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RecruitingNCT06040515Updated Sep 15, 2023

Probiotic After Acute Colonic Diverticulitis

An observational study in Diverticulitis, Colonic and Therapy, sponsored by Erasmo Spaziani. Recruiting at 12 sites in Italy. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2023-09-15.

Sponsored by Erasmo Spaziani · Observational

From the registry’s dates

  • Primary completion was expected by Dec 2023, 2 years 10 months ago, but the record still lists the study as recruiting.
  • Started May 2023; still recruiting 3 years 6 months later.
Study type
Observational
Model
Case-only
Time perspective
Prospective
Enrollment
145
Ages
18 Years and older
Sex
All
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Study summary

The goal of this observational study is to assess the efficacy and safety of the probiotic Escherichia coli Nissle 1917 (EcN®, Ca.Di.Group S.p.A) in the treatment of symptomatic patients after an episode of both complicated and uncomplicated acute colonic diverticulitis.

The main question it aims to answer are:

  • Is the studied probiotic able to significantly reduce symptoms, assessed by means of a validated and dedicated score?
  • Is there any difference in microbiota among the study group at baseline and a selected cohort of patients subdivided in subjects with diverticulosis and asymptomatic subjects after an episode of acute uncomplicated diverticulitis or an episode of complicated diverticulitis submitted to surgery with colonic resection without stoma?
  • Is there any difference in microbiota in the study group at baseline and after 3 and 6 months of treatment with the probiotic?
  • Is there any correlation between microbiota modification and symptoms during follow-up?
  • Is there any impact on fecal calprotectin values before and during probiotic therapy?
  • Is there any modification of evacuation before and during follow-up?
  • Is probiotic able to prevent recurrent episodes of acute diverticulitis during follow-up?
  • The safety of the probiotic will be assessed during the follow-up. The study group will be assessed at baseline and during follow-up with a dedicated clinical score and Bristol stool scale. Microbiota and fecal calprotectin values will be also assessed at baseline and during follow-up. Microbiota at baseline will be also evaluated for comparison in the three selected groups with diverticulosis and both asymptomatic and symptomatic after an episode of acute diverticulitis.
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Conditions studied

  • Diverticulitis, Colonic
  • Therapy
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In context

Diverticulitis, Colonic

27 studies on the registry are indexed under Diverticulitis, Colonic; 8 are open to participants now.

This study's planned enrollment of 145 is below the median of 250 across 15 observational studies indexed under Diverticulitis, Colonic.

Browse Diverticulitis, Colonic studies →

Lead sponsor

This is the only study on the registry with Erasmo Spaziani as lead sponsor.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

The study population will include the above specified study groups.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Symptomatic patients three months after an episode of uncomplicated acute colonic diverticulitis;
  • Symptomatic patients six months after an episode of complicated acute colonic diverticulitis; submitted to .surgical colonic resection without stoma;
  • Patients with diverticulosis;
  • Asymptomatic patients three months after an episode of uncomplicated acute colonic diverticulitis;
  • Asymptomatic patients six months after an episode of complicated acute colonic diverticulitis; submitted to surgical colonic resection without stoma.

Exclusion criteria

Exclusion Criteria:

  • Ongoing acute diverticulitis at radiologic assessment
  • Antibiotic therapy, both systemic and topic, and/or probiotics and/or mesalazine within four weeks before enrolment;
  • Lactulose-lactitol use within four weeks before enrolment;
  • Presence of chronic inflammatory bowel diseases;
  • Presence of Segmental Colitis Associated with Diverticulitis (SCAD);
  • Presence of ischemic colitis;
  • Severe chronic liver ( C) and/or pancreatic and/or renal diseases;
  • Patients with severe renal failure;
  • Presence of suspected/actual pregnancy;
  • Presence of recent/ongoing neoplasia, under oncological treatment within 6 months before enrolment;
  • Presence of COVID-19 infection;
  • Patients unable to give .
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Child-Pugh class

A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

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Study design

Observational model
Case-only
Time perspective
Prospective
Enrollment
145 participants (estimated)
Patient registry
No
Biospecimen retention
Samples with dna

Groups and cohorts

  • Symptomatic patients after acute diverticulitis

    Patients aged ≥18 with persistent symptoms at least three months after a radiologic and/or endoscopic documented acute diverticulitis or after six months of surgery for complicated acute diverticulitis. Therapy with Escherichia coli Nissle 1917 (EcN®) will be prescribed for a global duration of six months with the following assumption schedule: 2 capsules b.i.d. during 4 weeks, followed by 1 capsule o.i.d during 20 days each month for 5 months.

    Drug: Probiotic Formula

  • Diverticulosis

    Patients with asymptomatic diverticulosis. No therapy will be administered. Microbiota assessment will be performed.

  • Asymptomatic patients after acute uncomplicated diverticulitis

    Asymptomatic patients assessed three months after an episode of acute uncomplicated diverticulitis. No therapy will be administered. Microbiota assessment will be performed.

  • Asymptomatic patients after acute complicated diverticulitis

    Asymptomatic patients assessed six months after an episode of acute complicated diverticulitis submitted to surgery with resection and without stoma . No therapy will be administered. Microbiota assessment will be performed.

Interventions

  • DrugProbiotic Formula

    Capsule with 25 billion live strains of Escherichia coli Nissle 1917

    Also known as: Escherichia coli Nissle 1917

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What researchers measure

Primary outcomes

  1. Median symptomatic score reduction after therapy with Escherichia coli Nissle 1917

    Median symptomatic score assessed at baseline and during follow-up

    Time frame: Six-months follow-up

Secondary outcomes

  1. Microbiota qualitative composition

    Composition of microbiota will be assessed in all the study groups with a dedicated kit for collection.

    Time frame: Baseline

  2. Microbiota qualitative composition modification

    Composition of microbiota will be assessed in symptomatic study groups with a dedicated kit for collection.

    Time frame: Baseline and during 6-month follow-up.

  3. Microbiota qualitative composition and median symptomatic score correlation

    Correlation between the median symptomatic score and qualitative composition of microbiota modification after therapy.

    Time frame: Baseline and during 6-month follow-up.

  4. Concentration of fecal calprotectin

    Assessment of fecal calprotectin concentration in the symptomatic study group.

    Time frame: Baseline and during 6-month follow-up.

  5. Bristol stool scale modification

    Assessment of median Bristol stool scale in the symptomatic study group.

    Time frame: Baseline and during 6-month follow-up.

  6. Prevention of recurrent acute diverticulitis

    Number off patients with recurrent acute diverticulitis.

    Time frame: Six-month follow-up.

  7. Safety

    Number of patients with adverse events.

    Time frame: Six-month follow-up.

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Study locations

12 of 12 sites recruiting
  • UOC di Gastroenterologia ed Endoscopia Digestiva, Ospedale "Pugliese-Ciaccio
    Catanzaro, Calabria 88100, Italy
    Recruiting
  • UOSVD di Endoscopia Digestiva, Ospedale "S. Maria Goretti"
    Latina, Lazio 04100, Italy
    Recruiting
  • UOC di Gastroenterologia, Azienda Ospedaliera "S. Camillo-Forlanini"
    Roma, Lazio 00152, Italy
    Recruiting
  • UOSVD di Gastroenterologia ed Endoscopia Digestiva, Ospedale "Umberto I"
    Roma, Lazio 00161, Italy
    Recruiting
  • UOC di Medicina Interna e Gastroenterologia, Ospedale "Cristo Re"
    Roma, Lazio 00167, Italy
    Recruiting
  • UOC Chirurgia Generale, Ospedale "P. Colombo"
    Velletri, Lazio 00049, Italy
    Recruiting
  • UOC di Gastroenterologia, Ospedale "Belcolle",
    Viterbo, Lazio 01100, Italy
    Recruiting
  • • UOC di Gastroenterologia ed Endoscopia Digestiva, Ospedale Universitario "San Raffaele"
    Milan, Lombardia 20132, Italy
    Recruiting
  • UOC di Gastroenterologia Azienda Ospedaliero-Universitaria di Padova
    Padova, Lombardia 35031, Italy
    Recruiting
  • UOC di Gastroenterologia, Ospedale "Guglielmo da Saliceto"
    Piacenza, Lombardia 29121, Italy
    Recruiting
  • UOC di Gastroenterologia, Ospedale "S. Salvatore",
    Pesaro, Marche 61121, Italy
    Recruiting
  • Gastroenterology Service , ASL BAT,
    Andria, 76123, Italy
    Recruiting
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References and documents

Publications

  • Kvasnovsky CL, Adams K, Papagrigoriadis S. Diverticular disease as a chronic gastrointestinal condition: experience from a specialist clinic. Eur J Gastroenterol Hepatol. 2015 Apr;27(4):442-8. doi: 10.1097/MEG.0000000000000304. PubMed 25874519 ↗
  • Mj O, Turner GA, A S, Frizelle FA, R P. Distinct changes in the colonic microbiome associated with acute diverticulitis. Colorectal Dis. 2022 Dec;24(12):1591-1601. doi: 10.1111/codi.16271. Epub 2022 Aug 11. PubMed 35950499 ↗
  • Tursi A, Papa V, Lopetuso LR, Settanni CR, Gasbarrini A, Papa A. Microbiota Composition in Diverticular Disease: Implications for Therapy. Int J Mol Sci. 2022 Nov 26;23(23):14799. doi: 10.3390/ijms232314799. PubMed 36499127 ↗
  • Teng G, Liu Z, Liu Y, Wu T, Dai Y, Wang H, Wang W. Probiotic Escherichia coli Nissle 1917 Expressing Elafin Protects Against Inflammation and Restores the Gut Microbiota. Front Microbiol. 2022 May 6;13:819336. doi: 10.3389/fmicb.2022.819336. eCollection 2022. PubMed 35602072 ↗
  • Lahat A, Fidder HH, Ben-Horin S. Development and validation of a diverticular clinical score for symptomatic uncomplicated diverticular disease after acute diverticulitis in a prospective patient cohort. Therap Adv Gastroenterol. 2020 May 8;13:1756284820913210. doi: 10.1177/1756284820913210. eCollection 2020. PubMed 32523619 ↗

Individual participant data

Plan to share: No

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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 15, 2023, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT06040515
Lead sponsor
Erasmo Spaziani
Responsible party
Erasmo Spaziani (MD, PhD, University of Roma La Sapienza) — Sponsor-investigator
First posted
Sep 15, 2023
Start date
May 1, 2023
Primary completion
Dec 31, 2023 (estimated)
Completion
Jun 30, 2024 (estimated)
Last update
Sep 15, 2023

Study contacts

Antonio Tursi, MD, PhD
Contact
antotursi@tiscali.it
+393473490583
Marcello Picchio, MD
Contact
marcellopicchio@libero.it
+393392371293
Walter Elisei, MD
principal investigator · • UOC di Gastroenterologia, Azienda Ospedaliera "S. Camillo-Forlanini", Roma

Oversight

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

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