Prospective Study of Efficacy of Intra-muscular Vitamin D3 in Tropical Calcific Pancreatitis

NCT ID: NCT00956839

Last Updated: 2013-03-14

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-07-31

Study Completion Date

2010-12-31

Brief Summary

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The purpose of this study is to determine the efficacy of 2 different doses of intramuscular (IM) vitamin D3 as compared to an oral replacement dose in normalizing vitamin D levels in the blood of patients with tropical calcific pancreatitis.

Detailed Description

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Tropical calcific pancreatitis (TCP) is a form of chronic pancreatitis unique to developing countries. Patients with TCP often have malabsorption leading to nutritional deficiencies. We have noted that vitamin D deficiency is common in patients with TCP. The ideal regimen for supplementing vitamin D3 in chronic pancreatitis remains unclear and there are no previous studies available. High dose oral vitamin D2 has been shown to be ineffective in normalizing vitamin D levels in patients with pancreatic insufficiency due to cystic fibrosis.

Intramuscular (IM) vitamin D3 supplementation in chronic pancreatitis has certain advantages. Firstly, decreased and inconsistent absorption from the intestine is avoided. Secondly, IM vitamin D3 has a long duration of action (6-12 months). The safety of high-dose IM vitamin D3 has been proven in previous studies in healthy individuals. Finally, the injection form is considerably less expensive as compared to oral vitamin D3.

The aim of the current prospective double blind study is to compare 2 regimens of high dose IM vitamin D3 replenishment with oral vitamin D3 in standard recommended doses in normalizing serum vitamin D3 levels in patients with TCP.

Conditions

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Pancreatitis, Chronic

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Group A

IM Vitamin D3 3,00,000 Units single dose

Group Type ACTIVE_COMPARATOR

Vitamin D3 (Cholecalciferol)

Intervention Type DRUG

Arm 1 - Intramuscular vitamin D3 3,00,000 Units single dose

Arm 2 - Intramuscular vitamin D3 6,00,000 Units single dose

Arm 3 - Oral vitamin D3 500 Units/day for 6 months

Group B

IM vitamin D3 6,00,000 Units single dose

Group Type ACTIVE_COMPARATOR

Vitamin D3 (Cholecalciferol)

Intervention Type DRUG

Arm 1 - Intramuscular vitamin D3 3,00,000 Units single dose

Arm 2 - Intramuscular vitamin D3 6,00,000 Units single dose

Arm 3 - Oral vitamin D3 500 Units/day for 6 months

Group C

Oral vitamin D3 500 Units/ day

Group Type ACTIVE_COMPARATOR

Vitamin D3 (Cholecalciferol)

Intervention Type DRUG

Arm 1 - Intramuscular vitamin D3 3,00,000 Units single dose

Arm 2 - Intramuscular vitamin D3 6,00,000 Units single dose

Arm 3 - Oral vitamin D3 500 Units/day for 6 months

Interventions

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Vitamin D3 (Cholecalciferol)

Arm 1 - Intramuscular vitamin D3 3,00,000 Units single dose

Arm 2 - Intramuscular vitamin D3 6,00,000 Units single dose

Arm 3 - Oral vitamin D3 500 Units/day for 6 months

Intervention Type DRUG

Other Intervention Names

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IM vitamin D3 - Inj Arachitol (Solvay, India) Oral vitamin D3 - Tab Cipcal (Cipla, India)

Eligibility Criteria

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Inclusion Criteria

* Clinical diagnosis of tropical calcific pancreatitis established by history of abdominal pain or diabetes and evidence on ultrasound or CT scan of pancreatic ductal dilatation and intra-ductal stones

Exclusion Criteria

* History of alcohol intake or any secondary cause for chronic pancreatitis (hypercalcemia, hypertriglyceridemia, biliary tract stones)
* History of hepatic or renal dysfunction or of current intake of drugs such as steroids, anticonvulsant drugs
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sanjay Gandhi Postgraduate Institute of Medical Sciences

OTHER_GOV

Sponsor Role lead

Responsible Party

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Eesh Bhatia

Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Eesh Bhatia, MD

Role: PRINCIPAL_INVESTIGATOR

Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India

Locations

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Sanjay Gandhi Postgraduate Institute of Medical Sciences

Lucknow, Uttar Pradesh, India

Site Status

Countries

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India

References

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Mann ST, Stracke H, Lange U, Klor HU, Teichmann J. Vitamin D3 in patients with various grades of chronic pancreatitis, according to morphological and functional criteria of the pancreas. Dig Dis Sci. 2003 Mar;48(3):533-8. doi: 10.1023/a:1022540816990.

Reference Type BACKGROUND
PMID: 12757166 (View on PubMed)

Barman KK, Premalatha G, Mohan V. Tropical chronic pancreatitis. Postgrad Med J. 2003 Nov;79(937):606-15. doi: 10.1136/pmj.79.937.606.

Reference Type BACKGROUND
PMID: 14654569 (View on PubMed)

Dujsikova H, Dite P, Tomandl J, Sevcikova A, Precechtelova M. Occurrence of metabolic osteopathy in patients with chronic pancreatitis. Pancreatology. 2008;8(6):583-6. doi: 10.1159/000159845. Epub 2008 Sep 29.

Reference Type BACKGROUND
PMID: 18824882 (View on PubMed)

Aris RM, Merkel PA, Bachrach LK, Borowitz DS, Boyle MP, Elkin SL, Guise TA, Hardin DS, Haworth CS, Holick MF, Joseph PM, O'Brien K, Tullis E, Watts NB, White TB. Guide to bone health and disease in cystic fibrosis. J Clin Endocrinol Metab. 2005 Mar;90(3):1888-96. doi: 10.1210/jc.2004-1629. Epub 2004 Dec 21.

Reference Type BACKGROUND
PMID: 15613415 (View on PubMed)

Boyle MP, Noschese ML, Watts SL, Davis ME, Stenner SE, Lechtzin N. Failure of high-dose ergocalciferol to correct vitamin D deficiency in adults with cystic fibrosis. Am J Respir Crit Care Med. 2005 Jul 15;172(2):212-7. doi: 10.1164/rccm.200403-387OC. Epub 2005 Apr 28.

Reference Type BACKGROUND
PMID: 15860755 (View on PubMed)

Green D, Carson K, Leonard A, Davis JE, Rosenstein B, Zeitlin P, Mogayzel P Jr. Current treatment recommendations for correcting vitamin D deficiency in pediatric patients with cystic fibrosis are inadequate. J Pediatr. 2008 Oct;153(4):554-9. doi: 10.1016/j.jpeds.2008.04.058. Epub 2008 Jun 27.

Reference Type BACKGROUND
PMID: 18589445 (View on PubMed)

Lark RK, Lester GE, Ontjes DA, Blackwood AD, Hollis BW, Hensler MM, Aris RM. Diminished and erratic absorption of ergocalciferol in adult cystic fibrosis patients. Am J Clin Nutr. 2001 Mar;73(3):602-6. doi: 10.1093/ajcn/73.3.602.

Reference Type BACKGROUND
PMID: 11237938 (View on PubMed)

Diamond TH, Ho KW, Rohl PG, Meerkin M. Annual intramuscular injection of a megadose of cholecalciferol for treatment of vitamin D deficiency: efficacy and safety data. Med J Aust. 2005 Jul 4;183(1):10-2. doi: 10.5694/j.1326-5377.2005.tb06879.x.

Reference Type BACKGROUND
PMID: 15992330 (View on PubMed)

Vieth R. Vitamin D supplementation, 25-hydroxyvitamin D concentrations, and safety. Am J Clin Nutr. 1999 May;69(5):842-56. doi: 10.1093/ajcn/69.5.842.

Reference Type BACKGROUND
PMID: 10232622 (View on PubMed)

Reddy SV, Ramesh V, Bhatia E. Double blind randomized control study of intramuscular vitamin D3 supplementation in tropical calcific pancreatitis. Calcif Tissue Int. 2013 Jul;93(1):48-54. doi: 10.1007/s00223-013-9726-6. Epub 2013 Apr 6.

Reference Type DERIVED
PMID: 23564348 (View on PubMed)

Other Identifiers

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PGI/AA/EMP/IEC/46/25.7.09

Identifier Type: -

Identifier Source: org_study_id

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