Evaluating the Utility of RELiZORB™ for Treating Feeding Intolerance in Critically Ill Adults With Multi-Organ Failure

NCT ID: NCT05710315

Last Updated: 2025-09-30

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

RECRUITING

Clinical Phase

NA

Total Enrollment

32 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-05-07

Study Completion Date

2026-03-02

Brief Summary

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The purpose of this research is to determine if the use of RELiZORB™ improves nutrition tolerance and helps critically ill patients meet their nutrition goals. RELiZORB™ is a digestive enzyme cartridge that contains lipase and works as a pancreatic enzyme replacement. It promotes breaking down fat and helps the body absorb it. The device connects with tube feedings to help the body with digestion.

RELiZORB™ is approved by the U.S. Food and Drug Administration (FDA) for use with tube feedings in patients 5 years of age or older. While the use of RELiZORB™ in this study is consistent with the FDA approval, the use of RELiZORB™ in patients with multi organ failure is not in the current standard of care practice at Inova Health Care facilities.

Detailed Description

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This is a double-blind, placebo-controlled, parallel design study. A total of 32 adult patients who have been admitted to the Surgical or Medical Intensive Care Unit over the previous 72 hours with evidence of MOF (defined as requiring mechanical ventilation and demonstrating at least one more system failure on the SOFA score on the day of ICU admission) and who have not yet been initiated on enteral nutrition or were initiated on enteral nutrition up to 48 hours prior.

After informed consent has been obtained, two patients will receive enteral formula administered through RELiZORB™ as test subjects (will be excluded from analysis). Subsequently, patients will be randomized to RELiZORB™ vs placebo cartridges in a 1:1 ratio. Enteral nutrition will be administered through RELiZORB™ cartridges (up to 6 cartridges per day depending on the volume of enteral nutrition). Patients will be studied for a total of 5 days (considered to be the end of study). Patients will return to the original form of nutritional support per their routine clinical care.

Conditions

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Multi Organ Failure Exocrine Pancreatic Insufficiency

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Two patients will receive enteral formula administered through RELiZORB™ as test subjects (will be excluded from analysis). Subsequently, patients will be randomized to RELiZORB™ vs placebo cartridges in a 1:1 ratio. Enteral nutrition will be administered through RELiZORB™ cartridges (up to 6 cartridges per day depending on the volume of enteral nutrition). Patients will be studied for a total of 5 days (considered to be the end of study). Patients will return to the original form of nutritional support per their routine clinical care.
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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RELiZORB

RELiZORB™ cartridges connect in-line with existing enteral feeding pump tubing sets and patient extension sets or enteral feeding tubes.

Group Type EXPERIMENTAL

RELiZORB™

Intervention Type DEVICE

RELiZORB cartridges will be used with routine enteral feedings for 5 days for randomized participants

Placebo

Placebo cartridges connect in-line with existing enteral feeding pump tubing sets and patient extension sets or enteral feeding tubes

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Placebo cartridges will be used with routine enteral feedings for 5 days for randomized participants

Interventions

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RELiZORB™

RELiZORB cartridges will be used with routine enteral feedings for 5 days for randomized participants

Intervention Type DEVICE

Placebo

Placebo cartridges will be used with routine enteral feedings for 5 days for randomized participants

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Male or female patients aged 18 - 89 years of age.
* Patients who have Multi-Organ Failure (MOF) (defined as requiring mechanical ventilation and demonstrating at least one more system failure on the SOFA score on the day of ICU admission).
* Patients who have not yet been initiated on enteral nutrition, yet enteral nutritional support is needed, or patients who have been initiated on enteral nutrition within the previous 48 hours. Enteral nutrition support defined as support planned to be given via any route connected to the gastrointestinal system (i.e., the enteral route). This includes tube feeding using nasogastric, nasoduodenal, gastrostomy, jejunostomy tubes, or similar.
* Patients who lack the capacity to consent for themselves may be included upon receiving consent from their legally authorized representatives.

Exclusion Criteria

* Pregnant women and prisoners.
* Hypotension is attributed to suspected or confirmed cardiogenic shock.
* Evidence of unresolved intestinal obstruction, ischemia, bleeding, perforation, fistulas or tract discontinuity, or other contraindication for enteral nutrition.
* Sepsis suspected or confirmed due to an abdominal source and enteral nutrition is contraindicated.
* C. Difficile or other gastrointestinal infection that may manifest with diarrhea.
* Use of pancreatic hormone stimulant or inhibitor (e.g. octreotide, pancreatic enzyme supplements) during or immediately prior to hospital admission.
* Any other reason that the treating or investigator team considers to be a contraindication to enteral nutrition.
Minimum Eligible Age

18 Years

Maximum Eligible Age

89 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Alcresta Therapeutics, Inc.

INDUSTRY

Sponsor Role collaborator

Inova Health Care Services

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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George Kasotakis, MD MPH

Role: PRINCIPAL_INVESTIGATOR

Inova Fairfax Medical Campus

Locations

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Inova Fairfax Medical Campus

Falls Church, Virginia, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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George J Kasotakis, MD MPH

Role: CONTACT

(703) 776-2274

Laura E Madarasz, MS, BA

Role: CONTACT

(703) 776-2189

Facility Contacts

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Laura E Madarasz, MS,BA

Role: primary

703-776-2189

References

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Charlson M, Szatrowski TP, Peterson J, Gold J. Validation of a combined comorbidity index. J Clin Epidemiol. 1994 Nov;47(11):1245-51. doi: 10.1016/0895-4356(94)90129-5.

Reference Type BACKGROUND
PMID: 7722560 (View on PubMed)

Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, Hiesmayr M, Mayer K, Montejo JC, Pichard C, Preiser JC, van Zanten ARH, Oczkowski S, Szczeklik W, Bischoff SC. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019 Feb;38(1):48-79. doi: 10.1016/j.clnu.2018.08.037. Epub 2018 Sep 29.

Reference Type BACKGROUND
PMID: 30348463 (View on PubMed)

Stevens J, Wyatt C, Brown P, Patel D, Grujic D, Freedman SD. Absorption and Safety With Sustained Use of RELiZORB Evaluation (ASSURE) Study in Patients With Cystic Fibrosis Receiving Enteral Feeding. J Pediatr Gastroenterol Nutr. 2018 Oct;67(4):527-532. doi: 10.1097/MPG.0000000000002110.

Reference Type BACKGROUND
PMID: 30074573 (View on PubMed)

Freedman S, Orenstein D, Black P, Brown P, McCoy K, Stevens J, Grujic D, Clayton R. Increased Fat Absorption From Enteral Formula Through an In-line Digestive Cartridge in Patients With Cystic Fibrosis. J Pediatr Gastroenterol Nutr. 2017 Jul;65(1):97-101. doi: 10.1097/MPG.0000000000001617.

Reference Type BACKGROUND
PMID: 28471913 (View on PubMed)

van den Berghe G, Wouters P, Weekers F, Verwaest C, Bruyninckx F, Schetz M, Vlasselaers D, Ferdinande P, Lauwers P, Bouillon R. Intensive insulin therapy in critically ill patients. N Engl J Med. 2001 Nov 8;345(19):1359-67. doi: 10.1056/NEJMoa011300.

Reference Type BACKGROUND
PMID: 11794168 (View on PubMed)

Wang S, Ma L, Zhuang Y, Jiang B, Zhang X. Screening and risk factors of exocrine pancreatic insufficiency in critically ill adult patients receiving enteral nutrition. Crit Care. 2013 Aug 7;17(4):R171. doi: 10.1186/cc12850.

Reference Type BACKGROUND
PMID: 23924602 (View on PubMed)

Saberi F, Heyland D, Lam M, Rapson D, Jeejeebhoy K. Prevalence, incidence, and clinical resolution of insulin resistance in critically ill patients: an observational study. JPEN J Parenter Enteral Nutr. 2008 May-Jun;32(3):227-35. doi: 10.1177/0148607108316195.

Reference Type BACKGROUND
PMID: 18443133 (View on PubMed)

Nordenstrom J, Carpentier YA, Askanazi J, Robin AP, Elwyn DH, Hensle TW, Kinney JM. Free fatty acid mobilization and oxidation during total parenteral nutrition in trauma and infection. Ann Surg. 1983 Dec;198(6):725-35. doi: 10.1097/00000658-198312000-00011.

Reference Type BACKGROUND
PMID: 6416194 (View on PubMed)

Kutsogiannis J, Alberda C, Gramlich L, Cahill NE, Wang M, Day AG, Dhaliwal R, Heyland DK. Early use of supplemental parenteral nutrition in critically ill patients: results of an international multicenter observational study. Crit Care Med. 2011 Dec;39(12):2691-9. doi: 10.1097/CCM.0b013e3182282a83.

Reference Type BACKGROUND
PMID: 21765355 (View on PubMed)

Kelly MK. Bedside caregivers as change agents: implementation of early enteral nutrition in critical care. Crit Care Nurs Clin North Am. 2014 Jun;26(2):263-75. doi: 10.1016/j.ccell.2014.02.001.

Reference Type BACKGROUND
PMID: 24878211 (View on PubMed)

Jarden RJ, Sutton LJ. A practice change initiative to improve the provision of enteral nutrition to intensive care patients. Nurs Crit Care. 2015 Sep;20(5):242-55. doi: 10.1111/nicc.12107. Epub 2014 Jul 18.

Reference Type BACKGROUND
PMID: 25040624 (View on PubMed)

Jordan EA, Moore SC. Enteral nutrition in critically ill adults: Literature review of protocols. Nurs Crit Care. 2020 Jan;25(1):24-30. doi: 10.1111/nicc.12475. Epub 2019 Oct 10.

Reference Type BACKGROUND
PMID: 31602712 (View on PubMed)

Compton F, Bojarski C, Siegmund B, van der Giet M. Use of a nutrition support protocol to increase enteral nutrition delivery in critically ill patients. Am J Crit Care. 2014 Sep;23(5):396-403. doi: 10.4037/ajcc2014140.

Reference Type BACKGROUND
PMID: 25179035 (View on PubMed)

Doig GS, Heighes PT, Simpson F, Sweetman EA, Davies AR. Early enteral nutrition, provided within 24 h of injury or intensive care unit admission, significantly reduces mortality in critically ill patients: a meta-analysis of randomised controlled trials. Intensive Care Med. 2009 Dec;35(12):2018-27. doi: 10.1007/s00134-009-1664-4. Epub 2009 Sep 24.

Reference Type BACKGROUND
PMID: 19777207 (View on PubMed)

Marik PE, Zaloga GP. Early enteral nutrition in acutely ill patients: a systematic review. Crit Care Med. 2001 Dec;29(12):2264-70. doi: 10.1097/00003246-200112000-00005.

Reference Type BACKGROUND
PMID: 11801821 (View on PubMed)

Tian F, Heighes PT, Allingstrup MJ, Doig GS. Early Enteral Nutrition Provided Within 24 Hours of ICU Admission: A Meta-Analysis of Randomized Controlled Trials. Crit Care Med. 2018 Jul;46(7):1049-1056. doi: 10.1097/CCM.0000000000003152.

Reference Type BACKGROUND
PMID: 29629984 (View on PubMed)

Hejazi N, Mazloom Z, Zand F, Rezaianzadeh A, Amini A. Nutritional Assessment in Critically Ill Patients. Iran J Med Sci. 2016 May;41(3):171-9.

Reference Type BACKGROUND
PMID: 27217600 (View on PubMed)

Elpern EH, Stutz L, Peterson S, Gurka DP, Skipper A. Outcomes associated with enteral tube feedings in a medical intensive care unit. Am J Crit Care. 2004 May;13(3):221-7.

Reference Type BACKGROUND
PMID: 15149056 (View on PubMed)

Osooli F, Abbas S, Farsaei S, Adibi P. Identifying Critically Ill Patients at Risk of Malnutrition and Underfeeding: A Prospective Study at an Academic Hospital. Adv Pharm Bull. 2019 Jun;9(2):314-320. doi: 10.15171/apb.2019.037. Epub 2019 Jun 1.

Reference Type BACKGROUND
PMID: 31380259 (View on PubMed)

Wray CJ, Mammen JM, Hasselgren PO. Catabolic response to stress and potential benefits of nutrition support. Nutrition. 2002 Nov-Dec;18(11-12):971-7. doi: 10.1016/s0899-9007(02)00985-1.

Reference Type BACKGROUND
PMID: 12431720 (View on PubMed)

Lew CCH, Yandell R, Fraser RJL, Chua AP, Chong MFF, Miller M. Association Between Malnutrition and Clinical Outcomes in the Intensive Care Unit: A Systematic Review [Formula: see text]. JPEN J Parenter Enteral Nutr. 2017 Jul;41(5):744-758. doi: 10.1177/0148607115625638. Epub 2016 Feb 2.

Reference Type BACKGROUND
PMID: 26838530 (View on PubMed)

Other Identifiers

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INOVA-2023-42

Identifier Type: -

Identifier Source: org_study_id

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