Combination of Diet and Oral Budesonide for Ulcerative Colitis

NCT ID: NCT05791487

Last Updated: 2024-05-23

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

RECRUITING

Clinical Phase

NA

Total Enrollment

90 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-12-01

Study Completion Date

2026-09-01

Brief Summary

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The ReDUCE Trial is a multinational single-blinded randomized controlled trial in mild to moderate flare of Ulcerative colitis (UC) disease patients. The purpose of the study is to validate the clinical efficacy of the UCED (Ulcerative colitis Exclusion Diet) with partial enteral nutrition (PEN) using a novel formula.

The investigators anticipate that adding a novel specifically designed dietary intervention in addition to drug will lead to superior remission and mucosal healing via changes in the microbiome.

Detailed Description

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Rational: Ulcerative colitis is currently treated only by medical therapies or surgery and there is no other option to avoid immune suppression.

Thus, developing a dietary therapy that would treat the cause of the disease, while having no side effects, would likely lead to immediate implementation and be sought out by patients hesitant to be on lifelong medications or immune suppression.

Objectives: To evaluate if the UC Exclusion Diet (UCED), can improve outcomes when administered with an oral budesonide regimen to adult patients with mild to moderate UC.

Methods: This will be a 24-week multinational single-blinded randomized controlled trial.

After a baseline flexible sigmoidoscopy, Group 1 will receive oral budesonide 9 mg topical therapy + the UCED+PEN phase 1 diet for 6 weeks, while Group 2 will receive oral budesonide 9 mg topical therapy alone for 6 weeks with no dietary intervention.

Both groups will continue the previous maintenance therapy through week 12 and both groups will stop budesonide at week 6.

Group 1 will continue with the phase 2 diet/PEN from week 7-12 while group 2 will stay on habitual diet. A flexible sigmoidoscopy will be repeated at week 12.

Population: adults and adolescents between the ages of 17-65 with a mild to moderate active disease (Simple Clinical Colitis Activity Index (SCCAI) 5-10 with an endoscopic Mayo score 1-3), on an existing maintenance therapy comparing two arms.

Time frame: The induction of remission phase will last 8 weeks followed by maintenance phase for a period of 24 weeks

Expected outcomes and significance: The investigators anticipate that adding a novel specifically designed dietary intervention in addition to drug will lead to superior remission and mucosal healing via changes in the microbiome.

Conditions

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Ulcerative Colitis Ulcerative Colitis Chronic Mild Ulcerative Colitis Chronic Moderate

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Caregivers
The physician

Study Groups

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Ulcerative colitis Exclusion Diet + Partial enteral nutrition

Participants in Group 1 will receive the UCED combined with partial enteral nutrition (PEN) using a novel nutritional formula for 6 weeks (diet phase 1) that will add to oral budesonide 9 mg topical therapy for 6 weeks and will follow diet + PEN (phase 2: wk6-wk12) and diet phase 3 for 24 weeks.

Group Type EXPERIMENTAL

Ulcerative colitis Exclusion Diet

Intervention Type OTHER

a limited whole food diet (UCED)

Partial enteral nutrition (PEN)

Intervention Type OTHER

The diet will be supplemented by 3 glasses a day (750 m"l) of the formula developed for UC using the UCED principles.

Oral Budesonide

Intervention Type DRUG

Oral Budesonide 9 mg

Free diet

Participants in Group 2 will receive oral budesonide 9 mg topical therapy alone for 6 weeks with no dietary intervention

Group Type ACTIVE_COMPARATOR

free diet

Intervention Type OTHER

oral Budeosnide for 6 weeks + free diet

Oral Budesonide

Intervention Type DRUG

Oral Budesonide 9 mg

Interventions

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Ulcerative colitis Exclusion Diet

a limited whole food diet (UCED)

Intervention Type OTHER

Partial enteral nutrition (PEN)

The diet will be supplemented by 3 glasses a day (750 m"l) of the formula developed for UC using the UCED principles.

Intervention Type OTHER

free diet

oral Budeosnide for 6 weeks + free diet

Intervention Type OTHER

Oral Budesonide

Oral Budesonide 9 mg

Intervention Type DRUG

Other Intervention Names

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UCED UC nutritional formula, Nestle

Eligibility Criteria

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Inclusion Criteria

* Informed consent
* Established diagnosis of UC with mild to moderate active disease, 5 ≤ SCCAI ≤ 10
* Age: 17-65 years (inclusive)
* Extent E1-E3 by the Montreal classification
* Active colitis in the rectum or sigmoid colon on sigmoidoscopy
* Stable medication use of oral 5ASA for at least 8 weeks, thiopurines, vedolizumabs, Ustekinumab or tofacitinib for at least 12 weeks

Exclusion Criteria

* Severe colitis (SCCAI\>10) hospitalization for acute severe colitis (ASC) in the previous 6 months
* Use of steroids in the previous 3 months
* Patients treated with Anti-TNF currently or in patients who had previously failed or lost response to anti TNF
* Vegans (vegetarians may enroll)
* Pregnancy
* Inability use of budesonide due to severe adverse events
* Extraintestinal manifestations such as arthritis, spondyloarthropathy or uveitis
* Presence of baseline hypoalbuminemia
* Fever \>38°C
* Evidence for Clostridioides difficile infection
* Renal failure
* Hepatitis or PSC (Primary Sclerosing Cholangitis)
* Active malignancy (excluding skin BCC).
Minimum Eligible Age

17 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Wolfson Medical Center

OTHER_GOV

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Emek Medical Center

Afula, , Israel

Site Status NOT_YET_RECRUITING

Wolfson Medical Center

Holon, , Israel

Site Status RECRUITING

Tel Aviv Sourasky Medical Center

Tel Aviv, , Israel

Site Status RECRUITING

FONDAZIONE GEMELLI HOSPITAL Catholic University of the Sacred Hearth

Roma, , Italy

Site Status NOT_YET_RECRUITING

Radboud University Medical Center (Radboudumc)

Nijmegen, , Netherlands

Site Status NOT_YET_RECRUITING

Kantonsspital St. Gallen

Sankt Gallen, , Switzerland

Site Status RECRUITING

Countries

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Israel Italy Netherlands Switzerland

Facility Contacts

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Eran Zittan, MD

Role: primary

Eran Israeli, Professor

Role: primary

972-52-5912199

Chen Sarbagili, RD

Role: backup

972-52-5912199

Nitsan Maharshak, Professor

Role: primary

972-52-7360384

Franco Scaldaferri, MD, PhD

Role: primary

+390630155923

Marjolijn Duijvestein, MD, PhD

Role: primary

Claudia Krieger-Grübel, MD

Role: primary

+417977390545

References

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Sarbagili Shabat C, Scaldaferri F, Zittan E, Hirsch A, Mentella MC, Musca T, Cohen NA, Ron Y, Fliss Isakov N, Pfeffer J, Yaakov M, Fanali C, Turchini L, Masucci L, Quaranta G, Kolonimos N, Godneva A, Weinberger A, Kopylov U, Levine A, Maharshak N. Use of Faecal Transplantation with a Novel Diet for Mild to Moderate Active Ulcerative Colitis: The CRAFT UC Randomised Controlled Trial. J Crohns Colitis. 2022 Mar 14;16(3):369-378. doi: 10.1093/ecco-jcc/jjab165.

Reference Type BACKGROUND
PMID: 34514495 (View on PubMed)

Sarbagili-Shabat C, Albenberg L, Van Limbergen J, Pressman N, Otley A, Yaakov M, Wine E, Weiner D, Levine A. A Novel UC Exclusion Diet and Antibiotics for Treatment of Mild to Moderate Pediatric Ulcerative Colitis: A Prospective Open-Label Pilot Study. Nutrients. 2021 Oct 23;13(11):3736. doi: 10.3390/nu13113736.

Reference Type BACKGROUND
PMID: 34835992 (View on PubMed)

Related Links

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Other Identifiers

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0073-22-WOMC

Identifier Type: -

Identifier Source: org_study_id

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