Buspirone for Early Satiety and Symptoms of Gastroparesis (BESST)
Buspirone for Early Satiety and Symptoms of Gastroparesis: A Multicenter, Randomized, Placebo-Controlled, Double-Masked Trial (BESST)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Kentucky
-
Louisville, Kentucky, United States, 40202
- University of Louisville
-
-
Maryland
-
Baltimore, Maryland, United States, 21287
- Johns Hopkins Hospital
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02114
- Massachusetts General Hospital
-
-
North Carolina
-
Winston-Salem, North Carolina, United States, 27157
- Wake Forest University Health Sciences
-
-
Pennsylvania
-
Philadelphia, Pennsylvania, United States, 19140
- Temple University
-
-
Texas
-
El Paso, Texas, United States, 79905
- Texas Tech University Health Science Center
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age 18 to 85 years of age at initial screening interview
- Symptoms compatible with gastroparesis or other functional gastric disorder for at least 3 months (does not have to be contiguous) prior to initial screening interview
- Diagnosis of either diabetic or idiopathic gastroparesis
- Delayed or normal gastric emptying retention on screening 4-hour Gastric Emptying Scintigraphy test
- Symptoms of gastroparesis measured by the 9-item PAGI-SYM Gastroparesis Cardinal Symptom Index (GCSI) total score > 2.0 at enrollment
- Symptomatic with postprandial fullness/early satiety severity at enrollment using the PAGI-SYM GCSI post-prandial fullness/early satiety subscore ≥ 3
- Upper endoscopy or upper GI series without ulcers or mass lesions in the 2 years prior to enrollment
Exclusion Criteria:
- Post-surgical gastroparesis, including prior pyloromyotomy, pyloric resection, vagotomy, bariatric surgery or post-Nissen fundoplication
- Another active disorder which could explain symptoms in the opinion of the investigator
- Concurrent use of opiate narcotic analgesics more than 3 days per week
- Significant hepatic injury as defined by alanine aminotransferase (ALT) elevation of greater than twice the Upper Limit of Normal (ULN) or a Child-Pugh score of 10 or greater
- Significant renal impairment as defined by serum creatinine > 3.0
- Uncontrolled diabetes defined as HbA1c (%) of 10% or more within 60 days of enrollment
- Allergy to buspirone
- Concurrent or prior use (within 30 days) of monoamine oxidase (MAO) inhibitors
- Concurrent or prior use (within 30 days) of benzodiazepines
- Concurrent or prior use (within 30 days) of buspirone, warfarin, haloperidol, and drugs to treat seizures (e.g., phenytoin and carbamazepine)
- Women breast feeding or known to be pregnant
- Any other condition, which in the opinion of the investigator would impede compliance or hinder completion of the study
- Failure to give informed consent
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Buspirone
Buspirone HCl 10 mg capsule orally three times daily, 30 minutes before each meal, for 4-weeks
|
Buspirone tablet
Other Names:
|
|
Placebo Comparator: Placebo
Placebo capsule orally three times daily, 30 minutes before each meal, for 4-weeks; manufactured to look identical to buspirone capsule
|
"Sugar" pill manufactured to mimic buspirone 10 mg tablet
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
4-Week Change in the Postprandial Fullness and Early Satiety Symptoms Severity
Time Frame: baseline and 4-weeks
|
The outcome is assessed using the self-reported early satiety/postprandial fullness subscore (ES/PPF), which is computed as the average of 4 scores for 4-items on the Gastroparesis Cardinal Symptom Index (GCSI) survey: stomach fullness, inability to finish a normal-sized meal, feeling excessively full after meals, and loss of appetite.
Each item is scored from 0 (no) to 5 (very severe) symptoms in the past 2-weeks; the subscore ranges from 0 to 5. The change is computed as the subscore at 4-weeks minus the baseline subscore.
|
baseline and 4-weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
4-Week Change in Gastroesophageal (GERD) Symptoms Severity
Time Frame: baseline and 4-weeks
|
The outcome is assessed using the self-reported GERD subscore, which is computed as the average of 7 scores for 7-items on the Patient Assessment of Gastrointestinal Disorders Symptom Severity Index (PAGI-SYM) survey: heartburn during the day, heartburn when lying down, feeling of discomfort inside chest during the day, feeling of discomfort inside chest during sleep, regurgitation or reflux during the day, regurgitation when lying down, bitter, acid or sour taste in mouth.
Each item is scored from 0 (no) to 5 (very severe) symptoms in the past 2-weeks; the subscore ranges from 0 to 5. The change is computed as the subscore at 4-weeks minus the baseline subscore.
|
baseline and 4-weeks
|
|
4-Week Change in Stomach Fullness Symptom Severity
Time Frame: baseline and 4-weeks
|
The outcome is assessed using self-reported assessment of stomach fullness severity in the prior 2-weeks using the Gastroparesis Cardinal Symptoms Index (GCSI) survey.
The item is scored from 0 (no) to 5 (very severe) symptoms; the change is computed as the score at 4-weeks minus the baseline score.
|
baseline and 4-weeks
|
|
4-Week Change in Excessive Fullness Symptom Severity
Time Frame: baseline and 4-weeks
|
The outcome is assessed using self-reported assessment of feeling excessively full after meals severity in the prior 2-weeks using the Gastroparesis Cardinal Symptom Index (GCSI) survey.
The item is scored from 0 (no) to 5 (very severe) symptoms; the change is computed as the score at 4-weeks minus the baseline score.
|
baseline and 4-weeks
|
|
4-Week Change in Inability to Finish a Normal-sized Meal Symptom Severity
Time Frame: baseline and 4-weeks
|
The outcome is assessed using self-reported assessment of inability to finish a normal-sized meal severity in the prior 2-weeks using the Gastroparesis Cardinal Symptom Index (GCSI) survey.
The item is scored from 0 (no) to 5 (very severe) symptoms; the change is computed as the score at 4-weeks minus the baseline score.
A negative change indicates symptom improvement.
|
baseline and 4-weeks
|
|
4-Week Change in Loss of Appetite Symptom Severity
Time Frame: baseline and 4-weeks
|
The outcome is assessed using self-reported assessment of loss of appetite severity in the prior 2-weeks using the Gastroparesis Cardinal Symptom Index (GCSI) survey.
The item is scored from 0 (no) to 5 (very severe) symptoms; the change is computed as the score at 4-weeks minus the baseline score.
A negative change indicates symptom improvement.
|
baseline and 4-weeks
|
|
4-Week Change in Total Overall GCSI Symptom Severity
Time Frame: baseline and 4-weeks
|
The outcome is assessed using the self-reported Gastroparesis Cardinal Symptom Index (GCSI) total score, which is computed as the average of the 3 subscores on the GCSI survey: 3-item early satiety/postprandial fullness subscore, the nausea/vomiting subscore (average of 3-items: nausea, retching, vomiting), and bloating subscore (average of 2-items: bloating, stomach visibly larger).
Each item is scored from 0 (no) to 5 (very severe) symptoms in the past 2-weeks; the total score ranges from 0 to 5. The change is computed as the total score at 4-weeks minus the baseline total score.
A negative change indicates improved symptoms.
|
baseline and 4-weeks
|
|
4-Week Change in Nausea, Vomiting and Retching Symptoms Severity
Time Frame: baseline and 4-weeks
|
The outcome is assessed using the self-reported nausea/vomiting subscore, which is computed as the average of 3 scores for 3-items on the Gastrointestinal Cardinal Symptom Index (GCSI) survey: nausea, retching, vomiting.
Each item is scored from 0 (no) to 5 (very severe) symptoms in the past 2-weeks.
The change is computed as the subscore at 4-weeks minus the baseline subscore.
Negative change indicates improvement in symptoms.
|
baseline and 4-weeks
|
|
4-Week Change in Nausea Symptom Severity
Time Frame: baseline and 4-weeks
|
The outcome is assessed using self-reported assessment of nausea severity item from the Patient Assessment of Upper Gastrointestinal Disorders Symptom Severity Index (PAGI-SYM) in the prior 2-weeks using the Gastroparesis Cardinal Symptom Index (GCSI) survey.
The item is scored from 0 (no) to 5 (very severe) symptoms; the change is computed as the score at 4-weeks minus the baseline score.
|
baseline and 4-weeks
|
|
4-Week Change in Vomiting Symptom Severity
Time Frame: baseline and 4-weeks
|
The outcome is assessed using self-reported assessment of vomiting severity in the prior 2-weeks using the Gastroparesis Cardinal Symptom Index (GCSI) survey.
The item is scored from 0 (no) to 5 (very severe) symptoms; the change is computed as the score at 4-weeks minus the baseline score.
A negative change indicates improvement in vomiting severity.
|
baseline and 4-weeks
|
|
4-Week Change in Bloating and Stomach Distention Symptoms Severity
Time Frame: baseline and 4-weeks
|
The outcome is assessed using the self-reported bloating subscore, which is computed as the average of 2 scores for 2-items on the Gastroparesis Cardinal Symptom Index (GCSI) survey: bloating, stomach visibly larger.
Each item is scored from 0 (no) to 5 (very severe) symptoms in the past 2-weeks; the subscore ranges from 0 to 5. The change is computed as the subscore at 4-weeks minus the baseline subscore.
A negative value for change indicates improvement in symptoms.
|
baseline and 4-weeks
|
|
4-Week Change in Bloating Symptom Severity
Time Frame: baseline and 4-weeks
|
The outcome is assessed using self-reported assessment of bloating severity in the prior 2-weeks using the Gastroparesis Cardinal Symptom Index (GCSI) survey.
The item is scored from 0 (no) to 5 (very severe) symptoms; the change is computed as the score at 4-weeks minus the baseline score.
A negative change indicates symptom improvement.
|
baseline and 4-weeks
|
|
4-Week Change in Upper Abdominal Pain and Discomfort Symptoms Severity
Time Frame: baseline and 4-weeks
|
The outcome is assessed using the self-reported upper abdominal pain subscore, which is computed as the average of 2 scores for 2-items on the Patient Assessment of Upper Gastrointestinal Disorders-Symptom Severity Index (PAGI-SYM) survey: upper abdominal pain, upper abdominal discomfort.
Each item is scored from 0 (no) to 5 (very severe) symptoms in the past 2-weeks; the subscore ranges from 0 to 5. The change is computed as the subscore at 4-weeks minus the baseline subscore.
|
baseline and 4-weeks
|
|
4-Week Change in Upper Abdominal Pain Symptom Severity
Time Frame: baseline and 4-weeks
|
The outcome is assessed using self-reported assessment of upper abdominal pain severity in the prior 2-weeks using the Patient Assessment of Upper Gastrointestinal Disorders Symptom Severity Index (PAGI-SYM) survey.
The item is scored from 0 (no) to 5 (very severe) symptoms; the change is computed as the score at 4-weeks minus the baseline score.
A negative change indicates symptom improvement.
|
baseline and 4-weeks
|
|
4-Week Change in Gastrointestinal Symptoms Rating Scale (GSRS) Global Score
Time Frame: baseline and 4-weeks
|
The outcome is assessed using the self-reported GSRS total score which is computed as the mean of the 15 item scores on the Gastrointestinal Symptom Rating Scale (GSRS) survey.
Each item is scored from 1 (no discomfort) to 7 (very severe discomfort) of the symptom in the past week.
The change is computed as the score at 4-weeks minus the baseline score.
A negative change indicates symptom improvement.
|
baseline and 4-weeks
|
|
4-Week Change in Participant's Rating of Symptom Relief
Time Frame: baseline and 4-weeks
|
The outcome is assessed using the participant-rated Clinical Patient Grading Assessment Scale (CPGAS) score which is scored from -3 (very considerably worse) to 3 (completely better) in the past week compared to the way the participant usually feels.
The change is computed as the score at 4-weeks minus the baseline score.
A positive change indicates patient feeling better.
|
baseline and 4-weeks
|
|
4-Week Change in Severity of Somatic Symptoms
Time Frame: baseline and 4-weeks
|
The outcome is assessed using the self-reported Patient Health Questionnaire 15 Somatic Symptom Severity Scale (PHQ-15) total somatization score (ranges from 0 -30, with 30 being most bothered by symptoms in prior 4-weeks), calculated as the sum of 15-items, each scored from 0 (not bothered at all) to 2 (bothered a lot) by somatic symptoms in the prior 4-weeks.
The change is computed as the score at 4-weeks minus the baseline score.
A negative change indicates being less bothered by the symptoms.
|
baseline and 4-weeks
|
|
4-Week Change in Depression
Time Frame: baseline and 4-weeks
|
The outcome is assessed using the self-reported Hospital Anxiety and Depression Scale (HADS) depression subscore, calculated as the sum of 7 items, each scored from 0 (not at all) to 3 (most of the time).
The change is computed as the subscore at 4-weeks minus the baseline subscore.
A negative change indicates reduced depression.
|
baseline and 4-weeks
|
|
4-Week Change in Anxiety
Time Frame: baseline and 4-weeks
|
The outcome is assessed using the self-reported Hospital Anxiety and Depression Scale (HADS) anxiety subscore, calculated as the sum of 7-items, each scored from 0 (not at all) to 3 (most of the time).
The change is computed as the subscore at 4-weeks minus the baseline subscore.
A negative change indicates reduced anxiety at 4-weeks.
|
baseline and 4-weeks
|
|
4-Week Change Overall Quality of Health Due to Gastroparesis Issues
Time Frame: baseline and 4-weeks
|
The outcome is assessed using the self-reported Patient Assessment of Upper Gastrointestinal Disorders-Quality of Life (PAGI-QOL) total score which comprises 30 items scored from 0 (none of the time) to 5 (all of the time) the participant's QOL has been affected by their gastrointestinal issues in the prior two weeks.
The total score is the mean of the 5 subscale scores and ranges from 0 (lowest QOL) to 5 (highest QOL) in past 2-weeks.
The change is computed as the score at 4-weeks minus the baseline score.
A positive change indicates improved QOL.
|
baseline and 4-weeks
|
|
4-Week Change in Overall Mental Quality of Life (QOL)
Time Frame: baseline and 4-weeks
|
The outcome is assessed using the self-reported 36-item Short Form Health Survey (SF-36v2) mental health QOL component score.
The score ranges from 0 (poorest) to 100 (highest) QOL.
The change is computed as the score at 4-weeks minus the baseline score.
A positive change indicates improved mental QOL.
|
baseline and 4-weeks
|
|
4-Week Change in Overall Physical Quality of Life (QOL)
Time Frame: baseline and 4-weeks
|
The outcome is assessed using the self-reported 36-item Short Form Health Survey (SF-36v2) physical health QOL component score.
The score ranges from 0 (poorest) to 100 (highest) QOL.
The change is computed as the score at 4-weeks minus the baseline score.
A positive change indicates improved Physical QOL.
|
baseline and 4-weeks
|
|
4-Week Change in Gastric Retention
Time Frame: baseline and 4-weeks
|
The outcome is assessed using the percent of gastric retention at 4-hours from the Gastric Emptying Scintigraphy (GES) test.
The change is computed as the percent retention at 4-weeks minus the baseline percent retention.
% retention is the amount of food remaining in the stomach at 4-hours of the GES test and ranges from 0% (no food) to 100% (all of the food).
|
baseline and 4-weeks
|
|
Change at 4-weeks in the Intragastric Meal Distribution (IMD)
Time Frame: baseline and 4-weeks
|
The Intragastric meal distribution (IMD) is assessed at baseline and 4-weeks during the Gastric Emptying Scintigraphy Test.
The ratio of gastric counts of the meal in the proximal stomach to the distal stomach is used to compute the Intragastric meal distribution (IMD) which can be used as an indirect measure of Fundic Accommodation.
|
baseline and 4-weeks
|
|
Change From Baseline at 4-weeks in the Water Load Satiety Test (WLST)
Time Frame: baseline and 4-weeks
|
The Water Load Satiety Test (WLST) is the amount of water a patient can consume until full in 5 minutes.
The volume of water is recorded.
The change is computed as the volume of water ingested at baseline subtracted from the amount of water ingested at 4-weeks.
A positive change indicates that the patient can ingest more water at 4-weeks than at baseline.
|
baseline and 4-weeks
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
4-Week Change in Weight
Time Frame: baseline and 4-weeks
|
This safety outcome is computed by subtracting the weight (kg) at baseline from the weight (kg) at 4-weeks
|
baseline and 4-weeks
|
|
4-Week Change in Creatinine
Time Frame: baseline and 4-weeks
|
This safety outcome is computed by subtracting the baseline level of creatinine (mg/dL) from the 4-week level.
|
baseline and 4-weeks
|
|
4-Week Change in Fasting Glucose
Time Frame: baseline and 4-weeks
|
This safety outcome is computed by subtracting the baseline level of glucose (mg/dL) from the 4-week level.
|
baseline and 4-weeks
|
|
4-Week Cardiac Rhythm
Time Frame: baseline and 4-weeks
|
This safety outcome is computed from the results of an electrocardiogram (ECG) QTc interval at 4-weeks measured in milliseconds (msec).
|
baseline and 4-weeks
|
|
4-Week Change in Aspartate Aminotransferase (ALT)
Time Frame: baseline and 4-weeks
|
This safety outcome is computed by subtracting the baseline level of Alanine Aminotransferase (ALT) (U/L) from the 4-week level.
|
baseline and 4-weeks
|
|
Assessment of Adverse Events Over 4-Weeks
Time Frame: over 4-weeks
|
This safety outcome is the frequency over the 4-weeks of the study of all reported adverse events using the v5.0 CTCAE classification system.
|
over 4-weeks
|
|
Assessment of the Severity of Adverse Events Over 4-Weeks
Time Frame: over 4-weeks
|
This safety outcome is the frequency over the 4-weeks of the study of all reported adverse events' severity grade as classified by the NCI's Common Terminology Criteria for Adverse Events (CTCAE v5.0).
For the patient with 2 AE's, the AE with the maximum severity is reported.
|
over 4-weeks
|
|
Serious Adverse Events
Time Frame: over 4 weeks of treatment
|
Serious Adverse Event (SAE) defined by the FDA as an event meeting one or more of the following criteria; inpatient hospitalization or prolonged existing hospitalization; persistent or significant incapacity or substantial disruption of ability to conduct normal life functions; jeopardized patient and required medical or surgical intervention to prevent a serious event; or congenital anomaly or birth defect.
|
over 4 weeks of treatment
|
|
Total Number of Hospitalizations Over 4-weeks of Treatment
Time Frame: over the 4-weeks of the trial
|
Hospitalization events by treatment arm were reported on the Adverse Event Case-Report form at each visit and also at time of occurrence and tabulated at end of treatment visit for comparison between placebo and buspirone arms.
|
over the 4-weeks of the trial
|
|
Adverse Events by Body Classification System by Treatment Group During the Trial
Time Frame: over 4-weeks of treatment
|
Adverse events were reported on the Adverse Event Report form by the principal investigator at each clinic site using the CTCAE v5 classification system.
|
over 4-weeks of treatment
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Henry P Parkman, MD, Temple University Hospital, Philadelphia, PA
- Study Chair: Pankaj J Pasricha, MD, Johns Hopkins Hospital, Baltimore, MD
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Neurologic Manifestations
- Gastrointestinal Diseases
- Stomach Diseases
- Paralysis
- Gastroparesis
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Tranquilizing Agents
- Psychotropic Drugs
- Serotonin Agents
- Serotonin Receptor Agonists
- Anti-Anxiety Agents
- Buspirone
Other Study ID Numbers
Other Study ID Numbers
- 10- GpCRC3-BESST
- U24DK074008 (U.S. NIH Grant/Contract)
- U01DK073983 (U.S. NIH Grant/Contract)
- U01DK112193 (U.S. NIH Grant/Contract)
- U01DK073975 (U.S. NIH Grant/Contract)
- U01DK074035 (U.S. NIH Grant/Contract)
- U01DK074007 (U.S. NIH Grant/Contract)
- U01DK073974 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
- ICF
- ANALYTIC_CODE
- CSR
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.