Reduce Crohn's-Associated Diarrhea With Sodium Channel Therapy (REACT)

Vanderbilt University Medical Center

Status and phase: Terminated; Phase 2

Conditions: Inflammatory Bowel Disease; Crohn's Disease

Treatments: Drug: Placebo; Drug: Ranolazine

Study type: Interventional

Funder types: Other

Identifiers

NCT04456517

200640

Details and patient eligibility

About

Crohn's disease is an inflammatory disorder that can affect any part of the gastrointestinal (GI) tract. Some patients still experience persistent diarrhea or other symptoms such as abdominal pain even when their Crohn's disease is in remission. Diarrhea and/or abdominal pain that is not responsive to standard therapies can significantly affect a patient's quality of life and ability to work. The purpose of this study is to test the safety and effectiveness of the drug ranolazine in reducing Crohn's disease-associated diarrhea and other symptoms. Ranolazine is approved by the US Food & Drug Administration (FDA) for chronic angina (a heart condition). This study is investigating if ranolazine could be used in the setting of Crohn's disease.

Enrollment: 4 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Meet diagnostic criteria for Crohn's Disease with active diarrhea Either with active disease or in remission (as defined by endoscopic or radiographic findings) but experiencing symptoms (e.g., diarrhea, abdominal pain)
• Have greater than three loose stools per day

Exclusion criteria

• Male and female subjects <18 years of age

• Significant change in medication including prednisone, antidepressant medications, or stimulants within the last 4 weeks

  a. Allowances include: Rectal hydrocortisone, rectal mesalamine, addition of prednisone (up to 20mg) for flares, etc.

• Regular (daily) use of opioids or other drugs of abuse including heavy alcohol or marijuana use

• Severe psychiatric disease including schizophrenia, psychosis, suicidal depression

• Previous use of ranolazine within 2 months prior to enrollment

• Prior use of ranolazine which was discontinued for safety or tolerability

• Metabolic derangement defined as liver function tests >3x upper limit of normal or severe renal disease defined as calculated creatinine clearance <30 mL/min

• Have liver cirrhosis

• Concurrent use of CYP3A inhibitors, inducers, or substrates

  a. These may include: ketoconazole, itraconazole, nefazodone, nelfinavir, ritonavir, indinavir, and saquinavir, clarithromycin, or rifampin, rifapentine, phenobarbital, phenytoin, and St. John's Wort, digoxin.

• A family history of (or congenital) long QT syndrome or known acquired QT interval prolongation

• Inability or refusal to give informed consent for any reason including a diagnosis of dementia or cognitive impairment

• Patients who are pregnant or breastfeeding

• Patients who are enrolled in other investigational drug studies or who have taken investigational drugs within 30 days before enrollment

• Other factors which in the opinion of the investigator could potentially impact the study outcomes (e.g., underlying disease, medications, history) or prevent the participant from completing the protocol (poor compliance or unpredictable schedule)

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: Quadruple Blind

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4 participants in 2 patient groups

Ranolazine, Then Placebo

Experimental group

Description:

- Participants first receive a Ranolazine 500 mg tablet twice daily for 12 weeks, they then receive a Placebo tablet (matching Ranolazine 500 mg tablets) twice daily for 12 weeks. This treatment will be given to participants with either active CD or patients with CD that is in remission but who experience continued symptoms

Treatment:

Drug: Ranolazine

Drug: Placebo

Placebo, Then Ranolazine

Experimental group

Description:

- Participants first receive a Placebo tablet (matching Ranolazine 500 mg tablets) twice daily for 12 weeks, they then receive a Ranolazine 500mg tablet twice daily for 12 weeks. This treatment will be given to participants with either active CD or patients with CD that is in remission but who experience continued symptoms

Treatment:

Drug: Ranolazine

Drug: Placebo