Assessing the Tolerability of Oligosaccharide Supplementation in Patients With Crohn's Disease

NCT ID: NCT02193750

Last Updated: 2021-04-30

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

TERMINATED

Clinical Phase

NA

Total Enrollment

24 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-08-31

Study Completion Date

2020-09-30

Brief Summary

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The investigators hypothesize that a novel method for oligosaccharide supplementation, in the form of nutritional bars and/or muesli high in fructans and galacto-oligosaccharides (GOS), will be a safe and tolerable therapeutic intervention in patients with Crohn's disease (CD) in remission.

Detailed Description

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Subjects age \>/= 19 years with the diagnosis of CD for \>/= 6 months, currently in remission based on the Harvey-Bradshaw Index score (\</=4 points) and C-reactive protein (\<5 mg/L) will be recruited from two academic hospitals and affiliated gastroenterology outpatient clinics (St. Paul's Hospital, Vancouver, British Columbia, Canada; Alfred Hospital, Melbourne, Victoria, Australia).

The study is a randomized, double-blind, placebo-controlled trial that consist of a 2-week run-in period followed by a 4-week study period. Prior to study entry, a screening visit will be required for all potential participants. If a participant meets the inclusion criteria, they will be randomized to either a placebo (0.55 g total fructans/GOS), a moderate oligosaccharide group (3.25 g total fructans/GOS) or a high oligosaccharide group (5.43 g total fructans/GOS) through a computed-generated scheme within each respective center. During the run-in period, enrolled subjects will undergo the following: 1) Laboratory analyses (CBC, routine biochemistry, CRP and fecal calprotectin); 2) Stool collection for fecal calprotectin analysis; 3) tolerability assessment including overall gastrointestinal symptoms and specific symptoms (abdominal bloating, abdominal pain, gut rumbling, flatulence) utilizing a 100mm visual analogue scale (VAS, 0 = no symptoms; 100 = worst symptoms ever experienced); 4) fatigue assessment utilizing a multi-dimensional fatigue impact scale (FIS); 5) health-related quality of life (HRQOL) assessment utilizing the Short Form 36-Item Health Survey (SF-36) and 6) Mood assessment utilizing the Spielberger State-Trait Personality Inventory (STPI). Participants will also meet with a registered dietitian to quantify baseline oligosaccharide consumption by completing a prospective 5-day diet diary alongside a validated food frequency questionnaire (FFQ), the Monash University Comprehensive Nutritional Assessment Questionnaire (CNAQ) that assesses oligosaccharide intake in addition to the usual nutrients \[49\]. Once the initial dietary assessment is complete, participants will begin up-titration of their oligosaccharide supplementation in a step-wise fashion until they reach their required daily amounts defined by their treatment group allocation. Once this is achieved, they will enter the 4 weeks of treatment or at time of relapse. Participants will undergo re-assessment during the study period at 2 weeks (Visit #3), and at study completion (Visit #4).

If a participant undergoes a CD flare during the run-in period, they will be withdrawn from the study. The end point of the study will be at 4 weeks of treatment or at time of relapse.

Conditions

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Crohn's Disease

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

OTHER

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Placebo

1 placebo muesli bars and 1 serving placebo muesli per day (0.55 g total fructans/GOS)

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DIETARY_SUPPLEMENT

1 placebo muesli bar and 1 serving placebo muesli per day (0.55 g total fructans/GOS)

Moderate Oligosaccharide Group

1 placebo muesli bar and 1 serving intervention muesli per day (3.25 g total fructans/GOS)

Group Type EXPERIMENTAL

Moderate Oligosaccharide Group

Intervention Type DIETARY_SUPPLEMENT

1 placebo muesli bar and 1 serving intervention muesli per day (3.25 g total fructans/GOS)

High Oligosaccharide Group

1 intervention muesli bar and 1 serving intervention muesli per day (5.43 total fructans/GOS)

Group Type EXPERIMENTAL

High Oligosaccharide Group

Intervention Type DIETARY_SUPPLEMENT

1 placebo muesli bar and 1 serving placebo muesli per day (5.43 g total fructans/GOS)

Interventions

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Placebo

1 placebo muesli bar and 1 serving placebo muesli per day (0.55 g total fructans/GOS)

Intervention Type DIETARY_SUPPLEMENT

Moderate Oligosaccharide Group

1 placebo muesli bar and 1 serving intervention muesli per day (3.25 g total fructans/GOS)

Intervention Type DIETARY_SUPPLEMENT

High Oligosaccharide Group

1 placebo muesli bar and 1 serving placebo muesli per day (5.43 g total fructans/GOS)

Intervention Type DIETARY_SUPPLEMENT

Eligibility Criteria

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Inclusion Criteria

* age \>/= 19 years
* diagnosed with CD for \>/= 6 months, currently in remission based on the Harvey-Bradshaw Index score (\</= 4 points) and C-reactive protein (\<5mg/L)

Exclusion Criteria

* unable to provide informed consent;
* have significant hepatic, renal, endocrine, respiratory, neurological, or cardiovascular disease;
* confirmed diagnosis of celiac disease, or have suspected celiac disease and are following a gluten-free diet to manage symptoms with an elevated screening anti-tissue transglutaminase antibody test;
* significant complications of CD which includes a history of extensive colonic resection, including subtotal or total colectomy, history of \>/= 3 small bowel resections or received a diagnosis of short bowel syndrome, current ileostomy, colostomy or ileal-anal pouch, or a fixed symptomatic intestinal stenosis;
* antibiotic use in the 4 weeks prior to study start;
* use of any rectal preparations in the 2 weeks prior to study start;
* use of any non-steroidal anti-inflammatory drugs in the 2 weeks prior to study start;
* use of commercial probiotic supplements in the 4 weeks prior to study start
* change in CD therapy in the 4 weeks prior to study start (excluding steroid taper, however steroid dosing must be stable for 2 weeks prior to study start);
* recently been adhering to a novel dietary intervention for alternative health issues within the last 4 weeks prior to study start.
Minimum Eligible Age

19 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Alfred

OTHER

Sponsor Role collaborator

Melbourne Health

OTHER

Sponsor Role collaborator

University of British Columbia

OTHER

Sponsor Role lead

Responsible Party

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Brian Bressler

Clinical Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Brian Bressler, MD

Role: PRINCIPAL_INVESTIGATOR

Division of Gastroenterology, Department of Medicine St. Paul's Hospital, Vancouver, BC Cananda

Peter Gibson, MD

Role: PRINCIPAL_INVESTIGATOR

Department of Gastroenterology Alfred Hospital, Melbourne, Australia

Locations

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Department of Gastroenterology Alfred Hospital

Melbourne, , Australia

Site Status

GI Clinic, St. Paul's Hospital

Vancouver, British Columbia, Canada

Site Status

Countries

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Australia Canada

References

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Talley NJ, Abreu MT, Achkar JP, Bernstein CN, Dubinsky MC, Hanauer SB, Kane SV, Sandborn WJ, Ullman TA, Moayyedi P; American College of Gastroenterology IBD Task Force. An evidence-based systematic review on medical therapies for inflammatory bowel disease. Am J Gastroenterol. 2011 Apr;106 Suppl 1:S2-25; quiz S26. doi: 10.1038/ajg.2011.58. No abstract available.

Reference Type BACKGROUND
PMID: 21472012 (View on PubMed)

Kappelman MD, Rifas-Shiman SL, Kleinman K, Ollendorf D, Bousvaros A, Grand RJ, Finkelstein JA. The prevalence and geographic distribution of Crohn's disease and ulcerative colitis in the United States. Clin Gastroenterol Hepatol. 2007 Dec;5(12):1424-9. doi: 10.1016/j.cgh.2007.07.012. Epub 2007 Sep 29.

Reference Type RESULT
PMID: 17904915 (View on PubMed)

Herrinton LJ, Liu L, Lewis JD, Griffin PM, Allison J. Incidence and prevalence of inflammatory bowel disease in a Northern California managed care organization, 1996-2002. Am J Gastroenterol. 2008 Aug;103(8):1998-2006. doi: 10.1111/j.1572-0241.2008.01960.x.

Reference Type RESULT
PMID: 18796097 (View on PubMed)

Lichtenstein GR, Hanauer SB, Sandborn WJ; Practice Parameters Committee of American College of Gastroenterology. Management of Crohn's disease in adults. Am J Gastroenterol. 2009 Feb;104(2):465-83; quiz 464, 484. doi: 10.1038/ajg.2008.168. Epub 2009 Jan 6.

Reference Type RESULT
PMID: 19174807 (View on PubMed)

Pai CG, Khandige GK. Is Crohn's disease rare in India? Indian J Gastroenterol. 2000 Jan-Mar;19(1):17-20.

Reference Type RESULT
PMID: 10659482 (View on PubMed)

El Mouzan MI, Abdullah AM, Al Habbal MT. Epidemiology of juvenile-onset inflammatory bowel disease in central Saudi Arabia. J Trop Pediatr. 2006 Feb;52(1):69-71. doi: 10.1093/tropej/fmi039. Epub 2005 Jun 9.

Reference Type RESULT
PMID: 15947013 (View on PubMed)

Ouyang Q, Tandon R, Goh KL, Ooi CJ, Ogata H, Fiocchi C. The emergence of inflammatory bowel disease in the Asian Pacific region. Curr Opin Gastroenterol. 2005 Jul;21(4):408-13.

Reference Type RESULT
PMID: 15930979 (View on PubMed)

Aghazadeh R, Zali MR, Bahari A, Amin K, Ghahghaie F, Firouzi F. Inflammatory bowel disease in Iran: a review of 457 cases. J Gastroenterol Hepatol. 2005 Nov;20(11):1691-5. doi: 10.1111/j.1440-1746.2005.03905.x.

Reference Type RESULT
PMID: 16246187 (View on PubMed)

Wright JP, Froggatt J, O'Keefe EA, Ackerman S, Watermeyer S, Louw J, Adams G, Girdwood AH, Burns DG, Marks IN. The epidemiology of inflammatory bowel disease in Cape Town 1980-1984. S Afr Med J. 1986 Jul 5;70(1):10-5.

Reference Type RESULT
PMID: 3726680 (View on PubMed)

Other Identifiers

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H14-01420

Identifier Type: -

Identifier Source: org_study_id

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