To Evaluate Patient Preference of Movantik and Polyethylene Glycol 3350 for Opioid Induced Constipation

NCT ID: NCT03060512

Last Updated: 2018-07-13

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

276 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-03-02

Study Completion Date

2017-08-23

Brief Summary

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The purpose of this study is to determine whether patients with opioid induced constipation prefer treatment with naloxegol (Movantik) or with Polyethylene Glycol 3350.

Detailed Description

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This study is a prospective, randomized, open-label crossover study consisting of a 1-week washout period, a 2-week treatment period, another 1-week washout and a final 2-week treatment period. The study will assess the overall patient preference Movantik versus Polyethylene Glycol 3350 for the treatment of their opioid-induced constipation. This study will also evaluate the reasons for patient preference (only among subjects who indicate a preference), patient global impression of change, and change in bowel function over the treatment periods measured by Bowel Function Index. Patient's bowel movement diary will also be collected during the study.

Conditions

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Opioid Induced Constipation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Crossover Group 1

Crossover Group Movantik to Polyethylene Glycol 3350

2-period, 2-treatment cross-over model: Subjects will be randomized to Movantik during Treatment period 1 (2 weeks), then crossed over to receive Polyethylene Glycol 3350 for Treatment period 2 (2 weeks) after 1 week washout.

Group Type ACTIVE_COMPARATOR

Polyethylene Glycol 3350

Intervention Type DRUG

Polyethylene Glycol 3350, 17 grams of powder to be dissolved in 4 to 8 ounces of water, juice, soda, coffee or tea to be taken once a day.

Bisacodyl 5mg, 1-3 tablets may be taken by subject who does not experience a bowel movement within 72 hours.

Movantik

Intervention Type DRUG

Movantik 25 mg, 1 tablet taken once a day on an empty stomach at least 1 hour prior to the first meal of the day or 2 hours after the meal.

Bisacodyl 5mg, 1-3 tablets may be taken by subject who does not experience a bowel movement within 72 hours.

Crossover Group 2

Crossover group Polyethylene Glycol 3350 to Movantik

2-period, 2-treatment cross-over model: Subjects will be randomized to Polyethylene Glycol 3350 during Treatment period 1 (2 weeks), then crossed over to receive Movantik for Treatment period 2 (2 weeks) after 1 week washout.

Group Type ACTIVE_COMPARATOR

Polyethylene Glycol 3350

Intervention Type DRUG

Polyethylene Glycol 3350, 17 grams of powder to be dissolved in 4 to 8 ounces of water, juice, soda, coffee or tea to be taken once a day.

Bisacodyl 5mg, 1-3 tablets may be taken by subject who does not experience a bowel movement within 72 hours.

Movantik

Intervention Type DRUG

Movantik 25 mg, 1 tablet taken once a day on an empty stomach at least 1 hour prior to the first meal of the day or 2 hours after the meal.

Bisacodyl 5mg, 1-3 tablets may be taken by subject who does not experience a bowel movement within 72 hours.

Interventions

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Polyethylene Glycol 3350

Polyethylene Glycol 3350, 17 grams of powder to be dissolved in 4 to 8 ounces of water, juice, soda, coffee or tea to be taken once a day.

Bisacodyl 5mg, 1-3 tablets may be taken by subject who does not experience a bowel movement within 72 hours.

Intervention Type DRUG

Movantik

Movantik 25 mg, 1 tablet taken once a day on an empty stomach at least 1 hour prior to the first meal of the day or 2 hours after the meal.

Bisacodyl 5mg, 1-3 tablets may be taken by subject who does not experience a bowel movement within 72 hours.

Intervention Type DRUG

Other Intervention Names

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MiraLAX Naloxegol

Eligibility Criteria

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Inclusion Criteria

* Male or female between the ages of ≥18 and \<85 years
* Self-reported active symptoms of OIC (Opioid Induced Constipation) based on components of the Rome IV criteria at screening. Patients should have at least 2 of the following:

* \<3 SBMs (Spontaneous Bowel Movements) per week
* Straining \>25% of defecations
* Sensation of incomplete evacuation \>25% of defecations
* Lumpy or hard stools \>25% of defecations
* Sensation of anorectal obstruction/blockage \>25% of defecations
* Confirmed OIC by BFI (Bowel Function Index) ≥30
* Stable maintenance opioid regimen consisting of a total daily dose of at least 30 mg of oral morphine, or equivalent of 1 or more other opioid therapies
* Willingness to stop all laxatives and other bowel regimens other than specified rescue medication

Exclusion Criteria

* Pain related to cancer or has a history of cancer within 5 years
* Current constipation or chronic constipation not caused by or related to use of opioids
* History of rectal evacuation disorders, surgery or procedures that can potentially affect pelvic floor function; requirement of using manual maneuvers to facilitate a bowel movement
* Evidence of significant GI structural abnormalities, acute or chronic GI conditions that could post risk to the patient or confound the study results
* Recent surgery that may affect GI motility or increase risk for bowel obstruction or perforation
* Severe hepatic impairment
* Moderate or severe renal impairment
* Condition that may affect the permeability of blood-brain barrier
* Concomitantly using strong or moderate CYP3A4 inhibitors and strong CYP3A4 inducers
* Any other significant and/or progressive medical, surgical, psychiatric, or mental health condition or any significant laboratory findings that could increase the risk of participation in the study or affect the interpretation of study data as determined by the Investigator
Minimum Eligible Age

18 Years

Maximum Eligible Age

84 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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QuintilesIMS, Inc.

UNKNOWN

Sponsor Role collaborator

AstraZeneca

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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AstraZeneca Scientific Leadership

Role: STUDY_DIRECTOR

AstraZeneca

Locations

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Research Site

Huntsville, Alabama, United States

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Phoenix, Arizona, United States

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Phoenix, Arizona, United States

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Phoenix, Arizona, United States

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Anaheim, California, United States

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Anaheim, California, United States

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Lincoln, California, United States

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Los Gatos, California, United States

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North Hollywood, California, United States

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Orange, California, United States

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San Diego, California, United States

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Westminster, California, United States

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DeLand, Florida, United States

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Fort Myers, Florida, United States

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Jacksonville, Florida, United States

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Jacksonville, Florida, United States

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Jupiter, Florida, United States

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Lake City, Florida, United States

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Miami, Florida, United States

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Miami Springs, Florida, United States

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North Miami Beach, Florida, United States

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Ormond Beach, Florida, United States

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Plantation, Florida, United States

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Port Orange, Florida, United States

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West Palm Beach, Florida, United States

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Atlanta, Georgia, United States

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Decatur, Georgia, United States

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Marietta, Georgia, United States

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Bloomington, Illinois, United States

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Brownsburg, Indiana, United States

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Pikesville, Maryland, United States

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Waltham, Massachusetts, United States

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Troy, Michigan, United States

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Wyoming, Michigan, United States

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Biloxi, Mississippi, United States

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St Louis, Missouri, United States

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Omaha, Nebraska, United States

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Las Vegas, Nevada, United States

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Trenton, New Jersey, United States

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Albuquerque, New Mexico, United States

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Endwell, New York, United States

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Charlotte, North Carolina, United States

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Greensboro, North Carolina, United States

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High Point, North Carolina, United States

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Winston-Salem, North Carolina, United States

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Beavercreek, Ohio, United States

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Edmond, Oklahoma, United States

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Collegeville, Pennsylvania, United States

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Levittown, Pennsylvania, United States

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Greer, South Carolina, United States

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Chattanooga, Tennessee, United States

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Kingsport, Tennessee, United States

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West Jordan, Utah, United States

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Countries

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United States

References

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Argoff CE, Brennan MJ, Camilleri M, Davies A, Fudin J, Galluzzi KE, Gudin J, Lembo A, Stanos SP, Webster LR. Consensus Recommendations on Initiating Prescription Therapies for Opioid-Induced Constipation. Pain Med. 2015 Dec;16(12):2324-37. doi: 10.1111/pme.12937. Epub 2015 Nov 19.

Reference Type RESULT
PMID: 26582720 (View on PubMed)

Bell TJ, Panchal SJ, Miaskowski C, Bolge SC, Milanova T, Williamson R. The prevalence, severity, and impact of opioid-induced bowel dysfunction: results of a US and European Patient Survey (PROBE 1). Pain Med. 2009 Jan;10(1):35-42. doi: 10.1111/j.1526-4637.2008.00495.x. Epub 2008 Aug 18.

Reference Type RESULT
PMID: 18721170 (View on PubMed)

Camilleri M, Drossman DA, Becker G, Webster LR, Davies AN, Mawe GM. Emerging treatments in neurogastroenterology: a multidisciplinary working group consensus statement on opioid-induced constipation. Neurogastroenterol Motil. 2014 Oct;26(10):1386-95. doi: 10.1111/nmo.12417. Epub 2014 Aug 28.

Reference Type RESULT
PMID: 25164154 (View on PubMed)

Chey WD, Webster L, Sostek M, Lappalainen J, Barker PN, Tack J. Naloxegol for opioid-induced constipation in patients with noncancer pain. N Engl J Med. 2014 Jun 19;370(25):2387-96. doi: 10.1056/NEJMoa1310246. Epub 2014 Jun 4.

Reference Type RESULT
PMID: 24896818 (View on PubMed)

Coyne KS, LoCasale RJ, Datto CJ, Sexton CC, Yeomans K, Tack J. Opioid-induced constipation in patients with chronic noncancer pain in the USA, Canada, Germany, and the UK: descriptive analysis of baseline patient-reported outcomes and retrospective chart review. Clinicoecon Outcomes Res. 2014 May 23;6:269-81. doi: 10.2147/CEOR.S61602. eCollection 2014.

Reference Type RESULT
PMID: 24904217 (View on PubMed)

Coyne KS, Margolis MK, Yeomans K, King FR, Chavoshi S, Payne KA, LoCasale RJ. Opioid-Induced Constipation Among Patients with Chronic Noncancer Pain in the United States, Canada, Germany, and the United Kingdom: Laxative Use, Response, and Symptom Burden Over Time. Pain Med. 2015 Aug;16(8):1551-65. doi: 10.1111/pme.12724. Epub 2015 Mar 20.

Reference Type RESULT
PMID: 25802051 (View on PubMed)

Hurst H, Bolton J. Assessing the clinical significance of change scores recorded on subjective outcome measures. J Manipulative Physiol Ther. 2004 Jan;27(1):26-35. doi: 10.1016/j.jmpt.2003.11.003.

Reference Type RESULT
PMID: 14739871 (View on PubMed)

Holzer P. New approaches to the treatment of opioid-induced constipation. Eur Rev Med Pharmacol Sci. 2008 Aug;12 Suppl 1(0 1):119-27.

Reference Type RESULT
PMID: 18924451 (View on PubMed)

Johanson JF. Review of the treatment options for chronic constipation. MedGenMed. 2007 May 2;9(2):25.

Reference Type RESULT
PMID: 17955081 (View on PubMed)

Kumar L, Barker C, Emmanuel A. Opioid-induced constipation: pathophysiology, clinical consequences, and management. Gastroenterol Res Pract. 2014;2014:141737. doi: 10.1155/2014/141737. Epub 2014 May 5.

Reference Type RESULT
PMID: 24883055 (View on PubMed)

McGraw T. Safety of polyethylene glycol 3350 solution in chronic constipation: randomized, placebo-controlled trial. Clin Exp Gastroenterol. 2016 Jul 15;9:173-80. doi: 10.2147/CEG.S111693. eCollection 2016.

Reference Type RESULT
PMID: 27486340 (View on PubMed)

Brenner DM, Hu Y, Datto C, Creanga D, Camilleri M. A Randomized, Multicenter, Prospective, Crossover, Open-Label Study of Factors Associated With Patient Preferences for Naloxegol or PEG 3350 for Opioid-Induced Constipation. Am J Gastroenterol. 2019 Jun;114(6):954-963. doi: 10.14309/ajg.0000000000000229.

Reference Type DERIVED
PMID: 31058652 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Related Links

Other Identifiers

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D3820L00017

Identifier Type: -

Identifier Source: org_study_id

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