Phase 3
N=368
Dulcolax vs Placebo in Functional Constipation
Constipation
Bottom Line
View on ClinicalTrials.gov: NCT00526097 ↗Enrolled (actual)
368
Serious AEs
0.8%
Results posted
Aug 2010
Primary outcome: Primary: Mean Number of Complete Spontaneous Bowel Movements (CSBMs) Per Week Over the 4 Weeks Treatment Period — 1.9; 5.2 CSBMs per week — p=<0.0001
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Bisacodyl 10 mg (Drug); Placebo (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Boehringer Ingelheim
- Primary completion
- Jun 2009
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Mean Number of Complete Spontaneous Bowel Movements (CSBMs) Per Week Over the 4 Weeks Treatment Period |
1.9; 5.2 | <0.0001 sig |
| SECONDARY Number of CSBMs at Week 1 |
2.0; 6.3 | <0.0001 sig |
| SECONDARY Number of CSBMs at Week 2 |
1.4; 4.9 | <0.0001 sig |
| SECONDARY Number of CSBMs at Week 3 |
1.8; 4.6 | <0.0001 sig |
| SECONDARY Number of CSBMs at Week 4 |
1.7; 4.3 | <0.0001 sig |
| SECONDARY Mean Number of SBMs Per Week Over the 4 Weeks Treatment Period |
5.1; 10.0 | <0.0001 sig |
| SECONDARY Number of SBMs at Week 1 |
5.3; 12.1 | <0.0001 sig |
| SECONDARY Number of SBMs at Week 2 |
4.9; 9.6 | <0.0001 sig |
| SECONDARY Number of SBMs at Week 3 |
4.8; 8.6 | <0.0001 sig |
| SECONDARY Number of SBMs at Week 4 |
4.0; 7.8 | <0.0001 sig |
| SECONDARY Time to the First SBM Following the First Dose of Study Medication (SM) |
19; 12 | <0.0001 sig |
| SECONDARY Number of Participants With an Increase of at Least 1 in the Mean Number of CSBMs Per Week Over the 4 Weeks Treatment Period Compared to Baseline |
47; 196 | <0.0001 sig |
| SECONDARY Number of Participants With an Increase of at Least 1 CSBM at Week 1 Compared to Baseline |
57; 204 | <0.0001 sig |
| SECONDARY Number of Participants With an Increase of at Least 1 CSBM at Week 2 Compared to Baseline |
43; 178 | <0.0001 sig |
| SECONDARY Number of Participants With an Increase of at Least 1 CSBM at Week 3 Compared to Baseline |
51; 163 | <0.0001 sig |
| SECONDARY Number of Participants With an Increase of at Least 1 CSBM at Week 4 Compared to Baseline |
52; 148 | <0.0001 sig |
| SECONDARY Number of Participants With a Mean of at Least 1 CSBM a Day Over the 4 Weeks Treatment Period |
2; 70 | <0.0001 sig |
| SECONDARY Number of Participants With a Mean of at Least 3 CSBMs a Week Over the 4 Weeks Treatment Period |
32; 161 | <0.0001 sig |
| SECONDARY Number of Premature Withdrawals Over the 4 Weeks Treatment Period |
10; 51 | 0.0025 sig |
| SECONDARY Number of Premature Withdrawals at Week 1 in the Treatment Period |
3; 25 | 0.0105 sig |
| SECONDARY Number of Premature Withdrawals at Week 2 in the Treatment Period |
3; 11 | 0.4002 |
| SECONDARY Number of Premature Withdrawals at Week 3 in the Treatment Period |
4; 9 | 1.0000 |
| SECONDARY Number of Premature Withdrawals at Week 4 in the Treatment Period |
0; 6 | 0.0951 |
| SECONDARY Number of Participants Using Rescue Medication Over the 4 Weeks Treatment Period |
21; 8 | <0.0001 sig |
| SECONDARY Number of Participants Using Rescue Medication at Week 1 in the Treatment Period |
2; 1 | 0.2524 |
| SECONDARY Number of Participants Using Rescue Medication at Week 2 in the Treatment Period |
10; 4 | 0.0035 sig |
| SECONDARY Number of Participants Using Rescue Medication at Week 3 in the Treatment Period |
9; 1 | 0.0004 sig |
| SECONDARY Number of Participants Using Rescue Medication at Week 4 in the Treatment Period |
12; 6 | 0.0086 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Straining' at Week 1 |
-0.3; -1.3 | <0.0001 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Straining' at Week 2 |
-0.1; -1.1 | <0.0001 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Straining' at Week 3 |
-0.3; -1.3 | <0.0001 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Straining' at Week 4 |
-0.5; -1.2 | <0.0001 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Stool Quality' at Week 1 |
0.4; 3.0 | <0.0001 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Stool Quality' at Week 2 |
0.2; 2.7 | <0.0001 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Stool Quality' at Week 3 |
0.5; 2.8 | <0.0001 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Stool Quality' at Week 4 |
0.6; 2.6 | <0.0001 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Sensation of Incomplete Evacuation' at Week 1 |
-0.0; -0.2 | 0.0002 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Sensation of Incomplete Evacuation' at Week 2 |
-0.0; -0.2 | 0.0003 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Sensation of Incomplete Evacuation' at Week 3 |
-0.1; -0.2 | 0.0127 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Sensation of Incomplete Evacuation' at Week 4 |
-0.1; -0.2 | 0.0064 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Anorectal Obstructions/Blockade' at Week 1 |
-0.1; -0.9 | <0.0001 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Anorectal Obstructions/Blockade' at Week 2 |
-0.1; -0.9 | <0.0001 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Anorectal Obstructions/Blockade' at Week 3 |
-0.1; -0.9 | <0.0001 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Anorectal Obstructions/Blockade' at Week 4 |
-0.1; -0.8 | <0.0001 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Manual Manoeuvre' at Week 1 |
-0.0; -0.2 | <0.0001 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Manual Manoeuvre' at Week 2 |
0.0; -0.2 | <0.0001 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Manual Manoeuvre' at Week 3 |
-0.0; -0.2 | <0.0001 sig |
| SECONDARY Change From Baseline in the Mean Score for Constipation Symptom 'Manual Manoeuvre' at Week 4 |
-0.1; -0.2 | 0.0018 sig |
| SECONDARY Number of Participants With Improved, Unchanged or Worsened Overall Satisfaction With Bowel Habits at Week 1 in the Treatment Period in Comparison to Baseline |
44; 153; 46; 45; 22; 26 | <0.0001 sig |
| SECONDARY Number of Participants With Improved, Unchanged or Worsened Overall Satisfaction With Bowel Habits at Week 2 in the Treatment Period in Comparison to Baseline |
41; 163; 48; 37; 22; 12 | <0.0001 sig |
| SECONDARY Number of Participants With Improved, Unchanged or Worsened Overall Satisfaction With Bowel Habits at Week 3 in the Treatment Period in Comparison to Baseline |
44; 153; 43; 31; 17; 11 | <0.0001 sig |
| SECONDARY Number of Participants With Improved, Unchanged or Worsened Overall Satisfaction With Bowel Habits at Week 4 in the Treatment Period in Comparison to Baseline |
37; 135; 47; 32; 14; 8 | <0.0001 sig |
| SECONDARY Number of Participants With Reduced, Unchanged or Increased Bothersomeness With Constipation at Week 1 in the Treatment Period in Comparison to Baseline |
36; 168; 51; 46; 25; 10 | <0.0001 sig |
| SECONDARY Number of Participants With Reduced, Unchanged or Increased Bothersomeness With Constipation at Week 2 in the Treatment Period in Comparison to Baseline |
35; 160; 45; 36; 31; 16 | <0.0001 sig |
| SECONDARY Number of Participants With Reduced, Unchanged or Increased Bothersomeness With Constipation at Week 3 in the Treatment Period in Comparison to Baseline |
39; 147; 41; 30; 24; 18 | <0.0001 sig |
| SECONDARY Number of Participants With Reduced, Unchanged or Increased Bothersomeness With Constipation at Week 4 in the Treatment Period in Comparison to Baseline |
30; 125; 47; 35; 21; 15 | <0.0001 sig |
| SECONDARY Number of Participants With Reduced, Unchanged or Increased Bothersomeness With Abdominal Bloating at Week 1 in the Treatment Period in Comparison to Baseline |
33; 136; 47; 59; 32; 29 | <0.0001 sig |
| SECONDARY Number of Participants With Reduced, Unchanged or Increased Bothersomeness With Abdominal Bloating at Week 2 in the Treatment Period in Comparison to Baseline |
31; 142; 46; 43; 34; 27 | <0.0001 sig |
| SECONDARY Number of Participants With Reduced, Unchanged or Increased Bothersomeness With Abdominal Bloating at Week 3 in the Treatment Period in Comparison to Baseline |
27; 129; 45; 49; 32; 17 | <0.0001 sig |
| SECONDARY Number of Participants With Reduced, Unchanged or Increased Bothersomeness With Abdominal Bloating at Week 4 in the Treatment Period in Comparison to Baseline |
25; 107; 46; 49; 27; 19 | <0.0001 sig |
| SECONDARY Number of Participants With Reduced, Unchanged or Increased Bothersomeness With Abdominal Discomfort at Week 1 in the Treatment Period in Comparison to Baseline |
37; 93; 46; 62; 29; 69 | 0.6773 |
| SECONDARY Number of Participants With Reduced, Unchanged or Increased Bothersomeness With Abdominal Discomfort at Week 2 in the Treatment Period in Comparison to Baseline |
29; 104; 49; 67; 33; 41 | 0.0002 sig |
| SECONDARY Number of Participants With Reduced, Unchanged or Increased Bothersomeness With Abdominal Discomfort at Week 3 in the Treatment Period in Comparison to Baseline |
34; 101; 33; 63; 37; 31 | 0.0001 sig |
| SECONDARY Number of Participants With Reduced, Unchanged or Increased Bothersomeness With Abdominal Discomfort at Week 4 in the Treatment Period in Comparison to Baseline |
31; 97; 36; 46; 31; 32 | 0.0005 sig |
| SECONDARY Number of Participants With Respect to the Final Global Assessment of Efficacy by the Investigator |
26; 156; 37; 59; 30; 18 | <0.0001 sig |
| SECONDARY Number of Participants With Respect to the Final Global Assessment of Efficacy by the Patient |
23; 132; 35; 58; 40; 27 | <0.0001 sig |
| SECONDARY Number of Participants With Respect to the Final Global Assessment of Tolerability by the Investigator |
75; 85; 31; 84; 10; 43 | <0.0001 sig |
| SECONDARY Number of Participants With Respect to the Final Global Assessment of Tolerability by the Patient |
38; 125; 50; 65; 19; 22 | 0.0058 sig |
| SECONDARY Change From Baseline in the SF-36 Dimension 'Physical Functioning' |
-0.6; -0.0 | 0.7980 |
| SECONDARY Change From Baseline in the SF-36 Dimension 'Role Limitation Due to Physical Problems' |
-0.2; 0.9 | 0.6129 |
| SECONDARY Change From Baseline in the SF-36 Dimension 'Bodily Pain' |
-2.3; -0.2 | 0.3567 |
| SECONDARY Change From Baseline in the SF-36 Dimension 'General Health' |
-1.3; 0.7 | 0.1407 |
| SECONDARY Change From Baseline in the SF-36 Dimension 'Vitality' |
-1.6; 2.7 | 0.0130 sig |
| SECONDARY Change From Baseline in the SF-36 Dimension 'Social Functioning' |
-2.6; -1.5 | 0.5849 |
| SECONDARY Change From Baseline in the SF-36 Dimension 'Role Limitation Due to Emotional Problems' |
-0.5; 0.1 | 0.7543 |
| SECONDARY Change From Baseline in the SF-36 Dimension 'Mental Health' |
-2.9; 0.6 | 0.0273 sig |
| SECONDARY Change From Baseline in the SF-36 Mental Component Scale (MCS) |
-1.0; 0.3 | 0.1290 |
| SECONDARY Change From Baseline in the SF-36 Physical Component Scale (PCS) |
-0.4; 0.3 | 0.3780 |
| SECONDARY Change From Baseline in the PAC-QoL Subscale 'Worries and Concerns' |
-0.1; -0.6 | <0.0001 sig |
| SECONDARY Change From Baseline in the PAC-QoL Subscale 'Physical Discomfort' |
-0.2; -1.0 | <0.0001 sig |
| SECONDARY Change From Baseline in the PAC-QoL Subscale 'Psychosocial Discomfort' |
-0.1; -0.3 | 0.0070 sig |
| SECONDARY Change From Baseline in the PAC-QoL Subscale 'Satisfaction' |
-0.2; -1.4 | <0.0001 sig |
| SECONDARY Change From Baseline in the PAC-QoL Overall Score |
-0.1; -0.8 | <0.0001 sig |
| SECONDARY Change From Baseline for Sodium (Normalized Value) |
-0; -0 | — |
| SECONDARY Change From Baseline for Potassium (Normalized Value) |
0.0; -0.0 | — |
| SECONDARY Change From Baseline for Chloride (Normalized Value) |
0; 0 | — |
Summary
The objective of the study was to compare the efficacy and safety of 4 weeks treatment with bisacodyl (Dulcolax) tablets 10 mg to placebo in patients with functional constipation. In addition, the effect of treatment on quality of life and general health status was evaluated.
Eligibility Criteria
Inclusion Criteria
- Male and female patients, aged 18 and above
- Suffering from functional constipation, according to their medical history, as defined by the Rome III diagnostic criteria , i.e.:Criteria fulfilled for the last 3 months with symptom onset at least 6 months prior to diagnosis.
- Must include 2 or more of the following::
- straining during at least 25% of the defecations
- lumpy or hard stools in at least 25% of the defecations
- sensation of incomplete evacuation for at least 25% of the defecations
- sensation of anorectal obstruction/blockade for at least 25% of the defecations
- manual manoeuvres to facilitate at least 25% of the defecations (e.g. digital evacuation, support of the pelvic floor)
- fewer than 3 defecations per week
- Loose stools are rarely present without the use of laxatives
- There are insufficient criteria for irritable bowel syndrome (IBS)
- Able and willing to complete a daily e-diary
- Able and willing to use the trial rescue medication
- Signed and dated written informed consent prior to enrolment into the study in accordance with GCP and local legislation
At Visit 2, patients must comply with the following additional inclusion criteria to be eligible for entry into the treatment phase:
- Functional constipation is confirmed by e-diary data at the end of the baseline period:
a. An average of less than 3 CSBMs per week, together with at least one of the following symptoms occurring at least 25% of the time:
- straining
- incomplete evacuation
- lumpy or hard stools (i.e. type 1 or type 2 stools)
- Compliant with the use of the e-diary throughout the baseline period (compliance is defined as completing 80% of the evening reports)
- Compliant with the use of rescue medication throughout the baseline period. Compliance is defined as follows:
- rescue medication may be used if there has not been a bowel movement for more than 72 hrs rescue medication may not be used on either day -1 or on the day of randomisation (day 1)
Exclusion Criteria
- Eating disorders such as anorexia nervosa and bulimia, as a cause of excessive use of laxatives
- Patients whose constipation is caused by primary organic disease of the colon or pelvic floor
- Patients with metabolic disorders, neurological disorders, severe or psychiatric disorders, or any other significant disease or intercurrent illness (e.g. abdominal/gastrointestinal surgery) that, in the Investigators opinion, would interfere with participation in the trial
- Patients with restricted mobility (e.g. wheelchair bound, or bed-ridden) that, in the Investigators opinion, would interfere with participation in the trial
- Patients with a known hypersensitivity to bisacodyl or any other ingredient in the study medication
- Patients with ileus, intestinal obstruction, acute surgical abdominal conditions (such as acute appendicitis and acute inflammatory bowel diseases), or severe dehydration
- Patients with anal fissures or ulcerative proctitis with mucosal damage
- Patients with known clinically significant abnormal electrolyte values
- Patients whose concomitant therapy includes an opioid medication (e.g. morphine, codeine)
- Constipation which, in the Investigators opinion, is caused by medication (e.g. anticholinergics)
- Patients who are not willing to discontinue the use of prohibited concomitant therapy
- Pre-menopausal women who:
- are nursing (breast-feeding) or who are pregnant OR
- who are of child-bearing potential and are not practicing an acceptable method of birth control, or do not plan to continue using this method throughout the study. Acceptable methods of birth control include:
- transdermal patch
- intra-uterine devices/systems (IUDs/IUSs)
- oral, implantable or injectable contraceptives
- sexual abstinence
- sterilisation or a vasectomised partner
- Participation in another trial with an investigational product with 1 month of enrolment into this study
- Drug or alcohol abuse
Data sourced from ClinicalTrials.gov (NCT00526097). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.