capsules, orally, once daily.

LINZESS® 72 μg (CIC, Dose-reduced Open Label)

Following participation in the Double-blind Treatment Period, if an intolerable AE occurred, LINZESS® 72 μg capsules, orally, once daily up to Week 52 for participants with CIC.

Group Type EXPERIMENTAL

Linaclotide

Intervention Type DRUG

Linaclotide capsules, orally, once daily.

LINZESS® 72 μg (IBS-C, Dose-reduced Open Label)

Following participation in the Double-blind Treatment Period, if an intolerable AE occurred, LINZESS® 72 μg capsules, orally, once daily up to Week 52 for participants with IBS-C.

Group Type EXPERIMENTAL

Linaclotide

Intervention Type DRUG

Linaclotide capsules, orally, once daily.

Interventions

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Linaclotide

Linaclotide capsules, orally, once daily.

Intervention Type DRUG

Other Intervention Names

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LINZESS®

Eligibility Criteria

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Inclusion Criteria

* Participants meet the Rome III criteria for IBS-C or CIC:
* IBS-C Criteria: the participant must meet the following 2 criteria (A and B).

A. IBS Criteria: The participant must have abdominal pain or discomfort at least 3 days per month in the 3 months before diagnosis (with symptom onset at least 6 months before diagnosis) associated with 2 or more of the following:

1. Improvement with defecation.
2. Onset associated with a change in frequency of stool.
3. Onset associated with a change in form (appearance) of stool. B. Stool Consistency Requirement: During the 3 months before diagnosis in the absence of laxative or enema use, the patient has hard or lumpy stools (Bristol Stool Form Scale \[BSFS\] score 1 or 2) with at least 25% of bowel movements (BMs) and has loose or mushy stools (BSFS 5 or 6) with \<25% of BMs.

* CIC Criteria: the participant must meet the following 3 criteria (A, B, and C):

A. Participant meets 2 or more of the following criteria for 3 months before the diagnosis with symptom onset at least 6 months before diagnosis:

1. Straining during at least 25% of defecations.
2. Lumpy or hard stools in at least 25% of defecations.
3. Sensation of incomplete evacuation for at least 25% of defecations.
4. Sensation of anorectal obstruction/blockage for at least 25% of defecations.
5. Manual maneuvers to facilitate at least 25% of defecations (e.g., digital evacuation, support of the pelvic floor).
6. Fewer than 3 defecations per week. B. Loose stools are rarely present without the use of laxatives. C. Insufficient criteria for irritable bowel syndrome. (The criteria for IBS are provided in Point A under IBS Criteria, above).

* Participant meets the colonoscopy requirements, which are modified from the Summary of the US-Multi-Society Task Force on Colorectal Cancer and other Colonoscopy Requirements.
* Participant has successfully completed protocol procedures (with no clinically significant findings).

Exclusion Criteria

* At Day 1 visit, the participant reports having 6 or more spontaneous bowel movements (SBMs) in the week prior to screening.
* At Day 1 visit, the participant reports having any SBMs that were watery (BSFS=7) or more than 1 SBM that was mushy (BSFS=6) in the week prior to screening.
* Participant has a structural abnormality of the gastrointestinal (GI) tract or a disease or condition that can affect GI motility.
* Participant has any protocol excluded or clinically significant medical or surgical history that would limit the patient's ability to complete or participate in this clinical trial or could confound the study assessments.
* Participant has ever received linaclotide as a treatment (including commercially-available product) or has been randomized into any clinical study in which linaclotide was a treatment. (participant who enrolled into linaclotide clinical studies conducted prior or during this study but failed to be randomized are eligible for the current study).
* Participant has ever received plecanatide, SP-333, or has participated in a plecanatide clinical study.
Minimum Eligible Age

18 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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Wieslaw Bochenek

Role: STUDY_DIRECTOR

Allergan

Locations

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Pinnacle Research Group, LLC

Anniston, Alabama, United States

Site Status

North Alabama Research Center, LLC

Athens, Alabama, United States

Site Status

Alliance Clinical Research

Childersburg, Alabama, United States

Site Status

G & L Research, LLC

Foley, Alabama, United States

Site Status

Radiant Research, Inc.

Chandler, Arizona, United States

Site Status

Radiant Research, Inc.

Scottsdale, Arizona, United States

Site Status

Clinical Research Institute of Arizona, LLC

Surprise, Arizona, United States

Site Status

Clinical Research Consortium

Tempe, Arizona, United States

Site Status

Desert Sun Clinical Research, LLC.

Tucson, Arizona, United States

Site Status

Preferred Research Partners, Inc.

Little Rock, Arkansas, United States

Site Status

Applied Research Center of Arkansas

Little Rock, Arkansas, United States

Site Status

Kindred Medical Institute for Clinical Trials, LLC

Corona, California, United States

Site Status

Global Clinical Trials LLC

Costa Mesa, California, United States

Site Status

Diagnamics Inc

Encinitas, California, United States

Site Status

MD Studies, Inc.

Fountain Valley, California, United States

Site Status

Research Center of Fresno, Inc.

Fresno, California, United States

Site Status

VVCRD Clinical Research

Garden Grove, California, United States

Site Status

Facey Medical Foundation

Mission Hills, California, United States

Site Status

Clinical Trials Research

Sacramento, California, United States

Site Status

Northern California Research

Sacramento, California, United States

Site Status

Artemis Institute for Clinical Research

San Diego, California, United States

Site Status

Precision Research Institute

San Diego, California, United States

Site Status

Empire Clinical Research

Upland, California, United States

Site Status

Lynn Institute of Denver

Denver, Colorado, United States

Site Status

ZASA Clinical Research

Boynton Beach, Florida, United States

Site Status

Meridien Research

Bradenton, Florida, United States

Site Status

Clinical Research of Brandon LLC

Brandon, Florida, United States

Site Status

Clinical Physiology Associates

Fort Myers, Florida, United States

Site Status

Direct Helpers Research Center

Hialeah, Florida, United States

Site Status

Eastern Research, Inc.

Hialeah, Florida, United States

Site Status

Center for Advanced Gastroenterology

Maitland, Florida, United States

Site Status

Florida Medical Center and Research, Inc.

Miami, Florida, United States

Site Status

Clinical Neuroscience Solutions, Inc

Orlando, Florida, United States

Site Status

Accord Clinical Research

Port Orange, Florida, United States

Site Status

Meridien Research

St. Petersburg, Florida, United States

Site Status

River Birch Research Alliance, LLC

Blue Ridge, Georgia, United States

Site Status

North Georgia Clinical Research

Woodstock, Georgia, United States

Site Status

Northwest Clinical Trials

Boise, Idaho, United States

Site Status

Rockford Gastroenterology Associates

Rockford, Illinois, United States

Site Status

Iowa Digestive Center, PC

Clive, Iowa, United States

Site Status

University of Iowa Hospitals and Clinics

Iowa City, Iowa, United States

Site Status

Integrated Clinical Trial Services, Inc.

West Des Moines, Iowa, United States

Site Status

Heartland Research Associates, LLC

Newton, Kansas, United States

Site Status

Health Science Research Center

Pratt, Kansas, United States

Site Status

Heartland Research Associates, LLC

Wichita, Kansas, United States

Site Status

Heartland Research Associates, LLC

Wichita, Kansas, United States

Site Status

KAMP Medical Research Inc

Natchitoches, Louisiana, United States

Site Status

Coastal Research Associates, Inc.

South Weymouth, Massachusetts, United States

Site Status

Bay State Clinical Trials, Inc.

Watertown, Massachusetts, United States

Site Status

Aa Mrc Llc

Flint, Michigan, United States

Site Status

Beyer Research

Kalamazoo, Michigan, United States

Site Status

The Center for Clinical Trials, Inc.

Biloxi, Mississippi, United States

Site Status

Sundance Clinical Research, LLC

St Louis, Missouri, United States

Site Status

Digestive Health Associates

Reno, Nevada, United States

Site Status

Albuquerque Clinical Trials

Albuquerque, New Mexico, United States

Site Status

Lovelace Scientific Resources, Inc.

Albuquerque, New Mexico, United States

Site Status

Drug Trials America

Hartsdale, New York, United States

Site Status

Manhattan Medical Research Practice PLLC

New York, New York, United States

Site Status

DiGiovanna Institute for Medical Education & Research

North Massapequa, New York, United States

Site Status

UNC Health Care, University of North Carolina Medical Center, Memorial Hospital

Chapel Hill, North Carolina, United States

Site Status

PharmQuest

Greensboro, North Carolina, United States

Site Status

Northstate Clinical Research

Lenoir, North Carolina, United States

Site Status

Digestive Health Specialists, PA

Winston-Salem, North Carolina, United States

Site Status

New Horizons Clinical Research

Cincinnati, Ohio, United States

Site Status

Clinical Inquest Center LTD

Dayton, Ohio, United States

Site Status

Dayton Gastroenterology, Inc.

Dayton, Ohio, United States

Site Status

IPS Research Company

Oklahoma City, Oklahoma, United States

Site Status

The Clinical Trial Center, LLC

Jenkintown, Pennsylvania, United States

Site Status

Temple University

Philadelphia, Pennsylvania, United States

Site Status

Preferred Primary Care Physicians, INC

Pittsburgh, Pennsylvania, United States

Site Status

Montgomery Medical, Inc.

Smithfield, Pennsylvania, United States

Site Status

Partners In Clinical Research

Cumberland, Rhode Island, United States

Site Status

Greenville Pharmaceutical Research, Inc.

Greenville, South Carolina, United States

Site Status

Radiant Research, Inc.

Greer, South Carolina, United States

Site Status

Clinical Neuroscience Solutions, Inc.

Memphis, Tennessee, United States

Site Status

Houston Endoscopy & Research Center

Houston, Texas, United States

Site Status

Research Across America

Plano, Texas, United States

Site Status

Sun Research Institute

San Antonio, Texas, United States

Site Status

Charlottesville Medical Research Center, LLC

Charlottesville, Virginia, United States

Site Status

Countries

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United States

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-10

Identifier Type: -

Identifier Source: org_study_id

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