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To Study the Efficacy and Safety of L. Plantarum UALp-05TM in Diarrhea- Predominant-irritable Bowel Syndrome

Primary Purpose

Irritable Bowel Syndrome With Diarrhea

Status
Completed
Phase
Not Applicable
Locations
India
Study Type
Interventional
Intervention
Group I: L. plantarum UALp-05TM,
Group II: L. plantarum UALp-05TM,
Microcrystalline cellulose
Sponsored by
Vedic Lifesciences Pvt. Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Irritable Bowel Syndrome With Diarrhea

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Males and females aged 18 to 70 years.
  2. Participants with Irritable bowel syndrome (IBS) as per Rome IV IBS criteria:

    Recurrent abdominal pain on average at least 1 day/week in the last 3 months, associated with two or more of the following criteria:

    • Related to defecation (Maybe increased or decreased by defecation)
    • Associated with a change in the frequency of stool (increase in frequency)
    • Associated with a change in the form (appearance) of stool
  3. History of abnormal bowel movements, which are predominantly diarrhea (more than one-fourth (25%) of bowel movements with BSS Types 6-7 and less than one-fourth (25%) with BSS Types 1-2) in the last one month prior to screening.
  4. Average APS-NRS score of ≥ 6 for last 3 months prior to screening visit.
  5. Fasting blood glucose levels ≤ 125 mg/dL (6.94 mmol/l).
  6. Hemoglobin ≥ 10 g/dL.
  7. Able to comply and perform the procedures requested by the protocol (consumption of study medications, filling scheduled eDiary for health updates, biological sample collection procedures and study visit schedule).
  8. Participants with access to western toilet facilities.
  9. Participants with non-vegetarian dietary preferences (Note: Non-vegetarian food will be defined as food derived from animals, birds, fish, shell-fish, etc)
  10. Participants consuming non-vegetarian food for at least 2 times in a week.
  11. SpO2 ≥ 96% as assessed by fingertip pulse oximetry
  12. Participants who are sufficiently literate to understand the essence of the study, are informed about the purpose of the study, and understand their rights.
  13. Participants who are able to give written informed consent and are willing to participate in the study.

Exclusion Criteria:

  1. Participants not meeting IBS-D diagnostic criteria (i.e. IBS-Constipation, Mixed or Unclassified).
  2. Uncontrolled abnormal Thyroid Stimulating Hormone (TSH) value which is < 0.35 or > 4.94 μIU/mL.
  3. Uncontrolled Type II DM (Controlled Type II diabetics can be included upon investigator's discretion).
  4. Type I diabetes.
  5. Uncontrolled hypertension defined as SBP ≥ 140 mm Hg and/or DBP ≥ 90 mm Hg.
  6. Use of probiotics and/or prebiotics (In the form of supplements) within the last 4 weeks prior to screening.
  7. Use of medicines (Prescription, OTC, etc), health supplements or herbal medicines expected to promote gut health and alleviate IBS related complications within the last four 4 months prior to screening.
  8. Established diagnosis of Helicobacter pylori infection in last 3 months prior to screening.
  9. History of surgical resection of the stomach, small intestine or large intestine.
  10. Participants with acute gastroenteritis.
  11. History or complications of inflammatory bowel disease (Crohn's disease or ulcerative colitis) or ischemic colitis.
  12. Participants with complications from infectious enteritis.
  13. History of any diet-based intolerance (gluten or lactose intolerance).
  14. History of or complications from malignant tumors.
  15. History of any significant neurological or psychiatric condition which may affect study participation or inference of study outcomes.
  16. Consumption of psychotropic agents in the last 1 year prior to screening.
  17. History (in past 2 years) of smoking or currently smoking or using any form of smokeless tobacco.
  18. Participation in other clinical trials in last 90 days prior to screening.
  19. Participants with heavy alcohol consumption, defined as:

    • For men: More than 14 standard alcoholic drinks (SAD)/week or more than 4 SAD in a day.
    • For women: More than 7 SAD/week or more than 3 SAD in a day. (NOTE - A standard alcoholic drink contains approximately 14 grams of alcohol, which is equivalent to 12 ounces of beer (~5% alcohol), 8.5 ounces of malt liquor (~9% alcohol), 5 ounces of wine (~12% alcohol), 3.5 ounces of fortified wine (e.g., sherry or port), or 1.5 ounces of liquor (distilled spirits; ~40% alcohol).
  20. Participants who have a clinically active state of systemic illness, which may include but is not limited to cardiovascular, endocrine, immune, respiratory, hepatobiliary, kidney and genitourinary, neuropsychiatric, and gastrointestinal system. To be ruled out by physician based on prior history and physical examination.
  21. Females who are pregnant/planning to be pregnant/lactating or taking any oral contraceptives.
  22. Any condition that could, in the opinion of the investigator, preclude the participant's ability to successfully and safely complete the study or that may confound study outcomes.

Sites / Locations

  • Apex Gastro Clinic and Hospital,
  • SN Gastro and Liver Clinic
  • Ahmedabad Gastro Associates,
  • Aman Hospital and research center
  • My Health Clinic,
  • Dr. Khanna Clinic,
  • Stress Test Clinic
  • Samarth Digestive Disease Centre
  • Rahate Surgical Hospital,
  • Ashirwad Hospital And Research Centre,
  • Khannas Clinic
  • Shubham Sudbhawana Superspeciality Hospital,

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Active Comparator

Placebo Comparator

Arm Label

Group I: L. plantarum UALp-05TM,

Group II: L. plantarum UALp-05TM,

Microcrystalline Cellulose

Arm Description

One capsule to be taken orally before lunch with a glass of water. In case the dose is missed, advise participant to take before dinner.

One capsule to be taken orally before lunch with a glass of water. In case the dose is missed, advise participant to take before dinner.

One capsule to be taken orally before lunch with a glass of water. In case the dose is missed, advise participant to take before dinner.

Outcomes

Primary Outcome Measures

Irritable Bowel Syndrome Symptom Severity Scale
To evaluate the effect of IP consumption on change in Irritable Bowel Syndrome Symptom Severity Scale total score on day 56 from baseline (Day 0) in comparison to placebo. A score on a scale, include 0 to 100 pointer scale the minimum score is the better outcome and maximum values is worse outcome.

Secondary Outcome Measures

Irritable Bowel Syndrome Symptom Severity Scale
To evaluate the effect of Investigational Product on global assessment of Irritable Bowel Syndrome symptoms, as assessed by the change in Irritable Bowel Syndrome Symptom Severity Scale total score on day 28 from baseline (day 0) in comparison to placebo. A score on a scale, include 0 to 100 pointer scale the minimum score is the better outcome and maximum values is worse outcome.
Abdominal Pain Severity Numeric Rating Scale
To evaluate the effect of IP on abdominal pain severity (11-point scale), as assessed by the change in Abdominal Pain Severity Numeric Rating Scale score on day 56 from baseline (day 0) in comparison to placebo. A score on a scale, include 0 to 10 pointer scale the minimum score is the better outcome and maximum values is worse outcome.
Bristol Stool Scale
To evaluate the effect of IP on percentage of study population achieving normal stool consistency, as assessed by Bristol Stool Scale on day 56 from baseline (day 0) in comparison to placebo. Bristol Stool Scale (BSS), a validated ordinal scale of stool types ranging from 1 through 7, with types 1-2 and 6-7, in conjunction with other symptoms, indicative of constipation and diarrhea, respectively. Types 3-5 are generally considered to be the most normal stool form and are the modal stool forms in cross-sectional surveys of healthy adults.
Irritable Bowel Syndrome Symptom Severity Scale percent responder
To evaluate the effect of IP on percent responders defined by clinically significant Irritable Bowel Syndrome Symptom Severity Scale total score improvement on day 56 in comparison to placebo. A score on a scale, include 0 to 100 pointer scale the minimum score is the better outcome and maximum values is worse outcome.
Irritable Bowel Syndrome -Quality of Life
To evaluate the effect of IP on quality of life as assessed by the change in Irritable Bowel Syndrome -Quality of Life score on day 56 from baseline (day 0) in comparison to placebo. 34 set of Questionnaire indication following score 1=Not at all, 2=Slightly, 3=Moderately, 4=Quite a bit, 5=A great deal, the minimum score is the better outcome and maximum values is worse outcome.

Full Information

First Posted
June 16, 2021
Last Updated
July 8, 2022
Sponsor
Vedic Lifesciences Pvt. Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT04950296
Brief Title
To Study the Efficacy and Safety of L. Plantarum UALp-05TM in Diarrhea- Predominant-irritable Bowel Syndrome
Official Title
A Randomized, Double-blind, Placebo-controlled, Parallel Group Study of the Efficacy and Safety of L. Plantarum UALp-05TM in Diarrhea- Predominant-irritable Bowel Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
September 16, 2021 (Actual)
Primary Completion Date
May 5, 2022 (Actual)
Study Completion Date
May 5, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Vedic Lifesciences Pvt. Ltd.

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
Several probiotic strains have shown beneficial outcomes in IBS patients, particularly among the Lactobacillus and Bifidobacterium genera, Lactobacillus plantarum (recently reclassified as Lactiplantibacillus plantarum) is a frequently isolated species of the healthy human GI tract that has been studied in numerous GI clinical studies, including for IBS.In the present study, the efficacy and tolerability of L. plantarum (UALp-05TM), will be evaluated in individuals with IBS-D.
Detailed Description
Several strains of Lactobacillus genus have previously been assessed in patients with IBS in multiple randomized controlled trials, demonstrating the efficacy of these strains in reducing IBS-related symptoms such as abdominal pain, distension and flatulence. We hypothesize the L. plantarum UALp-05 strain to benefit research participants by reducing pain severity, normalizing diarrhea predominant stool type and subsequently improving quality of life (QOL) standards. The current study with L. plantarum UALp-05, will include a lower dose of 1 billion CFU/day (considered a low dose among probiotic IBS studies) and a higher dose of 10 billion CFU/ day (considered a mid-point dose among probiotic IBS studies) for a period of 8-weeks.Each probiotic dosage group will be assessed individually in comparison to placebo.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Irritable Bowel Syndrome With Diarrhea

7. Study Design

Primary Purpose
Other
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
randomized, double-blind, placebo-controlled, parallel group
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
314 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group I: L. plantarum UALp-05TM,
Arm Type
Active Comparator
Arm Description
One capsule to be taken orally before lunch with a glass of water. In case the dose is missed, advise participant to take before dinner.
Arm Title
Group II: L. plantarum UALp-05TM,
Arm Type
Active Comparator
Arm Description
One capsule to be taken orally before lunch with a glass of water. In case the dose is missed, advise participant to take before dinner.
Arm Title
Microcrystalline Cellulose
Arm Type
Placebo Comparator
Arm Description
One capsule to be taken orally before lunch with a glass of water. In case the dose is missed, advise participant to take before dinner.
Intervention Type
Other
Intervention Name(s)
Group I: L. plantarum UALp-05TM,
Other Intervention Name(s)
Active
Intervention Description
One capsule to be taken orally before lunch with a glass of water. In case the dose is missed, advise participant to take before dinner.
Intervention Type
Other
Intervention Name(s)
Group II: L. plantarum UALp-05TM,
Other Intervention Name(s)
Active
Intervention Description
One capsule to be taken orally before lunch with a glass of water. In case the dose is missed, advise participant to take before dinner.
Intervention Type
Other
Intervention Name(s)
Microcrystalline cellulose
Other Intervention Name(s)
Placebo
Intervention Description
One capsule to be taken orally before lunch with a glass of water. In case the dose is missed, advise participant to take before dinner.
Primary Outcome Measure Information:
Title
Irritable Bowel Syndrome Symptom Severity Scale
Description
To evaluate the effect of IP consumption on change in Irritable Bowel Syndrome Symptom Severity Scale total score on day 56 from baseline (Day 0) in comparison to placebo. A score on a scale, include 0 to 100 pointer scale the minimum score is the better outcome and maximum values is worse outcome.
Time Frame
Day 0, Day 56
Secondary Outcome Measure Information:
Title
Irritable Bowel Syndrome Symptom Severity Scale
Description
To evaluate the effect of Investigational Product on global assessment of Irritable Bowel Syndrome symptoms, as assessed by the change in Irritable Bowel Syndrome Symptom Severity Scale total score on day 28 from baseline (day 0) in comparison to placebo. A score on a scale, include 0 to 100 pointer scale the minimum score is the better outcome and maximum values is worse outcome.
Time Frame
Day 28
Title
Abdominal Pain Severity Numeric Rating Scale
Description
To evaluate the effect of IP on abdominal pain severity (11-point scale), as assessed by the change in Abdominal Pain Severity Numeric Rating Scale score on day 56 from baseline (day 0) in comparison to placebo. A score on a scale, include 0 to 10 pointer scale the minimum score is the better outcome and maximum values is worse outcome.
Time Frame
Screening, Day 0, Day 28 and Day 56
Title
Bristol Stool Scale
Description
To evaluate the effect of IP on percentage of study population achieving normal stool consistency, as assessed by Bristol Stool Scale on day 56 from baseline (day 0) in comparison to placebo. Bristol Stool Scale (BSS), a validated ordinal scale of stool types ranging from 1 through 7, with types 1-2 and 6-7, in conjunction with other symptoms, indicative of constipation and diarrhea, respectively. Types 3-5 are generally considered to be the most normal stool form and are the modal stool forms in cross-sectional surveys of healthy adults.
Time Frame
Screening, Day 0, Day 28 and Day 56
Title
Irritable Bowel Syndrome Symptom Severity Scale percent responder
Description
To evaluate the effect of IP on percent responders defined by clinically significant Irritable Bowel Syndrome Symptom Severity Scale total score improvement on day 56 in comparison to placebo. A score on a scale, include 0 to 100 pointer scale the minimum score is the better outcome and maximum values is worse outcome.
Time Frame
Day 56
Title
Irritable Bowel Syndrome -Quality of Life
Description
To evaluate the effect of IP on quality of life as assessed by the change in Irritable Bowel Syndrome -Quality of Life score on day 56 from baseline (day 0) in comparison to placebo. 34 set of Questionnaire indication following score 1=Not at all, 2=Slightly, 3=Moderately, 4=Quite a bit, 5=A great deal, the minimum score is the better outcome and maximum values is worse outcome.
Time Frame
Day 0, Day 28 and Day 56

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Males and females aged 18 to 70 years. Participants with Irritable bowel syndrome (IBS) as per Rome IV IBS criteria: Recurrent abdominal pain on average at least 1 day/week in the last 3 months, associated with two or more of the following criteria: Related to defecation (Maybe increased or decreased by defecation) Associated with a change in the frequency of stool (increase in frequency) Associated with a change in the form (appearance) of stool History of abnormal bowel movements, which are predominantly diarrhea (more than one-fourth (25%) of bowel movements with BSS Types 6-7 and less than one-fourth (25%) with BSS Types 1-2) in the last one month prior to screening. Average APS-NRS score of ≥ 6 for last 3 months prior to screening visit. Fasting blood glucose levels ≤ 125 mg/dL (6.94 mmol/l). Hemoglobin ≥ 10 g/dL. Able to comply and perform the procedures requested by the protocol (consumption of study medications, filling scheduled eDiary for health updates, biological sample collection procedures and study visit schedule). Participants with access to western toilet facilities. Participants with non-vegetarian dietary preferences (Note: Non-vegetarian food will be defined as food derived from animals, birds, fish, shell-fish, etc) Participants consuming non-vegetarian food for at least 2 times in a week. SpO2 ≥ 96% as assessed by fingertip pulse oximetry Participants who are sufficiently literate to understand the essence of the study, are informed about the purpose of the study, and understand their rights. Participants who are able to give written informed consent and are willing to participate in the study. Exclusion Criteria: Participants not meeting IBS-D diagnostic criteria (i.e. IBS-Constipation, Mixed or Unclassified). Uncontrolled abnormal Thyroid Stimulating Hormone (TSH) value which is < 0.35 or > 4.94 μIU/mL. Uncontrolled Type II DM (Controlled Type II diabetics can be included upon investigator's discretion). Type I diabetes. Uncontrolled hypertension defined as SBP ≥ 140 mm Hg and/or DBP ≥ 90 mm Hg. Use of probiotics and/or prebiotics (In the form of supplements) within the last 4 weeks prior to screening. Use of medicines (Prescription, OTC, etc), health supplements or herbal medicines expected to promote gut health and alleviate IBS related complications within the last four 4 months prior to screening. Established diagnosis of Helicobacter pylori infection in last 3 months prior to screening. History of surgical resection of the stomach, small intestine or large intestine. Participants with acute gastroenteritis. History or complications of inflammatory bowel disease (Crohn's disease or ulcerative colitis) or ischemic colitis. Participants with complications from infectious enteritis. History of any diet-based intolerance (gluten or lactose intolerance). History of or complications from malignant tumors. History of any significant neurological or psychiatric condition which may affect study participation or inference of study outcomes. Consumption of psychotropic agents in the last 1 year prior to screening. History (in past 2 years) of smoking or currently smoking or using any form of smokeless tobacco. Participation in other clinical trials in last 90 days prior to screening. Participants with heavy alcohol consumption, defined as: For men: More than 14 standard alcoholic drinks (SAD)/week or more than 4 SAD in a day. For women: More than 7 SAD/week or more than 3 SAD in a day. (NOTE - A standard alcoholic drink contains approximately 14 grams of alcohol, which is equivalent to 12 ounces of beer (~5% alcohol), 8.5 ounces of malt liquor (~9% alcohol), 5 ounces of wine (~12% alcohol), 3.5 ounces of fortified wine (e.g., sherry or port), or 1.5 ounces of liquor (distilled spirits; ~40% alcohol). Participants who have a clinically active state of systemic illness, which may include but is not limited to cardiovascular, endocrine, immune, respiratory, hepatobiliary, kidney and genitourinary, neuropsychiatric, and gastrointestinal system. To be ruled out by physician based on prior history and physical examination. Females who are pregnant/planning to be pregnant/lactating or taking any oral contraceptives. Any condition that could, in the opinion of the investigator, preclude the participant's ability to successfully and safely complete the study or that may confound study outcomes.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dr. Ramesh Dargad
Organizational Affiliation
Stress test clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Apex Gastro Clinic and Hospital,
City
Ahmedabad
State/Province
Gujarat
ZIP/Postal Code
380013.
Country
India
Facility Name
SN Gastro and Liver Clinic
City
Ahmedabad
State/Province
Gujarat
ZIP/Postal Code
380054
Country
India
Facility Name
Ahmedabad Gastro Associates,
City
Ahmedabad
State/Province
Gujarat
ZIP/Postal Code
380061
Country
India
Facility Name
Aman Hospital and research center
City
Vadodara
State/Province
Gujarat
ZIP/Postal Code
-390021.
Country
India
Facility Name
My Health Clinic,
City
Mumbai
State/Province
Maharashtra
ZIP/Postal Code
400059.
Country
India
Facility Name
Dr. Khanna Clinic,
City
Mumbai
State/Province
Maharashtra
ZIP/Postal Code
400059
Country
India
Facility Name
Stress Test Clinic
City
Mumbai
State/Province
Maharashtra
ZIP/Postal Code
400059
Country
India
Facility Name
Samarth Digestive Disease Centre
City
Mumbai
State/Province
Maharashtra
ZIP/Postal Code
400705,
Country
India
Facility Name
Rahate Surgical Hospital,
City
Nagpur
State/Province
Maharashtra
ZIP/Postal Code
440008.
Country
India
Facility Name
Ashirwad Hospital And Research Centre,
City
Ulhasnagar
State/Province
Maharashtra
ZIP/Postal Code
421004
Country
India
Facility Name
Khannas Clinic
City
Varanasi .
State/Province
Uttar Pradesh
ZIP/Postal Code
221010
Country
India
Facility Name
Shubham Sudbhawana Superspeciality Hospital,
City
Varanasi
State/Province
Uttar Pradesh
ZIP/Postal Code
221005.
Country
India

12. IPD Sharing Statement

Learn more about this trial

To Study the Efficacy and Safety of L. Plantarum UALp-05TM in Diarrhea- Predominant-irritable Bowel Syndrome

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