The Gastrointestinal Microbiome of Infants With GERD and PPI Therapy: a Pilot Study

NCT ID: NCT02359604

Last Updated: 2017-02-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

12 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-10-31

Study Completion Date

2017-02-07

Brief Summary

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Proton Pump Inhibitors (PPI) are standard in the therapy of pediatric GERD. In the past it has been hypothesized, that either direct inhibition of bacterial ATPase or elevation of the pH may lead to changes in the intestinal microbiome. Small series published in adults suggest a predominance of streptococci, a possible reason for increased incidences of pneumonia under PPI therapy. Studies in children are yet scarce.

This study will include 20 infants. GERD will be verified by 24h-intraluminal impedance monitoring. All patients will have undergone conservative measures prior to initiation of PPI therapy (due to persisting symptoms). Children will receive a commercial PPI for 8 weeks (esomeprazole 1mg/kg/day). Stool samples will be collected before initiation of PPI, under PPI (4 weeks after initiation) and 8 weeks after discontinuing PPI therapy. The intestinal microbiome will be determined by 16S rDNA-based microbial community profiling by high-throughput pyrosequencing.

Data will be compared by dependent non parametric test (Wilcoxon). P-values \<0.05 will be considered statistically significant.

Detailed Description

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Conditions

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Gastroesophageal Reflux

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Longitudinal study
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Single Arm Study -microbiome

This is a single-arm study. The patients will serve as their own controls. The PPI administered for PPI-therapy is already FDA approved. A stool sample will be obtained for intestinal microbiome testing before PPI, under PPI and after PPI therapy.

Group Type OTHER

PPI therapy

Intervention Type DRUG

PPI therapy (medication has FDA approval) for 8 weeks in children with proven GERD.

The medication used (esomeprazole) in this trial is approved by the FDA

Stool sample

Intervention Type PROCEDURE

Stool sample will be obtained before initiation of PPI (before PPI therapy)

Stool sample

Intervention Type PROCEDURE

Stool sample will be obtained 4 weeks after initiation of PPI (under PPI therapy)

Stool sample

Intervention Type PROCEDURE

Stool sample will be obtained 8 weeks after termination of PPI therapy (after PPI therapy).

Interventions

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PPI therapy

PPI therapy (medication has FDA approval) for 8 weeks in children with proven GERD.

The medication used (esomeprazole) in this trial is approved by the FDA

Intervention Type DRUG

Stool sample

Stool sample will be obtained before initiation of PPI (before PPI therapy)

Intervention Type PROCEDURE

Stool sample

Stool sample will be obtained 4 weeks after initiation of PPI (under PPI therapy)

Intervention Type PROCEDURE

Stool sample

Stool sample will be obtained 8 weeks after termination of PPI therapy (after PPI therapy).

Intervention Type PROCEDURE

Other Intervention Names

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esomeprazole

Eligibility Criteria

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Inclusion Criteria

symptomatic GERD (proved by impedance monitoring) despite conservative treatment requiring PPI therapy

Exclusion Criteria

neurological impairments
Minimum Eligible Age

3 Months

Maximum Eligible Age

1 Year

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University of Graz

OTHER

Sponsor Role lead

Responsible Party

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Castellani Christoph, MD

PD Dr. med.

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Christoph Castellani, MD

Role: PRINCIPAL_INVESTIGATOR

Dept. of Pediatric and Adolescent Surgery, Medical University Graz

Locations

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Department of Pediatric and Adolescent Surgery, Medical University of Graz

Graz, Styria, Austria

Site Status

Countries

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Austria

References

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Castellani C, Singer G, Kashofer K, Huber-Zeyringer A, Flucher C, Kaiser M, Till H. The Influence of Proton Pump Inhibitors on the Fecal Microbiome of Infants with Gastroesophageal Reflux-A Prospective Longitudinal Interventional Study. Front Cell Infect Microbiol. 2017 Oct 11;7:444. doi: 10.3389/fcimb.2017.00444. eCollection 2017.

Reference Type DERIVED
PMID: 29075620 (View on PubMed)

Other Identifiers

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MUG-KCH-1

Identifier Type: -

Identifier Source: org_study_id

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