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Evaluation Of The Effect Of L. Casei DG® On Vitamin D Absorption In Patients Under Vitamin D Supplementation.

Primary Purpose

Vitamin D Deficiency

Status
Not yet recruiting
Phase
Not Applicable
Locations
United Arab Emirates
Study Type
Interventional
Intervention
L. casei DG® (Lactobacillus paracasei CNCM I-1572)
placebo
Sponsored by
SOFAR S.p.A.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Vitamin D Deficiency focused on measuring 25-hydroxyvitamin D- 25(OH) D, ENTEROLACTIS, food supplement, Lactobacillus paracasei CNCM I-1572, probiotic

Eligibility Criteria

18 Years - 60 Years (Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male and female adults aged ≥ 18 and ≤ 60 years;
  2. Middle East Area residency;
  3. Serum levels of Vit. D≤ 20 ng/ml at screening, for which a course of Vitamin D at a dose of 4.000 U.I. daily has been prescribed as per clinical practice;
  4. Body Mass Index (BMI) between 18,50 and 29,99;
  5. Acceptance of the study by the patient and written informed consent to participate in the study provided.

Exclusion Criteria:

  1. Serum level of Vit. D > 20ng/ml;
  2. Documented malabsorption of Vit. D and/or other oligoelements and vitamins;
  3. BMI ≤ 18.5 and ≥29,99;
  4. Hypersensitivity to cholecalciferol or to any of the excipients of the prescribed drug;
  5. Contraindications to Vit. D supplementation (e.g. hypercalcemia, hypercalciuria, renal failure);
  6. Vit. D therapy or prophylaxis within 30 days before the enrolment in this study;
  7. History of administration of systemic antibiotics or antibiotics at bowel action (es: rifaximin) within 30 days before the enrolment in this study;
  8. History of administration of probiotics, prebiotics, (including probiotic/prebiotic enriched foods) within 30 days before the enrolment in this study;
  9. Present treatment with Proton Pump Inhibitors (PPIs) and aluminium-containing antacids;
  10. Present treatment with drugs interfering on the absorption of Vit. D, as barbiturates, antiepileptics (i.e. phenobarbital, phenytoin, carbamazepine), corticosteroids, antimycotics (i.e. ketoconazole, fluconazole), anti-retroviral agents, cholestyramine, colestipol, orlistat;
  11. Patients with certain or suspected diagnosis of chronic inflammatory bowel diseases, cystic fibrosis or mucoviscidosis;
  12. Patients with hepatic impairment (Alanine transaminase (ALT) or Aspartate aminotransferase (AST)>3 times the upper limit of normal);
  13. Patients with nephrolithiasis or nephrocalcinosis;
  14. Infective gastro-intestinal syndromes in active phase or gastro-intestinal infectious residue which can alter the bowel absorption on the judgement of the investigator;
  15. Episodes of viral or bacterial enteritis within 2 months before the enrolment in the study;
  16. History or presence of gastric and/or duodenal ulcers;
  17. Psychiatric syndromes and/or psychological disturbances;
  18. Any severe pathology which could interfere with the study treatment;
  19. Presence of any relevant severe condition or clinically relevant abnormal laboratory parameters that in the opinion of the investigator may interfere with the participation to the study;
  20. Poor reliability or presence of conditions leading to a poor compliance/adherence to the protocol by the patient;
  21. Active malignancy of any type, or history of a malignancy (patients with a history of other malignancies that have been surgically removed and who have no evidence of recurrence for at least five years before study enrolment are also acceptable);
  22. Pregnancy and/or breastfeeding*;
  23. Existence of mental illness or any mental condition potentially interfering with appropriate compliance with protocol procedures;
  24. Patients without self-judgement ability;
  25. Participation in another investigational study or treatment with any investigational drug within the previous 30 days;
  26. Recent history or suspicion of alcohol abuse or drug addiction;
  27. Patients not compliant with the procedures of the protocol.

Sites / Locations

  • Rashid Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

GROUP 1 (Investigational product)

GROUP 2 (Comparator)

Arm Description

23 patients Investigational product: L. casei DG® (Lactobacillus paracasei CNCM I-1572) containing 8 billion of live cells daily + Vitamin D 4.000 U.I. daily.

23 patients The comparator product is an identical matching placebo daily + Vitamin D 4.000 U.I. daily.

Outcomes

Primary Outcome Measures

Serum levels of vitamin D (25-hydroxyvitamin D- 25(OH) D) measured in ng/mL
Modification of the serum level of Vit. D in patients treated with L. casei DG® plus Vitamin D compared to the group treated with Vitamin D plus placebo will be measured in ng/mL

Secondary Outcome Measures

Time to reach normal serum levels of Vit. D.
Serum levels of vitamin D (25-hydroxyvitamin D- 25(OH) D) will be measured in ng/mL.
Presence of L. casei DG® strain in faeces
Presence of L. casei DG® strain in faeceswill be assessed by real time quantitative PCR (qPCR).
Modification from baseline of faecal microbiota in terms of indices of microbial α diversity
Alpha-diversity will be measured by Shannon and Chao1 indexes
Modification from baseline of faecal microbiota in terms of indices of microbial β diversity
Beta-diversity will be analyzed with the UniFrac algorithms and plotted applying non-metric multidimensional scaling (NMDS)
Modification from baseline of faecal microbiota in terms of indices of microbial relative taxonomic abundance
The relative abundance of microbial taxa will be evaluated descriptively and graphically by treatment groups and by study visits to show the phyla, orders, genera and operational taxonomic units (OTUs) most commonly detected in the collected samples.
Modification from baseline of faecal short-chain fatty acid (SCFAs);
measurement of fecal levels (mmol/100g) of: lactate, acetate, succinate, propionate,butyrate,valerate, iso-valerate.
Modification of serum levels of Interleukin 6 (IL-6), Interleukin 8 (IL-8), Interleukin 10 (IL-10)
serum levels of Interleukin 6 (IL-6), Interleukin 8 (IL-8), Interleukin 10 (IL-10) will be measured in pg/mL
Modification of serum levels of C reactive protein (CRP)
serum levels of C reactive protein (CRP) will be measured in mg/mL
Modification of serum levels of zonulin
serum levels of zonulin measured in ng/mL;
Modification of serum levels of total cholesterol, LDL, HDL and triglycerides
serum levels of total cholesterol, LDL, HDL and triglycerides measured in mg/dL
Evaluate the overall patient satisfaction with treatment
Evaluate the overall satisfaction with treatment by means of Visual Analogue Scale (VAS) scale at V7. 10 cm scale where 0 not satisfied at all is and 10 is fully satisfied

Full Information

First Posted
May 24, 2022
Last Updated
April 11, 2023
Sponsor
SOFAR S.p.A.
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1. Study Identification

Unique Protocol Identification Number
NCT05394207
Brief Title
Evaluation Of The Effect Of L. Casei DG® On Vitamin D Absorption In Patients Under Vitamin D Supplementation.
Official Title
Evaluation Of The Effect Of L. Casei DG® (L. Paracasei CNCM I1572) On Vitamin D Absorption In Patients Under Vitamin D Supplementation. Double-Blind, Exploratory, Randomized, Controlled Clinical Trial.
Study Type
Interventional

2. Study Status

Record Verification Date
May 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
June 2023 (Anticipated)
Primary Completion Date
June 2024 (Anticipated)
Study Completion Date
June 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
SOFAR S.p.A.

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
Vitamin D deficiency is one of the most underdiagnosed and undertreated medical condition worldwide . The microbiome and vitamin D deeply influence each other and the immune system in many different ways. It is evident that the immune system and the microbiome are interconnected, and that vitamin D is a critical intermediary player in this dynamic . Probiotics were shown to increase vitamin D intestinal absorption and increase vitamin D receptor protein expression and transcriptional activity . Likewise, vitamin D receptor status seems to be crucial in regulating the mechanisms of action of probiotics and modulating their anti-inflammatory, immunomodulatory and anti-infective benefits, suggesting a two-sided pathway . The objective of this study is to assess the different absorption of Vitamin D (Vit. D) between patients treated with Vit. D supplementation combined to a probiotic containing L. casei DG® and patients treated with Vitamin D supplementation and placebo
Detailed Description
The present study is a monocentric, exploratory, randomized, double-blind, controlled study to evaluate the effects of daily intake of L. Casei DG® (L. Paracasei CNCM I1572) on vitamin D absorption in adult patients with Vitamin D (Vit. D) deficiency, defined as a blood level of 25(OH) D ≤ 20 ng/ml. The investigational product is ENTEROLACTIS®, a food supplement resulting from SOFAR research (listed in the Food Supplement Registry of the United Arab Emirates Ministry of Health & Prevention with the code #12235-13911-2) available as drinkable vials of 10 ml, containing 8 billion of live cells of L. casei DG The comparator product is an identical drinkable vial of placebo. Vit. D will be provided by the sponsor as oral drops of 10. 000 U.I./mL 16 drops of Vit. D must be dissolved in the Investigational Product/placebo vial and then this has to be reconstituted and drunk immediately. The patients will be involved in 10 on site visits: V-1 (Screening)- within 7 days before baseline visit, V0 (Baseline) at the start of therapy, V1- 1 week after the start of therapy, 6 visits (V2-V7) every two weeks and V8- follow up visit, 4 weeks after the end of treatment (EOT-V7). Investigational Product/comparator treatment will start at V0 and will end at V7, for a duration of 12 weeks. After the End of Treatment visit (EOT-V7), patients will enter in a 4 weeks Follow Up (FU) period, for a total duration of the study of 16 weeks (12 weeks of treatment + 4 weeks of FUP). If a patient reaches normal levels of Vitamin D before EOT visit, study treatment will be interrupted, and patient will enter the FU period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Vitamin D Deficiency
Keywords
25-hydroxyvitamin D- 25(OH) D, ENTEROLACTIS, food supplement, Lactobacillus paracasei CNCM I-1572, probiotic

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Double-Blind, Exploratory, Randomized, Controlled
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
Investigational and comparator product have similar appearance. All study products will be packaged in identical packs with identical labelling, except for the randomization number. Study patients, the clinical team, statisticians and the Sponsor will be blinded during the entire study until database lock. Only the Production Department of Sponsor will be un-blinded as necessary to perform labelling.
Allocation
Randomized
Enrollment
46 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
GROUP 1 (Investigational product)
Arm Type
Experimental
Arm Description
23 patients Investigational product: L. casei DG® (Lactobacillus paracasei CNCM I-1572) containing 8 billion of live cells daily + Vitamin D 4.000 U.I. daily.
Arm Title
GROUP 2 (Comparator)
Arm Type
Placebo Comparator
Arm Description
23 patients The comparator product is an identical matching placebo daily + Vitamin D 4.000 U.I. daily.
Intervention Type
Dietary Supplement
Intervention Name(s)
L. casei DG® (Lactobacillus paracasei CNCM I-1572)
Intervention Description
L. casei DG® (Lactobacillus paracasei CNCM I-1572) containing 8 billion of live cells daily + Vitamin D 4.000 U.I. daily.
Intervention Type
Other
Intervention Name(s)
placebo
Intervention Description
The comparator product is an identical matching placebo daily + Vitamin D 4.000 U.I. daily.
Primary Outcome Measure Information:
Title
Serum levels of vitamin D (25-hydroxyvitamin D- 25(OH) D) measured in ng/mL
Description
Modification of the serum level of Vit. D in patients treated with L. casei DG® plus Vitamin D compared to the group treated with Vitamin D plus placebo will be measured in ng/mL
Time Frame
week 12
Secondary Outcome Measure Information:
Title
Time to reach normal serum levels of Vit. D.
Description
Serum levels of vitamin D (25-hydroxyvitamin D- 25(OH) D) will be measured in ng/mL.
Time Frame
week 12
Title
Presence of L. casei DG® strain in faeces
Description
Presence of L. casei DG® strain in faeceswill be assessed by real time quantitative PCR (qPCR).
Time Frame
week 12
Title
Modification from baseline of faecal microbiota in terms of indices of microbial α diversity
Description
Alpha-diversity will be measured by Shannon and Chao1 indexes
Time Frame
week 12
Title
Modification from baseline of faecal microbiota in terms of indices of microbial β diversity
Description
Beta-diversity will be analyzed with the UniFrac algorithms and plotted applying non-metric multidimensional scaling (NMDS)
Time Frame
week 12
Title
Modification from baseline of faecal microbiota in terms of indices of microbial relative taxonomic abundance
Description
The relative abundance of microbial taxa will be evaluated descriptively and graphically by treatment groups and by study visits to show the phyla, orders, genera and operational taxonomic units (OTUs) most commonly detected in the collected samples.
Time Frame
week 12
Title
Modification from baseline of faecal short-chain fatty acid (SCFAs);
Description
measurement of fecal levels (mmol/100g) of: lactate, acetate, succinate, propionate,butyrate,valerate, iso-valerate.
Time Frame
week 12
Title
Modification of serum levels of Interleukin 6 (IL-6), Interleukin 8 (IL-8), Interleukin 10 (IL-10)
Description
serum levels of Interleukin 6 (IL-6), Interleukin 8 (IL-8), Interleukin 10 (IL-10) will be measured in pg/mL
Time Frame
week 12
Title
Modification of serum levels of C reactive protein (CRP)
Description
serum levels of C reactive protein (CRP) will be measured in mg/mL
Time Frame
week 12
Title
Modification of serum levels of zonulin
Description
serum levels of zonulin measured in ng/mL;
Time Frame
week 12
Title
Modification of serum levels of total cholesterol, LDL, HDL and triglycerides
Description
serum levels of total cholesterol, LDL, HDL and triglycerides measured in mg/dL
Time Frame
week 12
Title
Evaluate the overall patient satisfaction with treatment
Description
Evaluate the overall satisfaction with treatment by means of Visual Analogue Scale (VAS) scale at V7. 10 cm scale where 0 not satisfied at all is and 10 is fully satisfied
Time Frame
week 12
Other Pre-specified Outcome Measures:
Title
Incidence of Treatment-Emergent Adverse Events
Description
Incidence of Treatment-Emergent Adverse Events assessed by the diary dispensed to patients at V0.
Time Frame
week 16

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
60 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female adults aged ≥ 18 and ≤ 60 years; Middle East Area residency; Serum levels of Vit. D≤ 20 ng/ml at screening, for which a course of Vitamin D at a dose of 4.000 U.I. daily has been prescribed as per clinical practice; Body Mass Index (BMI) between 18,50 and 29,99; Acceptance of the study by the patient and written informed consent to participate in the study provided. Exclusion Criteria: Serum level of Vit. D > 20ng/ml; Documented malabsorption of Vit. D and/or other oligoelements and vitamins; BMI ≤ 18.5 and ≥29,99; Hypersensitivity to cholecalciferol or to any of the excipients of the prescribed drug; Contraindications to Vit. D supplementation (e.g. hypercalcemia, hypercalciuria, renal failure); Vit. D therapy or prophylaxis within 30 days before the enrolment in this study; History of administration of systemic antibiotics or antibiotics at bowel action (es: rifaximin) within 30 days before the enrolment in this study; History of administration of probiotics, prebiotics, (including probiotic/prebiotic enriched foods) within 30 days before the enrolment in this study; Present treatment with Proton Pump Inhibitors (PPIs) and aluminium-containing antacids; Present treatment with drugs interfering on the absorption of Vit. D, as barbiturates, antiepileptics (i.e. phenobarbital, phenytoin, carbamazepine), corticosteroids, antimycotics (i.e. ketoconazole, fluconazole), anti-retroviral agents, cholestyramine, colestipol, orlistat; Patients with certain or suspected diagnosis of chronic inflammatory bowel diseases, cystic fibrosis or mucoviscidosis; Patients with hepatic impairment (Alanine transaminase (ALT) or Aspartate aminotransferase (AST)>3 times the upper limit of normal); Patients with nephrolithiasis or nephrocalcinosis; Infective gastro-intestinal syndromes in active phase or gastro-intestinal infectious residue which can alter the bowel absorption on the judgement of the investigator; Episodes of viral or bacterial enteritis within 2 months before the enrolment in the study; History or presence of gastric and/or duodenal ulcers; Psychiatric syndromes and/or psychological disturbances; Any severe pathology which could interfere with the study treatment; Presence of any relevant severe condition or clinically relevant abnormal laboratory parameters that in the opinion of the investigator may interfere with the participation to the study; Poor reliability or presence of conditions leading to a poor compliance/adherence to the protocol by the patient; Active malignancy of any type, or history of a malignancy (patients with a history of other malignancies that have been surgically removed and who have no evidence of recurrence for at least five years before study enrolment are also acceptable); Pregnancy and/or breastfeeding*; Existence of mental illness or any mental condition potentially interfering with appropriate compliance with protocol procedures; Patients without self-judgement ability; Participation in another investigational study or treatment with any investigational drug within the previous 30 days; Recent history or suspicion of alcohol abuse or drug addiction; Patients not compliant with the procedures of the protocol.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Silvia Porta
Phone
+39 02909362 1
Email
silvia.porta@sofarfarm.it
First Name & Middle Initial & Last Name or Official Title & Degree
Laura Patrucco
Phone
+39 02909362 1
Email
laura.patrucco@sofarfarm.it
Facility Information:
Facility Name
Rashid Hospital
City
Dubai
Country
United Arab Emirates
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dr.Sameer Al Awadhi, Dr
Phone
+9714 219 1144
Email
saalawadhi@dha.gov.ae

12. IPD Sharing Statement

Learn more about this trial

Evaluation Of The Effect Of L. Casei DG® On Vitamin D Absorption In Patients Under Vitamin D Supplementation.

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