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Sphincter of Oddi DysfunctionPhase 4NCT02833103

Pinaverium Bromide in Post-cholecystectomy Sphincter of Oddi Dysfunction

A Phase 4 study testing Danshu Capsules and Pinaverium Bromide in people with Sphincter of Oddi Dysfunction, run by Xinhua Hospital, Shanghai Jiao Tong University School of Medicine at 1 site in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Sphincter of Oddi dysfunction (SOD) refers to biliary kinetic abnormality of the sphincter of Oddi (SO), often accompanied by pain, hepatic and pancreatic enzyme elevation, common bile duct (CBD) dilation or onset of pancreatitis. Read more about this study

Who is it for?
Ages 18 to 69 years
Conditions the study is for
Sphincter of Oddi Dysfunction
What is being tested?
Danshu Capsules and Pinaverium Bromide
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
168 participants
Where
1 siteChina
Study dates
Jul 2016to Feb 2018
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 69 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Chief complaint of upper right abdominal pain following LC (within 2 weeks to 6 months) at a hospital visit, but not a pain caused by surgical incision, lasting 3 to 5 minutes each time, without a history of other biliary tract operation
  • No presence of intestinal obstruction as evidenced by plain abdominal X-ray, with peptic ulcer and duodenal diverticulum ruled out through barium meal examination or gastroscopy
  • No other obvious abnormalities as evidenced by abdominal ultrasound B and MRCP, except for bile duct dilation
  • Patients with biliary-type sphincter of Oddi dysfunction (SOD) who are classified as SOD type II (biliary-type abdominal pain accompanied by hepatic enzyme elevation or common bile duct (CBD) dilation) and SOD type III (only biliary-type abdominal pain) according to Geenen-Hogan classification criteria

Who cannot join

  • Postoperative biliary calculi, benign biliary stenosis, bile duct infection, overlong residual cystic duct (> 0.5cm), biliary tumors, etc.
  • Peptic ulcer, duodenal diverticulum
  • Pancreatitis, pancreatic-type SOD
  • Adhesive intestinal obstruction
  • Postoperative irritable bowel syndrome (IBS)
  • A history of abdominal operation or other surgery
Show all 9Show fewer
  • Pregnant and lactating women
  • Use of other drugs from one week after LC to enrollment, including antispasmodic drugs, analgesics, choleretic agents, calcium ion antagonists and GI motility drugs
  • A history of allergy to Pinaverium Bromide / Danshu Tablets

Trial locations and contacts

1 site in 1 country.

Zhaohui Tang, MD,PhD contact

+86 021 25078999-7905

tangzhaohui@yahoo.com

China1 site, 1 recruiting
  • Zhang Yong

    Shanghai, Shanghai Municipality, 200092

    Yong Zhang, MD,PhD, +86 21 25078999-7905

    Yong Zhang, MD,PhD

    Recruiting

Other trials in China

About this study

Official title: Application of Pinaverium Bromide in the Treatment of Patients With Post-cholecystectomy Sphincter of Oddi Dysfunction (SOD): A Randomized, Controlled and Multicenter Clinical Study

Sphincter of Oddi dysfunction (SOD) refers to biliary kinetic abnormality of the sphincter of Oddi (SO), often accompanied by pain, hepatic and pancreatic enzyme elevation, common bile duct (CBD) dilation or onset of pancreatitis. Pain caused by SOD affects the quality of life (QoL).The primary objective of this trial is to evaluate the efficacy of relieving abdominal pain of Pinaverium Bromide in medication therapy for patients with post-cholecystectomy SOD.

Read the detailed description

1.1 Background (I)

1.1.1 10%~50% of the patients who previously underwent cholecystectomy experience recurrent abdominal pain with or without diarrhea, abdominal distention, enzymatic changes, etc., and sphincter of Oddi dysfunction (SOD) accounts for about 13% of such cases;

1.1.2 Sphincter of Oddi dysfunction (SOD):

  • It refers to biliary kinetic abnormality of the sphincter of Oddi (SO), often accompanied by pain, hepatic and pancreatic enzyme elevation, common bile duct (CBD) dilation or onset of pancreatitis.
  • Pain caused by SOD affects the quality of life (QoL).

1.1.3 The diagnosis of SOD is still being disputed, and there has been no optimal solution so far.

  • The diagnosis of SOD is largely based on clinical judgment
  • The gold standards ERCP and SOM are invasive diagnostic criteria

1.2 Background (II)

1.2.1 If biliary-type abdominal pain after cholecystectomy is considered as SOD, most of the patients are classified as SOD II and SOD III according to Rome III Criteria-modified.

Biliary SOD Type I: moderate or severe biliary-type abdominal pain; transient ALT / AST/ALP elevation > 2ULN; CBD dilation > 8mm as evidenced by ultrasound or other non-invasive examination Type II: biliary-type abdominal pain; One or two of above items Type III:only biliary-type abdominal pain

1.3 Background (III)

1.3.1 Treatment of SOD is being disputed: currently, the main method is to relax sphincter of Oddi (SO).

  • Medications: antispasmodic drugs, nitrates, calcium ion antagonists, modulators of gastrointestinal (GI) motility
  • EST(endoscopic sphincterotomy): postoperative complications and mortality

1.3.2 EST is not well effective in the treatment of SOD type II and type III, which are mostly caused by functional abnormalities

-ASGE guideline 2015 points out that EST is not recommended for patients with SOD type III. Endoscopic stents are not recommended, either.

1.3.3 Danshu Capsules: contains the active pharmaceutical ingredient (API) and has the effects of fighting infection, alleviating pain, promoting bile secretion and lifting muscle spasms; literature showed that Danshu Capsules effectively improved the symptoms of biliary disorders, such as pain, nausea and abdominal distension.

1.3.4 Pinaverium Bromide: able to improve the spasms of SO; literature showed that it treated biliary disorders effectively.·10%~50% of the patients who previously underwent cholecystectomy experience recurrent abdominal pain with or without diarrhea, abdominal distention, enzymatic changes, etc., and sphincter of Oddi dysfunction (SOD) accounts for about 13% of such cases.

Being tested
Danshu Capsules, Pinaverium Bromide
Keywords
Pinaverium Bromide, cholecystectomy, Sphincter of Oddi Dysfunction
Medical subject headings
Sphincter of Oddi Dysfunction

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Danshu CapsulesDrug

    Also called Danshu softgel Capsules

    Danshu Capsules (0.9g potid/day) for three months by oral

  • Pinaverium BromideDrug

    Also called Dicetel

    Pinaverium Bromide (100mg potid/day) for three months by oral

Study groups in NCT02833103
Study groupRoleWhat they receive
Pinaverium Bromide groupExperimentalAble to improve the spasms of SO; literature showed that it treated biliary disorders effectively.
Receives: Drug: Pinaverium Bromide
Danshu groupActive comparatorContains the active pharmaceutical ingredient (API) and has the effects of fighting infection, alleviating pain, promoting bile secretion and lifting muscle spasms; literature showed that Danshu Capsules effectively improved the symptoms of biliary disorders, such as pain, nausea and abdominal distension.
Receives: Drug: Danshu Capsules

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Efficacy Evaluation of Reduction in Abdominal Pain Scores,Change From Baseline to 3 Months After Medication

    abdominal pain scores (baseline vs. 3 months after treatment)

    • Abdominal pain score based on main symptom: Degree of pain in point(0 - no pain [0 point];1~3 - mild pain [1 point];4~6 moderate pain [2 point]];7~10 - severe pain [3 point])、Frequency in times/week (No episodes[0 point];1 time/week[1 point];2 times/week[2 point]; 3 times/week[3 point])、Duration in days/week(No episodes[0 point];< 1 day/week[1 point];1-2days/week[2 points];≥ 3days/week[3 points])
    • The sum of the scores for the above three items is the total score for abdominal pain.
    • Efficacy evaluation: reduction in abdominal pain score, as compared with the baseline
    • = 100%: complete remission (CR);60%~99%: significant remission (SR);30% ~ 59%: partial remission (PR);0% ~ 29%: no response (NR)
    • Treatment response = CR + SR
    • Treatment response rate = (CR + SR) / the total number of patients

    Measured: Change From Baseline to 3 Months After Medication

Secondary outcomes (3)
  1. Changes in the Common Bile Duct (CBD) Diameter Measured by Ultrasound B Once a Month

    Changes in the CBD diameter measured by ultrasound B

    • Each patient is required to abstain from eating for 12 hours and then takes a measurement of the CBD diameter by ultrasound B the next morning
    • The measurement takes places once a month, four times totally (baseline / 4w after treatment / 8w after treatment / 12w after treatment)

    Measured: Once a Month, Four Times Totally (baseline / 4w after treatment / 8w after treatment / 12w after treatment)

  2. Efficacy of Lowering Liver Enzymes as Assessed by Laboratory Test Once a Month

    • Changes in hepatic enzyme levels (ALT, AST and ALP)
    • The measurement takes place once a month, four times totally (baseline / 4w after treatment / 8w after treatment / 12w after treatment)

    Measured: Once a Month, Four Times Totally (baseline / 4w after treatment / 8w after treatment / 12w after treatment)

  3. Number of Participants With Treatment-Related Diarrhea,Change From Baseline to 3 Months After Medication

    The number of patients presenting the symptoms of diarrhea will be calculated at the time of enrollment (baseline) and 3 months after treatment respectively.

    Measured: From Baseline to 3 Months After Medication

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted14 Jul 2016 (estimated)
  2. Study startJul 2016
  3. Primary completionFeb 2018 (estimated)
  4. Study completionFeb 2018 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
168 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02833103
Sponsor's protocol ID
XH-16-015
Status last verified
Jul 2016
First submitted
4 Jul 2016
Last updated
14 Jul 2016
Results posted
No
Data monitoring committee
No
Individual data sharing
No

Publications

  • Cotton PB, Durkalski V, Romagnuolo J, Pauls Q, Fogel E, Tarnasky P, Aliperti G, Freeman M, Kozarek R, Jamidar P, Wilcox M, Serrano J, Brawman-Mintzer O, Elta G, Mauldin P, Thornhill A, Hawes R, Wood-Williams A, Orrell K, Drossman D, Robuck P. Effect of endoscopic sphincterotomy for suspected sphincter of Oddi dysfunction on pain-related disability following cholecystectomy: the EPISOD randomized clinical trial. JAMA. 2014 May;311(20):2101-9. doi: 10.1001/jama.2014.5220.

    PubMed 24867013
  • Vitton V, Ezzedine S, Gonzalez JM, Gasmi M, Grimaud JC, Barthet M. Medical treatment for sphincter of oddi dysfunction: can it replace endoscopic sphincterotomy? World J Gastroenterol. 2012 Apr 14;18(14):1610-5. doi: 10.3748/wjg.v18.i14.1610.

    PubMed 22529689
  • Okoro N, Patel A, Goldstein M, Narahari N, Cai Q. Ursodeoxycholic acid treatment for patients with postcholecystectomy pain and bile microlithiasis. Gastrointest Endosc. 2008 Jul;68(1):69-74. doi: 10.1016/j.gie.2007.09.046.

    PubMed 18577477
  • Kalaitzakis E, Ambrose T, Phillips-Hughes J, Collier J, Chapman RW. Management of patients with biliary sphincter of Oddi disorder without sphincter of Oddi manometry. BMC Gastroenterol. 2010 Oct 22;10:124. doi: 10.1186/1471-230X-10-124.

    PubMed 20969779
  • Behar J, Corazziari E, Guelrud M, Hogan W, Sherman S, Toouli J. Functional gallbladder and sphincter of oddi disorders. Gastroenterology. 2006 Apr;130(5):1498-509. doi: 10.1053/j.gastro.2005.11.063.

    PubMed 16678563
  • Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology. 2006 Apr;130(5):1377-90. doi: 10.1053/j.gastro.2006.03.008. No abstract available.

    PubMed 16678553
  • Hernando N, Gisler SM, Reining SC, Deliot N, Capuano P, Biber J, Murer H. NaPi-IIa interacting proteins and regulation of renal reabsorption of phosphate. Urol Res. 2010 Aug;38(4):271-6. doi: 10.1007/s00240-010-0304-3. Epub 2010 Jul 28.

    PubMed 20665015

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Danshu Capsules and Pinaverium Bromide in people with Sphincter of Oddi Dysfunction, run by Xinhua Hospital, Shanghai Jiao Tong University School of Medicine at 1 site in China.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 14 Jul 2016. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in China. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Zhaohui Tang, MD,PhD (+86 021 25078999-7905, tangzhaohui@yahoo.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Efficacy Evaluation of Reduction in Abdominal Pain Scores,Change From Baseline to 3 Months After Medication (time frame: Change From Baseline to 3 Months After Medication). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02833103, which also lists 7 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Jul 2016.

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