Efficacy And Safety Of Probiatop In The Treatment Of Digestive Symptoms

Signs and Symptoms, Digestive Clinical Trial

— Probiatop  

Official title:

Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial Placebo-Controlled Clinical Trial To Evaluate The Efficacy And Safety Of Probiatop In The Treatment Of Digestive Symptoms

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05603403
• Other study ID #: PROFQM0422OR-IV
• Secondary ID: 60215522.6.1001.
• Status: Completed
• Phase: Phase 4
• Start date: October 20, 2022
• Est. completion date: March 15, 2023

Study information

• Verified date: March 2024
• Source: Azidus Brasil
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

A Multicenter, Randomized, Double-blind, Placebo-Controlled Clinical Trial to Evaluate the Efficacy and Safety of Probiatop in the Treatment of Digestive Symptoms. Phase IV. The casuistic presented in this protocol is 150 participants randomized at a 1:1 ratio (75 receiving Probiatop and 75 receiving placebo), balanced by age, sex, prebiotic intake* and summation of the Gastrointestinal Symptom Rating Scale (GSRS) questions related to the domains of diarrhea (questions 11, 12, and 14), indigestion (questions 6, 7, 8, and 9), and constipation (questions 10, 13, and 15) separated by intensity and frequency. Participants with recurrent digestive symptoms for at least 3 months, with a score of 21 on the sum of questions 6, 7, 8, 9, 10, 11, 12, 13, 14 and 15 of the GSRS (corresponding to the domains diarrhea, indigestion and constipation) will be randomized to Probiatop or placebo.

Description:

This is a Phase IV clinical trial that will evaluate the efficacy and safety of Probiatop (investigational product). Participants with recurrent digestive symptoms for at least 3 months, with a score of 21 on the sum of questions: 6, 7, 8, 9, 10, 11, 12, 13, 14 and 15 of the GSRS questionnaire (corresponding to the domains diarrhea, indigestion and constipation) will be randomized to Probiatop or placebo. It will also be applied by electronic means (whatsapp link) on D7, D21 and D35. On these days participants will also be contacted by telemedicine to collect adverse events adverse events and data on concomitant medication. Treatment will be discontinued on D42. On D70 the participant will again be contacted by telemedicine for final data collection.

Product under investigation and dosage: Probiatop composition: association of probiotic strains containing 1 g/sachet of 1 x 109 CFU Bifidobacterium lactis HN019 (ATCC SD 5674), 1 x 109 CFU Lactobacillus acidophilus NCFM (ATCC SD 5221), 1 x 109 CFU Lactobacillus rhamnosus HN001 / Lacticaseibacillus rhamnosus HN001 (ATCC SD 5675) and 1 x 109 CFU Lactobacillus paracasei Lpc-37 / Lacticaseibacillus paracasei Lpc-37 (ATCC SD 5275). Placebo composition: collagen

Recruitment information / eligibility

• Status: Completed
• Enrollment: 150
• Est. completion date: March 15, 2023
• Est. primary completion date: March 15, 2023
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Male or female gender;

• Age = 18 years;

• BMI = 18, 5 = 29.9 Kg/m2;

• Complaint of recurrent digestive symptoms for at least 3 months with value = 21 of the sum of questions: 6, 7, 8, 9, 10, 11, 12, 13, 14, and 15 of the GSRS in frequency or intensity separately.

Exclusion Criteria:

• Extreme eating habits for which the primary intervention is dietary re-education: more than 7 of the of the 14 main meals of the week (lunch and dinner) based on ultra-processed products (industrial formulations formulations such as: filled cookies, "packaged" snacks packaged" snacks, soft drinks and "instant" noodles, frozen frozen and ready-to-eat products such as pasta, pizzas hamburgers, nuggets, sausages, etc) or "fast food" or average consumption of soft drinks exceeding 2 glasses per day.

• Alcoholism (DSM V): disorder defined as the repetition problems resulting from the use of alcohol that lead to clinically significant clinically significant impairment and/or suffering;

• Diabetes mellitus type I or II;

• Chronic diarrhea with signs of malabsorption (weight loss bulky and exceptionally smelly stools), AND/OR bleeding, AND/OR presence of mucus in the stool, bleeding without diarrhea;

• Weight loss = 10% in the past 6 months;

• Any recent change in eating habit, including veganism;

• Clinically significant illnesses at the discretion of the Investigator;

• Use of medications or supplements that may modify gastrointestinal function in the 30 days prior to randomization, especially proton pump inhibitors antacids, laxatives, constipating agents (loperamide, racecadotrilla, tricyclic antidepressants), other probiotics and prebiotics (containing dietary fiber including inulin, resistant starch, cellulose, oligofructose, fiber oligofructose, soy fiber, polydextrose, Kefir, Kombucha, and others);

• Use of antibiotics in the 3 months prior to randomization for any indications, including Helicobacter pylori;

• History of digestive surgery;

• Active cancer or cancer under treatment in the 6 months prior to randomization, except operated basal cell carcinoma;

• History of allergy or hypersensitivity to probiotics or components of the formula;

• Pregnant and lactating women.

Related Conditions & MeSH terms

• Signs and Symptoms, Digestive

Intervention

Drug:
• Probiatop
1 sachet orally, 2 times a day, for 42 days

Other:
• Placebo
1 sachet orally, 2 times a day, for 42 days

Locations

Country	Name	City	State
Brazil	A2Z Clinical Centro Avancado de Pesquisa Clinica Eireli	Valinhos	São Paulo

Sponsors (2)

Lead Sponsor	Collaborator
Azidus Brasil	Farmoquimica S.A.

Country where clinical trial is conducted

Brazil, 

References & Publications (37)

Almeida, L. B., C. B. Marinho, C. S. Souza and V. Cheib (2009).

ANVISA, Instrução Normativa - IN Nº 28, DE 26 DE JULHO DE 2018. Estabelece as listas de constituintes, de limites de uso, de alegações e de rotulagem complementar dos suplementos alimentares. Almeida, L. B., C. B. Marinho, C. S. Souza and V. Cheib (2009).

Bae JY, Kim JI, Park S, Yoo K, Kim IH, Joo W, Ryu BH, Park MS, Lee I, Park MS. Effects of Lactobacillus plantarum and Leuconostoc mesenteroides Probiotics on Human Seasonal and Avian Influenza Viruses. J Microbiol Biotechnol. 2018 Jun 28;28(6):893-901. doi: 10.4014/jmb.1804.04001. — View Citation

Blumstein DT, Levy K, Mayer E, Harte J. Gastrointestinal dysbiosis. Evol Med Public Health. 2014;2014(1):163. doi: 10.1093/emph/eou029. Epub 2014 Nov 20. No abstract available. — View Citation

Breton J, Galmiche M, Dechelotte P. Dysbiotic Gut Bacteria in Obesity: An Overview of the Metabolic Mechanisms and Therapeutic Perspectives of Next-Generation Probiotics. Microorganisms. 2022 Feb 16;10(2):452. doi: 10.3390/microorganisms10020452. — View Citation

Chen Y, Zhou J, Wang L. Role and Mechanism of Gut Microbiota in Human Disease. Front Cell Infect Microbiol. 2021 Mar 17;11:625913. doi: 10.3389/fcimb.2021.625913. eCollection 2021. — View Citation

Cremonini F, Di Caro S, Nista EC, Bartolozzi F, Capelli G, Gasbarrini G, Gasbarrini A. Meta-analysis: the effect of probiotic administration on antibiotic-associated diarrhoea. Aliment Pharmacol Ther. 2002 Aug;16(8):1461-7. doi: 10.1046/j.1365-2036.2002.01318.x. — View Citation

Cruchet S, Furnes R, Maruy A, Hebel E, Palacios J, Medina F, Ramirez N, Orsi M, Rondon L, Sdepanian V, Xochihua L, Ybarra M, Zablah RA. The use of probiotics in pediatric gastroenterology: a review of the literature and recommendations by Latin-American experts. Paediatr Drugs. 2015 Jun;17(3):199-216. doi: 10.1007/s40272-015-0124-6. — View Citation

de Almada CN, Nunes de Almada C, Martinez RC, Sant'Ana Ade S. Characterization of the intestinal microbiota and its interaction with probiotics and health impacts. Appl Microbiol Biotechnol. 2015 May;99(10):4175-99. doi: 10.1007/s00253-015-6582-5. Epub 2015 Apr 21. — View Citation

Ding RX, Goh WR, Wu RN, Yue XQ, Luo X, Khine WWT, Wu JR, Lee YK. Revisit gut microbiota and its impact on human health and disease. J Food Drug Anal. 2019 Jul;27(3):623-631. doi: 10.1016/j.jfda.2018.12.012. Epub 2019 Feb 1. — View Citation

Divella R, DE Palma G, Tufaro A, Pelagio G, Gadaleta-Caldarola G, Bringiotti R, Paradiso A. Diet, Probiotics and Physical Activity: The Right Allies for a Healthy Microbiota. Anticancer Res. 2021 Jun;41(6):2759-2772. doi: 10.21873/anticanres.15057. — View Citation

Fan Y, Pedersen O. Gut microbiota in human metabolic health and disease. Nat Rev Microbiol. 2021 Jan;19(1):55-71. doi: 10.1038/s41579-020-0433-9. Epub 2020 Sep 4. — View Citation

Ford AC, Harris LA, Lacy BE, Quigley EMM, Moayyedi P. Systematic review with meta-analysis: the efficacy of prebiotics, probiotics, synbiotics and antibiotics in irritable bowel syndrome. Aliment Pharmacol Ther. 2018 Nov;48(10):1044-1060. doi: 10.1111/apt.15001. Epub 2018 Oct 8. — View Citation

Fraher MH, O'Toole PW, Quigley EM. Techniques used to characterize the gut microbiota: a guide for the clinician. Nat Rev Gastroenterol Hepatol. 2012 Mar 27;9(6):312-22. doi: 10.1038/nrgastro.2012.44. — View Citation

Ganji-Arjenaki M, Rafieian-Kopaei M. Probiotics are a good choice in remission of inflammatory bowel diseases: A meta analysis and systematic review. J Cell Physiol. 2018 Mar;233(3):2091-2103. doi: 10.1002/jcp.25911. Epub 2017 May 3. — View Citation

Gebrayel P, Nicco C, Al Khodor S, Bilinski J, Caselli E, Comelli EM, Egert M, Giaroni C, Karpinski TM, Loniewski I, Mulak A, Reygner J, Samczuk P, Serino M, Sikora M, Terranegra A, Ufnal M, Villeger R, Pichon C, Konturek P, Edeas M. Microbiota medicine: towards clinical revolution. J Transl Med. 2022 Mar 7;20(1):111. doi: 10.1186/s12967-022-03296-9. — View Citation

Hill C, Guarner F, Reid G, Gibson GR, Merenstein DJ, Pot B, Morelli L, Canani RB, Flint HJ, Salminen S, Calder PC, Sanders ME. Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol. 2014 Aug;11(8):506-14. doi: 10.1038/nrgastro.2014.66. Epub 2014 Jun 10. — View Citation

Houghteling PD, Walker WA. Why is initial bacterial colonization of the intestine important to infants' and children's health? J Pediatr Gastroenterol Nutr. 2015 Mar;60(3):294-307. doi: 10.1097/MPG.0000000000000597. — View Citation

Huang R, Wang K, Hu J. Effect of Probiotics on Depression: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2016 Aug 6;8(8):483. doi: 10.3390/nu8080483. — View Citation

Johnston BC, Lytvyn L, Lo CK, Allen SJ, Wang D, Szajewska H, Miller M, Ehrhardt S, Sampalis J, Duman DG, Pozzoni P, Colli A, Lonnermark E, Selinger CP, Wong S, Plummer S, Hickson M, Pancheva R, Hirsch S, Klarin B, Goldenberg JZ, Wang L, Mbuagbaw L, Foster G, Maw A, Sadeghirad B, Thabane L, Mertz D. Microbial Preparations (Probiotics) for the Prevention of Clostridium difficile Infection in Adults and Children: An Individual Patient Data Meta-analysis of 6,851 Participants. Infect Control Hosp Epidemiol. 2018 Jul;39(7):771-781. doi: 10.1017/ice.2018.84. Epub 2018 Apr 26. Erratum In: Infect Control Hosp Epidemiol. 2018 Jul;39(7):894. — View Citation

Khurshid M, Aslam B, Nisar MA, Akbar R, Rahman H, Khan AA, Rasool MH. Bacterial munch for infants: potential pediatric therapeutic interventions of probiotics. Future Microbiol. 2015;10(11):1881-95. doi: 10.2217/fmb.15.102. Epub 2015 Oct 30. — View Citation

Kopp-Hoolihan L. Prophylactic and therapeutic uses of probiotics: a review. J Am Diet Assoc. 2001 Feb;101(2):229-38; quiz 239-41. doi: 10.1016/S0002-8223(01)00060-8. — View Citation

Kurugol Z, Koturoglu G. Effects of Saccharomyces boulardii in children with acute diarrhoea. Acta Paediatr. 2005 Jan;94(1):44-7. doi: 10.1111/j.1651-2227.2005.tb01786.x. — View Citation

Lange K, Buerger M, Stallmach A, Bruns T. Effects of Antibiotics on Gut Microbiota. Dig Dis. 2016;34(3):260-8. doi: 10.1159/000443360. Epub 2016 Mar 30. — View Citation

Li D, Wang P, Wang P, Hu X, Chen F. The gut microbiota: A treasure for human health. Biotechnol Adv. 2016 Nov 15;34(7):1210-1224. doi: 10.1016/j.biotechadv.2016.08.003. Epub 2016 Aug 31. — View Citation

Linares DM, Ross P, Stanton C. Beneficial Microbes: The pharmacy in the gut. Bioengineered. 2016;7(1):11-20. doi: 10.1080/21655979.2015.1126015. — View Citation

Marchesi JR, Adams DH, Fava F, Hermes GD, Hirschfield GM, Hold G, Quraishi MN, Kinross J, Smidt H, Tuohy KM, Thomas LV, Zoetendal EG, Hart A. The gut microbiota and host health: a new clinical frontier. Gut. 2016 Feb;65(2):330-9. doi: 10.1136/gutjnl-2015-309990. Epub 2015 Sep 2. — View Citation

Revicki DA, Wood M, Wiklund I, Crawley J. Reliability and validity of the Gastrointestinal Symptom Rating Scale in patients with gastroesophageal reflux disease. Qual Life Res. 1998 Jan;7(1):75-83. doi: 10.1023/a:1008841022998. — View Citation

Sanchez B, Delgado S, Blanco-Miguez A, Lourenco A, Gueimonde M, Margolles A. Probiotics, gut microbiota, and their influence on host health and disease. Mol Nutr Food Res. 2017 Jan;61(1). doi: 10.1002/mnfr.201600240. Epub 2016 Oct 10. — View Citation

Sanders ME, Heimbach JT, Pot B, Tancredi DJ, Lenoir-Wijnkoop I, Lahteenmaki-Uutela A, Gueimonde M, Banares S. Health claims substantiation for probiotic and prebiotic products. Gut Microbes. 2011 May-Jun;2(3):127-33. doi: 10.4161/gmic.2.3.16174. Epub 2011 May 1. — View Citation

Souza GS, Sarda FA, Giuntini EB, Gumbrevicius I, Morais MB, Menezes EW. TRANSLATION AND VALIDATION OF THE BRAZILIAN PORTUGUESE VERSION OF THE GASTROINTESTINAL SYMPTOM RATING SCALE (GSRS) QUESTIONNAIRE. Arq Gastroenterol. 2016 Jul-Sep;53(3):146-51. doi: 10.1590/S0004-28032016000300005. — View Citation

Thaiss CA, Itav S, Rothschild D, Meijer MT, Levy M, Moresi C, Dohnalova L, Braverman S, Rozin S, Malitsky S, Dori-Bachash M, Kuperman Y, Biton I, Gertler A, Harmelin A, Shapiro H, Halpern Z, Aharoni A, Segal E, Elinav E. Persistent microbiome alterations modulate the rate of post-dieting weight regain. Nature. 2016 Dec 22;540(7634):544-551. doi: 10.1038/nature20796. Epub 2016 Nov 24. — View Citation

Turnbaugh PJ, Ley RE, Mahowald MA, Magrini V, Mardis ER, Gordon JI. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature. 2006 Dec 21;444(7122):1027-31. doi: 10.1038/nature05414. — View Citation

Turnbaugh PJ, Ridaura VK, Faith JJ, Rey FE, Knight R, Gordon JI. The effect of diet on the human gut microbiome: a metagenomic analysis in humanized gnotobiotic mice. Sci Transl Med. 2009 Nov 11;1(6):6ra14. doi: 10.1126/scitranslmed.3000322. — View Citation

Vandenplas Y, Huys G, Daube G. Probiotics: an update. J Pediatr (Rio J). 2015 Jan-Feb;91(1):6-21. doi: 10.1016/j.jped.2014.08.005. Epub 2014 Oct 23. — View Citation

Waskito LA, Rezkitha YAA, Vilaichone RK, Wibawa IDN, Mustika S, Sugihartono T, Miftahussurur M. Antimicrobial Resistance Profile by Metagenomic and Metatranscriptomic Approach in Clinical Practice: Opportunity and Challenge. Antibiotics (Basel). 2022 May 13;11(5):654. doi: 10.3390/antibiotics11050654. — View Citation

Wei L, Singh R, Ro S, Ghoshal UC. Gut microbiota dysbiosis in functional gastrointestinal disorders: Underpinning the symptoms and pathophysiology. JGH Open. 2021 Mar 23;5(9):976-987. doi: 10.1002/jgh3.12528. eCollection 2021 Sep. — View Citation

* Note: There are 37 references in all — Click here to view all references

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Clinical Outcome Measure: Efficacy	Multicriteria evaluation of the impact of Probiatop on gastrointestinal symptom reduction symptoms by the Gastrointestinal Symptom Rating Scale (GSRS).	42 days
Secondary	Clinical Outcome Measure: Safety	Evaluation of the impact of Probiatop on the reduction of each domain of the questionnaire Gastrointestinal Symptom Rating Scale (GSRS) - abdominal pain, reflux syndrome, diarrhea, indigestion and constipation.	42 days
Secondary	Clinical Outcome Measure: Safety	Incidence and severity of adverse reactions to Probiatop.	Day 0 to Day 42