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The study is a prospective, randomized, multicenter, adaptive design, double blinded, placebo-controlled study, to evaluate the efficacy and safety of Vibrant Capsule vs. placebo in relieving constipation in subjects with Chronic Idiopathic Constipation.
Subjects came for 4 visits: Screening (visit 1), baseline (visit 2), after 4 treatment weeks from baseline (visit 3) and after 8 treatment weeks from baseline (Final visit , visit 4). A total of 8 treatment weeks
Three arms were assessed:
Following Interim Analysis one active arm was dropped and the study continued with 2 arms, placebo and an active arm.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Vibrant Capsule mode A | Active Comparator | Vibrant Capsule mode A administered 5 times per week |
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| Vibrant Capsule mode B | Active Comparator | Vibrant Capsule mode B administered 5 times per week. Based on the analysis of the first pre-define phase of the study, active mode B was discontinued, and the trial was completed using mode A. Therefore, study results are not available for arm B. |
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| Placebo Capsule | Placebo Comparator | Placebo Capsule administered 5 times per week |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Vibrating capsule | Device | Vibrating Capsule administered 5 times per week |
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| Measure | Description | Time Frame |
|---|---|---|
| CSBM1 & CSBM2 Success Rate | CSBM1Success Rate: defined as the number of subjects with an increase from the run-in period of at least one weekly Complete Spontaneous Bowel Movement (CSBM) during at least 6 of the 8 weeks of treatment. CSBM2 success rate: defined as the number of subject with an increase from the run-in period of at least two weekly Complete Spontaneous Bowel Movement (CSBM) during at least 6 of the 8 weeks of treatment. The study will be deemed successful if either the CSBM1 or the CSBM2 success rate is statistically significantly higher in the active arm that was continued after the interim analysis (Vibrant Capsule Mode A), than in the placebo arm NOTE:
| 8 weeks of treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in Average Straining | Change from baseline in average straining using (0-10) scale where "0" is no straining and "10" is unbearable straining | 8 weeks of treatment |
| Change From Baseline in Average Stool Consistency |
| Measure | Description | Time Frame |
|---|---|---|
| Change in SBM | Change from baseline in weekly number of Spontaneous Bowel Movement (SBM) | 8 weeks of treatment |
| Change From Baseline in Quality of Life | Change from baseline in average PAC-QOL (=Patient Assessment of Constipation Quality of Life) score. The results below present the number of participants who completed PAC-QOL questionnaire and reported an improvement in quality of life from baseline. |
Inclusion Criteria:
Exclusion Criteria:
History of complicated/obstructive diverticular disease 2. History of intestinal or colonic obstruction, or suspected intestinal obstruction.
3. History of significant gastrointestinal disorder, including any form of inflammatory bowel disease or gastrointestinal malignancy (celiac disease is accepted if the subject has been treated and is in remission) 4. History of gastroparesis 5. Use of any of the following medications:
Medications that may affect intestinal motility, prokinetics, anti-Parkinsonian medications, opiates, opioids, calcium-channel blockers, aluminum/magnesium hydroxide
With the exception of antidepressants, thyroid or hormonal replacement therapy, when the subject has been on a stable dose for at least 3 months prior to enrollment.
6. Clinical evidence of significant respiratory, cardiovascular, renal, hepatic, biliary, endocrine, psychiatric or neurologic disease 7. Presence of cardiac pacemaker or gastric electrical stimulator. 8. History of, or current eating disorders, such as anorexia, bulimia, or compulsory overeating.
9. Diagnosis of mega-rectum or colon, congenital anorectal malformation, clinically significant rectocele, history of intestinal resection (with an exception for appendectomy, cholecystectomy and inguinal hernia repair), history of bariatric surgery or evidence of any structural abnormality of the gastrointestinal tract that might affect transit 10. History of Zenker's diverticulum, dysphagia, Barrett's esophagus, esophageal stricture or achalasia 11. Chronic use of non-steroidal anti-inflammatory drugs (NSAIDs): chronic use is defined as taking full dose NSAIDs more than three times a week for at least six months. Subjects on cardiac doses of aspirin may be enrolled in the study 12. Subjects with pelvic floor dysfunction/defecatory disorder, based on subject history 13. Participation in another clinical study within one month prior to screening.
14. Women who are pregnant or lactating 15. Use of any medication for constipation relief during the study, except as rescue medication, as indicated by study rules 16. Inability to use an electronic daily Diary (on a computer, phone application, tablet or other electronic device) to report bowel movements, symptoms and medication usage 17. Subject participated in a previous Vibrant study 18. Subjects planning to undergo MRI during the study 19. Any known allergy to soybean or beeswax or Calcium Carbonate 20. Any other condition which in the opinion of the investigator may adversely affect the safety of the subject or would limit the subject's ability to complete the study
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| Name | Affiliation | Role |
|---|---|---|
| Tal Malina, MBA | Vibrant Ltd. | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| G & L Research, LLC. | Foley | Alabama | 36535 | United States | ||
| Del Sol Research Management |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36822371 | Derived | Rao SSC, Quigley EMM, Chey WD, Sharma A, Lembo AJ. Randomized Placebo-Controlled Phase 3 Trial of Vibrating Capsule for Chronic Constipation. Gastroenterology. 2023 Jun;164(7):1202-1210.e6. doi: 10.1053/j.gastro.2023.02.013. Epub 2023 Feb 21. | |
| 32449277 | Derived | Rao SSC, Lembo A, Chey WD, Friedenberg K, Quigley EMM. Effects of the vibrating capsule on colonic circadian rhythm and bowel symptoms in chronic idiopathic constipation. Neurogastroenterol Motil. 2020 Nov;32(11):e13890. doi: 10.1111/nmo.13890. Epub 2020 May 25. |
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Following the consent process, subjects who met the study criteria started a run-in period of 2-4 weeks, during which they completed a daily eDiary with questions regrading their bowel movements and constipation symptoms.
The study was conducted at 95 centers in the USA. Recruitment began on 8 Apr 2019 and concluded on 16 July 2021.
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| ID | Title | Description |
|---|---|---|
| FG000 | Vibrant Capsule Mode A | Vibrant Capsule mode A administered 5 times per week Vibrating capsule: Vibrating Capsule administered 5 times per week |
| FG001 | Vibrant Capsule Mode B |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jan 24, 2019 |
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The study design initially comprised 3 arms: 2 active vibrating capsule arms (Modes A and B) and 1 placebo arm. Based on the analysis of the first pre-define phase of the study, active mode B was discontinued and the trial was completed using mode A. Therefore, study results are available only for active A and Placebo arms.
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This was a double blind, placebo controlled study and both the participant and the investigator were masked. The study investigators, sponsors and participants were all blinded throughout the study. A research pharmacist/investigator who was not involved with evaluating patients or conducting the study, provided training to the participants and dispensed the correct study arm allocation. This individual had no other role in the study.
Change from baseline in average stool consistency, using the Bristol Stool Scale (1-7) where 1 = Separate hard lumps, like nuts (hard to pass) and 7 =watery, no solid pieces, entirely liquid
| 8 weeks of treatment |
| Change From Baseline in Average Bloating | Change from baseline in average bloating using scale (0-10) for bloating where 0=No bloating and 10=Unbearable bloating | 8 weeks of treatment |
| 8 weeks of treatment |
| Tucson |
| Arizona |
| 85712 |
| United States |
| Augusta University | Augusta | Georgia | 30912 | United States |
| PharmQuest | Greensboro | North Carolina | 27408 | United States |
| Great Lakes Medical Research LLC | Beachwood | Ohio | 44122 | United States |
| Clinical Inquest Center Ltd | Huber Heights | Ohio | 45424 | United States |
| Great Lakes Gastroenterology Research | Mentor | Ohio | 44060 | United States |
| Clinical Neuroscience Solutions dba CNS Healthcare | Memphis | Tennessee | 38119 | United States |
Vibrant Capsule mode B administered 5 times per week
Vibrating capsule: Vibrating Capsule administered 5 times per week
| FG002 | Placebo Capsule | Placebo Capsule administered 5 times per week Vibrating capsule: Vibrating Capsule administered 5 times per week |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Vibrant Capsule Mode A | Vibrant Capsule mode A administered 5 times per week. |
| BG001 | Vibrant Capsule Mode B | Vibrant Capsule mode B administered 5 times per week. Based on the analysis of the first pre-define phase of the study Arm B was discontinued. |
| BG002 | Placebo Capsule | Placebo Capsule administered 5 times per week. |
| BG003 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race/Ethnicity, Customized | Count of Participants | Participants |
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| Duration of constipation (years) | History of Constipation: presents the history of constipation parameters for all the subjects enrolled (3 study arms). | Mean | Standard Deviation | years |
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| 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 | CSBM1 & CSBM2 Success Rate | CSBM1Success Rate: defined as the number of subjects with an increase from the run-in period of at least one weekly Complete Spontaneous Bowel Movement (CSBM) during at least 6 of the 8 weeks of treatment. CSBM2 success rate: defined as the number of subject with an increase from the run-in period of at least two weekly Complete Spontaneous Bowel Movement (CSBM) during at least 6 of the 8 weeks of treatment. The study will be deemed successful if either the CSBM1 or the CSBM2 success rate is statistically significantly higher in the active arm that was continued after the interim analysis (Vibrant Capsule Mode A), than in the placebo arm NOTE:
| A predefined first-phase analysis was included in the protocol and approved by the FDA. The objective of this first phase analysis was to identify which of the 2 activation modes was superior, and to recommend that mode for the remainder of the study. Based on the analysis of the study's first phase, mode B was discontinued, and the trial was completed using mode A. Hence, per the pre-specified outcomes definition, the results are available for mode A &Placebo arms without the dropped Arm B. | Posted | Count of Participants | Participants | 8 weeks of treatment |
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| Secondary | Change From Baseline in Average Straining | Change from baseline in average straining using (0-10) scale where "0" is no straining and "10" is unbearable straining | A predefined first-phase analysis was included in the protocol and approved by the FDA. The objective of this first phase analysis was to identify which of the 2 activation modes was superior, and to recommend that mode for the remainder of the study. Based on the analysis of the study's first phase, mode B was discontinued, and the trial was completed using mode A. Hence, per the pre-specified outcomes definition, the results are available for mode A &Placebo arms without the dropped Arm B. | Posted | Mean | 95% Confidence Interval | units on a scale | 8 weeks of treatment |
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| Secondary | Change From Baseline in Average Stool Consistency | Change from baseline in average stool consistency, using the Bristol Stool Scale (1-7) where 1 = Separate hard lumps, like nuts (hard to pass) and 7 =watery, no solid pieces, entirely liquid | A predefined first-phase analysis was included in the protocol and approved by the FDA. The objective of this first phase analysis was to identify which of the 2 activation modes was superior, and to recommend that mode for the remainder of the study. Based on the analysis of the study's first phase, mode B was discontinued, and the trial was completed using mode A. Hence, per the pre-specified outcomes definition, the results are available for mode A &Placebo arms without the dropped Arm B. | Posted | Mean | 95% Confidence Interval | units on a scale | 8 weeks of treatment |
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| Secondary | Change From Baseline in Average Bloating | Change from baseline in average bloating using scale (0-10) for bloating where 0=No bloating and 10=Unbearable bloating | A predefined first-phase analysis was included in the protocol and approved by the FDA. The objective of this first phase analysis was to identify which of the 2 activation modes was superior, and to recommend that mode for the remainder of the study. Based on the analysis of the study's first phase, mode B was discontinued, and the trial was completed using mode A. Hence, per the pre-specified outcomes definition, the results are available for mode A &Placebo arms without the dropped Arm B. | Posted | Mean | 95% Confidence Interval | units on a scale | 8 weeks of treatment |
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| Other Pre-specified | Change in SBM | Change from baseline in weekly number of Spontaneous Bowel Movement (SBM) | A predefined first-phase analysis was included in the protocol and approved by the FDA. The objective of this first phase analysis was to identify which of the 2 activation modes was superior, and to recommend that mode for the remainder of the study. Based on the analysis of the study's first phase, mode B was discontinued, and the trial was completed using mode A. Hence, per the pre-specified outcomes definition, the results are available for mode A &Placebo arms without the dropped Arm B. | Posted | Mean | 95% Confidence Interval | bowel movements/week | 8 weeks of treatment |
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| Other Pre-specified | Change From Baseline in Quality of Life | Change from baseline in average PAC-QOL (=Patient Assessment of Constipation Quality of Life) score. The results below present the number of participants who completed PAC-QOL questionnaire and reported an improvement in quality of life from baseline. | A predefined first-phase analysis was included in the protocol and approved by the FDA. The objective of this first phase analysis was to identify which of the 2 activation modes was superior, and to recommend that mode for the remainder of the study. Based on the analysis of the study's first phase, mode B was discontinued, and the trial was completed using mode A. Hence, per the pre-specified outcomes definition, the results are available for mode A &Placebo arms without the dropped Arm B. | Posted | Count of Participants | Participants | 8 weeks of treatment |
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The Safety reporting conducted throughout the treatment period (8 weeks)
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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 | Vibrant Capsule Mode A | Vibrant Capsule mode A administered 5 times per week | 0 | 163 | 0 | 163 | 43 | 163 |
| EG001 | Vibrant Capsule Mode B | Vibrating capsule mode B administered 5 times per week. Based on the predefined interim analysis, mode B was discontinued, and the trial was completed using mode A. Therefore, only safety data was available for the dropped Arm B. | 0 | 37 | 0 | 37 | 9 | 37 |
| EG002 | Placebo Capsule | Placebo Capsule administered 5 times per week | 0 | 149 | 2 | 149 | 26 | 149 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| significant abdominal pain | Gastrointestinal disorders | Non-systematic Assessment |
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| transient ischemic attack | Nervous system disorders | Non-systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Sensation of vibration | Product Issues | Non-systematic Assessment | Sensation of vibration was described as ''I think I felt vibration". Most patients did not find the sensation bothersome and none of the patients stopped the therapy due to this sensation. |
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| Headache | Nervous system disorders | Non-systematic Assessment |
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| Urinary tract infection | Renal and urinary disorders | Non-systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | Non-systematic Assessment |
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| Abdominal discomfort | Gastrointestinal disorders | Non-systematic Assessment |
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| Vomiting | Gastrointestinal disorders | Non-systematic Assessment |
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| Nausea | Gastrointestinal disorders | Non-systematic Assessment |
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| Abdominal distention | Gastrointestinal disorders | Non-systematic Assessment |
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| Anorectal problem | Gastrointestinal disorders | Non-systematic Assessment |
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| Diarrhea | Gastrointestinal disorders | Non-systematic Assessment |
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| Covid-19 | Infections and infestations | Non-systematic Assessment |
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| Nasopharyngitis/ Bronchitis | Respiratory, thoracic and mediastinal disorders | Non-systematic Assessment |
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| Musculoskeletal | Musculoskeletal and connective tissue disorders | Non-systematic Assessment |
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| Fatigue | General disorders | Systematic Assessment |
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Permission to use study data is required
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Tal Malina / Clinical trials manager | Vibrant LTD | +972 046663322 | tal.m@vibrantgastro.com |
| May 15, 2024 |
| Prot_SAP_000.pdf |
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| Male |
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| Hispanic or Latino |
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| Black or African American |
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| Asian/ Pacific Islander |
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| Other |
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| 0.0085 |
Responder Rate on Weekly CSBM2 in the ITT (Intention to Treat) analysis set. (For details, refer to the primary outcome description). |
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