Anti-inflammatory Effect of Pre-operative Stimulation of the Cholinergic Anti-Inflammatory Pathway
Anti-inflammatory Effect of Pre-operative Stimulation of the Cholinergic Anti-Inflammatory Pathway: A Potential New Therapeutical Intervention for Postoperative Ileus
Hypothesis:
Prucalopride can mimic electrical stimulation of the abdominal vagus nerve and has an anti-inflammatory effect.
Aims:
In the present pilot study, the investigators want to evaluate the anti-inflammatory effect of prucalopride. The following aims are formulated:
- to show that prucalopride has a similar inflammatory effect as abdominal vagus nerve stimulation (VNS)
- to evaluate whether prucalopride leads to accelerated post-operative recovery
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Vlaams-Brabant
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Leuven, Vlaams-Brabant, Belgium, 3000
- University Hospitals Leuven
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- patients undergoing partial or full resection of the pancreas due to a benign or malignant tumor
Exclusion Criteria:
- adjuvant radiotherapy
- evident intra-abdominal inflammation (diagnosed by imaging and/or laboratory results, including an abscess or cholecystitis)
- chronic pancreatitis
- pancreatic polypeptide producing endocrine tumor
- American Society of Anesthesiologists physical-health status classification (ASA-PS)>3
- Poorly regulated diabetes (>200 mg/dl (=11 mmol/l))
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: Sham stimulation + Placebo
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|
|
Active Comparator: Vagus stimulation + placebo
|
|
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Active Comparator: Prucalopride + sham stimulation
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Levels of pro-inflammatory cytokines in intestinal tissue, serum, peritoneal lavage and supernatant of stimulated whole blood
Time Frame: From the date of surgery until the date of lab analysis (up to 6 months)
|
From the date of surgery until the date of lab analysis (up to 6 months)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Time to first flatus
Time Frame: From the date of surgery until the date of discharge from the hospital (on average 14 days)
|
From the date of surgery until the date of discharge from the hospital (on average 14 days)
|
|
Time to tolerance of oral food intake
Time Frame: From the date of surgery until the date of discharge from the hospital (on average 14 days)
|
From the date of surgery until the date of discharge from the hospital (on average 14 days)
|
|
Time to first defecation
Time Frame: From the date of surgery until the date of discharge from the hospital (on average 14 days)
|
From the date of surgery until the date of discharge from the hospital (on average 14 days)
|
|
Gastrointestinal symptoms (nausea, pain, vomiting, bloating)
Time Frame: From the date of surgery until the date of discharge from the hospital (on average 14 days)
|
From the date of surgery until the date of discharge from the hospital (on average 14 days)
|
|
Time to discharge from the hospital
Time Frame: From the date of surgery until the date of discharge from the hospital (on average 14 days)
|
From the date of surgery until the date of discharge from the hospital (on average 14 days)
|
|
Time to tolerance of oral food intake AND first defecation
Time Frame: From the date of surgery until the date of discharge from the hospital (on average 14 days)
|
From the date of surgery until the date of discharge from the hospital (on average 14 days)
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Guy Boeckxstaens, M.D., Catholic University Leuven
Publications and helpful links
General Publications
- Kalff JC, Buchholz BM, Eskandari MK, Hierholzer C, Schraut WH, Simmons RL, Bauer AJ. Biphasic response to gut manipulation and temporal correlation of cellular infiltrates and muscle dysfunction in rat. Surgery. 1999 Sep;126(3):498-509.
- Kalff JC, Schraut WH, Simmons RL, Bauer AJ. Surgical manipulation of the gut elicits an intestinal muscularis inflammatory response resulting in postsurgical ileus. Ann Surg. 1998 Nov;228(5):652-63. doi: 10.1097/00000658-199811000-00004.
- Stakenborg N, Labeeuw E, Gomez-Pinilla PJ, De Schepper S, Aerts R, Goverse G, Farro G, Appeltans I, Meroni E, Stakenborg M, Viola MF, Gonzalez-Dominguez E, Bosmans G, Alpizar YA, Wolthuis A, D'Hoore A, Van Beek K, Verheijden S, Verhaegen M, Derua R, Waelkens E, Moretti M, Gotti C, Augustijns P, Talavera K, Vanden Berghe P, Matteoli G, Boeckxstaens GE. Preoperative administration of the 5-HT4 receptor agonist prucalopride reduces intestinal inflammation and shortens postoperative ileus via cholinergic enteric neurons. Gut. 2019 Aug;68(8):1406-1416. doi: 10.1136/gutjnl-2018-317263. Epub 2018 Nov 24.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimated)
First Posted
Study Record Updates
Last Update Posted (Actual)
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
Other Study ID Numbers
Other Study ID Numbers
- S56328
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