Prebiotic vs Probiotic in Multiple Sclerosis

NCT ID: NCT04038541

Last Updated: 2024-05-22

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

37 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-03-11

Study Completion Date

2023-12-30

Brief Summary

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This is a randomized crossover-designed study to explore the immunologic effects of Prebiotics, as opposed to direct supplementation with beneficial bacteria (Probiotics) in the immune system of patients with MS and Clinically Isolated Syndrome (CIS). Eligible patients will take 6 weeks of two different supplements - Prebiotics and Probiotics. Participants will be randomly assigned to take either of two agents for 6 weeks as their first supplement. Then, participants enter a 6-week washout period. After the washout period, participants will take the second supplement for 6 weeks. After taking the second supplement, participants will have a 6-week washout period.

Detailed Description

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Soluble fibers (prebiotics) are fermented by beneficial bacteria (probiotics) in the colon to produce short-chain fatty acids (SCFAs) which are the main source of nutrition for the cells in the gut. It has been reported that the fermentable fiber inulin and SCFAs may exert some beneficial effects including anti-inflammatory effect on the immune system. To date, the effect of supplementation with fermentable dietary fiber, such as prebiotics in patients with Multiple Sclerosis (MS) has not been investigated.

Conditions

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Multiple Sclerosis Clinically Isolated Syndrome (CIS)

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

This is a randomized, interventional trial with a crossover design, in which participants will be taking either probiotic (commercially available Visbiome) or prebiotic (prebiotin prebiotic) for 6 weeks as the first agent. Then, participants enter a 6-week washout period. After the washout period, participants take the second agent for 6 weeks. After taking the second agent, participants again have a 6-week wash-out period.
Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Prebiotic/ Probiotic

These subjects will be assigned to first receive prebiotics (Prebiotin Prebiotic Fiber Stick Pac) for 6 weeks. Then after a 6 week wash-out period, subjects will take probiotics (Visbiome®) for 6 weeks (followed again by a 6 week washout period).

Group Type OTHER

Prebiotics (Prebiotin Prebiotic Fiber Stick Pac)

Intervention Type DIETARY_SUPPLEMENT

Commercially available Prebiotin Prebiotic.

2 packets (Inulin 4000 mg), Twice Daily (Total of 16 g Daily)

Probiotics (Visbiome®)

Intervention Type DIETARY_SUPPLEMENT

Commercially available Probiotics Visbiome extra strength, which is a combination of live lactic acid bacteria probiotics that have been cultivated, freeze-dried and mixed in very high concentrations.

2 packets (450 billion CFU), Twice Daily (Total of 3,600 billion Daily)

Probiotic/ Prebiotic

These subjects will be assigned to first receive probiotics (Visbiome®) for 6 weeks. Then after a 6 week wash-out period, subjects will take (Prebiotin Prebiotic Fiber Stick) for 6 weeks (followed again by a 6 week washout period).

Group Type OTHER

Prebiotics (Prebiotin Prebiotic Fiber Stick Pac)

Intervention Type DIETARY_SUPPLEMENT

Commercially available Prebiotin Prebiotic.

2 packets (Inulin 4000 mg), Twice Daily (Total of 16 g Daily)

Probiotics (Visbiome®)

Intervention Type DIETARY_SUPPLEMENT

Commercially available Probiotics Visbiome extra strength, which is a combination of live lactic acid bacteria probiotics that have been cultivated, freeze-dried and mixed in very high concentrations.

2 packets (450 billion CFU), Twice Daily (Total of 3,600 billion Daily)

Interventions

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Prebiotics (Prebiotin Prebiotic Fiber Stick Pac)

Commercially available Prebiotin Prebiotic.

2 packets (Inulin 4000 mg), Twice Daily (Total of 16 g Daily)

Intervention Type DIETARY_SUPPLEMENT

Probiotics (Visbiome®)

Commercially available Probiotics Visbiome extra strength, which is a combination of live lactic acid bacteria probiotics that have been cultivated, freeze-dried and mixed in very high concentrations.

2 packets (450 billion CFU), Twice Daily (Total of 3,600 billion Daily)

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Adult patients (age 18 or older) diagnosed with MS (Relapsing-remitting type) or CIS and recruited within 10 years of symptom onset, and
* Adult patients receiving anti-CD20 therapy (rituximab or ocrelizumab) who have received at least one cycle at the time of recruitment

Exclusion Criteria

* Active relapse within 3 months of enrollment
* Steroid use within 4 weeks of enrollment
* Antibiotics use within 3 months of enrollment
* Daily pre or prebiotic use within 3 months of enrollment
* Diagnosed with any of the autoimmune disorders: Rheumatoid Arthritis, Lupus, Celiac disease, Vitiligo, Psoriasis, Psoriatic Arthritis, Hashimoto's Thyroiditis, Graves' Disease, Sjogren's syndrome, Type 1 Diabetes, Scleroderma, Crohn's Disease, Ulcerative Colitis, Alopecia Areata.
* Had surgery of the GI tract in the last 5 years (with the exception of cholecystectomy and appendectomy)
* Had a major bowel resection
* Prior use of any of the following drugs: Mycophenolate/Cellcept, Cyclophosphamide/Cytoxan, Methotrexate/Novantrone, Azathioprine/Imuran, Cladribine/Leustatin/Mavenclad, Daclizumab/Zenepax, Alemtuzumab/Campath/Lemtrada
* Have any of the following active uncontrolled gastrointestinal (GI) illnesses:

1. Crohn's disease, ulcerative colitis, indeterminate colitis
2. Irritable bowel syndrome: moderate-severe
3. Persistent or chronic diarrhea of unknown etiology
4. Severe Chronic constipation or difficulties with defecation
5. Persistent, infectious gastroenteritis, colitis or gastritis
6. Clostridium difficile infection (recurrent)
7. Gastric or intestinal ulcerations/GI bleeding
8. Gastrointestinal or colonic malignancy: polyps, masses, dysplasia or cancer
* Active use of bismuth subsalicylate-containing products
* Currently pregnant
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Multiple Sclerosis Society

OTHER

Sponsor Role collaborator

Exegi Pharma

UNKNOWN

Sponsor Role collaborator

Columbia University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Rebecca Farber, MD

Role: PRINCIPAL_INVESTIGATOR

Columbia University

Zongqi Xia, MD

Role: PRINCIPAL_INVESTIGATOR

University of Pittsburgh (Collaborator Site)

Locations

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Columbia University Irving Medical Center

New York, New York, United States

Site Status

University of Pittsburg

Pittsburgh, Pennsylvania, United States

Site Status

Countries

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United States

Other Identifiers

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AAAR9614

Identifier Type: -

Identifier Source: org_study_id

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