The purpose of this study is to assess the safety, tolerability, and preliminary efficacy of LB1148 in subjects undergoing elective bowel resection. During abdominal surgery, surgeons handle, manipulate, and often make incisions in the bowel. These actions can create bruising, lesions, and microscopic damage to the bowel, which may allow digestive enzymes to cross the intestinal mucosal barrier potentially resulting in injury both locally and remotely. Leaking digestive enzymes may delay return of normal gastrointestinal (GI) function, lead to a lack of motility in the intestine (ileus), and promote the formation of intestinal scar tissue (adhesions).
The intestinal mucosal barrier plays a key role in both acute critical care medical conditions as well as burdensome chronic diseases. Healthy maintenance of the intestinal mucosal barrier requires oxygenation and blood flow and avoidance of mechanical or physical injury. Potent digestive enzymes are maintained within the intestine as long as normal blood flow continues and no damage or disturbances to the wall occur. Breakdown of the intestinal mucosal barrier can be produced by wide variety of events. These include prolonged low blood pressure (e.g. during shock), disruption of blood flow (e.g. during ischemia), and physical and mechanical perturbations (e.g. during trauma or abdominal surgery). One of the key advances toward the use of LB1148 to reduce postoperative complications was the learning that with more subtle perturbations of the mucosal barriers, such as during abdominal surgery, intraluminal pancreatic digestive enzymes played a role in GI dysfunction. Perioperative oral administration of LB1148 in preclinical models was sufficient to reduce the delayed return of GI function. Furthermore, the reduction in pancreatic digestive enzyme-induced tissue damage resulted in a profound reduction in postoperative adhesion formation. Together, these preclinical studies provide evidence that blocking pancreatic digestive enzymes with LB1148 in the intestine reduces local tissue damage, preserves GI function, and reduces adhesion formation.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
PREVENTION
Masking
NONE
Enrollment
11
A total of 700 mL of study drug should be completely consumed orally 2-12 hours prior to surgery as a split dose; 350 mL 6-12 hours prior to surgery and the remaining 350 mL 2-6 hours prior to surgery.
Centinela Hospital Medical Center
Inglewood, California, United States
The number of participants who experience treatment-emergent adverse events (TEAEs)
The number of participants who experience treatment-emergent adverse events (TEAEs) with Investigator-specified relationship to LB1148 and assessment of severity
Time frame: From first study drug dosing through Day 30
Number of participants who require a nasogastric (NG) tube placement
Necessity for nasogastric (NG) tube placement
Time frame: During hospitalization (up to 14 days postoperatively), yes or no
Average length of time an NG tube was in place, if required
Time NG tube was in place, if needed
Time frame: During hospitalization (up to 14 days postoperatively), in hours
Number of participants who experience post surgical vomiting
Presence of postsurgical vomiting
Time frame: During hospitalization (from surgical closure to up to 14 days postoperatively), yes or no
Average number of vomiting episodes, when present
Number of vomiting episode(s)
Time frame: During hospitalization (from surgical closure to up to 14 days postoperatively), number of total episodes
Average time to first flatus following surgery
Time to first flatus
Time frame: During hospitalization (from surgical closure to up to 14 days postoperatively), in hours
Average time to first bowel movement following surgery
Time to first bowel movement
Time frame: During hospitalization (from surgical closure to up to 14 days postoperatively), in hours
Average time to tolerate a liquid diet following surgery
Time to toleration of a liquid diet
Time frame: During hospitalization (from surgical closure to up to 14 days postoperatively), in hours
Average time to tolerate a solid diet after surgery
Time to toleration of a solid diet
Time frame: During hospitalization (from surgical closure to up to 14 days postoperatively), in hours
Average time to hospital discharge order
Time to hospital discharge order written
Time frame: During hospitalization (from admission to up to 14 days postoperatively), in hours
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