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NCT Number: NCT03827655

A Study of TAK-954 to Treat Gastrointestinal Dysfunction in Adults After Surgery

The main aim of this study is to check for side effects from TAK-954 and whether it speeds up the recovery of gastrointestinal function after small-bowel or large-bowel resection surgery.

Participants will be treated with TAK-954 before surgery and up to 10 days after surgery.

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 2

Primary location

Universitatsklinikum Freiburg, Freiburg im Breisgau, Baden-Wurttemberg, Germany

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About this study

The drug being tested in this study is called TAK-954. In this study TAK-954 is being administered presurgery to evaluate if it can enhance the recovery of GI function postsurgery in participants undergoing open or laparoscopic-assisted partial small- or large-bowel resection. In addition, some participants will also receive TAK-954 postoperatively to evaluate if there is an additional benefit when this drug is administered both pre and post-surgery.

The study will enroll approximately 180 participants. Participants will be equally randomized into one of the three remaining parallel treatment arms- which will remain undisclosed to the participant and study doctor during the study (unless there is an urgent medical need).

All participants will be given intravenous infusion preoperation and daily postoperation until return of upper and lower GI function or for up to 10 days.

This multi-center trial will be conducted in the United States and Germany. The overall time to participate in this study is up to 100 days. Participants will be treated with the study drug for up to 10 days after surgery or until return of GI function post-surgery (whichever occurs first).

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Participant is scheduled to undergo a laparoscopic-assisted or open partial small- or large-bowel resection.
  • Participant's American Society of Anesthesiologists (ASA) physical status classification is ASA 1 to 3.

Exclusion criteria

  • Has significant mechanical bowel obstruction that is not expected to resolve after the surgery, short bowel syndrome, pre-existing clinically significant GI motility disorder (example, gastroparesis, scleroderma, chronic intestinal pseudo-obstruction), uncontrolled diabetes (glycosylated hemoglobin [HbA1c] greater than [>] 10 percent [%]), has an active gastric pacemaker, or requires parenteral nutrition.
  • Had previous major abdominal surgery (example, gastrectomy, gastric bypass, gastric sleeve, lap banding, Whipple, pancreatic resection, total/subtotal colectomy, hemicolectomy, extensive bowel resection).
  • Had a history of radiation therapy to the abdomen or pelvis.
  • Scheduled to undergo any of the following surgeries: low anterior resection, total or subtotal colectomy, colostomy, ileostomy or reversal of stoma, or has a diagnosis that requires rectal resection (eg, tumors in the anorectum) and will likely require lower anterior resection surgery. Participants with planned surgery for which there is no anticipated significant rectal resection and is, therefore, likely to preserve anorectal function and continence postsurgery, will likely be eligible for inclusion in the study if they meet all the study inclusion/exclusion criteria (eg, participants with lesions not involving the rectum [sigmoid colon and above]).
  • Has pre-existing hepatic disease that meets Child-Pugh Class B (moderate; total score 7 to 9 points) or C (severe; total score 10 to 15 points).
  • Has received alvimopan, erythromycin, prucalopride, metoclopramide, domperidone, cisapride, mosapride, renzapride, or azithromycin in the 24 hours prior to starting study drug.
  • Participant has known COVID-19 infection, or suspected COVID-19 infection.
  • Scheduled for abdominal surgery that is classified as emergency.

Treatment and study plan

TAK-954 Placebo

Drug

TAK-954 placebo-matching intravenous infusion.

TAK-954

Drug

TAK-954 intravenous infusion.

Primary outcomes

  1. Time From End of the Surgery to Resolution of Upper and Lower Gastrointestinal (GI) Function Postsurgery as Assessed by the Investigator

    Time frame: Day 1 (surgery) up to Day 10 postsurgery

    The time from end of surgery to tolerance of solid food, without first occurrence of vomiting or clinically significant nausea for 1 calendar day after a solid meal (upper GI function) and first spontaneous bowel movement (lower GI function), whichever occurred later up to 10 days postsurgery was observed. Kaplan-Meier survival analysis method was used.

Secondary outcomes

  1. Time From the End of the Surgery (Time the Incision is Closed) Until Ready for Discharge as Assessed by the Investigator

    Time frame: Day 1 (surgery) up to Day 24

    The time from the end of surgery (time the incision is closed) until ready for discharge was defined as time from end of surgery until the participant presented effective intestinal transit (spontaneous bowel movement), tolerated solids without vomiting or clinically significant nausea for 1 calendar day after a solid meal, had satisfactory pain control with oral analgesics, and was medically stable/free of complications. Kaplan-Meier survival analysis method was used.

  2. Time From the End of Surgery Until the Discharge Order is Written

    Time frame: Day 1 (surgery) up to Day 24

    Kaplan-Meier survival analysis method was used.

  3. Time From the End of Surgery to Discharge From Hospital

    Time frame: Day 1 (surgery) up to Day 24

    Kaplan-Meier survival analysis method was used.

  4. Time From End of Surgery to Tolerance of Solid Food as Assessed by the Investigator

    Time frame: Day 1 (surgery) up to Day 10 postsurgery

    The time from end of surgery to tolerance of solid food was defined as intake of solids without vomiting or clinically significant nausea for 1 calendar day after a solid meal. Kaplan-Meier survival analysis method was used.

  5. Time From End of Surgery to First Spontaneous Bowel Movement as Assessed by the Investigator

    Time frame: Day 1 (surgery) up to Day 10 postsurgery

    The time from end of surgery to first spontaneous bowel movement was defined as a stool not induced by the use of enemas or laxatives. Kaplan-Meier survival analysis method was used.

  6. Percentage of Participants With Postoperative Gastrointestinal Dysfunction (POGD) >= 5 Days as Assessed by the Investigator

    Time frame: Day 1 (surgery) up to Day 10

    Participants unable to tolerate solid foods, take anything by mouth, or requiring insertion or reinsertion of nasogastric (NG) tube at or after 5 days post-surgery. Percentages are rounded off to whole number at the nearest single decimal. Stratified Miettinen and Nurminen approach was used for analysis.

  7. Percentage of Participants Requiring Insertion of Nasogastric (NG) Tube Postsurgery

    Time frame: Day 1 (surgery) up to Day 24 postsurgery (10 days of treatment period postsurgery plus 14-day observation period post last dose for recurrence of symptoms)

    Participants who required insertion of NG tube postsurgery for drainage and symptom relief in case of persistent nausea and vomiting postsurgery were observed. Percentages are rounded off to whole number at the nearest single decimal. Stratified Miettinen and Nurminen approach was used for analysis.

  8. Time From End of Surgery to First Flatus

    Time frame: Day 1 (surgery) up to first flatus (up to Day 10 postsurgery)

    Kaplan-Meier survival analysis method was used.

  9. Observed Plasma Concentration of TAK-954 at the End of Infusion on Day 1

    Time frame: Day 1 (surgery): postinfusion

Sponsors and collaborators

Lead sponsor

Takeda

Industry

Collaborators

  • Takeda Development Center Americas, Inc.

Registry information

Official study title

A Randomized, Double-Blind, Placebo-Controlled, Phase 2 Dose Ranging Study to Evaluate the Efficacy and Safety of 2 Dose Regimens of Intravenous TAK-954 for the Prophylaxis and Treatment of Postoperative Gastrointestinal Dysfunction in Patients Undergoing Large- and Small-Bowel Resection

Important dates

Study start
2019
Primary completion
2022
Study completion
2022
First posted
Feb 1, 2019
Registry last updated
Jun 23, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

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This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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