Colon to Rectum

Gastroenterology. 2023;164(7):1202−10.e6

Rao SSC, Quigley EMM, Chey WD, Sharma A, Lembo AJ

Randomized placebo-controlled phase 3 trial of vibrating capsule for chronic constipation

Background and aims: Despite therapeutic advances, effective treatments for chronic constipation remain an unmet need. The vibrating capsule is a non-pharmacologic, orally ingested, programmable capsule that vibrates intraluminally to induce bowel movements. The authors aimed to determine the efficacy and safety of the vibrating capsule in patients with chronic constipation.
Methods: They conducted a phase 3, double-blind, placebo-controlled trial of patients with chronic constipation, who were randomized to re-ceive either a vibrating or placebo capsule, once daily, 5 days a week for 8 weeks. The primary efficacy end points were an increase of 1 or more complete spontaneous bowel movements per week (CSBM1 responder) or 2 or more CSBMs per week (CSBM2) from baseline during at least 6 of the 8 weeks. Safety analyses were performed.
Results: Among 904 patients screened, 312 were enrolled. A greater percentage of patients receiving the vibrating capsule achieved both primary efficacy end points compared with placebo (39.3% vs. 22.1%, p = 0.001 for CSBM1; 22.7% vs. 11.4%, p = 0.008 for CSBM2). Significantly greater improvements were seen with the vibrating capsule for the secondary end points of straining, stool consistency, and quality-of-life measures compared with placebo. Adverse events were mild, gastrointestinal in nature, and similar between groups, except that a mild vibrating sensation was reported by 11% of patients in the vibrating capsule group, but none withdrew from the trial.

Conclusions: In patients with chronic constipation, the vibrating capsule was superior to placebo in improving bowel symptoms and quality of life. The vibrating capsule was safe and well tolerated.

S.S.C. Rao, M.D., Ph.D., Professor of Medicine, Division of Gastroenterology and Hepatology, Augusta University, Augusta, GA, USA,

DOI: 10.1053/j.gastro.2023.02.013

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