Influenza Management With Polyherbal Formulation

Indian Herbal Medicine for Influenza - Randomized Controlled Study

The aim of this study is to determine the efficacy of Flu care polyherbal formulation in the management of acute uncomplicated case of Influenza within 48 hours of symptoms onset.

Study Overview

• Status: Unknown
• Conditions: Influenza
• Intervention / Treatment: Drug: polyherbal formulation; Drug: Oseltamivir 75mg

Detailed Description

Influenza is one of the most common epidemics occurring in India during winter months. Most of the commonly used antiviral have limited efficacy and safety in influenza treatment. Flu Care polyherbal consist of antiviral, antitussive and anti-inflammatory herbal medicine. If this Flu care intervention is shown to be effective, there will be major potential benefits to general population.

• Study Type: Interventional
• Enrollment (Anticipated): 100
• Phase: Not Applicable

Contacts and Locations

Study Locations

• India
  • Karnataka
    • Bangalore, Karnataka, India, 560099
      • Recruiting
      • Mazumdar Shaw Medical Centre
      • Contact: Alben Sigamani, MD; Phone Number: 8884431444; Email: alben.sigamani.dr@nhhospitals.org
      • Contact: Sanjaya Chauhan, Pharm.D; Phone Number: 9611252350; Email: drsanjayachauhan49@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Subjects above the age of 18 years, providing written informed consent.

• Patients with a duration of influenza symptoms confirmed by all of the following:

  1. Fever ≥ 38º C (axillary) during the predose examinations or within the 4 hours prior if antipyretics were taken
  2. At least 1 each of the following general and respiratory symptoms associated with influenza is present with a severity of moderate or greater: i. General symptoms (headache, feverishness or chills, muscle or joint pain, or fatigue) ii. Respiratory symptoms (cough, sore throat, or nasal congestion) Rapid diagnostic test, PCR, or viral culture positive for influenza in the 96 hours prior to first dose

• The time interval between the onset of symptoms and the predose examinations is 48 hours or less. The onset of symptoms is defined as either:

  1. Time of the first increase in body temperature (an increase of at least 1º C from normal body temperature)
  2. Time when the patient experiences at least 1 new general or respiratory symptom

Exclusion Criteria:

Patients will be considered at high risk of influenza complications due to the presence of at least 1 of the following inclusion criteria:

1. Asthma or chronic lung disease (such as chronic obstructive pulmonary disease or cystic fibrosis)
2. Endocrine disorders (including diabetes mellitus)
3. Residents of long-term care facilities (e.g., nursing homes)
4. Compromised immune system (including patients receiving corticosteroids not exceeding 20 mg of prednisolone or equivalent, and patients being treated for human immunodeficiency virus (HIV) infection with a cluster of differentiation 4 count > 350 cells/mm³ within the last 6 months)
5. Neurological and neurodevelopmental disorders (including disorders of the brain, spinal cord, peripheral nerve, and muscle, e.g., cerebral palsy, epilepsy [seizure disorders], stroke, muscular dystrophy, or spinal cord injury)
6. Heart disease (such as congenital heart disease, congestive heart failure, or coronary artery disease), excluding hypertension without any other heart-related symptoms
7. Adults aged ≥ 65 years
8. Blood disorders (such as sickle cell disease)
9. Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
10. Morbid obesity (body mass index ≥ 40)

Other Exclusion criteria Any one of the following

• Influenza vaccination with live attenuated vaccine in the 3 months prior to randomization
• Antiviral treatment for influenza in 2 weeks prior to randomization
• Severe Hepatic and renal impairment
• Pregnant, attempting to conceive, or lactating women

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention Group; Each Flu Care capsule consists of combination of seven polyherbal formulation (350 mg). Participant will be instructed to take one capsule thrice daily at a fixed time in the day for the study duration of 7 days along with 75 mg of Oseltamivir.	Drug: polyherbal formulation; Each Flu Care consist of 350 mg of polyherbal component; Other Names: Flu Care; Drug: Oseltamivir 75mg; All the participant has to take 75 mg of oseltamivir for five days.
Active Comparator: Standard Care Group; Standard of care consist of 75 mg of Oseltamivir for five days and any other required provision of care. These will be determined on case by case basis by research clinician.	Drug: Oseltamivir 75mg; All the participant has to take 75 mg of oseltamivir for five days.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Time to improvement of symptoms	Time to improvement of symptoms is defined as the time from initiation of study treatment to improvement of influenza symptoms for a duration of at least 21.5 hours (24 hours - 10%).	Day 1 pretreatment upto Day 7

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Percentage change in participants positive for influenza virus titer and viral RNA at end of treatment	Defined as the percentage of patients whose virus titer and ribonucleic acid (RNA) load are become less than the lower limit of quantification among those assessed for virus titer and RNA load. RNA load is measured by reverse transcription polymerase chain reaction (RT-PCR).	7 days
Time to alleviation of symptoms	Time to alleviation of symptoms is defined as the time between the initiation of the study treatment and the alleviation of influenza symptoms. The alleviation of influenza symptoms is defined as the time when all of 7 influenza symptoms (cough, sore throat, headache, nasal congestion, feverishness or chills, muscle or joint pain, and fatigue) have been assessed by the patient.	Day 1 pretreatment up to Day 7
Time to improvement in the 4 systemic symptoms	Defined as the time between the initiation of the study treatment and the improvement in the 4 systemic symptoms symptoms (headache, feverishness or chills, muscle or joint pain, and fatigue).	Day 1 pretreatment up to Day 7
Time to improvement in the 3 respiratory symptoms	Defined as the time between the initiation of the study treatment and the improvement in the 3 respiratory symptoms (cough, sore throat, and nasal congestion).	Day 1 pretreatment up to Day 7
Time to resolution of fever	Defined as the time between the initiation of the study treatment and the resolution of fever. The resolution of fever is defined as the time when the patient's self-measured temperature becomes less than 37º C.	Day 1 pretreatment up to Day 7
Percentage of participants with adverse events		Baseline up to Day 7
Percentage of participants who had been hospitalized		Baseline up to Day 7
Percentage of participants with influenza-related complications	Defined as the percentage of patients who experience each influenza-related complication (hospitalization, death, sinusitis, otitis media, bronchitis, and radiologically-confirmed pneumonia) as an adverse event after the initiation of study treatment.	Baseline up to Day 7

Collaborators and Investigators

• Sponsor: Composite Interceptive Med Science
• Investigators: Principal Investigator: Dayanand B Yaligar, MBBS, Narayana Hrudayalaya Hospital

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2018
• Primary Completion (Anticipated): May 15, 2018
• Study Completion (Anticipated): May 15, 2018

Study Registration Dates

• First Submitted: December 2, 2017
• First Submitted That Met QC Criteria: December 2, 2017
• First Posted (Actual): December 7, 2017

Study Record Updates

• Last Update Posted (Actual): April 11, 2018
• Last Update Submitted That Met QC Criteria: April 10, 2018
• Last Verified: April 1, 2018

More Information

Terms related to this study

• Additional Relevant MeSH Terms: RNA Virus Infections; Virus Diseases; Infections; Respiratory Tract Infections; Respiratory Tract Diseases; Orthomyxoviridae Infections; Influenza, Human; Molecular Mechanisms of Pharmacological Action; Anti-Infective Agents; Antiviral Agents; Enzyme Inhibitors; Oseltamivir
• Other Study ID Numbers: OI-008-2017

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No