225 Participants NeededMy employer runs this trial

Rifaximin + NAC for IBS-D

MP
MR
AH
Overseen ByAva Hosseini
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to determine if combining rifaximin, a standard IBS-D treatment, with NAC, a dietary supplement, can better relieve symptoms of irritable bowel syndrome with diarrhea (IBS-D) than rifaximin alone. Researchers are testing two different doses of this combination to identify the most effective one. Individuals diagnosed with IBS-D who continue to experience frequent diarrhea, abdominal pain, or inconsistent stools might be suitable candidates for this trial. As a Phase 2 trial, the research focuses on assessing the treatment's effectiveness in an initial, smaller group, providing participants an opportunity to contribute to significant findings.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that rifaximin is generally safe and effective for treating irritable bowel syndrome with diarrhea (IBS-D). The FDA has approved it for this use. However, it benefits only about 44% of patients, so it does not work for everyone. Rifaximin has been used multiple times without major safety issues.

N-acetyl-L-cysteine (NAC) is also considered safe. The FDA has approved it for certain lung conditions, and it is available over-the-counter as a dietary supplement. While researchers are still studying the combination of rifaximin and NAC for IBS-D, both are known to be safe when used individually.

This study is in an early stage, focusing on the safety and effectiveness of this combination. Current evidence suggests that using rifaximin with NAC might improve treatment for some patients. However, the specific effects and safety of using them together for IBS-D remain under investigation.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments for IBS-D because they combine rifaximin, an antibiotic, with N-acetylcysteine (NAC), an antioxidant. This pairing is unique because while standard treatments often focus solely on gut bacteria or inflammation, this duo targets both. The potential synergy between rifaximin's ability to adjust gut bacteria and NAC's antioxidant properties might offer more comprehensive relief. Plus, the trial explores both low and high doses of rifaximin, providing insights into optimizing dosage for better patient outcomes.

What evidence suggests that this trial's treatments could be effective for IBS-D?

This trial will evaluate the effectiveness of combining rifaximin with N-acetylcysteine (NAC) for IBS-D. Studies have shown that rifaximin effectively relieves symptoms like stomach pain and diarrhea in IBS-D patients. However, not everyone experiences complete relief, and symptoms might return over time. In this trial, participants will receive either a low or high dose of rifaximin combined with NAC, or a placebo. Research suggests that combining rifaximin with NAC could enhance results for IBS-D patients. NAC, known for clearing mucus in the lungs, might also clear mucus in the intestines, allowing rifaximin to work more effectively. Early findings indicate that adding NAC to rifaximin may increase the number of patients who respond well to the treatment.12456

Are You a Good Fit for This Trial?

Inclusion Criteria

I still have IBS symptoms like pain or abnormal stools.
My worst daily abdominal pain averages more than 3 out of 10 each week.
I have had at least one watery or loose stool.
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive RNIB21 containing rifaximin and NAC or placebo for 14 days

2 weeks
Randomization visit on Day 1, visits at Week 1 (Day 7 ± 2) and Week 2 (Day 14 ± 2)

Primary Evaluation Period

Participants are monitored for adequate relief of IBS symptoms based on abdominal pain and stool consistency

4 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment, including an End of Study visit

10 weeks
End of Study visit at Week 14 (Day 98 ± 3)

What Are the Treatments Tested in This Trial?

Interventions

  • Placebo
  • Rifaximin 66mg + N-acetylcysteine 560mg
  • RNIB21 containing rifaximin 132mg + N-acetylcysteine 560mg

How Is the Trial Designed?

3

Treatment groups

Experimental Treatment

Placebo Group

Group I: low dose for IBS-DExperimental Treatment1 Intervention
Group II: high dose for IBS-DExperimental Treatment1 Intervention
Group III: placeboPlacebo Group1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Mark Pimentel, MD

Lead Sponsor

Trials
2
Recruited
260+

Citations

NCT06727422 | Efficacy of Rifaximin With NAC in IBS-D

The primary outcome for the study will be adequate relief of IBS symptoms based on FDA guidance during this period, specifically: the proportion of patients who ...

Trial | NCT06727422

The purpose of this study is to examine the effectiveness of using a combination of a drug, rifaximin and a dietary supplement, N-acetyl-L-cysteine (NAC), ...

Effectiveness of Rifaximin on the Outcomes of Irritable Bowel ...

The results of our meta-analysis support the use of rifaximin in the treatment of IBS, owing to its safety and effectiveness.

Efficacy of Rifaximin With NAC in IBS-D - Carebox Connect

The purpose of this study is to examine the effectiveness of using a combination of a drug, rifaximin and a dietary supplement, N-acetyl-L-cysteine (NAC), to ...

5.

clinicaltrials.cedars-sinai.edu

clinicaltrials.cedars-sinai.edu/view/RNIB21-201

RNIB21 in the Treatment of Irritable Bowel Syndrome with ...

The purpose of this study is to determine whether an investigational drug called RNIB21 can effectively relieve the symptoms of patients with irritable bowel ...

Low dose rifaximin combined with N-acetylcysteine is superior ...

These findings suggest that combining rifaximin with NAC may improve the percentage of IBS-D patients responding to treatment.