A Nutrition Intervention for Arthritis -3 (WCCR-ARTH3)

NCT ID: NCT03417648

Last Updated: 2019-03-04

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 8 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-03-08
• Study Completion Date: 2018-12-14

Brief Summary

The purpose of the study is to assess whether, in individuals with rheumatoid arthritis, a low-fat, vegan diet improves pain and other subjective symptoms more effectively than a control supplement or a placebo. The principal measure is pain as measured by Visual Analog Scale (VAS) and disease activity as measured by number of painful swollen and tender joints, respectively. The study duration is 36 weeks.

This study tests that a low fat, plant-based (vegan) diet free of foods commonly identified as triggers improves mood, using the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R), and the Beck Depression Inventory II (BDI-II).

Detailed Description

Preliminary evidence suggests that low-fat, vegetarian diets and certain nutritional supplements can help reduce pain and also reduce the need for pain medications for some people. The investigators will ask about 100 people to participate. All of them will get a low-fat, vegan diet and a nutritional supplement (mixture of omega-3 oils and vitamin E or a placebo), although some will get the diet first, and others will get the supplement first. This order in which they will get the diet and the supplement will be determined randomly, that is, by chance (like the toss of a coin). The principal measure is pain as measured by Visual Analog Scale (VAS) and disease activity as measured by number of painful swollen and tender joints, respectively. The Beck Depression Inventory II (BDI-II)will be used to measure changes in mood. The study duration is 36 weeks.

Conditions

Rheumatoid Arthritis

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: CROSSOVER
• Primary Study Purpose: SUPPORTIVE_CARE
• Blinding Strategy: NONE

Study Groups

Plant-based diet

The diet group will be asked to follow a low-fat, vegan diet for 16 weeks

Group Type: EXPERIMENTAL

Plant-based diet

Intervention Type: OTHER

Weekly instructions will be given to the participants in the intervention group about following vegan diet.

Supplement

The supplement group will follow an unrestricted diet, but will be given a pill containing a small, clinically insignificant amount of omega- 3 oils and vitamin E, which will serve as a placebo.

Group Type: PLACEBO_COMPARATOR

Supplement

Intervention Type: OTHER

unrestricted diet with clinically insignificant amount of omega- 3 oils and vitamin E

Interventions

Plant-based diet

Weekly instructions will be given to the participants in the intervention group about following vegan diet.

Intervention Type: OTHER

Supplement

unrestricted diet with clinically insignificant amount of omega- 3 oils and vitamin E

Intervention Type: OTHER

Other Intervention Names

Vitamin E

Eligibility Criteria

Inclusion Criteria

• A diagnosis of rheumatoid arthritis based on 2010 ACR / EULAR Rheumatoid Arthritis Classification Criteria. Classification as "definite RA" is based on:
• the confirmed presence of synovitis in at least 1 joint
• absence of an alternative diagnosis that better explains the synovitis
• and achievement of a total score of 6 or greater (of a possible 10): 24 Joint involvement, designating the metacarpophalangeal joints, proximal interphalangeal joints, the interphalangeal joint of the thumb, second through third metatarsophalangeal joint and wrist as small joints, and elbows, hip joints and knees as large joints:

1. Involvement of 1 large joint gives 0 points

2. Involvement of 2-10 large joints gives 1 point

3. Involvement of 1-3 small joints (with or without involvement of large joints) gives 2 points

4. Involvement of 4-10 small joints (with or without involvement of large joints) gives 3 points

5. Involvement of more than 10 joints (with involvement of at least 1 small joint) gives 5 points

• Serological parameters - including the rheumatoid factor as well as anti-citrullinated protein antibody (ACPA):

1. Negative RF and negative ACPA gives 0 points

2. Low-positive RF or low-positive ACPA gives 2 points

3. High-positive RF or high-positive ACPA gives 3 points Acute phase reactants: 1 point for elevated erythrocyte sedimentation rate (ESR) or elevated C-reactive protein (CRP) value Duration of arthritis: 1 point for symptoms lasting six weeks or longer

• Continuing or recurring pain (i.e., joint pain daily, unless on pain medication).
• Age at least 18 years
• Ability and willingness to participate in all components of the study
• Willingness to be assigned to either the diet group or supplement group
• Pain medications unchanged within last 6 weeks.

Exclusion Criteria

• < 18 years of age
• Alcohol consumption of more than 2 drinks per day or the equivalent, episodic increased drinking (e.g., more than 2 drinks per day on weekends), or a history of alcohol abuse or dependency followed by any current use
• Use of recreational drugs in the past 6 months (past drug use, if fully recovered, is not a criteria for exclusion)
• Pregnancy
• Unstable medical or psychiatric illness
• Likely to be disruptive in group sessions (as determined by research staff)
• Already following a low-fat, vegan diet
• Lack of English fluency
• Inability to maintain current medication regimen
• Inability or unwillingness to participate in all components of the study

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 90 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Physicians Committee for Responsible Medicine

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Neal D Barnard

Role: PRINCIPAL_INVESTIGATOR

Physicians Committee for Responsible Medicine

Locations

Physicians Committee for Responsible Medicine

Washington D.C., District of Columbia, United States

Countries

United States

References

Barnard ND, Levin S, Crosby L, Flores R, Holubkov R, Kahleova H. A Randomized, Crossover Trial of a Nutritional Intervention for Rheumatoid Arthritis. Am J Lifestyle Med. 2022 Apr 3;19(2):266-275. doi: 10.1177/15598276221081819. eCollection 2025 Feb.

Reference Type: DERIVED

PMID: 39981557 (View on PubMed)

Other Identifiers

WCCR-ARTH-3

Identifier Type: -

Identifier Source: org_study_id