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Trial registered on ANZCTR
Registration number
ACTRN12621000254897p
Ethics application status
Not yet submitted
Date submitted
17/12/2020
Date registered
10/03/2021
Date last updated
10/03/2021
Date data sharing statement initially provided
10/03/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Efficacy of oral pyridostigmine for the treatment of acute colonic pseudo-obstruction - a prospective, randomized, placebo-controlled trial.
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Scientific title
Efficacy of oral pyridostigmine for the treatment of acute colonic pseudo-obstruction in adults - a prospective, randomized, placebo-controlled trial.
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Secondary ID [1]
303040
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None
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Universal Trial Number (UTN)
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Trial acronym
OPPS-1
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute colonic pseudo-obstruction
320108
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Condition category
Condition code
Oral and Gastrointestinal
318049
318049
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Oral pyridostigmine 10mg two times a day for up to 48 hours or until bowels open, whichever earlier. Medication will be administered by nursing staff on the wards, as the trial participants will be current inpatients. Inpatient medical records will provide evidence of medication administration.
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Intervention code [1]
319329
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Treatment: Drugs
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Comparator / control treatment
Placebo-controlled (glucose capsule).
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Control group
Placebo
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Outcomes
Primary outcome [1]
326036
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Passage of bowel motions, as sighted and documented on stool chart by ward nursing staff.
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Assessment method [1]
326036
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Timepoint [1]
326036
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48 hours post commencement of intervention.
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Secondary outcome [1]
389939
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Time to passage of flatus, as reported by the patient, to the ward nursing staff.
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Assessment method [1]
389939
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Timepoint [1]
389939
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48 hours post commencement of intervention.
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Eligibility
Key inclusion criteria
Adult patients with acute colonic pseudo-obstruction confirmed on imaging (plain abdominal radiograph, computed tomography, or magnetic resonance imaging) in whom a distal colonic obstruction has been ruled out via a rigid sigmoidoscopy.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients with known adverse reaction to pyridostigmine.
Patients with signs of abdominal peritonism.
Patients currently already on oral pyridostigmine.
Patients
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Via sealed opaque envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomization using a randomization table.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/04/2021
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Actual
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Date of last participant enrolment
Anticipated
17/01/2022
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Actual
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Date of last data collection
Anticipated
28/02/2022
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
18234
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Box Hill Hospital - Box Hill
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Recruitment hospital [2]
18235
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Maroondah Hospital - Ringwood East
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Recruitment hospital [3]
18236
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Angliss Hospital - Upper Ferntree Gully
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Recruitment postcode(s) [1]
32298
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3128 - Box Hill
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Recruitment postcode(s) [2]
32299
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3135 - Ringwood East
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Recruitment postcode(s) [3]
32300
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3156 - Upper Ferntree Gully
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Funding & Sponsors
Funding source category [1]
307452
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Charities/Societies/Foundations
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Name [1]
307452
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Eastern Health Foundation
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Address [1]
307452
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Eastern Health
5 Arnold Street
Box Hill 3128
Victoria
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Country [1]
307452
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Australia
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Primary sponsor type
Hospital
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Name
Eastern Health - Box Hill Hospital
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Address
5 Arnold Street
Box Hill 3128
Victoria
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Country
Australia
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Secondary sponsor category [1]
308125
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None
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Name [1]
308125
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Address [1]
308125
0
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Country [1]
308125
0
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
307530
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Eastern Health Human Research Ethics Committee
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Ethics committee address [1]
307530
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Level 2 5 Arnold Street Box Hill 3128 Victoria
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Ethics committee country [1]
307530
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Australia
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Date submitted for ethics approval [1]
307530
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31/03/2021
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Approval date [1]
307530
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Ethics approval number [1]
307530
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Summary
Brief summary
This trial aims to investigate the efficacy of oral pyridostigmine, a medication currently used to treat Myasthenia Gravis, in the treatment of acute colonic pseudo-obstruction (ACPO). Acute colonic pseudo-obstruction occurs when the large intestine becomes dilated in the absence of downstream mechanical obstruction, and often occurs in the setting of hospitalized patients who are non-mobile, and/or are on significant amounts of opioid medications. Current treatment options for ACPO include the use of medications such as intravenous neostigmine, which is effective but requires cardiac monitoring due to the risk of cardiac arrhythmias, endoscopic decompression, or surgery. A recently published case series has suggested that oral pyridostigmine is effective in treating patients with ACPO, without the need for cardiac monitoring, unlike neostigmine. However, strong evidence in this field is still lacking, which this study aims to help address.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
107562
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Dr Jonathan Chua
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Address
107562
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Eastern Health
Box Hill Hospital
5 Arnold Street
Box Hill 3128 Victoria
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Country
107562
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Australia
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Phone
107562
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+61 403647567
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Fax
107562
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Email
107562
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[email protected]
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Contact person for public queries
Name
107563
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Jonathan Chua
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Address
107563
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Eastern Health
5 Box Hill Hospital
Arnold Street
Box Hill 3128 Victoria
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Country
107563
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Australia
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Phone
107563
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+61 403647567
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Fax
107563
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Email
107563
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[email protected]
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Contact person for scientific queries
Name
107564
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Jonathan Chua
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Address
107564
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Eastern Health
Box Hill Hospital
5 Arnold Street
Box Hill 3128 Victoria
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Country
107564
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Australia
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Phone
107564
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+61 403647567
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Fax
107564
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Email
107564
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Patient demographics, comorbidity count, control or intervention group, primary outcome, adverse events.
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When will data be available (start and end dates)?
28/02/2022 - 1 March 2026
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Available to whom?
De-identified data will be made available to clinical researchers upon request.
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Available for what types of analyses?
To achieve the aim of the study, and potential meta-analyses in the future within the proposed timeframe.
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How or where can data be obtained?
Access subject to approval from the principal investigator:
Dr Jonathan Chua
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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