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HayfeverPhase 3NCT00554736

Lactobacillus Acidophilus L92 on Markers of Allergic Inflammation by Nasal Provocation With Grass Pollen

A Phase 3 study testing Lactobacillus acidophilus L-92 in people with Hayfever, run by University of California, Davis.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

This is a placebo controlled double-blind single center study initiated and sponsored by CALPIS, Inc., Japan, and CALPIS U.S.A., Inc., Torrance, CA. The overall objective of this study is to establish the benefit of a bacterial product, Lactobacillus acidophilus strain L-92 (CALPIS U.S.A., Inc., Torrance, CA), in… Read more about this study

Who is it for?
Ages 18 to 55 yearsHealthy volunteers can take part
Conditions the study is for
Hayfever
What is being tested?
Lactobacillus acidophilus L-92
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
No sites listed yet
Study dates
May 2006to Aug 2008
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 55 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Each subject qualified by entry criteria history in a brief phone interview will be invited to come to a screening visit. A brief history and targeted physical exam to detect inclusion and exclusion criteria, listed below, will be performed after obtaining informed consent. Then, if the subject still appears eligible, they will undergo allergy skin testing to perennial ryegrass pollen extract as a key inclusion criteria. Skin testing will utilize standard prick techniques with appropriate saline/glycerin controls. The cross sectional measurements of the wheal and flare reaction will be recorded. A positive test will require a wheal >3mm vs the control diluent.
  • at least a 2-year clinical history of springtime allergic rhinitis
  • allergy to grass pollen, defined by positive case history and positive skin prick test
  • Males or non-pregnant, non-lactating females who are post-menopausal or naturally or surgically sterile
  • Females of childbearing potential should be using acceptable birth control methods
  • Patients who are normally active and otherwise judged to be in good health
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  • Patients must be willing and able to give written informed consent and must provide this consent
  • Patients must be willing and able to attend required study visits
  • Patients must be able to follow instructions
  • Off allergy medication for at least one month prior to study entry (nasal corticosteroids, nasal azelastine, cromolyn sodium, IPRATROPRIUM bromide, antihistamines, leukotriene antagonists)

Who cannot join

  • History of nasal deviation
  • Current cigarette smoker
  • History of allergy symptoms August to January
  • History of nasal polyposis
  • History of asthma
  • Concurrent disease that might complicate or interfere with investigation or evaluation of the study medications
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  • Concurrent use of any prohibited medication(s)
  • Chronic or intermittent use of inhaled, oral, intramuscular, intravenous, or potent or super-potent topical corticosteroids
  • Chronic use of long acting antihistamines and other concomitant medications that would affect assessment of the effectiveness of study drug(s)
  • Any systemic disorder that could interfere with the evaluation of the study medication(s)
  • Upper or lower respiratory infection requiring antibiotics within 14 days of the first visit
  • Diagnosis of sinusitis within 30 days of the first Baseline visit
  • Hypersensitivity to the study supplement tablet fillers
  • active or quiescent tuberculosis infection of the respiratory tract
  • nasal septal ulcers, nasal surgery or nasal trauma within 90 days of enrollment
  • Clinical history of anaphylaxis
  • Patients with contraindications for allergy vaccines
  • Clinical history of immunodeficiency, including immunosuppressant therapy
  • Patients with contraindications to adrenaline
  • Subject is taking β-blockers
  • Clinical history of drug or alcohol abuse that would interfere with the patient's participation in the study
  • Clinical history of severe or uncontrolled cardiovascular, hepatic, renal and/or other disease/illness that could be expected to interfere with the study
  • Clinical history, or evidence, of nasolacrimal drainage system malfunction
  • Study site staff who would have access to the clinical study protocol
  • History of immunotherapy with grass pollen extract
  • Participation in any other investigational study within 30 days before entry into this study or concomitantly with this study

About this study

Official title: A Randomized, Double-blind, Placebo-controlled Trial of Lactobacillus Acidophilus L92 on Markers of Allergic Inflammation by Nasal Provocation With Grass Pollen

This is a placebo controlled double-blind single center study initiated and sponsored by CALPIS, Inc., Japan, and CALPIS U.S.A., Inc., Torrance, CA.

The overall objective of this study is to establish the benefit of a bacterial product, Lactobacillus acidophilus strain L-92 (CALPIS U.S.A., Inc., Torrance, CA), in patients with allergic rhinitis.

Read the detailed description

The overall objective of this study is to establish the benefit of a bacterial product, Lactobacillus acidophilus strain L-92 (CALPIS U.S.A., Inc., Torrance, CA), in patients with allergic rhinitis. This will be done by noting:

  • The threshold dose of pollen extract required on nasal challenge needed to elicit nasal obstruction as measured by acoustic rhinometry pre-treatment, and then comparing the nasal response to the same dose at the end of treatment.
  • The dose of pollen extract needed (by progressive dose escalation) to elicit nasal obstruction at the end of treatment if significant nasal obstruction is not reached with the pre-treatment dose.
  • Changes in the cytokine and chemokine profile obtained by analysis of the nasal secretion specimens pre- and post-treatment.
  • Changes in the cytokine profile of cultured peripheral blood mononuclear cells stimulated with PHA pre- and post-treatment.
  • PHADIA ImmunoCAP perennial ryegrass pollen titer pre- and post-treatment.
  • The threshold concentration of standardized perennial ryegrass extract to elicit a positive skin prick test pre- and post-treatment
  • Total serum IgE pre- and post-

The active product to be used is a tablet made from desiccated Lactobacillus acidophilus strain L-92 and fillers. These bacteria are present in the GI tract of most healthy humans. They are non-pathogenic, and have been used in the food industry for preparation of fermented foods for centuries. They lower the pH of their environment by converting sugar to lactic acid, which inhibits the growth of some pathogens. Lactobacilli are the first genus of bacteria suspected to have health benefits. Most Probiotic studies have been done with live cultures, and indeed there is animal model literature to support greater beneficial immunomodulatory effects of live bacteria over killed organisms. However, some beneficial effects of Lactobacilli are proposed to be due to uptake and processing of cell wall components and bacterial DNA, thus interaction with living bacteria may not be required for all the beneficial effects. However, if a tablet form can deliver live bacteria, in terms of ease of consumption by consumers, it would be preferred by many people, as well as allowing easier blinding of the supplement in clinical trials. The study proposed herein will be the first large study of this product using a live, but desiccated tablet preparation of the bacteria. If this product has a beneficial effect, the fact that it is in a tablet form will greatly benefit consistency in manufacturing, as well as ease storage and ultimate use of the product by consumers.

CALPIS has selected a strain of lactobacilli, L. acidophilus (L92), on the basis of an IgE- lowering effect in experimental studies with mice. This product, in a liquid fermented milk form, has been tested in the following clinical studies:

  1. Cedar pollen allergy study (2003). Significant improvement in symptom-medication score was detected (ISHIDA et al BIOSCI. BIOTECH. BIOCHEM. 1652-60, 2005). Product: Liquid fermentation L acidophilus L-92 milk, heat-treated at 75°C for 10 minutes in 100 mL volume.
  2. Perennial allergic rhinitis (2002/03). Significant improvement in symptom-medication score was observed (ISHIDA et al J. Dairy Sci. 528-33, 2005). Product: 100 mL heat-treated milk fermented by L acidophilus L-92 (about 3x1010 counts/100 mL)
  3. Atopic dermatitis (2005). Improvement in symptom-medication score was detected. Unpublished data. Product: 100 mL fermented milk with L acidophilus L-92. An initial study using a desiccated form in tablets has been performed:
  4. Artificial pollen allergy study (2005). Improvement in quality of life was noted. Product: desiccated bacteria and fillers in tablets. 20 mg, 60 mg and 180 mg were studied. 180 mg/day was most effective. Unpublished data.

METHODS

PHASE 1

In the first phase, subjects with a history of grass pollinosis, with positive skin tests to grass, will be studied out of season and will be randomized to placebo and active treatment for 4 months. Randomization will be based upon a retrospective Rhinitis Quality of Life Questionnaire regarding their recollection of the worst week of the last pollen season. The intent is to randomize subjects such that the distribution of those with severe versus mild allergy symptoms is equal in both groups. The subjects will be evaluated for their nasal function (patency by acoustic rhinometry) and undergo a nasal provocation test and collection of nasal secretions at the beginning and end of the study. Blood will be drawn and skin tests will be performed at the beginning and end of the study.

Primary Objective:

To assess the efficacy of L-92 versus placebo by comparing the change in nasal obstruction using acoustic rhinometry from the baseline, upon nasal provocation with the same dose of grass pollen extract found to elicit obstruction at enrollment.

Secondary objectives:

  1. To compare the change in threshold dose for nasal specific provocation (NPT) test with grass pollen required to elicit nasal obstruction.
  2. To compare the change of serum IgE levels to grass pollen (performed by PHADIA ImmunoCAP) and total IgE.
  3. To compare the change of cytokines IFN-gamma, IL-2, IL-4, IL-5, IL-9 and IL-13, and the chemokine, eotaxin, in nasal secretion fluid using the same dose of pollen that elicited nasal obstruction at baseline.
  4. To compare the change of cytokines IFN-gamma, IL-2, IL-4, IL-5, IL-9 and IL-13 in the supernatant from peripheral blood mononuclear cells (PBMCs) stimulated with PHA pre and post-treatment.

PHASE 2

In the second phase:

Subjects will be given the option to participate for Phase 2 of the study. In this phase, subjects will continue on either placebo or active product throughout the next pollen season, starting in January 2008, and fill out Rhinitis Quality of Life Questionnaires when they pick up the study tablets at the beginning of April, May and June. They will be asked to fill out daily medication/symptom diaries during the first two weeks of May (exact dates subject to change depending on climatic factors). The peak grass pollen season is April through June. Blood will be drawn at a last visit in late June 2008 for specific and total IgE by ImmunoCAP.

Conditions
Hayfever
Being tested
Lactobacillus acidophilus L-92
Keywords
Pollen Allergy, Allergy
Medical subject headings
Rhinitis, Allergic, Seasonal, Hypersensitivity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Lactobacillus acidophilus L-92Biological

    Nasal challenge and acoustic rhinometry will be performed at the first study visit and again at the end of the 4-month supplement period. Standardized perennial ryegrass pollen extract (Lolium perenne) (Hollister-Stier, Inc., Spokane, WA) will be used. Dilutions of the standard product will be made in sterile saline prior to use. The standard product strength is 100,000 BAU/mL. Provocation will start with 100 BAU/mL, delivered as a 100 microliter puff into each nostril nose during breath holding, followed by expiration. Acoustic rhinometry, performed in each nostril, will be recorded at 15 minutes. A change of 30% from baseline in the composite score is considered significant. The dose will be increased every 20 minutes if there is no response. The concentrations used will be 100 BAU, 330 BAU, 1000 BAU, 3300 BAU, 10,000 BAU or 33,000 BAU/mL.

Study groups in NCT00554736
Study groupRoleWhat they receive
1ExperimentalIn the first phase, subjects with a history of grass pollinosis, with positive skin tests to grass, will be studied out of season and will be randomized to active treatment for 4 months.
Receives: Biological: Lactobacillus acidophilus L-92

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The objective is to establish the benefit of Lactobacillus acidophilus strain L-92 in patients with allergic rhinitis. The threshold dose of pollen extract required to elicit nasal obstruction as measured by acoustic rhinometry pre-treatment.

    Measured: one year

Secondary outcomes (1)
  1. • The dose of pollen extract needed (by progressive dose escalation) to elicit nasal obstruction at the end of treatment if significant nasal obstruction is not reached with the pre-treatment dose.

    Measured: one year

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Nov 2007 (estimated)
  2. Study startMay 2006
  3. Primary completionDec 2007 (estimated)
  4. Study completionAug 2008 (estimated)

Why it stopped: Sponsor suspended study do to funding

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00554736
Sponsor's protocol ID
200614299-2
Other IDs
200614299-1
Status last verified
Apr 2015
First submitted
5 Nov 2007
Last updated
22 Apr 2015
Results posted
No
Data monitoring committee
Yes

Publications

  • Ishida Y, Nakamura F, Kanzato H, Sawada D, Hirata H, Nishimura A, Kajimoto O, Fujiwara S. Clinical effects of Lactobacillus acidophilus strain L-92 on perennial allergic rhinitis: a double-blind, placebo-controlled study. J Dairy Sci. 2005 Feb;88(2):527-33. doi: 10.3168/jds.S0022-0302(05)72714-4.

    PubMed 15653517

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Lactobacillus acidophilus L-92 in people with Hayfever, run by University of California, Davis.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 10 inclusion and 26 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 22 Apr 2015. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The objective is to establish the benefit of Lactobacillus acidophilus strain L-92 in patients with allergic rhinitis. The threshold dose of pollen extract required to elicit nasal obstruction as measured by acoustic rhinometry pre-treatment. (time frame: one year). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00554736, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 22 Apr 2015.

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