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Trial registered on ANZCTR
Registration number
ACTRN12617000710325
Ethics application status
Approved
Date submitted
10/05/2017
Date registered
17/05/2017
Date last updated
5/07/2021
Date data sharing statement initially provided
8/04/2019
Date results provided
8/04/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Randomised clinical trial of the probiotic BLIS M18 (Streptococcus salivarius) on the post-radiotherapy oral microbiome and periodontal health
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Scientific title
Randomised clinical trial of the probiotic BLIS M18 (Streptococcus salivarius) on the post-radiotherapy oral microbiome and periodontal health in adults with a history of head and neck cancer
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Secondary ID [1]
291907
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None
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Universal Trial Number (UTN)
U1111-1183-1833
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Head and neck cancer
303241
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Condition category
Condition code
Oral and Gastrointestinal
302652
302652
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Cancer
302665
302665
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0
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Head and neck
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
BLIS M18 (BLIS Technologies, Dunedin, New Zealand), a lozenge containing 2.5 X 10^9 cfu per lozenge (at the time of manufacture) of the bacterial oral probiotic Streptococcus salivarius.
One lozenge daily for one month.
Patients will be asked to return any unused lozenges when they attend the final appointment.
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Intervention code [1]
298031
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Treatment: Other
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Intervention code [2]
298070
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Prevention
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Comparator / control treatment
Placebo controlled study.
BLIS M18 lozenge ingredients: Isomalt, Tableting Aids, Streptococcus salivarius M18 (contains at least 2.50 billion cfu/ dose at the date of manufacture), Strawberry Flavour.
Placebo: as per BLIS M18 lozenge; Streptococcus salivarius M18 excluded
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Microbiological changes: 16S rRNA sequencing of the DNA extracted from the probiotic lozenges will be use to study changes in abundance of S. salivarius.
No samples were analysed and the change was made after recruitment was completed.
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Assessment method [1]
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Timepoint [1]
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Pre-intervention, four weeks post BLIS intervention commencement.
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Primary outcome [2]
302112
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Microbiological changes: Changes in the diversity of oral bacterial communities based on Illumina sequencing of the 16S rRNA gene
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Assessment method [2]
302112
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Timepoint [2]
302112
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Pre-intervention, four weeks post BLIS intervention commencement.
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Secondary outcome [1]
334648
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Periodontal health: will be assessed using a periodontal probe to determine Community Periodontal Index of Treatment Need (CPITN) scores
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Assessment method [1]
334648
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Timepoint [1]
334648
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Pre-intervention, four weeks post BLIS intervention commencement.
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Secondary outcome [2]
334831
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Periodontal health: Silness-Loe Plaque Index scores
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Assessment method [2]
334831
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Timepoint [2]
334831
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Pre-intervention, four weeks post BLIS intervention commencement.
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Secondary outcome [3]
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Microbiological changes: Changes in the predicted function of oral bacterial communities based on Illumina sequencing of the 16S rRNA gene
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Assessment method [3]
334910
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Timepoint [3]
334910
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Pre-intervention, four weeks post BLIS intervention commencement.
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Eligibility
Key inclusion criteria
Dentate (at least 50% of own teeth present), received radiotherapy to the head and neck region (at least 60 Gy) completed or to be completed within 7 days
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Edentulous, palliative care
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Lettered containers. Allocation will be recorded.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Block randomisation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
5/06/2017
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Actual
6/11/2017
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Date of last participant enrolment
Anticipated
30/04/2018
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Actual
31/10/2018
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Date of last data collection
Anticipated
28/05/2018
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Actual
28/11/2018
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Sample size
Target
20
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Accrual to date
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Final
17
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Recruitment outside Australia
Country [1]
8893
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New Zealand
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State/province [1]
8893
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Auckland
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Funding & Sponsors
Funding source category [1]
296414
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University
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Name [1]
296414
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The University of Auckland
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Address [1]
296414
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The University of Auckland
Private Bag 92019
Auckland 1142
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Country [1]
296414
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New Zealand
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Primary sponsor type
University
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Name
The University of Auckland
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Address
The University of Auckland
Private Bag 92019
Auckland 1142
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Country
New Zealand
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Secondary sponsor category [1]
295357
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None
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Name [1]
295357
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Address [1]
295357
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Country [1]
295357
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
297638
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Health and Disability Ethics Committees
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Ethics committee address [1]
297638
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140
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Ethics committee country [1]
297638
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New Zealand
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Date submitted for ethics approval [1]
297638
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04/08/2016
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Approval date [1]
297638
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24/08/2016
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Ethics approval number [1]
297638
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16/STH/123
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Ethics committee name [2]
297655
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ADHB Research Review Committee
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Ethics committee address [2]
297655
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Auckland DHB Research Office Level 14, Support Building Auckland City Hospital Private Bag 92024 Grafton Auckland 1023
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Ethics committee country [2]
297655
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New Zealand
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Date submitted for ethics approval [2]
297655
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09/06/2016
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Approval date [2]
297655
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10/05/2017
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Ethics approval number [2]
297655
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A+7396
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Summary
Brief summary
Radiotherapy to the head and neck region permanently damages salivary glands, resulting in a decrease in salivary flow that manifests as a dry mouth. Post-radiotherapy, head and neck cancer patients suffer long-term changes to the oral environment, including a reduction in salivary flow that results in a loss of salivary buffering capacity. Ultimately, an increase in bacterial load and alteration of the bacterial community structure potentially have negative effects on the patient’s oral health. Oral probiotics have been successfully shown to improve oral health, particularly in terms of reducing periodontal inflammation. The benefits of gut probiotics are well documented and include modulation of immune responses and metabolic effect – therefore, the potential mechanisms of oral probiotic action are hypothesised to be similar to those seen in the intestines: antagonism against pathogens and the reduction of inflammation and tissue destruction. Hence, this pilot study proposes that the provision of Streptococcus salivarius in the form of an oral probiotic (BLIS M18) post-radiotherapy treatment may favorably alter the composition of the oral microbial community, reducing periodontal inflammation and improving oral health.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Richard Douglas
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Address
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Department of Surgery (University of Auckland)
12th Floor Support Building
Auckland City Hospital
Grafton
Auckland 1142
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Country
74678
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New Zealand
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Phone
74678
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+64 9 923 1658
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Fax
74678
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Email
74678
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[email protected]
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Contact person for public queries
Name
74679
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Kim Gear
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Address
74679
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Oral Health Unit (Auckland District Health Board)
Green Lane Clinical Centre
214 Green Lane West
Epsom
Auckland 1051
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Country
74679
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New Zealand
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Phone
74679
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+64 9 630 9809
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Fax
74679
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Email
74679
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[email protected]
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Contact person for scientific queries
Name
74680
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Mike Taylor
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Address
74680
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School of Biological Sciences
University of Auckland
Private Bag 92019
Auckland 1142
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Country
74680
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New Zealand
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Phone
74680
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+64 9 923 2280
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Fax
74680
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Email
74680
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Patient demographics and individual participant clinical data collected during the trial, after de-identification.
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When will data be available (start and end dates)?
Immediately following publication. The study was published in August 2020, meaning that data was available from 6th August 2020 - indefinitely.
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Available to whom?
Published in an open access journal.
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Available for what types of analyses?
To achieve the aims in the approved proposal.
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How or where can data be obtained?
The datasets analysed during this study are available in the NCBI Sequence Read Archive (https://www.ncbi.nlm.nih.gov/sra) under Accession Number PRJNA588128.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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