Comparing Alvimopan to placebo for bowel recovery after bladder cancer surgery

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This clinical trial aims to evaluate the effectiveness of Alvimopan in promoting faster gastrointestinal recovery in patients undergoing radical cystectomy with urinary diversion. It is a prospective, randomized, double-blind study involving 136 participants, who will be divided into two groups: one receiving Alvimopan and the other receiving a placebo. The primary outcome is the time taken for patients to tolerate solid food and have their first bowel movement post-surgery. This approach seeks to control for confounding factors and provide robust data on the intervention's efficacy.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Patients undergoing radical cystectomy and urinary diversion via open or robotic approach.
* Man or woman between the ages of 18 and 85.
* American Society of Anesthesiologists (ASA) Physical Status Score of class 1-4
* Ileal conduit or ileal neobladder urinary diversion
* Able to understand the study procedures, agreed to participate in the study program, and voluntarily provided informed consent

Exclusion criteria:

* Patients who met any of the following criteria were excluded from participating in the study:
* Scheduled for a partial cystectomy
* Previous total colectomy, gastrectomy, or gastric bypass, or functional colostomy or ileostomy
* More than three doses of opioids (oral or parenteral) within 7 days before the day of surgery
* Chemotherapy for bladder cancer within 1 month of scheduled surgery; prior neoadjuvant chemotherapy allowed.
* Pregnant (identified by a positive serum pregnancy test administered after the initial screening process and before the commencement of study activities) or lactating, or not postmenopausal (no menses for at least 1 year) and of childbearing potential and not using an accepted method of birth control (i.e, surgical sterilization; intrauterine contraceptive device; oral contraceptive, diaphragm, or condom in combination with contraceptive cream, jelly, or foam; or abstinence) (Participants will be asked to use birth control for the entire study and for at least 2 weeks after the last dose of study drug.)
* Participated in another investigational drug or medical device study within 30 days of surgery or planning to be enrolled in another investigational drug or medical device study or any study in which active patient participation was required outside normal hospital data collection during the course of this study
* Clinically significant laboratory abnormalities at screening that would have resulted in the cancellation of surgery
* Using illicit drugs or abusing alcohol
* History of previous surgeries, illness, or behavior (eg, depression, psychosis) that in the opinion of the investigator might have confounded the study results or might have posed additional risk in administering the study procedures
* Patients with severe dementia (as determined from medical records and history. Severe dementia will be defined as dementia that impacts daily functioning.)
* Patients with severe hepatic impairment.
* Patients with end-stage renal disease.
* Patients with heart failure. .
* Patients with complete gastrointestinal obstruction.

Where it's running

• Brigham and Women's Hospital
  Boston, Massachusetts, United States Recruiting

Study contacts

• Principal investigator: Mark A Preston, MD — Brigham and Women's Hospital
• Study coordinator: Martin Barylak
• Email: mbarylak@bwh.harvard.edu
• Phone: 6175258274

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.