search
Back to results

Efficacy, Tolerability and Adherence of the Modified Atkins Diet on Drug-resistant Epilepsy

Primary Purpose

Epilepsy, Drug Resistant

Status
Completed
Phase
Not Applicable
Locations
Mexico
Study Type
Interventional
Intervention
modified adkins diet
Pharmacotherapy without diet
Sponsored by
Instituto Mexicano del Seguro Social
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Epilepsy, Drug Resistant focused on measuring epilepsy, Diet, Carbohydrate-Restricted, Drug Resistance

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Minimum age of 18 years
  • Patients that meet the criteria of drug-resistant epilepsy
  • Patients treated with Rational polytherapy, a minimum of 6 months, with no changes in their drug refractory condition.
  • Patients with drug- resistant epilepsy with informed consent signed by themselves and their proxy.
  • Patients with drug-resistant epilepsy of any etiology, except tumor, metabolic, degenerative or progressive.

Exclusion Criteria:

  • Patients with drug-resistant epilepsy simultaneous alternate treatment to the Atkins Diet modified.
  • Patients with a neurological entity progressive and fatal
  • Patients with congenital diseases and difficulty to metabolize fats or that require high amounts of carbohydrates in the diet.

Sites / Locations

  • Western Medical Center, Mexican Institute of Social Security

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

modified adkins diet

Pharmacotherapy without diet

Arm Description

modified adkins diet. It consists in the free intake of proteins and fats, and the restriction of carbohydrates that are gradually being installed. Its mechanism of action that induces a state of ketosis.

It consists in administer only pharmacological treatment withot a special diet, Drug-resistant epilepsy is characterized by the use of antiepileptic drugs and in optimal doses, depending on the type of epilepsy, at least on two consecutive occasions without response to management.

Outcomes

Primary Outcome Measures

Frequency of epileptic seizures
Frequency of epileptic seizures measured according to the clinical criteria of therapeutic evaluation of Huttenlocher

Secondary Outcome Measures

Therapeutic response observed in electroencephalogram
Panic electroencephalographic criteria on the therapeutic response. Having regard to the standardization, improvement or worsening of the crisis in the electroencephalogram
Measurement of quality of life and decrease in seizures
Interrogate the patient with a questionnaire of refractory epilepsy drugs. And ask to the patient with this questionnaire if improved their quality of life and have decreased seizures after using the atkins diet modified.
Blood tests (Hematic biometry)
Take this blood test to assess the general conditions of the patient and see their levels of hemoglobin, hematocrit, leukocyte and platelet count.
Blood chemistry (serum electrolytes)
It will evaluate the general condition of the patient and with this test rule out the presence of electrolyte imbalance
liver function tests
Will be evaluated with this test levels of transaminases as can be raised by treatment anticonvulsant and see if there are any changes with the changes in the diet of patients
ketonuria
It will assess the levels of ketones in urine due to the change in the diet of patients with the Atkins diet

Full Information

First Posted
May 31, 2017
Last Updated
June 8, 2017
Sponsor
Instituto Mexicano del Seguro Social
search

1. Study Identification

Unique Protocol Identification Number
NCT03183076
Brief Title
Efficacy, Tolerability and Adherence of the Modified Atkins Diet on Drug-resistant Epilepsy
Official Title
Efficacy, Tolerability and Adherence of the Modified Atkins Diet on Drug-resistant Epilepsy in Adults Patients
Study Type
Interventional

2. Study Status

Record Verification Date
May 2017
Overall Recruitment Status
Completed
Study Start Date
September 1, 2015 (Actual)
Primary Completion Date
April 30, 2016 (Actual)
Study Completion Date
December 30, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Instituto Mexicano del Seguro Social

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The Atkins Diet Modified (ADM) is the best alternative treatment for drug-resistant epilepsy, There is a high prevalence worldwide , especially in Latin American countries, including Mexico. Low income earners, many of which do not have a social security, must meet the high costs by Antiepileptic Drugs (AEDS), which in addition should be used in conjunction or combination therapy, because monotherapy is insufficient . The diet adkins makes some changes in the traditional food habits by others that are accessible and not necessarily expensive, whose mechanism allows for better control of the seizures.
Detailed Description
Objective: To assess the efficacy, tolerability and adherence of the modified adkins diet in adult patients with drug-resistent epilepsy Materials and Methods: Clinical trial, made up of patients with drug-resistent epilepsy, selected by convenience, who will be handled pharmacologically with the standard treatment of this condition for a period of not less than 6 months, after which they will be treated with adkins diet modified, prior informed consent, to establish its effect and a comparative analysis later. The objective of this work is to analyze the efficacy, tolerability and adherence of the modified atkins diet in adult patients with drug-resistant epilepsy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Epilepsy, Drug Resistant
Keywords
epilepsy, Diet, Carbohydrate-Restricted, Drug Resistance

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Clinical trial, Parallel, controled
Masking
Investigator
Masking Description
MD María Ingrid Alanis Guevara. Neurologist Hospital of the Western National Medical Center. Guadalajara. Mexico
Allocation
Randomized
Enrollment
14 (Actual)

8. Arms, Groups, and Interventions

Arm Title
modified adkins diet
Arm Type
Active Comparator
Arm Description
modified adkins diet. It consists in the free intake of proteins and fats, and the restriction of carbohydrates that are gradually being installed. Its mechanism of action that induces a state of ketosis.
Arm Title
Pharmacotherapy without diet
Arm Type
Active Comparator
Arm Description
It consists in administer only pharmacological treatment withot a special diet, Drug-resistant epilepsy is characterized by the use of antiepileptic drugs and in optimal doses, depending on the type of epilepsy, at least on two consecutive occasions without response to management.
Intervention Type
Other
Intervention Name(s)
modified adkins diet
Other Intervention Name(s)
adkins diet in drug-resistant epilepsy
Intervention Description
Patients were assigned to two groups, one of them received modified adkins diet for treatment of drug-resistant epilepsy. It consists in the free intake of proteins and fats, and the restriction of carbohydrates that are gradually being installed. Its mechanism of action that induces a state of ketosis
Intervention Type
Drug
Intervention Name(s)
Pharmacotherapy without diet
Other Intervention Name(s)
treatment with antiepileptic drugs
Intervention Description
Patients were assigned to two groups, one of them received conventional treatment with antiepileptic drugs without a special diet
Primary Outcome Measure Information:
Title
Frequency of epileptic seizures
Description
Frequency of epileptic seizures measured according to the clinical criteria of therapeutic evaluation of Huttenlocher
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Therapeutic response observed in electroencephalogram
Description
Panic electroencephalographic criteria on the therapeutic response. Having regard to the standardization, improvement or worsening of the crisis in the electroencephalogram
Time Frame
3 months
Title
Measurement of quality of life and decrease in seizures
Description
Interrogate the patient with a questionnaire of refractory epilepsy drugs. And ask to the patient with this questionnaire if improved their quality of life and have decreased seizures after using the atkins diet modified.
Time Frame
3 months
Title
Blood tests (Hematic biometry)
Description
Take this blood test to assess the general conditions of the patient and see their levels of hemoglobin, hematocrit, leukocyte and platelet count.
Time Frame
3 months
Title
Blood chemistry (serum electrolytes)
Description
It will evaluate the general condition of the patient and with this test rule out the presence of electrolyte imbalance
Time Frame
3 months
Title
liver function tests
Description
Will be evaluated with this test levels of transaminases as can be raised by treatment anticonvulsant and see if there are any changes with the changes in the diet of patients
Time Frame
3 months
Title
ketonuria
Description
It will assess the levels of ketones in urine due to the change in the diet of patients with the Atkins diet
Time Frame
3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Minimum age of 18 years Patients that meet the criteria of drug-resistant epilepsy Patients treated with Rational polytherapy, a minimum of 6 months, with no changes in their drug refractory condition. Patients with drug- resistant epilepsy with informed consent signed by themselves and their proxy. Patients with drug-resistant epilepsy of any etiology, except tumor, metabolic, degenerative or progressive. Exclusion Criteria: Patients with drug-resistant epilepsy simultaneous alternate treatment to the Atkins Diet modified. Patients with a neurological entity progressive and fatal Patients with congenital diseases and difficulty to metabolize fats or that require high amounts of carbohydrates in the diet.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
María I Alanis
Organizational Affiliation
Instituto Mexicano del Seguro Social
Official's Role
Principal Investigator
Facility Information:
Facility Name
Western Medical Center, Mexican Institute of Social Security
City
Guadalajara
State/Province
Jalisco
ZIP/Postal Code
44340
Country
Mexico

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
2502382
Citation
Proposal for revised classification of epilepsies and epileptic syndromes. Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia. 1989 Jul-Aug;30(4):389-99. doi: 10.1111/j.1528-1157.1989.tb05316.x. No abstract available.
Results Reference
background
PubMed Identifier
10742989
Citation
Panico LR, Rios VG, Demartini MG, Carniello MA. [The electroencephalographic evolution of a group of patients on a ketonic diet]. Rev Neurol. 2000 Jan 1-15;30(1):8-15. Spanish.
Results Reference
background
PubMed Identifier
16523530
Citation
Freeman J, Veggiotti P, Lanzi G, Tagliabue A, Perucca E; Institute of Neurology IRCCS C. Mondino Foundation. The ketogenic diet: from molecular mechanisms to clinical effects. Epilepsy Res. 2006 Feb;68(2):145-80. doi: 10.1016/j.eplepsyres.2005.10.003.
Results Reference
background
PubMed Identifier
18823325
Citation
Kossoff EH, Zupec-Kania BA, Amark PE, Ballaban-Gil KR, Christina Bergqvist AG, Blackford R, Buchhalter JR, Caraballo RH, Helen Cross J, Dahlin MG, Donner EJ, Klepper J, Jehle RS, Kim HD, Christiana Liu YM, Nation J, Nordli DR Jr, Pfeifer HH, Rho JM, Stafstrom CE, Thiele EA, Turner Z, Wirrell EC, Wheless JW, Veggiotti P, Vining EP; Charlie Foundation, Practice Committee of the Child Neurology Society; Practice Committee of the Child Neurology Society; International Ketogenic Diet Study Group. Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009 Feb;50(2):304-17. doi: 10.1111/j.1528-1167.2008.01765.x. Epub 2008 Sep 23.
Results Reference
background
PubMed Identifier
16499772
Citation
Berg AT, Kelly MM. Defining intractability: comparisons among published definitions. Epilepsia. 2006 Feb;47(2):431-6. doi: 10.1111/j.1528-1167.2006.00440.x.
Results Reference
result
PubMed Identifier
11971127
Citation
Brodie MJ, Kwan P. Staged approach to epilepsy management. Neurology. 2002 Apr 23;58(8 Suppl 5):S2-8. doi: 10.1212/wnl.58.8_suppl_5.s2.
Results Reference
result
PubMed Identifier
19889013
Citation
Kwan P, Arzimanoglou A, Berg AT, Brodie MJ, Allen Hauser W, Mathern G, Moshe SL, Perucca E, Wiebe S, French J. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia. 2010 Jun;51(6):1069-77. doi: 10.1111/j.1528-1167.2009.02397.x. Epub 2009 Nov 3. Erratum In: Epilepsia. 2010 Sep;51(9):1922.
Results Reference
result
PubMed Identifier
19914135
Citation
Kwan P, Brodie MJ. Definition of refractory epilepsy: defining the indefinable? Lancet Neurol. 2010 Jan;9(1):27-9. doi: 10.1016/S1474-4422(09)70304-7. Epub 2009 Nov 13. No abstract available.
Results Reference
result
PubMed Identifier
10660394
Citation
Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med. 2000 Feb 3;342(5):314-9. doi: 10.1056/NEJM200002033420503.
Results Reference
result
PubMed Identifier
22278892
Citation
Martinez-Juarez IE, Lopez-Zapata R, Gomez-Arias B, Bravo-Armenta E, Romero-Ocampo L, Estevez-Cruz Z, Hernandez-De la Cruz G, Moran-Molina S. [Refractory epilepsy: use of the new definition and related risk factors. A study in the Mexican population of a third-level centre]. Rev Neurol. 2012 Feb 1;54(3):159-66. Spanish.
Results Reference
result
PubMed Identifier
8641240
Citation
Shorvon SD. The epidemiology and treatment of chronic and refractory epilepsy. Epilepsia. 1996;37 Suppl 2:S1-S3. doi: 10.1111/j.1528-1157.1996.tb06027.x.
Results Reference
result
PubMed Identifier
10332020
Citation
Devinsky O. Patients with refractory seizures. N Engl J Med. 1999 May 20;340(20):1565-70. doi: 10.1056/NEJM199905203402008. No abstract available.
Results Reference
result
PubMed Identifier
10870204
Citation
Arroyo S. [Evaluation of drug-resistant epilepsy]. Rev Neurol. 2000 May 1-15;30(9):881-6. Spanish.
Results Reference
result
PubMed Identifier
11188984
Citation
Benbadis SR, Tatum WO, Vale FL. When drugs don't work: an algorithmic approach to medically intractable epilepsy. Neurology. 2000 Dec 26;55(12):1780-4. doi: 10.1212/wnl.55.12.1780. No abstract available.
Results Reference
result
PubMed Identifier
1418457
Citation
Hauser WA. The natural history of drug resistant epilepsy: epidemiologic considerations. Epilepsy Res Suppl. 1992;5:25-8.
Results Reference
result
PubMed Identifier
17903391
Citation
Marson AG, Appleton R, Baker GA, Chadwick DW, Doughty J, Eaton B, Gamble C, Jacoby A, Shackley P, Smith DF, Tudur-Smith C, Vanoli A, Williamson PR. A randomised controlled trial examining the longer-term outcomes of standard versus new antiepileptic drugs. The SANAD trial. Health Technol Assess. 2007 Oct;11(37):iii-iv, ix-x, 1-134. doi: 10.3310/hta11370.
Results Reference
result
PubMed Identifier
12436398
Citation
Sanchez-Alvarez JC, Serrano-Castro P, Canadillas-Hidalgo F. [Refractory epilepsy in adults]. Rev Neurol. 2002 Nov 16-30;35(10):931-53. Spanish.
Results Reference
result
PubMed Identifier
11299481
Citation
Serrano Castro PJ, Sanchez Alvarez JC. [Controversies about the new anti-epileptic drugs]. Rev Neurol. 2001 Jan 16-31;32(2):165-71. Spanish.
Results Reference
result
PubMed Identifier
17642053
Citation
Gomez-Alonso J, Giraldez BG. [Epilepsy: a new definition for an old disease]. Rev Neurol. 2007 Jul 16-31;45(2):126-7. No abstract available. Spanish.
Results Reference
result
PubMed Identifier
15816939
Citation
Fisher RS, van Emde Boas W, Blume W, Elger C, Genton P, Lee P, Engel J Jr. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia. 2005 Apr;46(4):470-2. doi: 10.1111/j.0013-9580.2005.66104.x.
Results Reference
result
PubMed Identifier
16158066
Citation
Hefft S, Jonas P. Asynchronous GABA release generates long-lasting inhibition at a hippocampal interneuron-principal neuron synapse. Nat Neurosci. 2005 Oct;8(10):1319-28. doi: 10.1038/nn1542. Epub 2005 Sep 11.
Results Reference
result
PubMed Identifier
16189532
Citation
Hestrin S, Galarreta M. Synchronous versus asynchronous transmitter release: a tale of two types of inhibitory neurons. Nat Neurosci. 2005 Oct;8(10):1283-4. doi: 10.1038/nn1005-1283. No abstract available.
Results Reference
result
PubMed Identifier
17880009
Citation
Callaghan BC, Anand K, Hesdorffer D, Hauser WA, French JA. Likelihood of seizure remission in an adult population with refractory epilepsy. Ann Neurol. 2007 Oct;62(4):382-9. doi: 10.1002/ana.21166.
Results Reference
result
PubMed Identifier
11254763
Citation
Duncan JS. The outcome of epilepsy surgery. J Neurol Neurosurg Psychiatry. 2001 Apr;70(4):432. doi: 10.1136/jnnp.70.4.432. No abstract available.
Results Reference
result
PubMed Identifier
5166216
Citation
Huttenlocher PR, Wilbourn AJ, Signore JM. Medium-chain triglycerides as a therapy for intractable childhood epilepsy. Neurology. 1971 Nov;21(11):1097-103. doi: 10.1212/wnl.21.11.1097. No abstract available.
Results Reference
result
PubMed Identifier
10996924
Citation
Panico LR, Demartini MG, Rios VG, Carniello MA. [The ketogenic diet in infantile refractory epilepsy: electroclinical response, complications and secondary effects]. Rev Neurol. 2000 Aug 1-15;31(3):212-20. Spanish.
Results Reference
result
PubMed Identifier
10742367
Citation
Lefevre F, Aronson N. Ketogenic diet for the treatment of refractory epilepsy in children: A systematic review of efficacy. Pediatrics. 2000 Apr;105(4):E46. doi: 10.1542/peds.105.4.e46.
Results Reference
result
PubMed Identifier
17641989
Citation
Vicente-Hernandez M, Garcia-Garcia P, Gil-Nagel A, Lopez-Munoz F, Alamo C. [Therapeutic approach to epilepsy from the nutritional view: current status of dietary treatment]. Neurologia. 2007 Oct;22(8):517-25. Spanish.
Results Reference
result
PubMed Identifier
17444813
Citation
Yudkoff M, Daikhin Y, Melo TM, Nissim I, Sonnewald U, Nissim I. The ketogenic diet and brain metabolism of amino acids: relationship to the anticonvulsant effect. Annu Rev Nutr. 2007;27:415-30. doi: 10.1146/annurev.nutr.27.061406.093722.
Results Reference
result
PubMed Identifier
32588435
Citation
Martin-McGill KJ, Bresnahan R, Levy RG, Cooper PN. Ketogenic diets for drug-resistant epilepsy. Cochrane Database Syst Rev. 2020 Jun 24;6(6):CD001903. doi: 10.1002/14651858.CD001903.pub5.
Results Reference
derived

Learn more about this trial

Efficacy, Tolerability and Adherence of the Modified Atkins Diet on Drug-resistant Epilepsy

We'll reach out to this number within 24 hrs