52-Week Efficacy and Safety Study of Ibodutant in Women With Irritable Bowel Syndrome With Diarrhea (IBS-D)
52-Week Efficacy and Safety Study of Ibodutant in Women With Irritable Bowel Syndrome With Diarrhea (IBS-D)
Irritable Bowel Syndrome with diarrhoea (IBS-D) is a functional gastrointestinal disorder
 characterised by chronic or recurrent abdominal pain or discomfort and diarrhoea. This trial
 aims at the evaluation of the efficacy and safety of oral ibodutant 10 mg once daily as
 compared to placebo in women with IBS-D over a 24-week treatment period.
The study evaluates the efficacy and safety of ibodutant 10 mg, given once daily for 24 weeks
 in comparison with placebo in female IBS-D patients. Randomisation to ibodutant and placebo
 will be 1:1. Efficacy is evaluated in terms of weekly response for abdominal pain intensity
 and stool consistency over 24 weeks of treatment in at least 50% of the weeks of treatment.

 The clinical phase of the study comprises up to 2 weeks of screening for patient's
 eligibility, a 2-week run-in period (treatment-free) for IBS severity assessment, a first
 24-week double-blind treatment period, a second 28-week re-randomised double-blind treatment
 period and a 2-week safety follow-up, resulting in a maximum 58-week overall duration of the
 study for each patient.

 Patients report their IBS-related symptoms daily in a telephone-based electronic diary from
 run-in until end of treatment.
Inclusion Criteria:

 -  At screening:

 -  Female patients aged 18 years or older.

 -  Clinical diagnosis of IBS-D according to the following symptoms-based criteria as
 per Rome III modular questionnaire criteria:

 1. Recurrent abdominal pain or discomfort for at least 3 days per month in the
 last 3 months associated with at least 2 of the following characteristics:
 a) improvement with defecation; b) onset associated with a change in the
 frequency of stool; c) onset associated with a change in form (appearance)
 of stool.

 2. Symptom-onset at least 6 months prior to diagnosis.

 3. Loose or watery stools at least 25% of the time in the last 3 months AND
 hard or lumpy stools less than 25% of the time in the last 3 months.

 4. Additional criterion: more than 3 bowel movements per day at least 25% of
 the time in the last 3 months.

 -  For patients older than 50 years OR patients with a positive family history of
 colorectal cancer: normal results from colonoscopy/flexible sigmoidoscopy
 performed within the last 5 years.

 -  For patients aged 65 years or older: absence of ischaemic colitis, microscopy
 colitis or any other organic gastrointestinal disease as evidenced by the results
 of a colonoscopy/flexible sigmoidoscopy with biopsy performed within 6 months.

 -  For women of childbearing potential: Use of a highly effective contraceptive
 method with a failure rate <1% per year throughout the entire study period.

 -  Physical examination without clinically relevant abnormalities during screening.

 -  No clinically relevant abnormalities in 12-Lead ECG or in laboratory findings.

 -  Mentally competent, able to give written informed consent, and compliant to
 undergo all visits and procedures.

 -  Unrestricted access to a touch-tone telephone.

 -  Willingness to refrain from using loperamide within 3 days prior to run-in visit
 and during the run-in period.

 Additional criteria at randomisation:

 -  During both weeks of the run-in period:

 1. A weekly average of worst abdominal pain in the past 24 hours with a score of
 ≥3.0 on a 0 to 10 point scale.

 2. At least one bowel movement on each day.

 3. A weekly average of at least 3 bowel movements per day.

 4. At least one stool with a consistency of Type 6 or Type 7 according to the
 Bristol Stool Scale (BSS) on at least 2 days per week.

 5. Less than 2 bowel movements with a consistency of Type 1 or Type 2 according to
 the BSS per week.

 6. Adequate compliance with the e-diary recording procedure defined as at least 11
 of 14 days (≥75%) of the nominal daily data entry.

 Exclusion Criteria:

 -  Male gender.

 -  Diagnosis of IBS with a subtype of constipation, mixed IBS, or un-subtyped IBS.

 -  Colonic or major abdominal surgery, any other major abdominal surgery or elective
 major surgery planned or expected during the study.

 -  History of organic GI abnormalities, inflammatory bowel diseases, complicated
 diverticulosis, ischaemic colitis, microscopic colitis.

 -  History of pancreatitis, active biliary duct disease, cholecystitis or symptomatic
 gallbladder stone disease in the previous 6 months.

 -  History of gluten enteropathy or lactose intolerance.

 -  Current or previous diagnosis of neoplasia.

 -  History of endometriosis.

 -  History of positive tests for ova or parasites, or clostridium difficile toxin or
 occult blood in the stool in the previous 6 months.

 -  History of human immunodeficiency virus infection.

 -  History of major cardiovascular events in the previous 6 months.

 -  Uncontrolled hypertension, insulin-dependent diabetes mellitus or abnormal thyroid
 function.

 -  Major psychiatric or neurological disorders or unstable medical condition which may
 compromise the efficacy and safety assessments.

 -  Evidence of clinically significant hepatic disease, severe renal insufficiency or
 anemia.

 -  Relevant changes in dietary habits, lifestyle, or exercise regimen in the previous 2
 months.

 -  Use of prohibited concurrent medication within the previous month such as antibiotics,
 antimuscarinic drugs, drugs enhancing GI motility and analgesics.

 -  Pregnancy or breastfeeding.

 -  Inability to understand or collaborate throughout the study.

 -  Participation in other clinical studies in the previous 4 weeks or concurrent
 enrollment in a clinical study.

 -  Any condition that would compromise the well-being of the patient.