A Trial of Actazin Versus PEG 3350 for Maintenance Therapy in Children With Constipation

Summary

The goal of this pilot feasibility randomized controlled trial is to determine whether Actazin (kiwifruit extract) is a feasible and effective alternative to polyethylene glycol 3350 (PEG 3350) for maintenance therapy in children with functional constipation (FC). This study will include children aged 4 to 17 years who meet the Rome IV criteria for functional constipation.

The main questions it aims to answer are:

1. Is it feasible to conduct a definitive, multi-centre trial comparing Actazin to PEG 3350 in children with FC?
2. What are the within-group differences in clinical outcomes such as stool frequency, abdominal pain, and laxative use over a 4-week period?

Researchers will compare chewable Actazin tablets with placebo PEG 3350 powder to PEG 3350 powder with placebo Actazin tablets to see if Actazin is a viable non-pharmacologic natural health product alternative for treating FC.

Participants will:

Undergo an initial bowel cleanout using PEG 3350 and bisacodyl. Following, they will be randomized to one of two groups:

1. Actazin chewable tablets (titrate to effect: 600-2400 mg/day) + placebo PEG 3350
2. PEG 3350 (dose based on age and titratable to effect) + placebo Actazin chewable tablets Participants will take the assigned intervention daily for 4 weeks and complete a daily bowel diary recording stool frequency, consistency (Bristol Stool Scale), abdominal pain, and laxative use. They will have weekly follow-ups via phone or electronic survey to assess adherence, medication use, and adverse events.

Additionally, a bi-weekly follow-up will be conducted for an additional 8 weeks to track longer-term outcomes.

Outcomes:

Primary feasibility outcomes include consent rate, adherence to allocated intervention, and 4-week follow-up completion rate.

Secondary clinical outcomes include resolution of FC (Rome IV criteria), weekly stool frequency, abdominal pain episodes, use of rescue laxatives, and treatment palatability.

This study is being conducted at McMaster Children's Hospital and is funded by the Hamilton Academic Health Sciences Organization (HAHSO). Data collection will be managed using the Lumedi™ platform, and safety will be overseen by a Data Safety Monitoring Board (DSMB).

Conditions

• Constipation - Functional
• Constipation
• Constipation Aggravated

Interventions

DIETARY_SUPPLEMENT

Actazin chewable tablet

Actazin tablets are tableted non-GMO, freeze-dried, green kiwifruit powder from 100% New Zealand-grown green kiwifruit. Currently, kiwifruit extracts (such as Actazin), are marketed in Canada as a natural supplement. It is safe, bioavailable, and has been previously shown to be well tolerated at doses up to 2400 mg.

DRUG

PEG 3350

a commonly used over the counter laxative in north America. A stool softener.

OTHER

Chewable Tablet

Sorbitol-based placebo chewable tablets made by Pharma NZ. Those tablets will have a similar appearance to active Actazin but will not taste the same. This is because the taste of Actazin is a non-altered natural kiwi taste. They will be administered in the same dose and manner as the active Actazin oral chewable tablets.

OTHER

Maltodextrin (Placebo)

Maltodextrin powder, administered in the same doses and manner as active PEG 3350 group.

Sponsors & Collaborators

• Hamilton Health Sciences Corporation

  lead OTHER

Principal Investigators

• Elyanne Ratcliffe, MD · Hamilton Health Sciences Corporation

• Mohamed M Eltorki, MBChB, MSc · Hamilton Health Sciences Corporation

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Model

PARALLEL

Eligibility

Min Age

4 Years

Max Age

17 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-06-01

Primary Completion

2026-12-30

Completion

2027-02-01

Countries

• Canada

Study Locations