E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Irritable Bowel Syndrome (IBS), subtypes IBS-C and IBS-D |
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E.1.1.1 | Medical condition in easily understood language |
Irritable Bowel Syndrome, which is a chronic bowel disease that can affect any part of the gastrointestinal tract |
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E.1.1.2 | Therapeutic area | Diseases [C] - Digestive System Diseases [C06] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10060849 |
E.1.2 | Term | Diarrhoea predominant irritable bowel syndrome |
E.1.2 | System Organ Class | 100000004856 |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10066868 |
E.1.2 | Term | Constipation predominant irritable bowel syndrome |
E.1.2 | System Organ Class | 100000004856 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of the trial is to assess the efficacy of repeated twice daily doses of Blautix™ >1E10 MPN for 8 weeks in adult subjects with either IBS-C or IBS-D |
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E.2.2 | Secondary objectives of the trial |
The secondary objectives of the trial is to assess the safety of repeated twice daily doses of Blautix™ >1E10MPN for 8 weeks in adult subjects with either IBS-C or IBS-D |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
All subjects must meet all of the following inclusion criteria:
1. Written consent on an Institutional Review Board (IRB)/ Independent Ethics Committee (IEC) approved ICF before any study specific evaluation
2. Males and Females between 18 and 70 years of age
3. Body Mass Index (BMI): 18-39 kg/m2
4. Having IBS-C or IBS-D as defined by Rome IV including Subtype Classification:
Recurrent abdominal pain on average, at least 1 day/week in the last 3 months associated with two or more of the following criteria:
• Related to defecation
• Associated with a change in frequency of stool
• Associated with a change in form (appearance) of stool
The above criteria must be met for the last 3 months with symptom onset at least 6 months prior to diagnosis.
5. Have a moderate or severe IBS symptom severity score ; ≥175 at the screening visit as defined by IBS-SSS. A tolerance of -10% (≥ an IBS-SSS score of 157.5) will be allowable at the Baseline (Visit 1). |
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E.4 | Principal exclusion criteria |
Any of the following criteria will exclude the Subject from study participation:
1. Males or females <18 and >70 years of age
2. Have an IBS symptom severity score < 175 as defined by IBS-SSS
3. BMI: <18 or >39 kg/m2
4. Have a significant acute or chronic coexisting illness (cardiovascular, gastrointestinal, endocrine, immunological, metabolic or any condition which contraindicates, in the investigators' judgment, entry to the study)
5. Confirmed clinical diagnosis of bile acid malabsorption and / or on medication for bile acid malabsorption
6. Individuals who, in the opinion of the investigator, are poor attendees or unlikely for any reason to be able to comply with the study requirements
7. Patient is currently enrolled in or has not yet completed at least 30 days since ending other investigational device or drug study(s), or patient is receiving other investigational agent(s)
8. Have an active or recent (within 3 years) malignant disease or any concomitant end-stage organ disease. A non-melanoma skin cancer that has been adequately treated with no recurrence within 3 months of screening is not excluded.
9. Females who are pregnant or breast feeding
10. Refusal to use acceptable methods of birth control (true abstinence, sterilisation, birth control pills, injections or contraceptive implants) for women of child bearing potential while on treatment and following completion of 2 menstrual cycles/ months after the last dose of study treatment. For Males, a barrier method of birth control from randomisation until the Follow-Up visit, unless vasectomised
11. Use of antibiotics within 30 days of screening
12. Use of systemic steroids within 30 days of screening
13. Change in dose or introduction of an antipsychotic within the last month
14. Have suffered from an uncontrolled or current major psychiatric disorder
15. Clinically diagnosed Lactose intolerance
16. Clinically diagnosed Coeliac disease
17. Change of diet e.g. FODMAP, gluten-free within last 3 months
18. Those > 50 will be excluded if their diagnosis of IBS is recent (<12 months) and if they have not had a sigmoidoscopy or colonoscopy within previous 5 years.
19. Any GI related abdominal surgery other than hernia repair or appendectomy. Cholecystectomy more than 6 months previously is not an exclusion
20. Subjects taking prucalopride
21. Known HIV infection, or hepatitis A, B, or C active infection
22. Subjects with abnormal laboratory values at screening deemed by the investigator to be clinically significant
23. Subjects who have taken commercially available probiotics within the last month (30 days prior to randomisation)
24. Subjects with known or suspected hereditary fructose intolerance, glucose-galactose malabsorption or sucrase-isomaltase insufficiency
25. Subjects taking guanylate cyclase agonists; such as linaclotide and lubiprostone |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy endpoint is whether the subject is an overall responder.
A subject is an 'overall responder' if they have reported an improvement in their weekly (Cohort specific) symptoms (abdominal pain intensity and stool frequency or consistency) for > 50% of the treatment period (in this case 4 out of 8 weeks). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
On-going throughout the 8 week duration of the study |
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E.5.2 | Secondary end point(s) |
Secondary Efficacy Endpoints:
- Subject global assessment of relief
- Stool consistency /Stool frequency
- IBS-QOL
- IBS-SSS
- HADS
Exploratory Endpoints
- Microbiota diversity and stability
- Metabolomics
- Cytokine analysis
Safety Endpoints
- Incidence, nature, severity, relatedness, seriousness, expectedness and outcome of adverse events
- Haematology and blood chemistry assessments
- Vital signs |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
On-going throughout the 8 week duration of the study |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 2 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Ireland |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |