A Phase 4 interventional study of placebo and prucalopride in Constipation, sponsored by Shire. Completed at 60 sites in 9 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-06-11.
Sponsored by Shire · Phase 4, Interventional, and Treatment
The purpose of this trial is to evaluate the long-term (24 weeks) efficacy of prucalopride versus placebo in subjects aged 18 years and older with chronic constipation.
In this phase IV trial a total of 340 subjects (170 subjects per treatment group), with chronic constipation, are planned to be randomly assigned to double-blind treatment.
The trial duration for a subject can be 26 to 28 weeks in total, including a 2- to 4-week run-in phase followed by a 24-week double-blind treatment phase. The patient will complete an e-diary.
Adult subjects (≥18 to \<65 years of age) will take 2 mg prucalopride or matching placebo throughout the entire 24-week treatment period. Elderly subjects (≥65 years of age) will start at a dose of 1 mg prucalopride or matching placebo. In case of insufficient response the daily dose has to be increased to 2 mg (i.e. changed to 2 mg prucalopride or matching placebo).
1,018 studies on the registry are indexed under Constipation; 139 are open to participants now.
This study's enrollment of 364 is above the median of 80 across 850 interventional studies indexed under Constipation.
Browse Constipation studies →Shire is the lead sponsor of 346 studies on the registry; 2 are open to participants now.
Of its 47 completed or terminated interventional studies of FDA-regulated products, 47 (100%) have results posted.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Placebo 2 mg tablet once daily before breakfast
Drug: placebo
Prucalopride 2 mg once daily before breakfast
Drug: prucalopride
Placebo matching tablet 2 mg once daily before breakfast for 24 weeks
Prucalopride 2 mg daily before breakfast 1 mg for subjects \>65 years; in case of insufficient response 2 mg at week 2 or week 4
The Percentage of Subjects With an Average of ≥3 Spontaneous Complete Bowel Movements (SCBM) Per Week Over the 24 Week Treatment Period
Spontaneous Bowel Movements defined as a bowel movement that is not preceded within a period of 24 hours by the intake of a laxative agent or by the use of an enema.
Time frame: Over 24 week treatment period
Percentage of Subjects With an Increase of ≥1 Spontaneous Complete Bowel Movement (SCBM) Per Week Up to 24 Weeks
Time frame: Over 24 week treatment period
Average Number of Spontaneous Complete Bowel Movements (SCBM) Per Week Up to 24 Weeks
Time frame: Over 24 week treatment period
Change From Baseline in Spontaneous Complete Bowel Movements Per Week at Up to 24 Weeks
Time frame: Baseline and Over 24 week treatment period
Percent of Subjects With an Average Weekly Frequency of at Least 3 SCBM by Week
Time frame: Over 24 week treatment period
Percent of Subjects With an Average Weekly Frequency of at Least 3 SCBM by 4-Week Treatment Period
Time frame: Over 24 week treatment period
Change From Baseline in Average Consistency Per SCBM at Up to 24 Weeks
Consistency measured using the 7-point Bristol scale where 1-2 indicate constipation (=hard/very hard), 3-4 are ideal stools (=normal), and 5-7 tending toward diarrhea.
Time frame: Baseline and Over 24 week treatment period
Change From Baseline in Percent SCBM With a Consistency of Normal and Hard/Very Hard at Up to 24 Weeks
Time frame: Baseline and Over 24 week treatment period
Change From Baseline in Straining Per SCBM at Up to 24 Weeks
Straining was evaluated on a 5-point scale (0=none, 1=mild, 2=moderate, 3=severe, or 4=very severe)
Time frame: Baseline and Over 24 week treatment period
Change From Baseline in Percent SCBM With No Straining and Severe/Very Severe Straining at Up to 24 Weeks
Time frame: Baseline and Over 24 week treatment period
Change From Baseline in Percent SBM With Sensation of Complete Evacuation at Up to 24 Weeks
Time frame: Baseline and Over 24 week treatment period
Time to First SCBM After Investigational Product Intake on Day 1 and Day 28
Time frame: Day 1 and 28
Change From Baseline in the Number of Bisacodyl Tablets Taken Per Week at Up to 24 Weeks
Time frame: Baseline and Over 24 week treatment period
Change From Baseline in the Number of Days With Rescue Medication Taken Per Week at Up to 24 Weeks
Rescue medications include laxatives and enemas.
Time frame: Baseline and Over 24 week treatment period
Change From Baseline in the Patient Assessment of Constipation - Symptom (PAC-SYM) Questionnaire Score at Up to the Final On Treatment Assessment Value
The PAC-SYM is a validated 12-item questionnaire for the evaluation of severity of symptoms of constipation in subjects with constipation. Items are rated on a 5-point Likert scale: 0=absent, 1=mild, 2=moderate, 3=severe, 4=very severe. Total score ranges from 0 to 48. Lower scores indicate improvement in symptoms. A 1-point improvement in PAC-SYM total score was considered clinically meaningful.
Time frame: Baseline and Over 24 week treatment period
Change From Baseline in the Patient Assessment of Constipation - Quality of Life (PAC-QOL) Score at Up to the Final On Treatment Assessment Value
The PAC-QOL is a validated 28-item questionnaire for the evaluation of quality of life in subjects with constipation. Items are rated on a 5-point Likert scale: 0=not at all/none of the time, 1=a little bit/a little bit of the time, 2=moderately/some of the time, 3=quite a bit/most of the time, 4=extremely/all of the time. Total score ranges from 0-112. Lower scores indicate improvement in symptoms. A 1-point improvement in PAC-QOL total score was considered clinically meaningful.
Time frame: Baseline and Over 24 week treatment period
Change From Baseline in the Short Form-36 Health Survey (SF-36) Score at Up to the Final On Treatment Assessment Value
The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Total score ranges from 0 (lowest level of health) - 100 (highest level of health) on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability (i.e. a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability). Higher scores are associated with better quality of life.
Time frame: Baseline and Over 24 week treatment period
| Milestone | Placebo | Prucalopride |
|---|---|---|
| Started | 182 | 182 |
| Completed | 126 | 135 |
| Not completed | 56 | 47 |
| Withdrew: Withdrawal by subject | 27 | 11 |
| Withdrew: Adverse event | 10 | 14 |
| Withdrew: Sponsor's decision | 9 | 12 |
| Withdrew: Lack of efficacy | 5 | 7 |
| Withdrew: Inclusion/exclusion criteria not met | 2 | 2 |
| Withdrew: Non-compliance | 2 | 0 |
| Withdrew: Worsening of symptoms | 1 | 0 |
| Withdrew: Unplanned journey | 0 | 1 |
Spontaneous Bowel Movements defined as a bowel movement that is not preceded within a period of 24 hours by the intake of a laxative agent or by the use of an enema.
| percentage of subjects | Placebo | Prucalopride |
|---|---|---|
| The Percentage of Subjects With an Average of ≥3 Spontaneous Complete Bowel Movements (SCBM) Per Week Over the 24 Week Treatment Period | 20.7 | 25.1 |
| percentage of subjects | Placebo | Prucalopride |
|---|---|---|
| Percentage of Subjects With an Increase of ≥1 Spontaneous Complete Bowel Movement (SCBM) Per Week Up to 24 Weeks | 42.0 | 48.0 |
| SCBM/week | Placebo | Prucalopride |
|---|---|---|
| Average Number of Spontaneous Complete Bowel Movements (SCBM) Per Week Up to 24 Weeks | 1.7 ± 1.86 | 2.1 ± 1.96 |
| SCBM/week | Placebo | Prucalopride |
|---|---|---|
| Change From Baseline in Spontaneous Complete Bowel Movements Per Week at Up to 24 Weeks | 1.3 ± 1.77 | 1.7 ± 1.90 |
| percentage of subjects | Placebo | Prucalopride |
|---|---|---|
| Week 1 | 18.3 | 32.2 |
| Week 2 | 23.1 | 34.5 |
| Week 3 | 22.5 | 32.2 |
| Week 4 | 23.1 | 31.6 |
| Week 5 | 26.6 | 27.5 |
| Week 6 | 28.4 | 29.2 |
| Week 7 | 29.0 | 29.8 |
| Week 8 | 26.0 | 30.4 |
| Week 9 | 27.8 | 33.3 |
| Week 10 | 26.0 | 30.4 |
| Week 11 | 25.4 | 37.4 |
| Week 12 | 27.2 | 33.9 |
| Week 13 | 23.7 | 30.4 |
| Week 14 | 30.2 | 35.7 |
| Week 15 | 24.9 | 29.2 |
| Week 16 | 29.6 | 35.1 |
| Week 17 | 28.4 | 35.1 |
| Week 18 | 30.2 | 32.7 |
| Week 19 | 32.0 | 32.2 |
| Week 20 | 24.9 | 37.4 |
| Week 21 | 26.6 | 30.4 |
| Week 22 | 27.8 | 32.7 |
| Week 23 | 30.2 | 31.0 |
| Week 24 | 32.0 | 31.6 |
| percentage of subjects | Placebo | Prucalopride |
|---|---|---|
| First 4-week period | 18.3 | 26.9 |
| Second 4-week period | 23.7 | 25.7 |
| Third 4-week period | 23.7 | 29.2 |
| Fourth 4-week period | 22.5 | 29.2 |
| Fifth 4-week period | 23.7 | 33.3 |
| Sixth 4-week period | 24.9 | 26.9 |
Consistency measured using the 7-point Bristol scale where 1-2 indicate constipation (=hard/very hard), 3-4 are ideal stools (=normal), and 5-7 tending toward diarrhea.
| units on a scale | Placebo | Prucalopride |
|---|---|---|
| Change From Baseline in Average Consistency Per SCBM at Up to 24 Weeks | -0.1 ± 1.79 | -0.1 ± 1.31 |
| percentage of SCBM | Placebo | Prucalopride |
|---|---|---|
| Normal consistency | 16.82 ± 42.365 | 25.71 ± 40.1 |
| Hard/Very Hard consistency | -9.11 ± 41.495 | -13.82 ± 31.349 |
Straining was evaluated on a 5-point scale (0=none, 1=mild, 2=moderate, 3=severe, or 4=very severe)
| units on a scale | Placebo | Prucalopride |
|---|---|---|
| Change From Baseline in Straining Per SCBM at Up to 24 Weeks | -0.44 ± 0.948 | -0.23 ± 0.870 |
| percentage of SCBM | Placebo | Prucalopride |
|---|---|---|
| No straining | 11.14 ± 39.786 | 6.61 ± 33.916 |
| Severe/Very Severe straining | -9.85 ± 29.711 | -4.49 ± 28.177 |
| percentage of SBM | Placebo | Prucalopride |
|---|---|---|
| Change From Baseline in Percent SBM With Sensation of Complete Evacuation at Up to 24 Weeks | 20.94 ± 32.619 | 24.22 ± 32.878 |
| hours | Placebo | Prucalopride |
|---|---|---|
| Day 1 | 359.67 (179.6 to 461.42) | 100.83 (74.0 to 170.75) |
| Day 28 | 100.58 (75.2 to 199.02) | 81.78 (52.25 to 151.05) |
| tablets/week | Placebo | Prucalopride |
|---|---|---|
| Change From Baseline in the Number of Bisacodyl Tablets Taken Per Week at Up to 24 Weeks | -0.68 ± 1.583 | -0.97 ± 1.821 |
Rescue medications include laxatives and enemas.
| days/week | Placebo | Prucalopride |
|---|---|---|
| Change From Baseline in the Number of Days With Rescue Medication Taken Per Week at Up to 24 Weeks | -0.42 ± 0.892 | -0.54 ± 1.018 |
The PAC-SYM is a validated 12-item questionnaire for the evaluation of severity of symptoms of constipation in subjects with constipation. Items are rated on a 5-point Likert scale: 0=absent, 1=mild, 2=moderate, 3=severe, 4=very severe. Total score ranges from 0 to 48. Lower scores indicate improvement in symptoms. A 1-point improvement in PAC-SYM total score was considered clinically meaningful.
| units on a scale | Placebo | Prucalopride |
|---|---|---|
| Change From Baseline in the Patient Assessment of Constipation - Symptom (PAC-SYM) Questionnaire Score at Up to the Final On Treatment Assessment Value | -0.68 ± 0.929 | -0.55 ± 0.794 |
The PAC-QOL is a validated 28-item questionnaire for the evaluation of quality of life in subjects with constipation. Items are rated on a 5-point Likert scale: 0=not at all/none of the time, 1=a little bit/a little bit of the time, 2=moderately/some of the time, 3=quite a bit/most of the time, 4=extremely/all of the time. Total score ranges from 0-112. Lower scores indicate improvement in symptoms. A 1-point improvement in PAC-QOL total score was considered clinically meaningful.
| units on a scale | Placebo | Prucalopride |
|---|---|---|
| Change From Baseline in the Patient Assessment of Constipation - Quality of Life (PAC-QOL) Score at Up to the Final On Treatment Assessment Value | -0.73 ± 0.902 | -0.67 ± 0.932 |
The SF-36 consists of eight scaled scores, which are the weighted sums of the questions in their section. Total score ranges from 0 (lowest level of health) - 100 (highest level of health) on the assumption that each question carries equal weight. The lower the score the more disability. The higher the score the less disability (i.e. a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability). Higher scores are associated with better quality of life.
| units on a scale | Placebo | Prucalopride |
|---|---|---|
| Mental component | 3.786 ± 10.0887 | 3.179 ± 10.5714 |
| Physical component | 3.331 ± 6.9830 | 2.965 ± 6.9320 |
Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Placebo | — | 4/180 (2.2%) | 23/180 (12.8%) |
| Prucalopride | — | 4/181 (2.2%) | 41/181 (22.7%) |
| Event | Placebo | Prucalopride |
|---|---|---|
| Colitis ischemicGastrointestinal disorders | 1/180 | 0/181 |
| Cholecystitis chronicHepatobiliary disorders | 1/180 | 0/181 |
| Vestibular neuronitisInfections and infestations | 1/180 | 0/181 |
| Ischemic strokeNervous system disorders | 1/180 | 0/181 |
| Orthostatic hypotensionVascular disorders | 1/180 | 0/181 |
| Obstruction gastricGastrointestinal disorders | 0/180 | 1/181 |
| Blood pressure decreasedInvestigations | 0/180 | 1/181 |
| Electrocardiogram QT prolongedInvestigations | 0/180 | 1/181 |
| Cerebrovascular accidentNervous system disorders | 0/180 | 1/181 |
| Abnormal behaviorPsychiatric disorders | 0/180 | 1/181 |
| Event | Placebo | Prucalopride |
|---|---|---|
| HeadacheNervous system disorders | 10/180 | 21/181 |
| Abdominal painGastrointestinal disorders | 8/180 | 18/181 |
| NauseaGastrointestinal disorders | 7/180 | 13/181 |
The Safety Population was used for demographics. The Safety Population includes all subjects randomized into the study who took at least 1 dose of investigational product. Three subjects did not receive investigational product and therefore were not included in the Safety Population (n = 361).
| Age, Continuous(years) | Placebo | Prucalopride | Total |
|---|---|---|---|
| Mean | 48.3 ± 16.25 | 49.4 ± 15.78 | 48.9 ± 16.00 |
| Age, Customized(Participants) | Placebo | Prucalopride | Total |
|---|---|---|---|
| <65 years | 149 | 146 | 295 |
| > = 65 years to <75 years | 20 | 26 | 46 |
| >=75 years | 11 | 9 | 20 |
| Sex: Female, Male(Participants) | Placebo | Prucalopride | Total |
|---|---|---|---|
| Female | 153 | 155 | 308 |
| Male | 27 | 26 | 53 |
| Region of Enrollment(Participants) | Placebo | Prucalopride | Total |
|---|---|---|---|
| Romania | 38 | 37 | 75 |
| Poland | 34 | 31 | 65 |
| Hungary | 29 | 31 | 60 |
| Slovakia | 28 | 29 | 57 |
| Italy | 19 | 18 | 37 |
| Spain | 11 | 8 | 19 |
| Belgium | 8 | 11 | 19 |
| Sweden | 9 | 9 | 18 |
| Czech Republic | 6 | 8 | 14 |
This study is completed, as verified in May 2021. You cannot join it, but the record below documents what was studied.
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