Naloxegol and Opioid-induced Constipation

NCT03316859 — Phase 2 / Phase 3, Unknown, 280 participants, TriHealth Inc.

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A Prospective Randomized, Double-Blind Study to Evaluate the Addition of Naloxegol to the Pre-Op Regimen of the Cardiac Surgery Patient and Its Effect on Opioid-Induced Constipation

RegistryNCT03316859
StatusUnknown
PhasePhase 2 / Phase 3
Study typeInterventional; randomized, parallel, masking: double, treatment
Enrollment280 (Estimated)
SponsorTriHealth Inc. (Other)
ConditionsConstipation, Constipation Drug Induced
InterventionsNaloxegol 25 MG, Placebo pill (Drug, other)
Datesstart 2017-11-06, primary completion 2022-12-01 (estimated), completion 2022-12-01 (estimated), first posted 2017-10-20, last updated 2022-05-05
Locations1 site in United States

Related Papers Related Patents Related Grants Related Experts
All trials for Constipation All trials for Constipation Drug Induced All trials of Naloxegol 25 MG All trials of Placebo pill

-Summary

This is a double-blind, randomized, placebo-controlled trial to examine the effectiveness of adding one 25mg dose of naloxegol to the cardiac surgery pre-operative regimen.

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+Detailed description

This is a double-blind, randomized, placebo-controlled trial to examine the effectiveness of adding one 25mg dose of naloxegol to the cardiac surgery pre-op regimen. There will be 140 subjects per study group. The patient and treating physician/nurse will be blinded as to which group the subject is assigned. On the day of surgery, subjects in both groups will complete a questionnaire to assess compliance with prescribed pre-operative regimen. Subjects in both groups will receive post-operative bowel regimen in the cardiovascular intensive care unit (CVICU) according to current standard of care, including procedures for rescue medications for constipation prevention and induction of a bowel movement.

+Arms and interventions

ArmTypeInterventionsDescription
NaloxegolExperimentalDrug: Naloxegol 25 MGnaloxegol 25 mg pill
PlaceboPlacebo comparatorOther: Placebo pillplacebo pill
  • Naloxegol 25 MG (Drug), also known as Movantik: Naloxegol 25 mg administered 1 hour pre-operatively
  • Placebo pill (Other): Placebo pill administered 1 hour pre-operatively

+Outcome measures

Primary outcomes

  • Time to substantial bowel movement [Post-operative day 1]: Time to bowel movement of Type 2 or higher on the Bristol stool chart
  • Time to substantial bowel movement [Post-operative day 2]: Time to bowel movement of Type 2 or higher on the Bristol stool chart
  • Time to substantial bowel movement [Post-operative day 3]: Time to bowel movement of Type 2 or higher on the Bristol stool chart
  • Time to substantial bowel movement [Post-operative day 4]: Time to bowel movement of Type 2 or higher on the Bristol stool chart
  • Time to substantial bowel movement [Post-operative day 5]: Time to bowel movement of Type 2 or higher on the Bristol stool chart

Secondary outcomes

  • Rescue medications [Post-operative day 1]: Amount of rescue medications
  • Rescue medications [Post-operative day 2]: Amount of rescue medications
  • Rescue medications [Post-operative day 3]: Amount of rescue medications
  • Rescue medications [Post-operative day 4]: Amount of rescue medications
  • Rescue medications [Post-operative day 5]: Amount of rescue medications

Other outcomes

  • Length of stay [Post-operative day 1]: CVICU length of stay
  • Length of stay [Post-operative day 2]: CVICU length of stay
  • Length of stay [Post-operative day 3]: CVICU length of stay
  • Length of stay [Post-operative day 4]: CVICU length of stay
  • Length of stay [Post-operative day 5]: CVICU length of stay

+Eligibility

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Scheduled to undergo elective cardiac surgery at Bethesda North TriHealth Hospital
* Admitted to Bethesda North TriHealth Hospital CVICU post-surgery

Exclusion Criteria:

* Medically unstable
* Cognitive deficits that impair the patient's ability to understand the informed consent
* Language barriers
* Patient has a documented diagnosis of one of the following: Crohn's disease; Ulcerative Colitis; History of bowel surgery that will impact absorption of study drug (as deemed by physician); History of small bowel obstruction
* Chronic constipation requiring subject to take one of the following medications on a daily basis prior to time of consent: Linzess, Trulance, Amitza, Senna/Senokot, Colace, Dulcolax, Miralax, Metamucil
* Patients on following medications prior to time of consent: Diltiazem, Verapamil, Amiodarone, Ketoconazole, Clarithromycin/ erythromycin, Antivirals
* Conditions that present an increased risk of bowel perforation (as determined by the physician)
* Pre-existing diagnosis of opioid-induced constipation AND receiving naloxegol as a treatment by their physician

+Locations (1)

FacilityCityCountryStatus
Bethesda North TriHealth HospitalCincinnati, OhioUnited StatesRecruiting

+Publications

  • Chey WD, Webster L, Sostek M, Lappalainen J, Barker PN, Tack J. Naloxegol for opioid-induced constipation in patients with noncancer pain. N Engl J Med. 2014 Jun 19;370(25):2387-96. doi: 10.1056/NEJMoa1310246. Epub 2014 Jun 4. PMID 24896818
  • DePriest AZ, Miller K. Oxycodone/Naloxone: role in chronic pain management, opioid-induced constipation, and abuse deterrence. Pain Ther. 2014 Jun;3(1):1-15. doi: 10.1007/s40122-014-0026-2. Epub 2014 May 6. PMID 25135384
  • Nelson AD, Camilleri M. Chronic opioid induced constipation in patients with nonmalignant pain: challenges and opportunities. Ther Adv Gastroenterol. 2015 Jul;8(4):206-20. doi: 10.1177/1756283X15578608. PMID 26136838

+Investigators