A double-blind clinical trial to compare the efficacy and safety of a multiple amino acid-based ORS with the standard WHO-ORS in the management of non-cholera acute watery diarrhea in infants and young children: “VS002A” trial protocol

Abstract Background Diarrhea is the second deadliest disease for under-five children globally and the situation is more serious in developing countries. Oral rehydration solution (ORS) is being used as a standard treatment for acute watery diarrhea for a long time. Our objective is to compare the ef...

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Main Authors: Rina Das, Rukaeya Amin Sobi, Al-Afroza Sultana, Baitun Nahar, Pradip Kumar Bardhan, Laura Luke, Olivier Fontaine, Tahmeed Ahmed
Format: Article
Language:English
Published: BMC 2022-08-01
Series:Trials
Subjects:
Online Access:https://doi.org/10.1186/s13063-022-06601-5
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author Rina Das
Rukaeya Amin Sobi
Al-Afroza Sultana
Baitun Nahar
Pradip Kumar Bardhan
Laura Luke
Olivier Fontaine
Tahmeed Ahmed
author_facet Rina Das
Rukaeya Amin Sobi
Al-Afroza Sultana
Baitun Nahar
Pradip Kumar Bardhan
Laura Luke
Olivier Fontaine
Tahmeed Ahmed
author_sort Rina Das
collection DOAJ
description Abstract Background Diarrhea is the second deadliest disease for under-five children globally and the situation is more serious in developing countries. Oral rehydration solution (ORS) is being used as a standard treatment for acute watery diarrhea for a long time. Our objective is to compare the efficacy of amino acid-based ORS “VS002A” compared to standard glucose-based WHO-ORS in infants and young children suffering from acute non-cholera watery diarrhea. Methods It is a randomized, double-blind, two-cell clinical trial at Dhaka Hospital of icddr,b. A total of 312 male children aged 6–36 months old with acute non-bloody watery diarrhea are included in this study. Intervention arm participants get amino acid-based ORS (VS002A) and the control arm gets standard glucose-based WHO-ORS. The primary efficacy endpoint is the duration of diarrhea in the hospital. Discussion Oral rehydration therapy (ORT) with the present ORS formulation has certain limitations - it does not reduce the volume, frequency, or duration of diarrhea. Additionally, the failure of present standard ORS to significantly reduce stool output likely contributes to the relatively limited use of ORS by mothers as they do not feel that ORS is helping their child recover from the episode of diarrhea. Certain neutral amino acids (e.g., glycine, L-alanine, L-glutamine) can enhance the absorption of sodium ions and water from the gut. By using this concept, a shelf-stable, sugar-free amino acid-based hydration medicinal food named ‘VS002A’ that effectively rehydrates, and improves the barrier function of the bowel following infections targeting the gastrointestinal tract has been developed. If the trial shows significant benefits of VS002A use, this may provide evidence to support consideration of the use of VS002A in the present WHO diarrhea management guidelines. Conversely, if there is no evidence of benefit, these results will reaffirm the current guidelines. Trial registration ClinicalTrials.gov NCT04677296 . Registered on December 21, 2020.
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spelling doaj.art-23694ca93d22439c9b59235884227aa82022-12-22T03:05:51ZengBMCTrials1745-62152022-08-0123111210.1186/s13063-022-06601-5A double-blind clinical trial to compare the efficacy and safety of a multiple amino acid-based ORS with the standard WHO-ORS in the management of non-cholera acute watery diarrhea in infants and young children: “VS002A” trial protocolRina Das0Rukaeya Amin Sobi1Al-Afroza Sultana2Baitun Nahar3Pradip Kumar Bardhan4Laura Luke5Olivier Fontaine6Tahmeed Ahmed7International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)Science & Technology, Entrinsic Bioscience Inc.Science & Technology, Entrinsic Bioscience Inc.International Centre for Diarrheal Disease Research, Bangladesh (icddr,b)Abstract Background Diarrhea is the second deadliest disease for under-five children globally and the situation is more serious in developing countries. Oral rehydration solution (ORS) is being used as a standard treatment for acute watery diarrhea for a long time. Our objective is to compare the efficacy of amino acid-based ORS “VS002A” compared to standard glucose-based WHO-ORS in infants and young children suffering from acute non-cholera watery diarrhea. Methods It is a randomized, double-blind, two-cell clinical trial at Dhaka Hospital of icddr,b. A total of 312 male children aged 6–36 months old with acute non-bloody watery diarrhea are included in this study. Intervention arm participants get amino acid-based ORS (VS002A) and the control arm gets standard glucose-based WHO-ORS. The primary efficacy endpoint is the duration of diarrhea in the hospital. Discussion Oral rehydration therapy (ORT) with the present ORS formulation has certain limitations - it does not reduce the volume, frequency, or duration of diarrhea. Additionally, the failure of present standard ORS to significantly reduce stool output likely contributes to the relatively limited use of ORS by mothers as they do not feel that ORS is helping their child recover from the episode of diarrhea. Certain neutral amino acids (e.g., glycine, L-alanine, L-glutamine) can enhance the absorption of sodium ions and water from the gut. By using this concept, a shelf-stable, sugar-free amino acid-based hydration medicinal food named ‘VS002A’ that effectively rehydrates, and improves the barrier function of the bowel following infections targeting the gastrointestinal tract has been developed. If the trial shows significant benefits of VS002A use, this may provide evidence to support consideration of the use of VS002A in the present WHO diarrhea management guidelines. Conversely, if there is no evidence of benefit, these results will reaffirm the current guidelines. Trial registration ClinicalTrials.gov NCT04677296 . Registered on December 21, 2020.https://doi.org/10.1186/s13063-022-06601-5VS002AWHO-ORSDiarrheaRandomizedAmino acid-based ORS
spellingShingle Rina Das
Rukaeya Amin Sobi
Al-Afroza Sultana
Baitun Nahar
Pradip Kumar Bardhan
Laura Luke
Olivier Fontaine
Tahmeed Ahmed
A double-blind clinical trial to compare the efficacy and safety of a multiple amino acid-based ORS with the standard WHO-ORS in the management of non-cholera acute watery diarrhea in infants and young children: “VS002A” trial protocol
Trials
VS002A
WHO-ORS
Diarrhea
Randomized
Amino acid-based ORS
title A double-blind clinical trial to compare the efficacy and safety of a multiple amino acid-based ORS with the standard WHO-ORS in the management of non-cholera acute watery diarrhea in infants and young children: “VS002A” trial protocol
title_full A double-blind clinical trial to compare the efficacy and safety of a multiple amino acid-based ORS with the standard WHO-ORS in the management of non-cholera acute watery diarrhea in infants and young children: “VS002A” trial protocol
title_fullStr A double-blind clinical trial to compare the efficacy and safety of a multiple amino acid-based ORS with the standard WHO-ORS in the management of non-cholera acute watery diarrhea in infants and young children: “VS002A” trial protocol
title_full_unstemmed A double-blind clinical trial to compare the efficacy and safety of a multiple amino acid-based ORS with the standard WHO-ORS in the management of non-cholera acute watery diarrhea in infants and young children: “VS002A” trial protocol
title_short A double-blind clinical trial to compare the efficacy and safety of a multiple amino acid-based ORS with the standard WHO-ORS in the management of non-cholera acute watery diarrhea in infants and young children: “VS002A” trial protocol
title_sort double blind clinical trial to compare the efficacy and safety of a multiple amino acid based ors with the standard who ors in the management of non cholera acute watery diarrhea in infants and young children vs002a trial protocol
topic VS002A
WHO-ORS
Diarrhea
Randomized
Amino acid-based ORS
url https://doi.org/10.1186/s13063-022-06601-5
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