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Trial registered on ANZCTR
Registration number
ACTRN12608000266369
Ethics application status
Approved
Date submitted
23/05/2008
Date registered
26/05/2008
Date last updated
26/05/2008
Type of registration
Prospectively registered
Titles & IDs
Public title
Probiotics and Sulphasalazine in the treatment of Rheumatoid Arthritis
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Scientific title
In patients with Rheumatoid Arthritis taking Sulphasalazine, does the addition of Probiotic alter the drug's metabolism as measured in blood and urine?
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Universal Trial Number (UTN)
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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:
Rheumatoid Arthritis
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Rheumatoid arthritis
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Condition category
Condition code
Inflammatory and Immune System
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0
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Rheumatoid arthritis
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Musculoskeletal
3347
3347
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Trial intervention is a probiotic provided by BLIS Technologies Dunedin.
The probiotic is a preparation of live bacteria in powdered form containing 100 million Streptococcus Salivarius K12, 400 million Lactobacillus Acidophilus L10, 400 million Bifidobacterium Lactis B94 per dose.
Each participant will take one dose of the probiotic twice daily for one week.
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Intervention code [1]
2913
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Treatment: Drugs
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Comparator / control treatment
The same patients taking the probiotic will act as controls.
The same metabolite levels of Sulphasalazine will be measured prior to starting probiotic and one month after completion of probiotic to determine the alteration of its levels whilst participants are on probiotic.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Change in levels of sulphasalazine metabolites (sulphapyridine, 5 aminosalicylic acid and sulphasalazine levels in blood and urine)
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Assessment method [1]
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Timepoint [1]
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At baseline, one week (at completion of course of probiotics) and four weeks.
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Secondary outcome [1]
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Disease activity of Rheumatoid Arthritis assessed by Disease Activity Score (DAS), which is a count of swollen and/or tender joints combined with the C-reactive protein (CRP) in mg/l- level and patient global assessment score.
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Assessment method [1]
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Timepoint [1]
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At baseline, one week and four weeks.
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Secondary outcome [2]
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Side effects of Sulphasalazine as measured by blood full blood count, liver function tests and creatinine.
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Assessment method [2]
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Timepoint [2]
7147
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At baseline, one week and four weeks.
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Eligibility
Key inclusion criteria
Fulfillment of ACR (American College of Rheumatology) criteria of Rheumatoid Arthritis
Taking Sulphasalazine for at least 3 months
If female of reproductive age must be on effective contraception
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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
Psychiatric illness - major depression, psychosis or dementia
Pregnancy or lactation
Malignancy
Current acute infection - especially Gastro-Intestinal infection
Current treatment with antibiotics
Chronic infection - HIV, hepatitis B + C, EBV, TB
Known allergy to probiotics
Sulphasalazine dose greater than 1g twice daily or 40mg/kg
Symptoms attributable to side effects of sulphasalazine
Significant renal impairment
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
Subjects are identified from a database of patients with Rheumatoid Arthritis and invited to participate.
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Phase
Phase 2
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Type of endpoint/s
Bio-availability
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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
16/06/2008
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Actual
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Date of last participant enrolment
Anticipated
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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
12
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Otago
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Dunedin School of Medicine
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Address [1]
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Dunedin School of Medicine,
Great King Street,
Dunedin
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Country [1]
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New Zealand
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Funding source category [2]
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Commercial sector/Industry
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Name [2]
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Blis Technologies Ltd,
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Address [2]
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Centre for Innovation,
87 St. David Street,
Dunedin
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Country [2]
3419
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New Zealand
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Primary sponsor type
University
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Name
Dr. Simon Stebbings, Dunedin School of Medicine
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Address
Dunedin School of Medicine,
Great King Street,
Dunedin
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Country
New Zealand
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Secondary sponsor category [1]
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University
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Name [1]
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Dunedin School of Pharmacy
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Address [1]
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Dunedin School of Pharmacy,
Great King Street,
Dunedin
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Country [1]
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New Zealand
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Other collaborator category [1]
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Commercial sector/Industry
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Name [1]
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Blis Technology Ltd,
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Address [1]
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Centre for Innovation,
87 St. David Street,
Dunedin
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Country [1]
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Lower South Regional Ethics Committee
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Ethics committee address [1]
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229 Moray Place, Dunedin
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Ethics committee country [1]
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Date submitted for ethics approval [1]
5442
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Approval date [1]
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14/05/2008
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Ethics approval number [1]
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LRS/08/05/017
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Summary
Brief summary
Probiotics are cultures of bacteria intended to impart a beneficial effect on the host. Sulphasalazine, a drug frequently used to treat Rheumatoid Arthritis, is split into two active ingredients by the resident bacteria of the normal human gut. Preliminary evidence from animal work suggests that there would be an increase in sulphasalazine metabolites when combined with probiotics. This could alter its efficacy and side effects, which could be clinically important, especially as probiotics are now widely available and usually regarded as harmless. There is little awareness about the interactions between probiotics and conventional medications either by health professionals or the public. We plan to carry out a pilot study of 12 patients with Rheumatoid Arthritis. Patients will have a baseline assessment of their disease in rheumatology clinic and will have blood, 24 hour urine and stool analysed for sulphasalazine and its metabolites. Subjects will then take probiotics for a week and have blood, urine and stool samples reanalysed. They will also have a clinical assessment in clinic. These tests will be repeated in a further 3 weeks after stopping probiotics. Any patient becoming unwell during the time of taking probiotics will have earlier analysis.
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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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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr. Simon Stebbings
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Address
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Dunedin School of Medicine,
Great King Street,
Dunedin
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Country
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New Zealand
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Phone
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0064 34740999
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Fax
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0064 34747641
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Email
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[email protected]
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Contact person for scientific queries
Name
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Dr. Simon Stebbings
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Address
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Dunedin School of Medicine,
Great King Street,
Dunedin
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Country
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New Zealand
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Phone
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0064 34740999
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Fax
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0064 34747641
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Email
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[email protected]
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No information has been provided regarding IPD availability
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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