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IBS - Irritable Bowel SyndromePROBE2NCT03449628

L. Casei DG® in Patients With Irritable Bowel Syndrome.

A study testing L.casei DG in people with IBS - Irritable Bowel Syndrome, run by SOFAR S.p.A. at 20 sites in Italy.

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

To assess the effect of L. casei DG® (Lactobacillus paracasei CNCMI1572; Enterolactis® plus) on abdominal symptoms and gut microbiota metabolism/composition in non constipated patients with IBS (Irritable Bowel Syndrome). Patients will be randomized to receive L. casei DG® capsules, b.i.d. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
IBS - Irritable Bowel Syndrome
What is being tested?
L.casei DG
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
264 participants
Where
20 sitesItaly
Study dates
6 Nov 2017to 30 Dec 2021
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 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age > 18 years and ≤ 65 years
  • A positive diagnosis of non constipated IBS (i.e., IBS-D and IBS-M, both males and females), according to Rome IV criteria.
  • A negative outcome of colonoscopy performed within 5 years before screening if patient is at least 50 years old, or if patient meet any of the following alarm features:
  • Has a documented weight loss within the past 6 months; or
  • Has nocturnal symptoms; or
  • Has a familiar history of colon cancer; or
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  • Has blood mixed with their stool (excluding blood from hemorroids).
  • Negative relevant additional screening or consultation whenever appropriate
  • Ability to conform to the study protocol.

Who cannot join

  • Patients with IBS-C or IBS-U according to Rome IV criteria
  • Presence of any relevant organic, systemic or metabolic disease (particularly significant history of cardiac, renal, neurological, psychiatric, oncology, endocrinology, metabolic or hepatic disease), or abnormal laboratory values that will be deemed clinically significant on the basis of predefined values, (i.e..liver or kidney functional levels 2-times greater than the upper reference values)
  • Ascertained intestinal organic diseases, including celiac disease, food allergies or inflammatory bowel diseases (Crohn's disease, ulcerative colitis, diverticular disease, infectious colitis, ischemic colitis, microscopic colitis).
  • Previous major abdominal surgery.
  • Active malignancy of any type, or history of a malignancy (patients with a history of other malignancies that have been surgically removed and who have no evidence of recurrence for at least five years before study enrolment are also acceptable).
  • Untreated food intolerance such as ascertained or suspected lactose intolerance, as defined by anamnestic evaluation or, if appropriate, lactose breath test.
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  • Use of probiotics or topical and/or systemic antibiotic therapy during the last month.
  • Systematic/frequent use of contact laxatives.
  • Pregnant females or females of childbearing potential in the absence of effective contraceptive methods.
  • Inability to conform to protocol.
  • Treatment with any investigational drug within the previous 30 days.
  • Recent history or suspicion of alcohol abuse or drug addiction.
  • Presence of red or white flags at the Rome IV Psychosocial Alarm Questionnaire for Functional gastrointestinal Disorders.

Trial locations and contacts

20 sites in 1 country.

20 sites in 1 country

Italy20 sites
  • Gastroenterologia Universitaria Policlinico Giovanni XXIII

    Bari

  • Azienda ULSS 1

    Belluno

  • Azienda Ospedaliero-Universitaria S. Orsola Malpighi

    Bologna, 40100

  • A.O. "G. Brotzu"- Ospedale San Michele

    Cagliari, CA

  • AOU di Cagliari - Policlinico di Monserrato

    Cagliari, CA

  • Ospedale SS. Annunziata

    Chieti

  • Ospedale Valduce

    Como, CO

  • ASST-FTB-Sacco

    Milan, MI

  • Fondazione IRCCS Policlinico

    Milan

  • Policlinico

    Naples, 80100

  • Policlinico Federico II

    Naples

  • Azienda Ospedaliera di Padova

    Padova

  • Fondazione IRCCS Policlinico S. Matteo

    Pavia

  • U.O. Gastroenterologia Universitaria

    Pisa

  • Policlinico Universitario Campus Biomedico

    Roma, 00128

  • A.O. San Camillo-Forlanini

    Roma

  • Ospedale Sant'Andrea

    Roma

  • Policlinico San Donato

    San Donato Milanese, MI

  • A.O. Bolognini

    Seriate, BG

  • Ospedale Sant'Andrea

    Vercelli, VC

Other trials in Italy

About this study

Official title: L. Casei DG® (Lactobacillus Paracasei CNCMI1572) in the Treatment of Patients With Irritable Bowel Syndrome: a Multicenter, Randomized, Double-Blind, Parallel-Group, Placebo Controlled Study.

To assess the effect of L. casei DG® (Lactobacillus paracasei CNCMI1572; Enterolactis® plus) on abdominal symptoms and gut microbiota metabolism/composition in non constipated patients with IBS (Irritable Bowel Syndrome). Patients will be randomized to receive L. casei DG® capsules, b.i.d. for 12 weeks the a 4 weeks Follow Up period will follow.

Being tested
L.casei DG, PLACEBO
Medical subject headings
Irritable Bowel Syndrome

What participants receive

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

  • L.casei DGDietary supplement

    (At least 24 billion live cells per capsule)

    1 capsule, b.i.d. for 12 weeks

  • PLACEBODietary supplement

    1 capsule, b.i.d. for 12 weeks

Study groups in NCT03449628
Study groupRoleWhat they receive
L. casei DG®ExperimentalInterventions: Lactobacillus paracasei CNCMI1572 (At least 24 billion live cells per capsule) 1 capsule, b.i.d. for 12 weeks
Receives: Dietary Supplement: L.casei DG
PlaceboPlacebo comparatorInterventions : capsules for oral use, indistinguishable from active product. 1 capsule, b.i.d. for 12 weeks
Receives: Dietary Supplement: PLACEBO

What is being measured

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

  1. Proportion of patients who have a response in pain

    Patients who record on ≥ 50% of the days a reduction of ≥ 30% from their average baseline score for their worst abdominal pain.The standard 11-point numeric rating scale (from 0=none to 10=worst possible pain) will be used to measure abdominal pain.

    Measured: 12 weeks

  2. Proportion of patients who have a response in stool consistencies

    Patients who record a stool-consistency score < 5 in the same days in which they record a reduction of ≥ 30% from their average baseline score for their worst abdominal pain .For abnormal defecation, stool frequency and form will be measured using the Bristol Stool Form Scale (BSFS).

    Measured: 12 weeks

Secondary outcomes (16)
  1. Evaluation of Pain relief

    reduction of ≥ 30% from baseline in the score for the worst abdominal pain on ≥ 50% of days

    Measured: 16 weeks

  2. Evaluation of global symptom score

    Improvement in the global symptom score: a score of 0 or 1, or an improvement ≥ 2 over the baseline score, on ≥ 50% of days

    Measured: 16 weeks

  3. Relief of IBS symptoms

    Adequate relief of IBS symptoms on ≥ 50% of the past weeks (a response of "yes" on ≥50% of the weeks to the following question: "Over the past week, have you had adequate relief of your IBS symptoms?)"

    Measured: 16 weeks

  4. IBS-SSS score questionnaire (Severity Scoring System )

    To assess the severity of symptoms related to Irritable Bowel Syndrome, assessed at baseline and at the end of treatment after 12 weeks (it is considered clinically significant a score reduction of at least 50 points). The questionnaire is composed by five questions wich generate a maximum score of 100 each using prompted visual analogue scales, leading to a total possible score of 500.

    Measured: 16 weeks

  5. Improvement in stool consistency

    stool consistency score ≤ 5 assessed with BSFS (Bristol Stool Form Scale) BSFS evaluates stool form and consistency (score from 1=dry stool to 7=liquid stoo. The ideal stool is generally 3 or 4)

    Measured: 16 weeks

  6. Satisfaction with treatment

    Overall satisfaction with treatment assessed by VAS scale (Visual Analogue Scale)

    Measured: 16 weeks

  7. Quality of life

    Quality of life assessment by validated Short-Form 12 Items Health Survey (SF-12) on a scale of 0 to 100

    Measured: 16 weeks

  8. Intake of rescue medication

    type and frequencies of rescue medication

    Measured: 16 weeks

  9. gut microbiota composition

    Evaluation of changes in the gut microbiota composition and the relative abundance of bacterial OTUs (Operational Taxonomic Unit).

    Measured: 16 weeks

  10. Short Chain Fatty Acids (SCFA)

    Evaluation of Short Chain Fatty Acids levels in fecal samples

    Measured: 16 weeks

  11. Free Aminoacids

    Evaluation of Free aminoacids levels in fecal samples

    Measured: 16 weeks

  12. Biogenic Amines

    Evaluation of biogenic amines levels in fecal samples

    Measured: 16 weeks

  13. Gut permeability for zonulin

    evaluation of serum levels of zonulin

    Measured: 16 weeks

  14. Gut permeability for citrulline

    evaluation of serum levels of citrulline

    Measured: 16 weeks

  15. Gut permeability for PV-1 (Plasmalemma vesicle-associated) protein

    evaluation of serum levels of PV-1 (Plasmalemma vesicle-associated) protein

    Measured: 16 weeks

  16. L. casei DG® strain in the feces

    the recovery of L. casei DG® strain in the feces

    Measured: 16 weeks

Timeline

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

  1. First posted28 Feb 2018
  2. Study start6 Nov 2017
  3. Primary completion4 May 2021
  4. Study completion30 Dec 2021

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
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
264 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03449628
Sponsor's protocol ID
PSC-DS PROBE2-IBS/17
Acronym
PROBE2
Status last verified
May 2022
First submitted
7 Feb 2018
Last updated
6 May 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Mearin F, Lacy BE, Chang L, Chey WD, Lembo AJ, Simren M, Spiller R. Bowel Disorders. Gastroenterology. 2016 Feb 18:S0016-5085(16)00222-5. doi: 10.1053/j.gastro.2016.02.031. Online ahead of print.

    PubMed 27144627
  • Barbara G, Feinle-Bisset C, Ghoshal UC, Quigley EM, Santos J, Vanner S, Vergnolle N, Zoetendal EG. The Intestinal Microenvironment and Functional Gastrointestinal Disorders. Gastroenterology. 2016 Feb 18:S0016-5085(16)00219-5. doi: 10.1053/j.gastro.2016.02.028. Online ahead of print.

    PubMed 27144620
  • Spiller R, Garsed K. Postinfectious irritable bowel syndrome. Gastroenterology. 2009 May;136(6):1979-88. doi: 10.1053/j.gastro.2009.02.074. Epub 2009 May 7.

    PubMed 19457422
  • Schoepfer AM, Schaffer T, Seibold-Schmid B, Muller S, Seibold F. Antibodies to flagellin indicate reactivity to bacterial antigens in IBS patients. Neurogastroenterol Motil. 2008 Oct;20(10):1110-8. doi: 10.1111/j.1365-2982.2008.01166.x. Epub 2008 Aug 6.

    PubMed 18694443
  • Langhorst J, Junge A, Rueffer A, Wehkamp J, Foell D, Michalsen A, Musial F, Dobos GJ. Elevated human beta-defensin-2 levels indicate an activation of the innate immune system in patients with irritable bowel syndrome. Am J Gastroenterol. 2009 Feb;104(2):404-10. doi: 10.1038/ajg.2008.86. Epub 2009 Jan 20.

    PubMed 19174795
  • Pimentel M, Morales W, Rezaie A, Marsh E, Lembo A, Mirocha J, Leffler DA, Marsh Z, Weitsman S, Chua KS, Barlow GM, Bortey E, Forbes W, Yu A, Chang C. Development and validation of a biomarker for diarrhea-predominant irritable bowel syndrome in human subjects. PLoS One. 2015 May 13;10(5):e0126438. doi: 10.1371/journal.pone.0126438. eCollection 2015.

    PubMed 25970536
  • Rajilic-Stojanovic M, Biagi E, Heilig HG, Kajander K, Kekkonen RA, Tims S, de Vos WM. Global and deep molecular analysis of microbiota signatures in fecal samples from patients with irritable bowel syndrome. Gastroenterology. 2011 Nov;141(5):1792-801. doi: 10.1053/j.gastro.2011.07.043. Epub 2011 Aug 5.

    PubMed 21820992
  • Jalanka-Tuovinen J, Salojarvi J, Salonen A, Immonen O, Garsed K, Kelly FM, Zaitoun A, Palva A, Spiller RC, de Vos WM. Faecal microbiota composition and host-microbe cross-talk following gastroenteritis and in postinfectious irritable bowel syndrome. Gut. 2014 Nov;63(11):1737-45. doi: 10.1136/gutjnl-2013-305994. Epub 2013 Dec 5.

    PubMed 24310267
  • Simren M, Barbara G, Flint HJ, Spiegel BM, Spiller RC, Vanner S, Verdu EF, Whorwell PJ, Zoetendal EG; Rome Foundation Committee. Intestinal microbiota in functional bowel disorders: a Rome foundation report. Gut. 2013 Jan;62(1):159-76. doi: 10.1136/gutjnl-2012-302167. Epub 2012 Jun 22.

    PubMed 22730468
  • Moayyedi P, Ford AC, Talley NJ, Cremonini F, Foxx-Orenstein AE, Brandt LJ, Quigley EM. The efficacy of probiotics in the treatment of irritable bowel syndrome: a systematic review. Gut. 2010 Mar;59(3):325-32. doi: 10.1136/gut.2008.167270. Epub 2008 Dec 17.

    PubMed 19091823

Questions about this trial

What is this clinical trial studying?

A study testing L.casei DG in people with IBS - Irritable Bowel Syndrome, run by SOFAR S.p.A. at 20 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 9 inclusion and 13 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 6 May 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 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?

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?

Proportion of patients who have a response in pain (time frame: 12 weeks). The study lists 2 primary outcomes in all. 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 NCT03449628, which also lists 10 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 6 May 2022.

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