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CompletedNCT03305653Updated Jul 6, 2021Results posted

Use of Esophageal String Test to Understand Symptoms, Inflammation, and Function in Eosinophilic Esophagitis

An interventional study of Esophageal String Test (EST) in Eosinophilic Esophagitis, sponsored by University of Colorado, Denver. Completed at 1 site in United States. Open to participants aged 7 Years to 17 Years. Per ClinicalTrials.gov, last updated 2021-07-06.

Sponsored by University of Colorado, Denver · Not applicable, Interventional, and Basic science

Phase
Not applicable
Study type
Interventional
Enrollment
21
Allocation
Not applicable
Ages
7 Years to 17 Years
Sex
All
01

Study summary

Presently, the only method available to monitor disease activity in Eosinophilic Esophagitis (EoE) is endoscopy with pathological review of biopsies. The overall goal of this study is to determine the ability of the Esophageal String Test (EST), a minimally invasive capsule based technology, to measure disease activity in children with EoE. Additionally, to determine esophageal distensibility in children presenting with EoE by using the EndoFLIP (functional luminal imaging probe) device during endoscopic procedures.

Read the detailed description

When children are scheduled to undergo an endoscopy, research assistants will contact the family to arrange for the Esophageal String Test (EST) to be performed within one week of the endoscopy. The string test involves swallowing a small capsule with a thin piece of string inside it. The string unravels as the capsule goes down into the stomach. The investigator would tape the end of the string to the child's cheek, leaving it there for one hour. At the end of the hour, the investigator would remove the string by gently pulling it out through the mouth. Prior to swallowing the EST, the patient will complete the PEESS form (Pediatric Eosinophilic Esophagitis Symptom Scores) to assess symptoms.

The endoscopy and Endoscopic Reference System (EREFs) and EndoFLIP will be performed. The EndoFLIP is a slender probe covered by a smooth long balloon that is passed into the esophagus and slowly expanded with a salt solution. After standard of care endoscopic visualization, the FLIP, a 16 cm probe (Crospon) will be placed transorally and positioned 3 cm distal to the lower esophageal sphincter. Esophageal cross sectional areas and intrabag pressure will be measured during stepwise distensions beginning with 5 mL and increasing to a maximum of 70mL or intrabag pressure of 50 mmHg is achieved, whichever comes first. FLIP is FDA-approved without age restriction and its use has been approved by our IRBs previously. Primary results will be reported as distensibility plateau (mm).

Endoscopic severity: Endoscopic esophageal appearances will be scored using a validated EoE scoring system (EREFS). Five features of EoE will be scored: Edema (0-1), Rings (0-3) Exudates (0-2), Furrows (0-1), Stricture (0-1). Results will be reported as an inflammatory score (edema, exudates, furrows) and fibrostenotic score (rings, stricture). Functional Luminal Imaging Probe (FLIP):

02

Conditions studied

  • Eosinophilic Esophagitis

Keywords

  • Pediatrics
03

Who can participate

Ages eligible
7 Years to 17 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Provide signed and dated informed consent form.
  • Willing to comply with all study procedures and be available for the duration of the study.
  • Male or female, aged 7 to 18 years old, inclusive
  • Undergoing upper Endoscopy with biopsy for clinical care at CHCO or CHOP
  • Current or historical diagnosis of EoE, or suspected of having EoE

Exclusion criteria

Exclusion Criteria:

  • Known connective tissue disease, other eosinophilic disorders
  • Past history of caustic injestion, esophageal surgery or other esophageal injury
  • Known inflammatory bowel disease or esophageal motility disease (achalasia)
  • Unwilling or unable to swallow the EST
  • Oral or intravenous steroids in the preceding 60 days (not including swallowed topical fluticasone, budesonide, etc)
  • Pregnancy
  • Participation in a clinical study that may interfere with participation in this study
04

Study design

Phase
Not applicable
Primary purpose
Basic science
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
21 participants (actual)

Study arms

  • Experimental
    Current/historical diagnosis of EoE

    Subjects with current or historical diagnosis of EoE, or suspected of having EoE will complete the Esophageal String Test (EST) and EndoFLIP

    Device: Esophageal String Test (EST)

Interventions

  • DeviceEsophageal String Test (EST)

    The EST is a gelatin capsule filled with a 90cm nylon string. A trailing end of the string protrudes from one end of the capsule. This end is taped to the cheek and the capsule is swallowed. As the capsule travels to the small intestine, the string inside the capsule is dislodged, leaving a string that goes from the cheek to the small intestine. The capsule dislodges from the string and the string is left in place, in the mouth, esophagus, stomach and small intestine for an hour. During this time, the string rubs against the inside of the esophagus and collects eosinophil proteins. After one hour, the string is removed through the mouth and placed in preservative to save the eosinophil proteins.

05

What researchers measure

Primary outcomes

  1. Measurement of Eosinophilic Degranulating Protein Concentration

    Measure the concentration of eosinophilic degranulating protein on strings that have been swallowed by subjects diagnosed with EoE

    Time frame: Measurement at one hour, when string is removed

06

Results

Posted Jul 6, 2021

Participant flow

Participant flow — Overall Study
MilestoneCurrent/Historical Diagnosis of EoE
Started21
Completed21
Not completed0

Outcome measures

PrimaryMeasurement of Eosinophilic Degranulating Protein Concentration

Measure the concentration of eosinophilic degranulating protein on strings that have been swallowed by subjects diagnosed with EoE

Time frame:
Measurement at one hour, when string is removed
Reported as:
Mean · ng/mL
Measurement of Eosinophilic Degranulating Protein Concentration
ng/mLCurrent/Historical Diagnosis of EoE
Measurement of Eosinophilic Degranulating Protein Concentration456.5 (6.6 to 3428.9)

Adverse events

Collected over Up to 72 hours.. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Current/Historical Diagnosis of EoE0/21 (0%)0/21 (0%)0/21 (0%)

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Current/Historical Diagnosis of EoE
<=18 years21
Between 18 and 65 years0
>=65 years0
Sex: Female, Male
Sex: Female, Male(Participants)Current/Historical Diagnosis of EoE
Female5
Male16
Race/Ethnicity, Customized
Race/Ethnicity, Customized(Participants)Current/Historical Diagnosis of EoE
Asian2
Black2
White15
Hispanic2
Region of Enrollment
Region of Enrollment(participants)Current/Historical Diagnosis of EoE
United States21
07

Study locations

1 site
  • Children's Hospital Colorado
    Aurora, Colorado 80045, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Apr 25, 2018

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03305653
Lead sponsor
University of Colorado, Denver
Collaborators
Children's Hospital of Philadelphia, Children's Hospital Colorado
Responsible party
Sponsor
First posted
Oct 10, 2017
Start date
May 1, 2018
Primary completion
Mar 1, 2019
Completion
Mar 1, 2019
Results posted
Jul 6, 2021
Last update
Jul 6, 2021

Study contacts

Calies Menard-Katcher, MD
principal investigator · University of Colorado, Denver

Oversight

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

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