- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT02950077
Mindfulness - Based Stress Reduction and the Relationship on Inflammation in Autoimmune Hepatitis
Mindfulness - Based Stress Reduction and the Relationship on Inflammation in Autoimmune Hepatitis - A Human Pilot Study Protocol
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
With the understanding that autoimmune hepatitis has a relationship with psychological stress, the use of a strategy such as mindfulness stress based reduction (MBSR) may similarly have a substantial impact as seen in other disease conditions. The proposed hypothesis is that undergoing MBSR has potential to benefit patients with autoimmune hepatitis in relation to decreased relapse rate and ultimately improved quality of life.
The focus of this study is surrounding the possibility of psychosocial stress for relapse in AIH. The investigators, however, would like to also understand the role of serological testing at the time of these relapses and during states of psychosocial stress to demonstrate if the association can be found. During active disease activity or relapses of autoimmune hepatitis, there is an expected rise in alanine aminotransferase (ALT) and immunoglobulin G (IgG) levels. Demonstrating the correlation of ALT and IgG with disease status and possible improvement with stress modifications is also key for this proposed study.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Connecticut
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New Haven, Connecticut, United States, 06520
- Yale Liver Center
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-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Between ages 18-80 years
- Diagnosis of Autoimmune Hepatitis Type I
Exclusion Criteria:
Medical
- Hospitalization in the last 30 days
- New immunosuppression agent started <6 weeks prior to study
- Patients with concurrent viral hepatitis and/or alcoholic liver disease
- Patients with decompensated cirrhosis (defined as ascites, encephalopathy, variceal hemorrhage)
- Patients with hepatocellular carcinoma
- Patients post-liver transplantation Psychological
- Any psychotic disorder or current psychiatric symptoms
Attitudinal
- Inability to commit to program schedule and attendance of classes
Physical
- Inability to physically attend classes; disability or physical impairment not included as an exclusion criteria Other
- Inadequate English proficiency
- Inability to read and/or write
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: NA
- Interventional Model: SINGLE_GROUP
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: All subjects
Individuals who are under the care of the Yale Liver Center with a diagnosis of autoimmune hepatitis
|
The intervention will be delivered in a group setting and the group will meet for 2 hours once per week for 8 weeks.
The intervention is based on new neuroscience of stress and resilient adaptive behaviors, mindfulness based stress reduction, therapeutic breath and synchronized yogic movement with a focus on the lower abdomen, integrated with cognitive and behavioral strategies for self-control and healthy decision making.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Subjective Stress: The Perceived Stress Scale
Time Frame: 12 months
|
Subjective Stress: The Perceived Stress Scale, a 14-item self-report scale that assesses the degree to which individuals appraise situations in their lives as stressful, will be used to assess subjective interpretation of stress and assign subjects to the low stress or high stress condition. Scale It has excellent test-retest reliability and good construct validity and has been used with adults and adolescents. Scale ranges from 0 to 40. A higher score indicates higher stress. |
12 months
|
Change in Recent Life Stress: Life Experience Survey
Time Frame: 12 months
|
The LES is a widely used 57 item self-report measure. It shows convergent validity with personality measures (e.g., anxiety) and is not correlated with social desirability measures. Scale ranges from -250 to +250. A higher score indicates higher stress. |
12 months
|
Daily Hassles Questionnaire
Time Frame: 12 months
|
This self-report item measures how stressful subjects perceived situations occurring in the past year of their life. Scale ranges from 0 to 351. A higher score indicates higher stress. |
12 months
|
The Brief Self-Control Scale
Time Frame: 12 months
|
The Brief Self-Control Scale will be used to measure self-reported self-control and impulsivity. The BSCS also shows good internal consistency (alphas = .83 - .84) and high retest reliability (.87). Scale ranges from 13-65. A higher score indicates better self-control. |
12 months
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in ALT levels and IgG levels
Time Frame: 12 months
|
Abnormal AST and ALT will be defined as >2x upper limits of normal Normal Lab ranges that will be used are the following:
These levels are used together for clinical significance and diagnosis. |
12 months
|
Change in average medication needed
Time Frame: 12 months
|
E.g (changes in monthly prednisone dose)
|
12 months
|
Change in number of relapses
Time Frame: up to 2 years
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Relapse is defined in one of two ways once immunosuppression has been tapered off: I. An increase in the AST or ALT ≥2 X ULN (upper limit of normal) II. An increase in AST and/or ALT ≥ 2 X the prior level of AST or ALT on routine labs checked at start of clinical study |
up to 2 years
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Demonstration of MIF and CD74 have a role as a biomarker for disease activity
Time Frame: 12 months
|
Demonstration of a correlation of serum MIF and CD74 levels with autoimmune hepatitis disease activity.
|
12 months
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: James Boyer, MD, Yale University
- Study Director: David Assis, MD, Yale University
Publications and helpful links
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 (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Pathologic Processes
- RNA Virus Infections
- Virus Diseases
- Infections
- Immune System Diseases
- Autoimmune Diseases
- Liver Diseases
- Hepatitis, Viral, Human
- Enterovirus Infections
- Picornaviridae Infections
- Hepatitis, Chronic
- Inflammation
- Hepatitis
- Hepatitis A
- Hepatitis, Autoimmune
Other Study ID Numbers
- 2000020043
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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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