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Effect of Probiotic Supplementation on Lactose Maldigestion Induced by Lactose Solution

Primary Purpose

Lactose Intolerance

Status
Completed
Phase
Not Applicable
Locations
France
Study Type
Interventional
Intervention
Probiotic
Lactase
Placebo
Sponsored by
Danisco
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Lactose Intolerance

Eligibility Criteria

25 Years - 65 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Voluntary, written, informed consent to participate in the study
  2. Agreement to comply with the protocol and study restrictions
  3. Healthy females and males of age 25 to 60 years (inclusive)
  4. Self-declared, suspected or medically diagnosed lactose intolerance
  5. Increase of more than 20 ppm in breath hydrogen within 3 h from the baseline fasting breath hydrogen value
  6. Participants who agree to maintain their usual dietary habits throughout the trial period
  7. Participants who agree not to consume probiotics, prebiotics, fermented milk, and/or yogurt containing probiotics during the intervention period (Visits 3-5) and two weeks before Visit 3 (2 weeks after screening visit)
  8. Females of child-bearing potential who agree to use a medically approved method of birth control
  9. Ability of the participant (in the investigator's opinion) to comprehend the full nature and purpose of the study including possible risks and side effects
  10. Covered by Health Insurance System and / or in compliance with the recommendations of National Law in force relating to biomedical research

Exclusion Criteria:

  1. Gastrointestinal disorder or disease (e.g. Crohn's disease, ulcer, irritable bowel syndrome (IBS), Celiac disease, small intestinal bacterial overgrowth (SIBO), pancreatitis and disorders affecting gastrointestinal motility)
  2. Diagnosed type 1 or type 2 diabetes
  3. Prior abdominal surgery that, in the opinion of the investigator, may present a risk for the participant or affect study results
  4. Ongoing or recent (last 1 month) antibiotic treatment.
  5. Use of laxatives or drugs known to affect gut motility 1 month preceding the screening visit and during the study
  6. Ongoing or recurrent use of proton pump inhibitors
  7. Colonoscopy within 3 months before screening
  8. History of recurrent colon cleansing and/or a colon cleansing within 3 months before screening
  9. Gastrointestinal infection within 1 month before screening or during the trial
  10. Clinically significant underlying systemic illness that may preclude the participant's ability to complete the trial or that may affect the study outcomes (e.g. bowel cancer, prostate cancer, terminal illness)
  11. History of diagnosed coronary heart disease/cardiovascular disease or artificial heart valve
  12. Any obstructive or restrictive respiratory syndrome/disease that may impact breath test (e.g. asthma or chronic obstructive pulmonary disease (COPD))
  13. Regular use of tobacco, snuff, nicotine and e-cigarette, and possible other inhaled products. Light smokers (less than 5 cigarettes per day) who agree not to smoke during the whole duration of the study may be included.
  14. Self-declared history of alcohol abuse (for females: >3 drinks on any single day and >7 drinks per week; for males: >4 drinks on any single day and >14 drinks per week)
  15. Self-declared use of illicit drugs within 4 weeks preceding the screening visit
  16. Pregnant or lactating female, or pregnancy planned during study period
  17. Participants under administrative or legal supervision.
  18. Participation in another study with any investigational product within 60 days of screening
  19. Clinically significant abnormal values in safety blood tests at screening
  20. Other reasons that, in the opinion of the Investigator, make the participant unsuitable for enrolment
  21. Who would receive more than 4500€ as indemnities for his participation in biomedical research within the last 12 months, including the indemnities for the present study.

Sites / Locations

  • Eurofins Optimed

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Placebo Comparator

Arm Label

Probiotic powder

Lactase

Placebo

Arm Description

One sachet of Probiotic powderwill be consumed with 25 g lactose in 250 ml of water in the beginning of a 6-hour challenge at the study visits.

One sachet of Lactase powder will be consumed with 25 g lactose in 250 ml of water in the beginning of a 6-hour challenge at the study visits.

One sachet of placebo powder will be consumed with 25 g lactose in 250 ml of water in the beginning of a 6-hour challenge at the study visits.

Outcomes

Primary Outcome Measures

Difference in breath hydrogen concentration (BHC, ppm) in probiotic group compared to placebo
Difference in breath hydrogen concentration (BHC, ppm) in probiotic compared to placebo, measured by the iAUC analysis
Difference in breath hydrogen concentration (BHC, ppm) in lactase group compared to placebo
Difference in breath hydrogen concentration (BHC, ppm) in lactase group compared to placebo, measured by the iAUC analysis
Non-inferiority in breath hydrogen concentration (BHC, ppm) of probiotic group compared to lactase group (positive control)
Non-inferiority in breath hydrogen concentration (BHC, ppm) of probiotic group compared to lactase group (positive control), measured by the iAUC analysis

Secondary Outcome Measures

Difference in breath hydrogen concentration (BHC, ppm) in lactase group compared to placebo, measured by breath hydrogen peak value
Difference in breath hydrogen concentration (BHC, ppm) in lactase group compared to placebo, measured by breath hydrogen peak value
Difference in breath hydrogen concentration (BHC, ppm) in probiotic group compared to placebo, measured by breath hydrogen peak value
Difference in breath hydrogen concentration (BHC, ppm) in probiotic group compared to placebo, measured by breath hydrogen peak value
Difference in breath hydrogen concentration (BHC, ppm) in lactase group compared to placebo, measured by cumulative breath hydrogen value
Difference in breath hydrogen concentration (BHC, ppm) in lactase group compared to placebo, measured by cumulative breath hydrogen value
Difference in breath hydrogen concentration (BHC, ppm) in probiotic group compared to placebo, measured by cumulative breath hydrogen value
Difference in breath hydrogen concentration (BHC, ppm) in probiotic group compared to placebo, measured by cumulative breath hydrogen value
Difference in the severity of abdominal pain in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the severity of abdominal pain in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the severity of abdominal pain in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the severity of abdominal pain in probioticgroup compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the severity of flatulence in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the severity of flatulence in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the severity of flatulence in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the severity of flatulence in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the severity of bloating in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the severity of bloating in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the severity of bloating in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the severity of bloating in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the severity of nausea in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the severity of nausea in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the severity of nausea in probioticgroup compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the severity of nausea in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the presence of vomiting in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the presence of vomiting in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the presence of vomiting in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the presence of vomiting in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the presence of bowel movements in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the presence of bowel movements in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the presence of bowel movements in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the presence of bowel movements in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the presence of diarrhea in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the presence of diarrhea in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the presence of diarrhea in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Difference in the presence of diarrhea in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey

Full Information

First Posted
January 20, 2019
Last Updated
August 11, 2019
Sponsor
Danisco
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1. Study Identification

Unique Protocol Identification Number
NCT03814668
Brief Title
Effect of Probiotic Supplementation on Lactose Maldigestion Induced by Lactose Solution
Official Title
Effect of Probiotic Supplementation on Lactose Maldigestion Induced by Lactose Solution: Randomized, Double-blind, Placebo-controlled, Positive-controlled, Three-way Crossover, Acute Lactose Challenge
Study Type
Interventional

2. Study Status

Record Verification Date
August 2019
Overall Recruitment Status
Completed
Study Start Date
November 5, 2018 (Actual)
Primary Completion Date
April 30, 2019 (Actual)
Study Completion Date
April 30, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Danisco

4. Oversight

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

5. Study Description

Brief Summary
Study objectives: Primary: Difference in breath hydrogen concentration (BHC, ppm) in lactase and probiotic groups compared to placebo, measured by the incremental area under curve (iAUC) analysis Non-inferiority in breath hydrogen concentration (BHC, ppm) of probiotic group compared to lactase group, measured by the incremental area under curve (iAUC) analysis Secondary: Breath test Breath hydrogen peak value (ppm) in lactase and probiotic groups compared to placebo Cumulative breath hydrogen (ppm) in lactase and probiotic groups compared to placebo Acute gastrointestinal symptoms (severity or presence/absence to be defined on a Likert scale) in lactase and probiotic groups compared to placebo Abdominal pain Flatulence Bloating Nausea and vomiting Bowel movements and diarrhea (if present, stool consistency to be defined on Bristol stool scale and number of bowel movements to be recorded) Ancillary: Baseline fasting BHC (ppm) Breath methane CH4 (ppm) Breath carbon dioxide CO2 (ppm) Probiotic identification in feces before each lactose challenge by molecular methods Gene test to determine lactase deficiency status at screening (following SNP variants to be screened: 13910*C (Europe, Central Asia, commonly used) -22018*G (Europe), -13915*T (Saudi-Arabia, Africa), -14010*G (Africa), -13907*C (Africa))

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
34 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Probiotic powder
Arm Type
Experimental
Arm Description
One sachet of Probiotic powderwill be consumed with 25 g lactose in 250 ml of water in the beginning of a 6-hour challenge at the study visits.
Arm Title
Lactase
Arm Type
Active Comparator
Arm Description
One sachet of Lactase powder will be consumed with 25 g lactose in 250 ml of water in the beginning of a 6-hour challenge at the study visits.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
One sachet of placebo powder will be consumed with 25 g lactose in 250 ml of water in the beginning of a 6-hour challenge at the study visits.
Intervention Type
Dietary Supplement
Intervention Name(s)
Probiotic
Intervention Description
Intake of probiotic
Intervention Type
Dietary Supplement
Intervention Name(s)
Lactase
Intervention Description
Intake of lactase
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
Intake of placebo
Primary Outcome Measure Information:
Title
Difference in breath hydrogen concentration (BHC, ppm) in probiotic group compared to placebo
Description
Difference in breath hydrogen concentration (BHC, ppm) in probiotic compared to placebo, measured by the iAUC analysis
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in breath hydrogen concentration (BHC, ppm) in lactase group compared to placebo
Description
Difference in breath hydrogen concentration (BHC, ppm) in lactase group compared to placebo, measured by the iAUC analysis
Time Frame
During the 6-hour acute lactose challenge
Title
Non-inferiority in breath hydrogen concentration (BHC, ppm) of probiotic group compared to lactase group (positive control)
Description
Non-inferiority in breath hydrogen concentration (BHC, ppm) of probiotic group compared to lactase group (positive control), measured by the iAUC analysis
Time Frame
During the 6-hour acute lactose challenge
Secondary Outcome Measure Information:
Title
Difference in breath hydrogen concentration (BHC, ppm) in lactase group compared to placebo, measured by breath hydrogen peak value
Description
Difference in breath hydrogen concentration (BHC, ppm) in lactase group compared to placebo, measured by breath hydrogen peak value
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in breath hydrogen concentration (BHC, ppm) in probiotic group compared to placebo, measured by breath hydrogen peak value
Description
Difference in breath hydrogen concentration (BHC, ppm) in probiotic group compared to placebo, measured by breath hydrogen peak value
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in breath hydrogen concentration (BHC, ppm) in lactase group compared to placebo, measured by cumulative breath hydrogen value
Description
Difference in breath hydrogen concentration (BHC, ppm) in lactase group compared to placebo, measured by cumulative breath hydrogen value
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in breath hydrogen concentration (BHC, ppm) in probiotic group compared to placebo, measured by cumulative breath hydrogen value
Description
Difference in breath hydrogen concentration (BHC, ppm) in probiotic group compared to placebo, measured by cumulative breath hydrogen value
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in the severity of abdominal pain in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Description
Difference in the severity of abdominal pain in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in the severity of abdominal pain in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Description
Difference in the severity of abdominal pain in probioticgroup compared to placebo, as defined by the gastrointestinal symptom survey
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in the severity of flatulence in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Description
Difference in the severity of flatulence in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in the severity of flatulence in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Description
Difference in the severity of flatulence in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in the severity of bloating in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Description
Difference in the severity of bloating in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in the severity of bloating in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Description
Difference in the severity of bloating in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in the severity of nausea in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Description
Difference in the severity of nausea in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in the severity of nausea in probioticgroup compared to placebo, as defined by the gastrointestinal symptom survey
Description
Difference in the severity of nausea in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in the presence of vomiting in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Description
Difference in the presence of vomiting in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in the presence of vomiting in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Description
Difference in the presence of vomiting in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in the presence of bowel movements in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Description
Difference in the presence of bowel movements in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in the presence of bowel movements in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Description
Difference in the presence of bowel movements in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in the presence of diarrhea in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Description
Difference in the presence of diarrhea in lactase group compared to placebo, as defined by the gastrointestinal symptom survey
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in the presence of diarrhea in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Description
Difference in the presence of diarrhea in probiotic group compared to placebo, as defined by the gastrointestinal symptom survey
Time Frame
During the 6-hour acute lactose challenge
Other Pre-specified Outcome Measures:
Title
Difference in baseline fasting BHC (ppm) between the treatments
Description
Difference in baseline fasting BHC (ppm) between the treatments
Time Frame
Baseline
Title
Difference in breath methane concentration (ppm) between the treatments
Description
Difference in breath methane concentration (ppm) between the treatments
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in breath carbon dioxide concentration (ppm) between the treatments
Description
Difference in breath methane concentration (ppm) between the treatments
Time Frame
During the 6-hour acute lactose challenge
Title
Difference in the quantity of probiotic in fecal samples between the treatments
Description
Difference in the quantity of probiotic in fecal samples between the treatments
Time Frame
48-hours before the visits
Title
Description of the SNP variants in each treatment group
Description
Description of the SNP variants in each treatment group
Time Frame
At screening

10. Eligibility

Sex
All
Minimum Age & Unit of Time
25 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Voluntary, written, informed consent to participate in the study Agreement to comply with the protocol and study restrictions Healthy females and males of age 25 to 60 years (inclusive) Self-declared, suspected or medically diagnosed lactose intolerance Increase of more than 20 ppm in breath hydrogen within 3 h from the baseline fasting breath hydrogen value Participants who agree to maintain their usual dietary habits throughout the trial period Participants who agree not to consume probiotics, prebiotics, fermented milk, and/or yogurt containing probiotics during the intervention period (Visits 3-5) and two weeks before Visit 3 (2 weeks after screening visit) Females of child-bearing potential who agree to use a medically approved method of birth control Ability of the participant (in the investigator's opinion) to comprehend the full nature and purpose of the study including possible risks and side effects Covered by Health Insurance System and / or in compliance with the recommendations of National Law in force relating to biomedical research Exclusion Criteria: Gastrointestinal disorder or disease (e.g. Crohn's disease, ulcer, irritable bowel syndrome (IBS), Celiac disease, small intestinal bacterial overgrowth (SIBO), pancreatitis and disorders affecting gastrointestinal motility) Diagnosed type 1 or type 2 diabetes Prior abdominal surgery that, in the opinion of the investigator, may present a risk for the participant or affect study results Ongoing or recent (last 1 month) antibiotic treatment. Use of laxatives or drugs known to affect gut motility 1 month preceding the screening visit and during the study Ongoing or recurrent use of proton pump inhibitors Colonoscopy within 3 months before screening History of recurrent colon cleansing and/or a colon cleansing within 3 months before screening Gastrointestinal infection within 1 month before screening or during the trial Clinically significant underlying systemic illness that may preclude the participant's ability to complete the trial or that may affect the study outcomes (e.g. bowel cancer, prostate cancer, terminal illness) History of diagnosed coronary heart disease/cardiovascular disease or artificial heart valve Any obstructive or restrictive respiratory syndrome/disease that may impact breath test (e.g. asthma or chronic obstructive pulmonary disease (COPD)) Regular use of tobacco, snuff, nicotine and e-cigarette, and possible other inhaled products. Light smokers (less than 5 cigarettes per day) who agree not to smoke during the whole duration of the study may be included. Self-declared history of alcohol abuse (for females: >3 drinks on any single day and >7 drinks per week; for males: >4 drinks on any single day and >14 drinks per week) Self-declared use of illicit drugs within 4 weeks preceding the screening visit Pregnant or lactating female, or pregnancy planned during study period Participants under administrative or legal supervision. Participation in another study with any investigational product within 60 days of screening Clinically significant abnormal values in safety blood tests at screening Other reasons that, in the opinion of the Investigator, make the participant unsuitable for enrolment Who would receive more than 4500€ as indemnities for his participation in biomedical research within the last 12 months, including the indemnities for the present study.
Facility Information:
Facility Name
Eurofins Optimed
City
Gières
ZIP/Postal Code
38610
Country
France

12. IPD Sharing Statement

Plan to Share IPD
Undecided
Citations:
PubMed Identifier
36149331
Citation
Rasinkangas P, Forssten SD, Marttinen M, Ibarra A, Bothe G, Junnila J, Uebelhack R, Donazzolo Y, Ouwehand AC. Bifidobacterium animalis subsp. lactis Bi-07 supports lactose digestion in vitro and in randomized, placebo- and lactase-controlled clinical trials. Am J Clin Nutr. 2022 Dec 19;116(6):1580-1594. doi: 10.1093/ajcn/nqac264.
Results Reference
derived

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Effect of Probiotic Supplementation on Lactose Maldigestion Induced by Lactose Solution

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