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Irritable Bowel SyndromeNCT05064930

The Efficacy of Single-strain Probiotics in Patients With Irritable Bowel Syndrome

A study testing Probiotic Bifidobacterium lactis and Probiotic Bacillus coagulans in people with Irritable Bowel Syndrome, run by Nordic Biotic Sp. z o.o. at 1 site in Poland.

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

Irritable bowel syndrome (IBS) is one of the most common, yet still not fully understood, gastrointestinal disorders in adults. One suspected etiology involves intestinal dysbiosis, i.e. both quantitative and qualitative alterations in intestinal microbiota composition, which affects the gut-brain axis. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Irritable Bowel Syndrome
What is being tested?
Probiotic Bifidobacterium lactis and Probiotic Bacillus coagulans
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
120 participants
Where
1 sitePoland
Study dates
1 Sep 2021to 31 Jul 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 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Caucasian males and females;
  • Age from 18 to 70 years, inclusive;
  • Good physical and mental condition assessed based on the patient's history and physical examination;
  • Laboratory test results (blood tests, including blood chemistry and antibody tests; and urinalysis) within the normal limits for the local laboratory or considered clinically insignificant by the study investigator;
  • A voluntarily provided written informed consent;
  • Being available throughout the duration of the study;
  • Patients with IBS diagnosed based on the Rome IV criteria;
  • Patients with any form of IBS of at least moderate severity assessed via the IBS-SSS (score >175).

Who cannot join

  • Cardiovascular disorders: uncontrolled hypertension (blood pressure > 170/100 mmHg), cerebrovascular disease;
  • Severe respiratory disorders (asthma, chronic obstructive pulmonary disease)
  • Liver or kidney disease and unexplained blood chemistry abnormalities: serum creatinine of more than twice the upper limit of normal, serum aminotransferease (AST or ALT) levels more than twice the upper limit of normal;
  • Gastrointestinal disorders other than IBS (including gastroenteritis, celiac disease, and bacterial infections or parasitic infestations confirmed either clinically or endoscopically);
  • Endocrine disorders, including diabetes (fasting blood glucose > 11 mmol/L) and serum thyroid stimulating hormone (TSH) levels above normal;
  • Severe neurological conditions, with psychosis;
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  • Malignancy;
  • Pregnancy or breastfeeding;
  • Hypersensitivity to soy;
  • Lactose intolerance that may explain the symptoms (i.e. the symptoms resolve or considerably subside in response to a lactose-free diet);
  • The use of gastrointestinal motility stimulants or dietary fiber supplements during the 2 weeks preceding the clinical study;
  • The use of antithrombotic agents;
  • A surgical procedure scheduled during the course of the clinical study;
  • Current probiotic use and refusal to undergo a 3-month washout period;
  • Antibiotic therapy within the previous 3 months;
  • The patients who receive antibiotics during the study will be excluded;
  • Being included in another clinical study within the previous 3 months;
  • History of alcohol or substance abuse.

Trial locations and contacts

1 site in 1 country.

Poland1 site
  • Medical University of Lublin

    Lublin

Other trials in Poland

About this study

Official title: Assessment of the Efficacy of Single-strain Probiotics in Patients With Irritable Bowel Syndrome - a Randomized Double-blind Placebo-controlled Study

Irritable bowel syndrome (IBS) is one of the most common, yet still not fully understood, gastrointestinal disorders in adults. One suspected etiology involves intestinal dysbiosis, i.e. both quantitative and qualitative alterations in intestinal microbiota composition, which affects the gut-brain axis. Probiotics are live microorganisms, which-administered at the right dose-are beneficial for human health; their mechanism of action involves modifying the gut microbiota. Clinical study reports document that probiotic administration is beneficial for patients with IBS. The ultimate clinical effects depend primarily on probiotic strain selection. Our research team evaluated a multi-strain probiotic formulation and a multi-strain synbiotic (a combination of probiotic strains with short-chain prebiotic fructooligosaccharides) formulation as part of two randomized placebo-controlled clinical trials in patients with IBS with predominant diarrhea. The results indicated a beneficial effect of these formulations on the clinical course of IBS assessed with the international IBS symptom severity scale (IBS-SSS), with each of the study formulations exhibiting efficacy in different fields. The formulation composed of a mixture of Bifidobacterium and Lactobacillus strains reduced the levels of pain and improved the quality of life, whereas the synbiotic formulation effectively improved bloating and had a beneficial effect on the general condition of the intestines. A systematic review and meta-analysis published in 2020 showed that high doses of single-strain formulations, particularly those containing Bifidobacterium or Lactobacillus strains, may be more effective in IBS patients. Other reports demonstrated a high efficacy of the new-generation probiotic Bacillus coagulans in IBS. Therefore, the main objective of this research project is to assess the efficacy of single-strain probiotics containing Bifidobacterium lactis or Bacillus coagulans in patients with IBS.

Read the detailed description

This is a randomized double-blind placebo-controlled trial included 120 adult patients, who had been diagnosed with IBS according to the Rome IV diagnostic criteria. The patients will receive orally a probiotic formulation containing Bifidobacterium lactis or Bacillus coagulans or placebo over a period of 12 weeks. Once the period of supplementation is completed, the patients will be followed-up for the subsequent 4 weeks. The patients included in the study will receive diaries, which they will complete daily. The patient's dairy will include information about the number of stools, stool consistency (assessed based on the Bristol Stool Form Scale) and IBS symptoms (abdominal pain, bloating, bowel urgency, and feeling of incomplete evacuation) rated in a 5-grade scale. The diary will also include information on any adverse events and the use of any new medications during the study. Once a week, the patients will be contacted by phone by interviewers who will collect the information recorded in the patient's diary.

During the first visit, the patients included in the study will be informed of the study procedure and educated on the phone exchanges with the interviewers. One week prior to study intervention, the patients will be asked to record their symptoms in their patient diaries every day. Subsequently, the patients will visit their study doctor every four weeks (from the beginning of the study intervention) in order to receive the next dose of the study formulation/placebo. During each study visit, the patients will be evaluated with the use of IBS-SSS and IBS Global Improvement Scale (IBS-GIS). The patients included in the study will undergo a hydrogen breath test for small intestinal bacterial overgrowth (SIBO) both prior to receiving the study formulation/placebo and 12 weeks later, after intervention is completed.

The study will last a total of 16 weeks from the moment the intervention is initiated (12 weeks of interventions and 4 weeks of follow-up).

Being tested
Probiotic Bifidobacterium lactis, Probiotic Bacillus coagulans, Placebo
Keywords
Probiotics
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.

  • Probiotic Bifidobacterium lactisDietary supplement

    The probiotic will be administered orally over a period of 12 weeks.

  • Probiotic Bacillus coagulansDietary supplement

    The probiotic will be administered orally over a period of 12 weeks.

  • PlaceboDietary supplement

    Maltodextrin as a placebo will be administered orally over a period of 12 weeks. The taste and appearance of the placebo will be similar to those of the probiotic formulation.

Study groups in NCT05064930
Study groupRoleWhat they receive
Bifidobacterium lactisActive comparatorProbiotic formula contains 5x109 Bifidobacterium lactis Nordbiotic™ BI040 colony forming units (CFU)/capsule
Receives: Dietary Supplement: Probiotic Bifidobacterium lactis
Bacillus coagulansActive comparatorProbiotic formula contains 2x109 Bacillus coagulans Nordbiotic™BC300 colony forming units (CFU)/capsule
Receives: Dietary Supplement: Probiotic Bacillus coagulans
MaltodextrinPlacebo comparatorMaltodextrin (starch hydrolisate) as a compound presents in probiotic formula.
Receives: Dietary Supplement: Placebo

What is being measured

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

  1. Changes in severity of IBS symptoms using IBS Severity Scoring System (IBS-SSS)

    IBS-SSS is a 5-question survey that asks: 1. the severity of abdominal pain, 2. frequency of abdominal pain, 3. severity of abdominal distention, 4.dissatisfaction with bowel habit, and 5. interference with quality of life over the past 10 days. Subjects respond to each question on a 100-point visual analogue scale. Each of the five question generates a maximum score of 100 point, and total scores can range from 0-500 with higher scores indicating severe symptoms. A decrease of 50 points is associated with a clinically meaningful improvement.

    Measured: From baseline at 4, 8, 12 weeks of intervention, and 4 weeks (16 weeks of the study) after intervention

  2. Improvement of IBS global symptoms using Global Improvement Scale (IBS-GIS)

    IBS-Global Improvement Scale assesses IBS symptoms using a patient-defined 7 point Likert scale ranging from symptoms substantially worse to substantially improved.

    Patients answer the question "Have you felt any change in the severity of your symptoms over the past 7 days compared to how you felt before the medicine was given?

    The answers are recorded based on the 7-point scale:

    1. = I feel that the symptoms have worsened significantly
    2. = I feel that the symptoms have moderately worsened
    3. = I feel that the symptoms have slightly worsened
    4. = I feel no change
    5. = I feel a slight improvement
    6. = I feel moderate improvement
    7. = I feel significant improvement IBS-GIS score indicates: improvement if is >4 or worsening if is<4, no change if is 4

    Measured: From baseline at 4, 8, 12 weeks of intervention, and 4 weeks (16 weeks of the study) after intervention

Secondary outcomes (5)
  1. Changes in number of stools

    The number of stools per day assessed before intervention and then 3 times a week

    Measured: From baseline for 12 weeks of intervention, and for 4 weeks after intervention

  2. Changes in severity of pain

    The severity of pain assessed before intervention and then 3 times a week using a patient-defined 5 point Likert scale: point 0 - no pain, and 1-4 the severity of pain with higher scores indicating worse pain.

    Measured: From baseline for 12 weeks of intervention, and for 4 weeks after intervention

  3. Changes in flatulence

    The severity of flatulence assessed before intervention and then 3 times a week using a patient-defined 5 point Likert scale: point 0 - no flatulence/abdominal distension, and 1-4 the severity of flatulence/abdominal distension with higher scores indicating worse pain.

    Measured: From baseline for 12 weeks of intervention, and for 4 weeks after intervention

  4. Occurrence of side effects

    Side effects will be pointed in patient's dairy and collected by phone by interviewers.

    Measured: From baseline for 12 weeks of intervention

  5. Changes in type of stools

    The type of stools analyzed before intervention and then 3 times a week. Type of stools assessed using the Bristol Stool Scale (BSS). BSS is designed to classify faeces into seven groups: type 1-2 indicate constipation, type 3-4 are "normal" stools; type 5-7 indicate diarrhea. The type of stool will be assessed with 7-point numerical scale (range 1-7).

    Measured: From baseline for 12 weeks of intervention, and for 4 weeks after intervention

Timeline

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

  1. First posted1 Oct 2021
  2. Study start1 Sep 2021
  3. Primary completion30 Jun 2022
  4. Study completion31 Jul 2022

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
120 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05064930
Sponsor's protocol ID
CT/NB/120/2020/PR-SS
Status last verified
Jul 2023
First submitted
10 Sep 2021
Last updated
7 Jul 2023
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Publications

  • Skrzydlo-Radomanska B, Prozorow-Krol B, Kurzeja-Miroslaw A, Cichoz-Lach H, Laskowska K, Majsiak E, Bierla JB, Agnieszka S, Cukrowska B. The Efficacy and Safety of Single-Strain Probiotic Formulations Containing Bifidobacterium lactis or Bacillus coagulans in Adult Patients with Irritable Bowel Syndrome-A Randomized Double-Blind Placebo-Controlled Three-Arm Interventional Trial. J Clin Med. 2023 Jul 22;12(14):4838. doi: 10.3390/jcm12144838.

    PubMed 37510953

Questions about this trial

What is this clinical trial studying?

A study testing Probiotic Bifidobacterium lactis and Probiotic Bacillus coagulans in people with Irritable Bowel Syndrome, run by Nordic Biotic Sp. z o.o. at 1 site in Poland.

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 8 inclusion and 18 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 7 Jul 2023. 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 Poland. 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?

Changes in severity of IBS symptoms using IBS Severity Scoring System (IBS-SSS) (time frame: From baseline at 4, 8, 12 weeks of intervention, and 4 weeks (16 weeks of the study) after intervention). 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 NCT05064930, 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 7 Jul 2023.

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