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A Clinical Study to Investigate the Effect of a Partially Hydrolysed Infant Formula With Added Synbiotics on Gut Microbiota Composition and Clinical Effectiveness in Infants at High Risk of Developing Allergy (TEMPO)

Primary Purpose

Immunity

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Infant formula with added synbiotics
Standard infant formula
Sponsored by
Nutricia Research
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Immunity

Eligibility Criteria

undefined - 16 Weeks (Child)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Healthy term infants (gestational age ≥ 37 and ≤ 42 weeks) at high risk of developing allergy based on family history of allergy (*1).
  2. Infants aged ≤ 16 weeks (max. 16 weeks + 0 days), preferably as soon as possible after birth.
  3. Infants who start formula feeding within 16 weeks of age (infants of mothers who have chosen not to breastfeed or mothers who completely/partially cease breastfeeding before the subject's age of 16 weeks) (*2) OR Infants who are exclusively breastfed and whose mothers have the intention to exclusively breastfeed at least until their infant is 16 weeks of age (*2,3).
  4. Written informed consent from one or both parents (according to local laws) and/or legal guardian.

1* Family history of allergy is defined as at least one first-degree relative (parent or full sibling) with self-reported historically doctor confirmed allergic disease (allergic rhinitis, asthma, food allergy, allergic eczema). In case of a self-reported historically non-doctor confirmed allergic disease, doctor confirmation must be done as part of the screening procedure according to local practice (e.g. skin prick test, IgE measurement).

2* Subjects whose mother intents to switch to formula feeding before the subject's age of 16 weeks but in the end still exclusively breastfeed, will be included in the breastfed reference group. The other way around, subjects whose mother intents to exclusively breastfeed for at least 16 weeks, but in the end decides to switch to formula earlier, will be included in the randomised groups. All these subjects should meet all other in-/exclusion criteria.

3* Exclusive breast feeding. WHO definition: only breast milk and no other liquids or solids except for drops or syrups consisting of vitamins, mineral supplements or medicines [2]. In addition to the WHO definition, in this study water is allowed as well as formula feeding during the first 72 hours of life.

  • Exclusion Criteria:

    1. Consumption of any amount of infant formula based on intact protein before randomisation, except from consumption during the first 72 hours of life.
    2. Consumption of any amount of infant formula with added probiotics and/or probiotic supplement before randomisation.
    3. Existing allergic manifestations (e.g. allergic skin disorders, food allergy) before randomisation according to investigator's clinical assessment.
    4. Established or suspected cows' milk allergy, lactose intolerance, galactosaemia, or in infants on a fibre-free diet.
    5. Severe congenital abnormalities which could influence the subjects' growth (e.g. cystic fibrosis, bronchopulmonary dysplasia, tracheomalacia, tracheoesophageal fistula, major congenital heart disease, or any other condition according to investigator's clinical judgement).
    6. Severe neonatal illnesses (e.g. respiratory distress syndrome, severe sepsis intraventricular hemorrhage, severe neonatal jaundice, necrotizing enterocolitis, persistent pulmonary hypertension of the newborn, or any other condition which required to be treated with intravenous and/or intramuscular antibiotics).
    7. Known underlying disease predisposing to infection (e.g. HIV, viral hepatitis B, and C, auto-immune diabetes, immune deficiency).
    8. Severe renal failure and hepatic failure according to investigator's clinical judgement.
    9. Incapability of the parents to comply with study protocol or investigator's uncertainty about the willingness or ability of the subject to comply with the protocol requirements
    10. Participation in other studies involving investigational or marketed products concomitantly or within two weeks prior to screening visit.

Sites / Locations

  • Algemeen Stedelijk Ziekenhuis
  • Cliniques universitaires Saint-Luc
  • Universitair Ziekenhuis Brussel
  • Centre Hospitalier Régional de Namur
  • MUDr. Daniel Drazan, prakticky lekar pro deti a dorost
  • MUDr. Jitka Fabianova
  • Prakticky lekar pro deti a dorost
  • Ustav pro peci o matku a dite
  • Nemocnice Strakonice, a.s.
  • Charité Universitätsmedizin Berlin
  • Queen Mary Hospital
  • Prince of Wales Hospital
  • Dr. Kenessey Albert Korhaz-Rendelointezet
  • Pestszentimrei Gyermekrendelő / Elitance Duo Kft.
  • Rózsavölgyi Gyermekháziorvosi Rendelő / CEBA Egészségügyi Bt.
  • Gyermekorvosi Rendelő
  • Futurenest Kft.
  • Prehospital Med Kft
  • Kanizsai Dorottya Korhaz
  • Házi Gyermekorvosi Rendelő /Babadoki Kft.
  • Hillel Yaffe Medical center
  • Rambam Health Care Campus
  • Meir Medical Center
  • Schneider Children's Medical
  • Kaplan Medical Center
  • Tel Aviv Sourasky Medical Center
  • Ospdale Maggiore Policlinico, Fondazione IRCCS Ca' Granda
  • IRCCS Policlinico San Matteo, Università degli studi di Pavi
  • UOC Allergologia, Osp. Pediatrico Bambino Gesù, IRCCS;
  • Amphia Ziekenhuis
  • VU University Medical Center
  • PT&R
  • Deventer Ziekenhuis
  • EB UtrechtResearch BV
  • Kandang Kerbau Women's and Children's Hospital
  • National University Hospital
  • PEGYS s.r.o.
  • Juvenalia, s.r.o.
  • GASTREN, spol. s.r.o.
  • PEDMAN s.r.o.
  • Univerzitna nemocnica Martin
  • Fakultna nemocnica Nitra
  • GASTOL s.r.o.
  • Fakultna nemocnica Trencin
  • Ambulancia vseobecneho lekara pre deti a dorast
  • Hospital HLA Inmaculada Servicio de Pediatría
  • Hospital Universitario Virgen de las Nieves
  • Hospital Materno Infantil La Paz
  • Hospital Sant Joan de Deu
  • Complejo Hospitalario Universitario de Santiago
  • Instituto Hispalense de Pediatría
  • Hospital Universitari i Politecnic La Fe
  • China Medical University Hospital
  • LinKou Chang Gung Memorial Hospital
  • Royal London Hospital
  • University College Hospital
  • Central Manchester University Hospitals NHS Foundation Trust
  • The Newcastle Hospitals NHS Foundation Trust
  • University Hospital Southampton NHS Foundation Trust

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Active product: partially hydrolysed formula + synbiotics

Control product: standard formula (intact protein)

Arm Description

Outcomes

Primary Outcome Measures

Faecel levels of Bifidobacteria
Levels of Bifidobacteria at 17 weeks of age - stool sample

Secondary Outcome Measures

Faecal levels of Bifidobacteria and adult-like bacterial cluster
Levels of Bifidobacteria and adult-like bacterial cluster up to 52 weeks of age - stool sample
IgE-mediated allergic manifestations
IgE-mediated allergic manifestations up to 52 weeks of age - blood sample

Full Information

First Posted
February 1, 2017
Last Updated
December 7, 2021
Sponsor
Nutricia Research
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1. Study Identification

Unique Protocol Identification Number
NCT03067714
Brief Title
A Clinical Study to Investigate the Effect of a Partially Hydrolysed Infant Formula With Added Synbiotics on Gut Microbiota Composition and Clinical Effectiveness in Infants at High Risk of Developing Allergy
Acronym
TEMPO
Official Title
A Randomised, Double-blind, Controlled, Parallel-group, Multi-country Study to Investigate the Effect of a Partially Hydrolysed Infant Formula With Added Synbiotics on Gut Microbiota Composition and Clinical Effectiveness in Infants at High Risk of Developing Allergy
Study Type
Interventional

2. Study Status

Record Verification Date
December 2021
Overall Recruitment Status
Completed
Study Start Date
March 30, 2017 (Actual)
Primary Completion Date
March 25, 2020 (Actual)
Study Completion Date
March 25, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Nutricia Research

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
With the rising prevalence of allergic diseases and the subsequent risk of developing other immune-related disorders, primary prevention of allergy has become a major priority. It is generally acknowledged that breastfeeding is one of the main pillars in allergy prevention. Infant formulas based on hydrolysed proteins have been developed to be used by infants at increased risk of developing allergy in case a mother is unable or chooses not to breastfeed her infant. It has recently been demonstrated that the gut microbiota composition and microbiota activity of infants receiving an infant formula based on partially hydrolysed proteins, supplemented with oligosaccharides, is more similar to breastfed infants than to infants receiving standard cow's milk formula, demonstrated by increased levels of bifidobacteria. However the interaction between microbial changes impacted by an hypoallergenic concept and its influence on early life immune development should be further explored. The aim of the present study is therefore to investigate the bifidogenic effect of a hypoallergenic formula supplemented with prebiotics and probiotics compared to standard infant formula in infants at increased risk of developing allergic disease. This study will secondary assess the effects of this concept on the development of allergic manifestations up to the age of 12 months, which will be verified in a separate clinical study MAESTRO as primary outcome. Furthermore, the effects on growth and safety will be studied.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Immunity

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
855 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Active product: partially hydrolysed formula + synbiotics
Arm Type
Experimental
Arm Title
Control product: standard formula (intact protein)
Arm Type
Active Comparator
Intervention Type
Other
Intervention Name(s)
Infant formula with added synbiotics
Intervention Description
Intervention group: Infant Formula / Follow-On formula with partially hydrolysed cow's milk protein supplemented with prebiotics and probiotics.
Intervention Type
Other
Intervention Name(s)
Standard infant formula
Intervention Description
Control group: Standard Infant Formula / Follow-On formula with intact cow's milk protein (only standard ingredients, without addition of pre- and probiotics).
Primary Outcome Measure Information:
Title
Faecel levels of Bifidobacteria
Description
Levels of Bifidobacteria at 17 weeks of age - stool sample
Time Frame
17 weeks
Secondary Outcome Measure Information:
Title
Faecal levels of Bifidobacteria and adult-like bacterial cluster
Description
Levels of Bifidobacteria and adult-like bacterial cluster up to 52 weeks of age - stool sample
Time Frame
52 weeks
Title
IgE-mediated allergic manifestations
Description
IgE-mediated allergic manifestations up to 52 weeks of age - blood sample
Time Frame
52 weeks

10. Eligibility

Sex
All
Maximum Age & Unit of Time
16 Weeks
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Healthy term infants (gestational age ≥ 37 and ≤ 42 weeks) at high risk of developing allergy based on family history of allergy (*1). Infants aged ≤ 16 weeks (max. 16 weeks + 0 days), preferably as soon as possible after birth. Infants who start formula feeding within 16 weeks of age (infants of mothers who have chosen not to breastfeed or mothers who completely/partially cease breastfeeding before the subject's age of 16 weeks) (*2) OR Infants who are exclusively breastfed and whose mothers have the intention to exclusively breastfeed at least until their infant is 16 weeks of age (*2,3). Written informed consent from one or both parents (according to local laws) and/or legal guardian. 1* Family history of allergy is defined as at least one first-degree relative (parent or full sibling) with self-reported historically doctor confirmed allergic disease (allergic rhinitis, asthma, food allergy, allergic eczema). In case of a self-reported historically non-doctor confirmed allergic disease, doctor confirmation must be done as part of the screening procedure according to local practice (e.g. skin prick test, IgE measurement). 2* Subjects whose mother intents to switch to formula feeding before the subject's age of 16 weeks but in the end still exclusively breastfeed, will be included in the breastfed reference group. The other way around, subjects whose mother intents to exclusively breastfeed for at least 16 weeks, but in the end decides to switch to formula earlier, will be included in the randomised groups. All these subjects should meet all other in-/exclusion criteria. 3* Exclusive breast feeding. WHO definition: only breast milk and no other liquids or solids except for drops or syrups consisting of vitamins, mineral supplements or medicines [2]. In addition to the WHO definition, in this study water is allowed as well as formula feeding during the first 72 hours of life. Exclusion Criteria: Consumption of any amount of infant formula based on intact protein before randomisation, except from consumption during the first 72 hours of life. Consumption of any amount of infant formula with added probiotics and/or probiotic supplement before randomisation. Existing allergic manifestations (e.g. allergic skin disorders, food allergy) before randomisation according to investigator's clinical assessment. Established or suspected cows' milk allergy, lactose intolerance, galactosaemia, or in infants on a fibre-free diet. Severe congenital abnormalities which could influence the subjects' growth (e.g. cystic fibrosis, bronchopulmonary dysplasia, tracheomalacia, tracheoesophageal fistula, major congenital heart disease, or any other condition according to investigator's clinical judgement). Severe neonatal illnesses (e.g. respiratory distress syndrome, severe sepsis intraventricular hemorrhage, severe neonatal jaundice, necrotizing enterocolitis, persistent pulmonary hypertension of the newborn, or any other condition which required to be treated with intravenous and/or intramuscular antibiotics). Known underlying disease predisposing to infection (e.g. HIV, viral hepatitis B, and C, auto-immune diabetes, immune deficiency). Severe renal failure and hepatic failure according to investigator's clinical judgement. Incapability of the parents to comply with study protocol or investigator's uncertainty about the willingness or ability of the subject to comply with the protocol requirements Participation in other studies involving investigational or marketed products concomitantly or within two weeks prior to screening visit.
Facility Information:
Facility Name
Algemeen Stedelijk Ziekenhuis
City
Aalst
Country
Belgium
Facility Name
Cliniques universitaires Saint-Luc
City
Brussels
Country
Belgium
Facility Name
Universitair Ziekenhuis Brussel
City
Brussels
Country
Belgium
Facility Name
Centre Hospitalier Régional de Namur
City
Namur
Country
Belgium
Facility Name
MUDr. Daniel Drazan, prakticky lekar pro deti a dorost
City
Praha
Country
Czechia
Facility Name
MUDr. Jitka Fabianova
City
Praha
Country
Czechia
Facility Name
Prakticky lekar pro deti a dorost
City
Praha
Country
Czechia
Facility Name
Ustav pro peci o matku a dite
City
Praha
Country
Czechia
Facility Name
Nemocnice Strakonice, a.s.
City
Strakonice
Country
Czechia
Facility Name
Charité Universitätsmedizin Berlin
City
Berlin
Country
Germany
Facility Name
Queen Mary Hospital
City
Hong Kong
Country
Hong Kong
Facility Name
Prince of Wales Hospital
City
Shatin
Country
Hong Kong
Facility Name
Dr. Kenessey Albert Korhaz-Rendelointezet
City
Balassagyarmat
Country
Hungary
Facility Name
Pestszentimrei Gyermekrendelő / Elitance Duo Kft.
City
Budapest
Country
Hungary
Facility Name
Rózsavölgyi Gyermekháziorvosi Rendelő / CEBA Egészségügyi Bt.
City
Budapest
Country
Hungary
Facility Name
Gyermekorvosi Rendelő
City
Debrecen
Country
Hungary
Facility Name
Futurenest Kft.
City
Miskolc
Country
Hungary
Facility Name
Prehospital Med Kft
City
Miskolc
Country
Hungary
Facility Name
Kanizsai Dorottya Korhaz
City
Nagykanizsa
Country
Hungary
Facility Name
Házi Gyermekorvosi Rendelő /Babadoki Kft.
City
Szeged
Country
Hungary
Facility Name
Hillel Yaffe Medical center
City
Hadera
Country
Israel
Facility Name
Rambam Health Care Campus
City
Haifa
Country
Israel
Facility Name
Meir Medical Center
City
Kfar Saba
Country
Israel
Facility Name
Schneider Children's Medical
City
Petah tikva
Country
Israel
Facility Name
Kaplan Medical Center
City
Reẖovot
Country
Israel
Facility Name
Tel Aviv Sourasky Medical Center
City
Tel Aviv
Country
Israel
Facility Name
Ospdale Maggiore Policlinico, Fondazione IRCCS Ca' Granda
City
Milano
Country
Italy
Facility Name
IRCCS Policlinico San Matteo, Università degli studi di Pavi
City
Pavia
Country
Italy
Facility Name
UOC Allergologia, Osp. Pediatrico Bambino Gesù, IRCCS;
City
Roma
Country
Italy
Facility Name
Amphia Ziekenhuis
City
Breda
State/Province
Brabant
ZIP/Postal Code
4819 EV
Country
Netherlands
Facility Name
VU University Medical Center
City
Amsterdam
Country
Netherlands
Facility Name
PT&R
City
Beek
Country
Netherlands
Facility Name
Deventer Ziekenhuis
City
Deventer
Country
Netherlands
Facility Name
EB UtrechtResearch BV
City
Utrecht
Country
Netherlands
Facility Name
Kandang Kerbau Women's and Children's Hospital
City
Singapore
Country
Singapore
Facility Name
National University Hospital
City
Singapore
Country
Singapore
Facility Name
PEGYS s.r.o.
City
Dolný Kubín
Country
Slovakia
Facility Name
Juvenalia, s.r.o.
City
Dunajská Streda
Country
Slovakia
Facility Name
GASTREN, spol. s.r.o.
City
Košice
Country
Slovakia
Facility Name
PEDMAN s.r.o.
City
Martin
Country
Slovakia
Facility Name
Univerzitna nemocnica Martin
City
Martin
Country
Slovakia
Facility Name
Fakultna nemocnica Nitra
City
Nitra
Country
Slovakia
Facility Name
GASTOL s.r.o.
City
Prešov
Country
Slovakia
Facility Name
Fakultna nemocnica Trencin
City
Trenčín
Country
Slovakia
Facility Name
Ambulancia vseobecneho lekara pre deti a dorast
City
Zlaté Moravce
Country
Slovakia
Facility Name
Hospital HLA Inmaculada Servicio de Pediatría
City
Granada
Country
Spain
Facility Name
Hospital Universitario Virgen de las Nieves
City
Granada
Country
Spain
Facility Name
Hospital Materno Infantil La Paz
City
Madrid
Country
Spain
Facility Name
Hospital Sant Joan de Deu
City
Manresa
Country
Spain
Facility Name
Complejo Hospitalario Universitario de Santiago
City
Santiago De Compostela
Country
Spain
Facility Name
Instituto Hispalense de Pediatría
City
Sevilla
Country
Spain
Facility Name
Hospital Universitari i Politecnic La Fe
City
Valencia
Country
Spain
Facility Name
China Medical University Hospital
City
Taichung
Country
Taiwan
Facility Name
LinKou Chang Gung Memorial Hospital
City
Taoyuan
Country
Taiwan
Facility Name
Royal London Hospital
City
London
Country
United Kingdom
Facility Name
University College Hospital
City
London
Country
United Kingdom
Facility Name
Central Manchester University Hospitals NHS Foundation Trust
City
Manchester
Country
United Kingdom
Facility Name
The Newcastle Hospitals NHS Foundation Trust
City
Newcastle
Country
United Kingdom
Facility Name
University Hospital Southampton NHS Foundation Trust
City
Southampton
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Clinical Study to Investigate the Effect of a Partially Hydrolysed Infant Formula With Added Synbiotics on Gut Microbiota Composition and Clinical Effectiveness in Infants at High Risk of Developing Allergy

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