Linaclotide for Colonoscopy Preparation

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Overseen ByPavel Mazirka, MD
Age: 18+
Sex: Any
Trial Phase: Phase 1 & 2
Sponsor: University of Florida
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 3 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether Linaclotide can prepare the bowel for a colonoscopy using less liquid than the usual method. The goal is to determine if Linaclotide, combined with Gatorade and a clear liquid diet, can effectively replace the standard 4 liters of another solution. The trial seeks adults admitted to the hospital who are scheduled for a colonoscopy and have not had colon surgeries or certain health issues like renal failure. Participants will take two doses of Linaclotide before their procedure to test this new preparation method. As a Phase 1, Phase 2 trial, this research aims to understand how the treatment works in people and measure its effectiveness in an initial, smaller group.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, it does mention that patients already taking Linaclotide are excluded from participating.

Is there any evidence suggesting that Linaclotide is likely to be safe for use in colonoscopy preparation?

Research has shown that linaclotide is generally safe for humans. Its approval for treating irritable bowel syndrome with constipation (IBS-C) supports its safety for other uses. Studies indicate that using linaclotide with standard bowel prep solutions like polyethylene glycol (PEG) enhances bowel cleaning without adding safety risks.

When combined with PEG, linaclotide improves bowel cleaning and aids in detecting more polyps during colonoscopies, while maintaining safety. However, linaclotide can cause serious dehydration in children, so it is not used for them.

Overall, linaclotide is well-tolerated in adults, with no major side effects reported when used for bowel preparation.12345

Why do researchers think this study treatment might be promising?

Unlike the standard colonoscopy prep options, which usually involve strong laxatives and a lot of liquid intake, linaclotide offers a new approach. Linaclotide works by increasing the secretion of chloride and water in the intestines, which helps to clear the bowels in a potentially gentler way. Researchers are excited because this mechanism might reduce the discomfort and unpleasantness typically associated with traditional colonoscopy preparations. Additionally, linaclotide is already known for treating chronic constipation and irritable bowel syndrome, which suggests it could offer a dual benefit of prep efficiency and comfort.

What evidence suggests that Linaclotide might be an effective treatment for colonoscopy preparation?

Research has shown that Linaclotide can help prepare bowels for a colonoscopy. In this trial, participants will receive Linaclotide with a smaller amount of the usual prep solution. Studies indicate that Linaclotide increases the likelihood of achieving a clean bowel, and using it with less prep solution resulted in better bowel cleaning than the standard large amount of solution. Linaclotide increases fluid in the intestines, aiding in bowel cleaning. These findings suggest that Linaclotide could simplify colonoscopy preparation by reducing the amount of liquid needed.678910

Who Is on the Research Team?

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Johan Nordenstam, MD PhD

Principal Investigator

University of Florida

Are You a Good Fit for This Trial?

This trial is for individuals needing a colonoscopy. Participants should be able to take Linaclotide and follow a clear liquid diet with Gatorade before the procedure. Details on who can't join are not provided, but typically those with allergies or conditions that could interfere with the drug or prep process would be excluded.

Exclusion Criteria

Patients who experienced hypersensitivity reactions to Linaclotide in the past
I have had surgery to remove part of my colon.
I have a colostomy.
See 8 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Preparation

Participants take Linaclotide and Gatorade as bowel preparation for colonoscopy

36 hours
1 visit (in-person)

Procedure

Participants undergo colonoscopy to assess bowel preparation quality

1 day
1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after the colonoscopy

48 hours

What Are the Treatments Tested in This Trial?

Interventions

  • Linaclotide
Trial Overview The study tests if taking two doses of Linaclotide (one 36 hours before and another 8 hours prior) plus Gatorade provides adequate bowel preparation for a colonoscopy compared to the standard method using Polyethylene glycol.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Patients scheduled for ColonoscopyExperimental Treatment1 Intervention

Linaclotide is already approved in United States, European Union, Canada for the following indications:

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Approved in United States as Linzess for:
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Approved in European Union as Constella for:
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Approved in Canada as Linzess for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Florida

Lead Sponsor

Trials
1,428
Recruited
987,000+

Citations

1.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/41123247/
The Efficacy of Single Dose Linaclotide in Polyethylene ...Linaclotide used as a single dose adjunct to bowel prep before colonoscopy increased ADR and PDR. Adequate prep was higher with linaclotide ...
Linaclotide Plus 3-L PEG Effective for Bowel Preparation in ...The 3-L PEG + L group had a significantly increased rate of adequate bowel preparation (89.4% vs 73.6%; P <.001) than the 4-L PEG group. The 3-L ...
a grade-assessed systematic review and meta-analysisLinaclotide has been shown to be effective in treating chronic constipation and irritable bowel syndrome with constipation by increasing ...
Effect of 3-day linaclotide administration to reduce the PEG...The primary outcome was adequate bowel preparation rate, defined as a score ≥ 2 for all colon segments (right-side colon, transverse colon, and ...
A novel ultra-low-volume regimen combining 1 L ...The primary outcome was the effectiveness of bowel cleansing according to the Boston Bowel Preparation Scale. Secondary outcomes included cecal intubation ...
Bowel preparation efficacy and safety of compound ...Linaclotide is approved for irritable bowel syndrome with predominant constipation (IBS‐C) symptoms. The main objective of this study was to ...
S493 Efficacy and Safety of Linaclotide-Enhanced...Conclusion: Linaclotide-assisted PEG regimens significantly improve stool preparation adequacy and polyp detection rates without compromising safety, supporting ...
Efficacy and Safety of Linaclotide as an Adjunct ...Linaclotide, a guanylyl cyclase-C agonist, may enhance efficacy and tolerability when combined with polyethylene glycol (PEG) for bowel ...
4066835 This label may not be the latest approved by FDA ...WARNING: RISK OF SERIOUS DEHYDRATION IN PEDIATRIC. PATIENTS. See full prescribing information for complete boxed warning. • LINZESS is contraindicated in ...
a grade assessed systematic review and meta-analysisPEG combined with linaclotide is a safe alternative to PEG alone, improving ADR, bowel preparation quality, and patient comfort. Keywords: Colonoscopy; ...
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