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
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Age: 6 months - 17 years
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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/assentto the sparse Pharmacokinetic (PK) sampling in this study.- Toilet-trained participants 3 years to 17 years of age, inclusive, ornon-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 andagree to comply with the applicable contraceptive requirements of the protocol orfemales of non-childbearing potential.Note: All female participants >= 12 years and/or female participants lesser than (<) 12years 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 ofthe following occurring at least once per week for a minimum of 1 month:- >= 1 episode of fecal incontinence per week (only for participants after theacquisition 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, theparticipant does not satisfy sufficient criteria for a diagnosis of irritable bowelsyndrome (IBS) and, after appropriate evaluation, the participants symptoms cannot befully 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 thefollowing:- 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 rectumIn 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/orparent(s)/caregiver(s)/legally authorized representative(s) is willing to discontinueany laxatives during the screening period up to disimpaction and agrees to adhere tothe 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 screeningperiod and prior to the disimpaction.- Participant or legally authorized representative (dependent on participant age) iscompliant with completing the electronic diary for at least 7 consecutive dayspreceding the disimpaction.Exclusion Criteria:- Current or recurrent disease that could affect the action, absorption, or dispositionof the investigational product (IP), or clinical or laboratory assessments.- Any clinically significant abnormal findings on the electrocardiogram (ECG) thatindicates 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 theparticipant unlikely to fully complete the study, or any condition that presents unduerisk from the IP or procedures.- Non-retentive fecal incontinence.- Intestinal perforation or obstruction due to structural or functional disorder of thegut wall, obstructive ileus, severe inflammatory conditions of the intestinal tractsuch as Crohn's disease, ulcerative colitis, and toxic megacolon/megarectum.- Current use of any medication (including over-the-counter, herbal, or homeopathicpreparations) that could affect (improve or worsen) the condition being studied (e.g.opioids), or could affect the action, absorption, or disposition of the IP, orclinical or laboratory assessment. (Current use is defined as use within the past 5days).- 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 renaldisease (estimated glomerular filtration rate [eGFR] <30 mL/min/1.73 m^2).- Known or suspected intolerance or hypersensitivity to the IP(s), closely-relatedcompounds, 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 ormay 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 hasbeen unsuccessfully treated with prucalopride before.- Participant meets Rome IV criteria for other Child/Adolescent FunctionalGastrointestinal 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 byappropriate medical therapy. Participant with uncontrolled diabetes mellitus isto be excluded- Metabolic disorders (e.g. porphyria, uremia, hypokalemia, hypothyroidism, amyloidneuropathy), unless controlled by appropriate medical therapy- Neurological disorders (e.g. cerebral tumors, cerebrovascular accidents, multiplesclerosis, meningocele, aganglionosis, hypoganglionosis, hyperganglionosis,autonomic neuropathy, spinal cord injury, Chagas disease- Organic disorders (known or suspected) of the large bowel (e.g. obstruction fromany cause including biliary obstruction, malignancy, intestinal perforation,obstructive ileus, pseudo-obstruction, history of or current anorectalmalformations, severe inflammation of the intestinal tract, such as Crohn'sdisease, ulcerative colitis or toxic megacolon/megarectum, Hirschsprung'sdisease)- Celiac disease, cow milk allergy- Surgery: history of gastrointestinal surgery related or possibly related to thepresence 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) atscreening.- Serum alanine aminotransferase (ALT) >1.5 times ULN at screening.- Total bilirubin outside the age-adjusted normal range, except for participantswith 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-providedmedication.- Participant has used non-protocol approved medications to induce BMs during thescreening 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