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CompletedNCT03295747PMOUpdated Apr 6, 2022

Peppermint Oil Pharmacokinetics/Dynamics and Novel Biological Signatures in Children With Functional Abdominal Pain

A Phase 1 interventional study of Peppermint oil in Abdominal Pain, sponsored by Robert Shulman, M.D.. Completed at 1 site in United States. Open to participants aged 7 Years to 12 Years. Per ClinicalTrials.gov, last updated 2022-04-06.

Sponsored by Robert Shulman, M.D. · Phase 1, Interventional, and Treatment

Phase
Phase 1
Study type
Interventional
Enrollment
30
Allocation
Randomized
Ages
7 Years to 12 Years
Sex
All
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Study summary

Aim 1 - Determine the pharmacokinetics of PMO (menthol) of three different doses in children with functional abdominal pain (FAP) (n=30).

Aim 2 - Determine pharmacodynamic effect of three different doses of PMO on gut microbiome composition and contractile activity/gut transit rate.

Read the detailed description

Children with functional abdominal pain (FAP) ages 7-12 years (n=30) will be recruited.

The study participants will be admitted to the Children's Nutrition Research Center. A medical history and a general physical examination performed by the investigator or the research nurse. The height, weight, and vital signs (pulse rate, respiratory rate, and seated blood pressure) will be obtained. After application of a topical anesthetic to the site chosen for study-related blood sampling, a cannula will be inserted e to obtain repeated blood samples.

At approximately 0900, subjects will receive one of three doses of PMO as a single oral dose. Immediately prior to administration of the PMO, a blood sample will be obtained to measure total menthol concentration and leukocytes for isolation of DNA for CYP2A6 and UGT2B7 genotyping.

After PMO administration, repeated blood samples will be obtained over 24 hours.

At 2 hours after PMO administration, participants will be given a standardized meal and will eat ad libitum thereafter.

After completion of the final (24 hours) blood samples, vital signs will be reassessed and the venous cannula removed. Parents will receive a follow-up call from the research coordinator to access/evaluate if any adverse effects from dose or blood sampling received at the overnight study visit.

Prior to and after administration of peppermint oil (PMO) for 1 week at the dose defined above, children will undergo measurement of gut microbiome composition and GI motility and transit time. At the time of the stool collection, the child will also keep a 3 day diet history.

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Conditions studied

  • Abdominal Pain

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03

Who can participate

Ages eligible
7 Years to 12 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Children ages 7-12 years old
  2. They will be able to complete the protocol
  3. A child will be recruited if the medical evaluation reveals no organic reason for the abdominal pain

Exclusion criteria

Exclusion Criteria:

  1. Children who have had past bowel surgery;
  2. A child with documented GI disorders (e.g., Crohn's disease);
  3. A child with a serious chronic medical condition (e.g., diabetes);
  4. A child with a weight and/or height \< 2 SD for age;
  5. Children with chronic conditions with GI symptoms (e.g., cystic fibrosis);
  6. Children with autism spectrum disorder, significant developmental delay, psychosis, depression, or a history of bipolar disorder;
  7. Children who have been treated with antibiotics/probiotics within 2 mo. (because of effects on microbiome analysis).
  8. Children who speak only Spanish
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Study design

Phase
Phase 1
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
30 participants (actual)

Study arms

  • Experimental
    180 mg

    180 mg of peppermint oil

    Drug: Peppermint oil

  • Experimental
    360 mg

    360 mg of peppermint oil

    Drug: Peppermint oil

  • Experimental
    540 mg

    540 mg of peppermint oil

    Drug: Peppermint oil

Interventions

  • DrugPeppermint oil

    Three doses of peppermint oil will be investigated: 180, 360, 540 mg; i.e. three arms.

    Also known as: Enteric coated peppermint oil capsules

05

What researchers measure

Primary outcomes

  1. Pharmacokinetics

    Area under the curve

    Time frame: 24 hours

Secondary outcomes

  1. Contractility

    Number and amplitude of gut contractions as measured by SmartPill

    Time frame: Prior to and during peppermint oil treatment

  2. Gut Microbiome Composition

    Microbiome is defined for this study as a statistically significant change from baseline after treatment with PMO, correcting for multiple testing (q value). Such changes may occur with respect to gut microbiome diversity and/or composition (e.g., phylum, family, genera). We anticipate there will be an increased bacterial diversity, as well as increases in the abundance of organisms associated with a healthy microbiome, in response to PMO administration.

    Time frame: Prior to and during peppermint oil treatment

  3. Motility

    Gut transit time as measured by SmartPill

    Time frame: Prior to and during peppermint oil treatment

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Study locations

1 site
  • Texas Children's Hospital
    Houston, Texas 77030, United States
07

References and documents

Publications

  • Shulman RJ, Chumpitazi BP, Abdel-Rahman SM, Garg U, Musaad S, Kearns GL. Randomised trial: Peppermint oil (menthol) pharmacokinetics in children and effects on gut motility in children with functional abdominal pain. Br J Clin Pharmacol. 2022 Mar;88(3):1321-1333. doi: 10.1111/bcp.15076. Epub 2021 Oct 19. Erratum In: Br J Clin Pharmacol. 2022 Dec;88(12):5436. doi: 10.1111/bcp.15556. PubMed 34528282 ↗
  • Thapa S, Luna RA, Chumpitazi BP, Oezguen N, Abdel-Rahman SM, Garg U, Musaad S, Versalovic J, Kearns GL, Shulman RJ. Peppermint oil effects on the gut microbiome in children with functional abdominal pain. Clin Transl Sci. 2022 Apr;15(4):1036-1049. doi: 10.1111/cts.13224. Epub 2022 Jan 20. PubMed 35048535 ↗

Study documents

  • Protocol and statistical analysis plan · Nov 15, 2017

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

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Registry details

Key details

Study ID
NCT03295747
Lead sponsor
Robert Shulman, M.D.
Responsible party
Robert Shulman, M.D. (Professor, Baylor College of Medicine) — Sponsor-investigator
First posted
Sep 28, 2017
Start date
Oct 15, 2017
Primary completion
Mar 28, 2019
Completion
Mar 28, 2019
Last update
Apr 6, 2022

Study contacts

Shulman J. Shulman, MD
principal investigator · Baylor College of Medicine

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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