Evidence map›Paper›PMID 27075314›Full record

Trial reportInternational journal of colorectal disease2016

Libertas: a phase II placebo-controlled study of NRL001 in patients with faecal incontinence showed an unexpected and sustained placebo response.

L Siproudhis, W Graf, A Emmanuel, D Walker, R Ng Kwet Shing, C Pediconi, J Pilot, S Wexner, J Scholefield

Open access · hybridAbstract readClinical Trial, Phase IIMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in International journal of colorectal disease, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 4 countries.

L SiproudhisCHU Pontchaillou, Rennes, France.
W GrafInstitution of Surgical Sciences, Akademiska Sjukhuset, Uppsala University, 75185, Uppsala, Sweden.
A EmmanuelUniversity College Hospital, 235 Euston Road, London, UK.
D WalkerNorgine Ltd, Norgine House, Widewater Place, Moorhall Road, Uxbridge, UB9 6NS, UK. dwalker@norgine.com.
R Ng Kwet ShingNorgine Ltd, Norgine House, Widewater Place, Moorhall Road, Uxbridge, UB9 6NS, UK.
C PediconiNorgine Ltd, Norgine House, Widewater Place, Moorhall Road, Uxbridge, UB9 6NS, UK.
J PilotNorgine Ltd, Norgine House, Widewater Place, Moorhall Road, Uxbridge, UB9 6NS, UK.
S WexnerCleveland Clinic Florida, Weston, FL, USA.
J ScholefieldDivision of Surgery, University Hospital Nottingham, Nottingham, UK.
Norgine (United Kingdom) · GBCleveland Clinic Florida · USHôpital Pontchaillou · FRUniversity College Hospital · GBUppsala University Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFaecal incontinence (FI) is distressing, significantly reduces quality of life (QoL) and has few pharmacological treatments. The α1-adrenoceptor agonist NRL001 (1R,2S-methoxamine hydrochloride) improves anal sphincter tone. NRL001 efficacy was evaluated by changes in Wexner scores at week 4 vs. baseline in NRL001-treated patients compared with placebo. Impact of NRL001 on QoL and safety were also assessed.

methodsFour hundred sixty-six patients received NRL001 (5, 7.5 or 10 mg) or placebo as suppository, once daily over 8 weeks. Wexner score, Vaizey score and QoL were analysed at baseline, week 4 and week 8. FI episodes and adverse events were recorded in diaries.

resultsAt week 4, mean reductions in Wexner scores were -3.0, -2.6, -2.6 and -2.4 for NRL001 5, 7.5, 10 mg and placebo, respectively. All reduced further by week 8. As placebo responses also improved, there was no significant treatment effect at week 4 (p = 0.6867) or week 8 (p = 0.5005). FI episode frequency improved for all patients, but not significantly compared with placebo (week 4: p = 0.2619, week 8: p = 0.5278). All patients' QoL improved, but not significantly for all parameters (p > 0.05) except depression/self-perception at week 4 (p = 0.0102) and week 8 (p = 0.0069), compared with placebo. Most adverse events were mild and judged probably or possibly related to NRL001.

conclusionsAll groups demonstrated improvement in efficacy and QoL compared with baseline. NRL001 was well-tolerated without serious safety concerns. Despite the improvement in all groups, there was no statistically significant treatment effect, underlining the importance of relating results to a placebo arm.

Indexed as

DemographyFecal IncontinenceFemaleHumansMaleMethoxamineMiddle AgedPatient SatisfactionPlacebosQuality of LifeSurveys and QuestionnairesTreatment OutcomeMethoxaminePlacebosAlpha-1 receptor agonistEpisode frequencyFaecal incontinenceNRL001Quality of life

Identifiers

PMID27075314
PMCPMC4867152
OpenAlexW2338461047

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.