Nutrition in Rheumatic Diseases

NCT ID: NCT04586933

Last Updated: 2023-01-23

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-10

Study Completion Date

2025-06-10

Brief Summary

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Background: Patients with inflammatory rheumatic diseases (IRD) are prone to malnutrition for several reasons. The diseases and treatment can cause reduced intake and absorption of nutrients and the inflammatory processes may cause an increased demand for nutrients, especially proteins. Studies report that nutritional status can affect disease activity. Dietary supplement of 3-4 gram omega-3 has shown beneficial effect upon disease activity in patients with IRD.

Aim: To investigate whether improved dietary intake with and without supplements of omega-3 will affect disease activity in patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA).

Hypothesis 1: A systematic change of diet in line with the Norwegian dietary guidelines, which will result in increased intake of, among other nutrients, omega-3 fatty acids and complete protein, as well as reduced intake of saturated fat and sugar, will improve nutritional status and reduce disease activity.

Hypothesis 2: A systematic change of diet (as above), included a high dose of omega-3 will further improve nutritional status and reduce disease activity compared with placebo.

Design: A DB-RCT-study will be conducted. All patients will receive individualized dietary guidance by a clinical dietician for 12 weeks, before randomization to supplements of omega-3 or placebo, for 24 weeks. The supplement will be blinded for the participants, researchers and physicians.

Clinical implications: The study will investigate the effect of improved diet and nutrition on treatment offered to patients with IRD to provide more evidence-based knowledge, and thus specific dietary guidelines for patients with IRD. In addition, the study might increase the understanding of the role of omega-3 in the pathogenesis of inflammation.

Detailed Description

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The study is approved by the Regional Committee for Medical and Health Research Ethics. Participation is voluntary, and informed consent will be requested. Outpatients will be recruited by doctors at the Rheumatology Department at Haukeland University Hospital (HUH). Patients recruited will be included consecutively. The recruitment period will last up to 12 months. Anthropometrical measurements, analysis of body composition, blood tests, clinical parameters, and dietary data will be collected at baseline, and after 12, 24, 36 and 52 weeks.

Conditions

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Spondyloarthritis Rheumatoid Arthritis Polyarthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The study will be twofold and consist of Intervention 1 and Intervention 2.

Intervention 1: Dietary guidance (12 weeks). All participants will receive individual dietary guidance, as well as an intensive dietary course with 4 sessions. Participants will receive contact information to the clinical dietitian, and the opportunity to ask questions throughout the intervention period. Patients will be asked to not use other omega-3 supplement during the intervention period 1.

Intervention 2: Omega-3 vs. placebo (24 weeks). After intervention 1, patients will be randomized to take either 3 grams of omega-3 or placebo daily, divided into 4 capsules. Patients will be asked not to use other omega-3 supplements in the period from 2 months until after intervention period 2.
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Omega-3

0,9 gram omega-3/capsule x 4 = 3,6 gram omega-3 daily

It will be investigated whether diet optimization followed with supplementation of omega-3s can reduce disease activity in patients with inflammatory arthritis. A new omega-3 high concentrate from GC Rieber Oils will be used

Group Type ACTIVE_COMPARATOR

Omega-3

Intervention Type DIETARY_SUPPLEMENT

It will be investigated whether diet optimization and supplementation of omega-3s can reduce disease activity in patients with inflammatory arthritis. A new omega-3 high concentrate from GC Rieber Oils will be used.

Dietary guidance

Intervention Type BEHAVIORAL

Dietary guidance

Placebo capsules

Soya oil

Group Type PLACEBO_COMPARATOR

Placebo (soya)

Intervention Type DIETARY_SUPPLEMENT

Placebo (soya)

Dietary guidance

Intervention Type BEHAVIORAL

Dietary guidance

Interventions

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Omega-3

It will be investigated whether diet optimization and supplementation of omega-3s can reduce disease activity in patients with inflammatory arthritis. A new omega-3 high concentrate from GC Rieber Oils will be used.

Intervention Type DIETARY_SUPPLEMENT

Placebo (soya)

Placebo (soya)

Intervention Type DIETARY_SUPPLEMENT

Dietary guidance

Dietary guidance

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Patients must be diagnosed with one of the following diagnoses: rheumatoid arthritis, according to the ACR / EULAR 2010 criteria, psoriatic arthritis, according to the CASPAR criteria, axial spondylarthritis, including ankylosing spondylarthritis and non-radiographic spondylarthritis, according to the ASAS criteria
* Duration of illness ≥0.5 years
* Between 18 and 75 years
* Understand Norwegian
* The patient has given informed consent to participate
* No change in medication the last 12 weeks before inclusion

Exclusion Criteria

Diagnoses / conditions that make it difficult to follow a dietary intervention and / or supplementation of omega-3s, including:

* Conditions or use of medications where omega-3 is contraindicated
* Pregnancy / lactation
* Allergy to soy or fish
* Severe liver disease
* Severe mental or physical illnesses, such as insulin-requiring diabetes
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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GC Rieber Oils AS

UNKNOWN

Sponsor Role collaborator

Haukeland University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Anne-Kristine H Halse, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Haukeland University Hospital

Locations

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Haukeland University Hospital

Bergen, Vestland, Norway

Site Status RECRUITING

Countries

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Norway

Central Contacts

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Marie N Olsen, Msc

Role: CONTACT

0047-95802404

Anne-Kristine H Halse, MD, PhD

Role: CONTACT

0047-95883957

Facility Contacts

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Anne-Kristine H. Halse, MD, PhD

Role: primary

004755975434

Other Identifiers

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79907

Identifier Type: -

Identifier Source: org_study_id

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