Gastritis Clinical Trial
Official title:
Open Label, Randomized, Single Site Clinical Trial To Compare The Safety Of Herbal Melanin Extracted From Nigella Sativa Seeds Vs Standard Of Care Treatment In Treating Gastritis Patients
The aim of the study is to use Melanole, a herbal extract from Nigella sativa, for treatment
of gastritis. The effect of Melanole will be compared between participants (including H.
pylori and non-H.pylori infected patients), with the triple therapy and Standard of care
treatment of gastritis, respectively.
All participants will be examined before and after the administration of Melanole. The
results showing a relief of gastritis symptoms for non-H. pylori patients and partial or
complete eradication of H. pylori for H.pylori infected patients will be evaluated.
Background:
The melanin to be used in this study is a herbal melanin (HM) that has been extracted from
the plant Nigella sativa. Nigella sativa was obtained from local market in Riyadh, Saudi
Arabia. HM has been obtained from seed total powdered extract using standard extraction
procedure and has been reported as a patent for the first time.The percentage of pure melanin
in total Nigella sativa L. is 9% as identified using Electron Spin Resonance (ESR) and
Fourier Transform- Infra Red (FI-IR) and calculated using wet chemical methods. Three
different patches of Nigella sativa L that were obtained from different Nigella sativa L
species were tested (Saudi, Ethiopian and Indian) and the same percentage of HM was obtained.
The safety of HM has been tested and confirmed by different labs including lab for Quality
and Safety and Industrial Research Institute(IRI) (see supplements 1 and 2). Similarly, the
safety of the HM capsules have been tested at the Toxicology and Bioanalysis in King Faisal
Specialist Hospital(KFSH) (see supplement 3). Moreover, the capsules have been approved and
certified for free sale by the Ministry of Health at Lebanon.
Study Area:
The study will be performed in the gastroenterology clinic at National Guard Health
Affairs(NGHA). Volunteers who participate in the study will be recruited from NGHA clinics.
Participates are patients diagnosed with gastritis, both H. Pylori and non-H.Pylori infected,
together with healthy volunteers.
The histological studies will be performed at the pathology department at NGHA.
Taking biopsies during endoscopy:
The best way to get tissue samples from the stomach is through a procedure called an
esophagogastroduodenoscopy. It is more commonly known as an endoscopy or EGD. This is
generally done as an outpatient procedure. The biopsies will be taken through the
esophagogastroduodenoscopy (EGD) by a ultra-thin forceps, then will be saved in special
container and send to the Laboratory for staining and microscopic examination. Under the
microscope the pathologist will look for the abnormal mucosa , inflammation, ulceration , and
helicobacter pylori gram negative micro-organism .During the procedure there is low chance of
some complications which happened in 1: 10 000 , these include ; injury to the mucosa with
bleeding and perforation , discomfort , sedation related complication like headache and
nausea . These rare but the patient will be informed about it.
Study Subjects:
Patients with gastritis or showing gastritis symptoms will be enrolled in this study.
Gastritis participate patients will be selected after detection of gastric lesions by
undergoing routine diagnostic tests (such as endoscopy of upper digestive system).
Sample Size Calculation and Estimation:
The sample size has been estimated as 132 ( 22 subjects per group). The calculation and
estimation have been done as follows:
Sample Size Calculation
The calculation of sample size was performed using Query Advisor V.7
Sample Size Estimated
The minimum number of Subjects needed in each group is 18, a two sided 95.0% confidence
interval for the difference between a Group 1 proportion of 0.6 and Group 2 proportion of 0.2
based on the large sample normal approximation will extend 0.3 from the observed differences
in proportions. The total required sample would be (6 groups x 18=108).The assumed
withdrawal/dropout rate is 20% in each group (22 subjects per group), the final sample size
would ne 132 subjects. The calculation of sample size was performed using Query Advisor V.7)
Data Collection method:
All data will be collected electronically and reported in Case Report Forms.
Data Cleaning:
Raw data will be processed in accordance with the best practices for raw data management to
identify any inaccuracies or incompleteness in advance to the statistical analysis. In order
to accomplish this task, all interval variables will be checked and summarized in terms of
maximum and minimum values. Minimum and maximum values will be checked and compared against
the nominal maximum and minimum value of each variable and variables with implausible values
will be flagged. A similar process will be applied to categorical variables to identify any
potential anomalies (miscode) by running a general frequency analysis.
Cohort Characterization:
All variables will be summarized and reported using descriptive statistics. Interval
variables will be summarized and reported in terms of mean and standard deviation.
Categorical variables will be summarized and reported in terms of frequency distribution. All
variables will be compared across study groups using chi square and t test accordingly.
Primary Outcome(s) Analysis:
Chi square test will be used to compare the distribution of gastritis across the study
groups. Results will be reported in terms of count, percent, and p-value. Significance will
be declared at alfa less than 0.05. Binary logistic regression will be used to identify
significant predictors of the primary outcomes. The statistical model will include key
variables that showed significance with the primary outcome at the bivariate level. Results
will be reported in terms of odds ratio, std. error, 95% confidence interval, and p-value.
Significance will be declared at alfa less than 0.05.
Intent to treat analysis will be the approach in analyzing the data.
Statistical Analytical System(SAS) 9.2 will be used for all statistical analyses.
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