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Effect of L. Paracasei Strain Shirota on Constipation in Healthy US Adults

Primary Purpose

Constipation

Status
Not yet recruiting
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
Test product consumption group
Sponsored by
Yakult U.S.A. Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Constipation focused on measuring probiotics, Lacticaseibacillus paracasei strain Shirota, Bristol stool form scale, imaging, constipation

Eligibility Criteria

18 Years - 64 Years (Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria: ≥18 and <65 years old at Visit 1. BMI between ≥18.5 to <30.0 kg/m2. Has at least 3 bowel movements per week ≥25% of bowel movements during the 2-week screening period produce hard or lumpy stools, defined as a Bristol Stool Form Scale (BSFS) score of 1 or 2. Regular breakfast consumer by self-report. Has a smartphone supporting either iOS version 11.0 (or later) or Android version 5.0 (or later) operating software capable of downloading and running the Dieta Health app to collect study data. Willing to consume the study product per the protocol instructions throughout the 28-day study intervention period. Willing to maintain habitual dietary, lifestyle, and physical activity (with exceptions per study instructions) throughout the trial. Willing to refrain from exclusionary medications, supplements, and products throughout the study. Willing to limit alcohol consumption to ≤3 standard drinks/day and ≤7 standard drinks/week throughout the trial. Non-user of tobacco or nicotine products or former user of any tobacco or nicotine product (not used within 6 months) and has no plans to change during the study period. Tobacco products include tobacco, smoking products (including, but not limited to cigarettes, cigars, chewing tobacco, e-cigarettes), and nicotine products (e.g., nicotine gum and/or nicotine patches) within 6 months of Visit 1 (Day 0) and during the study period. Non-user or former user of any marijuana or hemp products (not used within 6 months) of Visit 1 (Day 0) and during the study period and has no plans to use marijuana or hemp products during the study period. No washout is required for topical marijuana or hemp products, but subjects are required to abstain from these products during the study period. No health conditions that would prevent him/her from fulfilling the study requirements as judged by the Clinical Investigator on the basis of medical history and screening physical exam. Understands the study procedures and signs forms providing informed consent to participate in the study and authorizes the release of relevant protected health information to the Clinical Investigator. Exclusion Criteria: Any known food allergies or intolerances to dairy or to any of the study product ingredients. Consumption of probiotics or fermented products within 14 days of Visit 1 (Day 0) and during the study. Presence of a clinically important GI condition that would potentially interfere with the evaluation of the study product (e.g., inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), gastric reflux, indigestion, dyspepsia, Crohn's disease, celiac disease, history of surgery for weight loss, gastroparesis, and clinically significant lactose or gluten intolerance or other food or ingredient allergies). IBS will be determined as recurrent abdominal pain or discomfort at least 3 days/month in the last 3 months associated with: (a) improvement with defecation, (b) onset associated with change in frequency of stool, and (c) onset associated with a change in form (appearance of stool). Constipation symptoms caused by primary organic disease of the colon or pelvic floor or, in the Investigator's opinion, caused by medication (e.g., morphine, codeine). Uncontrolled and/or clinically important pulmonary (including uncontrolled asthma), hepatic, renal (except history of kidney stones in participants who are symptom free for 6 months), cardiac (including, but not limited to, atherosclerotic disease, history of myocardial infarction, peripheral arterial disease, stroke), endocrine (including Type 1 and Type 2 diabetes mellitus), hematologic, immunologic, neurologic (such as Alzheimer's or Parkinson's disease), psychiatric (including depression and/or anxiety disorders) or biliary condition(s). Conditions which are well-controlled or resolved will be assessed by the Clinical Investigator on a case-by-case basis. Uncontrolled hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg) as defined by the blood pressure measured at Visit 1 (Day 0). Stable use of hypertension medication is allowed [defined as no change in medication regimen within 90 days of Visit 1 (Day 0)]. Weight loss or gain > 4.5 kg within 90 days of Visit 1 (Day 0), or currently or planning to be on a weight loss regimen or muscle-building/strengthening program during the study. Signs or symptoms of an active infection of clinical relevance within 5 days of Visit 1 (Day 0). The visit may be rescheduled such that all signs and symptoms have resolved (at the discretion of the Clinical Investigator) at least 5 days prior to Visit 1 (Day 0). Major trauma or any other surgical event within 90 days of Visit 1 (Day 0). History or presence of cancer in the prior 2 years, except for non-melanoma skin cancer. Use of proton pump inhibitors, H2 receptor antagonists, corticosteroids, antibiotics, antifungals, antiparasitics, antidiarrheals, and/or laxatives within 30 days of Visit 1 (Day 0). Regular (>3 days/week) use of NSAIDs within 14 days of Visit 1 (Day 0). Exposure to any non-registered drug product within 30 days prior to Visit 1 (Day 0). Subject is a female who is pregnant, planning to be pregnant during the study period, lactating, or is of childbearing potential and is unwilling to commit to the use of a medically approved form of contraception during the study period. The method of contraception must be recorded. Recent history (within 12 months of screening; Visit 1; Day 0) of alcohol or substance abuse. Alcohol abuse is defined as >14 drinks/week (1 drink = 12 oz beer, 5 oz wine, or 1½ oz distilled spirits). Recent (within 2 months) participation in any other clinical study prior to Visit 1 (Day 0). Has a condition the Clinical Investigator believes would interfere with his/her ability to provide informed consent, comply with the study protocol, which might confound the interpretation of the study results, or put the subject at undue risk.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    No Intervention

    Experimental

    Arm Label

    No Intervention group

    Test product consumption group

    Arm Description

    Not taking test product

    Participants will take one bottle (80 ml) of Yakult® drink daily for a period of 4 weeks. Yakult is a branded probiotic drink with 8x10^9 CFU Lacticaseibacillus paracasei strain Shirota. Subsequently, a two-week follow-up period will follow.

    Outcomes

    Primary Outcome Measures

    Proportion of subjects that produce hard or lumpy stools (Subjectively evaluated Bristol stool form scale (BSFS) score of 1 or 2, ) ≥ 25% of bowel movements.
    Compare the odds ratio of subjects with hard or lumpy stools (BSFS score of 1 or 2) in at least 25% of the weekly bowel movements between experimental group and control group during the test product consumption period.

    Secondary Outcome Measures

    Proportion of subjects that produce hard or lumpy stools (Objectively evaluated Bristol stool form scale (BSFS) score of 1 or 2, ) ≥ 25% of bowel movements.
    Difference between groups in stool fuzziness.
    Difference between groups in stool fragmentation.
    Difference between groups in stool volume.
    Difference between groups in stool frequency.
    Difference between groups in Patient Assessment of Constipation Quality of Life Questionnaire score (higher scores indicate worse QOL).
    Difference between groups in the proportion of bowel movements having straining during evacuation.
    Difference between groups in the proportion of bowel movement having sensation of remaining stool in the rectum after evacuation.

    Full Information

    First Posted
    August 22, 2023
    Last Updated
    August 25, 2023
    Sponsor
    Yakult U.S.A. Inc.
    Collaborators
    Biofortis, Merieux NutriSciences, Dieta Inc.
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    1. Study Identification

    Unique Protocol Identification Number
    NCT06014008
    Brief Title
    Effect of L. Paracasei Strain Shirota on Constipation in Healthy US Adults
    Official Title
    The Effect of Lacticaseibacillus Paracasei Strain Shirota (LcS) in Healthy US Individuals Suffering From Hard or Lumpy Stools: A Randomized Controlled Open Trial.
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    August 2023
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    August 2023 (Anticipated)
    Primary Completion Date
    April 2024 (Anticipated)
    Study Completion Date
    August 2024 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Yakult U.S.A. Inc.
    Collaborators
    Biofortis, Merieux NutriSciences, Dieta Inc.

    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
    The objective of this study is to investigate the efficacy of daily consumption of a fermented milk containing LcS in reducing the frequency of bowel movement with hard or lumpy stools in generally healthy U.S. adult population with intermittent bowel movements producing hard or lumpy stools.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Constipation
    Keywords
    probiotics, Lacticaseibacillus paracasei strain Shirota, Bristol stool form scale, imaging, constipation

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Not Applicable
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    50 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    No Intervention group
    Arm Type
    No Intervention
    Arm Description
    Not taking test product
    Arm Title
    Test product consumption group
    Arm Type
    Experimental
    Arm Description
    Participants will take one bottle (80 ml) of Yakult® drink daily for a period of 4 weeks. Yakult is a branded probiotic drink with 8x10^9 CFU Lacticaseibacillus paracasei strain Shirota. Subsequently, a two-week follow-up period will follow.
    Intervention Type
    Other
    Intervention Name(s)
    Test product consumption group
    Intervention Description
    Participants will take one bottle (80 ml) of Yakult® drink daily for a period of 4 weeks. Yakult is a branded probiotic drink with 8x10^9 CFU Lacticaseibacillus paracasei strain Shirota. Subsequently, a two-week follow-up period will follow.
    Primary Outcome Measure Information:
    Title
    Proportion of subjects that produce hard or lumpy stools (Subjectively evaluated Bristol stool form scale (BSFS) score of 1 or 2, ) ≥ 25% of bowel movements.
    Description
    Compare the odds ratio of subjects with hard or lumpy stools (BSFS score of 1 or 2) in at least 25% of the weekly bowel movements between experimental group and control group during the test product consumption period.
    Time Frame
    Four-week period from the start to the end of test product consumption.
    Secondary Outcome Measure Information:
    Title
    Proportion of subjects that produce hard or lumpy stools (Objectively evaluated Bristol stool form scale (BSFS) score of 1 or 2, ) ≥ 25% of bowel movements.
    Time Frame
    Four-week period from the start to the end of test product consumption.
    Title
    Difference between groups in stool fuzziness.
    Time Frame
    Four-week period from the start to the end of test product consumption.
    Title
    Difference between groups in stool fragmentation.
    Time Frame
    Four-week period from the start to the end of test product consumption.
    Title
    Difference between groups in stool volume.
    Time Frame
    Four-week period from the start to the end of test product consumption.
    Title
    Difference between groups in stool frequency.
    Time Frame
    Four-week period from the start to the end of test product consumption.
    Title
    Difference between groups in Patient Assessment of Constipation Quality of Life Questionnaire score (higher scores indicate worse QOL).
    Time Frame
    Four-week period from the start to the end of test product consumption.
    Title
    Difference between groups in the proportion of bowel movements having straining during evacuation.
    Time Frame
    Four-week period from the start to the end of test product consumption.
    Title
    Difference between groups in the proportion of bowel movement having sensation of remaining stool in the rectum after evacuation.
    Time Frame
    Four-week period from the start to the end of test product consumption.
    Other Pre-specified Outcome Measures:
    Title
    Difference between groups in the Bristol stool form score of the first stool after waking up.
    Time Frame
    Four-week period from the start to the end of test product consumption.
    Title
    Difference between groups in the fuzziness of the first stool after waking up.
    Time Frame
    Four-week period from the start to the end of test product consumption.
    Title
    Difference between groups in the fragmentation of the first stool after waking up.
    Time Frame
    Four-week period from the start to the end of test product consumption.
    Title
    Difference between groups in the consistency of the first stool after waking up.
    Time Frame
    Four-week period from the start to the end of test product consumption.
    Title
    Difference between groups in the volume of the first stool after waking up.
    Time Frame
    Four-week period from the start to the end of test product consumption.
    Title
    Clustering analysis on the multivariate data and to identify distinct groups of subjects who receive benefit from the product.
    Time Frame
    Four-week period from the start to the end of test product consumption.

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    64 Years
    Accepts Healthy Volunteers
    Accepts Healthy Volunteers
    Eligibility Criteria
    Inclusion Criteria: ≥18 and <65 years old at Visit 1. BMI between ≥18.5 to <30.0 kg/m2. Has at least 3 bowel movements per week ≥25% of bowel movements during the 2-week screening period produce hard or lumpy stools, defined as a Bristol Stool Form Scale (BSFS) score of 1 or 2. Regular breakfast consumer by self-report. Has a smartphone supporting either iOS version 11.0 (or later) or Android version 5.0 (or later) operating software capable of downloading and running the Dieta Health app to collect study data. Willing to consume the study product per the protocol instructions throughout the 28-day study intervention period. Willing to maintain habitual dietary, lifestyle, and physical activity (with exceptions per study instructions) throughout the trial. Willing to refrain from exclusionary medications, supplements, and products throughout the study. Willing to limit alcohol consumption to ≤3 standard drinks/day and ≤7 standard drinks/week throughout the trial. Non-user of tobacco or nicotine products or former user of any tobacco or nicotine product (not used within 6 months) and has no plans to change during the study period. Tobacco products include tobacco, smoking products (including, but not limited to cigarettes, cigars, chewing tobacco, e-cigarettes), and nicotine products (e.g., nicotine gum and/or nicotine patches) within 6 months of Visit 1 (Day 0) and during the study period. Non-user or former user of any marijuana or hemp products (not used within 6 months) of Visit 1 (Day 0) and during the study period and has no plans to use marijuana or hemp products during the study period. No washout is required for topical marijuana or hemp products, but subjects are required to abstain from these products during the study period. No health conditions that would prevent him/her from fulfilling the study requirements as judged by the Clinical Investigator on the basis of medical history and screening physical exam. Understands the study procedures and signs forms providing informed consent to participate in the study and authorizes the release of relevant protected health information to the Clinical Investigator. Exclusion Criteria: Any known food allergies or intolerances to dairy or to any of the study product ingredients. Consumption of probiotics or fermented products within 14 days of Visit 1 (Day 0) and during the study. Presence of a clinically important GI condition that would potentially interfere with the evaluation of the study product (e.g., inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), gastric reflux, indigestion, dyspepsia, Crohn's disease, celiac disease, history of surgery for weight loss, gastroparesis, and clinically significant lactose or gluten intolerance or other food or ingredient allergies). IBS will be determined as recurrent abdominal pain or discomfort at least 3 days/month in the last 3 months associated with: (a) improvement with defecation, (b) onset associated with change in frequency of stool, and (c) onset associated with a change in form (appearance of stool). Constipation symptoms caused by primary organic disease of the colon or pelvic floor or, in the Investigator's opinion, caused by medication (e.g., morphine, codeine). Uncontrolled and/or clinically important pulmonary (including uncontrolled asthma), hepatic, renal (except history of kidney stones in participants who are symptom free for 6 months), cardiac (including, but not limited to, atherosclerotic disease, history of myocardial infarction, peripheral arterial disease, stroke), endocrine (including Type 1 and Type 2 diabetes mellitus), hematologic, immunologic, neurologic (such as Alzheimer's or Parkinson's disease), psychiatric (including depression and/or anxiety disorders) or biliary condition(s). Conditions which are well-controlled or resolved will be assessed by the Clinical Investigator on a case-by-case basis. Uncontrolled hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg) as defined by the blood pressure measured at Visit 1 (Day 0). Stable use of hypertension medication is allowed [defined as no change in medication regimen within 90 days of Visit 1 (Day 0)]. Weight loss or gain > 4.5 kg within 90 days of Visit 1 (Day 0), or currently or planning to be on a weight loss regimen or muscle-building/strengthening program during the study. Signs or symptoms of an active infection of clinical relevance within 5 days of Visit 1 (Day 0). The visit may be rescheduled such that all signs and symptoms have resolved (at the discretion of the Clinical Investigator) at least 5 days prior to Visit 1 (Day 0). Major trauma or any other surgical event within 90 days of Visit 1 (Day 0). History or presence of cancer in the prior 2 years, except for non-melanoma skin cancer. Use of proton pump inhibitors, H2 receptor antagonists, corticosteroids, antibiotics, antifungals, antiparasitics, antidiarrheals, and/or laxatives within 30 days of Visit 1 (Day 0). Regular (>3 days/week) use of NSAIDs within 14 days of Visit 1 (Day 0). Exposure to any non-registered drug product within 30 days prior to Visit 1 (Day 0). Subject is a female who is pregnant, planning to be pregnant during the study period, lactating, or is of childbearing potential and is unwilling to commit to the use of a medically approved form of contraception during the study period. The method of contraception must be recorded. Recent history (within 12 months of screening; Visit 1; Day 0) of alcohol or substance abuse. Alcohol abuse is defined as >14 drinks/week (1 drink = 12 oz beer, 5 oz wine, or 1½ oz distilled spirits). Recent (within 2 months) participation in any other clinical study prior to Visit 1 (Day 0). Has a condition the Clinical Investigator believes would interfere with his/her ability to provide informed consent, comply with the study protocol, which might confound the interpretation of the study results, or put the subject at undue risk.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Hideyuki Shibata, Ph.D.
    Phone
    714-434-6500
    Ext
    215
    Email
    hideyuki.shibata@yakultusa.com
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Dawn Beckman, MD
    Organizational Affiliation
    Biofortis, Merieux NutriSciences
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

    Learn more about this trial

    Effect of L. Paracasei Strain Shirota on Constipation in Healthy US Adults

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