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Prevention With Ismigen of RTIs in Kids (PIRTIK)

6 juli 2026 bijgewerkt door: Lallemand Pharma AG

A Randomized Double-blind Placebo-controlled Study to Demonstrate the Efficacy of PMBL® Sublingual Tablets in Reducing the Incidence of Respiratory Tract Infections in Children Aged 3-12 Years (PIRTIK).

Although the efficacy of PMBL® sublingual tablets is evident to most prescribers, the clinical studies available to demonstrate the efficacy of this bacterial lysate in preventing recurrent respiratory tract infections have undeniable methodological biases. To demonstrate the efficacy of PMBL® in the pediatric population without questionable bias, a randomized double-blind Placebo-controlled study will be conducted: one arm of children presenting with a risk of recurrent respiratory tract infections will be treated with PMBL® for a 3-month period, 10 days per months during the fall-winter whereas subjects of the Placebo arm will receive sublingual tablet indistinguishable from PMBL® but without active ingredients. Both groups of subjects will be followed for four additional months. To improve the accuracy of data and the tracking of respiratory tract infections (RTI), a diary will be provided to each subject, allowing them to report the event as soon as it occurs. If necessary, a visit may be planned to enable the investigator to assess the event accurately.

Studie Overzicht

Toestand

Werving

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

Respiratory tract infections (RTIs) are the leading cause of acute disease incidence worldwide that affect people of all ages. They are usually caused by viral pathogens, the most common of which including rhinoviruses, coronaviruses, adenoviruses, respiratory syncytial virus and influenza viruses. Bacterial pathogens can also cause RTIs, but they are less common. Various studies show the seasonality of RTIs. Influenza tends to occur in late autumn and winter, while other RTIs have a much more diffuse occurrence throughout the year. Although RTIs are usually not life-threatening, they significantly decrease quality of life and represent a substantial proportion of healthcare visits, mainly in women and young children, contributing to a financial burden on society.

Ismigen® (Polyvalent Mechanical Bacterial Lysate; PMBL) which is manufactured by mechanical lysis is currently authorized in two EU Member States (MS), Italy and Poland, where Lallemand Pharma Europe is the Marketing Authorization Holder (MAH) as sublingual tablets for the prophylaxis of recurrent RTI in adults. It is authorized in Poland in children from 3 years of age.

On 27 June 2019, the European Medicines Agency (EMA) recommended that bacterial lysates-containing medicinal products authorized for respiratory conditions should only be used for the prevention of recurrent respiratory tract infections, with the exception of pneumonia. This followed a review in which EMA's human medicines committee (CHMP) considered the results of clinical studies, data on side effects reported with these medicines, and advice from an expert group on infectious diseases. Although data are limited, the review found some evidence of effectiveness of bacterial lysates in the prevention of recurrent RTI together with a safety profile in line with what is expected for this type of product. The CHMP therefore recommended that use of bacterial lysates for prevention can continue, but the companies must provide further data on safety and effectiveness by Q1 2026 through the conduct of phase IV double-blind, multicenter, RCTs in this indication.

The present study is a Post-Authorization Efficacy Study (PAES) designed to demonstrate that PMBL® sublingual tablet used according to the SmPC instructions can reduce the incidence of respiratory tract infections in children 3 to 12 years old during the fall and winter period when compared to a matched Placebo.

Studietype

Ingrijpend

Inschrijving (Geschat)

224

Fase

  • Fase 4

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Locaties

  • Polen
      • Bialystok, Polen
        • Werving
        • Bio Zdrowie
      • Bydgoszcz, Polen
        • Werving
        • In Vivo Sp. z o.o.
      • Bydgoszcz, Polen
        • Werving
        • Vitamed
      • Krakow, Polen
        • Werving
        • Centrum Nowoczesnych Terapii
      • Krakow, Polen
        • Nog niet aan het werven
        • Comarch Healthcare S.A.
      • Krakow, Polen
        • Werving
        • Linden Sp. z o.o. sp.k.
      • Lublin, Polen
        • Werving
        • Allergotest
      • Oświęcim, Polen
        • Werving
        • Medicome Sp. z o.o.
      • Poznan, Polen
        • Werving
        • Med - Polonia
      • Tarnów, Polen
        • Werving
        • Alergo-Med Specjalistyczna Przychodnia

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Kind

Accepteert gezonde vrijwilligers

Ja

Beschrijving

Inclusion Criteria:

  1. Children of both genders aged from 3 to 12 years.
  2. Written informed consent obtained from the parents/legally authorized representatives
  3. Written assent obtained from the subject from 7 years
  4. Subject presenting with a susceptibility to respiratory tract infections according to the investigator
  5. No respiratory tract infection within 15 days before the randomization visit
  6. All girls of childbearing potential have a negative pregnancy urine testing at randomization visit and are informed and their parents as well of the requirement for contraception during the study.
  7. A cooperative attitude and ability to correct use of PMBL® tablet.

Exclusion Criteria:

  1. Subject treated with bacterial lysates within the previous 6 months prior to V1 or ongoing treatment.
  2. Body temperature ≥ 37.5°C at the randomization visit.
  3. Pregnant/Lactating female or with sexual activity without hormonal contraception, intrauterine device or barrier methods.
  4. Primary or secondary immunodeficiency, cystic fibrosis, bronchiectasis, alpha-1 antitrypsin deficiency, malignancy, endocrinological diseases or other chronic respiratory diseases, except asthma and allergic rhinitis.
  5. Known sensitivity to the components of study medication.
  6. Any major surgery within the last 3 months prior to study enrolment or planned to occur within the duration of study.

  7. Treatment with the following medications:

    1. Injection or oral administration of steroids within 4 weeks prior to study enrolment.
    2. Previous and/or concomitant immunosuppressants, immunostimulants, allergen-immunotherapy or gamma globulins within 6 months prior to study enrolment.
  8. Inability to understand or comply with study procedures or with study treatment intake.
  9. Subject participating in another interventional clinical study at the time of screening visit.

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Preventie
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Parallelle opdracht
  • Masker: Verdrievoudigen

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Actieve vergelijker: PMBL® sublingual tablet

Ismigen® (Polyvalent Mechanical Bacterial Lysate; PMBL) is a sublingual tablet marketed by Lallemand Pharma Europe. Each tablet contains:

  • Lyophilised bacterial lysate 50 mg
  • Excipients q.s. 250mg

The posology of Ismigen® for paediatric population (from 3 years of age) is one tablet per day before food, to be dissolved under the tongue. Use for ten consecutive days per month, over a period of 3 months.
Geneesmiddel: Bacterial Lysates
3-month period, 10 days per months during the fall-winter
Andere namen:
  • PMBL® sublingual tablet
  • ISMIGEN®
Placebo-vergelijker: Placebo

The comparator is a sublingual tablet, indistinguishable from the investigational product.

Each tablet of placebo comparator has the same composition as the investigational medicinal product being tested (with the exception of the active substance, which is replaced by glycine (7 mg)). Posology, instructions for use, contraindications, precautions of use and labelling are identical to those for Ismigen®.

The posology of Placebo is one tablet per day before food, to be dissolved under the tongue. Use for ten consecutive days per month, over a period of 3 months.
Geneesmiddel: Placebo
3-month period, 10 days per months during the fall-winter

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
The total number of RTIs experienced by each subject throughout the 7-month study period (3-month treatment + 4-month follow-up).
Tijdsspanne: Throughout the 7-month study period (3-month treatment + 4-month follow-up).
Rate of Respiratory Tract Infections (RTIs): the number of RTIs experienced by a subject throughout the study (3 month-treatment period and 4 month-follow-up) will be assessed.
Throughout the 7-month study period (3-month treatment + 4-month follow-up).

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Mean duration in days per RTI during the overall study period.
Tijdsspanne: Throughout the 7-month study period (3-month treatment + 4-month follow-up).
Estimated treatment effect from MMRM with 95% CI.
Throughout the 7-month study period (3-month treatment + 4-month follow-up).
Number of days with respiratory tract infections during the overall study period
Tijdsspanne: Throughout the 7-month study period (3-month treatment + 4-month follow-up).
Negative binomial or Poisson regression with 95% CI.
Throughout the 7-month study period (3-month treatment + 4-month follow-up).
Number of days of antibiotics use during the overall study period
Tijdsspanne: Throughout the 7-month study period (3-month treatment + 4-month follow-up).
Estimated incidence rate ratio (IRR) using negative binomial regression (or Poisson if appropriate) with 95% CI.
Throughout the 7-month study period (3-month treatment + 4-month follow-up).
Total number of workdays lost by parents due to their child's respiratory infections during the overall study period.
Tijdsspanne: Throughout the study (3 month-treatment period and 4 month-follow-up)
Total number of workdays lost by children's parents due to the child's respiratory infections during the overall study period (cumulative days) For each endpoint: mean (SD), median (IQR), and cumulative counts by treatment arm; primary between-group effect presented as an incidence rate ratio (IRR) with 95% CI (PMBL® vs placebo). Absolute mean difference and 95% CI will also be provided for interpretability
Throughout the study (3 month-treatment period and 4 month-follow-up)
Number of physician consultations due to RTI or related complications.
Tijdsspanne: Throughout the study (3 month-treatment period and 4 month-follow-up)
Number of physician consultations due to RTI or related complications during the overall study period (count) For each endpoint: mean (SD), median (IQR), and cumulative counts by treatment arm; primary between-group effect presented as an incidence rate ratio (IRR) with 95% CI (PMBL® vs placebo). Absolute mean difference and 95% CI will also be provided for interpretability
Throughout the study (3 month-treatment period and 4 month-follow-up)
Number of antibiotic treatments (courses) for a respiratory event during the overall study period.
Tijdsspanne: Throughout the study (3 month-treatment period and 4 month-follow-up)
Number of antibiotic treatments courses for a respiratory event during the overall study period (count of courses) For each endpoint: mean (SD), median (IQR), and cumulative counts by treatment arm; primary between-group effect presented as an incidence rate ratio (IRR) with 95% CI (PMBL® vs placebo). Absolute mean difference and 95% CI will also be provided for interpretability
Throughout the study (3 month-treatment period and 4 month-follow-up)
Number of subjects with (serious) adverse event and (serious) adverse drug reaction
Tijdsspanne: Throughout the study (3 month-treatment period and 4 month-follow-up)
Descriptive statistics: number and proportion of subjects experiencing events by type and severity Number and type of AEs, SAEs, and SARs during the study period
Throughout the study (3 month-treatment period and 4 month-follow-up)

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Lallemand Pharma AG

Onderzoekers

  • Hoofdonderzoeker: Andrzej EMERYK, MD, PhD, University Children Hospital, Lublin, Poland

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

1 juni 2026

Primaire voltooiing (Geschat)

1 maart 2027

Studie voltooiing (Geschat)

1 april 2027

Studieregistratiedata

Eerst ingediend

5 mei 2026

Eerst ingediend dat voldeed aan de QC-criteria

5 mei 2026

Eerst geplaatst (Werkelijk)

11 mei 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

8 juli 2026

Laatste update ingediend die voldeed aan QC-criteria

6 juli 2026

Laatst geverifieerd

1 juli 2026

Meer informatie

Termen gerelateerd aan deze studie

Trefwoorden

Aanvullende relevante MeSH-voorwaarden

Andere studie-ID-nummers

  • LPI-2501
  • 2025-524212-11-00 (Ctis)

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

ONBESLIST

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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