Symptomatic Response to Gluten Challenge in Patients With Suspected Non Celiac Gluten Sensitivity

NCT ID: NCT01864993

Last Updated: 2016-02-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-03-31

Study Completion Date

2016-02-29

Brief Summary

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Non Celiac Gluten Sensitivity (NCGS) is an emergent syndrome mainly inducing gastrointestinal symptoms. NCGS is suspected to be present in the 6% of the population and thus it represents an important issue in health care. Actually it remains difficult to diagnose and prove due to the lack of established criteria. The investigators intention is to establish a diagnostic flowchart to evaluate the real impact of NCGS in a cohort of patients suffering from functional gastrointestinal symptoms.

Detailed Description

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The proposed study has been designed to be a randomised double-blind multicenter clinical trial with crossover. The Coordinating Center will be the "Centro per la Prevenzione e la Diagnosi della Malattia Celiaca", Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milano. Secondary enrollment centers will be Italian Gastroenterology Units with outpatient services. Enrollment criteria will be diagnosis of irritable bowel syndrome (IBS) or functional dyspepsia. Patients with other functional gastrointestinal disorders will be included in the group "Functional non specific gastrointestinal symptoms".

After they give their written informed consent, patients will undergo the diagnostic work-up recommended in case of suspected irritable bowel symptoms/functional dyspepsia and aimed at the exclusion of CD or allergy to alimentary antigens by means of serological testing (anti transglutaminase antibodies) or skin tests, or other gastrointestinal diseases. Endoscopic, histologic and/or imaging exams together with supplemental blood tests will be prescribed on individual cases and according with the international guidelines.

Enrolled subjects will be asked to fill

* a checklist for the evaluation of the psychological profile (SCL90 questionnaire, with the particular aim of evaluating levels of anxiety, depression and somatisation);
* a questionnaire about the perceived level of physical and mental health (SF36 questionnaire);
* Ten centimeters long visual analogue scales (VAS) on the level of satisfaction with their health status and on the intensity of the single symptoms.

At the end of the present phase patients will start a GFD for the subsequent three weeks.

At the end of the GFD period patients will fill VAS and SF36. Only those patients presenting a 30% increase of the global VAS score ("GFD Responders") will continue the study. Conversely, non responders will be considered "non gluten sensitive" and they will finish the trial.

Responders to the GFD period will entry the randomisation phase and will undergo a double-blind stimulation test with cross over. Patients will be randomised to assume gluten or placebo for 7 days. After the treatment patients will fill VAS and SF36.

A diagnosis of NCGS will be ascertained in case of symptomatic response limited to gluten ingestion.

Conditions

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Non Celiac Gluten Sensitivity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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suspected NC gluten sensitive subjects

Patients referring gastrointestinal functional disorders will be selected and they will follow a gluten free diet

Group Type EXPERIMENTAL

gluten

Intervention Type DIETARY_SUPPLEMENT

The enrolled patients will be invited to follow a gluten free diet. Patients responsive to the diet will be invited to assume gluten or placebo following a double blind with cross over scheme

Placebo

Intervention Type DIETARY_SUPPLEMENT

Patients responsive to the diet will be invited to blindly assume gluten or placebo following a double blind with cross over scheme

suspected NC gluten sensitive

Patients referring gastrointestinal functional disorders will be selected and they will follow a gluten free diet

Group Type EXPERIMENTAL

gluten

Intervention Type DIETARY_SUPPLEMENT

The enrolled patients will be invited to follow a gluten free diet. Patients responsive to the diet will be invited to assume gluten or placebo following a double blind with cross over scheme

Placebo

Intervention Type DIETARY_SUPPLEMENT

Patients responsive to the diet will be invited to blindly assume gluten or placebo following a double blind with cross over scheme

Interventions

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gluten

The enrolled patients will be invited to follow a gluten free diet. Patients responsive to the diet will be invited to assume gluten or placebo following a double blind with cross over scheme

Intervention Type DIETARY_SUPPLEMENT

Placebo

Patients responsive to the diet will be invited to blindly assume gluten or placebo following a double blind with cross over scheme

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* Subjects with gastrointestinal functional disorders (irritable bowel syndrome, functional dyspepsia or unspecified functional gastrointestinal symptoms)

Exclusion Criteria

* Celiac disease
* Alimentary allergies
* Inflammatory bowel disease
* Major abdominal surgery
* Psychiatric disorders
* Neoplasia
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico

OTHER

Sponsor Role lead

Responsible Party

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Luca Elli

researcher

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Luca Elli, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Center for Prevention and Diagnosis of Celiac Disease, Fondazione IRCCS Cà Granda

Locations

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Ospedale Maggiore di Crema

Crema, Italy, Italy

Site Status

Ospedale S. Maria

Feltre, Italy, Italy

Site Status

Ospedale Di Busto Arsizio

Busto Arsizio, Lombardy, Italy

Site Status

Ospedale Valduce di Como

Como, Lombardy, Italy

Site Status

Arcispedale S. Maria Nuova

Reggio Emilia, , Italy

Site Status

Countries

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Italy

References

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Scricciolo A, Lombardo V, Elli L, Bascunan KA, Doneda L, Rinaldi F, Pinto D, Araya M, Costantino A, Vecchi M, Roncoroni L. Use of a proline-specific endopeptidase to reintroduce gluten in patients with non-coeliac gluten sensitivity: A randomized trial. Clin Nutr. 2022 Sep;41(9):2025-2030. doi: 10.1016/j.clnu.2022.07.029. Epub 2022 Jul 31.

Reference Type DERIVED
PMID: 35973395 (View on PubMed)

Other Identifiers

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1876

Identifier Type: OTHER

Identifier Source: secondary_id

1876/2012

Identifier Type: -

Identifier Source: org_study_id

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