A Pragmatic Trial of Dietary Programs in People With Multiple Sclerosis (MS)
18 mai 2018 mis à jour par: Johns Hopkins University
A Pragmatic Trial of Dietary Programs in People With Multiple Sclerosis
This is a pragmatic, single-blinded randomized trial of improving adherence to dietary interventions in patients with MS who are receiving monthly natalizumab infusions.
Aperçu de l'étude
Statut
Complété
Les conditions
Intervention / Traitement
Description détaillée
MS affects at least 400,000 people in the US alone, and its incidence has increased in the past 50 years, likely due to changing environmental risk factors. Recent research suggests that diet may be a critical factor in the development of MS. The "Western diet", high in sugar, fat, and salt, may influence MS risk and progression by directly affecting the immune system, altering gut bacteria, and changing metabolism.
Studying patients with MS who are overweight and obese may be relevant as obesity can cause chronic low-grade inflammation, potentially worsening MS symptoms. Diet modification represents an interesting potential therapy for MS, particularly calorie restriction and fasting, which have been associated with reduced markers of inflammation. In addition to these direct effects, weight optimization may lead to improvements in MS-related symptoms, like fatigue, and overall quality of life.
This is a single-blinded randomized trial of adherence to a dietary intervention in patients with MS who are receiving monthly natalizumab infusions. The study will evaluate how use of technology may help patients with MS adhere to a calorie restricted diet. It will also evaluate the effect of weight loss on fatigue and quality of life in patients with MS. A second part of the study will evaluate if shortening the period during the day in which people consume their typical food amounts leads to improvements in patient-reported outcomes.
Type d'étude
Interventionnel
Inscription (Réel)
54
Phase
- N'est pas applicable
Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
18 ans à 75 ans (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Non
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- Body Mass Index (BMI) ≥ 25 kg/m^2 for calorie restriction study
- BMI < 25 kg/m^2, or ≥ 25 kg/m^2 if participant was unwilling to enroll in calorie restriction study
- Smartphone with the ability to download and use the LoseIt! application (calorie restriction only)
- Smartphone with the ability to take and store photos (calorie timing only)
Exclusion Criteria:
- History of diabetes requiring medication
- Currently pregnant or breastfeeding
- History of an eating disorder
- Currently taking warfarin
- History of major surgery within past 3 months
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: Calorie Restriction - Frequent Patient Communication
MS patients receiving monthly natalizumab infusions will use the LoseIt!
smartphone application to log daily food consumption.
Data from the app will be collected at follow-up visits.
Patients will receive initial training in using the app, and then receive weekly supportive messages encouraging them to adhere to the calorie restriction diet between 3- and 6-month followup visits.
Results will be compared primarily to those collected from the Standard of Care arm.
|
Weekly informational and supportive text messages will be sent to patients, encouraging adherence to the calorie restriction diet.
Patients will be trained by study staff to download the LoseIt!
application, and use it to log all food intake throughout the study duration.
Data collected from the application will be the primary measure of adherence to dietary changes.
|
|
Expérimental: Timing Restriction
MS patients receiving monthly natalizumab infusions who are ineligible for the calorie restriction portion of the study (the Frequent Patient Activation and Standard of Care arms) will be offered the option to enroll in the second part of the study, assessing differences in outcomes between daily 16-hour fasting periods and no dietary changes.
Patients in the second part of the study randomized to this arm will consume their normal daily food intake, but restrict eating to an 8-hour period during the day.
Results will be compared to patients who do not make any changes to their diet, the No Change arm.
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Patients continue to follow their normal diet, but limit food intake to an 8-hour period during the day.
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Comparateur placebo: Calorie Restriction - Communication Standard of Care
MS patients receiving monthly natalizumab infusions will use the LoseIt!
smartphone application to log daily food consumption.
Data from the app will be collected at follow-up visits.
Besides initial training with the application and 3- and 6-month follow up exams, participants will not receive additional support or interaction from the study team.Results will be compared with those collected from the Frequent Patient Interaction arm.
|
Patients will be trained by study staff to download the LoseIt!
application, and use it to log all food intake throughout the study duration.
Data collected from the application will be the primary measure of adherence to dietary changes.
|
|
Aucune intervention: No Diet Change
MS patients receiving natalizumab infusions who were ineligible for the calorie restriction portion of the study (e.g.
body mass index < 25 kg/m^2) or did not wish to participate in calorie restriction, may elect to be part of the second portion of the study.
If so, they may be randomized to this arm, in which no changes are made to amount or timing of daily food intake.
Results will be compared with the experimental Timing arm
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Adherence
Délai: Baseline and 6 months
|
Number of participants adhering to the prescribed dietary intervention at the end of the 6-month study period.
|
Baseline and 6 months
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Body Mass Index (BMI)
Délai: Baseline and 6 months
|
Change in body mass index from baseline to 6 months.
|
Baseline and 6 months
|
|
Weight Change
Délai: Baseline and 6 months
|
Change in participant weight over the 6-month study period
|
Baseline and 6 months
|
|
Weight Change Among Adherent Participants
Délai: Baseline and 6 months
|
The change in weight over 6 months among participants were remained adherence to the calorie restriction diet versus those who admitted to non-compliance by the end of the study period.
|
Baseline and 6 months
|
|
Functional Assessment in MS Score
Délai: Baseline and 6 months
|
The Functional Assessment in Multiple Sclerosis (FAMS) is an instrument that measures quality of life among people with MS.
The instrument contains 44 questions scored on a 5-point Likert scale in 6 areas: mobility, symptoms, emotional wellbeing, general contentment, thanking/fatigue, and family/social wellbeing.
Subscores for each area is calculated as the sum of responses in that section, and the total FAMS score is the sum of all subscores.
Minimum total score is 0 and maximum total score is 176, where a higher score indicates better quality of life.
Increase in the FAMS score over the study period indicates a better outcome, or improved quality of life, among participants.
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Baseline and 6 months
|
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Fatigue
Délai: Baseline and 6 months
|
The Patient-Reported Outcomes Measurement Information System (PROMIS) - Fatigue is a question bank of 95 items validated to evaluated fatigue in a variety of chronic conditions.
The PROMIS-FatigueMS is a subset of 8 questions from the question bank, which have been validated to measure fatigue in people with multiple sclerosis.
Individual items are scored on a 5-point Likert scale, and the total score is the sum of individual items, with a minimum score of 8 and maximum score of 40.
Lower scores indicate less fatigue, while higher scores indicate more fatigue.
Reduction in score over 6 months indicates a better outcome, or improved fatigue among participants.
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Baseline and 6 months
|
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Sleep Quality
Délai: Baseline and 6 months
|
The Pittsburgh Sleep Quality Index (PSQI) is an instrument used to measure the quality and sleeping pattern of adults.
It differentiates "poor" from "good" sleep quality, and the total score is calculated from the sum of seven components, each scored from 0 to 3. The minimum total score is 0 and the maximum total score is 21.
A total score equal to or greater than 5 units indicates "poor" quality sleep, while a score of 0-4 indicates "good" quality sleep; lower scores indicate better sleep quality.
Decrease in PSQI score indicates a better outcome, or improved sleep quality, among study participants.
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Baseline and 6 months
|
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Self-esteem
Délai: Baseline and 6 months
|
The Rosenberg Self-Esteem Scale (RSES) is a 10-item scale that measures global self-worth using a 4-point Likert scale to ask about negative and positive feelings about the self.
Individual items are summed to calculate the total score.
Minimum score is 0 and maximum score is 30.
Scores between 15 and 25 are considered within the normal range, while scores below 15 indicates poor self-esteem.
An increase in RSES score over 6 months indicates a better outcome, or improved self-esteem, among participants.
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Baseline and 6 months
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Parrainer
Les enquêteurs
- Chercheur principal: Ellen Mowry, MD, Johns Hopkins University
Publications et liens utiles
La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude
1 août 2016
Achèvement primaire (Réel)
1 juin 2017
Achèvement de l'étude (Réel)
1 juillet 2017
Dates d'inscription aux études
Première soumission
20 juillet 2016
Première soumission répondant aux critères de contrôle qualité
22 juillet 2016
Première publication (Estimation)
27 juillet 2016
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
15 juin 2018
Dernière mise à jour soumise répondant aux critères de contrôle qualité
18 mai 2018
Dernière vérification
1 mai 2018
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- IRB00105123
Plan pour les données individuelles des participants (IPD)
Prévoyez-vous de partager les données individuelles des participants (DPI) ?
NON
Description du régime IPD
Individual participant's data will not be shared
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