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OsteopeniaNCT02422082

The Effect of Lactobacillus Reuteri ATCC PTA 6475 on Volumetric Bone Mineral Density in Patients With Osteopenia

A study testing L. reuteri in people with Osteopenia, run by Sahlgrenska University Hospital at 1 site in Sweden.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Lactobacillus reuteri (L. reuteri) has been widely studied in clinical trials and has probiotic, health-promoting effects in both adults and children, and is safe for human consumption. Animal models indicate that treatment with L. reuteri has positive effects on bone metabolism and bone density. Read more about this study

Who is it for?
Ages 75 to 80 years, women onlyHealthy volunteers can take part
Conditions the study is for
Osteopenia
What is being tested?
L. reuteri
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
90 participants
Where
1 siteSweden
Study dates
8 May 2015to 1 Dec 2017
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 75 to 80 years
  • Women only
  • Healthy volunteers accepted
  • Older adult

Who may be able to join

  • bone mineral density T-score less than -1 but more than -2.5 in the total hip or femoral neck or lumbar spine (L1-L4) by dual energy x-ray absorptiometry
  • signed informed consent
  • stated availability throughout the entire study period
  • mental ability to understand and willingness to fulfill all the details of the protocol

Who cannot join

  • untreated hyperthyroidism
  • rheumatoid arthritis
  • diagnosed with disease causing secondary osteoporosis within the last year, including primary hyperparathyroidism, chronic obstructive pulmonary disease, inflammatory bowel disease, celiac disease, or diabetes
  • recently diagnosed malignancy (within the last 5 years)
  • per oral corticosteroid use
  • use of antiresorptive therapy, including systemic hormone replacement therapy, bisphosphonates, strontium ran elate
Show all 9Show fewer
  • use of teriparatide (current or during the last 3 years)
  • participation in other clinical interventional trials
  • use of antibiotics within 2 months preceding the inclusion

Trial locations and contacts

1 site in 1 country.

Sweden1 site
  • Geriatric Medicine, Mölndal Hospital

    Mölndal, Västra Götaland County, 43180

Other trials in Sweden

About this study

Lactobacillus reuteri (L. reuteri) has been widely studied in clinical trials and has probiotic, health-promoting effects in both adults and children, and is safe for human consumption. Animal models indicate that treatment with L. reuteri has positive effects on bone metabolism and bone density. In other animal models of diabetes and the metabolic syndrome, positive effects on blood glucose and weight have been reported. The present double-blind, placebo-controlled, randomized study is designed to investigate if dietary supplementation with L. reuteri twice daily for 12 months has any effect on bone density, body composition, inflammation, or metabolic and endocrine markers in elderly women with osteopenia.

Read the detailed description

The role of the gut microbes for human health has gained considerable interest in recent years. Lactobacillus reuteri (L.reuteri) is a naturally occurring bacterial species in the human gut. L. reuteri has been widely studied in clinical trials of adults and children and treatment with L. reuteri is safe and is associated with health-promoting effects in humans. In animal models, L. reuteri has anti-inflammatory effects and in ovariectomized mice supplementation with L. reuteri partly prevented the bone loss induced by estrogen deficiency. Furthermore, both bone density and bone formation increased in male mice in another mice model. In mice with medically induced diabetes mellitus, L. reuteri reduced blood glucose and in a mouse model mimicking the metabolic syndrome, L. reuteri prevented diet-induced obesity. The present study is a double-blind, placebo-controlled, randomized, study in 90 elderly women with osteopenia recruited from the population. These women will be treated with L. reuteri or placebo orally twice daily for 12 months. The effects on bone will be investigated with dual energy x-ray absorptiometry, high-resolution peripheral quantitative computed tomography, and bone turnover markers. Hormones and markers of inflammation and metabolism will be followed as well as changes in the gut microbiota composition.

Conditions
Osteopenia
Being tested
L. reuteri, Placebo
Keywords
Osteopenia, Lactobacillus reuteri, Volumetric bone mineral density
Medical subject headings
Bone Diseases, Metabolic

What participants receive

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

  • L. reuteriDietary supplement

    Also called Lactobacillus reuteri ATCC PTA 6475

    Dietary supplementation with L. reuteri twice daily for 12 months

  • PlaceboDietary supplement

    Dietary supplementation with placebo twice daily for 12 months

Study groups in NCT02422082
Study groupRoleWhat they receive
L. reuteriActive comparatorLactobacillus reuteri (L. reuteri) ATCC PTA 6475 at a dose of 5 000 000 000 CFU as a powder in a stick-pack, orally twice daily (morning and evening) yielding a total daily dose of 10 000 000 000 CFU per day, for 12 months.
Receives: Dietary Supplement: L. reuteri
PlaceboPlacebo comparatorPlacebo product identical to the active product (L. reuteri) in taste and appearance but without the active component, orally twice daily, for 12 months.
Receives: Dietary Supplement: Placebo

What is being measured

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

  1. Total tibia volumetric bone mineral density

    Change in percent in total tibia volumetric bone mineral density compared to placebo group after 1 year of dietary supplementation with L. reuteri

    Measured: 12 months

Secondary outcomes (33)
  1. Trabecular volumetric bone mineral density

    Change in percent in trabecular volumetric bone mineral density compared to placebo group after 1 year of dietary supplementation with L. reuteri

    Measured: 12 months

  2. Cortical volumetric bone mineral density

    Change in percent in cortical volumetric bone mineral density compared to placebo group after 1 year of dietary supplementation with L. reuteri

    Measured: 12 months

  3. Cortical thickness

    Change in percent in cortical thickness compared to placebo group after 1 year of dietary supplementation with L. reuteri

    Measured: 12 months

  4. Cortical porosity

    Change in percent in cortical porosity compared to placebo group after 1 year of dietary supplementation with L. reuteri

    Measured: 12 months

  5. Areal bone mineral density

    Change in percent in areal bone mineral density compared to placebo group after 1 year of dietary supplementation with L. reuteri

    Measured: 12 months

  6. Bone material strength index

    Change in percent in bone material strength index compared to placebo group after 1 year of dietary supplementation with L. reuteri

    Measured: 12 months

  7. Blood pressure

    Change in percent in blood pressure compared to placebo group after 1 year of dietary supplementation with L. reuteri

    Measured: 12 months

  8. Change in gut microbiota composition

    Change in percent in gut microbiota composition compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  9. Ultrasensitive C-reactive protein

    Change in percent in ultrasensitive C-reactive protein in serum compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  10. Interleukin-10

    Change in percent in interleukin-10 in serum compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  11. Interleukin-17

    Change in percent in interleukin-17 in serum compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  12. Tumor-necrosis factor-alpha

    Change in percent in tumor-necrosis factor-alpha in serum compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  13. Tartrate-resistent alkaline phosphatase 5b

    Change in percent in tartrate-resistent alkaline phosphatase 5b in serum compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  14. Cross-linked N-terminal telopeptide

    Change in percent in cross-linked N-terminal telopeptide in serum compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  15. Bone-specific alkaline phosphatase

    Change in percent in bone-specific alkaline phosphatase in serum compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  16. Receptor activator of nuclear factor kappa B (RANK)

    Change in percent in RANK in serum compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  17. Receptor activator of nuclear factor kappa B ligand (RANK-ligand)

    Change in percent in RANK-ligand in serum compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  18. Osteocalcin

    Change in percent in osteocalcin in serum compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  19. Blood glucose

    Change in percent in blood glucose compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  20. Haemoglobin A1C

    Change in percent in haemoglobin A1C compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  21. Apolipoprotein A1 (ApoA1)

    Change in percent in ApoA1 compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  22. Apolipoprotein B (ApoB)

    Change in percent in ApoB compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  23. Cholesterol

    Change in percent in cholesterol compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  24. High density lipoprotein (HDL)

    Change in percent in HDL compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  25. Low density lipoprotein (LDL)

    Change in percent in LDL compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  26. Triglycerides

    Change in percent in triglycerides compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  27. Oxytocin

    Change in percent in oxytocin in serum compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  28. Estradiol

    Change in percent in estradiol in serum compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  29. Leptin

    Change in percent in leptin in serum compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  30. Adiponectin

    Change in percent in adiponectin in serum compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  31. Testosterone

    Change in percent in testosterone in serum compared to placebo after 3, 6, 9, and 12 months of dietary supplementation with L. reuteri

    Measured: 3-12 months

  32. Lean mass

    Change in percent in lean mass compared to placebo after 12 months of dietary supplementation with L. reuteri

    Measured: 12 months

  33. Fat mass

    Change in percent in fat mass compared to placebo after 12 months of dietary supplementation with L. reuteri

    Measured: 12 months

Timeline

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

  1. First posted21 Apr 2015 (estimated)
  2. Study start8 May 2015
  3. Primary completion15 Sep 2017
  4. Study completion1 Dec 2017

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
90 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02422082
Sponsor's protocol ID
LRvBMD
Status last verified
Apr 2018
First submitted
10 Apr 2015
Last updated
18 Apr 2018
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Adams MR, Marteau P. On the safety of lactic acid bacteria from food. Int J Food Microbiol. 1995 Oct;27(2-3):263-4. doi: 10.1016/0168-1605(95)00067-t. No abstract available.

    PubMed 8579995
  • Reid G, Kim SO, Kohler GA. Selecting, testing and understanding probiotic microorganisms. FEMS Immunol Med Microbiol. 2006 Mar;46(2):149-57. doi: 10.1111/j.1574-695X.2005.00026.x.

    PubMed 16487295
  • Britton RA, Irwin R, Quach D, Schaefer L, Zhang J, Lee T, Parameswaran N, McCabe LR. Probiotic L. reuteri treatment prevents bone loss in a menopausal ovariectomized mouse model. J Cell Physiol. 2014 Nov;229(11):1822-30. doi: 10.1002/jcp.24636.

    PubMed 24677054
  • McCabe LR, Irwin R, Schaefer L, Britton RA. Probiotic use decreases intestinal inflammation and increases bone density in healthy male but not female mice. J Cell Physiol. 2013 Aug;228(8):1793-8. doi: 10.1002/jcp.24340.

    PubMed 23389860
  • Fak F, Backhed F. Lactobacillus reuteri prevents diet-induced obesity, but not atherosclerosis, in a strain dependent fashion in Apoe-/- mice. PLoS One. 2012;7(10):e46837. doi: 10.1371/journal.pone.0046837. Epub 2012 Oct 9.

    PubMed 23056479

Questions about this trial

What is this clinical trial studying?

A study testing L. reuteri in people with Osteopenia, run by Sahlgrenska University Hospital at 1 site in Sweden.

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 4 inclusion and 9 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: finished, as of the sponsor's last update on 18 Apr 2018. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Total tibia volumetric bone mineral density (time frame: 12 months). 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 NCT02422082, which also lists 5 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 18 Apr 2018.

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