Ulcerative Colitis and Vitamin D Supplementation
Immunomodulating and Clinical Effects of Vitamin D on Remission Induction in Patients With Moderate and Severe Ulcerative Colitis, Undergoing Treatment With Infliximab.
Ulcerative colitis (UC) is an inflammatory disease involving the colonic mucosa, with bleedings and ulcerations. Consequences are destroyed mucosal barrier and increased permeability. Several cytokines are described to mediate the progressive course of ulcerative colitis and it is considered nowadays an immunologic disease. Patients with UC have often low levels of vitamin D and elevated prevalence of osteoporosis.
In vitro studies demonstrate that vitamin D has an immunomodulating effect, and may have a direct healing action on colonic mucosa has been described in animal studies. One can therefore rise a hypothesis that vitamin D supplementation could be crucial in patients with UC. To our knowledge, it has not been performed randomized clinical trials to study these possible effects of vitamin D and it has not been studied the effects of vitamin D on the relapse frequency and immunological composition of colic mucosa in patient with moderate to severe ulcerative colitis.
Objectives for our study are as follows: To examine if high-dose vitamin D supplementation in patients with moderate to severe ulcerative colitis:
- reduces relapse frequency and increase the duration of the Infliximab induced remission
- mediates and changes the cytokines composition in the colic mucosa
- decreases the excretion of calprotectin in feces and reduces the concentration of inflammation markers
- augments bone mass
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Locations
-
-
-
Tromsø, Norway, 9014
- University Hospital of North Norway
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Men and women older than18 years old, diagnosed with UC (either debut or relapsed chronic UC), moderate or severe, where it is an indication to treat with infliximab.
Exclusion Criteria:
- Primary hyperparathyroidism (PHPT)
- Sarcoidosis
- Renal failure (serum creatinine > 125 mumol/L in men or > 105 mumol/L in women)
- Those, who use solarium routinely are not included
- Pregnant or breastfeeding women, otherwise women of fertile age must be on approved birth control methods during the study
- Renal stones last 15 years
- Cancer of any origin, diagnosed during last 5 years
- Unstable angina pectoris
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Vitamin D
Decristol (cholecalciferol) 20000 IU per capsule 1 capsule per week |
compare how vitamin D influences the course of ulcerative colitis versus placebo
Other Names:
|
|
Placebo Comparator: Placebo
capsule with peanut oil
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
number of patients with remission
Time Frame: 12 months after start of intervention
|
Mandatory criterion of remission: clinical remission (defined as Mayo score <= 1, including endoscopic findings) and non-mandatory: laboratory (calprotectin < 100, WBC and SR within reference range).
These criteria will be assessed at 12 month after the start of intervention
|
12 months after start of intervention
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
change in fecal calprotectin
Time Frame: 12 months after start of intervention
|
change in fecal calprotectin compared to baseline value
|
12 months after start of intervention
|
|
change in bone mineral density (whole body)
Time Frame: 12 months after the start of intervention
|
change in bone mineral density in whole body, measured with DEXA (t-score and z-score)
|
12 months after the start of intervention
|
|
change in fecal calprotectin
Time Frame: 3 months
|
change in fecal calprotectin
|
3 months
|
|
change in tnf-alpha levels in colonic mucosa
Time Frame: 3 months
|
change in mucosal tnf-alpha levels.
Biopsies will be taken with the forceps from the colonic mucosa (colon sigmoid) and stored in RNA later media for the further analysis for TNF alpha concentration with PCR method.
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3 months
|
|
change in tnf-alpha (in colonic mucosa)
Time Frame: 12 months after baseline
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Biopsies and analysis will be carried out as described ata 3 months follow-up
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12 months after baseline
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Elena Kamycheva, MD, PhD, Medical Clinic, University Hospital of North Norway
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Anticipated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Pathologic Processes
- Gastrointestinal Diseases
- Gastroenteritis
- Colonic Diseases
- Intestinal Diseases
- Inflammatory Bowel Diseases
- Ulcer
- Colitis
- Colitis, Ulcerative
- Physiological Effects of Drugs
- Micronutrients
- Vitamins
- Bone Density Conservation Agents
- Calcium-Regulating Hormones and Agents
- Vitamin D
- Cholecalciferol
Other Study ID Numbers
Other Study ID Numbers
- 2009/1392-13 (REK)
- 2009-015649-21 (EudraCT Number)
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