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The purpose of this study is to determine the safety, efficacy, and dose response of a range of oral doses of linaclotide administered to patients meeting criteria for IBS-C.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 72 ug linaclotide acetate | Active Comparator |
| |
| 145 ug linaclotide acetate | Active Comparator |
| |
| 290 ug linaclotide acetate | Active Comparator |
| |
| 579 ug linaclotide acetate | Active Comparator |
| |
| Matching Placebo | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Linaclotide Acetate | Drug | Oral, once daily |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in the Weekly Normalized Complete Spontaneous Bowel Movement (CSBM) Rate During Weeks 1 Through 12 of the Treatment Period | The change in the weekly normalized CSBM Rate during Weeks 1 through 12 of the Treatment Period from the weekly normalized CSBM Rate obtained during the Pretreatment Period. The CSBM rate was normalized based on the number of CSBMs occurring in that week, adjusting for differences in the duration of the week and black-out periods (time not covered due to a missed IVRS call) versus 7x24 hours. | Change from Baseline to Week 12 |
| Measure | Description | Time Frame |
|---|---|---|
| CSBM 75% Responder for the Treatment Period (Based on the Normalized Rate) | For each week of the Treatment and Posttreatment Periods, a patient was considered a CSBM Responder if for that week the patient 1) completed ≥ 4 days of IVRS questions, 2) had a CSBM rate of ≥ 3 for the week, and 3) had an increase in CSBM rate of ≥ 1 from the baseline weekly CSBM rate. | Change from Baseline to Week 12 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Microbia Medical Director, MD | Microbia, Inc. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Microbia Investigational Site | Huntsville | Alabama | 35801 | United States | ||
| Microbia Investigational Site |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36324245 | Derived | Lembo A, Kuo B, Boinpally R, Li E, Mallick M, Bochenek W, Bartolini W. Randomised clinical trial: effects of MD-7246 on irritable bowel syndrome with diarrhoea. Aliment Pharmacol Ther. 2023 Jan;57(2):192-204. doi: 10.1111/apt.17274. Epub 2022 Nov 2. | |
| 20801122 | Derived | Johnston JM, Kurtz CB, Macdougall JE, Lavins BJ, Currie MG, Fitch DA, O'Dea C, Baird M, Lembo AJ. Linaclotide improves abdominal pain and bowel habits in a phase IIb study of patients with irritable bowel syndrome with constipation. Gastroenterology. 2010 Dec;139(6):1877-1886.e2. doi: 10.1053/j.gastro.2010.08.041. Epub 2010 Aug 27. |
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Patients went through a 14 to 17 day Pretreatment Period during which the patients provided qualifying bowel habit and symptoms, and rescue medicine usage information through an interactive voice response system (IVRS).
Patient recruitment occurred over a 12 month period from March 2007 to February 2008 at 92 US study sites.
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| ID | Title | Description |
|---|---|---|
| FG000 | 72 μg Linaclotide Acetate | Linaclotide, 72μg dose, oral administration, once per day |
| FG001 | 145 μg Linaclotide Acetate | Linaclotide, 145μg dose, oral administration, once per day |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Matching placebo | Drug | Oral, once daily |
|
| Change From Baseline in the Weekly Normalized SBM Rate for the Treatment Period | SBMs were measured daily during the treatment period by patient calls to the IVRS. | Change from Baseline to Week 12 |
| Change From Baseline in Stool Consistency (7-point Ordinal BSFS) for the Treatment Period | Stool consistency analyses were performed using the 7-point Bristol Stool Form Scale (BSFS), whereby a score of 1 = separate hard lumps like nuts (difficult to pass); 2 = sausage shaped but lumpy; 3 = like a sausage but with cracks on surface; 4 = like a sausage or snake, smooth and soft; 5 = soft blobs with clear-cut edges (passed easily); 6 = fluffy pieces with ragged edges, a mushy stool; and 7 = watery, no solid pieces (entirely liquid). | Change from Baseline to Week 12 |
| Change From Baseline in Straining (5-point Ordinal Scale) for the Treatment Period | Straining was assessed using a 5-point ordinal scale, whereby a score of 1 = not at all, 2 = a little bit, 3 = a moderate amount, 4 = a great deal, and 5 = an extreme amount. | Change from Baseline to Week 12 |
| Change From Baseline in Degree of Relief of Irritable Bowel Syndrome (IBS) Symptoms (7-point Balanced Scale) for the Treatment Period | Patients provided a weekly assessment of Degree of Relief of IBS Symptoms using a 7-point balanced scale (1=completely relieved, 2=considerably relieved, 3=somewhat relieved, 4=unchanged, 5=somewhat worse, 6=considerably worse, 7=as bad as I can imagine). | Change from Baseline to Week 12 |
| Change From Baseline in Abdominal Pain (5-point Ordinal Scale) for the Treatment Period | During the study, patients provided their self assessment of abdominal pain using a 5-point ordinal scale (1=none, 2=mild, 3=moderate, 4=severe, 5=very severe | Change from Baseline to Week 12 |
| Chandler |
| Arizona |
| United States |
| Microbia Investigational Site | Tuscon | Arizona | United States |
| Microbia Investigational Site | Sherwood | Arkansas | United States |
| Microbia Investigational Site | Anaheim | California | United States |
| Microbia Investigational Site | Garden Grove | California | United States |
| Microbia Investigational Site | Sacramento | California | United States |
| Microbia Investigational Site | San Diego | California | United States |
| Microbia Investigational Site | Bristol | Connecticut | United States |
| Microbia Investigational Site | Boynton Beach | Florida | United States |
| Microbia Investigational Site | Dunedin | Florida | United States |
| Microbia Investigational Site | Largo | Florida | United States |
| Microbia Investigational Site | Ocala | Florida | United States |
| Microbia Investigational Site | Port Orange | Florida | United States |
| Microbia Investigational Site | Stuart | Florida | United States |
| Microbia Investigational Site | Tampa | Florida | 33607 | United States |
| Microbia Investigational Site | Stockbridge | Georgia | United States |
| Microbia Investigational Site | Libertyville | Illinois | United States |
| Microbia Investigational Site | Peoria | Illinois | 60601 | United States |
| Microbia Investigational Site | Clive | Iowa | United States |
| Microbia Investigational Site | Davenport | Iowa | United States |
| Microbia Investigational Site | Mission | Kansas | United States |
| Microbia Investigational Site | Shawnee | Kansas | United States |
| Microbia Investigational Site | Baton Rouge | Louisiana | United States |
| Microbia Investigational Site | Monroe | Louisiana | 71201 | United States |
| Microbia Investigational Site | West Monroe | Louisiana | United States |
| Microbia Investigational Site | Annapolis | Maryland | United States |
| Microbia Investigational Site | Silver Spring | Maryland | United States |
| Microbia Investigational Site | Fall River | Massachusetts | United States |
| Microbia Investigational Site | Ann Arbor | Michigan | United States |
| Microbia Investigational Site | St Louis | Missouri | United States |
| Microbia Investigational Site | Missoula | Montana | United States |
| Microbia Investigational Site | Henderson | Nevada | United States |
| Microbia Investigational Site | Las Vegas | Nevada | United States |
| Microbia Investigational Site | Blackwood | New Jersey | United States |
| Microbia Investigational Site | Great Neck | New York | 11020 | United States |
| Microbia Investigational Site | Pittsford | New York | United States |
| Microbia Investigational Site | Asheville | North Carolina | United States |
| Microbia Investigational Site | Chapel Hill | North Carolina | United States |
| Microbia Investigational Site | Elkin | North Carolina | United States |
| Microbia Investigational Site | Greensboro | North Carolina | United States |
| Microbia Investigational Site | Harrisburg | North Carolina | United States |
| Microbia Investigational Site | Hickory | North Carolina | United States |
| Microbia Investigational Site | Raleigh | North Carolina | United States |
| Microbia Investigational Site | Statesville | North Carolina | United States |
| Microbia Investigational Site | Winston-Salem | North Carolina | United States |
| Microbia Investigational Site | Cincinnati | Ohio | United States |
| Microbia Investigational Site | Cleveland | Ohio | United States |
| Microbia Investigational Site | Dayton | Ohio | United States |
| Microbia Investigational Site | Sylvania | Ohio | United States |
| Microbia Investigational Site | Oklahoma City | Oklahoma | United States |
| Microbia Investigational Site | Tulsa | Oklahoma | United States |
| Microbia Investigational Site | Yukon | Oklahoma | United States |
| Microbia Investigational Site | Medford | Oregon | United States |
| Microbia Investigational Site | Levittown | Pennsylvania | United States |
| Microbia Investigational Site | Pittsburgh | Pennsylvania | United States |
| Microbia Investigational Site | Reading | Pennsylvania | United States |
| Microbia Investigational Site | Sellersville | Pennsylvania | 18960 | United States |
| Microbia Investigational Site | Anderson | South Carolina | United States |
| Microbia Investigational Site | Mt. Pleasant | South Carolina | United States |
| Microbia Investigational Site | Simpsonville | South Carolina | United States |
| Microbia Investigational Site | Summerville | South Carolina | United States |
| Microbia Investigational Site | Bristol | Tennessee | United States |
| Microbia Investigational Site | Germantown | Tennessee | United States |
| Microbia Investigational Site | Jackson | Tennessee | United States |
| Microbia Investigational Site | Kingsport | Tennessee | United States |
| Microbia Investigational Site | Beaumont | Texas | United States |
| Microbia Investigational Site | Corsicana | Texas | United States |
| Microbia Investigational Site | El Paso | Texas | United States |
| Microbia Investigational Site | San Antonio | Texas | United States |
| Microbia Investigational Site | Ogden | Utah | United States |
| Microbia Investigational Site | Chesapeake | Virginia | United States |
| Microbia Investigational Site | Lynchburg | Virginia | United States |
| Microbia Investigational Site | Richmond | Virginia | United States |
| Microbia Investigational Site | Lakewood | Washington | United States |
| Microbia Investigational Site | Olympia | Washington | United States |
| Microbia Investigational Site | Vancouver | Washington | United States |
| Microbia Investigational Site | Charleston | West Virginia | United States |
| Microbia Investigational Site | La Crosse | Wisconsin | United States |
| Microbia Investigational Site | Abbortsford | British Columbia | Canada |
| Microbia Investigational Site | Winnipeg | Manitoba | Canada |
| Microbia Investigational Site | Guelph | Ontario | Canada |
| Microbia Investigational Site | Milton | Ontario | Canada |
| Microbia Investigational Site | Toronto | Ontario | Canada |
| Microbia Investigational Site | Saskatoon | Saskatchewan | Canada |
| FG002 | 290 μg Linaclotide Acetate | Linaclotide, 290μg dose, oral administration, once per day |
| FG003 | 579 μg Linaclotide Acetate | Linaclotide, 579μg dose, oral administration, once per day |
| FG004 | Matching Placebo | Dose-matched placebo, oral administration, once per day |
| COMPLETED |
|
| NOT COMPLETED |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | 72 µg Linaclotide Acetate | Linaclotide, 72μg dose, oral administration, once per day |
| BG001 | 145 µg Linaclotide Acetate | Linaclotide, 145μg dose, oral administration, once per day |
| BG002 | 290 µg Linaclotide Acetate | Linaclotide, 290μg dose, oral administration, once per day |
| BG003 | 579 µg Linaclotide Acetate | Linaclotide, 579μg dose, oral administration, once per day |
| BG004 | Matching Placebo | Dose-matched placebo, oral administration, once per day |
| BG005 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Age, Customized | Number | Participants |
| ||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Region of Enrollment | Number | participants |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change From Baseline in the Weekly Normalized Complete Spontaneous Bowel Movement (CSBM) Rate During Weeks 1 Through 12 of the Treatment Period | The change in the weekly normalized CSBM Rate during Weeks 1 through 12 of the Treatment Period from the weekly normalized CSBM Rate obtained during the Pretreatment Period. The CSBM rate was normalized based on the number of CSBMs occurring in that week, adjusting for differences in the duration of the week and black-out periods (time not covered due to a missed IVRS call) versus 7x24 hours. | The Intent-to-treat (ITT) Population included 419 patients of the Safety Population who also had ≥ 1 post-dose evaluation of the primary efficacy assessment (i.e., CSBM Frequency) | Posted | Least Squares Mean | Standard Error | CSBMs per week | Change from Baseline to Week 12 |
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| Secondary | CSBM 75% Responder for the Treatment Period (Based on the Normalized Rate) | For each week of the Treatment and Posttreatment Periods, a patient was considered a CSBM Responder if for that week the patient 1) completed ≥ 4 days of IVRS questions, 2) had a CSBM rate of ≥ 3 for the week, and 3) had an increase in CSBM rate of ≥ 1 from the baseline weekly CSBM rate. | The ITT Population included 419 patients of the Safety Population who also had ≥ 1 post-dose evaluation of the primary efficacy assessment (i.e., CSBM Frequency). | Posted | Number | participants | Change from Baseline to Week 12 |
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Change From Baseline in the Weekly Normalized SBM Rate for the Treatment Period | SBMs were measured daily during the treatment period by patient calls to the IVRS. | The ITT Population included 419 patients of the Safety Population who also had ≥ 1 post-dose evaluation of the primary efficacy assessment (i.e., CSBM Frequency). | Posted | Least Squares Mean | Standard Error | SBMs per week | Change from Baseline to Week 12 |
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Change From Baseline in Stool Consistency (7-point Ordinal BSFS) for the Treatment Period | Stool consistency analyses were performed using the 7-point Bristol Stool Form Scale (BSFS), whereby a score of 1 = separate hard lumps like nuts (difficult to pass); 2 = sausage shaped but lumpy; 3 = like a sausage but with cracks on surface; 4 = like a sausage or snake, smooth and soft; 5 = soft blobs with clear-cut edges (passed easily); 6 = fluffy pieces with ragged edges, a mushy stool; and 7 = watery, no solid pieces (entirely liquid). | The ITT Population included 419 patients of the Safety Population who also had ≥ 1 post-dose evaluation of the primary efficacy assessment (i.e., CSBM Frequency). 15 patients with no pretreatment spontaneous bowel movements were excluded from the Stool Consistency analysis. | Posted | Least Squares Mean | Standard Error | units on a scale | Change from Baseline to Week 12 |
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| Secondary | Change From Baseline in Straining (5-point Ordinal Scale) for the Treatment Period | Straining was assessed using a 5-point ordinal scale, whereby a score of 1 = not at all, 2 = a little bit, 3 = a moderate amount, 4 = a great deal, and 5 = an extreme amount. | The ITT Population included 419 patients of the Safety Population who also had ≥ 1 post-dose evaluation of the primary efficacy assessment (i.e., CSBM Frequency). 15 patients with no pretreatment spontaneous bowel movements were excluded from the Straining analysis. | Posted | Least Squares Mean | Standard Error | units on a scale | Change from Baseline to Week 12 |
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Change From Baseline in Degree of Relief of Irritable Bowel Syndrome (IBS) Symptoms (7-point Balanced Scale) for the Treatment Period | Patients provided a weekly assessment of Degree of Relief of IBS Symptoms using a 7-point balanced scale (1=completely relieved, 2=considerably relieved, 3=somewhat relieved, 4=unchanged, 5=somewhat worse, 6=considerably worse, 7=as bad as I can imagine). | The ITT Population included 419 patients of the Safety Population who also had ≥ 1 post-dose evaluation of the primary efficacy assessment (i.e., CSBM Frequency). 13 patients who dropped out prior to finishing 1 week of the trial have missing data. | Posted | Least Squares Mean | Standard Error | units on a scale | Change from Baseline to Week 12 |
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Secondary | Change From Baseline in Abdominal Pain (5-point Ordinal Scale) for the Treatment Period | During the study, patients provided their self assessment of abdominal pain using a 5-point ordinal scale (1=none, 2=mild, 3=moderate, 4=severe, 5=very severe | The ITT Population included 419 patients of the Safety Population who also had ≥ 1 post-dose evaluation of the primary efficacy assessment (i.e., CSBM Frequency). | Posted | Least Squares Mean | Standard Error | units on a scale | Change from Baseline to Week 12 |
|
Adverse event data were collected from March of 2007 to April 2008.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | 72 µg Linaclotide Acetate | Linaclotide, 72μg dose, oral administration, once per day | 0 | 79 | 21 | 79 | ||
| EG001 | 145 µg Linaclotide Acetate | Linaclotide, 145μg dose, oral administration, once per day | 0 | 82 | 23 | 82 | ||
| EG002 | 290 µg Linaclotide Acetate | Linaclotide, 290μg dose, oral administration, once per day | 1 | 85 | 26 | 85 | ||
| EG003 | 579 µg Linaclotide Acetate | Linaclotide, 579μg dose, oral administration, once per day | 0 | 89 | 30 | 89 | ||
| EG004 | Matching Placebo | Dose-matched placebo, oral administration, once per day | 0 | 85 | 17 | 85 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Faecaloma | Gastrointestinal disorders | medDRA 9.1 | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abdominal distension | Gastrointestinal disorders | MedDRA (9.1) | Systematic Assessment |
| |
| Abdominal pain | Gastrointestinal disorders | MedDRA (9.1) | Systematic Assessment |
| |
| Diarrhea | Gastrointestinal disorders | MedDRA (9.1) | Systematic Assessment |
| |
| Headache | Nervous system disorders | MedDRA (9.1) | Systematic Assessment |
| |
| Nasopharyngitis | Infections and infestations | MedDRA (9.1) | Systematic Assessment |
| |
| Nausea | Gastrointestinal disorders | MedDRA (9.1) | Systematic Assessment |
| |
| Upper respiratory tract infection | Infections and infestations | MedDRA (9.1) | Systematic Assessment |
| |
| Urinary tract infection | Infections and infestations | MedDRA (9.1) | Systematic Assessment |
|
The disclosure restriction on the PI is that publication cannot be made for 24 months from the date of final data lock of the study, the sponsor can review the publication prior to public release, sponsor requires a minimum 60 day review period for each publication, sponsor can request removal of confidential information of sponsor (not including results of trial), and sponsor can request an additional delay period of 60 days in order to protect potentially patentable information.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Doug Levine, MD | Ironwood Pharmaceuticals | 617.374.3906 | dlevine@ironwoodpharma.com |
| ID | Term |
|---|---|
| D043183 | Irritable Bowel Syndrome |
| ID | Term |
|---|---|
| D003109 | Colonic Diseases, Functional |
| D003108 | Colonic Diseases |
| D007410 | Intestinal Diseases |
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
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| ID | Term |
|---|---|
| C523483 | linaclotide |
Not provided
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| Older than 65 years |
|
| Male |
|
| Canada |
|
For each of the 4 active linaclotide groups, the null hypothesis was that there was no difference between placebo and the dose group in the change from baseline in the weekly normalized CSBM Rate. An observed cases (OC) approach to missing post-baseline data was applied: any missing data were not imputed. |
| ANCOVA |
| 0.0036 |
| 95 |
| No |
| Superiority or Other |
| For each of the 4 active linaclotide groups, the null hypothesis was that there was no difference between placebo and the dose group in the change from baseline in the weekly normalized CSBM Rate. An observed cases (OC) approach to missing post-baseline data was applied: any missing data were not imputed. | ANCOVA | <0.0001 | 95 | No | Superiority or Other |
| For each of the 4 active linaclotide groups, the null hypothesis was that there was no difference between placebo and the dose group in the change from baseline in the weekly normalized CSBM Rate. An observed cases (OC) approach to missing post-baseline data was applied: any missing data were not imputed. | ANCOVA | 0.0008 | 95 | No | Superiority or Other |
| OG004 | Matching Placebo | Dose-matched placebo, oral administration, once per day. |
|
|
| Matching Placebo |
Dose-matched placebo, oral administration, once per day. |
|
|
| OG003 | 579 μg Linaclotide Acetate | Linaclotide, 579μg dose, oral administration, once per day |
| OG004 | Matching Placebo | Dose-matched placebo, oral administration, once per day |
|
|
Linaclotide, 579μg dose, oral administration, once per day
| OG004 | Matching Placebo | Dose-matched placebo, oral administration, once per day |
|
|
Linaclotide, 579μg dose, oral administration, once per day |
| OG004 | Matching Placebo | Dose-matched placebo, oral administration, once per day |
|
|
| OG004 | Matching Placebo | Dose-matched placebo, oral administration, once per day |
|
|