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Prevention With Ismigen of RTIs in Kids (PIRTIK)

6 lipca 2026 zaktualizowane przez: 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.

Przegląd badań

Szczegółowy opis

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.

Typ studiów

Interwencyjne

Zapisy (Szacowany)

224

Faza

  • Faza 4

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

  • Nazwa: Bernard GOUT, PharmD, PhD
  • Numer telefonu: +33776583905
  • E-mail: bgout@pharmndev.ch

Lokalizacje studiów

      • Bialystok, Polska
        • Rekrutacyjny
        • Bio Zdrowie
      • Bydgoszcz, Polska
        • Rekrutacyjny
        • In Vivo Sp. z o.o.
      • Bydgoszcz, Polska
        • Rekrutacyjny
        • Vitamed
      • Krakow, Polska
        • Rekrutacyjny
        • Centrum Nowoczesnych Terapii
      • Krakow, Polska
        • Jeszcze nie rekrutacja
        • Comarch Healthcare S.A.
      • Krakow, Polska
        • Rekrutacyjny
        • Linden Sp. z o.o. sp.k.
      • Lublin, Polska
        • Rekrutacyjny
        • Allergotest
      • Oświęcim, Polska
        • Rekrutacyjny
        • Medicome Sp. z o.o.
      • Poznan, Polska
        • Rekrutacyjny
        • Med - Polonia
      • Tarnów, Polska
        • Rekrutacyjny
        • Alergo-Med Specjalistyczna Przychodnia

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

  • Dziecko

Akceptuje zdrowych ochotników

Tak

Opis

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.

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Zapobieganie
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Potroić

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Aktywny komparator: 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.

3-month period, 10 days per months during the fall-winter
Inne nazwy:
  • PMBL® sublingual tablet
  • ISMIGEN®
Komparator placebo: 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.

3-month period, 10 days per months during the fall-winter

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
The total number of RTIs experienced by each subject throughout the 7-month study period (3-month treatment + 4-month follow-up).
Ramy czasowe: 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).

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Mean duration in days per RTI during the overall study period.
Ramy czasowe: 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
Ramy czasowe: 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
Ramy czasowe: 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.
Ramy czasowe: 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.
Ramy czasowe: 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.
Ramy czasowe: 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
Ramy czasowe: 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)

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Śledczy

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

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Rzeczywisty)

1 czerwca 2026

Zakończenie podstawowe (Szacowany)

1 marca 2027

Ukończenie studiów (Szacowany)

1 kwietnia 2027

Daty rejestracji na studia

Pierwszy przesłany

5 maja 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

5 maja 2026

Pierwszy wysłany (Rzeczywisty)

11 maja 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

8 lipca 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

6 lipca 2026

Ostatnia weryfikacja

1 lipca 2026

Więcej informacji

Terminy związane z tym badaniem

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIEZDECYDOWANY

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

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