Sodium ascorbate / Ascorbic acid oral powder 11g sachets sugar free

BackgroundCommunity-acquired pneumonia (CAP) remains a leading cause of hospitalization, morbidity, and mortality worldwide, particularly among older adults with multimorbidity and frailty. Despite advances in antimicrobial therapy, clinical outcomes have improved little, highlighting the need for safe, inexpensive adjunctive treatments. Vitamin C plays a critical role in immune function, redox homeostasis, and endothelial integrity, all disrupted during acute infection. Hypovitaminosis C is common in hospitalized patients with CAP and has been associated with increased disease severity, longer length of stay (LOS), and worse outcomes. However, prior randomized trials of vitamin C have produced inconsistent results, often focusing on critically ill patients with sepsis, using short treatment durations, and discontinuing therapy abruptly.ObjectiveThe Vitamin C in Community-Acquired Pneumonia (VitCAP) trial aims to evaluate whether high-dose oral vitamin C administered over an extended period improves clinical recovery and patient-centered outcomes in adults hospitalized with CAP.MethodsVitCAP is a single-center, double-blind, placebo-controlled, parallel-group randomized clinical trial conducted at a tertiary hospital in Australia. Adults aged 18 years and older hospitalized with CAP will be randomized within 48 hours of admission in a 1:1 ratio to receive either oral sodium ascorbate (1 g 3 times daily for 7 days, followed by 500 mg twice daily for 30 days) or a matching placebo in addition to standard care. Randomization will be computer generated with allocation concealment via a centralized pharmacy service, and all participants, clinicians, investigators, and outcome assessors will remain blinded. The primary outcome is time to clinical stabilization, defined using standard physiological criteria. Secondary outcomes include early clinical response, symptom burden at 30 days, intensive care unit admission, need for ventilatory or vasopressor support, LOS, all-cause mortality at 30 days and 6 months, hospital readmission, health-related quality of life, and changes in inflammatory biomarkers (C-reactive protein and procalcitonin). Analyses will follow the intention-to-treat principle. The primary outcome will be analyzed using Cox proportional hazard regression adjusted for prespecified covariates, with sensitivity analyses including restricted mean survival time.ResultsThe VitCAP trial received ethics approval from the Southern Adelaide Local Health Network Human Research Ethics Committee in 2025 and funding in September 2025. Recruitment is expected to commence in 2026 and continue for 18 to 24 months. A total of 124 participants will be enrolled to provide 80% power to detect a clinically meaningful difference in time to clinical stabilization while allowing for attrition. Data analysis will follow completion of follow-up, with primary results anticipated in 2028.ConclusionsThe VitCAP trial is designed to address important evidence gaps by evaluating sustained oral vitamin C supplementation in hospitalized patients with CAP using clinically meaningful patient-centered outcomes. If effective, vitamin C could represent a safe, low-cost, and scalable adjunct to standard CAP management.Trial registrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12625001361493; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12625001361493.International registered report identifier (irrid)PRR1-10.2196/91037.

Abstract licence: CC BY

BackgroundSufficient cleansing of the colonic mucosa is of great importance during colonoscopy emphasizing the need for effective preparation agents. Studies evaluating the efficacy of a novel 1 L polyethylene glycol with ascorbate (1 L-PEG-Asc), Plenvu®, versus standard 2 L polyethylene glycol with ascorbate (2 L-PEG-Asc), Moviprep®, have shown promising results regarding bowel cleansing. Nonetheless superiority of 1 L-PEG-Asc has not been shown.MethodsIn this single-center randomized controlled superiority trial, participants of the Danish national colorectal cancer screening program scheduled for colonoscopy were randomized to either 1 L-PEG-Asc or 2 L-PEG-Asc administered as evening/morning split-dose. Primary endpoint was efficacy of the bowel preparation assessed as bowel cleansing success according to Boston Bowel Preparation Scale (BBPS), adequate defined as BBPS ≥ 2 in each segment. Secondary outcomes included excellent bowel preparation defined as BBPS = 3 in each segment, nausea, vomiting, willingness to repeat the cleansing, and lesion detection defined as polyp, adenoma, sessile serrated lesion, and cancer detection.Results1275 participants were randomized to 1 L-PEG-Asc (n = 629) or 2 L-PEG-Asc (n = 646). 1 L-PEG-Asc achieved superior frequencies for adequate (92.2% vs. 86.1%, p Conclusions1 L-PEG-Asc showed superior bowel cleansing efficacy, but increased rates of vomit and nausea compared to 2 L-PEG-Asc. Despite this, willingness to repeat the cleansing with the same agent was more frequent in the 1 L-PEG-Asc group.Trial registrationEudraCT number: 2018-003304-39. Trial registration date 29/10 2018, study start date 17/10 2019.

Abstract licence: CC BY-NC-ND