- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04225689
The Intensive Post Exclusive Enteral Nutrition Study (iPENS)
The Intensive Post Exclusive Enteral Nutrition Study (iPENS): A Randomised Trial to Evaluate CD-TREAT Diet as a Food Reintroduction Regime in Children and Young Adults With Crohn's Disease
Study Overview
Detailed Description
A maximum of 60 participants, who have successfully responded to EEN, will be allocated to the study arms with block randomisation, with a 1:1 allocation, in random size blocks. The electronic randomisation process will be performed by an independent researcher. Those participants who do not wish to be randomised to one of the two study arms, will be offered the chance to be allocated to the group of their preference. Using this approach, inclusion of all eligible participants will be ensured, as excluding those who do not wish to be randomised, may reduce the generalisation of findings and minimise statistical power of a study with modest eligible population to recruit from.
CD-TREAT diet (intervention group)
Participants in the intervention group will consume the CD-TREAT diet exclusively without being allowed to consume additional food, for the first 3 weeks of food reintroduction, after EEN completion. They will be provided with a tailored, dietitian-devised diet, which has been designed to replicate the nutritional composition of EEN. The intervention will be overseen by qualified dietitians, including a National Health Service (NHS) research dietitian.
Unrestricted diet (control group)
Participants in the control group will consume a free, unrestricted diet for the same period, as the intervention group.
Participants in both groups will record their diet on a daily basis. The investigators will meet the participants weekly to address any potential issues they may have during the trial and to review the dietary assessment process. Standard treatment for maintenance of clinical remission will be continued, as designated by the medical team.
Participants will be asked to provide serial faecal and urine samples (n=8). Collection of a maximum of 2 blood samples, anthropometric measurements and assessment of disease activity and quality of life will be performed before and after the end of the dietary intervention. Participants will also be followed through their clinical records until they clinically relapse, or maximum up to a year after EEN completion.
The primary endpoint is the comparison of faecal calprotectin levels between the two groups at the end of the dietary intervention (3 weeks after EEN completion).
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Konstantinos Gkikas, MSc, Bsc
- Phone Number: 07759451611
- Email: k.gkikas.1@research.gla.ac.uk
Study Contact Backup
- Name: Richard K Russell, MBChB, MRCP, MRCPCH, PhD
- Phone Number: 01414516543
- Email: richardrussell@nhs.net
Study Locations
-
-
-
Crosshouse, United Kingdom, KA2 0BE
- Not yet recruiting
- University Hospital Crosshouse
-
Edinburgh, United Kingdom, EH9 1LF
- Not yet recruiting
- Royal Hospital for Sick Children
-
Glasgow, United Kingdom, G51 4TF
- Recruiting
- Royal Hospital for Children
-
Larbert, United Kingdom, FK5 4WR
- Not yet recruiting
- Forth Valley Royal Hospital
-
Wishaw, United Kingdom, ML2 0DP
- Not yet recruiting
- University Hospital Wishaw
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
Newly diagnosed or relapsing patients with active CD, who have shown clinical improvement by the 4th week of EEN treatment
Exclusion Criteria:
- Administration of another induction treatment (e.g. corticosteroids, biologic agents).
- Lack of clinical improvement with EEN treatment, as assessed by the clinical team.
- Enrolment in other studies investigating the efficacy of novel therapies for maintenance or induction of remission.
- Patients or families unable to provide written consent for participation in the study.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: CD-TREAT diet
Solid food-based dietary intervention replicating composition of exclusive enteral nutrition (EEN). Daily for a maximum of 21 days. Individualised diet based on energy requirements and physical activity levels. |
Dietary intervention
|
No Intervention: Unrestricted diet
Free, unrestricted diet.
Daily for a maximum of 21 days.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Colonic inflammation
Time Frame: Baseline to 21 days post EEN completion
|
Comparison of faecal calprotectin levels between the intervention (CD-TREAT) and the control (unrestricted diet) group
|
Baseline to 21 days post EEN completion
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Diet and faecal microbiome
Time Frame: Baseline to 21 days post EEN completion
|
Association of fermentable carbohydrates intake with relative abundance of faecal bacteria
|
Baseline to 21 days post EEN completion
|
Diet and faecal metabolome
Time Frame: Baseline to 21 days post EEN completion
|
Association of fermentable carbohydrates intake with concentration of short chain fatty acids in stool
|
Baseline to 21 days post EEN completion
|
Crohn's Disease activity score
Time Frame: Baseline to 21 days post EEN completion
|
Comparison of weighted Paediatric Crohn's Disease Activity Index score between the two groups (minimum score: 0, maximum: 125).
Higher score indicates higher disease activity severity.
|
Baseline to 21 days post EEN completion
|
Blood inflammatory markers
Time Frame: Baseline to 21 days post EEN completion
|
Comparison of concentration of blood inflammatory cytokines between the two groups
|
Baseline to 21 days post EEN completion
|
Quality of life
Time Frame: Baseline to 21 days post EEN completion
|
Comparison of IMPACT III scores between the two groups (minimum score: 35, maximum: 135).
Higher scores indicate better quality of life.
|
Baseline to 21 days post EEN completion
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Richard K Russell, MBChB, MRCP, MRCPCH, PhD, NHS Greater Glasgow and Clyde
- Principal Investigator: Konstantinos Gerasimidis, PhD, MSc, BSc, FHEA, University of Glasgow
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- GN19GA433P
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
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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