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Trial registered on ANZCTR
Registration number
ACTRN12621000029897
Ethics application status
Approved
Date submitted
29/10/2020
Date registered
14/01/2021
Date last updated
14/01/2021
Date data sharing statement initially provided
14/01/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Effect of Probiotic supplementation on gut bacteria in children with autism - a pilot randomized controlled trial
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Scientific title
Effect of probiotic supplementation on composition of fecal microbiota in children with autism spectrum disorder-a pilot randomized controlled trial
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Secondary ID [1]
302631
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none
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Universal Trial Number (UTN)
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Trial acronym
PROACTIVE
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Autism spectrum disorder
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Condition category
Condition code
Mental Health
317480
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0
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Autistic spectrum disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The participants will receive 450 billion CFU of probiotics (or an equivalent volume of placebo) twice a day for one month followed by 450 billion CFU (or an equivalent volume of placebo) once a day for three months.The probiotic selected for this study is Vivomixx® Italy, with each sachet containing total 450 billion (450x10^9) lyophilized bacterial cells of eight probiotic strains: Streptococcus thermophilus DSM 24731, B. breve DSM 24732, B. longum DSM 24736, B. infantis DSM 24737), and L. acidophilus DSM 24735, L. plantarum DSM 24730, L. paracasei DSM 24733, L. delbrueckii subsp. bulgaricus DSM 24734). All strains in Vivomixx work in synergy (http://www.vivomixx.eu/en/2017/09/06/product-facts-why-so-many-different-strains/) Vivomixx® is currently being studied for various conditions in children (non-alcoholic steatohepatitis, infantile colic and ASD) and adults (HIV) , and pregnant women. It is available as water-soluble powder and administered orally. It can be dissolved directly in the mouth or mixed in a cold, but not carbonated drink.
During the study period to monitor adherence, we will check if there have been any changes in diet or medications. This will involve 2 phone calls a month apart. Any left over probiotics sachets with the parents will be asked to bring during there last visit to be returned to pharmacy.
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Intervention code [1]
318918
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Treatment: Other
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Comparator / control treatment
Participants will be given,Equivalent volume of placebo, placebo sachets will contain 4.4 g of maltose and silicon dioxide.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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composite primary outcome will be the “Compositional differences” in gut microbiome. The selected markers of ‘compositional differences’ will include alpha-diversity, richness, and abundance of particular species/pathways, or clusters based on unsupervised clustering of gut microbiome.
Fecal microbiota will be assessed using the 2 samples collected from each participant (before and after completing 4 months of study supplementation). Metagenomics studies will be performed by extracting the fecal DNA and creating an amplicon 16s rRNA library for analysis by high throughput 454 pyrosequencing to allow calculation of diversity indices and rarefaction curves
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Assessment method [1]
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Timepoint [1]
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at baseline and after 4 months of study supplementation
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Secondary outcome [1]
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Developmental outcomes: Participants will undergo developmental assessments and parenteral questionnaire
The Preschool Language Scale – 5
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Assessment method [1]
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Timepoint [1]
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at baseline and after 4 months of study supplementation
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Secondary outcome [2]
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2) Gastrointestinal outcomes: the Frequency of gastrointestinal symptoms including constipation, average stool consistency, stomach cramps, flatulence etc will be assessed by the Gastrointestinal severity index (GSI) .
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Assessment method [2]
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Timepoint [2]
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at baseline and after 4 months of study supplementation
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Secondary outcome [3]
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Fecal SCFA: Fecal acetate, propionate, and butyrate levels will be analysed using gas chromatography.
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Assessment method [3]
389479
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Timepoint [3]
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at baseline and after 4 months of study supplementation
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Secondary outcome [4]
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Developmental outcomes: Participants will undergo developmental assessments and parenteral questionnaire
Repetitive Behaviour Scale – Revised (RBS-R),
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Assessment method [4]
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Timepoint [4]
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at baseline and after four months of trial supplementation
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Secondary outcome [5]
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Developmental outcomes: Participants will undergo developmental assessments and parenteral questionnaire
The Short Sensory Profile (SSP-2),
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Assessment method [5]
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Timepoint [5]
390303
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at baseline and after 4 months of trial supplementation
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Secondary outcome [6]
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Developmental outcomes: Participants will undergo developmental assessments and parenteral questionnaire
Vineland Adaptive Behavioural Scales – 2nd edition (VABS-II),
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Assessment method [6]
390304
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Timepoint [6]
390304
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at baseline and after 4 months of trial supplementation
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Secondary outcome [7]
390305
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Developmental outcomes: Participants will undergo developmental assessments and parenteral questionnaire
Mullen’s Scale of Early Learning (MSEL)
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Assessment method [7]
390305
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Timepoint [7]
390305
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at baseline and after 4 months of trial supplementation
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Eligibility
Key inclusion criteria
(1)Children Age: 2–5 years. (2) Confirmed diagnosis of ASD based on DSM-5 criteria.
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Minimum age
2
Years
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Maximum age
5
Years
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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
(1) Major congenital anomalies (2) Epilepsy syndromes, significant sensory impairment (e.g., blindness, deafness), neonatal hypoxic ischemic encephalopathy requiring therapeutic cooling (3) Coeliac disease, inflammatory bowel disease (4) Use of probiotics for 4 weeks in the 90 days before enrolment (5) Current or recent (within 4 weeks before enrolment) exposure to antibiotics, chemotherapy or immunosuppressant agents, or laxatives. (6) Prosthetic devices including heart valves (7) Confirmed HIV, Hepatitis B, and/or Hepatitis C. (8) Known allergy to probiotics (9) Special diets(10) Cows’ milk protein allergy, food allergy, or conditions such as atopic dermatitis, or eczema.
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Study design
Purpose of the study
Treatment
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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)
Randomisation (using computer generated random numbers) will be stratified based on Mullen’s Early learning composite score as less them or equal to 85. This approach is selected because consideration of the intellectual/developmental ability is important as it reflects severity of ASD, and influences the ability for proper neurodevelopmental assessment. Allocation concealment will be optimised by using serially numbered, sealed, coded, opaque envelopes .
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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 administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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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
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/02/2021
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Actual
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Date of last participant enrolment
Anticipated
28/02/2022
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Funding & Sponsors
Funding source category [1]
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Other
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Name [1]
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Telethon Kids institute
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Address [1]
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Northern Entrance, Perth Children's Hospital, 15 Hospital Ave, Nedlands WA 6009
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Country [1]
307062
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Australia
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Primary sponsor type
Hospital
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Name
Perth children hospital, Child and Adolescent health services
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Address
15 Hospital Ave, Nedlands, WA 6009
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
307631
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Address [1]
307631
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Country [1]
307631
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
307186
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Child and Adolescent health services,Human Research Ethics Committee (HREC
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Ethics committee address [1]
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Perth children hospital, 15 Hospital avenue, Nedlands, WA Perth 6009
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Ethics committee country [1]
307186
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Australia
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Date submitted for ethics approval [1]
307186
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01/07/2019
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Approval date [1]
307186
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12/08/2020
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Ethics approval number [1]
307186
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RGS0000003318
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Summary
Brief summary
Autism is a condition with early-onset difficulties in social communication and unusually restricted, repetitive behaviors. It is being increasingly diagnosed in the last 10 years and is currently diagnosed in 1 in 59 children. Children with Autism need lifelong support for their symptoms and associated conditions. Current options for improving their behavioral issues are limited or only partially effective. Beneficial bacteria that commonly live in the gut promote health by suppressing the growth of harmful bacteria, and improving immune function of the gut. Humans have been consuming probiotics (beneficial bacteria) for hundreds of years in the form of various foods. . Research suggests that the proportion of beneficial bacteria in the gut is reduced (called as ‘dysbiosis’) in children with autism, and may explain their symptoms. We plan to study whether probiotic supplementation will improve the proportion of beneficial bacteria in the gut of children with autism. Such an effect may improve their behavioral symptoms
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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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Dr Sachin agrawal
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Address
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King Edward Memorial Hospital for women,
374 Bagot Road, Subiaco, Perth 6008
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Country
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Australia
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Phone
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+61 864582222
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Fax
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+61864581266
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Email
106326
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[email protected]
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Contact person for public queries
Name
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Sachin agrawal
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Address
106327
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King Edward Memorial hospital for women,
374 Bagot Road, Subiaco,Perth 6008
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Country
106327
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Australia
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Phone
106327
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+61 864582222
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Fax
106327
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Email
106327
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[email protected]
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Contact person for scientific queries
Name
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Sanjay Patole
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Address
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King Edward Memorial hospital for women,
374 Bagot Road, Subiaco,Perth 6008
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Country
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Australia
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Phone
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+618 64582222
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Fax
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+61864581266
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Email
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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?
all of the individual participant data collected during the trial, after de-identification; individual participant data underlying published results only
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When will data be available (start and end dates)?
Available for 5 years after publication
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Available to whom?
Only to those who request for systematic review and meta-analysis of IPD data
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Available for what types of analyses?
IPD meta-analysis
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How or where can data be obtained?
From the principle investigator and only after ethics approval.
[email protected]
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
9539
Study protocol
380817-(Uploaded-26-10-2020-18-45-11)-Study-related document.docx
9541
Informed consent form
380817-(Uploaded-26-10-2020-18-46-35)-Study-related document.doc
9542
Ethical approval
380817-(Uploaded-26-10-2020-18-46-35)-Study-related document.pdf
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.
Download to PDF