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Manage Diarrhea in Patients With Multiple Myeloma While Receiving Conditioning Chemotherapy for Autologous SCT

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Mayo Clinic

Status and phase

Terminated
Phase 2

Conditions

Multiple Myeloma

Treatments

Other: Double Placebo
Drug: Colesevelam
Other: Serum-derived bovine immunoglobulin/protein isolate (SBI)

Study type

Interventional

Funder types

Other
Industry

Identifiers

NCT02619812
15-006205

Details and patient eligibility

About

For patients who receive a hematopoietic cell transplant (HCT), there is a risk of developing a diarrhea secondary to the chemotherapy which we give. Diarrhea is usually harmless in healthy adults; however, in transplant patients, diarrhea can result in dehydration, negative impact on quality of life, and prolonged hospitalization. The purpose of this study was to see if Colesevelam (Welchol) and Serum-derived bovine immunoglobulin-protein (SBI) result in a change in the frequency or consistency of your bowel movements.

Full description

This was a randomized, double-blind, placebo-controlled pilot study of SBI, colesevelam, and placebo in patients undergoing autologous HSCT for the clinical care of multiple myeloma.

The number of adults undergoing hematopoietic stem cell transplant (HSCT) has grown significantly over the past two decades as a result of the availability of therapies for advanced hematologic and solid tumor malignancies, and the broader selection criteria for eligibility to receive these transplants. Generally, the stem cell transplant procedure consists of administration of chemotherapy and/or radiation therapy to ablate all residual malignancy (called conditioning therapy), followed by intravenous infusion of hematopoietic stem cells to restore bone marrow function. Generally, HSCT has a positive effect on survival, despite serious adverse effects and life-threatening complications.

Diarrhea can affect up to 91% of patients receiving autologous or allogeneic HSCT and is identified by 9% of the patients as the single most debilitating adverse effect post-HSCT. Other commonly encountered symptoms are nausea and vomiting (13%) and mouth sores (42%). The impact of diarrhea can be significant and result in dehydration, negative impact on quality of life, prolonged hospitalization with an increased cost and risk, and the diarrhea may be potentially life-threatening.

Enrollment

4 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Age ≥18 years, male or female
  • Diagnosis: multiple myeloma undergoing Autologous Stem Cell Transplantation (SCT)
  • Planning to receive conditioning chemotherapy (Melphalan) for autologous stem cell transplantation and standard prophylactic antibiotics treatment.
  • Can drink 200ml of mannitol and agrees to undergo stool, urine, and blood checks 3 times during the study.
  • Agrees and able to take the investigational products or placebo starting from the day of completing conditioning therapy for a total of 4 weeks

Exclusion criteria

  • Patients with history of inflammatory bowel disease will be excluded from the study.
  • Patients with prior GI tract surgical (small or large bowel) resections
  • The concurrent presence of systemic light chain amyloidosis
  • Subject has known allergy or intolerance to beef or to any ingredient used in the product
  • Women who are pregnant, breast-feeding and of child-bearing potential

Trial design

Primary purpose

Supportive Care

Allocation

Randomized

Interventional model

Factorial Assignment

Masking

Triple Blind

4 participants in 4 patient groups, including a placebo group

Group A: SBI + Placebo
Active Comparator group
Description:
Serum-derived bovine immunoglobulin/protein isolate (SBI) 10 grams + placebo twice per day
Treatment:
Other: Serum-derived bovine immunoglobulin/protein isolate (SBI)
Other: Double Placebo
Group B: Colesevelam + Placebo
Active Comparator group
Description:
Colesevelam 1.875 g + Placebo twice per day
Treatment:
Drug: Colesevelam
Other: Double Placebo
Group C: Colesevelam + SBI
Active Comparator group
Description:
Colesevelam 1.875 g + Serum-derived bovine immunoglobulin/protein isolate (SBI) 10 grams twice per day
Treatment:
Other: Serum-derived bovine immunoglobulin/protein isolate (SBI)
Drug: Colesevelam
Group D: Double Placebo
Placebo Comparator group
Description:
Double placebo twice per day
Treatment:
Other: Double Placebo

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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