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Cranberry and Quillaja on Symptoms of Uncomplicated UTI

Primary Purpose

Urinary Tract Infections, UTI, UTI - Lower Urinary Tract Infection

Status
Recruiting
Phase
Phase 3
Locations
Canada
Study Type
Interventional
Intervention
Pacran and Sapnov P quillaja
Sponsored by
Lawson Health Research Institute
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Urinary Tract Infections

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  1. Pre-menopausal women 18 years and over
  2. Presenting with typical symptoms of an uncomplicated UTI
  3. Positive leukocyte or nitrite on in-office urine dipstick confirmed
  4. Able to swallow capsules
  5. Willing and able to fill out/ answer questionnaires and comply with the study requirement
  6. Willing to initiate clinically prescribed antibiotic therapy (typically 5-day antibiotic).
  7. Provided written informed consent
  8. BMI >17.5kg m2 and <35kg m2

Exclusion Criteria:

  1. Regular use of Vaccinium containing products (e.g. all forms of blueberries, cranberries, bilberry, lingonberry etc. i.e. fruit, dried fruit, pills, juices or supplements) within 28 days of Day 1,
  2. Allergy to cranberry, tree bark, or quillaja.
  3. Use of any antibacterial supplements or products, that in the opinion of the Medical Investigator may interfere with the study outcomes, within 28 days of Day 1
  4. A history of >5 UTIs in the last 6 months (confirmed by self-report or health professional)
  5. Use of antibiotics or antibiotics for prophylaxis to treat a UTI within 28 days of Day 1
  6. Women of child bearing potential not willing to use adequate and effective methods of contraception throughout the study, in the opinion of the Investigator
  7. Positive urine dipstick pregnancy test at screening on Day 1, currently pregnant and/or breastfeeding
  8. History of an adverse reaction or known hypersensitivity or suspected allergy to the investigational product ingredients
  9. History of pyelonephritis or reflux
  10. Presence of an intermittent or indwelling urinary catheter
  11. Anatomical abnormalities of the urinary tract (self-reported)
  12. History of or known clinically significant renal or urological disease (self-reported), at the discretion of the investigator
  13. History of or known clinically significant cardiac disease, at the discretion of the investigator
  14. History of or known clinically significant liver disease, at the discretion of the investigator
  15. History of or known clinically significant gastrointestinal disease, at the discretion of the investigator
  16. History of or known metabolic disorder or diabetes
  17. History of or known incomplete emptying of bladder
  18. History or presence of alcohol or illicit drug abuse, any surgical history, clinical condition or organ dysfunction that in the opinion of the Medical Investigator may affect the participant's ability to participate in the study or the study results
  19. Currently hospitalized or any planned hospitalizations within the study period.
  20. Immunocompromised participants or participants receiving immunosuppressive medication
  21. Currently taking warfarin or has received Warfarin within 28 days of Day 1
  22. Received an investigational drug within 28 days of Day 1 (pills, juices or supplements)

Sites / Locations

  • St. Joseph's Health Care LondonRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Cranberry and Quillaja

Arm Description

one 450mg cranberry capsule and one 50mg quillaja capsule in the morning and evening for 14 days.

Outcomes

Primary Outcome Measures

Urinary Tract Infection Symptoms Assessment Questionnaire (UTISA)
This questionnaire assesses the degree of symptoms and bother on a scale of 0 to 3, and has 3 domains of urinary regularity, problems with urination and pain associated with urination. The fourth domain includes the presence of hematuria. Subjects will complete the UTISA questionnaire every day for 14 days.
Time to UTI antibiotic initiation
This will be assessed using study form, UTI Comfort Measure Assessment. Subjects will have access to a clinically prescribed UTI antibiotic, nitrofurantoin 100mg. Subjects will be asked to record each day their intake of any antibiotic during the study period.

Secondary Outcome Measures

Microbiome changes prior to and post antibiotic initiation
This outcome measure can only be assessed for those participants that require antibiotic initiation. Changes in the entire bacterial community prior to and post antibiotic use will be assessed in the lab from faecal and urine samples collected by the participant. The microbes may vary by participant and the study will be looking at which ones present themselves in each case. Units of measure via culture are colony forming units per g (cfu/g).

Full Information

First Posted
July 29, 2020
Last Updated
January 13, 2023
Sponsor
Lawson Health Research Institute
Collaborators
Urobiome Therapeutics, St. Joseph's Health Care London
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1. Study Identification

Unique Protocol Identification Number
NCT04496726
Brief Title
Cranberry and Quillaja on Symptoms of Uncomplicated UTI
Official Title
A Proof-of-concept, Feasibility Study to Investigate the Effect of Cranberry and Quillaia Extract Type II on Symptoms in Women With Uncomplicated Urinary Tract Infection and to Study the Modulation of the Urinary and Gut Microbiome Pre- and Post-antibiotic Use
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Recruiting
Study Start Date
January 1, 2021 (Actual)
Primary Completion Date
June 1, 2023 (Anticipated)
Study Completion Date
December 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Lawson Health Research Institute
Collaborators
Urobiome Therapeutics, St. Joseph's Health Care London

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
This study will investigate the effects of cranberry and quillaja capsules on symptoms of uncomplicated urinary tract infections.
Detailed Description
Urinary tract infection (UTI) is one of the most common bacterial infections in humans and it disproportionately affects women. Currently there are only a few alternatives to antibiotics for treatment of UTI. Although symptomatic relief occurs more quickly in women treated with oral antibiotics for uncomplicated UTIs, patients appear to successfully resolve their UTI without antibiotic therapy. While antibiotics are the mainstay of therapy, there are growing concerns about collateral effects impacting healthy microbiomes and anti-bacterial resistance patterns. Recent estimates from the CDC indicate that more than 2.8 million antibiotic-resistant infections occur in the U.S. each year, and more than 35,000 people die as a result. The proposed research fills a key knowledge gap that will be critical in determining the role of a non-antibiotic substance with the potential to treat UTIs by modulating the urinary and gut microbiome to restore health and minimize the reliance on traditional antibiotic therapy while also preventing antibiotic resistance. In addition, this study will provide early evidence of the short-term symptom and urinary and gut microbiome changes following ingestion of two botanical food substances (cranberry and quillaja) that have the potential for beneficial effects on the microbiome and UTI symptoms.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Urinary Tract Infections, UTI, UTI - Lower Urinary Tract Infection

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Model Description
Open label, single site, single group prospective cohort study
Masking
None (Open Label)
Allocation
N/A
Enrollment
38 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Cranberry and Quillaja
Arm Type
Experimental
Arm Description
one 450mg cranberry capsule and one 50mg quillaja capsule in the morning and evening for 14 days.
Intervention Type
Other
Intervention Name(s)
Pacran and Sapnov P quillaja
Other Intervention Name(s)
Cranberry, Quillaja, Pacran, Naturex, Sapnov P, Quillaia extract type II
Intervention Description
Cranberry (450 mg) and quillaja (50 mg) capsules taken orally twice daily (morning and evening) for a total daily dose of 900 mg cranberry and 100 mg quillaja for 14 days. Nitrofurantoin 100 mg taken orally twice daily for five days as a rescue medication if symptoms do not subside.
Primary Outcome Measure Information:
Title
Urinary Tract Infection Symptoms Assessment Questionnaire (UTISA)
Description
This questionnaire assesses the degree of symptoms and bother on a scale of 0 to 3, and has 3 domains of urinary regularity, problems with urination and pain associated with urination. The fourth domain includes the presence of hematuria. Subjects will complete the UTISA questionnaire every day for 14 days.
Time Frame
14 days
Title
Time to UTI antibiotic initiation
Description
This will be assessed using study form, UTI Comfort Measure Assessment. Subjects will have access to a clinically prescribed UTI antibiotic, nitrofurantoin 100mg. Subjects will be asked to record each day their intake of any antibiotic during the study period.
Time Frame
14 days
Secondary Outcome Measure Information:
Title
Microbiome changes prior to and post antibiotic initiation
Description
This outcome measure can only be assessed for those participants that require antibiotic initiation. Changes in the entire bacterial community prior to and post antibiotic use will be assessed in the lab from faecal and urine samples collected by the participant. The microbes may vary by participant and the study will be looking at which ones present themselves in each case. Units of measure via culture are colony forming units per g (cfu/g).
Time Frame
14 days

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Pre-menopausal women 18 years and over Presenting with typical symptoms of an uncomplicated UTI Positive leukocyte or nitrite on in-office urine dipstick confirmed Able to swallow capsules Willing and able to fill out/ answer questionnaires and comply with the study requirement Willing to initiate clinically prescribed antibiotic therapy (typically 5-day antibiotic). Provided written informed consent BMI >17.5kg m2 and <35kg m2 Exclusion Criteria: Regular use of Vaccinium containing products (e.g. all forms of blueberries, cranberries, bilberry, lingonberry etc. i.e. fruit, dried fruit, pills, juices or supplements) within 28 days of Day 1, Allergy to cranberry, tree bark, or quillaja. Use of any antibacterial supplements or products, that in the opinion of the Medical Investigator may interfere with the study outcomes, within 28 days of Day 1 A history of >5 UTIs in the last 6 months (confirmed by self-report or health professional) Use of antibiotics or antibiotics for prophylaxis to treat a UTI within 28 days of Day 1 Women of child bearing potential not willing to use adequate and effective methods of contraception throughout the study, in the opinion of the Investigator Positive urine dipstick pregnancy test at screening on Day 1, currently pregnant and/or breastfeeding History of an adverse reaction or known hypersensitivity or suspected allergy to the investigational product ingredients History of pyelonephritis or reflux Presence of an intermittent or indwelling urinary catheter Anatomical abnormalities of the urinary tract (self-reported) History of or known clinically significant renal or urological disease (self-reported), at the discretion of the investigator History of or known clinically significant cardiac disease, at the discretion of the investigator History of or known clinically significant liver disease, at the discretion of the investigator History of or known clinically significant gastrointestinal disease, at the discretion of the investigator History of or known metabolic disorder or diabetes History of or known incomplete emptying of bladder History or presence of alcohol or illicit drug abuse, any surgical history, clinical condition or organ dysfunction that in the opinion of the Medical Investigator may affect the participant's ability to participate in the study or the study results Currently hospitalized or any planned hospitalizations within the study period. Immunocompromised participants or participants receiving immunosuppressive medication Currently taking warfarin or has received Warfarin within 28 days of Day 1 Received an investigational drug within 28 days of Day 1 (pills, juices or supplements)
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Alexandria Roa Agudelo, MLA/T
Phone
519-476-6846
Email
alexandria.roaagudelo@sjhc.london.on.ca
First Name & Middle Initial & Last Name or Official Title & Degree
Jeremy P Burton, PhD
Phone
519-646-6100
Ext
61365
Email
Jeremy.Burton@LawsonResearch.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Blayne Welk, MD
Organizational Affiliation
St. Joseph's Healthcare London
Official's Role
Principal Investigator
Facility Information:
Facility Name
St. Joseph's Health Care London
City
London
State/Province
Ontario
ZIP/Postal Code
N6A 4V2
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mary McKibbon, RN
Phone
519-646-6100
Ext
65308
Email
Mary.McKibbon@sjhc.london.on.ca
First Name & Middle Initial & Last Name & Degree
Alexandria Roa Agudelo, cMLA/T
Phone
519-646-6100
Ext
42696
Email
alexandria.roaagudelo@sjhc.london.on.ca

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
19195714
Citation
Falagas ME, Kotsantis IK, Vouloumanou EK, Rafailidis PI. Antibiotics versus placebo in the treatment of women with uncomplicated cystitis: a meta-analysis of randomized controlled trials. J Infect. 2009 Feb;58(2):91-102. doi: 10.1016/j.jinf.2008.12.009. Epub 2009 Feb 4.
Results Reference
background
PubMed Identifier
20443158
Citation
Pappas E, Schaich KM. Phytochemicals of cranberries and cranberry products: characterization, potential health effects, and processing stability. Crit Rev Food Sci Nutr. 2009 Oct;49(9):741-81. doi: 10.1080/10408390802145377.
Results Reference
background
PubMed Identifier
16055161
Citation
Howell AB, Reed JD, Krueger CG, Winterbottom R, Cunningham DG, Leahy M. A-type cranberry proanthocyanidins and uropathogenic bacterial anti-adhesion activity. Phytochemistry. 2005 Sep;66(18):2281-91. doi: 10.1016/j.phytochem.2005.05.022.
Results Reference
background
PubMed Identifier
26268913
Citation
Vostalova J, Vidlar A, Simanek V, Galandakova A, Kosina P, Vacek J, Vrbkova J, Zimmermann BF, Ulrichova J, Student V. Are High Proanthocyanidins Key to Cranberry Efficacy in the Prevention of Recurrent Urinary Tract Infection? Phytother Res. 2015 Oct;29(10):1559-67. doi: 10.1002/ptr.5427. Epub 2015 Aug 13.
Results Reference
background
PubMed Identifier
28959520
Citation
Sarkhel S. Evaluation of the anti-inflammatory activities of Quillaja saponaria Mol. saponin extract in mice. Toxicol Rep. 2015 Dec 1;3:1-3. doi: 10.1016/j.toxrep.2015.11.006. eCollection 2016.
Results Reference
background
PubMed Identifier
30621160
Citation
Fleck JD, Betti AH, da Silva FP, Troian EA, Olivaro C, Ferreira F, Verza SG. Saponins from Quillaja saponaria and Quillaja brasiliensis: Particular Chemical Characteristics and Biological Activities. Molecules. 2019 Jan 4;24(1):171. doi: 10.3390/molecules24010171.
Results Reference
background
PubMed Identifier
27819292
Citation
den Brok MH, Bull C, Wassink M, de Graaf AM, Wagenaars JA, Minderman M, Thakur M, Amigorena S, Rijke EO, Schrier CC, Adema GJ. Saponin-based adjuvants induce cross-presentation in dendritic cells by intracellular lipid body formation. Nat Commun. 2016 Nov 7;7:13324. doi: 10.1038/ncomms13324.
Results Reference
background
PubMed Identifier
30807432
Citation
Southworth E, Hochstedler B, Price TK, Joyce C, Wolfe AJ, Mueller ER. A Cross-sectional Pilot Cohort Study Comparing Standard Urine Collection to the Peezy Midstream Device for Research Studies Involving Women. Female Pelvic Med Reconstr Surg. 2019 Mar/Apr;25(2):e28-e33. doi: 10.1097/SPV.0000000000000693.
Results Reference
background
Links:
URL
https://www.federalregister.gov/documents/2007/08/01/E7-14894/quillaja-saponaria-extract-exemption-from-the-requirement-of-a-tolerance
Description
Quillaja Saponaria Extract; Exempt from the Requirement of a Tolerance
URL
http://tools.thermofisher.com/content/sfs/brochures/AA-UniversalUrine-Brochure-130826.pdf
Description
AssayAssure Universal Urine Collection & Transport Product

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Cranberry and Quillaja on Symptoms of Uncomplicated UTI

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