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| Name | Class |
|---|---|
| KGK Science Inc. | INDUSTRY |
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The goal of this randomized blinded placebo-controlled clinical trial is to investigate the effect of low- and high-dose supplementation of Acacia fiber on gut health and microbiota composition in adults with occasional constipation in a controlled diet context. Acacia fiber is a soluble dietary fiber with prebiotic properties, and this study evaluates its role in modulating gut microbiota and associated gastrointestinal outcomes. Acacia fiber has previously demonstrated improvements in stool frequency in the context of an irritable bowel syndrome with constipation (IBS-C)-characterized population. The main questions this study aims to answer are: Does Acacia fiber supplementation (5 g or 10 g) improve the frequency of bowel movements or stool consistency (assessed by Bristol Stool Scale) in the context of healthy population with occasional constipation? Does Acacia fiber benefit on gut health correlates with specific gut microbiota modulation characterised by shotgun sequencing? What are mechanistical faecal & blood markers that may support this correlation? Researchers will compare low-dose Acacia fiber (5 g), high-dose Acacia fiber (10 g), and placebo to see if Acacia fiber modulates gut microbiota composition in a manner consistent with prebiotic activity and whether these changes are associated with improvements in bowel movement frequency and stool consistency. Participants will:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Low-dose Acacia fiber | Experimental |
| |
| High-dose Acacia fiber | Experimental |
| |
| Placebo | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Placebo powder | Dietary Supplement | Starting the day following the baseline visit (Day 1), participants will take 1 sachet daily for 4 days, then increase to 2 sachets daily until the day prior to the end-of-study visit (Day 56). Each sachet will be mixed with a usual food or beverage prior to consumption. |
| Measure | Description | Time Frame |
|---|---|---|
| Frequency of complete and spontaneous bowel movements | Frequency of complete and spontaneous bowel movements (CSBMs), as assessed by the Bowel Habits Diary (BHD) | Baseline to Day 56 |
| Stool consistency | Stool consistency, as assessed by the Bristol Stool Scale (BSS). The BSS is a 7-item stool description and image scale that assesses the shape and consistency of stool. Scores range from 1 to 7, with higher scores indicating looser stool consistency and lower scores indicating harder stool consistency. | Baseline to Day 56 |
| Measure | Description | Time Frame |
|---|---|---|
| Gut Microbiota Composition | Change from baseline to Day 56 between Acacia fiber (5g or 10g) and placebo in gut microbiota composition, as assessed by fecal microbiome shotgun sequencing | Baseline to Day 56 |
| Frequency of CSBMs |
| Measure | Description | Time Frame |
|---|---|---|
| Change from baseline to Day 28 between Acacia fiber (5g or 10g) and placebo in gut microbiota composition, as assessed by fecal microbiome shotgun sequencing | Change from baseline to Day 28 between Acacia fiber (5g or 10g) and placebo in gut microbiota composition, as assessed by fecal microbiome shotgun sequencing | Baseline to Day 28 |
Inclusion Criteria:
Males and females aged between 30 and 60 years old, inclusive
Body Mass Index (BMI) between 18.5 to 29.9 kg/m², inclusive
Stable body weight defined as a <5% change in body weight in the three months prior to baseline as assessed by the Qualified Investigator (QI)
Participants must meet the following criteria of occasional constipation for the past 3 months. This will be assessed at screening and confirmed over a 2-week period prior to baseline:
OR,
At least 50% of BMs are BSS type 1 and 2, as assessed by the QI
OR,
≤ 3 CSBMs per week as assessed by the QI
OR,
Individuals of child-bearing potential must have a negative baseline urine pregnancy test and agree to use a medically approved method of birth control for the duration of the study. All hormonal birth control must have been in use for a minimum of three months. Acceptable methods of birth control include:
Hormonal contraceptives including oral contraceptives, hormone birth control patch (Ortho Evra), vaginal contraceptive ring (NuvaRing), injectable contraceptives (Depo-Provera, Lunelle), or hormone implant (Norplant System)
Double-barrier method
Intrauterine devices
Non-heterosexual lifestyle and agrees to use contraception if planning on changing to heterosexual partner(s)
Vasectomy of partner at least 6 months prior to screening
Abstinence and agrees to use contraception if planning on becoming sexually active during the study
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Erin Lewis, PhD | Contact | 1-226-242-4551 | 248 | elewis@kgkscience.com |
| Damien Guillemet | Contact | +33 2 32 83 18 18 | d.guillemet@nexira.com |
| Name | Affiliation | Role |
|---|---|---|
| David Crowley, MD | KGK Science Inc. | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| KGK Science Inc. | London | Ontario | N5Y 5V6 | Canada |
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Sponsor representatives will be masked to randomization assignments and treatment groups during the conduct of the study.
|
| Low-dose Acacia fiber | Dietary Supplement | Starting the day following the baseline visit (Day 1), participants will take 1 sachet daily for 4 days, then increase to 2 sachets daily until the day prior to the end-of-study visit (Day 56). Each sachet will be mixed with a usual food or beverage prior to consumption. |
|
| High-dose Acacia fiber | Dietary Supplement | Starting the day following the baseline visit (Day 1), participants will take 1 sachet daily for 4 days, then increase to 2 sachets daily until the day prior to the end-of-study visit (Day 56). Each sachet will be mixed with a usual food or beverage prior to consumption. |
|
Change from baseline to Day 28 between Acacia fiber (5g or 10g) and placebo in frequency of CSBMs, as assessed by the BHD
| Baseline to Day 28 |
| Stool Consistency | Change from baseline to Day 28 between Acacia fiber (5g or 10g) and placebo in stool consistency, as assessed by the Bristol Stool Scale (BSS). The BSS is a 7-item stool description and image scale that assesses the shape and consistency of stool. Scores range from 1 to 7, with higher scores indicating looser stool consistency and lower scores indicating harder stool consistency. | Baseline to Day 28 |
| Digestive symptoms | Change from baseline to Day 28 and Day 56 between Acacia fiber (5g or 10g) and placebo in digestive symptoms as assessed by Gastrointestinal Symptom Rating Scale (GSRS). The modified GSRS consists of 14 items on a four-point scale (0-3). It assesses abdominal pain, reflux syndrome, diarrhea syndrome, indigestion syndrome, and constipation syndrome. Higher scores indicate more severe gastrointestinal symptoms. | Baseline to Day 28 and Day 56 |
| Patient Assessment of Constipation Quality of Life questionnaire (PAC-QoL) | Change from baseline to Day 28 and Day 56 between Acacia fiber (5g or 10g) and placebo in Quality of life as assessed by Patient Assessment of Constipation Quality of Life questionnaire (PAC-QoL). The PAC-QoL consists of 28-items with four subscales (worries and concerns, physical discomfort, psychosocial discomfort, and satisfaction), and an overall scale. Items are scored on a 5-point Likert scale ranging from 0 to 4, with lower scores indicating better constipation-related quality of life. | Baseline to Day 28 and Day 56 |
| Proportion of CSBMs with complete defecation | The difference in the proportion of CSBMs with complete defecation at Day 28 and Day 56 between Acacia fiber (5g or 10g) and placebo | Day 28 and Day 56 |
| proportion of participants with occasional constipation | The difference in the proportion of participants with occasional constipation at Day 56 between Acacia fiber (5g or 10g) and placebo | Day 56 |
| Sleep and Stress | Change from baseline to Day 28 and Day 56 between Acacia fiber (5g or 10g) and placebo in sleep and stress, as assessed by the sleep and stress Likert scales. Four-point Likert scales will be used to measure the participant's perceived sleep quality (strongly disagree - 0, disagree - 1, agree - 2, strongly agree - 3) and stress (no stress - 0, minimally stressed - 1, moderately stressed - 2, extremely stressed - 3). Participants will be instructed to indicate their response on the scale for the following statements: "Overall, I am satisfied with my sleep" and " Rate your current stress level". Higher scores indicate greater perceived stress. | Baseline to Day 28 and Day 56 |
| Change from baseline to Day 28 and Day 56 between Acacia fiber (5g or 10g) and placebo in short-chain fatty acids (SCFAs) |
Change from baseline to Day 28 and Day 56 between Acacia fiber (5g or 10g) and placebo in constipation related fecal biomarkers (short-chain fatty acids (SCFAs). |
| Baseline to Day 28 and Day 56 |
| Change from baseline to Day 28 and Day 56 between Acacia fiber (5g or 10g) and placebo in lipopolysaccharides (LPS) and LPS binding proteins | Change from baseline to Day 28 and Day 56 between Acacia fiber (5g or 10g) and placebo in constipation related fecal biomarkers (lipopolysaccharides (LPS) and LPS binding proteins). | Baseline to Day 28 and Day 56 |
| Change from baseline to Day 28 and Day 56 between Acacia fiber (5g or 10g) and placebo in primary and secondary bile acids | Change from baseline to Day 28 and Day 56 between Acacia fiber (5g or 10g) and placebo in constipation related fecal biomarkers (primary and secondary bile acids). | Baseline to Day 28 and Day 56 |
| Change from baseline to Day 28 and Day 56 between Acacia fiber (5g or 10g) and placebo in fecal serotonin | Change from baseline to Day 28 and Day 56 between Acacia fiber (5g or 10g) and placebo in constipation related fecal biomarkers (serotonin). | Baseline to Day 28 and Day 56 |
| Change from baseline to Day 28 and Day 56 between Acacia fiber (5g or 10g) and placebo in Immunoglobulin A | Change from baseline to Day 28 and Day 56 between Acacia fiber (5g or 10g) and placebo in constipation related fecal biomarkers (Immunoglobulin A). | Baseline to Day 28 and Day 56 |
| Change from baseline to Day 56 between Acacia fiber (5g or 10g) and placebo in plasma short-chain fatty acid (SCFA) concentrations | Change from baseline to Day 56 between Acacia fiber (5g or 10g) and placebo in constipation related blood biomarkers (SCFAs) | Baseline to Day 56 |
| Change from baseline to Day 56 between Acacia fiber (5g or 10g) and placebo in plasma lipopolysaccharide (LPS) concentrations | Change from baseline to Day 56 between Acacia fiber (5g or 10g) and placebo in constipation related blood biomarkers (LPS) | Baseline to Day 56 |
| Change from baseline to Day 56 between Acacia fiber (5g or 10g) and placebo in plasma zonulin | Change from baseline to Day 56 between Acacia fiber (5g or 10g) and placebo in constipation related blood biomarkers (zonulin) | Baseline to Day 56 |
| Change from baseline to Day 56 between Acacia fiber (5g or 10g) and placebo in plasma serotonin | Change from baseline to Day 56 between Acacia fiber (5g or 10g) and placebo in constipation related blood biomarkers (serotonin) | Baseline to Day 56 |
| Change from baseline to Day 56 between Acacia fiber (5g or 10g) and placebo in plasma motilin | Change from baseline to Day 56 between Acacia fiber (5g or 10g) and placebo in constipation related blood biomarkers (motilin) | Baseline to Day 56 |
| Incidence of post-emergent adverse events (AE) | Incidence of post-emergent adverse events (AE) | From screening (Day -45 to Day -15) through final study visit (Visit 4) |
| Clinically relevant changes in blood pressure after supplementation | Changes in blood pressure (mmHg) after supplementation | From screening (day -45 to day -15) through final study visit (visit 4) |
| Change in complete blood count following supplementation | Clinically relevant changes in complete blood count after supplementation | At screening (day -45 to day -15) and visit 4 (day 56) |
| Change in plasma aspartate aminotransferase (AST) concentration following supplementation | Clinically relevant changes in clinical chemistry (aspartate aminotransferase (AST)) after supplementation | At screening (day -45 to day -15) and visit 4 (day 56) |
| Change in plasma alanine aminotransferase (ALT) concentration following supplementation | Clinically relevant changes in clinical chemistry (alanine aminotransferase (ALT)) after supplementation | At screening (day -45 to day -15) and visit 4 (day 56) |
| Change in plasma alkaline phosphatase (ALP) concentration following supplementation | Clinically relevant changes in clinical chemistry (alkaline phosphatase (ALP)) after supplementation | At screening (day -45 to day -15) and visit 4 (day 56) |
| Change in total bilirubin following supplementation | Clinically relevant changes in total bilirubin after supplementation | At screening (day -45 to day -15) and visit 4 (day 56) |
| Change in creatinine following supplementation | Clinically relevant changes in creatinine after supplementation | At screening (day -45 to day -15) and visit 4 (day 56) |
| Change in estimated glomerular filtration rate (eGFR) following supplementation | Clinically relevant changes in estimated glomerular filtration rate (eGFR) after supplementation | At screening (day -45 to day -15) and visit 4 (day 56) |
| Change in potassium following supplementation | Clinically relevant changes in serum potassium after supplementation | At screening (day -45 to day -15) and visit 4 (day 56) |
| Change in sodium following supplementation | Clinically relevant changes in serum sodium after supplementation | At screening (day -45 to day -15) and visit 4 (day 56) |
| Change in chloride following supplementation | Clinically relevant changes in serum chloride after supplementation | At screening (day -45 to day -15) and visit 4 (day 56) |
| Clinically relevant changes in heart rate after supplementation | Changes in heart rate (beats per minute) after supplementation | From screening (day -45 to day -15) through final study visit (visit 4) |