Abdominal Pain
Conditions
Brief summary
In contrast with Hyoscine Butylbromide Capsule 10mg, Study is to evaluate the efficacy and safety of Hyoscine Butylbromide tablets 10 mg (20mg, 3 times daily, orally) over a period of 3 days for the treatment of occasional or recurrent episodes of self-reported gastric or intestinal spasm-like pain or discomfort
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
1. Written Informed Consent given by the patient 2. Male and female patients aging from 18 to 70 3. Subjects with occasional or recurrent episodes of gastric or intestinal spasm-like pain, or discomfort, such as occur e.g. in irritable bowel syndrome, which has been present for at least 3 months 4. The pain intensity score upon screening is at least 4 cm in VAS score
Exclusion criteria
1. Patients with the following concomitant disease were not eligible for enrolment * Painful gastric or intestinal spasm of organic origin such as Crohn's disease, ulcerative colitis, lactose intolerance, gastritis, ulcer. Exception: diverticulitis and mild gastritis if dominant symptom was cramp pain, but ineligible if heartburn or reflux were dominant symptoms * Pain related with malignancy * Patients with other severe pain states of organic origin * Mechanical stenosis of the gastrointestinal tract, megacolon * Urinary retention associated with mechanical stenosis of urinary tract * Narrow-angled glaucoma * Tachyarrhythmia * Myasthenia gravis * Meulengracht-Gilbert syndrome * Known depression or known mental illness, anxiety disturbance 2. Frequent vomiting that might have prevented adequate absorption of the active ingredient after the film-coated tablet was taken 3. Patients taking the following concomitant medication are not eligible for enrolment * Analgesics * Spasmolytics * Anticholinergics * Affecting gastrointestinal motility, such as propantheline metoclopramide, cisapride, loperamide, diphenoxylate, opioid analgesics, antacids and other ulcer treatment * Regular administration of laxatives * Narcotics * Antidepressant treatment or treatment with psychoactive drugs 4. Pregnancy and/or lactation or planned pregnancy 5. Known hypersensitivity to N-butylscopolammonium bromide 6. Alcohol or drug abuse 7. Simultaneous participating in another clinical trial, or discontinuing from another clinical trial before randomization (administration of study medication); moreover, in the case of screening failure or premature discontinuing from the trial, repeated enrolment is forbidden 8. Unwilling to or unable to complete the entire trial procedure according to the protocol 9. In investigator's opinion, the patient was not proper for the trial
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change of the Mean Pain Intensity Score Measured on a Visual Analogue Scale (VAS) Within 3 Days (and Within 1 Day) - ANCOVA | 3 days (1 day) | The endpoint presents change of the mean Visual Analogue Scale (VAS) of pain intensity score, recorded daily by the patient in the evening in his/her patient diary describing pain intensity during the previous 24 hours, from the baseline pain intensity. The baseline pain intensity was the pain intensity of first episode on Day 1 after randomization before taking study medication. The mean VAS pain intensity score was calculated for the 3-day treatment period. A VAS for describing the pain intensity was used (VAS: maximum score of 10 cm, the score from 0 - 10 cm reaching from no pain to the most severe pain imaginable). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Global Assessment of Efficacy by Patient on 4-point Scale | Post 3 days of treatment. | The endpoint presents global assessment of efficacy: by the patient after 3 days of treatment using a 4-point rating scale (good, satisfactory, not satisfactory, and bad). |
| Number of Patients With Adverse Events | Up to 3 days. | The endpoint presents number of patients with Adverse Events (AEs). Subjects were required to report spontaneously any AEs as well as the time of onset, end and intensity of these events. Specific questions were asked wherever required or useful to more precisely describe an AE. An Adverse Event was termed serious when one of the following applied: death, directly lifethreatening, continuous or severe impairment, in-patient treatment or prolonging of hospitalization, congenital deformity and other similar medical criteria. |
| Change of the Pain Frequency Assessed on 4-stage Verbal Rating Scale (VRS) | Up to 3 days. | The endpoint presents frequency improvement, change of the pain frequency from baseline pain frequency for each of Day 1 - 3. Baseline pain frequency meant the pain frequency before randomization on visit 1. VRS score of Day 3 change from baseline was calculated. A retrospective assessment was entered by the patient in the patient diary, again once daily in the evening, of the pain frequency over the preceding 24 hour period. This was based on a 4-stage Verbal Rating Scale (VRS) with the following scores to the question: How many times have the spasm-like pains occurred today? 0 = not at all, 1 = 1-2 times, 2 = 3-5 times, 3 = more than 5 times. |
| Number of Subjects With Clinical Relevant Abnormalities for Laboratory, Vital Signs, ElectroCardioGram (ECG) and Physical Examination | Up to 3 days. | Number of patients with findings in clinical relevant abnormalities for laboratory, vital signs, ElectroCardioGram (ECG) and physical examination. Relevant findings or worsening of baseline conditions were reported as Adverse Events (AEs). |
| Percentage of Event for Time to Therapeutic Effect | From time of the first dose to the time that the first VAS reduction occurred, up to 180 minutes after the first dose on Day 1. | This outcome measure presents percentage of event for time to therapeutic effect defined as the time that the first VAS reduction occurred. |
| Global Assessment of Tolerability by Investigator on a 4-point Scale | Day 3. | The endpoint presents global assessment of tolerability by subject on a 4-point scale. Global assessment of tolerability regarding all episodes treated by the subject after 3 days of treatment (good, satisfactory, not satisfactory, bad). |
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Hyoscine Butylbromide - Tablet The subjects administered Hyoscine Butylbromide (10 mg), (Brand name: Buscopan) sugar coated tablet 20 mg orally, 3 times daily for 3 days. | 146 |
| Hyoscine Butylbromide - Capsule The subjects administered Hyoscine Butylbromide (10 mg), (Brand name: Jie Jing Ning) sugar coated capsule 20 mg orally, 3 times daily for 3 days. | 142 |
| Total | 288 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 1 | 0 |
| Overall Study | Lost to Follow-up | 2 | 0 |
| Overall Study | Non-compliance dosing regimen or visit | 2 | 2 |
| Overall Study | Subject withdraws inform consent | 0 | 4 |
| Overall Study | Without spasm-like pain during 3 weeks | 1 | 4 |
Baseline characteristics
| Characteristic | Hyoscine Butylbromide - Tablet | Hyoscine Butylbromide - Capsule | Total |
|---|---|---|---|
| Age, Continuous | 43.2 Years STANDARD_DEVIATION 12.49 | 41.9 Years STANDARD_DEVIATION 12.05 | 42.6 Years STANDARD_DEVIATION 12.27 |
| Sex: Female, Male Female | 89 Participants | 84 Participants | 173 Participants |
| Sex: Female, Male Male | 57 Participants | 58 Participants | 115 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 146 | 0 / 142 |
| serious Total, serious adverse events | 0 / 146 | 0 / 142 |
Outcome results
Change of the Mean Pain Intensity Score Measured on a Visual Analogue Scale (VAS) Within 3 Days (and Within 1 Day) - ANCOVA
The endpoint presents change of the mean Visual Analogue Scale (VAS) of pain intensity score, recorded daily by the patient in the evening in his/her patient diary describing pain intensity during the previous 24 hours, from the baseline pain intensity. The baseline pain intensity was the pain intensity of first episode on Day 1 after randomization before taking study medication. The mean VAS pain intensity score was calculated for the 3-day treatment period. A VAS for describing the pain intensity was used (VAS: maximum score of 10 cm, the score from 0 - 10 cm reaching from no pain to the most severe pain imaginable).
Time frame: 3 days (1 day)
Population: Per-Protocol Set (PPS): All randomized subjects in FAS without any major protocol violation were included into the per protocol set, including those subjects who had good treatment compliance (80% to 120%), who did not take any restriction medications during the study period and whose Case Report Form (CRF) was complete as requested.
| Arm | Measure | Group | Value (NUMBER) | Dispersion |
|---|---|---|---|---|
| Hyoscine Butylbromide - Tablet | Change of the Mean Pain Intensity Score Measured on a Visual Analogue Scale (VAS) Within 3 Days (and Within 1 Day) - ANCOVA | Within 3 days | -2.48 Units on a scale | 1.968 |
| Hyoscine Butylbromide - Tablet | Change of the Mean Pain Intensity Score Measured on a Visual Analogue Scale (VAS) Within 3 Days (and Within 1 Day) - ANCOVA | Within 1 day | -2.36 Units on a scale | 1.984 |
| Hyoscine Butylbromide - Capsule | Change of the Mean Pain Intensity Score Measured on a Visual Analogue Scale (VAS) Within 3 Days (and Within 1 Day) - ANCOVA | Within 3 days | -2.45 Units on a scale | 1.879 |
| Hyoscine Butylbromide - Capsule | Change of the Mean Pain Intensity Score Measured on a Visual Analogue Scale (VAS) Within 3 Days (and Within 1 Day) - ANCOVA | Within 1 day | -2.31 Units on a scale | 1.914 |
Change of the Pain Frequency Assessed on 4-stage Verbal Rating Scale (VRS)
The endpoint presents frequency improvement, change of the pain frequency from baseline pain frequency for each of Day 1 - 3. Baseline pain frequency meant the pain frequency before randomization on visit 1. VRS score of Day 3 change from baseline was calculated. A retrospective assessment was entered by the patient in the patient diary, again once daily in the evening, of the pain frequency over the preceding 24 hour period. This was based on a 4-stage Verbal Rating Scale (VRS) with the following scores to the question: How many times have the spasm-like pains occurred today? 0 = not at all, 1 = 1-2 times, 2 = 3-5 times, 3 = more than 5 times.
Time frame: Up to 3 days.
Population: Per-Protocol Set (PPS): All randomized subjects in FAS without any major protocol violation were included into the per protocol set, including those subjects who had good treatment compliance (80% to 120%), who did not take any restriction medications during the study period and whose Case Report Form (CRF) was complete as requested.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Hyoscine Butylbromide - Tablet | Change of the Pain Frequency Assessed on 4-stage Verbal Rating Scale (VRS) | Day 1-Baseline | -0.4 Units on a scale | Standard Deviation 0.77 |
| Hyoscine Butylbromide - Tablet | Change of the Pain Frequency Assessed on 4-stage Verbal Rating Scale (VRS) | Day 3-Baseline | -1.0 Units on a scale | Standard Deviation 0.94 |
| Hyoscine Butylbromide - Capsule | Change of the Pain Frequency Assessed on 4-stage Verbal Rating Scale (VRS) | Day 1-Baseline | -0.2 Units on a scale | Standard Deviation 0.73 |
| Hyoscine Butylbromide - Capsule | Change of the Pain Frequency Assessed on 4-stage Verbal Rating Scale (VRS) | Day 3-Baseline | -0.8 Units on a scale | Standard Deviation 0.94 |
Global Assessment of Efficacy by Patient on 4-point Scale
The endpoint presents global assessment of efficacy: by the patient after 3 days of treatment using a 4-point rating scale (good, satisfactory, not satisfactory, and bad).
Time frame: Post 3 days of treatment.
Population: Full Analysis Set (FAS): According to the Intent-to-Treat (ITT) principle, all randomized subjects who took at least one dose of study medication and who provided any data for the primary efficacy endpoint were used in FAS.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Hyoscine Butylbromide - Tablet | Global Assessment of Efficacy by Patient on 4-point Scale | Good | 35 Participants |
| Hyoscine Butylbromide - Tablet | Global Assessment of Efficacy by Patient on 4-point Scale | Satisfactory | 69 Participants |
| Hyoscine Butylbromide - Tablet | Global Assessment of Efficacy by Patient on 4-point Scale | Not satisfactory | 37 Participants |
| Hyoscine Butylbromide - Tablet | Global Assessment of Efficacy by Patient on 4-point Scale | Bad | 2 Participants |
| Hyoscine Butylbromide - Capsule | Global Assessment of Efficacy by Patient on 4-point Scale | Bad | 0 Participants |
| Hyoscine Butylbromide - Capsule | Global Assessment of Efficacy by Patient on 4-point Scale | Good | 35 Participants |
| Hyoscine Butylbromide - Capsule | Global Assessment of Efficacy by Patient on 4-point Scale | Not satisfactory | 30 Participants |
| Hyoscine Butylbromide - Capsule | Global Assessment of Efficacy by Patient on 4-point Scale | Satisfactory | 76 Participants |
Global Assessment of Tolerability by Investigator on a 4-point Scale
The endpoint presents global assessment of tolerability by subject on a 4-point scale. Global assessment of tolerability regarding all episodes treated by the subject after 3 days of treatment (good, satisfactory, not satisfactory, bad).
Time frame: Day 3.
Population: Safety Set (SFS): All randomized subjects who took at least one dose of study medication.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Hyoscine Butylbromide - Tablet | Global Assessment of Tolerability by Investigator on a 4-point Scale | Good | 51 Participants |
| Hyoscine Butylbromide - Tablet | Global Assessment of Tolerability by Investigator on a 4-point Scale | Satisfactory | 72 Participants |
| Hyoscine Butylbromide - Tablet | Global Assessment of Tolerability by Investigator on a 4-point Scale | Not satisfactory | 21 Participants |
| Hyoscine Butylbromide - Tablet | Global Assessment of Tolerability by Investigator on a 4-point Scale | Bad | 1 Participants |
| Hyoscine Butylbromide - Capsule | Global Assessment of Tolerability by Investigator on a 4-point Scale | Bad | 0 Participants |
| Hyoscine Butylbromide - Capsule | Global Assessment of Tolerability by Investigator on a 4-point Scale | Good | 47 Participants |
| Hyoscine Butylbromide - Capsule | Global Assessment of Tolerability by Investigator on a 4-point Scale | Not satisfactory | 22 Participants |
| Hyoscine Butylbromide - Capsule | Global Assessment of Tolerability by Investigator on a 4-point Scale | Satisfactory | 72 Participants |
Number of Patients With Adverse Events
The endpoint presents number of patients with Adverse Events (AEs). Subjects were required to report spontaneously any AEs as well as the time of onset, end and intensity of these events. Specific questions were asked wherever required or useful to more precisely describe an AE. An Adverse Event was termed serious when one of the following applied: death, directly lifethreatening, continuous or severe impairment, in-patient treatment or prolonging of hospitalization, congenital deformity and other similar medical criteria.
Time frame: Up to 3 days.
Population: Safety Set (SFS): All randomized subjects who took at least one dose of study medication.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Hyoscine Butylbromide - Tablet | Number of Patients With Adverse Events | Subjects with Serious Adverse Event (SAE) | 0 Participants |
| Hyoscine Butylbromide - Tablet | Number of Patients With Adverse Events | Subjects with AE: Mild | 10 Participants |
| Hyoscine Butylbromide - Tablet | Number of Patients With Adverse Events | Subjects with treatment related AE | 5 Participants |
| Hyoscine Butylbromide - Tablet | Number of Patients With Adverse Events | Subjects with AE: Moderate | 0 Participants |
| Hyoscine Butylbromide - Tablet | Number of Patients With Adverse Events | AE leading to discontinuation from treatment | 1 Participants |
| Hyoscine Butylbromide - Tablet | Number of Patients With Adverse Events | Subjects with AE: Severe | 0 Participants |
| Hyoscine Butylbromide - Tablet | Number of Patients With Adverse Events | Subjects with AE | 10 Participants |
| Hyoscine Butylbromide - Capsule | Number of Patients With Adverse Events | Subjects with AE: Severe | 0 Participants |
| Hyoscine Butylbromide - Capsule | Number of Patients With Adverse Events | Subjects with AE | 10 Participants |
| Hyoscine Butylbromide - Capsule | Number of Patients With Adverse Events | Subjects with treatment related AE | 5 Participants |
| Hyoscine Butylbromide - Capsule | Number of Patients With Adverse Events | Subjects with Serious Adverse Event (SAE) | 0 Participants |
| Hyoscine Butylbromide - Capsule | Number of Patients With Adverse Events | AE leading to discontinuation from treatment | 0 Participants |
| Hyoscine Butylbromide - Capsule | Number of Patients With Adverse Events | Subjects with AE: Mild | 10 Participants |
| Hyoscine Butylbromide - Capsule | Number of Patients With Adverse Events | Subjects with AE: Moderate | 0 Participants |
Number of Subjects With Clinical Relevant Abnormalities for Laboratory, Vital Signs, ElectroCardioGram (ECG) and Physical Examination
Number of patients with findings in clinical relevant abnormalities for laboratory, vital signs, ElectroCardioGram (ECG) and physical examination. Relevant findings or worsening of baseline conditions were reported as Adverse Events (AEs).
Time frame: Up to 3 days.
Population: Safety Set (SFS): All randomized subjects who took at least one dose of study medication.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Hyoscine Butylbromide - Tablet | Number of Subjects With Clinical Relevant Abnormalities for Laboratory, Vital Signs, ElectroCardioGram (ECG) and Physical Examination | Urinary Red Blood Cell count abnormalities | 2 Participants |
| Hyoscine Butylbromide - Tablet | Number of Subjects With Clinical Relevant Abnormalities for Laboratory, Vital Signs, ElectroCardioGram (ECG) and Physical Examination | White Blood Cell count abnormalities | 0 Participants |
| Hyoscine Butylbromide - Tablet | Number of Subjects With Clinical Relevant Abnormalities for Laboratory, Vital Signs, ElectroCardioGram (ECG) and Physical Examination | Urinary albumin abnormalities | 1 Participants |
| Hyoscine Butylbromide - Tablet | Number of Subjects With Clinical Relevant Abnormalities for Laboratory, Vital Signs, ElectroCardioGram (ECG) and Physical Examination | Platelet count abnormalities | 0 Participants |
| Hyoscine Butylbromide - Tablet | Number of Subjects With Clinical Relevant Abnormalities for Laboratory, Vital Signs, ElectroCardioGram (ECG) and Physical Examination | Urinary White Bllood Cell count abnormalities | 4 Participants |
| Hyoscine Butylbromide - Capsule | Number of Subjects With Clinical Relevant Abnormalities for Laboratory, Vital Signs, ElectroCardioGram (ECG) and Physical Examination | Platelet count abnormalities | 1 Participants |
| Hyoscine Butylbromide - Capsule | Number of Subjects With Clinical Relevant Abnormalities for Laboratory, Vital Signs, ElectroCardioGram (ECG) and Physical Examination | Urinary White Bllood Cell count abnormalities | 2 Participants |
| Hyoscine Butylbromide - Capsule | Number of Subjects With Clinical Relevant Abnormalities for Laboratory, Vital Signs, ElectroCardioGram (ECG) and Physical Examination | Urinary Red Blood Cell count abnormalities | 1 Participants |
| Hyoscine Butylbromide - Capsule | Number of Subjects With Clinical Relevant Abnormalities for Laboratory, Vital Signs, ElectroCardioGram (ECG) and Physical Examination | Urinary albumin abnormalities | 1 Participants |
| Hyoscine Butylbromide - Capsule | Number of Subjects With Clinical Relevant Abnormalities for Laboratory, Vital Signs, ElectroCardioGram (ECG) and Physical Examination | White Blood Cell count abnormalities | 1 Participants |
Percentage of Event for Time to Therapeutic Effect
This outcome measure presents percentage of event for time to therapeutic effect defined as the time that the first VAS reduction occurred.
Time frame: From time of the first dose to the time that the first VAS reduction occurred, up to 180 minutes after the first dose on Day 1.
Population: Per-Protocol Set (PPS): All randomized subjects in FAS without any major protocol violation were included into the per protocol set, including those subjects who had good treatment compliance (80% to 120%), who did not take any restriction medications during the study period and whose Case Report Form (CRF) was complete as requested.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Hyoscine Butylbromide - Tablet | Percentage of Event for Time to Therapeutic Effect | 93.6 Percentage of event |
| Hyoscine Butylbromide - Capsule | Percentage of Event for Time to Therapeutic Effect | 92.1 Percentage of event |