CASAD for Severe Diarrhea in the Emergency Department

July 24, 2018 updated by: M.D. Anderson Cancer Center

A Double-Blinded Placebo-Controlled Pilot Trial of Calcium Alumina-Silicate (CASAD) in the Treatment of Severe Diarrhea (Grade 3 or 4) in Cancer Patients Presenting for Emergency Care

The goal of this clinical research study is to learn if calcium alumina-silicate (CASAD) can help to stop your diarrhea. Researchers also want to know if this drug can help decrease the duration of your diarrhea.

In this study, CASAD will be compared to a placebo. A placebo is not a drug. It looks like the study drug but it is not designed to treat any disease or illness. It is designed in this study to be compared with the study drug to learn if the study drug has any real effect.

Study Overview

Status

Terminated

Conditions

Intervention / Treatment

Detailed Description

Study Groups:

If you agree to take part in this study, you will be randomly assigned (as in the flip of a coin) to receive either CASAD orally or a placebo. You will have an equal chance of being assigned to either group.

Neither you nor the study staff will know if you are receiving the study drug or the placebo. However, if needed for your safety, the study staff will be able to find out what you are receiving.

Study Treatment:

You take either CASAD or placebo by mouth every 6 hours with about 1 cup (8 oz.) of water. You will also be given other supportive care and treatment for diarrhea (such as imodium and lomotil).

You will be asked to keep a journal, which includes a record of the time you take the study drug each day and a history of your bowel movements every day you take CASAD or placebo.

Study Visits:

Before the dose:

  • You will have a physical exam, including measurement of your vital signs (blood pressure, heart rate, temperature, and breathing rate) will be recorded.
  • You will be asked when your diarrhea started.
  • You will be asked about any drugs you have taken for the cancer and diarrhea.
  • A stool sample will be collected to test for toxins.
  • Blood (about 1 teaspoon) will be drawn to measure cytokines (proteins that may affect the immune system and inflammation) .
  • You will be asked about your diarrhea and other symptoms. It should take about 5 minutes to answer these questions.

At the same visit after the dose:

  • You will have a physical exam, including measurement of your vital signs.
  • You will be asked about your diarrhea.
  • You will be asked if you have any side effects.

On Day 1 (the day after your visit to the Emergency Center):

-Blood (about 1 teaspoon) will be drawn to check your electrolytes and to measure cytokines and inflammation (optional).

On Days 2-6 (this will be by phone or the staff will visit you if you are in the hospital):

  • You will be asked about your diarrhea.
  • You will be asked if you have any side effects.

Length of Treatment:

You will take the study drug or placebo for up to 6 days or when the diarrhea stops, whichever happens first. You will no longer be able to take the study drug or placebo if the diarrhea gets worse, if intolerable side effects occur, or if you are unable to follow study directions.

Follow-Up:

After you are off study, the study nurse will call you and ask if you have had any other side effects since finishing the study treatment. The phone call should only last about 5 minutes. If you are still an inpatient at the hospital, the study nurse may visit you and ask you these questions in person.

At your next scheduled appointment at MD Anderson, the nurse will meet with you to get your final journal and any unused study drug. If you do not return to MD Anderson, you will receive a self-addressed stamped envelope for you to return this information.

This is an investigational study. CASAD is FDA approved as a food additive, but it has not been approved to treat a disease. Its use to treat diarrhea is investigational.

Up to 24 patients will take part in this study. All will be enrolled at MD Anderson.

Study Type

Interventional

Enrollment (Actual)

2

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Texas
      • Houston, Texas, United States, 77030
        • University of Texas MD Anderson Cancer Center

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. Cancer patients presenting to the EC or an acute care clinic for NCI grade >/= 2 diarrhea
  2. Able to understand the description of the study and give informed consent
  3. Patients must be willing to and capable of providing frequent assessments for the duration of the study
  4. English-speaking

Exclusion Criteria:

  1. Patients will not be approached while they have : a) evidence of fever or severe abdominal pain, melena, overt blood in stool; b) any clinical suspicion or evidence of peritonitis or bowel perforation; c) s/p allogenic stem cell transplant
  2. Patients will not be approached if the EC physician thinks that the diarrhea is due to Crohn's disease, ulcerative colitis, Celiac disease, graft-versus-host disease, short-gut syndrome, neuroendocrine paraneoplastic syndromes (e.g., MEN, VIPomas, etc.), or malabsorption syndromes
  3. Patients who are status post stem cell transplantation (both autologous or allogenic)
  4. Patients who are status post immunotherapy (including those who are receiving or have received ipilimumab)
  5. Patients participating in other clinical trials for diarrhea
  6. Patients with a known allergy to any components of the CASAD formulation
  7. Patients whose current medication schedule would not permit an approximate 2 hour window between administration of CASAD and other scheduled medications
  8. Patients who cannot comply with medications
  9. Patients taking any clay products
  10. Patients with radiological evidence of megacolon, intraperitoneal free air, pneumatosis intestinalis, or fecal impaction
  11. History of significant neurological or psychiatric disorders that would impede giving consent, treatment, or follow up
  12. Patients who are pregnant
  13. Patients less than 18 years of age

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: TREATMENT
  • Allocation: RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: DOUBLE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
EXPERIMENTAL: Calcium Alumina-Silicate (CASAD)
CASAD 1 gram orally every 6 hours for up to 6 days. Questionnaire completion at baseline about diarrhea and other symptoms.
Drug: Calcium Alumina-Silicate (CASAD)
1 gram by mouth every 6 hours for up to 6 days.
Other Names:
  • CASAD
  • Calcium Aluminosilicate anti-diarrheal
Behavioral: Questionnaire
Questionnaire completion at baseline about diarrhea and other symptoms.
Other Names:
  • Survey
PLACEBO_COMPARATOR: Placebo
Placebo orally every 6 hours for up to 6 days. Questionnaire completion at baseline about diarrhea and other symptoms.
Behavioral: Questionnaire
Questionnaire completion at baseline about diarrhea and other symptoms.
Other Names:
  • Survey
Other: Placebo
1 by mouth every 6 hours for up to 6 days.
Other Names:
  • Sugar pill

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Time to Resolution of Diarrhea (TTRD)
Time Frame: 6 days
The primary endpoint is time to resolution of diarrhea (TTRD) defined as the time of the bowel movement that is not followed by another bowel movement within 8 hours. Participants will be evaluated for the primary endpoint for up to 6 days.
6 days

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

M.D. Anderson Cancer Center

Collaborators

Salient Pharmaceuticals Incorporated

Investigators

  • Principal Investigator: Sai-Ching J. Yeung, MD,PHD, M.D. Anderson Cancer Center

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

December 1, 2013

Primary Completion (ACTUAL)

August 1, 2014

Study Completion (ACTUAL)

August 1, 2014

Study Registration Dates

First Submitted

December 17, 2013

First Submitted That Met QC Criteria

December 17, 2013

First Posted (ESTIMATE)

December 23, 2013

Study Record Updates

Last Update Posted (ACTUAL)

July 26, 2018

Last Update Submitted That Met QC Criteria

July 24, 2018

Last Verified

July 1, 2018

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2013-0452
  • NCI-2014-01027 (REGISTRY: NCI CTRP)

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.

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