Polaprezinc (Zinc L-carnosine) in Infants With Gastroesophageal Reflux (GER)

Efficacy and Safety of Polaprezinc/Zinc L-carnosine (Hepilor) in Infants With Gastroesophageal Reflux

The goal of this clinical trial is to evaluate efficacy and safety of Zinc-L carnosine/Polaprezinc in infants with GER.

Researchers will compare Zinc-L carnosine/Polaprezinc to a placebo (a look-alike substance that contains no drug) to see if Zinc-L carnosine/Polaprezinc works to treat infants with GER.

Participants will:

Take drug Zinc-L carnosine/Polaprezinc or a thickened formula every day for 8 weeks Visit the clinic once every 4 weeks for checkups and questionnaires

Study Overview

• Status: Completed
• Conditions: Infants; Gastroesophageal Reflux (GER)
• Intervention / Treatment: Device: Zinc-L carnosine/Polaprezinc; Other: Thickened formula

Detailed Description

This will be a randomised, single blind, controlled, study, designed to evaluate efficacy and safety of Zinc-L carnosine/Polaprezinc in infants (1-12 months of age) with symptoms suggestive of GER. The study will include a 2-week screening period, and a 8-week parallel arms treatment period. After the screening phase, eligible patients will be randomly assigned to either thickened formula or polaprezing twice a day, in a 1:1 ratio, for 8 weeks. Study visits will be conducted every 4 weeks during the treatment period. All the subjects will be blindly allocated by means of scratch cards to one of the two treatment groups according to a computer-generated randomisation list provided by our statistician. A validated program will be used by an independent statistician to generate a randomisation list with blocks, block size=4, pre-allocated to centres. Only study investigators will be blinderd to the randomisation codes. The codes will be kept confidential until the end of the study when the randomisation code will be broken after the database lock. All subjects will undergo a formal clinical assessment. The protocol will be approved by and indipendent etichs committee and conducted according to the Declaration of Helsinki and the principles of good clinical practice.

Eligible patients with symptoms meeting Rome IV criteria for diagnosis of Infant Regurgitation will be recruited from Sant'Andrea University Hospital and from Children Hospital SS Antonio E Biagio E C. Arrigo.

The estimated total sample size that was aimed was 48 (24 children per arm) with the power of 80% (alpha of 5%). We estimated a dropout rate of 20% and aimed to recruit 60 participants to provide at least 48 evaluable assessments.

Efficacy analysis will be performed on ITT population. A sensitivity analysis on PP population will be carried out only if 5% or more ITT subjects are excluded from PP population.

Comparison between the two groups will be performed according to ANCOVA model. For all ANCOVA models, the assumptions of normality and homogeneity of variance will be investigated. Violation of these assumptions will be overcome by performing a non-parametric test (the Wilcoxon Rank Sum test).

Statistical analysis will be performed using the computer software SPSS 25.0

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Italy
  • Italy
    • Rome, Italy, Italy, 00189
      • UOC Pediatria - Azienda Ospedaliero-Universitaria Sant'Andrea

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Patients with infant regurgitation accoding to Rome IV criteria
• Healthy infants aged 1-12 months
• I-GERQ-R score ≥ 16 at baseline

Exclusion Criteria:

• Organic disease
• Current or pregress use of pharmacological treatment for gastric acid suppression or current use of thickened formula
• Past history of preterm birth or atopy
• Absence of informed consent

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Zinc-L carnosine/Polaprezinc; This group will receive Zinc-L carnosine/Polaprezinc (Hepilor Liquido) 1 hour after meals: 2.5 ml twice a day in infants weighing <5 kg or 5 ml twice a day in infants weighing >5 kg.	Device: Zinc-L carnosine/Polaprezinc; This will be a randomised, single blind, controlled, multicenter study, designed to evaluate efficacy and safety of Zinc-L carnosine/Polaprezinc in infants (1-12 months of age) with symptoms suggestive of GER. This study will include a 2-week screening period, and a 8-week treatment period. After the screeing phase, eligible patients will be randomly assigned to either Zinc-L carnosine/Polaprezinc (Hepilor Liquido, Azienda Farmaceutica Italiana, Italy) twice a day or thickened formula, in a 1:1 ratio, for 8 weeks. Study visits will be conducted every 4 weeks during the treatment period.; Other Names: Zinc-L carnosine/Polaprezinc (Hepilor Liquido)
Active Comparator: Thickened formula; Infants will receive thickened but not hydrolyzed formula	Other: Thickened formula; This will be a randomised, single blind, controlled, multicenter study, designed to evaluate efficacy and safety of Zinc-L carnosine/Polaprezinc in infants (1-12 months of age) with symptoms suggestive of GER. This study will include a 2-week screening period, and a 8-week treatment period. After the screeing phase, eligible patients will be randomly assigned to either Zinc-L carnosine/Polaprezinc (Hepilor Liquido, Azienda Farmaceutica Italiana, Italy) twice a day or thickened formula, in a 1:1 ratio, for 8 weeks. Study visits will be conducted every 4 weeks during the treatment period.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
I-GERQ-R questionnaire	The primary outcome will be the quantitative improvement in Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) score from baseline to the end of the treatment period. The total score ranges from 0 to 42. A cut-off of ≥ 16 has been suggested to discriminate between GER and GER-disease.	From enrollment to the end of treatment at 8 weeks.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Acceptability	Secondary outcome will be the evaluation of product acceptability according to a five-point Likert scale, ranges from 1 (very poor) to 5 (very good)	From enrollement to the end of treatment at 8 weeks.

Collaborators and Investigators

• Sponsor: University of Roma La Sapienza
• Collaborators: Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo di Alessandria

Study record dates

Study Major Dates

• Study Start (Actual): December 1, 2024
• Primary Completion (Actual): May 1, 2025
• Study Completion (Actual): July 1, 2025

Study Registration Dates

• First Submitted: November 5, 2024
• First Submitted That Met QC Criteria: November 6, 2024
• First Posted (Actual): November 7, 2024

Study Record Updates

• Last Update Posted (Actual): May 5, 2026
• Last Update Submitted That Met QC Criteria: April 28, 2026
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Keywords: Infants; Gastroesophageal Reflux; Zinc-L carnosine/Polaprezinc
• Additional Relevant MeSH Terms: Digestive System Diseases; Gastrointestinal Diseases; Esophageal Diseases; Esophageal Motility Disorders; Deglutition Disorders; Gastroesophageal Reflux; Physiological Effects of Drugs; Gastrointestinal Agents; Trace Elements; Micronutrients; Anti-Ulcer Agents; Zinc; Polaprezinc
• Other Study ID Numbers: HEPILOR PED

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