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CompletedNCT03452189Updated Mar 26, 2021Results posted

The Effect of an Antibiotic on the Production of Uremic Toxins by the Gut Microbiome

A Phase 2 interventional study of Vancomycin and Placebo in End Stage Renal Disease, sponsored by NYU Langone Health. Completed at 1 site in United States. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2021-03-26.

Sponsored by NYU Langone Health · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
15
Allocation
Randomized
Ages
18 Years to 80 Years
Sex
All
01

Study summary

The purpose of this study is to determine if multiple doses of vancomycin over the course of 3 months will perturb the intestinal flora (microbiome) and result in reduced serum concentration of the uremic toxin indoxyl sulfate and p-cresyl sulfate. The design of the study will permit investigators to assess the variability of serum uremic retention solute concentrations with and without antibiotic over a three-month period.

02

Conditions studied

  • End Stage Renal Disease
03

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Patients with stable chronic kidney disease on hemodialysis with a fistula or an AV graft.

Exclusion criteria

Exclusion Criteria:

  • Antibiotics received within the last 3 months;
  • recent diarrhea
  • known allergy to vancomycin
  • history of C. difficile infection
  • elevation of white blood cell count or fever within one week of enrollment.
04

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Crossover assignment
Masking
Double (Participant, Care provider)
Enrollment
15 participants (actual)

Study arms

  • Active comparator
    250mg of oral vancomycin First

    After 3 months, initial experimental group will be switched to placebo for 3 months.

    Drug: Vancomycin · Other: Placebo

  • Placebo comparator
    Placebo First

    After three months, the control group will be crossed over to weekly oral vancomycin (250mg)

    Drug: Vancomycin · Other: Placebo

Interventions

  • DrugVancomycin

    Oral vancomycin 250mg capsules

    Also known as: vancomycin hydrochloride capsules

  • OtherPlacebo

    Placebo Pills distributed by Research Pharmacy labeled "placebo."

05

What researchers measure

Primary outcomes

  1. Change in Plasma Concentration Measure of Indoxyl Sulphate (IS)

    Plasma concentrations of IS were measured by HPLC (high pressure liquid chromatography). Assessed weekly between day 0 and Week 4; change from baseline/day 0 to Week 4 reported

    Time frame: 4 weeks

  2. Change in Plasma Concentration Measure P-Cresyl Sulphate (PCS)

    Plasma concentrations of P-Cresyl Sulphate (PCS) were measured by HPLC (high pressure liquid chromatography) Assessed weekly between day 0 and Week 4; change from baseline/day 0 to Week 4 reported

    Time frame: 4 weeks

06

Results

Posted Mar 26, 2021

Participant flow

First Intervention (3 Months)
Participant flow — First Intervention (3 Months)
Milestone250mg of Oral Vancomycin First, Then PlaceboPlacebo First, Then 250mg of Oral Vancomycin
Started105
Completed55
Not completed50
Withdrew: Adverse event10
Withdrew: Insufficient samples of plasma and stool40
Intervention 2 (3 Months)
Participant flow — Intervention 2 (3 Months)
Milestone250mg of Oral Vancomycin First, Then PlaceboPlacebo First, Then 250mg of Oral Vancomycin
Started55
Completed55
Not completed00

Outcome measures

PrimaryChange in Plasma Concentration Measure of Indoxyl Sulphate (IS)

Plasma concentrations of IS were measured by HPLC (high pressure liquid chromatography). Assessed weekly between day 0 and Week 4; change from baseline/day 0 to Week 4 reported

Time frame:
4 weeks
Reported as:
Mean · µM/ml
Change in Plasma Concentration Measure of Indoxyl Sulphate (IS)
µM/ml250mg of Oral Vancomycin First, Then PlaceboPlacebo First, Then 250mg of Oral Vancomycin
Change in Plasma Concentration Measure of Indoxyl Sulphate (IS)-25.31 ± 36.39.71 ± 49.80
PrimaryChange in Plasma Concentration Measure P-Cresyl Sulphate (PCS)

Plasma concentrations of P-Cresyl Sulphate (PCS) were measured by HPLC (high pressure liquid chromatography) Assessed weekly between day 0 and Week 4; change from baseline/day 0 to Week 4 reported

Time frame:
4 weeks
Reported as:
Mean · µM/ml
Change in Plasma Concentration Measure P-Cresyl Sulphate (PCS)
µM/ml250mg of Oral Vancomycin First, Then PlaceboPlacebo First, Then 250mg of Oral Vancomycin
Change in Plasma Concentration Measure P-Cresyl Sulphate (PCS)-73.51 ± 127.000.64 ± 79.50

Adverse events

Collected over 6 months. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
250mg of Oral Vancomycin First0/10 (0%)0/10 (0%)0/10 (0%)
Placebo First0/5 (0%)0/5 (0%)0/5 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)Placebo First or 250mg of Oral Vancomycin First (Crossover After 3 Months)
Mean57.6 ± 9
Sex: Female, Male
Sex: Female, Male(Participants)Placebo First or 250mg of Oral Vancomycin First (Crossover After 3 Months)
Female4
Male11
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Placebo First or 250mg of Oral Vancomycin First (Crossover After 3 Months)
White2
Black3
Asian2
Hispanic6
Other or more than one2
07

Study locations

1 site
  • New York University School of Medicine
    New York, New York 10016, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Nov 17, 2017

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

Individual participant data

Plan to share: Yes — Individual participant data that underlie the results reported in this article, after deidentification (text, tables, figures, and appendices).

Supporting information: Study protocol, Sap

09

Registry details

Key details

Study ID
NCT03452189
Lead sponsor
NYU Langone Health
Responsible party
Sponsor
First posted
Mar 2, 2018
Start date
Nov 27, 2017
Primary completion
Aug 18, 2018
Completion
Aug 18, 2018
Results posted
Mar 26, 2021
Last update
Mar 26, 2021

Study contacts

Jerome Lowenstein, MD
principal investigator · NYU Langone Health

Oversight

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

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