- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02823522
Non-Celiac Wheat Sensitivity: Permanent or Transient Condition?
Non-Celiac Wheat Sensitivity: Permanent or Transient Condition? A Follow-up Study
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Non-Celiac Gluten Sensitivity (NCGS) has been recently included among the gluten-related diseases. Patients suffering from NCGS are diagnosed after carefully excluding celiac disease (CD) diagnosis by negative CD-specific serum antibodies and absence of intestinal villi atrophy, and excluding IgE-mediated wheat allergy, by negative serum specific IgE and/or skin prick test with wheat antigens. Then, in the absence of sensitive and specific diagnostic biomarkers for NCGS, a monitoring of the patient during elimination and re-introduction of wheat by a double-blind placebo controlled (DBPC) challenge method has been suggested as diagnostic hallmark. Obviously, this a cumbersome and time-consuming procedure which has been used in few studies.
Despite an increasing percentage of the general population define themselves as "gluten-sensitive", and by the year 2017 the market of the gluten-free products will be worth 6.6 billion of dollars, doubts persist about many aspects of NCGS. Some studies seem to suggest that wheat components other than gluten can cause the symptoms, and therefore the term "non-celiac wheat sensitivity" (NCWS) has been proposed instead of NCGS. Furthermore, while it is well known that CD is a long-life condition and a strict adherence to the gluten-free diet must be maintained, it is unknown whether this is valid for NCWS.
On the year 2012, the researchers published a retrospective study, including 276 patients with irritable bowel syndrome (IBS)-like symptoms who had been diagnosed with NCWS using a DBPC challenge during a ten-years period (2001-2011).
The present prospective study aimed to evaluate the persistence of the NCWS condition in that cohort and, consequently, the researchers estimated : A) how many of these patients are still following a wheat-free diet, and B) which percentage was still suffering from NCWS, diagnosed by DBPC wheat challenge, in a subgroup of that cohort.
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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Palermo, Italy, 90129
- Department of Internal Medicine, University Hospital of Palermo
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Agrigento
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Sciacca, Agrigento, Italy, 92019
- Department of Internal Medicine, Giovanni Paolo II Hospital of Sciacca
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Patients previously diagnosed with NCWS by DBPC challenge.
Exclusion Criteria:
- The 22 patients, included in the previous study, who tested positives for anti-endomysial antibodies (EmA) in the culture medium of the duodenal biopsies, even if the villi/crypts ratio in the duodenal mucosa was normal, were excluded from the present study.
Study Plan
How is the study designed?
Design Details
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
How many patients were still following a gluten-free or a wheat-free diet
Time Frame: Between July and November 2016
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A structured questionnaire was administered to evaluate how many patients were still following a gluten-free diet (GFD) and how many a wheat-free diet.
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Between July and November 2016
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evaluation of the effect of the GFD on IBS symptoms
Time Frame: Between July and November 2016
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The researchers administered a modified version of the IBS Global Assessment of Improvement (IBS-GAI) score.
A responder was defined as a patient whose symptoms were either 'moderately improved' or 'substantially improved' compared with the period preceding the NCWS diagnosis.
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Between July and November 2016
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Evaluation of the severity of the IBS condition
Time Frame: Between July and November 2016
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The researchers administered the IBS Symptom Severity Scale (IBS-SSS), evaluating the change in total IBS-SSS score from the first evaluation (time of the NCWS diagnosis) and the follow-up evaluation (present study).
A respondent was classified as a patient whose overall symptom severity on the IBS-SSS changed >50 points.
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Between July and November 2016
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Re-evaluation of the NCWS condition by DBPC-Wheat challenge
Time Frame: Between July and November 2016
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Finally, the repetition of the DBPC-wheat challenge will be proposed to the patients still on GFD.
Those who will accept will be randomized to undergo the challenge.
It will be performed with the same method used in the retrospective study.
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Between July and November 2016
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Antonio Carroccio, MD, Department of Internal Medicine, Giovanni Paolo II Hospital of Sciacca
Publications and helpful links
General Publications
- Carroccio A, Mansueto P, Iacono G, Soresi M, D'Alcamo A, Cavataio F, Brusca I, Florena AM, Ambrosiano G, Seidita A, Pirrone G, Rini GB. Non-celiac wheat sensitivity diagnosed by double-blind placebo-controlled challenge: exploring a new clinical entity. Am J Gastroenterol. 2012 Dec;107(12):1898-906; quiz 1907. doi: 10.1038/ajg.2012.236. Epub 2012 Jul 24.
- Carroccio A, Rini G, Mansueto P. Non-celiac wheat sensitivity is a more appropriate label than non-celiac gluten sensitivity. Gastroenterology. 2014 Jan;146(1):320-1. doi: 10.1053/j.gastro.2013.08.061. Epub 2013 Nov 22. No abstract available.
- Francis CY, Morris J, Whorwell PJ. The irritable bowel severity scoring system: a simple method of monitoring irritable bowel syndrome and its progress. Aliment Pharmacol Ther. 1997 Apr;11(2):395-402. doi: 10.1046/j.1365-2036.1997.142318000.x.
- Catassi C, Elli L, Bonaz B, Bouma G, Carroccio A, Castillejo G, Cellier C, Cristofori F, de Magistris L, Dolinsek J, Dieterich W, Francavilla R, Hadjivassiliou M, Holtmeier W, Korner U, Leffler DA, Lundin KE, Mazzarella G, Mulder CJ, Pellegrini N, Rostami K, Sanders D, Skodje GI, Schuppan D, Ullrich R, Volta U, Williams M, Zevallos VF, Zopf Y, Fasano A. Diagnosis of Non-Celiac Gluten Sensitivity (NCGS): The Salerno Experts' Criteria. Nutrients. 2015 Jun 18;7(6):4966-77. doi: 10.3390/nu7064966.
- Sapone A, Bai JC, Ciacci C, Dolinsek J, Green PH, Hadjivassiliou M, Kaukinen K, Rostami K, Sanders DS, Schumann M, Ullrich R, Villalta D, Volta U, Catassi C, Fasano A. Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Med. 2012 Feb 7;10:13. doi: 10.1186/1741-7015-10-13.
- Ludvigsson JF, Leffler DA, Bai JC, Biagi F, Fasano A, Green PH, Hadjivassiliou M, Kaukinen K, Kelly CP, Leonard JN, Lundin KE, Murray JA, Sanders DS, Walker MM, Zingone F, Ciacci C. The Oslo definitions for coeliac disease and related terms. Gut. 2013 Jan;62(1):43-52. doi: 10.1136/gutjnl-2011-301346. Epub 2012 Feb 16.
- Spence D. Bad medicine: food intolerance. BMJ. 2013 Jan 30;346:f529. doi: 10.1136/bmj.f529. No abstract available.
- Fasano A, Sapone A, Zevallos V, Schuppan D. Nonceliac gluten sensitivity. Gastroenterology. 2015 May;148(6):1195-204. doi: 10.1053/j.gastro.2014.12.049. Epub 2015 Jan 9.
- Carroccio A, D'Alcamo A, Iacono G, Soresi M, Iacobucci R, Arini A, Geraci G, Fayer F, Cavataio F, La Blasca F, Florena AM, Mansueto P. Persistence of Nonceliac Wheat Sensitivity, Based on Long-term Follow-up. Gastroenterology. 2017 Jul;153(1):56-58.e3. doi: 10.1053/j.gastro.2017.03.034. Epub 2017 Mar 30.
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- ACPM11
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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