Exploring Treatments for Children's Abdominal Pain: Comparing Trimebutine and Probiotics

NCT ID: NCT06268964

Last Updated: 2024-08-16

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

RECRUITING

Clinical Phase

PHASE1/PHASE2

Total Enrollment

82 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-01

Study Completion Date

2025-06-30

Brief Summary

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The goal of this clinical trial is to test the effectiveness of trimebutine and probiotics in treating Functional Abdominal Pain Disorders (FAPD) in a pediatric population. The main questions it aims to answer are: Is trimebutine effective in reducing the symptoms of FAPD in children? Are probiotics effective in reducing the symptoms of FAPD in children? Participants will be randomly assigned to one of three treatment groups (trimebutine/probiotics, probiotics/placebo, or trimebutine/placebo). Undergo measurements for pain and other relevant metrics at the start of the study, after 4 weeks, and after 8 weeks.

Researchers will compare the trimebutine/probiotics group to the probiotics/placebo and the trimebutine/placebo groups to see if there are significant differences in the efficacy of these treatments in reducing symptoms of FAPD in children.

Detailed Description

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The protocol will be submitted for review by the Research Committee and the Ethics Committee of the Regional University Hospital of Colima. Upon receiving approval, a double-blind, placebo-controlled, randomized clinical trial will be carried out, based on CONSORT guidelines. This trial involves the participation of pediatric patients aged 4 to 18.

Patients will be selected from those attending private practice and satisfying Rome IV criteria for any of the Functional Abdominal Pain Disorders (FAPD). Before any intervention takes place, the purpose and procedures of the study will be explained to both the patients and their legal guardians. If they decide to participate, they will be asked to sign an informed consent letter and assent form for minors. Patients will be selected through stratified probabilistic sampling in 4 categories (Irritable Bowel Syndrome, Functional Dyspepsia, Abdominal Migraine, and Functional Abdominal Pain not otherwise specified (FAP-NOS)) until the desired sample size of 82 participants is reached. Once participants are selected, they will be randomly assigned to one of the three groups: trimebutine/probiotic, probiotic/placebo, or trimebutine/placebo, with each group consisting of at least 20 participants. The initial diagnosis will be carried out using the Rome IV Criteria Questionnaires for pediatric patients, and the intensity of pain will be evaluated using the Visual Analog Scale (VAS) and quality of life with PedsQL 4.0. Patients will be administered the treatment corresponding to their assigned group and will be clinically followed up at 4 and 8 weeks. During these follow-up consultations, the Rome IV Criteria Questionnaires and scales will be reapplied to assess the evolution of the patients' symptoms and their response to treatment. Any patient who requests voluntary withdrawal, those with treatment adherence less than 80%, and those participating in another study or being treated by another physician simultaneously will be removed from the study.

Statistical analysis will be carried out using international Business Machine (IBM®) Statistical Package for the Social Sciences (SPSS®) Statistics 26. Descriptive statistics with measures of central tendency will be used, presenting the results in tables and graphs. To determine whether the data follow a normal distribution, the Kolmogorov-Smirnov and Shapiro-Wilk tests will be applied. Measurements in 3 groups (trimebutine, probiotics, and control) and at 3 times (0, 4, and 8 weeks) will be analyzed. For intervening categorical variables like gender and education, the chi-square test (X2) will be used. For continuous variables like age and BMI, the Mann-Whitney U test will be applied, expecting statistically significant differences with p \< 0.05.

If the data follow a normal distribution, repeated measures ANOVA will be used to compare the means of the 3 groups (trimebutine, probiotics, and placebo). McNemar's test or the sign test will be considered as secondary analyses to evaluate changes within each group over time (0, 4, and 8 weeks). If the data do not follow a normal distribution, non-parametric tests like the Friedman test will be employed.

In case of finding a statistically significant difference in repeated measures ANOVA or the Friedman test, post hoc tests will be performed to identify specific differences between groups and times. If necessary, correlation tests like Pearson or Spearman will be used to evaluate relationships between different variables within the study.

Conditions

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Functional Abdominal Pain Syndrome Functional Gastrointestinal Disorders Irritable Bowel Syndrome Variant of Childhood

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Trimebutine + Probiotic

Participants received trimebutine in 200 mg tablets or 20 mg/ml suspension at a dose of 15 mg/kg/day adjusted to their weight, divided into 2 doses (morning and night) + Lactobacillus rhamnosus 5 billion Colony Forming Units (CFUs) in chewable tablets, a single dose (night), for a period of 8 weeks.

Group Type EXPERIMENTAL

Trimebutine

Intervention Type DRUG

Prescription of trimebutine at pediatric dosage (15 mg/kg/day), divided into 2 daily doses, for 8 weeks.

Lactobacillus rhamnosus

Intervention Type DIETARY_SUPPLEMENT

Prescription of Lactobacillus rhamnosus 5 billion CFUs in chewable tablets, a single dose (night) for 8 weeks.

Trimebutine + Placebo

Participants received trimebutine in 200 mg tablets or 20 mg/ml suspension at a dose of 15 mg/kg/day adjusted to their weight, divided into 2 doses (morning and night) + Placebo, 250 mg microcrystalline cellulose tablets, a single dose (night), for a period of 8 weeks.

Group Type ACTIVE_COMPARATOR

Trimebutine

Intervention Type DRUG

Prescription of trimebutine at pediatric dosage (15 mg/kg/day), divided into 2 daily doses, for 8 weeks.

Placebo

Intervention Type OTHER

Prescription of a placebo, 250 mg microcrystalline cellulose tablets, a single dose (night) for 8 weeks.

Probiotic + Placebo

Participants received Lactobacillus rhamnosus 5 billion Colony Forming Units (CFUs) in chewable tablets + Placebo, 250 mg microcrystalline cellulose tablets, a single dose (night), for a period of 8 weeks.

Group Type ACTIVE_COMPARATOR

Lactobacillus rhamnosus

Intervention Type DIETARY_SUPPLEMENT

Prescription of Lactobacillus rhamnosus 5 billion CFUs in chewable tablets, a single dose (night) for 8 weeks.

Placebo

Intervention Type OTHER

Prescription of a placebo, 250 mg microcrystalline cellulose tablets, a single dose (night) for 8 weeks.

Interventions

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Trimebutine

Prescription of trimebutine at pediatric dosage (15 mg/kg/day), divided into 2 daily doses, for 8 weeks.

Intervention Type DRUG

Lactobacillus rhamnosus

Prescription of Lactobacillus rhamnosus 5 billion CFUs in chewable tablets, a single dose (night) for 8 weeks.

Intervention Type DIETARY_SUPPLEMENT

Placebo

Prescription of a placebo, 250 mg microcrystalline cellulose tablets, a single dose (night) for 8 weeks.

Intervention Type OTHER

Other Intervention Names

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Microcrystalline cellulose

Eligibility Criteria

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Inclusion Criteria

* Pediatric patients from 4 to 18 years old.
* Meeting the Rome IV criteria for any of the Functional Abdominal Pain Disorders (Functional Dyspepsia, Irritable Bowel Syndrome, Abdominal Migraine or Functional Abdominal Pain Not Otherwise Specified)
* Having the informed consent signed by the parents or legal guardians of the minor.

Exclusion Criteria

* Patients presenting abdominal pain of organic cause.
* Immunosuppressed patients.
* Patients with previous hypersensitivity to the study drug.

Elimination Criteria:

* Voluntary withdrawal from the study.
* Patients not adhering to treatment (less than 80%)
* Patients participating in another study simultaneously.
* Patients being treated by another doctor simultaneously.
Minimum Eligible Age

4 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Universidad de Colima

OTHER

Sponsor Role lead

Responsible Party

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Fabian Rojas Larios

Doctor of Science

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Pablo H Sandoval-Villaseñor, MD

Role: PRINCIPAL_INVESTIGATOR

Universidad de Colima

Fabián Rojas-Larios, PhD

Role: STUDY_DIRECTOR

Universidad de Colima

Carmen A Sánchez-Ramírez, PhD

Role: STUDY_DIRECTOR

Universidad de Colima

Locations

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School of Medicine, University of Colima

Colima, , Mexico

Site Status RECRUITING

Countries

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Mexico

Central Contacts

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Pablo H Sandoval-Villaseñor, MD

Role: CONTACT

+523123007655

Fabián Rojas-Larios, PhD

Role: CONTACT

+523121206804

Facility Contacts

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Pablo H Sandoval-Villaseñor, MD

Role: primary

+523123007655

Fabián Rojas-Larios, PhD

Role: backup

References

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Provided Documents

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Document Type: Study Protocol, Statistical Analysis Plan, and Informed Consent Form

View Document

Other Identifiers

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2023-5

Identifier Type: -

Identifier Source: org_study_id

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