Autoimmune Gastrointestinal Dysmotility: Symptoms, Pathogenesis and Treatment

NCT ID: NCT04859829

Last Updated: 2023-03-13

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

Total Enrollment

1 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-04-22

Study Completion Date

2022-09-29

Brief Summary

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Autoimmune gastrointestinal dysmotility syndromes are poorly understood, and often difficult to treat because the underlying pathogenesis is unclear. Refractory symptoms result in an impaired quality of life. The presence of positive serum autoantibodies to peripheral nervous system gangliosides and glycoproteins is suggestive of a possible mechanism. Immunomodulator treatments have shown benefit in case reports and case series but standardized data for treatment response is lacking. Therefore, our primary aims are to further characterize this syndrome in terms of symptoms, laboratory testing, pathology, and assess treatment response of immunomodulator therapy. Our research plan involves identifying this subset of patients with autoimmune gastrointestinal dysmotility and dysautonomia, and studying them as they are managed by their gastroenterologists.The study team will administer symptom-based questionnaires in a systematic manner to assess the clinical trajectory of this population and treatment response. The investigators will also analyze laboratory values (antibody titers, tilt testing, inflammatory markers) and study pathology specimens (enteric and skin biopsies) obtained from this cohort to gain a deeper understanding of the pathogenesis of their disease.

Detailed Description

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Conditions

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Dysmotility Syndrome Autoimmunity

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Patients with autoimmune dysmotility receiving IVIG infusions

Current Intravenous Immunoglobulin (IVIG) treatment

Intervention Type OTHER

Questionnaires every two months for patients with a diagnosis of autoimmune dysmotility that are receiving Intravenous Immunoglobulin (IVIG) treatment.

Patients with autoimmune dysmotility without IVIG infusions

No Intravenous Immunoglobulin (IVIG) treatment

Intervention Type OTHER

Questionnaires every two months for patients with a diagnosis of autoimmune dismotility that are not receiving Intravenous Immunoglobulin (IVIG) treatment.

Interventions

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Current Intravenous Immunoglobulin (IVIG) treatment

Questionnaires every two months for patients with a diagnosis of autoimmune dysmotility that are receiving Intravenous Immunoglobulin (IVIG) treatment.

Intervention Type OTHER

No Intravenous Immunoglobulin (IVIG) treatment

Questionnaires every two months for patients with a diagnosis of autoimmune dismotility that are not receiving Intravenous Immunoglobulin (IVIG) treatment.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Males and females, Aged\>15
* Evidence of enteric dysmotility with documented abnormality on objective testing which may include high resolution esophageal manometry, gastric emptying scintigraphy, SmartPill Wireless Motility Capsule, Sitz marker studies, antroduodenal manometry or anorectal manometry.
* English proficiency and literacy sufficient to sign consent form and fill out questionnaires.
* Previous Mayo paraneoplastic panel testing.
* Referring gastroenterologist has recommended intravenous immunoglobulin (IVIg) therapy.

Exclusion Criteria

* Non-autoimmune causes of enteric dysmotility (diabetes, adrenal insufficiency, Parkinson's, thyroid, electrolytes, drugs, malignancy).
* Pregnancy as documented in EPIC with serum or urine Human chorionic gonadotropin (hCG) testing

* If participants believe that they are pregnant, they will need to notify a study physician who will order a serum or urine hCG test for pregnancy within EPIC and remove them from the study if the test results come back positive.
* Previous treatment with IVIg.
Minimum Eligible Age

15 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Johns Hopkins University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Pankaj J Pasricha, MD

Role: PRINCIPAL_INVESTIGATOR

Johns Hopkins University

Locations

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Johns Hopkins Bayview Medical Center

Baltimore, Maryland, United States

Site Status

Countries

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United States

References

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Pasricha PJ, McKnight M, Villatoro L, Barahona G, Brinker J, Hui K, Polydefkis M, Burns R, McMahan ZH, Gould N, Goodman B, Hentz J, Treisman G. Joint Hypermobility, Autonomic Dysfunction, Gastrointestinal Dysfunction, and Autoimmune Markers: Clinical Associations and Response to Intravenous Immunoglobulin Therapy. Am J Gastroenterol. 2024 Nov 1;119(11):2298-2306. doi: 10.14309/ajg.0000000000002910. Epub 2024 Jun 24.

Reference Type DERIVED
PMID: 38912927 (View on PubMed)

Other Identifiers

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IRB00087869

Identifier Type: -

Identifier Source: org_study_id

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