ClinicalTrials.gg
CompletedNCT04577456REINFUSEUpdated Dec 8, 2025

Chyme Reinfusion for Type 2 Intestinal Failure

An interventional study of The Insides System in Intestinal Failure, Enterocutaneous Fistula and Ileostomy - Stoma, sponsored by The Insides Company. Completed at 11 sites in 2 countries. Open to participants aged 21 Years and older. Per ClinicalTrials.gov, last updated 2025-12-08.

Sponsored by The Insides Company · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
44
Allocation
Randomized
Ages
21 Years and older
Sex
All
01

Study summary

This project aims to introduce and evaluate a novel assistive prosthetic system that helps prevent and treat nutrient and fluid loss from enterocutaneous fistulas. The device system functions simply to return the output from a fistula back into the distal limb of the intestine.

Read the detailed description

The development of enterocutaneous fistulas are devastating consequences of surgery or surgical diseases. They cause excessive fluid and nutrient losses from the gut resulting in severe dehydration and intestinal failure mandating invasive medical therapies to improve survival. These disorders inflict a vast burden of suffering, morbidity, and mortality on patients, while extracting enormous per-patient resources from healthcare systems. Parenteral nutrition is often required, meaning prolonged hospital stay, an attendant risk of line sepsis, venous damage and thrombosis, liver impairment, and death.

There is a pressing demand for breakthrough technologies that can restore lost fluids and nutrients to the body in patients affected by enterocutaneous fistulas in order to reverse intestinal failure, eliminate the need for parenteral nutrition, prevent dehydration and renal injury, allow safe care in the community, enable chemotherapy completion, and restore quality of life.

02

Conditions studied

  • Intestinal Failure
  • Enterocutaneous Fistula
  • Ileostomy - Stoma
  • High Output Stoma

Keywords

  • Chyme reinfusion
  • Intestinal failure
  • TPN or PN
  • Parenteral nutrition
  • Enterocutaneous fistula
  • Effluent
  • Ileostomy - stoma
  • Refeeding
03

In context

Intestinal Failure

64 studies on the registry are indexed under Intestinal Failure; 17 are open to participants now.

This study's enrollment of 44 is above the median of 38 across 42 interventional studies indexed under Intestinal Failure.

Browse Intestinal Failure studies →

Lead sponsor

This is the only study on the registry with The Insides Company as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

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

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age ≥ 21 years
  • Able to provide written
  • Dependent on parenteral nutrition (PN)
  • DES/ECF with exposed afferent and efferent limbs visible on the abdominal wall
  • Minimum of 2 weeks post DES/ECF creation
  • Distal limb of DES/ECF opening can be intubated by a minimum 24Fr feeding tube (dilatation of orifice strictures is allowable)

Exclusion criteria

Exclusion Criteria:

  • Insufficient distal access channel (distal limb) for device insertion
  • Bowel obstruction proximal to the DES/ECF
  • Small bowel obstruction, anastomotic leak, or perforation distal to the DES/ECF (diagnostic procedure such as gastrografin test, fistulograms, or similar must be performed, if there is a distal anastomosis with integrity not previously evaluated, to ensure that the subject is eligible)
  • Scheduled for DES/ECF reversal within 4 weeks of enrolment date
  • Current infection with Clostridium difficile colitis
  • Current infection small intestinal bacterial overgrowth (SIBO)
  • Signs or symptoms of systemic infection
  • Pre-existing gastrointestinal motility disorders including slow transit constipation, outlet obstruction, fecal incontinence, and gastroparesis
  • Metabolic, neurogenic, or endocrine disorders known to cause colonic dysmotility, e.g., multiple sclerosis, Parkinson's disease, hypothyroidism
  • Known peritoneal disease prior to DES/ECF closure (acceptable if only discovered at time of closure)
  • Liver cirrhosis
  • Hereditary coagulopathy, e.g., von Willebrand disease
  • Severe chronic renal insufficiency prior to DES/ECF formation (\<30mL/min/1.73m2)
  • Active implantable medical devices such as neuromodulation and cardiac systems
  • Metal stents implanted within 20cm of expected use of the controller
  • Women who are pregnant or breastfeeding
  • Subjects participating in an interventional clinical study within 30 days prior to randomization
Terms in these criteria, in plain language(3)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Metastases

Cancer that has spread from where it began to other parts of the body. “Metastatic” cancer is cancer that has spread this way.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
44 participants (actual)

Study arms

  • Experimental
    Active

    Reinfusion of chyme using the Insides System for subjects with Type II intestinal failure dependent on PN

    Device: The Insides System

  • No intervention
    Control

    Standard of care therapies in accordance with ASPEN and ESPEN treatment guidelines

Interventions

  • DeviceThe Insides System

    Novel pump designed to return effluent from the ostomy bag to the distal gut

06

What researchers measure

Primary outcomes

  1. Efficacy - the proportion of subjects who achieve a 50% reduction in total caloric intake obtained from parenteral nutrition measured at 30 days post randomization compared to baseline.

    Between group comparison of the proportion of subjects who achieve a 50% reduction in the use of parenteral nutrition

    Time frame: 30 days post randomization

Secondary outcomes

  1. Efficacy - Between group comparison of the time to reduction in the use of PN

    Between group comparison of the time to reduction of parenteral nutrition measured in days

    Time frame: 30 and 60 days

  2. Efficacy - Between group comparison of the time to discontinuation in the use of PN

    Between group comparison of the time to discontinuation in the use of PN

    Time frame: 30 and 60 days

  3. Efficacy - Between group comparison of the time to reduction in the use of other parentral support fluids

    Between group comparison of the time to reduction in the use of other parenteral support fluids

    Time frame: 30 and 60 days

  4. Safety - Between group comparison of the incidence of serious adverse events

    Between group comparison of the incidence of serious adverse events such as dehydration, metabolic disarray, failure to complete prescribed chemotherapy, IV line complications, fistula complications, device related effects

    Time frame: 30 and 60 days

  5. Efficacy - Between group comparison of the time to ostomy closure

    Between group comparison of the time to surgery for ostomy closure measured in days

    Time frame: 30 and 60 days

  6. Safety - Between group comparison of medication use to control fluid loss due to high output enterostomies

    Between group comparison of the use of proton pump inhibitors, anti motility agents, histamine receptor antagonists, a2 receptor antagonists, and somatostatins.

    Time frame: 30 and 60 days

  7. Safety - Between group comparison of nutritional failure measured by the nutritional risk index (NRI)

    Between group comparison of the nutritional risk index (NRI). Nutritional failure risk will be categorized as severe (NRI\<83.5), moderate (NRI 83.5 - 97.5) and low (NRI\>97.5).

    Time frame: 30 and 60 days

  8. Safety - Between group comparison of peristomal skin complications

    Between group comparison of peristomal skin complications measured by the discoloration, erosion, tissue overgrowth (DET) score as mild, moderate or severe

    Time frame: 30 and 60 days

  9. Healthcare Utilization - Between group comparison of length of stay for index hospitalization

    Between group comparison of length of stay for index hospitalization measured from the day of randomization to discharge

    Time frame: up to 30 days

  10. Healthcare Utilization - Between group comparison of all cause hospitalizations

    Between group comparison of all cause hospitalizations measured by the total number of discreet hospitalizations \>24 hours in duration

    Time frame: 30 and 60 days

  11. Healthcare Utilization - Between group comparison of hospitalizations due to dehydration

    Between group comparison of hospital admissions \>24 hours duration where the primary reason for admission is dehydration

    Time frame: 30 and 60 days

  12. Device performance - The overall incidence of device related adverse effects

    The overall incidence of device related adverse effects reported in subjects randomized to the device. Effects may include effluent cycling time, device wear, device failure.

    Time frame: 30 and 60 days

  13. Quality of Life - Between group comparison of quality of life indices as measured by the EuroQol 5D

    Between group comparison of quality of life as measured by the EQ-5D-3L - a survey of the following five health dimensions: mobility, self-care, usual activities, pain/discomfort, anxiety/depression, and a health thermometer where 0= the worst health you can imagine and 100= the best health you can imagine.

    Time frame: 30 and 60 days

  14. Quality of Life - Between group comparison of quality of life indices as measured by the Stoma QoL Questionnaire

    Stoma QoL - This questionnaire consists of 20 questions. An example of a question could be: "I worry that the pouch will loosen." All the questions must be answered on a 4-point scale. The options for answering each question are: 1. Always 2. Sometimes 3. Rarely 4. Not at all

    Time frame: 30 and 60 days

  15. Quality of Life - Between group comparison of quality of life indices as measured by the Beck Depression Inventory

    Beck Depression Inventory - a 21 question survey where each question has 4 possible answers scored 0-3. The total score is summed to give an overall level of depression 1-10\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_These ups and downs are considered normal 11-16\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ Mild mood disturbance 17-20\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Borderline clinical depression 21-30\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Moderate depression 31-40\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Severe depression over 40\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_Extreme depression

    Time frame: 30 and 60 days

07

Study locations

11 sites
  • Shands Hospital
    Gainesville, Florida 32611, United States
  • University Miami Hospital and Clinics
    Miami, Florida 33136, United States
  • University Illinois
    Chicago, Illinois 60607, United States
  • University Nebraska
    Lincoln, Nebraska 68198, United States
  • Royal Devon and Exeter Hospital
    Exeter, EX2 5DW, United Kingdom
  • St James's Hospital
    Leeds, LS9 7TF, United Kingdom
  • St Mark's Hospital
    London, NW107NS, United Kingdom
  • Salford Royal Hospital
    Manchester, M6 8HD, United Kingdom
  • Royal Victoria Hospital
    Newcastle upon Tyne, NE7 7DN, United Kingdom
  • Nottingham University Hospital
    Nottingham, NG5 1PB, United Kingdom
  • University Hospital Southampton
    Southampton, SO16 6YD, United Kingdom
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Oct 2022 to primary completion in Nov 2025, 37 months.

Of 17 interventional studies with no phase under Intestinal Failure, half reached primary completion within 29 months of starting (the median), counting those still running; a quarter within 12 and three quarters within 59. This study's 37 months is above that.

How these figures are worked out, and which studies are left out of them.

Registered
Sep 16, 2020
First posted
Oct 8, 2020
StartActual
Oct 15, 2022
Primary completionActual
Nov 17, 2025
CompletionActual
Nov 18, 2025
Last update
Dec 8, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Dec 8, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04577456
Lead sponsor
The Insides Company
Collaborators
Databean, Green Lane Coordinating Centre Limited, BioValeo
Responsible party
Sponsor
First posted
Oct 8, 2020
Start date
Oct 15, 2022
Primary completion
Nov 17, 2025
Completion
Nov 18, 2025
Last update
Dec 8, 2025

Study contacts

Dermot Burke, MD
principal investigator · St. James Hospital, Leeds, UK

Oversight

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

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This study is completed, as verified in Dec 2025. You cannot join it, but the record below documents what was studied.

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