Study Title- A Randomized double-blind, placebo-controlled, parallel multicenter phase III study to evaluate evaluate the effectiveness and safety of VHAKM-Akkermansia muciniphila sleep, stress and cognition study Study Population- 60 Patients with Irritable Bowel Syndrome Study Duration- 2 Months (60 days) Study Design- A randomized double-blind, placebo-controlled, parallel,multi-center, phase 3 clinical trial. Inclusion Criteria- Age 18 Years to 65 Years Both males and females Patients willing to provide written informed consent and comply with protocol requirements. Exclusion Criteria – Any patient with weight or appetite loss, iron deficiency anemia, fever or rectal bleeding, Known inflammatory bowel disease or celiac disease patients, Immunocompromised patients, Pregnancy or wishing to become pregnant during the study, End-stage kidney failure on dialysis, presence of other diseases, including cancer or severe hepatic insufficiency, The use of other probiotic products or antibiotics over the previous 6 months, Participation in other clinical trials Dose and Mode of Administration- Take one capsule or as directed, best taken prior to a meal. Frequency: One Capsule or as directed Route of Administration: Oral Primary Outcome Measure- Change in the reaction time (in milliseconds) will be measured at from using a computerized task-switching color-word Stroop task following acute stress from baseline to Day 60, Self reported cognitive control and cognitive flexibility as per the Cognitive Control and Flexibility Questionnaire (CCFQ) in a non-stressful condition, Anxiety subscale score of the Depression, Anxiety, and Stress Scale Short Form (DASS-21) total Pittsburgh Sleep Quality Index (PSQI) scores. Secondary Outcome Measures- Change in the Accuracy on a computerized task switching and an incongruent CWST, a go/no-go paradigm, a visual working memory maintenance paradigm, and a visual working memory complex span task (SYMSPAN) from baseline to Day 60 (end of study), Change in Self-reported cognitive control and cognitive flexibility as per the Cognitive Control and Flexibility Questionnaire (CCFQ) in a non-stressful condition from baseline to Day 60 (end of study), Change in Anxiety subscale score of the Depression, Anxiety, and Stress Scale Short Form (DASS-21) total Pittsburgh Sleep Quality Index (PSQI) scores from baseline to Day 60 (end of study), Change in the Generalized Anxiety Disorder-7 (GAD-7) score from baseline to Day 60. (end of study) Clinical evaluation- · Haematological and hepatic biomarkers were analyzed following the standard medical test protocols at screening (baseline) and end of treatment (Day 60) · Vital signs measurement and physical examination will be carried out at Screening, day 1, day 14, day 28, day 45 and day 60. Evaluation Schedule- Visit 01(Day 01) Baseline- • Informed consent • Demographic data • Medical and surgical history • Medication history • Physical examination • Vital signs • Checking of eligibility criteria • Randomization • Dispensing of study medication • Fasting Blood sugar level • Subject treatment and diary filling instruction • Providing patient diary • Reaction time (milliseconds) using a computerized task-switching color-word Stroop task following acute stress. • Accuracy on various cognitive tasks. • Self-reported cognitive control and cognitive flexibility scores on the CCFQ in a non stressful condition. • Anxiety subscale score of the DASS-21 total PSQI scores. • Generalized Anxiety Disorder-7 (GAD-7) scores. Visit 04 (Day 42) Interim visit. • Fasting Blood sugar level • Lipid profile • Change in reaction time (milliseconds) using a computerized task-switching color-word Stroop task following acute stress. • Change in accuracy on various cognitive tasks. • Change in self-reported cognitive control and cognitive flexibility scores on the CCFQ in a non-stressful condition. • Anxiety subscale score of the DASS-21 total PSQI scores. • Generalized Anxiety Disorder-7 (GAD-7) scores. Visit 05 (Day 60 ± 3 days) End of Treatment Visit • General physical examination • Vital signs • Physical examination • Collection of patient diary and checking treatment compliance • Vital signs • Fasting Blood sugar level • Change in reaction time (milliseconds) using a computerized task-switching color-word Stroop task following acute stress. • Change in accuracy on various cognitive tasks. • Change in self-reported cognitive control and cognitive flexibility scores on the CCFQ in a non-stressful condition. • Change in anxiety subscale score of the DASS-21 total PSQI scores. • Change in the Generalized Anxiety Disorder-7 (GAD-7) scores. Safety Endpoints- • Number of participants who experienced at least one Adverse Event during the study duration. • Number of participants who discontinued study drug due to an Adverse Event during the study Ethical Considerations- The study will be conducted as per the National Ethical Guidelines for Biomedical and Health Research involving Human participants ICMR (2017), ICH (Step 5) ’Guidance on Good Clinical Practice’, New Drugs and Clinical Trials Rules 2019 G.S.R. 227(E) dated 19 Mar 2019, ’Good Laboratory Practice’, ‘Good Clinical Practices for Clinical Research in India’ Guidelines, Good Clinical Laboratory Practice (GCLP) and Declaration of Helsinki (Fortaleza, October 2013). |