An interventional study of Inulinase and Maltodextrin placebo in Digestive Health and Gastrointestinal Health, sponsored by BIO-CAT, Inc.. Completed at 1 site in Canada. Open to participants aged 20 Years to 60 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-09-27.
Sponsored by BIO-CAT, Inc. · Not applicable, Interventional, and Basic science
The objectives of this clinical trial are to: 1) assess the effect of microbial inulinase on gastrointestinal symptoms in healthy participants compared to a placebo, and 2) to assess the safety and tolerability of microbial inulinase in healthy participants compared to a placebo.
Dietary FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) can be digestively bothersome for certain fiber-intolerant individuals, as well as those with irritable bowel syndrome (Dionne et al.). Oral supplementation of microbial enzymes is a promising strategy to ameliorate gastrointestinal (GI) symptoms-such as bloating, abdominal discomfort, and gas-that are associated with food intolerances. Oral enzyme supplementation with fungal beta-galactosidase (lactase), fungal alpha-galactosidase, and a mixture of microbial and plant proteases have previously been clinically shown to effectively reduce GI symptoms associated with dairy, legume, and gluten consumption, respectively (Lin et al.; Di Stefano et al.; Ido et al.). While alpha-galactosidase effectively hydrolyzes galactan-type FODMAPs, there remains a need to target fructan-type FODMAPs. Preclinical data using an in vitro static GI digestion model showed that the microbial enzyme inulinase can effectively digest fructan-rich substrates (e.g., inulin from chicory root, garlic, and a high-fructan meal mash) better than control conditions under simulated gastric conditions (Guice et al., submitted).
The present study is a randomized, double-blind, placebo-controlled clinical trial to determine the safety and tolerability of microbial inulinase as a digestive enzyme supplement in healthy adults. This clinical trial will include 60 participants who are healthy adults between the ages of 20 to 60 and who regularly consume at least two meals daily. The study duration will be up to 62 days. This trial consists of one screening visit (Visit 1, Day -30 to -15), a baseline visit (Visit 2, Day 1), and an end-of-study visit (Visit 3, Day 29 ± 3).
To assess the effect of inulinase on GI-related symptoms, participants will fill out the paper Gastrointestinal Symptom Rating Scale (GSRS) on a weekly basis over the course of the study. The GSRS is a validated questionnaire containing 15 questions used to assess symptoms that are commonly associated with GI disorders (Machnicki et al.). All 15 questions are rated using a 7-point Likert scale, where higher ratings represent more discomfort. The GSRS score is determined by the score of five subscales: reflux, diarrhea, abdominal Pain, indigestion, and constipation. The reflux score will be calculated as an average score of questions 2 and 3. The diarrhea score will be calculated as an average score of questions 11,12, and 14. The abdominal pain score will be calculated as an average score of questions 1, 4, and 5. The indigestion score will be calculated as an average score of questions 6, 7, 8, and 9. The constipation score will be calculated as an average score of questions 10, 13, and 15. Each subscale score is the domain score. The average of all 5 domain scores will give the GSRS score. The GSRS score and 5 sub-scale (domain) scores will be used for analysis. The scores in Visit 2 will be treated as baseline, and change from baseline to Week 1, Week 2, Week 3, and Week 4 will be calculated, as well as the proportion of participants showing improved scores.
At screening Visit 1 (up to 30 days and no less than 15 days prior to the baseline visit), participants will arrive at the clinic in a fasting state (≥ 10 hours). After participants provide voluntary informed consent, the following information will be recorded, and procedures carried out:
After confirming eligibility, from Day -14 to Day -1 (the day prior to baseline visit on Day 1), all participants will complete a 2-week run-in period where they will orally consume the placebo capsule twice daily with their usual two largest meals of the day (one capsule per meal) with the same two meals each day.
At baseline Visit 2 (Day 1), participants will arrive at the clinic in a fasting state (≥ 10 hours). The following visit procedures will occur:
At the baseline visit on Day 1, participants will be randomized in a 1:1 ratio to either study product [1,000 units of inulinase activity (INU) per serving] or placebo and then start the 28 ± 3 days of twice daily study product consumption. Study product will be taken in the same manner (1 capsule taken twice daily with their two usual larger meals of the day).
At end-of-study Visit 3 (Day 29 ± 3), participants will arrive at the clinic in a fasting state (≥ 10 hours). The following visit procedures will occur:
BIO-CAT, Inc. is the lead sponsor of 4 studies on the registry; none are open to participants now.
Counted across the registry records on this site, refreshed daily.
Exclusion Criteria:
Total 2,000 INU inulinase per day for 28 days
Dietary Supplement: Inulinase
Maltodextrin for 28 days
Dietary Supplement: Maltodextrin placebo
Participants will consume one capsule containing 1,000 INU inulinase, twice daily, for 28 days. Participants will be directed to consume the capsules with their two largest meals.
Also known as: Fructan hydrolyase, Beta-fructofuranosidase
Participants will consume one capsule containing maltodextrin, twice daily, for 28 days. Participants will be directed to consume the capsules with their two largest meals.
Gastrointestinal Symptom Rating Scale score
Between placebo and inulinase treatments, change from baseline to Day 7, Day 14, Day 21, and Day 28 in Gastrointestinal Symptom Rating Scale scores (overall score and domain scores). All 15 questions are rated using a 7-point Likert scale (1 to 7), where lower ratings represent a better outcome or less discomfort.
Time frame: 4 weeks
Gastrointestinal Symptom Rating Scale improvement
Between placebo and inulinase treatments, percentage of participants showing improvement from baseline to Day 28 as assessed by reduction of Gastrointestinal Symptom Rating scores (overall score and domain scores). All 15 questions are rated using a 7-point Likert scale (1 to 7), where lower ratings represent a better outcome or less discomfort.
Time frame: 4 weeks
Abdominal discomfort, bloating, and burping scores
Between placebo and inulinase treatments, change from baseline to Day 7, Day 14, Day 21, and Day 28 on individual Gastrointestinal Symptom Rating Scale questions on abdominal discomfort, bloating, and burping. These 3 questions are rated using a 7-point Likert scale (1 to 7), where lower ratings represent a better outcome or less discomfort.
Time frame: 4 weeks
Plasma lactate
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting plasma lactate concentration (mmol/L)
Time frame: 4 weeks
Serum insulin
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum insulin concentration (pmol/L)
Time frame: 4 weeks
Serum uric acid
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum uric acid concentration (umol/L)
Time frame: 4 weeks
Serum high-sensitivity C-reactive protein (hsCRP)
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum hsCRP concentration (mg/L)
Time frame: 4 weeks
Serum total cholesterol
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum total cholesterol concentration (mmol/L)
Time frame: 4 weeks
Serum low-density lipoprotein (LDL) cholesterol
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum LDL cholesterol concentration (mmol/L)
Time frame: 4 weeks
Serum high-density lipoprotein (HDL) cholesterol
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum HDL cholesterol concentration (mmol/L)
Time frame: 4 weeks
Plasma high-density lipoprotein (HDL) cholesterol
Between placebo and inulinase treatments, change from screening to Day 28 in fasting plasma HDL cholesterol concentration (mg/dL)
Time frame: 6 weeks
Serum triglycerides
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum triglycerides concentration (mmol/L)
Time frame: 4 weeks
Serum albumin
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum albumin concentration (g/L)
Time frame: 4 weeks
Serum alkaline phosphatase
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum alkaline phosphatase concentration (U/L)
Time frame: 4 weeks
Serum alanine transaminase
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum alanine transaminase concentration (U/L)
Time frame: 4 weeks
Serum aspartate transaminase
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum aspartate transaminase concentration (U/L)
Time frame: 4 weeks
Serum chloride
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum chloride concentration (mmol/L)
Time frame: 4 weeks
Serum creatinine
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum creatinine concentration (umol/L)
Time frame: 4 weeks
Serum globulin
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum globulin concentration (g/L)
Time frame: 4 weeks
Serum glucose
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum glucose concentration (mmol/L)
Time frame: 4 weeks
Serum potassium
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum potassium concentration (mmol/L)
Time frame: 4 weeks
Serum sodium
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum sodium concentration (mmol/L)
Time frame: 4 weeks
Serum total bilirubin
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum total bilirubin concentration (umol/L)
Time frame: 4 weeks
Serum total protein
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting serum total protein concentration (g/L)
Time frame: 4 weeks
Whole blood basophils
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting whole blood basophil count (x 10\^9/L)
Time frame: 4 weeks
Whole blood eosinophils
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting whole blood eosinophil count (x 10\^9/L)
Time frame: 4 weeks
Whole blood hematocrit
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting whole blood hematocrit (as volume percent)
Time frame: 4 weeks
Whole blood hemoglobin
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting whole blood hemoglobin concentration (g/dL)
Time frame: 4 weeks
Whole blood lymphocytes
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting whole blood lymphocyte count (x 10\^9/L)
Time frame: 4 weeks
Whole blood mean corpuscular hemoglobin
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting whole blood mean corpuscular hemoglobin (pg)
Time frame: 4 weeks
Whole blood mean corpuscular hemoglobin concentration
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting whole blood mean corpuscular hemoglobin concentration (g/L)
Time frame: 4 weeks
Whole blood mean corpuscular volume
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting whole blood mean corpuscular volume (fL)
Time frame: 4 weeks
Whole blood monocytes
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting whole blood monocyte count (x 10\^9/L)
Time frame: 4 weeks
Whole blood neutrophils
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting whole blood neutrophil count (x 10\^9/L)
Time frame: 4 weeks
Whole blood platelets
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting whole blood platelet count (x 10\^9/L)
Time frame: 4 weeks
Whole blood mean platelet volume
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting whole blood mean platelet volume (fL)
Time frame: 4 weeks
Whole blood red blood cells
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting whole blood red blood cell count (x 10\^9/L)
Time frame: 4 weeks
Whole blood red blood cell distribution width
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting whole blood red blood cell distribution width
Time frame: 4 weeks
Whole blood white blood cells
Between placebo and inulinase treatments, change from baseline to Day 28 in fasting whole blood white blood cell count (x 10\^9/L)
Time frame: 4 weeks
Whole blood hemoglobin A1c (HbA1c)
Fasting whole blood HbA1c concentration at Day 1 (%)
Time frame: Day 1
Estimated glomerular filtration (eGFR)
Between placebo and inulinase treatments, change from baseline to Day 28 in eGFR (mL/min/1.73m\^2)
Time frame: 4 weeks
Blood pressure
Resting systolic blood pressure over resting diastolic blood pressure (mmHg/mmHg)
Time frame: 4 weeks
Heart rate
Resting heart rate (beats per minute)
Time frame: 4 weeks
Body weight
Body weight (kg)
Time frame: 4 weeks
Body mass index
Body mass index (kg/m\^2)
Time frame: 4 weeks
Incidence of adverse events
Number of participants with adverse events
Time frame: 4 weeks
Incidence of serious adverse events
Number of participants with serious adverse events
Time frame: 4 weeks
Plan to share: No
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BIO-CAT, Inc.