NCT04272437

Brief Summary

Urinary tract infection (UTI) is one of the most common infection in nursing home residents, and symptomatic UTI in the nursing home setting is the most frequent reason for hospitalization and antimicrobial therapy in Taiwan. Increasing antimicrobial resistance has stimulated interest in non-antibiotic prophylaxis of UTI. The primary aim of this study is to test the efficacy of standardized concentrated herbal extract granules TRA in the reduction of the incidence of symptomatic UTI and associated hospitalization in high-risk nursing home residents. These aims were accomplished by conducting a double-blind randomized placebo-controlled efficacy trial of TRA daily versus placebo granules in a cohort of Changhua County nursing home residents in Taiwan. A total of 164 nursing home residents at high risk for UTI were be enrolled. A permuted block design with a block size of 6 were conducted. And a Stratification by nursing home accounted for potentially different standards of care. Subjects will be randomly assigned to receive either TRA (10 g) or the placebo two times per day for 42 consecutive days. All subjects in both groups will also continuously receive their daily medication without any dose or medicine change. Urinalysis was evaluated before and after administration. Independent statisticians performed the data analysis at the end of the trial.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
162

participants targeted

Target at P75+ for phase_2

Timeline
Completed

Started Jun 2017

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

June 15, 2017

Completed
1.5 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 31, 2018

Completed
2 months until next milestone

Study Completion

Last participant's last visit for all outcomes

March 3, 2019

Completed
11 months until next milestone

First Submitted

Initial submission to the registry

February 10, 2020

Completed
7 days until next milestone

First Posted

Study publicly available on registry

February 17, 2020

Completed
Last Updated

February 17, 2020

Status Verified

February 1, 2020

Enrollment Period

1.5 years

First QC Date

February 10, 2020

Last Update Submit

February 13, 2020

Conditions

Keywords

Nursing HomesTCM herbal extracts

Outcome Measures

Primary Outcomes (1)

  • Number of Episodes of Symptomatic UTI During Administration

    Nursing home medical record and National Health Insurance(NHI) IC cards checking were both performed every week for the symptomatic UIT diagnosis and hospitalization recording. Suspected UTI episodes that were recorded in nursing home medical record were reviewed by chart review, symptoms, signs, and laboratory data were recorded, two investigators determined if the definition of symptomatic UTI was met.

    42 days

Secondary Outcomes (5)

  • Number of Episodes of Symptomatic UTI Onset From First Administration Till 180 Days

    180 days.

  • Accumulated Rate of Symptomatic UTI During Administration

    42 days.

  • Accumulated Rate of Symptomatic UTI Onset From First Administration Till 180 Days

    180 days.

  • The Change of Urinalysis From Baseline to 42 Days

    42 days

  • Number of Deaths Onset From First Administration Till 180 Days

    180 days

Other Outcomes (1)

  • Number of Adverse Events in Participants

    42 days

Study Arms (2)

TRA group

EXPERIMENTAL

"Tokoro Combination" and "Rehmannia and Akebia Formula" (TRA) in each one batch number were manufactured by Chuang Song Zong Pharmaceutical Co., Ltd., a famous manufacturer of concentrated herbal extract granules in agreement with the standards of good manufacturing practices (GMP) in Kaohsiung City, Taiwan. TRA contains "Tokoro Combination" and "Rehmannia and Akebia Formula" "Tokoro Combination" and "Rehmannia and Akebia Formula" consists of Dioscorea Hypoglaucae Rhizoma, Acori Graminei Rhizoma, Linderae Radix, Alpiniae Oxyphyllae Fructus, Poria, Rehmanniae Radix, Akebiae Caulis, Lophatheri Hebra, and Glycyrrhizae Radix at a 2:2:2:2:1:1.3:1.3:1.3:2.5 ratio.

Drug: Concentrated herbal extract granules TRA

placebo group

PLACEBO COMPARATOR

The placebo was also prepared as granules by Chung Song Zong Pharmaceutical Co., Ltd., and the packaging of the placebo was identical to that of TRA.

Drug: Placebo

Interventions

Concentrated herbal extract granules Subjects in the TRA group orally ingested one package of granules (5 g/package) two times daily with warm water after lunch and dinner for 6 consecutive weeks.

TRA group

Subjects in the placebo group orally ingested one package of granules (5 g/package) two times daily with warm water after lunch and dinner for 6 consecutive weeks.

placebo group

Eligibility Criteria

Age65 Years+
Sexall
Healthy VolunteersNo
Age GroupsOlder Adult (65+)

You may qualify if:

  • Nursing home residents;
  • years or older; and
  • High UTI risk
  • Catheterization (\>1 m/o),
  • Diabetes mellitus, or
  • At least one UTI in the preceding year.

You may not qualify if:

  • Not expected to be in the nursing home for at least one month (i.e. pending discharge, terminal life expectancy \< 1 month);
  • On chronic suppressive antibiotic or anti-infective therapy
  • On dialysis for end stage renal disease; or
  • previous ADR to herbals.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Dept. of Traditional Chinese Medicine, Changhua Christian Hospital

Changhua, 500, Taiwan

Location

MeSH Terms

Conditions

Urinary Tract Infections

Condition Hierarchy (Ancestors)

InfectionsUrologic DiseasesFemale Urogenital DiseasesFemale Urogenital Diseases and Pregnancy ComplicationsUrogenital DiseasesMale Urogenital Diseases

Study Design

Study Type
interventional
Phase
phase 2
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR
Masking Details
Participants were randomly assigned to take either TRA or placebo. Participants in the two groups orally ingested one package of granules (5 g/package) two times daily after lunch and dinner. The placebo was prepared as granules by Chuang Song Zong Pharmaceutical Co., Ltd, and the packaging of the placebo was identical to that of herbal extract granules. During the trial, neither the care providers(including family numbers and nursing-home colleagues) nor investigators ( assist doctors or nurses ) were aware of the group.
Purpose
PREVENTION
Intervention Model
PARALLEL
Model Details: Participants were randomly assigned to receive intervention or placebo.
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

February 10, 2020

First Posted

February 17, 2020

Study Start

June 15, 2017

Primary Completion

December 31, 2018

Study Completion

March 3, 2019

Last Updated

February 17, 2020

Record last verified: 2020-02

Locations