CClinicalTrials.gg
CompletedNCT01692015Updated Mar 29, 2024Results posted

Diet and Hereditary Haemorrhagic Telangiectasia

An interventional study of Questionnaire on dietary history and Questionnaire on nosebleed severity in Hereditary Haemorrhagic Telangiectasia (HHT), sponsored by Imperial College London. Completed at 1 site in United Kingdom. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2024-03-29.

Sponsored by Imperial College London · Not applicable, Interventional, and Supportive care

Phase
Not applicable
Study type
Interventional
Enrollment
50
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

Hereditary Haemorrhagic Telangiectasia (HHT) affects 1 in 5,000 people. The purpose of this study is to provide data regarding the diet and nosebleed frequency using a questionnaire.

This will be filled in by people with HHT.

The questionnaire has been designed in paper format.

Read the detailed description

Hereditary Haemorrhagic Telangiectasia (HHT) affects 1 in 5,000 people, usually causing nosebleeds, skin blood spots, and/or anaemia as a result of bleeding from the nose or gut. The majority of people with HHT also have abnormal blood vessels (arteriovenous malformations) in internal organs such as the lungs, liver and brain. Management of this multisystem disorder is highly challenging.

The Lead Applicant has spent 20 years working on this rare disease, and identified multiple areas where more evidence is required to assist clinicians and patients with this lifelong condition. A particular issue is whether the diet influences HHT or its complications in any way.

In this study, people will fill in two questionnaires, one giving details of their diet, and another details of their nosebleeds. They will also be asked to consider participating in an accessory study arm which includes weighing food for one week and providing a food diary, in addition to having a single set of blood test.

02

Conditions studied

  • Hereditary Haemorrhagic Telangiectasia (HHT)

Keywords

  • Hereditary Haemorrhagic Telangiectasia
  • Nose bleeding
  • Iron supplements
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • A diagnosis of hereditary Haemorrhagic Telangiectasia (HHT)

Exclusion criteria

Exclusion Criteria:

  • Unable to provide informed consent
  • Presence of another major organ disorder that may affect nutritional status, such as inflammatory bowel disease, or celiac disease.
04

Study design

Phase
Not applicable
Primary purpose
Supportive care
Allocation
Non-randomized
Intervention model
Single group
Masking
None (open label)
Enrollment
50 participants (actual)

Study arms

  • Experimental
    Diet and nosebleed questionnaire

    Participants will only be required to fill in two paper questionnaires, one on dietary history, and one on nosebleed severity.

    Other: Questionnaire on dietary history · Other: Questionnaire on nosebleed severity

  • Experimental
    Weighed food diary arm

    Participants will be required to weigh their food for one week to generate a food dairy, and have a single blood test, in addition to filling in the two paper questionnaires, one on dietary history, and one on nosebleed severity.

    Other: Questionnaire on dietary history · Other: Questionnaire on nosebleed severity · Other: One week food diary generated by weighing foods · Procedure: Blood tests for full blood count, albumin, and indices of nutritional status

Interventions

  • OtherQuestionnaire on dietary history
  • OtherQuestionnaire on nosebleed severity
  • OtherOne week food diary generated by weighing foods
  • ProcedureBlood tests for full blood count, albumin, and indices of nutritional status
05

What researchers measure

Primary outcomes

  1. Number of Participants That Achieving Personal Recommended Intake of Iron

    Dietary food item iron content assessed by the European Prospective Investigation into Cancer and Nutrition (EPIC) food frequency questionnaire. This method has been validated against the gold standard for dietary assessment, a 7-day weighed food diary. Questions are asked about consumption of 130 major food items over the previous year, requiring participants to indicate the frequency of consumption, and to provide details about the methods of cooking, type of produce, and use of dietary supplements. The EPIC FFQ has been widely validated in a number of studies and is deemed an adequate assessment tool to assess dietary intake.

    Time frame: 1 year

  2. Nosebleed Severity

    Nosebleeds were quantified using the validated Epistaxis Severity Score (ESS). The six questions provide an objective measure of nosebleeds: three relate to different characteristics of typical nosebleeds within the previous three months (frequency, duration and intensity (gushing/pouring or not)), three to medical attention, anemia and transfusion requirements. The final ESS score ranges from 0-10, where a higher score equates to greater blood losses.

    Time frame: 3 months

  3. Number of Participants That Achieving the Hemorrhage Adjusted Iron Requirement (HAIR)

    The hemorrhage-adjusted iron requirement (HAIR) was calculated as the sum of the normal recommended dietary iron intake, and requirements to compensate for non-menstrual blood losses.

    Time frame: 1 year

Other outcomes

  1. Number of Participants That Ingested Chocolate

    Chocolate can precipitate nosebleeds Food items intake assessed by 7-day weighed food diary

    Time frame: 3 months

  2. Number of Participants That Ingested Bread

    Bread not precipitate nosebleeds Food items intake assessed by 7-day weighed food diary

    Time frame: 3 months

06

Results

Posted Mar 29, 2024

Participant flow

Participant flow — Overall Study
MilestoneHereditary Hemorrhagic Telangiectasia (HHT)
Started50
Completed50
Not completed0

Outcome measures

PrimaryNumber of Participants That Achieving Personal Recommended Intake of Iron

Dietary food item iron content assessed by the European Prospective Investigation into Cancer and Nutrition (EPIC) food frequency questionnaire. This method has been validated against the gold standard for dietary assessment, a 7-day weighed food diary. Questions are asked about consumption of 130 major food items over the previous year, requiring participants to indicate the frequency of consumption, and to provide details about the methods of cooking, type of produce, and use of dietary supplements. The EPIC FFQ has been widely validated in a number of studies and is deemed an adequate assessment tool to assess dietary intake.

Time frame:
1 year
Reported as:
Count of participants · Participants
Number of Participants That Achieving Personal Recommended Intake of Iron
ParticipantsHereditary Hemorrhagic Telangiectasia (HHT)
Number of Participants That Achieving Personal Recommended Intake of Iron43
PrimaryNosebleed Severity

Nosebleeds were quantified using the validated Epistaxis Severity Score (ESS). The six questions provide an objective measure of nosebleeds: three relate to different characteristics of typical nosebleeds within the previous three months (frequency, duration and intensity (gushing/pouring or not)), three to medical attention, anemia and transfusion requirements. The final ESS score ranges from 0-10, where a higher score equates to greater blood losses.

Time frame:
3 months
Reported as:
Median · units
Nosebleed Severity
unitsHereditary Hemorrhagic Telangiectasia (HHT)
Nosebleed Severity4.4 (0 to 9.1)
PrimaryNumber of Participants That Achieving the Hemorrhage Adjusted Iron Requirement (HAIR)

The hemorrhage-adjusted iron requirement (HAIR) was calculated as the sum of the normal recommended dietary iron intake, and requirements to compensate for non-menstrual blood losses.

Time frame:
1 year
Reported as:
Count of participants · Participants
Number of Participants That Achieving the Hemorrhage Adjusted Iron Requirement (HAIR)
ParticipantsHereditary Hemorrhagic Telangiectasia (HHT)
Number of Participants That Achieving the Hemorrhage Adjusted Iron Requirement (HAIR)10
Other pre-specifiedNumber of Participants That Ingested Chocolate

Chocolate can precipitate nosebleeds Food items intake assessed by 7-day weighed food diary

Time frame:
3 months
Reported as:
Count of participants · Participants
Number of Participants That Ingested Chocolate
ParticipantsHereditary Hemorrhagic Telangiectasia (HHT)
Number of Participants That Ingested Chocolate14
Other pre-specifiedNumber of Participants That Ingested Bread

Bread not precipitate nosebleeds Food items intake assessed by 7-day weighed food diary

Time frame:
3 months
Reported as:
Count of participants · Participants
Number of Participants That Ingested Bread
ParticipantsHereditary Hemorrhagic Telangiectasia (HHT)
Number of Participants That Ingested Bread25

Adverse events

Collected over 1 year. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Hereditary Hemorrhagic Telangiectasia (HHT)0/50 (0%)0/50 (0%)0/50 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(years)Hereditary Hemorrhagic Telangiectasia (HHT)
Median55 (20 to 80)
Sex: Female, Male
Sex: Female, Male(Participants)Hereditary Hemorrhagic Telangiectasia (HHT)
Female22
Male28
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)Hereditary Hemorrhagic Telangiectasia (HHT)
Region of Enrollment
Region of Enrollment(participants)Hereditary Hemorrhagic Telangiectasia (HHT)
United Kingdom50
07

Study locations

1 site
  • HHTIC London, Hammersmith Hospital, Imperial College Healthcare NHS Trust
    London, W12 0NN, United Kingdom
08

References and documents

Publications

  • Finnamore H, Le Couteur J, Hickson M, Busbridge M, Whelan K, Shovlin CL. Hemorrhage-adjusted iron requirements, hematinics and hepcidin define hereditary hemorrhagic telangiectasia as a model of hemorrhagic iron deficiency. PLoS One. 2013 Oct 16;8(10):e76516. doi: 10.1371/journal.pone.0076516. eCollection 2013. PubMed 24146883 ↗
  • Finnamore HE, Whelan K, Hickson M, Shovlin CL. Top dietary iron sources in the UK. Br J Gen Pract. 2014 Apr;64(621):172-3. doi: 10.3399/bjgp14X677761. No abstract available. PubMed 24686867 ↗
  • Chamali B, Finnamore H, Manning R, Laffan MA, Hickson M, Whelan K, Shovlin CL. Dietary supplement use and nosebleeds in hereditary haemorrhagic telangiectasia - an observational study. Intractable Rare Dis Res. 2016 May;5(2):109-13. doi: 10.5582/irdr.2016.01019. PubMed 27195194 ↗
  • Finnamore H, Silva BM, Hickson BM, Whelan K, Shovlin CL. 7-day weighed food diaries suggest patients with hereditary hemorrhagic telangiectasia may spontaneously modify their diet to avoid nosebleed precipitants. Orphanet J Rare Dis. 2017 Mar 28;12(1):60. doi: 10.1186/s13023-017-0576-6. PubMed 28347346 ↗

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT01692015
Lead sponsor
Imperial College London
Responsible party
Sponsor
First posted
Sep 25, 2012
Start date
Apr 2011
Primary completion
Sep 2013
Completion
Sep 2016
Results posted
Mar 29, 2024
Last update
Mar 29, 2024

Study contacts

Claire L Shovlin, PhD FRCP
principal investigator · Imperial College London

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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