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Food Supplementation With VSL#3 as a Support to Standard Pharmaceutical Therapy in Ulcerative Colitis

Primary Purpose

Ulcerative Colitis

Status
Completed
Phase
Not Applicable
Locations
Italy
Study Type
Interventional
Intervention
VSL#3
Placebo
Sponsored by
VSL Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Ulcerative Colitis focused on measuring Probiotics, VSL#3, Double-blind, Placebo controlled

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male and female patients aged more than 18 years;
  2. Diagnosis of ulcerative colitis established by previous colonoscopy, with consistent histology and clinical course;
  3. Ulcerative colitis extending for more than 15 cm from the anal verge, that is involving at least the rectosigmoid. This is based on colonoscopy at any time since the onset of ulcerative colitis. Activity (not extent) must be confirmed by colonoscopy at the beginning of the study;
  4. Mild to moderate active ulcerative colitis. Patients must have a minimum score of 3 and a maximum score of 8 on the 12 point UCDAI (Ulcerative Colitis Disease Activity Index - see Appendix 3) that measures stool frequency, rectal bleeding, endoscopic findings and physician's overall assessment of disease severity;
  5. Symptomatic (current episode) for less than 4 weeks;
  6. Minimum endoscopic score of 2 on the UCDAI at screening (mucosal appearance);
  7. Use of oral 5-ASA at least 4 weeks prior to study entry, at same dose; and/or use of Azathioprine or 6-mercaptopurine at least 3 months prior to study entry, at same dose;
  8. Negative pregnancy test on screening and agreeing to use valid contraception for the duration of the study;
  9. Patient not requiring hospitalisation;
  10. Willing an able to provide written informed consent

Exclusion Criteria:

  1. Crohn's disease or pouchitis;
  2. UCDAI greater than 8 (need for emergency surgery or presence of severe disease;
  3. Use of oral steroids within the last 4 weeks prior to study entry;
  4. Use of antibiotics within the last 2 weeks prior to study entry;
  5. Change in dose of oral 5-ASA within the last 4 weeks prior to study entry and throughout the 8 week study period, or change in dose of oral 6-mercaptopurine and azathioprine drugs within the last 3 months prior to study entry and throughout the 8 week study period;
  6. Use of rectal 5-ASA or steroids for one week before and throughout the 8 week study period;
  7. Use of probiotic preparations either prescribed or over-the-counter within 2 weeks prior to study entry;
  8. Use of NSAIDS for one week before and throughout the 8 week study period;
  9. Significant hepatic, renal, endocrine, respiratory, neurological or cardiovascular disease as determined by the Investigator;
  10. History of severe adverse reaction or known hypersensitivity to maltose and/or silicon dioxide;
  11. Patient requiring hospitalisation;
  12. Pregnant or lactating women, or women of child bearing potential not using an acceptable form of birth control (negative pregnancy test also required);
  13. Use of any investigational drug and/or participation in any clinical trial within 3 months of entry to this study;
  14. Inability to give a valid informed consent or to properly follow the protocol

Sites / Locations

  • U.O. di Medicina Interna Ospedaliera Policlinico di Bari
  • Reparto di Gastroenterologia ed Endoscopia Digestiva Azienda Ospedaliera Pugliese-Ciaccio
  • U.O. Fisiopatologia Digestiva Azienda Ospedaliera Mater Domini Campus Universitario di Germaneto
  • U.O. di Endoscopia Digestiva Presidio Ospedaliero San Salvatore
  • Dipartimento di Chirurgia Generale Servizio di Endoscopia Digestiva Ospedale Santa Maria Goretti
  • Struttura Complessa di Medicina Interna Azienda Ospedaliera Villa Sofia - CTO Ospedale Villa Sofia
  • U.O. di Nutrizione Clinica Ospedale Sant'Eugenio
  • P.O. Nuovo Regina Margherita Unità Operativa di Endoscopia e Gastroenterologia
  • Dipartimento di Medicina Interna U.O. di Gastroenterologia ed Endoscopia Digestiva Ospedale Cristo Re
  • Istituto di Medicina Interna CIC Columbus Policlinico Universitario Agostino Gemelli Università Cattolica del Sacro Cuore
  • Unità di Endoscopia Azienda Ospedaliera Sant'Andrea
  • Divisione di Gastroenterologia Istituto Clinico Humanitas
  • U.O.C. Endoscopia Digestiva IRCCS Ospedale Casa Sollievo della Sofferenza

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

VSL#3

placebo

Arm Description

Probiotic preparation VSL#3

Corn Starch

Outcomes

Primary Outcome Measures

The primary outcome is the evaluation of the beneficial effects of food supplementation with VSL#3 in patients affected by UC, assessed by a decrease in the UCDAI of 50% or more

Secondary Outcome Measures

Activity of ulcerative colitis
Change in subjective symptoms from baseline to weeks 2, 4 and 8 of food supplementation with VSL#3
Lack of beneficial effects, defined by need for further food supplementation
Inability to stay on study

Full Information

First Posted
August 2, 2009
Last Updated
August 3, 2009
Sponsor
VSL Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00951548
Brief Title
Food Supplementation With VSL#3 as a Support to Standard Pharmaceutical Therapy in Ulcerative Colitis
Official Title
Food Supplementation With the Probiotic Preparation VSL#3 as a Support to Standard Pharmaceutical Therapy in Patients With Mild to Moderate Active Ulcerative Colitis. A Double-blind, Randomized, Placebo Controlled Study
Study Type
Interventional

2. Study Status

Record Verification Date
August 2009
Overall Recruitment Status
Completed
Study Start Date
October 2006 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
October 2008 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
VSL Pharmaceuticals

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a double-blind, randomized, placebo controlled study to assess the beneficial effects of food supplementation with VSL#3 as a support to standard pharmaceutical therapy in patients affected by mild to moderate active ulcerative colitis.
Detailed Description
Title: Food supplementation with the probiotic preparation VSL#3 as a support to standard pharmaceutical therapy in patient with mild to moderate active Ulcerative Colitis. A double-blind, randomized, placebo controlled study. Study Design: Double blind, randomised, parallel groups, placebo controlled, multicentre, national study. Study Period: February 2006 - October 2007 (recruitment: 12 months; food supplementation with VSL#3: 8 weeks). Study Population: The study population will comprise 144 patients with mild to moderate active ulcerative colitis on top of standard pharmaceutical therapy. 72 patients will be randomised to receive food supplementation VSL#3 and 72 to receive placebo. Total Number of centers: Approximately 16 Study Objectives: To assess the beneficial effects of food supplementation with VSL#3 in patients affected by mild to moderate active ulcerative colitis in a double-blind, placebo-controlled study. Study product: VSL#3 consists of sachets each containing 900 billion viable lyophilised bacteria, comprising 4 strains of Lactobacillus (L. paracasei, L. plantarum, L. acidophilus and L. delbrueckii subsp. bulgaricus), 3 strains of Bifidobacterium (B. longum, B. breve and B. infantis) and 1 strain of Streptococcus thermophilus, in maltose and silicon dioxide as excipients. The placebo is in the form of identical sachets containing only maltose and silicon dioxide. The dose which will receive each patients is two sachets of VSL#3 or placebo to take twice a day orally (total amount of bacteria: 3.600 billion organisms per day). Assessments: Primary Outcome The primary outcome is the evaluation of the beneficial effects of food supplementation with VSL#3 in patients affected by UC, assessed by a decrease in the UCDAI of 50% or more, from baseline to week 8. Secondary Outcomes: Assessment of the beneficial effects of the food supplementation with the probiotic preparation VSL#3 on: activity of ulcerative colitis. change in subjective symptoms (rectal bleeding and stool frequency) from baseline to weeks 2, 4 and 8 of food supplementation with VSL#3. lack of beneficial effects, defined by need for further food supplementation or inability to stay on study till week 8. quality of life questionnaire (IBDQ) concordance between the Physician and Patient Global Assessment Scale at each time point. Physical Status Evaluations: Assessment of haematological laboratory tests, vital signs (blood pressure, pulse rate and respiratory rate), medical history and physical examination.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ulcerative Colitis
Keywords
Probiotics, VSL#3, Double-blind, Placebo controlled

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
144 (Actual)

8. Arms, Groups, and Interventions

Arm Title
VSL#3
Arm Type
Experimental
Arm Description
Probiotic preparation VSL#3
Arm Title
placebo
Arm Type
Placebo Comparator
Arm Description
Corn Starch
Intervention Type
Dietary Supplement
Intervention Name(s)
VSL#3
Intervention Description
Probiotic blend of 8 different strains of lactobacilli and bifidobacteria, dosed at 900 billion bacteria/sachet). Dosage regimen is 2 sachets b.i.d. for 8 weeks
Intervention Type
Dietary Supplement
Intervention Name(s)
Placebo
Intervention Description
Corn Starch. Dosage regimen is 2 sachets b.i.d. for 8 weeks
Primary Outcome Measure Information:
Title
The primary outcome is the evaluation of the beneficial effects of food supplementation with VSL#3 in patients affected by UC, assessed by a decrease in the UCDAI of 50% or more
Time Frame
8 weeks
Secondary Outcome Measure Information:
Title
Activity of ulcerative colitis
Time Frame
8 weeks
Title
Change in subjective symptoms from baseline to weeks 2, 4 and 8 of food supplementation with VSL#3
Time Frame
8 weeks
Title
Lack of beneficial effects, defined by need for further food supplementation
Time Frame
8 weeks
Title
Inability to stay on study
Time Frame
8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male and female patients aged more than 18 years; Diagnosis of ulcerative colitis established by previous colonoscopy, with consistent histology and clinical course; Ulcerative colitis extending for more than 15 cm from the anal verge, that is involving at least the rectosigmoid. This is based on colonoscopy at any time since the onset of ulcerative colitis. Activity (not extent) must be confirmed by colonoscopy at the beginning of the study; Mild to moderate active ulcerative colitis. Patients must have a minimum score of 3 and a maximum score of 8 on the 12 point UCDAI (Ulcerative Colitis Disease Activity Index - see Appendix 3) that measures stool frequency, rectal bleeding, endoscopic findings and physician's overall assessment of disease severity; Symptomatic (current episode) for less than 4 weeks; Minimum endoscopic score of 2 on the UCDAI at screening (mucosal appearance); Use of oral 5-ASA at least 4 weeks prior to study entry, at same dose; and/or use of Azathioprine or 6-mercaptopurine at least 3 months prior to study entry, at same dose; Negative pregnancy test on screening and agreeing to use valid contraception for the duration of the study; Patient not requiring hospitalisation; Willing an able to provide written informed consent Exclusion Criteria: Crohn's disease or pouchitis; UCDAI greater than 8 (need for emergency surgery or presence of severe disease; Use of oral steroids within the last 4 weeks prior to study entry; Use of antibiotics within the last 2 weeks prior to study entry; Change in dose of oral 5-ASA within the last 4 weeks prior to study entry and throughout the 8 week study period, or change in dose of oral 6-mercaptopurine and azathioprine drugs within the last 3 months prior to study entry and throughout the 8 week study period; Use of rectal 5-ASA or steroids for one week before and throughout the 8 week study period; Use of probiotic preparations either prescribed or over-the-counter within 2 weeks prior to study entry; Use of NSAIDS for one week before and throughout the 8 week study period; Significant hepatic, renal, endocrine, respiratory, neurological or cardiovascular disease as determined by the Investigator; History of severe adverse reaction or known hypersensitivity to maltose and/or silicon dioxide; Patient requiring hospitalisation; Pregnant or lactating women, or women of child bearing potential not using an acceptable form of birth control (negative pregnancy test also required); Use of any investigational drug and/or participation in any clinical trial within 3 months of entry to this study; Inability to give a valid informed consent or to properly follow the protocol
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Claudio De Simone, Prof.
Organizational Affiliation
VSL Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
U.O. di Medicina Interna Ospedaliera Policlinico di Bari
City
Bari
ZIP/Postal Code
70023
Country
Italy
Facility Name
Reparto di Gastroenterologia ed Endoscopia Digestiva Azienda Ospedaliera Pugliese-Ciaccio
City
Catanzaro
ZIP/Postal Code
88100
Country
Italy
Facility Name
U.O. Fisiopatologia Digestiva Azienda Ospedaliera Mater Domini Campus Universitario di Germaneto
City
Catanzaro
ZIP/Postal Code
88100
Country
Italy
Facility Name
U.O. di Endoscopia Digestiva Presidio Ospedaliero San Salvatore
City
L'Aquila
ZIP/Postal Code
67100
Country
Italy
Facility Name
Dipartimento di Chirurgia Generale Servizio di Endoscopia Digestiva Ospedale Santa Maria Goretti
City
Latina
ZIP/Postal Code
04100
Country
Italy
Facility Name
Struttura Complessa di Medicina Interna Azienda Ospedaliera Villa Sofia - CTO Ospedale Villa Sofia
City
Palermo
ZIP/Postal Code
90146
Country
Italy
Facility Name
U.O. di Nutrizione Clinica Ospedale Sant'Eugenio
City
Roma
ZIP/Postal Code
00144
Country
Italy
Facility Name
P.O. Nuovo Regina Margherita Unità Operativa di Endoscopia e Gastroenterologia
City
Roma
ZIP/Postal Code
00153
Country
Italy
Facility Name
Dipartimento di Medicina Interna U.O. di Gastroenterologia ed Endoscopia Digestiva Ospedale Cristo Re
City
Roma
ZIP/Postal Code
00167
Country
Italy
Facility Name
Istituto di Medicina Interna CIC Columbus Policlinico Universitario Agostino Gemelli Università Cattolica del Sacro Cuore
City
Roma
ZIP/Postal Code
00168
Country
Italy
Facility Name
Unità di Endoscopia Azienda Ospedaliera Sant'Andrea
City
Roma
ZIP/Postal Code
00189
Country
Italy
Facility Name
Divisione di Gastroenterologia Istituto Clinico Humanitas
City
Rozzano (MI)
ZIP/Postal Code
20089
Country
Italy
Facility Name
U.O.C. Endoscopia Digestiva IRCCS Ospedale Casa Sollievo della Sofferenza
City
San Giovanni Rotondo (FG)
ZIP/Postal Code
71013
Country
Italy

12. IPD Sharing Statement

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Food Supplementation With VSL#3 as a Support to Standard Pharmaceutical Therapy in Ulcerative Colitis

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