A Study of Prucalopride For Functional Constipation in Children and Teenagers

J
Joseph Croffie, MD

Primary Investigator

Not Recruiting
6 months - 17 years
All
Phase 3
255 participants needed
2 Locations

Brief description of study

Functional constipation is a condition when it is very hard to pass a stool that is not duey other health problem or to medicines being taken. This condition is more common inhildren and teenagers.
This study has 2 parts:
The main aim of the 1st part of the study is to learn if a medicine called prucalopride canve bowel movements in children and teenagers with functional constipation. Another aimheck for side effects from 2 different doses of prucalopride. The main aim of the 2ndhe study is to continue to check for side effects from 2 different doses ofucalopride.
In the 1st part, at the first visit, the study doctor will check who can take part. Participants who take part will be picked for 1 of 3 treatments by chance.
  • A low dose of prucalopride once a day.
  • A higher dose of prucalopride once a day.
  • A placebo once a day. In this study, a placebo will look like prucalopride but will not have any medicine in it. Participants will be treated with prucalopride or a placebo for 12 weeks.
Participants who took prucalopride will continue to the 2nd part of the study. They will havehe same treatment as they did in the 1st part of the study. They will continue with theirher 36 weeks. Participants who took placebo in the 1st part of the study will receive prucalopride in the 2nd part of the study. They will be picked for a low dose orhigh dose of prucalopride by chance.
Participants will visit the clinic a few times during treatment. The clinic staff will alsohone the participants, or their parents or caregivers throughout treatment for aheck-up 4 weeks after last treatment, the clinic staff will telephone the participants, orheir parents or caregivers for a final check-up.

Detailed description of study

This study consists of a 12-week double-blind, placebo-controlled part (Part A) followed by a 36-week double-blind safety extension part (Part B). Participants aged 3 to 17 years ared for randomization in a 1:1:1 ratio to the Low Dose Group, High Dose Group, orhing placebo (placebo-controlled part [Part A]). After completion of Part A, participantshe placebo group will be re-randomized in a 1:1 ratio to the Low Dose Group or the High Dose Group (safety extension part [Part B]). Randomization at study entry will be stratified by toilet-trained status.

Eligibility of study

You may be eligible for this study if you meet the following criteria:

  • Conditions: Constipation
  • Age: 6 months - 17 years
  • Gender: All

Inclusion Criteria:
  • Participants and/or their parent(s)/caregiver(s)/legally authorized representative(s)have an understanding, ability, and willingness to fully comply with study proceduresd restrictions.
  • Ability to voluntarily provide written, signed, and dated (personally or via[s]/caregiver[s]/legally authorized representative[s]) informed consent/assentble to participate in the study.
    Note: Participants and/or parent(s)/caregiver(s)/legally authorized representative(s)
    (where appropriate depending on age and local regulation) can also provide consent/assent
    to the sparse Pharmacokinetic (PK) sampling in this study.
     - Toilet-trained participants 3 years to 17 years of age, inclusive, or
       non-toilet-trained participants 6 months to 17 years of age, inclusive.
     - Participant weighs greater than or equal to (>=) 5.5 kilograms (kg) (12 pounds [lbs]).
     - Male, or non-pregnant, non-lactating female participants who are sexually active and
       agree to comply with the applicable contraceptive requirements of the protocol or
       females of non-childbearing potential.
    Note: All female participants >= 12 years and/or female participants lesser than (<) 12
    years who have started menarche must have a negative serum pregnancy test at screening.
    - Participant meets modified Rome IV criteria:
    * For child/adolescent (aged > 4 years) functional constipation (H3a):
    Participants must have lesser than or equal to (<=) 2 defecations per week and 1 or more of
    the following occurring at least once per week for a minimum of 1 month:
     - >= 1 episode of fecal incontinence per week (only for participants after the
       acquisition of toileting skills).
     - History of retentive posturing or excessive volitional stool retention.
     - History of painful or hard bowel movements (BMs).
     - Presence of large fecal mass in rectum.
     - History of large diameter stools which can obstruct the toilet. In addition, the
       participant does not satisfy sufficient criteria for a diagnosis of irritable bowel
       syndrome (IBS) and, after appropriate evaluation, the participants symptoms cannot be
       fully explained by another medical condition.
    For infants/toddler (aged 6 months to <= 4 years) functional constipation (G7):
    Participants must have <= 2 defecations per week and >= 1 month of at least 1 of the
    following:
     - History of excessive stool retention
     - History of painful or hard BMs
     - History of large-diameter stools (in the diaper)
     - Presence of a large fecal mass in the rectum
    In toilet-trained children, the following additional criteria may be used:
     - At least 1 episode/week of incontinence after the acquisition of toileting skills
     - History of large-diameter stools which may obstruct the toilet - Participant and/or
       parent(s)/caregiver(s)/legally authorized representative(s) is willing to discontinue
       any laxatives during the screening period up to disimpaction and agrees to adhere to
       the protocol-specified disimpaction and rescue medication rules, if applicable.
    To be evaluated prior to randomization:
     - Participant has an average of < 3 SBMs (defecations) per week during the screening
       period and prior to the disimpaction.
     - Participant or legally authorized representative (dependent on participant age) is
       compliant with completing the electronic diary for at least 7 consecutive days
       preceding the disimpaction.
    Exclusion Criteria:
     - Current or recurrent disease that could affect the action, absorption, or disposition
       of the investigational product (IP), or clinical or laboratory assessments.
     - Any clinically significant abnormal findings on the electrocardiogram (ECG) that
       indicates a dysrhythmia or conduction abnormalities (such as abnormal heart rate, PR,
       QRS, or QT).
     - Major cardiovascular disease such as: cardiomyopathy, cardiac insufficiency,
       uncorrected congenital heart disease, symptomatic valve disorders, or septal defects.
     - Current or relevant history of physical or psychiatric illness (e.g. severe autism,
       depression, etc.), any medical disorder that may require treatment or make the
       participant unlikely to fully complete the study, or any condition that presents undue
       risk from the IP or procedures.
     - Non-retentive fecal incontinence.
     - Intestinal perforation or obstruction due to structural or functional disorder of the
       gut wall, obstructive ileus, severe inflammatory conditions of the intestinal tract
       such as Crohn's disease, ulcerative colitis, and toxic megacolon/megarectum.
     - Current use of any medication (including over-the-counter, herbal, or homeopathic
       preparations) that could affect (improve or worsen) the condition being studied (e.g.
       opioids), or could affect the action, absorption, or disposition of the IP, or
       clinical or laboratory assessment. (Current use is defined as use within the past 5
       days).
     - Participants with renal impairment:
        - Participants <= 2 years of age with serum creatinine greater than normal
         (screening sample results using central laboratory pediatric reference ranges).
        - Participants > 2 years of age with severe renal impairment or end stage renal
         disease (estimated glomerular filtration rate [eGFR] <30 mL/min/1.73 m^2).
     - Known or suspected intolerance or hypersensitivity to the IP(s), closely-related
       compounds, or any of the stated ingredients.
     - Known history of alcohol or other substance abuse within the last year.
     - Within 30 days prior to the first dose of the IP in the current study:
        - Have used any IP.
        - Have been enrolled in a clinical study (including vaccine studies) that may or
         may not include the administration of an IP that, in the investigator's opinion,
         may impact this study.
     - Participant used prucalopride within 10 days prior to the first dose of the IP or has
       been unsuccessfully treated with prucalopride before.
     - Participant meets Rome IV criteria for other Child/Adolescent Functional
       Gastrointestinal Disorders (FGID) (H1 - H2 and H3b).
     - Participant with secondary causes of constipation:
        - Endocrine disorders (e.g., hypopituitarism, hypothyroidism, hypercalcemia,
         pheochromocytoma, glucagon-producing tumors) unless these are controlled by
         appropriate medical therapy. Participant with uncontrolled diabetes mellitus is
         to be excluded
        - Metabolic disorders (e.g. porphyria, uremia, hypokalemia, hypothyroidism, amyloid
         neuropathy), unless controlled by appropriate medical therapy
        - Neurological disorders (e.g. cerebral tumors, cerebrovascular accidents, multiple
         sclerosis, meningocele, aganglionosis, hypoganglionosis, hyperganglionosis,
         autonomic neuropathy, spinal cord injury, Chagas disease
        - Organic disorders (known or suspected) of the large bowel (e.g. obstruction from
         any cause including biliary obstruction, malignancy, intestinal perforation,
         obstructive ileus, pseudo-obstruction, history of or current anorectal
         malformations, severe inflammation of the intestinal tract, such as Crohn's
         disease, ulcerative colitis or toxic megacolon/megarectum, Hirschsprung's
         disease)
        - Celiac disease, cow milk allergy
        - Surgery: history of gastrointestinal surgery related or possibly related to the
         presence of constipation
        - Lactose intolerance
     - Any of the following clinically significant abnormalities of serum biochemistry:
        - Serum aspartate aminotransferase (AST) >1.5 times upper limit of normal (ULN) at
         screening.
        - Serum alanine aminotransferase (ALT) >1.5 times ULN at screening.
        - Total bilirubin outside the age-adjusted normal range, except for participants
         with Gilbert's syndrome.
     - Any significant underlying liver disease.
     - Participant is not able to swallow the IP (liquid or tablet).
     - Participant is pregnant or planning to get pregnant during study period.
    To be evaluated prior to randomization:
     - Participant has used other disimpaction medication in lieu of the protocol-provided
       medication.
     - Participant has used non-protocol approved medications to induce BMs during the
       screening period or disimpaction.
     - The participant has failed the disimpaction based on the investigator's assessment.
     - Worsening of depression and emergence of suicidal thoughts

Updated on 01 Aug 2024. Study ID: TAK-555-3010, PGI-TAKEDA-TAK-555-3010, 10951

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