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CompletedNCT03459482Updated Aug 5, 2024

Endpoint Determination Study Protocol

An interventional study of Food Elimination Diet in Irritable Bowel Syndrome, sponsored by Biomerica. Completed at 8 sites in United States. Open to participants aged 21 Years and older. Per ClinicalTrials.gov, last updated 2024-08-05.

Sponsored by Biomerica · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
556
Allocation
Randomized
Ages
21 Years and older
Sex
All
01

Study summary

This study is designed to evaluate the most applicable endpoints for evaluation of the Biomerica InFoods® IBS product.

Read the detailed description

The objective of this Endpoint Determination Study is to address key elements regarding a proposed larger clinical study design:

  1. Comparing different potential primary outcome measures
  2. Demonstrating that an exclusionary diet as determined by elevated IgG levels using the Biomerica InFoods® IBS Test is associated with alleviation of IBS symptoms
  3. Demonstrating the ability to mask the sham diet
  4. Demonstrating the safety of the exclusionary diet

Subjects' diets will be based on the results of the Biomerica, InFoods® IBS Test.

Immunoglobulin G (IgG) levels above a certain threshold are considered a positive response against a specific food or foods. It is expected that severity of symptoms of IBS will decrease when foods that generate a positive immune response in the Biomerica InFoods® IBS test are eliminated from the diet of the IBS patient.

The Endpoint Determination Study format will be a double-blinded randomized controlled clinical study enrolling subjects at two trial sites within the United States and designed to evaluate the use of IgG antibody guided dietary restrictions, based on the Biomerica InFoods® IBS Test, in the management of patients diagnosed with Irritable Bowel Syndrome (IBS).

The 2 sites will enroll approximately equal numbers of subjects. The target for each site is a minimum of 30 subjects in each classification: IBS with diarrhea [IBS-D], IBS with constipation [IBS-C] and IBS mixed [IBS-M] for a minimum of 90 patients per site, 180 total subjects for this study.

02

Conditions studied

  • Irritable Bowel Syndrome
03

Who can participate

Ages eligible
21 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • 21 years old or older.
  • Able to read and understand English.
  • Willing and able to sign the informed consent.
  • Have access to a computer and/or cell phone access for Electronic Data Capture (EDC)
  • Meets Rome IV Diagnostic Criteria for IBS
  • Willing to follow a food elimination die
  • Well controlled diabetic patients; A1C \<7.5 and stable medication (>3 months, NOT Metformin
  • Score between ≥ 3 and \<7.5 on the Abdominal Pain Intensity Assessment (IBS_API) based on a weekly average of worst daily (in past 24 hours) abdominal pain on a 0 to 10 point scale.
  • Patients who are on stable (> 3 months) doses of medications or treatments for their IBS (e.g., probiotics, fiber, Viberzi, Linzess, Amitiza, Alosetron, Plecanatide, anticholinergics, antidepressants, Zofran bile acid sequestrants, or anti-diarrheals) will be allowed to continue their medications as long as no change in treatment is planned for the duration of the study and no dose adjustment is made during the duration of the study.
  • A positive IgG antibody response for at least one food in the Biomerica InFoods® IBS panel

Exclusion criteria

Exclusion Criteria:

  • Unable to provide consent.
  • Cannot use EDC system due to no cell phone and no computer access
  • Does not qualify for a diagnosis of IBS by IV Diagnostic Criteria
  • Diagnosed IBS, but an IBS-API score of \<3.0 and >7.5
  • Pregnant or breastfeeding
  • Patients with diabetes currently on Metformin
  • Patients who have used Rifaximin in the past 3 months
  • Patients engaged in another type of diet therapy, i.e. FODMAP
  • Patients which physicians are anticipating starting a new medication, change in dosage, diet or other treatment for IBS during the study
  • Chronic pain from other conditions besides IBS
  • Current or previous use of narcotic medications within past 3 months
  • History of prior GI surgery except for cholecystectomy or appendectomy.
  • History with any of the following:

Gastroparesis, Uncontrolled GERD, Anorexia/bulimia Celiac disease Crohn's disease, Ulcerative Colitis, Abdominal/gastro cancer(s), Malabsorption syndrome(s).

  • History of any other relevant inter-current medical conditions that could interfere with their participation in the study or the objectives of the study
  • History of psychosis, schizophrenia, mania, or major psychiatric illness needing hospitalization within the past 6 months
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Care provider, Investigator)
Enrollment
556 participants (actual)

Study arms

  • Experimental
    Group 1 - True Food Elimination Diet

    Group 1 (experimental group): Subjects will be given an elimination diet based upon foods with a positive antibody profile in the Biomerica InFoods® IBS test. The elimination diet will also exclude any and all foods to which the subject has a known IgE allergy and foods the subject already currently eliminates.

    Other: Food Elimination Diet

  • Sham comparator
    Group 2 - Sham Food Elimination Diet

    Group 2 (control group): Subjects will be given a "Sham" elimination diet. The sham diet will eliminate the same number of foods but none of the actual foods to which the patient had a positive antibody profile in the Biomerica InFoods® IBS test. The sham diet will also eliminate any and all foods to which the subject has a known IgE allergy and foods the subject already currently eliminates.

    Other: Food Elimination Diet

Interventions

  • OtherFood Elimination Diet

    Subjects asked to participate in a food elimination diet, either True or Sham to evaluate the effects on their IBS symptoms

05

What researchers measure

Primary outcomes

  1. Change in the IBS-API - Abdominal Pain Intensity. The IBS-API is being assessed daily from enrollment (baseline) to study completion; total 10 weeks

    Abdominal pain intensity will be measured daily using an 11-point (0-10) numeric rating scale (NRS) that asks subjects to rate their worst abdominal pain over the past 24-hours.

    Time frame: Daily for 10 weeks

06

Study locations

8 sites
  • Mayo Clinic
    Scottsdale, Arizona 85259, United States
  • Mayo Clinic
    Jacksonville, Florida 32224, United States
  • Family Medicine Specialists
    Wauconda, Illinois 60084, United States
  • Beth Israel Deaconess Medical Center
    Boston, Massachusetts 02215, United States
  • University of Michigan Health System
    Ann Arbor, Michigan 48109-5362, United States
  • Houston Methodist Research Institute
    Houston, Texas 77030, United States
  • UT Health
    Houston, Texas 77030, United States
  • Gastroenterology Research of San Antonio
    San Antonio, Texas 78229, United States
07

References and documents

Individual participant data

Plan to share: No — It is not yet known if there will be a plan to make IPD available.

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT03459482
Lead sponsor
Biomerica
Responsible party
Sponsor
First posted
Mar 9, 2018
Start date
Jun 21, 2018
Primary completion
Dec 31, 2021
Completion
Dec 31, 2021
Last update
Aug 5, 2024

Study contacts

William D Chey, MD
principal investigator · University of Michigan
Anthony J Lembo, MD
principal investigator · Beth Israel Deaconess Medical Center (Harvard)

Oversight

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

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