- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04930237
RELISTOR's Effects on Opioid-Induced Constipation
RELISTOR's Effects on Opioid-Induced Constipation in Postoperative 1-2 Level Anterior Lumbar Interbody Fusion Patients: A Case-Control Study
Study Overview
Status
Conditions
Detailed Description
RELISTOR is a legally marketed device and will be used off-label under the authority of a health care practitioner within a legitimate practitioner-patient relationship with the intent of the "practice of medicine".
The use of RELISTOR in the experimental group of this study meets all of the following conditions:
- is not intended to be reported to the FDA in support of a new indication for use or to support any other significant change in the labeling for the drug;
- it is not intended to support a significant change in the advertising for the product;
- it does not involve a route of administration or dosage level, use in a subject population, or other factor that significantly increases the risks (or decreases the acceptability of the risks) associated with the use of the drug product;
- it is conducted in compliance with the requirements for IRB review and informed consent [21 CFR parts 56 and 50, respectively];
- it is conducted in compliance with the requirements concerning the promotion and sale of drugs [21 CFR 312.7]; and
- it does not intend to invoke 21 CFR 50.24
Screening and Enrollment:
Patients will undergo two levels of screening: the initial screening and a post-operative OIC screening. The initial screening will involve all 1-2 level ALIF patients in the experimental group and observational group who will be approached to participate in the study before surgery. After eligible patients agree to participate and sign the ICF, all patients will then be asked to complete the PAC-SYM instrument about their constipation symptoms over the past 2 weeks.
Patients in both groups will undergo their 1-2 level ALIF procedure and then will undergo the post-operative OIC screen/rescreen (as needed) daily for acute OIC for a maximum of 3 days (i.e., postoperative days 2 - 4). Patients who are found to have acute OIC will be designated to the experimental and observational treatment regimens accordingly to Study Treatment Regimens.
If a patient does not have acute OIC after they are rescreened on postoperative day 4, are discharged, or do not meet the inclusion criteria, will be placed in the not-constipated or post-operative screen failure group.
Study Type
Contacts and Locations
Study Locations
-
-
Texas
-
Dallas, Texas, United States, 75203
- Methodist Moody Brain and Spine Institute, Methodist Dallas Medical Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
Experimental Group (initial screen):
- Age 18 years or older
- Inpatient who will undergo a 1-2 level ALIF procedure with Dr. Richard Meyrat
- Are not pregnant or lactating
- Does not have a history of drug abuse within the past 2 years
- Does not have a gastrointestinal ostomy
Experimental Group (post-operative OIC screen/rescreen)
- Actively constipated (i.e., no BM in last 48 hours, difficult having a spontaneous BM, or inability to have a spontaneous BM)
- Receiving mu-agonist opioids
- Expected to require daily opioid analgesics for at least 7 days following enrollment
- Have not received or discontinued use of any laxatives, enemas and/or promotility agents within 48 hours of enrollment and the first dose of RELISTOR. Stool softeners are permitted.
- Does not have a known hypersensitivity to methylnaltrexone, naltrexone, or naloxone
Observational Group (initial screen):
- Age 18 years or older
- Inpatient who will undergo 1-2 level ALIF procedure with Dr. Graham
- Are not pregnant or lactating
- Does not have a history of drug abuse within the past 2 years
- Does not have a gastrointestinal ostomy
Observational Group (post-operative OIC screen/rescreen):
- Actively constipated (i.e. no BM in last 48 hours, difficulty having a spontaneous BM, or inability to have a spontaneous BM)
- Receiving mu-agonist opioids
- Expected to require daily opioid analgesics for at least 7 days following enrollment
Exclusion Criteria:
Experimental Group (post-operative OIC screen/rescreen):
Exclude patients with:
- Fecal impaction
- Mechanical bowel obstruction
- Constipation not attributed to post-procedural opioid use
- Calculated creatinine clearance less than 50 mL/min
- Corrected QT interval greater than 500 msec. on a 12-lead screening electrocardiogram
Observational Group (post-operative OIC screen/rescreen):
Exclude patients with:
- Fecal impaction
- Mechanical bowel obstruction
- Constipation not attributed to post-procedural opioid use
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Experimental Group
Patients who receive RELISTOR
|
12-mg RELISTOR to be administered as once-daily subcutaneous injections for 4 to 7 days
|
Observational Group
Patients that receive standard of care
|
Standard of care
Standard of Care
Standard of Care
Standard of Care
Standard of Care
Standard of Care
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Bowel Movement assessment
Time Frame: July 2021 - April 2022
|
Percentage of patients with bowel movement (BM) within four hours of first RELISTOR dose or SOC bowel regimen
|
July 2021 - April 2022
|
Post-treatment Bowel Movement
Time Frame: July 2021 - April 2022
|
Time to Bowel Movement after first treatment
|
July 2021 - April 2022
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Patient Assessment of Constipation Symptoms (PAC-SYM)
Time Frame: July 2021 - April 2022
|
to measure patient's self-reported experience of symptoms and symptom severity in constipation pre-operatively and at patients post-operative follow-up
|
July 2021 - April 2022
|
Treatment Satisfaction Questionnaire for Medication
Time Frame: July 2021 - April 2022
|
to measure patients' satisfaction with medication
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July 2021 - April 2022
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Bowel Function Diary
Time Frame: July 2021 - April 2022
|
Daily Assessment Module: to measure constipation symptoms experienced in the past 24 hours during hospitalization
|
July 2021 - April 2022
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Richard Meyrat, MD, Methodist Dallas Medical Center
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Chemically-Induced Disorders
- Substance-Related Disorders
- Signs and Symptoms, Digestive
- Narcotic-Related Disorders
- Constipation
- Opioid-Induced Constipation
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Peripheral Nervous System Agents
- Sensory System Agents
- Gastrointestinal Agents
- Narcotic Antagonists
- Calcium-Regulating Hormones and Agents
- Cathartics
- Laxatives
- Antacids
- Antidiarrheals
- Calcium
- Bisacodyl
- Magnesium Hydroxide
- Magnesium Oxide
- Bismuth subsalicylate
- Methylnaltrexone
- Magnesium citrate
Other Study ID Numbers
- 013.MBSI.2021.D
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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