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NCT03197922

Treatment of Encopresis in Children With Autism Spectrum Disorders

Completed Phase 3 Results posted Last updated 31 January 2024
What this trial tests

Phase 3 trial testing MIE Treatment in Encopresis in 117 participants. Completed in 17 November 2022.

Timeline
25 October 2017
Primary endpoint
17 November 2022
17 November 2022

Quick facts

Lead sponsorEmory University
PhasePhase 3
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingsingle
Primary purposetreatment
Enrollment117
Start date25 October 2017
Primary completion17 November 2022
Estimated completion17 November 2022
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

Emory University

Who can join

Adults 5 to 12, any sex, with Encopresis or Autism Spectrum Disorder. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Percentage of Continent Bowel Movements Primary · Baseline, Week 8

The percentage to continent bowel movements, based on parent report during the prior 7 day period, are reported for Baseline and the end of treatment at Week 8.

Baseline
GroupValue95% CI
Multidisciplinary Intervention for Encopresis (MIE) Treatment for One Week27.33± 29.72
Multidisciplinary Intervention for Encopresis (MIE) Treatment for Two Weeks16.99± 28.48
Treatment as Usual (TAU)20.70± 25.80
Week 8
GroupValue95% CI
Multidisciplinary Intervention for Encopresis (MIE) Treatment for One Week55.50± 33.18
Multidisciplinary Intervention for Encopresis (MIE) Treatment for Two Weeks79.69± 29.51
Treatment as Usual (TAU)37.74± 35.92
Number of Children Responding to Treatment as Rated by the Clinical Global Impression Scale - Improvement (CGI-I) Score Secondary · Week 8

The Clinical Global Impression Scale - Improvement (CGI-I) is a single item asking clinicians to indicate the degree of improvement following treatment on a 7-point scale. Responses are 1 = very much improved, 2 = much improved, 3 = minimally improved, 4 = no change, 5 = minimally worse, 6 = much worse, and 7 = very much worse. This study is interested in the proportion of children who are rated by the Independent Evaluator as "Much Improved" or "Very Much Improved" on the CGI-I at Week 8. Responding to treatment is defined as a score of 1 or 2, while scores of 3 to 7 are considered as not res

GroupValue95% CI
Multidisciplinary Intervention for Encopresis (MIE) Treatment for One Week16
Multidisciplinary Intervention for Encopresis (MIE) Treatment for Two Weeks26
Treatment as Usual (TAU)37
Multidisciplinary Intervention for Encopresis (MIE) Treatment for One Week10
Multidisciplinary Intervention for Encopresis (MIE) Treatment for Two Weeks21
Treatment as Usual (TAU)7
Parenting Stress Index Short Form Total Score Secondary · Baseline, Week 8

The Parenting Stress Index Short Form (PSI-SF) is a 36-item questionnaire assessing parental stress. It has three subscales of Parental Distress, Parent-Child Dysfunctional Interaction, and Difficult Child. Each subscale has 12 items where responses are given on a 5-point scale where 1 = strongly disagree and 5 = strongly agree. Scores for subscales range from 12 to 60 and the total score ranges from 36 to 180. Higher scores indicate greater parental stress.

Baseline
GroupValue95% CI
Multidisciplinary Intervention for Encopresis (MIE) Treatment for One Week82.38± 23.25
Multidisciplinary Intervention for Encopresis (MIE) Treatment for Two Weeks81.72± 24.79
Treatment as Usual (TAU)91.22± 20.94
Week 8
GroupValue95% CI
Multidisciplinary Intervention for Encopresis (MIE) Treatment for One Week80.88± 23.95
Multidisciplinary Intervention for Encopresis (MIE) Treatment for Two Weeks82.76± 29.68
Treatment as Usual (TAU)89.19± 24.45
Caregiver Strain Questionnaire - Short Form 7 (CGSQ-SF7) Objective Strain Subscale Score Secondary · Baseline, Week 8

The Caregiver Strain Questionnaire - Short Form (CGSQ-SF7) assesses parental stress and strain in the prior month in caregivers who are caring for a child with behavioral disorders. The CGSQ-SF includes 7 items where responses are given on a 5-point scale where "not at all" is scored as 0 and "very much" is scored as 4. The CGSQ-SF7 has two subscales: Objective Strain with four items, and Subjective Internalized Strain with three items. The total score for the Objective Strain subscale ranges from 0 to 16 and higher scores indicate greater parental strain.

Baseline Objective Strain Subscale Score
GroupValue95% CI
Multidisciplinary Intervention for Encopresis (MIE) Treatment for One Week9.68± 4.35
Multidisciplinary Intervention for Encopresis (MIE) Treatment for Two Weeks9.86± 4.51
Treatment as Usual (TAU)9.40± 3.91
Week 8 Objective Strain Subscale Score
GroupValue95% CI
Multidisciplinary Intervention for Encopresis (MIE) Treatment for One Week9.53± 3.41
Multidisciplinary Intervention for Encopresis (MIE) Treatment for Two Weeks8.21± 4.20
Treatment as Usual (TAU)9.29± 4.04
Caregiver Strain Questionnaire - Short Form 7 (CGSQ-SF7) Subjective Internalized Strain Subscale Score Secondary · Baseline, Week 8

The Caregiver Strain Questionnaire - Short Form (CGSQ-SF7) assesses parental stress and strain in the prior month in caregivers who are caring for a child with behavioral disorders. The CGSQ-SF includes 7 items where responses are given on a 5-point scale where "not at all" is scored as 0 and "very much" is scored as 4. The CGSQ-SF7 has two subscales: Objective Strain with four items, and Subjective Internalized Strain with three items. The total score for the Subjective Internalized Strain subscale ranges from 0 to 12 and higher scores indicate greater parental strain.

Baseline Subjective Internalized Strain Subscale Score
GroupValue95% CI
Multidisciplinary Intervention for Encopresis (MIE) Treatment for One Week8.88± 3.26
Multidisciplinary Intervention for Encopresis (MIE) Treatment for Two Weeks10.16± 3.89
Treatment as Usual (TAU)9.29± 3.06
Week 8 Subjective Internalized Strain Subscale Score
GroupValue95% CI
Multidisciplinary Intervention for Encopresis (MIE) Treatment for One Week9.06± 3.13
Multidisciplinary Intervention for Encopresis (MIE) Treatment for Two Weeks7.24± 3.51
Treatment as Usual (TAU)9.58± 3.58
Caregiver Strain Questionnaire - Short Form (CGSQ-SF7) Total Score Secondary · Baseline, Week 8

The Caregiver Strain Questionnaire - Short Form (CGSQ-SF7) assesses parental stress and strain in the prior month in caregivers who are caring for a child with behavioral disorders. The CGSQ-SF includes 7 items where responses are given on a 5-point scale where "not at all" is scored as 0 and "very much" is scored as 4. The CGSQ-SF7 has two subscales: Objective Strain with four items, and Subjective Internalized Strain with three items. A total score is obtained by adding the scores for each subscale. Total scores range from 0 to 28 where higher scores indicate greater caregiver strain.

Baseline
GroupValue95% CI
Multidisciplinary Intervention for Encopresis (MIE) Treatment for One Week18.56± 7.12
Multidisciplinary Intervention for Encopresis (MIE) Treatment for Two Weeks20.03± 7.58
Treatment as Usual (TAU)18.69± 6.46
Week 8
GroupValue95% CI
Multidisciplinary Intervention for Encopresis (MIE) Treatment for One Week18.59± 6.15
Multidisciplinary Intervention for Encopresis (MIE) Treatment for Two Weeks15.45± 7.30
Treatment as Usual (TAU)18.87± 7.05

Adverse events — posted to ClinicalTrials.gov

Time frame: Information on adverse events was collected from the time of the baseline visit through the follow-up assessment at Week 8.. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Multidisciplinary Intervention for Encopresis (MIE) Treatment for One Week
Serious: 0/26 (0%)
Deaths: 0/26
Multidisciplinary Intervention for Encopresis (MIE) Treatment for Two Weeks
Serious: 0/47 (0%)
Deaths: 0/47
Treatment as Usual (TAU)
Serious: 0/44 (0%)
Deaths: 0/44
Other adverse events (35 terms — click to expand)

ReactionSystemMultidisciplinary Interven…Multidisciplinary Interven…Treatment as Usual (TAU)
ConstipationGastrointestinal disorders
RhinitisInfections and infestations
Difficulty falling asleepGeneral disorders
VomitingGastrointestinal disorders
DiarrheaGastrointestinal disorders
Early morning wakingGeneral disorders
EczemaSkin and subcutaneous tissue disorders
FeverInfections and infestations
AllergiesImmune system disorders
Difficulty staying asleepGeneral disorders
Mid-sleep awakeningGeneral disorders
Difficulty waking upGeneral disorders
SeizuresNervous system disorders
Ear infectionEar and labyrinth disorders
Sore throatGeneral disorders
CoughingRespiratory, thoracic and mediastinal disorders
Excessive appetiteMetabolism and nutrition disorders
Decreased appetiteMetabolism and nutrition disorders
EnuresisRenal and urinary disorders
Tired during the dayGeneral disorders
Interrupted sleepGeneral disorders
Swollen tonsilsInfections and infestations
Runny noseRespiratory, thoracic and mediastinal disorders
Red itchy rash on legSkin and subcutaneous tissue disorders
Ear bleedEar and labyrinth disorders
Abrasion on chinInjury, poisoning and procedural complications
Bump on back of headInjury, poisoning and procedural complications
CavityGeneral disorders
Cut on ear from haircutInjury, poisoning and procedural complications
Problem behaviorGeneral disorders
Inappropriate languageGeneral disorders
Strep throatInfections and infestations
Infected toe nailInfections and infestations
Naps during the dayGeneral disorders
RashSkin and subcutaneous tissue disorders

Data from ClinicalTrials.gov NCT03197922 adverse events section.

Sponsor's own description

This study is comparing a multidisciplinary intervention for encopresis (MIE), consisting of both medical and behavioral components to treatment as usual control (TAU). Participants are first screened by a pediatric gastroenterologist and assessed and treated for any constipation or other potential medical complications. Following this, caregivers collect data on bowel movements and continence during a home baseline lasting no less than 14 days and no more than 21 days. Participants randomly assigned to treatment as usual or the treatment group, and begin attending daily appointments in clinic for 2 weeks. At appointments, the behavior team implements structured sits on the toilet to promote independent bowel movements (BMs). If an independent BM does not occur, the study team will administer a suppository to promote rapid release of the bowels and prompt the child to remain on the toilet following administration. In doing so, continent bowel movements are predictably evoked while the child is on the toilet, allowing for reinforcement with praise and preferred toys/activities. Eventually, suppositories are gradually decreased until the child is having BMs independently. Caregivers are trained to continue implementing the intervention following the clinic-based portion. The purpose of the current study is to evaluate MIE using a large randomized clinical trial (RCT), addressing the Department of Defense Autism Research Program, Area of Interest of Therapies to Alleviate Conditions Co-Occurring with autism spectrum disorder (ASD). The researchers will recruit 112 children diagnosed with ASD, randomizing them to two weeks of MIE, or treatment as usual (TAU) consisting of behavioral consultation and medical intervention. This study will evaluate MIE compared to TAU and determine the optimal treatment length.

Publications & conference data

No peer-reviewed publications indexed yet for this trial. Completed trials usually publish results within 12-18 months.

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