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Infantile ColicNCT00893711

Lactobacillus Reuteri Versus Placebo in the Treatment and Prevention of Infantile Colic

A study testing Lactobacillus reuteri DSM 17938 and L.reuteri + Vit D in people with Infantile Colic, run by Azienda Ospedaliera Ospedale Infantile Regina Margherita Sant'Anna at 3 sites in Italy.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The purpose of this study is: to study the intestinal microflora of colicky infants before and after L. reuteri or placebo administration, evaluating the effect of Lactobacillus reuteri on the growth of the main intestinal microbiota (coliforms, Clostridium butyricum, Lactobacilli, Bifidobacteria) with fluorescent in… Read more about this study

Who is it for?
Ages 4 to 16 weeks
Conditions the study is for
Infantile Colic
What is being tested?
Lactobacillus reuteri DSM 17938 and L.reuteri + Vit D
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
155 participants
Where
3 sitesItaly
Study dates
Mar 2008to Dec 2022
Phase
Interventional
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 4 to 16 weeks
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • clinical diagnosis of infantile colic according to Wessel's criteria
  • gestational age between 37 and 42 weeks
  • age between 4 and 16 weeks
  • birth weight between 2500 and 4000 g
  • exclusively breastfed

Who cannot join

  • clinical evidence of chronic illness or gastrointestinal disorders
  • administration of probiotics and antibiotics

Trial locations and contacts

3 sites in 1 country.

Francesco Savino, MD, PhD contact

00390113135618

francesco.savino@unito.it

Italy3 sites, 3 recruiting
  • Ospedale Infantile Regina Margherita

    Torino, TO, 10126

    Francesco Savino, MD PhD, +39 0113135618, francesco.savino@unito.it

    Francesco Savino, MD PhD

    Recruiting
  • Ospedale Infantile Regina Margherita

    Torino, 10126

    Francesco Savino, MD, PhD, 00390113135224, francesco.savino@unito.it

    Valentina Tarasco, MD

    Recruiting
  • Ospedale Infantile Regina Margherita

    Torino, 10126

    Francesco Savino, MD, PhD, +390113135618, francesco.savino@unito.it

    Francesco Savino, MD, PhD

    Recruiting

Other trials in Italy

About this study

Official title: Lactobacillus Reuteri Versus Placebo in the Treatment and Prevention of Infantile Colic: a Clinical and Microbiological, Double-blind, Prospective, Randomised, Controlled Study

The purpose of this study is:

  • to study the intestinal microflora of colicky infants before and after L. reuteri or placebo administration, evaluating the effect of Lactobacillus reuteri on the growth of the main intestinal microbiota (coliforms, Clostridium butyricum, Lactobacilli, Bifidobacteria) with fluorescent in situ hybridization (FISH) technique or with Real-Time PCR Taqman; Further, the global intestinal microflora composition, using large-scale DNA sequencing of 16S rRNA genes ( 454-pyrosequencing technique.
  • to evaluate the improvement of colicky symptoms by the oral administration of Lactobacillus reuteri (primary outcome: reduction of the daily average crying time from baseline to the end of the treatment period, to less than 3 hours a day, the cut-off proposed by Wessel; secondary outcome: number of responders versus non-responders in each group at the end of the treatment).
  • to evaluate fecal calprotectin values at the beginning and at the end of the study. BÜHLMANN Quantum Blue® Calprotectin High Range (Schönenbuch, Switzerland). A quantitative immunoassay.
  • to evaluate Th17/Treg balance at time 0 and t 30 ( days) investigating mRNA FOXP3 and RORγ in peripheral blood using RT-PCR Real Time Taqman.
  • the measurement of the expression level of CC-chemokine receptor 7 messenger RNA using the real-time TaqMan reverse transcription polymerase chain reaction method.
  • the measurement of expression of interleukin 10 (IL-10) messenger RNA using the real-time TaqMan reverse transcription polymerase chain reaction method.
  • Parental satisfaction at the end of the study period ( 30 day ) with a numerc scale from 1 to 10.
Read the detailed description

Infantile colic is one of the most common problems within the first three months of life. It consists of a behavioural syndrome characterised by paroxysmal, excessive and inconsolable crying without identifiable cause. Although infantile colic is commonly reported and causes appreciable distress for both parents and paediatricians, despite forty years of research, its aetiology still remains unclear. Recently the role of intestinal microflora has growing importance, and a lower count of intestinal lactobacilli has been observed in colicky infants compared to healthy ones. In a recent study we have observed that Lactobacillus reuteri improved colicky symptoms in breast-fed infants within one week of treatment compared to Simethicone, suggesting that probiotics may play a role in infantile colic (Savino F, Pelle E, Palumeri E, Oggero R, Miniero R.Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Pediatrics 2007; 119:e124-30). The mechanism involved in such finding is only partially understood and, for this reason, we have planned this new study to evaluate not only the clinical improvement but also the microbiological data.

Conditions
Infantile Colic
Being tested
Lactobacillus reuteri DSM 17938, Placebo, L.reuteri + Vit D, Vit D placebo
Keywords
infantile colic, lactobacillus, gut microflora, FISH, toll like receptor, T reg, messenger RNA, CC-chemokine receptor 7, interleukin 10
Medical subject headings
Colic

What participants receive

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

  • Lactobacillus reuteri DSM 17938Other

    Also called Reuterin,Noos - Italy; BIOGAIA drops - Sweden

    Lactobacillus reuteri is administered at a dose of 1.000.000.000 colony forming units (CFU) in V drops/day for 21 days

  • PlaceboOther

    Also called Placebo BIOGAIA Sweden

    Placebo is administered in V drops once a day for 21 days. Placebo is inactive, similar to the studied treatment with the same package, taste, characteristics of colour and consistency.

  • L.reuteri + Vit DDietary supplement

    Also called Reuterin D3 drops, Noos Italy, Reuflor D3 drops, Recordati Italy

  • Vit D placeboDietary supplement

Study groups in NCT00893711
Study groupRoleWhat they receive
Lactobacillus reuteriActive comparatorLactobacillus reuteri DSM 17938 is administered at a dose of 1.000.000.000 colony forming units (CFU) in V drops of a commercially available oil suspension, 30 min before feeding, once a day for 30 days.
Receives: Other: Lactobacillus reuteri DSM 17938
PlaceboPlacebo comparatorPlacebo is administered in V drops once a day for 30 days. Placebo is inactive, similar to the studied treatment with the same package, taste, characteristics of colour and consistency.
Receives: Other: Placebo
L.reuteri + vit DActive comparatorL. reuteri DSM 17938 (10^8 CFU) plus vitamin D3 (400 UI) five drops/day for 3 months
Receives: Dietary Supplement: L.reuteri + Vit D
Vit D PlaceboPlacebo comparatorvitamin D3 (400 UI) five drops/day for 3 months
Receives: Dietary Supplement: Vit D placebo

What is being measured

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

  1. Reduction of the daily average crying time from baseline to the end of the treatment period, to less than 3 hours a day, the cut-off proposed by Wessel and number of responders versus non-responders in each group at the end of the treatment

    diary crying Barr

    Measured: time 0 - 7 - 21 - 30 days

Secondary outcomes (3)
  1. Responders to treatment

    was defined as the number of responders in each group on days 7, 14 , 21 and 30 . Responders (defined in the protocol) were those who experienced a decrease in the daily average crying time of 50% from baseline. Diary Crying Barr.

    Measured: 30 day

  2. To analyze intestinal microflora

    The intestinal microflora of the infants will be analyzed the effect of the probiotic on selected intestinal microbiota (Escherichia coli, Clostridium butyricum, Lactobacillus, Bifidobacterium), using fluorescent in situ hybridization (FISH) or using with Real-Time PCR Taqman.

    Measured: day 0 and day 30

  3. Assay of Th17/Treg balance

    For the analyses of mRNA FOXP3 and RORγ in peripheral blood RT-PCR Real Time Taqman will be used

    Measured: time 0- 30 days

Timeline

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

  1. First posted6 May 2009 (estimated)
  2. Study startMar 2008
  3. Primary completionNov 2021 (estimated)
  4. Study completionDec 2022 (estimated)

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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
155 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00893711
Sponsor's protocol ID
FS-2009
Status last verified
Mar 2021
First submitted
5 May 2009
Last updated
3 Mar 2021
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: to partecipe to an individual partecipant data meta- analysis.

Publications

  • Savino F. Focus on infantile colic. Acta Paediatr. 2007 Sep;96(9):1259-64. doi: 10.1111/j.1651-2227.2007.00428.x.

    PubMed 17718777
  • Savino F, Pelle E, Castagno E, Palumeri E, Oggero R. Must infants with colic really be hospitalized? Acta Paediatr. 2007 Jul;96(7):1109; author reply 1110. doi: 10.1111/j.1651-2227.2007.00328.x. Epub 2007 May 10. No abstract available.

    PubMed 17498186
  • Savino F, Pelle E, Palumeri E, Oggero R, Miniero R. Lactobacillus reuteri (American Type Culture Collection Strain 55730) versus simethicone in the treatment of infantile colic: a prospective randomized study. Pediatrics. 2007 Jan;119(1):e124-30. doi: 10.1542/peds.2006-1222.

    PubMed 17200238
  • Savino F, Grassino EC, Guidi C, Oggero R, Silvestro L, Miniero R. Ghrelin and motilin concentration in colicky infants. Acta Paediatr. 2006 Jun;95(6):738-41. doi: 10.1080/08035250500522654.

    PubMed 16754557
  • Savino F, Palumeri E, Castagno E, Cresi F, Dalmasso P, Cavallo F, Oggero R. Reduction of crying episodes owing to infantile colic: A randomized controlled study on the efficacy of a new infant formula. Eur J Clin Nutr. 2006 Nov;60(11):1304-10. doi: 10.1038/sj.ejcn.1602457. Epub 2006 May 31.

    PubMed 16736065
  • Savino F, Castagno E, Bretto R, Brondello C, Palumeri E, Oggero R. A prospective 10-year study on children who had severe infantile colic. Acta Paediatr Suppl. 2005 Oct;94(449):129-32. doi: 10.1111/j.1651-2227.2005.tb02169.x.

    PubMed 16214780
  • Savino F, Cresi F, Castagno E, Silvestro L, Oggero R. A randomized double-blind placebo-controlled trial of a standardized extract of Matricariae recutita, Foeniculum vulgare and Melissa officinalis (ColiMil) in the treatment of breastfed colicky infants. Phytother Res. 2005 Apr;19(4):335-40. doi: 10.1002/ptr.1668.

    PubMed 16041731
  • Savino F, Bailo E, Oggero R, Tullio V, Roana J, Carlone N, Cuffini AM, Silvestro L. Bacterial counts of intestinal Lactobacillus species in infants with colic. Pediatr Allergy Immunol. 2005 Feb;16(1):72-5. doi: 10.1111/j.1399-3038.2005.00207.x.

    PubMed 15693915
  • Savino F, Cresi F, Pautasso S, Palumeri E, Tullio V, Roana J, Silvestro L, Oggero R. Intestinal microflora in breastfed colicky and non-colicky infants. Acta Paediatr. 2004 Jun;93(6):825-9.

    PubMed 15244234
  • Savino F, Garro M, Montanari P, Galliano I, Bergallo M. Crying Time and RORgamma/FOXP3 Expression in Lactobacillus reuteri DSM17938-Treated Infants with Colic: A Randomized Trial. J Pediatr. 2018 Jan;192:171-177.e1. doi: 10.1016/j.jpeds.2017.08.062. Epub 2017 Sep 29.

    PubMed 28969887
  • Roos S, Dicksved J, Tarasco V, Locatelli E, Ricceri F, Grandin U, Savino F. 454 pyrosequencing analysis on faecal samples from a randomized DBPC trial of colicky infants treated with Lactobacillus reuteri DSM 17938. PLoS One. 2013;8(2):e56710. doi: 10.1371/journal.pone.0056710. Epub 2013 Feb 28.

    PubMed 23468874

Questions about this trial

What is this clinical trial studying?

A study testing Lactobacillus reuteri DSM 17938 and L.reuteri + Vit D in people with Infantile Colic, run by Azienda Ospedaliera Ospedale Infantile Regina Margherita Sant'Anna at 3 sites in Italy.

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 5 inclusion and 2 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: status not confirmed, as of the sponsor's last update on 3 Mar 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 3 sites in Italy. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

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

Are results available for this study?

Results are not available in the source record.

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

Contact Francesco Savino, MD, PhD (00390113135618, francesco.savino@unito.it), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Reduction of the daily average crying time from baseline to the end of the treatment period, to less than 3 hours a day, the cut-off proposed by Wessel and number of responders versus non-responders in each group at the end of the treatment (time frame: time 0 - 7 - 21 - 30 days). 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 NCT00893711, which also lists 11 linked publications.

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 3 Mar 2021.

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