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CompletedNCT03320369Updated Oct 27, 2020Results posted

Effect of Elemental Diet on Adult Patients With Eosinophilic Gastroenteritis

An interventional study of Elemental Diet Therapy in Eosinophilic Gastroenteritis, sponsored by Children's Hospital Medical Center, Cincinnati. Completed at 1 site in United States. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2020-10-27.

Sponsored by Children's Hospital Medical Center, Cincinnati · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
18
Allocation
Not applicable
Ages
18 Years to 65 Years
Sex
All
01

Study summary

The purpose of this study is to investigate the effect of an elemental diet on adult patients with Eosinophilic Gastroenteritis

Read the detailed description

This prospective interventional study will investigate the effect of an exclusive, six week elemental diet in adult patients with Eosinophilic Gastroenteritis

02

Conditions studied

03

Who can participate

Ages eligible
18 Years to 65 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Participant must be able to understand and provide informed consent
  2. Males and Females ≥18 to 65 years of age;
  3. Have diagnosis of EG/EGE
  4. Have histologically confirmed active disease > 30 eosinophils/hpf
  5. Symptomatic (have experienced symptoms within the last one months prior to enrollment).
  6. Female subjects of childbearing potential must have a negative pregnancy test upon study entry
  7. Female (and male) subjects with reproductive potential, must agree to use FDA approved methods of birth control for the duration of the study-specific methods may be listed, if applicable

Exclusion criteria

Exclusion Criteria:

  1. Inability or unwillingness of a participant to give written informed consent or comply with study protocol
  2. Secondary causes of gastrointestinal and peripheral eosinophilia
  3. Eosinophilic infiltration isolated to the esophagus.
  4. Pregnancy
  5. Immunodeficiency states
  6. Have been treated with topical swallowed steroids within the last 6 weeks or systemic steroids within the last 2 months unless repeat endoscopy is performed and shows active inflammation on these therapies in which case these medications will be allowed to be continued without dose escalation.
  7. Have taken immunosuppression medication or immunomodulators within 2 months of the study unless the recent/baseline endoscopy has active histologic inflammation while on these medications. In this case, these medications will be permitted to be continued as long as the dose is not escalated during the treatment phase.
  8. Have been on an elemental diet previously for six weeks with follow up endoscopy completed.
  9. Have participated in any investigative drug study within 6 weeks prior to study entry.
  10. Unable to complete study procedures including endoscopy.
  11. Past or current medical problems or findings from physical examination or laboratory testing that are not listed above, which, in the opinion of the investigator, may pose additional risks from participation in the study, may interfere with the participant's ability to comply with study requirements or that may impact the quality or interpretation of the data obtained from the study.
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
18 participants (actual)

Study arms

  • Other
    Treatment

    Elemental formula Intervention: Elemental Diet Therapy

    Other: Elemental Diet Therapy

Interventions

  • OtherElemental Diet Therapy

    Elemental diet is a formula composed of amino-acids, carbohydrates, and lipids that is 100% nutritionally complete

05

What researchers measure

Primary outcomes

  1. Percent of Participants in Complete Histologic Remission

    Percent of patients who have achieved complete histologic remission. Complete histologic remission is defined as normalization of gastric mucosal eosinophilia (histology with less than the diagnostic threshold levels of mucosal eosinophilia (\<30 eosinophils per high power field (HPF))

    Time frame: 6 weeks after treatment

Secondary outcomes

  1. Percent of Participants in Partial Histologic Remission

    Percent of participants in partial histologic remission. Partial remission is defined as 50% or more reduction in the maximum of gastric and duodenal peak eosinophil count.

    Time frame: 6 weeks after treatment

  2. Mean Change From Baseline in Maximum Eosinophil Count

    The maximum between gastric and duodenal eosinophil counts per high power field were obtained at baseline and 6 weeks. Mean change in count is defined as maximum eosinophil count per high power field (hpf) at 6 weeks minus maximum eosinophil count per hpf at baseline. A reduction (negative change from baseline) in eosinophil count per hpf indicates improvement. Eosinophil counts per hpf from gastric and duodenal biopsies were assessed by research pathologists at 400X magnification.

    Time frame: Baseline, 6 weeks after treatment

  3. Change From Baseline in Total Gastric Endoscopic Reference Score

    The gastric endoscopic reference score utilizes standardized criteria for the presence and degree of major endoscopic features. Overall scores range from 0 - 10. Endoscopic features were assessed at baseline and 6 weeks. Change in overall endoscopic reference score is defined as overall score at 6 weeks minus overall score at baseline. A reduction (negative change) in score indicates improvement.

    Time frame: Baseline, 6 weeks after treatment

  4. Change From Baseline in Symptoms of Dyspepsia (SODA)

    The SODA questionnaire captures symptoms associated with gastric dyspepsia including symptoms associated with "pain" and "non-pain" as well as general satisfaction with present symptoms. The scores range from 0 to 47 for pain; 0 to 35 for non-pain, and 0 to 23 for satisfaction. Higher scores indicate more frequent and/or severe symptoms for pain and non-pain. Higher scores indicate greater satisfaction. Scores were obtained at baseline and 6 weeks. Change in score is defined as total score at 6 weeks minus total score at baseline. A reduction (negative change) indicates improvement in pain and non-pain. An increase (positive change) indicates improvement in satisfaction.

    Time frame: Baseline, 6 weeks after treatment

  5. Change From Baseline in Promis Anxiety

    The Promis 29 questionnaire was used to assess anxiety. The range of scores for the anxiety sub-domain is 4 - 20 (raw score) with T-scores ranging from 40 to 82. A higher T-score indicates greater anxiety. Scores were obtained at baseline and 6 weeks. Change in score is defined as total score at 6 weeks minus total score at baseline.

    Time frame: Baseline, 6 weeks after treatment

06

Results

Posted Sep 28, 2020

Participant flow

Participant flow — Overall Study
MilestoneTreatment
Started18
Completed15
Not completed3
Withdrew: Adverse event1
Withdrew: Withdrawal by subject2

Outcome measures

PrimaryPercent of Participants in Complete Histologic Remission

Percent of patients who have achieved complete histologic remission. Complete histologic remission is defined as normalization of gastric mucosal eosinophilia (histology with less than the diagnostic threshold levels of mucosal eosinophilia (\<30 eosinophils per high power field (HPF))

Time frame:
6 weeks after treatment
Reported as:
Number · percentage of participants
Percent of Participants in Complete Histologic Remission
percentage of participantsTreatment
Percent of Participants in Complete Histologic Remission100 (78 to 100)
SecondaryPercent of Participants in Partial Histologic Remission

Percent of participants in partial histologic remission. Partial remission is defined as 50% or more reduction in the maximum of gastric and duodenal peak eosinophil count.

Time frame:
6 weeks after treatment
Reported as:
Number · percentage of participants
Percent of Participants in Partial Histologic Remission
percentage of participantsTreatment
Percent of Participants in Partial Histologic Remission93 (68 to 100)
SecondaryMean Change From Baseline in Maximum Eosinophil Count

The maximum between gastric and duodenal eosinophil counts per high power field were obtained at baseline and 6 weeks. Mean change in count is defined as maximum eosinophil count per high power field (hpf) at 6 weeks minus maximum eosinophil count per hpf at baseline. A reduction (negative change from baseline) in eosinophil count per hpf indicates improvement. Eosinophil counts per hpf from gastric and duodenal biopsies were assessed by research pathologists at 400X magnification.

Time frame:
Baseline, 6 weeks after treatment
Reported as:
Mean · eosinophil counts per high power field
Mean Change From Baseline in Maximum Eosinophil Count
eosinophil counts per high power fieldTreatment
Baseline63.1 (50.6 to 75.5)
Change-46.9 (-59.1 to -34.7)
Statistical analysis
  • Treatment · t-test, 2 sided · p = <0.001
SecondaryChange From Baseline in Total Gastric Endoscopic Reference Score

The gastric endoscopic reference score utilizes standardized criteria for the presence and degree of major endoscopic features. Overall scores range from 0 - 10. Endoscopic features were assessed at baseline and 6 weeks. Change in overall endoscopic reference score is defined as overall score at 6 weeks minus overall score at baseline. A reduction (negative change) in score indicates improvement.

Time frame:
Baseline, 6 weeks after treatment
Reported as:
Median · score on a scale
Change From Baseline in Total Gastric Endoscopic Reference Score
score on a scaleTreatment
Baseline Endoscopic Score5 (4 to 5)
Change in Endoscopic Score-3 (-3 to -2)
SecondaryChange From Baseline in Symptoms of Dyspepsia (SODA)

The SODA questionnaire captures symptoms associated with gastric dyspepsia including symptoms associated with "pain" and "non-pain" as well as general satisfaction with present symptoms. The scores range from 0 to 47 for pain; 0 to 35 for non-pain, and 0 to 23 for satisfaction. Higher scores indicate more frequent and/or severe symptoms for pain and non-pain. Higher scores indicate greater satisfaction. Scores were obtained at baseline and 6 weeks. Change in score is defined as total score at 6 weeks minus total score at baseline. A reduction (negative change) indicates improvement in pain and non-pain. An increase (positive change) indicates improvement in satisfaction.

Time frame:
Baseline, 6 weeks after treatment
Reported as:
Mean · score on a scale
Change From Baseline in Symptoms of Dyspepsia (SODA)
score on a scaleTreatment
Baseline Pain21.8 (16.1 to 27.5)
Baseline Non Pain15.7 (13.8 to 17.7)
Baseline Satisfaction9.2 (6.1 to 12.3)
Change in Pain-6.9 (-11.3 to -2.6)
Change in Non Pain-1.6 (-3.1 to -0.1)
Change in Satisfaction6.1 (3.7 to 8.6)
SecondaryChange From Baseline in Promis Anxiety

The Promis 29 questionnaire was used to assess anxiety. The range of scores for the anxiety sub-domain is 4 - 20 (raw score) with T-scores ranging from 40 to 82. A higher T-score indicates greater anxiety. Scores were obtained at baseline and 6 weeks. Change in score is defined as total score at 6 weeks minus total score at baseline.

Time frame:
Baseline, 6 weeks after treatment
Reported as:
Mean · T-score
Change From Baseline in Promis Anxiety
T-scoreTreatment
Baseline Anxiety52.6 (47.2 to 58.0)
Change in Anxiety-2.7 (-7.0 to 1.6)

Adverse events

Collected over From informed consent to cessation of treatment which is approximately 8 weeks. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Treatment0/18 (0%)1/18 (5.6%)4/18 (22.2%)
Most frequent serious events
Most frequent serious events
EventTreatment
HyponatremiaMetabolism and nutrition disorders1/18
Most frequent other events
Most frequent other events
EventTreatment
NauseaGastrointestinal disorders1/18
VomitingGastrointestinal disorders1/18
Urinary Tract InfectionInfections and infestations1/18
Common ColdGeneral disorders1/18
Skin lacerationInjury, poisoning and procedural complications1/18
UrticariaSkin and subcutaneous tissue disorders1/18
SyncopeNervous system disorders1/18

Baseline characteristics

Age, Continuous
Age, Continuous(years)Treatment
Mean37.8 ± 12.5
Sex: Female, Male
Sex: Female, Male(Participants)Treatment
Female10
Male8
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Treatment
Hispanic or Latino0
Not Hispanic or Latino17
Unknown or Not Reported1
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Treatment
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American0
White17
More than one race0
Unknown or Not Reported1
07

Study locations

1 site
  • Northwestern University
    Chicago, Illinois 60208, United States
08

References and documents

Related links

Study documents

  • Study protocol · Sep 10, 2019
  • Statistical analysis plan · May 1, 2020

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

09

Registry details

Key details

Study ID
NCT03320369
Lead sponsor
Children's Hospital Medical Center, Cincinnati
Collaborators
National Institute of Allergy and Infectious Diseases (NIAID), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Office of Rare Diseases (ORD), National Center for Advancing Translational Sciences (NCATS)
Responsible party
Sponsor
First posted
Oct 25, 2017
Start date
Sep 5, 2017
Primary completion
Sep 5, 2019
Completion
Oct 5, 2019
Results posted
Sep 28, 2020
Last update
Oct 27, 2020

Study contacts

Nirmala Gonsalves, M.D.
principal investigator · Northwestern University

Oversight

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

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