# Cilansetron Improves Health Related Quality of Life in Patients with IBS-D



## Jeffrey Roberts (Apr 15, 1987)

Cilansetron Improves Health Related Quality of Life in Multinational Phase III Clinical Trial Patients with Irritable Bowel Syndrome with Diarrhea Predominance (IBS-D)Monday November 1, 11:45 am ET Researchers Also Unveil Additional Efficacy Data on 5-HT3 Receptor Antagonist in U.S. Population News from American College of Gastroenterology (ACG) 2004 ORLANDO, Fla., Nov. 1 /PRNewswire/ -- In a sub-sample analysis of IBS-D subjects that completed a Phase III, 6-month, multinational trial, treatment with cilansetron resulted in significant improvement of health related quality of life (HRQOL) in both men and women. The largest improvements were observed for the interference with activity, food avoidance, and dysphoria. Also presented, was additional efficacy data from a Phase III U.S. study, further demonstrating the significant treatment benefits among subjects who received cilansetron, including improvement in overall IBS symptoms, abdominal pain/discomfort and abnormal bowel habits. These data were presented this week during the annual meeting for the American College of Gastroenterology (ACG).Cilansetron is an investigational 5-HT3 receptor antagonist, being studied for the treatment of irritable bowel syndrome with diarrhea predominance (IBS- D) in men and women. 5-HT3 antagonists inhibit 5-HT3 receptors, resulting in decreased GI motility, secretion, and pain sensation, thus improving symptoms of IBS. Current 5-HT3 therapy indicated for IBS is approved for women only."Irritable Bowel Syndrome is a leading cause of worker absenteeism and can have a significant negative impact on an individual's daily activities," said Dr. Kevin Olden, Professor of Medicine, Division of Gastroenterology, University of South Alabama, Mobile, Alabama. "Effective symptom control is critical to improving quality of life for the men and women who struggle with this condition on a daily basis."Study DetailsEfficacy of cilansetron compared to placebo on HRQOLIn a Phase III, 6-month, multinational study, subjects (ages 18-84) meeting the Rome criteria for IBS-D, were randomized to receive cilansetron 2 mg three times daily (TID) or placebo. A subgroup of 157 male and 181 female subjects completed an IBS-QOL survey, a validated 34-item condition-specific, quality-of-life measure consisting of eight subscales (interference with daily activity, body image, health worry, food avoidance, social reaction, sexual, relationship, and dysphoria), at day 1 of randomization and after 6 months of treatment. * Subjects showed total improvements of 17.7 for cilansetron vs. 9.6 for placebo in HRQOL scores (p .LT. 0.005) * Lower scores at baseline at day 1 and after 6 months of treatment indicated lower HRQOL. Higher scores after 6 months of treatment indicated a higher HRQOL * Results for cilansetron were statistically significant from placebo (p .LT. 0.005) for all subscales except the sexual subscale (p=0.169) * The sexual subscale showed the highest score at baseline and treatment reflects a trend in favor of cilansetronCilansetron in IBS-D: Efficacy and Safety in a Three-Month US StudyIn a Phase III study, 205 males and 487 females meeting the Rome criteria for IBS-D were randomized to receive cilansetron 2 mg TID or placebo for three months. An interactive voice response system was used to collect weekly data concerning relief of IBS symptoms, abdominal pain/discomfort, and abnormal bowel habits. * The primary efficacy parameter was the proportion of subjects who reported adequate relief of IBS symptoms on at least 50% of their weekly responses while receiving treatment * After three months, 49% of subjects (male and female) receiving cilansetron reported overall adequate relief of IBS symptoms versus 28% of subjects receiving placebo (p .LT. 0.001), while specifically 52% receiving cilansetron versus 37% who received placebo (p .LT. 0.001) reported relief of abdominal pain/discomfort, and 51% in the cilansetron group versus 26% in the placebo group (p .LT. 0.001) reported relief of abnormal bowel habits * The most common adverse effect was constipation, which occurred in 19% of subjects receiving cilansetron versus 4% in the placebo group; other adverse effects included headache and abdominal pain * No severe complications of constipation occurred. There was one suspected case of ischemic colitis which was transient and resolved without complication within 9 days.Drug and Study StatusIf approved, cilansetron is expected to be the only 5-HT3 therapy available to treat IBS-D in both men and women throughout the world. Solvay Pharmaceuticals has completed three phase III efficacy studies. A new drug application (NDA) was submitted to the FDA in the United States on June 30, 2004, and a registration dossier to the MHRA in the UK on April 28, 2004. The product has been assigned priority review by the FDA in the United States.Appropriate Use ProgramSolvay Pharmaceuticals' NDA submission in both the US and the UK includes a comprehensive appropriate use program based on collaboration with physicians, pharmacists, patients, and risk minimization experts. The cilansetron Appropriate Use Program (AUP) features an array of educational tools and specific promotional strategies that the company intends to discuss with the FDA.About IBSAs many as 30-45 million North American adults have symptoms of IBS, with approximately one-third from IBS-D. The common symptoms of IBS-D are diarrhea, abdominal pain/discomfort, and fecal urgency. IBS-D is a chronic condition that may require long-term therapy. Symptoms of IBS-D vary widely in occurrence and intensity among patients. IBS has a significant negative impact on the quality of life for the many men and women who suffer from this condition, causing lost days of work and interfering with home-based, social and leisure activities.About Solvay Pharmaceuticals, Inc.Solvay Pharmaceuticals, Inc. (http://www.solvaypharmaceuticals-us.com) of Marietta, Georgia (USA), is a research-driven pharmaceutical company that seeks to fulfil unmet medical needs in the therapeutic areas of cardiology, gastroenterology, mental health, women's health and a select group of specialized markets including men's health. It is a part of the global Solvay Pharmaceuticals organization whose core activities consist of discovering, developing, and manufacturing medicines for human use. Solvay Pharmaceuticals, Inc. is a subsidiary corporation of the worldwide Solvay Group of chemical and pharmaceutical companies headquartered in Brussels, Belgium.About ACGThe ACG was formed in 1932 to advance the scientific study and medical treatment of disorders of the gastrointestinal tract. The College promotes the highest standards in medical education and is guided by its commitment to meeting the needs of clinical gastroenterology practitioners. --------------------------------------------------------------------------------Source: Solvay Pharmaceuticals, Inc.


----------



## gradstudent (Jun 28, 2004)

Just curious what the projected date for release of Cilansetron in the U.S. is? Should I be calling my GI doctor soon? Thanks for the update!


----------



## jason haberland (Jun 28, 2004)

Jeffrey, thanks for the news, I hope this stuff comes out soon! I wonder if this drug makes the bowels more normal, how does it exactly work?


----------



## Mauricej (Oct 15, 2003)

This sounds great. When will it be available in Canada?


----------



## steitzsteitz (Jun 3, 2003)

Sounds good ! Can people that are on Warfarin (A blood thinner ) take this drug ?? S.G.


----------



## SpAsMaN* (May 11, 2002)

1996,i'm in contact with the MD in chrage of Cilansetron in Canada.


----------



## JBERCH (Feb 1, 2001)

IS THERE ANY INDICATION OF WHEN IT WILL MADE AVAILABLE IN THE US??? I AM A LOTRONEX USER AND MY DOC RETIRED WITHOUT ANY ADVANCE NOTICE. THE DOCS WHO BOUGHT HIS PRACTICE AREN'T GIVING LOTRONEX. CAN'T FIND A NEW DOC .help!!!!!~


----------



## jjohnson (Apr 29, 2004)

JBerch,The FDA is expected to make a decision about this drug by April 1. No word yet on when it may be available, but presumably some time this year if it is approved. I would post a question in the 5-HT3 forum about Lotronex doctors in your area. I think a number of users still drop by here on occasion and these sorts of questions usually get some replies. Best of luck.


----------

