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Effect of Ileocolonic Delivered Vitamins and an Anti-Inflammatory Diet on Crohn's Disease and Healthy Volunteers (Vita-GrAID)

Primary Purpose

Crohn Disease

Status
Recruiting
Phase
Not Applicable
Locations
Netherlands
Study Type
Interventional
Intervention
Groningen Anti-Inflammatory Diet (GrAID)
ColoVit capsule
ColoPulse-placebo capsule
Sponsored by
University Medical Center Groningen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Crohn Disease focused on measuring Inflammatory Bowel Disease, IBD, Crohn, Vitamins, Diet, Riboflavin, Ascorbic Acid, Niacin, Microbiome

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria CD patients:

  • Participant understands the study procedures and signed an informed consent to participate in this study
  • Previously diagnosed with CD; Montreal classification: L1 (Ileal), L2 (colonic), or L3 (ileocolonic).
  • Low-mild disease activity (no clinically relevant symptoms and HBI<8 or CDAI <220)
  • Evidence of mucosal inflammation (faecal calprotectin ≥100 μg/g)
  • Able to attend to the outpatient clinic of the UMCG, Martini Hospital, MCL Leeuwarden or Isala
  • ≥18 years of age
  • Able to use oral feeding and willing to undergo a dietary intervention (Follow a diet or use a vitamin B2/B3/C supplement or placebo)

Inclusion Criteria healthy volunteers:

  • Participant understands the study procedures and signed an informed consent to participate in this study
  • Never been diagnosed with IBD or any other chronic inflammatory condition.
  • Participant has no health conditions that would prevent him/her from fulfilling the study requirements as judged by the investigator on the basis of medical history and routine laboratory test results.
  • Able to attend to the outpatient clinic of the UMCG, Martini Hospital, MCL Leeuwarden or Isala
  • ≥18 year of age
  • Able to use oral feeding and willing to undergo a dietary intervention (Follow a diet or use a vitamin B2/B3/C supplement or placebo)

Exclusion Criteria CD patients:

  • Life expectancy <12 months
  • Active Crohn's disease (HBI≥8 or CDAI>220), or expecting drug intervention within 3 months
  • Colonoscopy and colon cleansing in the past 3 months;
  • Use antibiotics, probiotics (eg Yakult, Vifit, Activia) or specific prebiotics supplements 3 weeks prior to the start of the intervention
  • Use of vitamin/mineral supplements 1 week prior to the start of the intervention (except for vitamin D and/or calcium)
  • Use Methotrexate drugs or chronic use of antacids, H2 or proton-pump inhibitors
  • With a history of GI disorders or GI surgery that are likely to interfere with the pH-dependent mode of action of the Colovit-capsule
  • Patients with a pouch or stoma
  • Pregnant or breastfeeding (or foreseen pregnancy during dietary intervention period)
  • Swallowing disorders, not able to tolerate oral food, or use of tube feeding (EEN)
  • Previously proven anaphylactic reaction to foods included in the food boxes
  • Previously diagnosed with Celiac Disease or following a gluten-free diet
  • Following a vegetarian or vegan diet

Exclusion Criteria healthy subjects:

  • Life expectancy <12 months
  • Previously diagnosed with IBD or any other chronic inflammatory condition
  • Colonoscopy and colon cleansing in the past 3 months;
  • Use antibiotics, probiotics (eg Yakult, Vifit, Activia) or specific prebiotics supplements 3 weeks prior to the start of the intervention
  • Use of vitamin/mineral supplements 1 week prior to the start of the intervention (except for vitamin D and/or calcium)
  • With a history of GI disorders or taken drugs that are likely to interfere with mode of action of interventions, such as chronic use of antacids or proton-pump inhibitors
  • Abnormal clinical chemistry and haematology laboratory test results of clinical significance that in the judgment of the investigator would interfere with the participant's ability to comply with the study protocol (which might confound the interpretation of the study results), or put the participant at undue risk.
  • Presence of a stoma
  • History or presence of cancer in the prior two years, except for non-melanoma skin cancer.
  • Recent history of (within 12 months of screening visit) or strong potential for alcohol or substance abuse. Alcohol abuse is defined as >60g (men) / 40g (women) pure alcohol per day (1.5 l / 1 l beer resp. 0.75 l / 0.5 l wine).
  • Pregnant or breastfeeding (or foreseen pregnancy during dietary intervention period) The method of contraception must be recorded in the source documentation.
  • Swallowing disorders, not able to tolerate oral food, or use of tube feeding (EEN)
  • Previously proven anaphylactic reaction to foods included in the food boxes
  • Previously diagnosed with Celiac Disease or following a gluten-free diet
  • Following a vegetarian or vegan diet

Sites / Locations

  • University Medical Center GroningenRecruiting

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

Groningen Anti-Inflammatory Diet (GrAID)

ColoVit capsule

Placebo capsule

Arm Description

Specially designed diet based on the most recent scientific evidence of the inflammatory characteristics of food and food groups.

2 times daily intake of a supplement containing 37,5 mg vitamin B2, 2,5 mg vitamin B3 and 250 mg vitamin C in a ColoPulse-coated capsule, a pH-sensitive coating allowing ileocolonic-targeted-delivery

2 times daily intake of a capsule containing microcrystalline cellulose which is coated using the same ColoPulse technology as is used with the ColoVit

Outcomes

Primary Outcome Measures

Change in faecal calprotectin
Primary outcome for CD patients
Change in microbiome composition measured by metagenomic sequencing- based profiles
Primary outcome for healthy volunteers and CD patients

Secondary Outcome Measures

The number of flares (defined as faecal calprotectin >200 μg/g and Crohn's Disease Activity Index (CDAI) ≥220 points)
Secondary outcome for CD patients
Improvements of Quality of life scores as assessed by Inflammatory Bowel Disease Questionnaire (Score range of 32-224, The higher the score the higher the Quality of Life)
Secondary outcome for CD patients
Improvements of Quality of life scores as assessed Food Related Quality of Life Questionnaire (Score range of 29-145, The higher the score the higher the Food related-Quality of Life)
Secondary outcome for CD patients and healthy volunteers
Adherence to the dietary interventions as assessed by a Dietary Compliance Questionnaire
Secondary outcome for CD patients and healthy volunteers

Full Information

First Posted
May 3, 2021
Last Updated
February 10, 2023
Sponsor
University Medical Center Groningen
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1. Study Identification

Unique Protocol Identification Number
NCT04913467
Brief Title
Effect of Ileocolonic Delivered Vitamins and an Anti-Inflammatory Diet on Crohn's Disease and Healthy Volunteers
Acronym
Vita-GrAID
Official Title
Potential Effects of Ileocolonic Delivered Vitamins or the Groningen Anti-Inflammatory Diet on Course of Crohn's Disease and the Microbiome of Healthy Volunteers: a Randomized Controlled Trial - The Vita-GrAID Study
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 8, 2021 (Actual)
Primary Completion Date
July 1, 2024 (Anticipated)
Study Completion Date
July 1, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University Medical Center Groningen

4. Oversight

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

5. Study Description

Brief Summary
This study will evaluate if the Groningen Anti-Inflammatory Diet and the ileocolonic delivery of vitamin B2, B3 and C can positively influence the course of Crohn's disease and can positively alter the gut microbiome of Crohn's disease patients as well as healthy volunteers.
Detailed Description
It is becoming increasingly more well known that diet and the microbiome have a pivotal role in the development and course of inflammatory bowel diseases (IBD). Strict exclusive enteral nutrition (EEN) can induce remission in Crohn's Disease (CD) and is the standard treatment in paediatric CD. Implementing a restrictive diet in adults is difficult; adult patients do not tend to adhere to EEN. Recently, the CD-exclusion diet (CDED) combined with partial enteral nutrition demonstrated to be effective in CD-patients with flares. Additionally, accumulating evidence suggests that intake of vitamins can influence disease course, mainly by beneficially modulating the gut microbiota and gut redox potential, especially if the vitamins can be delivered to the colon. Nevertheless, no dietary guidelines are available to physicians and patients. Due to complaints of certain foods and patients' eagerness to postpone new flares, patients start experimenting with their food. As patients with CD are already often malnourished, this poorly substantiated experimenting puts them even more at risk for malnutrition and could have a potential negative effect on their disease outcomes. Next, quality of life of patients decreases and healthcare costs will rise. Therefore, both patients and physicians are in desperate need of evidence for an anti-inflammatory dietary advice in CD. As compliance to a diet increases when they are supported by family members, their household members will also be asked to participate in the study. Simultaneously studying their healthy family members will also provide information of the effect of this anti-inflammatory diet or intake of lieocolonic-delivered vitamins on their microbiome and markers of inflammation and oxidative stress.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Crohn Disease
Keywords
Inflammatory Bowel Disease, IBD, Crohn, Vitamins, Diet, Riboflavin, Ascorbic Acid, Niacin, Microbiome

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Randomized, partly blinded, multicenter clinical food trial
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
510 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Groningen Anti-Inflammatory Diet (GrAID)
Arm Type
Experimental
Arm Description
Specially designed diet based on the most recent scientific evidence of the inflammatory characteristics of food and food groups.
Arm Title
ColoVit capsule
Arm Type
Experimental
Arm Description
2 times daily intake of a supplement containing 37,5 mg vitamin B2, 2,5 mg vitamin B3 and 250 mg vitamin C in a ColoPulse-coated capsule, a pH-sensitive coating allowing ileocolonic-targeted-delivery
Arm Title
Placebo capsule
Arm Type
Placebo Comparator
Arm Description
2 times daily intake of a capsule containing microcrystalline cellulose which is coated using the same ColoPulse technology as is used with the ColoVit
Intervention Type
Other
Intervention Name(s)
Groningen Anti-Inflammatory Diet (GrAID)
Intervention Description
Specially designed diet based on the most recent scientific evidence of the inflammatory characteristics of food and food groups. Basically, subjects will be instructed to increase uptake of food components that hold potential anti-inflammatory proportions and to avoid food components that may showcase potential pro-inflammatory proportions.
Intervention Type
Dietary Supplement
Intervention Name(s)
ColoVit capsule
Intervention Description
Vitamin B2/B3/C supplement in a ColoPulse-coated capsule
Intervention Type
Other
Intervention Name(s)
ColoPulse-placebo capsule
Intervention Description
A capsule containing microcrystalline cellulose which is coated using the same ColoPulse technology as is used with the ColoVit
Primary Outcome Measure Information:
Title
Change in faecal calprotectin
Description
Primary outcome for CD patients
Time Frame
Faeces sample collection at 4 time points: At baseline (0 months), after 3 months, after 6 months, after 12 months
Title
Change in microbiome composition measured by metagenomic sequencing- based profiles
Description
Primary outcome for healthy volunteers and CD patients
Time Frame
Faeces sample collection at 3 time points: At baseline (0 months), after 3 months, after 12 months
Secondary Outcome Measure Information:
Title
The number of flares (defined as faecal calprotectin >200 μg/g and Crohn's Disease Activity Index (CDAI) ≥220 points)
Description
Secondary outcome for CD patients
Time Frame
Faeces sample collection and CDAI score determination at 4 time points: At baseline (0 months), after 3 months, after 6 months, after 12 months
Title
Improvements of Quality of life scores as assessed by Inflammatory Bowel Disease Questionnaire (Score range of 32-224, The higher the score the higher the Quality of Life)
Description
Secondary outcome for CD patients
Time Frame
Questionnaires at 3 time points: At baseline (0 months), after 3 months, after 12 months
Title
Improvements of Quality of life scores as assessed Food Related Quality of Life Questionnaire (Score range of 29-145, The higher the score the higher the Food related-Quality of Life)
Description
Secondary outcome for CD patients and healthy volunteers
Time Frame
Questionnaires at 3 time points: At baseline (0 months), after 3 months, after 12 months
Title
Adherence to the dietary interventions as assessed by a Dietary Compliance Questionnaire
Description
Secondary outcome for CD patients and healthy volunteers
Time Frame
Questionnaires at 3 time points: At baseline (0 months), after 3 months, after 12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria CD patients: Participant understands the study procedures and signed an informed consent to participate in this study Previously diagnosed with CD; Montreal classification: L1 (Ileal), L2 (colonic), or L3 (ileocolonic). Low-mild disease activity (no clinically relevant symptoms and HBI<8 or CDAI <220) Evidence of mucosal inflammation (faecal calprotectin ≥100 μg/g) Able to attend to the outpatient clinic of the UMCG, Martini Hospital, MCL Leeuwarden or Isala ≥18 years of age Able to use oral feeding and willing to undergo a dietary intervention (Follow a diet or use a vitamin B2/B3/C supplement or placebo) Inclusion Criteria healthy volunteers: Participant understands the study procedures and signed an informed consent to participate in this study Never been diagnosed with IBD or any other chronic inflammatory condition. Participant has no health conditions that would prevent him/her from fulfilling the study requirements as judged by the investigator on the basis of medical history and routine laboratory test results. Able to attend to the outpatient clinic of the UMCG, Martini Hospital, MCL Leeuwarden or Isala ≥18 year of age Able to use oral feeding and willing to undergo a dietary intervention (Follow a diet or use a vitamin B2/B3/C supplement or placebo) Exclusion Criteria CD patients: Life expectancy <12 months Active Crohn's disease (HBI≥8 or CDAI>220), or expecting drug intervention within 3 months Colonoscopy and colon cleansing in the past 3 months; Use antibiotics, probiotics (eg Yakult, Vifit, Activia) or specific prebiotics supplements 3 weeks prior to the start of the intervention Use of vitamin/mineral supplements 1 week prior to the start of the intervention (except for vitamin D and/or calcium) Use Methotrexate drugs or chronic use of antacids, H2 or proton-pump inhibitors With a history of GI disorders or GI surgery that are likely to interfere with the pH-dependent mode of action of the Colovit-capsule Patients with a pouch or stoma Pregnant or breastfeeding (or foreseen pregnancy during dietary intervention period) Swallowing disorders, not able to tolerate oral food, or use of tube feeding (EEN) Previously proven anaphylactic reaction to foods included in the food boxes Previously diagnosed with Celiac Disease or following a gluten-free diet Following a vegetarian or vegan diet Exclusion Criteria healthy subjects: Life expectancy <12 months Previously diagnosed with IBD or any other chronic inflammatory condition Colonoscopy and colon cleansing in the past 3 months; Use antibiotics, probiotics (eg Yakult, Vifit, Activia) or specific prebiotics supplements 3 weeks prior to the start of the intervention Use of vitamin/mineral supplements 1 week prior to the start of the intervention (except for vitamin D and/or calcium) With a history of GI disorders or taken drugs that are likely to interfere with mode of action of interventions, such as chronic use of antacids or proton-pump inhibitors Abnormal clinical chemistry and haematology laboratory test results of clinical significance that in the judgment of the investigator would interfere with the participant's ability to comply with the study protocol (which might confound the interpretation of the study results), or put the participant at undue risk. Presence of a stoma History or presence of cancer in the prior two years, except for non-melanoma skin cancer. Recent history of (within 12 months of screening visit) or strong potential for alcohol or substance abuse. Alcohol abuse is defined as >60g (men) / 40g (women) pure alcohol per day (1.5 l / 1 l beer resp. 0.75 l / 0.5 l wine). Pregnant or breastfeeding (or foreseen pregnancy during dietary intervention period) The method of contraception must be recorded in the source documentation. Swallowing disorders, not able to tolerate oral food, or use of tube feeding (EEN) Previously proven anaphylactic reaction to foods included in the food boxes Previously diagnosed with Celiac Disease or following a gluten-free diet Following a vegetarian or vegan diet
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Gerard Dijkstra, MD PhD
Phone
+31 050 3612620
Email
gerard.dijkstra@umcg.nl
Facility Information:
Facility Name
University Medical Center Groningen
City
Groningen
ZIP/Postal Code
9713GZ
Country
Netherlands
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Gerard Dijkstra, Md PhD
Phone
+31 050 3612620
Email
gerard.dijkstra@umcg.nl

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
There is no plan to make individual participant data available to other researchers outside of the study team.

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Effect of Ileocolonic Delivered Vitamins and an Anti-Inflammatory Diet on Crohn's Disease and Healthy Volunteers

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