Tenapanor in Synucleinopathy-Related Constipation
Efficacy and Safety of Tenapanor in Synucleinopathy-Related Constipation
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Contact
Study Contact
- Name: Richard A. Manfready, MD, AM, FACP
- Phone Number: (319) 235-5390
- Email: rman@alum.mit.edu
Study Contact Backup
- Name: Harichandana Punukula, PharmD, MS
- Phone Number: 319-888-8270
- Email: hpunukula@cvmspc.com
Study Locations
-
-
Iowa
-
Waterloo, Iowa, United States, 50701
- Recruiting
- Cedar Valley Digestive Health Center
-
Contact:
- Harichandana Punukula, PharmD, MS
- Phone Number: 319-888-8275
- Email: hpunukula@cvmspc.com
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria
- Age 50-89 years.
- Diagnosis of PD within Hoehn and Yahr stages 1-3, confirmed by a neurologist per International Parkinson and Movement Disorder Society criteria.
- Average weekly stool frequency of ≤5 spontaneous bowel movements (SBMs) and ≤2 complete spontaneous bowel movements (CSBMs) over the past 6 months. These criteria will be verified during a 2-week screening period.
- Stool consistency ≤3 on the Bristol Stool Form Scale (BSFS). This criterion will be verified during a 2-week screening period.
- Agreement to use contraception, if applicable.
Exclusion Criteria
- Functional diarrhea or IBS-D/M based on Rome IV Criteria.
- Symptomatic structural GI abnormalities or inflammatory bowel disease.
- Significant hepatic (ALT or AST ≥ 2.5x the upper limit of normal) or renal (serum creatinine >2mg/dl) dysfunction.
- Pregnancy or lactation.
- Diagnosis of primary dyssynergic defecation by anorectal manometry.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: Placebo
Placebo orally twice daily for 12 weeks
|
Placebo drug
|
|
Experimental: Tenapanor
Tenapanor 50 mg orally twice daily for 12 weeks
|
Inhibitor of NHE3
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Complete spontaneous bowel movements (CSBM)
Time Frame: 6 of 12 weeks
|
Our primary endpoint will be CSBM response, defined as an increase of at least one CSBM per week compared to baseline for at least 6 of the 12 treatment weeks.
A CSBM is defined as a bowel movement that occurs naturally and is accompanied by a feeling of complete evacuation
|
6 of 12 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Calprotectin
Time Frame: Week 12
|
Decrease in fecal calprotectin by 20% or greater
|
Week 12
|
|
Abdominal pain and bloating response
Time Frame: 6 of 12 weeks
|
Decrease in severity score of at least 20% or more from baseline in 6 of 12 weeks (pain visual analog scale 1-10 where 10 is worst pain)
|
6 of 12 weeks
|
|
Lipopolysaccharide binding protein
Time Frame: Week 12
|
Decrease in serum lipopolysaccharide binding protein by 20% compared to baseline
|
Week 12
|
|
Complete spontaneous bowel movements (CSBM) continuous
Time Frame: Week 12
|
CSBM treated as a continuous variable.
The investigators expect an increase of CSBMs in the treatment group compared to the placebo group.
A CSBM is defined as a bowel movement that occurs naturally and is accompanied by a feeling of complete evacuation
|
Week 12
|
|
Plasma zonulin
Time Frame: Week 12
|
Decrease in zonulin by 20% compared to baseline
|
Week 12
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Richard A. Manfready, MD, AM, FACP, Cedar Valley Digestive Health Center
- Study Chair: Ravindra Mallavarapu, MD, Cedar Valley Digestive Health Center
- Study Director: Harichandana Punukula, PharmD, MS, Cedar Valley Digestive Health Center
Publications and helpful links
General Publications
- Manfready RA, Engen PA, Verhagen Metman L, Sanzo G, Goetz CG, Hall DA, Forsyth CB, Raeisi S, Voigt RM, Keshavarzian A. Attenuated Postprandial GLP-1 Response in Parkinson's Disease. Front Neurosci. 2021 Jul 2;15:660942. doi: 10.3389/fnins.2021.660942. eCollection 2021.
- Manfready RA, Forsyth CB, Voigt RM, Hall DA, Goetz CG, Keshavarzian A. Gut-Brain Communication in Parkinson's Disease: Enteroendocrine Regulation by GLP-1. Curr Neurol Neurosci Rep. 2022 Jul;22(7):335-342. doi: 10.1007/s11910-022-01196-5. Epub 2022 May 28.
- Post Z, Manfready RA, Keshavarzian A. Overview of the Gut-Brain Axis: From Gut to Brain and Back Again. Semin Neurol. 2023 Aug;43(4):506-517. doi: 10.1055/s-0043-1771464. Epub 2023 Aug 10.
- Hall DA, Voigt RM, Cantu-Jungles TM, Hamaker B, Engen PA, Shaikh M, Raeisi S, Green SJ, Naqib A, Forsyth CB, Chen T, Manfready R, Ouyang B, Rasmussen HE, Sedghi S, Goetz CG, Keshavarzian A. An open label, non-randomized study assessing a prebiotic fiber intervention in a small cohort of Parkinson's disease participants. Nat Commun. 2023 Feb 18;14(1):926. doi: 10.1038/s41467-023-36497-x.
- Chey WD, Lembo AJ, Rosenbaum DP. Tenapanor Treatment of Patients With Constipation-Predominant Irritable Bowel Syndrome: A Phase 2, Randomized, Placebo-Controlled Efficacy and Safety Trial. Am J Gastroenterol. 2017 May;112(5):763-774. doi: 10.1038/ajg.2017.41. Epub 2017 Feb 28.
- Chey WD, Lembo AJ, Yang Y, Rosenbaum DP. Efficacy of Tenapanor in Treating Patients With Irritable Bowel Syndrome With Constipation: A 26-Week, Placebo-Controlled Phase 3 Trial (T3MPO-2). Am J Gastroenterol. 2021 Jun 1;116(6):1294-1303. doi: 10.14309/ajg.0000000000001056.
- Chey WD, Lembo AJ, Rosenbaum DP. Efficacy of Tenapanor in Treating Patients With Irritable Bowel Syndrome With Constipation: A 12-Week, Placebo-Controlled Phase 3 Trial (T3MPO-1). Am J Gastroenterol. 2020 Feb;115(2):281-293. doi: 10.14309/ajg.0000000000000516.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
Other Study ID Numbers
Other Study ID Numbers
- 2405-21279
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
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