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Effect of Butyrate Supplement on Rheumatoid Arthritis

Primary Purpose

Rheumatoid Arthritis

Status
Recruiting
Phase
Phase 2
Locations
China
Study Type
Interventional
Intervention
Sodium Butyrate
Sponsored by
Peking University People's Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Rheumatoid Arthritis

Eligibility Criteria

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

Inclusion Criteria:

  • Male or female ≥18 years of age at time of screening, weight≥35kg.
  • Diagnosed with rheumatoid arthritis satisfying the 1987 American College of Rheumatology classification criteria.
  • Stable treatment including DMARDs (Disease Modifying Anti-Rheumatic Drugs), the doses had been stable for at least 3 months before baseline
  • Have given written informed consent

Exclusion Criteria:

  • Patient presenting or having a history of other inflammatory joint disease
  • Patient with ongoing or previous Stevens-Johnson syndrome, toxic epidermal necrolysis or erythema multiforme
  • Patient with significantly impaired bone marrow function or significant anemia, leucopenia or thrombocytopenia induced by other disease
  • Patient with persistent infection or severe infection within 3 months before enrollment
  • Patient with uncontrolled hypertension, uncontrolled diabetes, unstable ischemic heart disease, active inflammatory bowel disease, active peptic ulcer disease, terminal illness or other medical condition which would put the patient at risk to participate in the study according to the opinion of investigator
  • Patient with cardiovascular, hepatic, neurological, endocrine, or other major systemic disease which may make implementation of the protocol or interpretation of the study results become difficult
  • Patient who has severe hypoproteinemia (e.g., in case of severe liver disease or nephrotic syndrome), with serum albumin < 30 g/L
  • Patient who has moderate or severe impairment of renal function, as known by serum creatinine > 133μmol/L (or 1.5 mg/dl)
  • Patient with impairment of liver function or persisting Alanine transaminase (ALT) or Aspartate aminotransferase (AST) elevations of more than 2-fold the upper limit of normal
  • Patient with Known HIV positive status or positive serology for hepatitis B or C
  • Pregnant or breastfeeding woman
  • Women of childbearing potential
  • Men wishing to father children during the course of the study or within the 24 months thereafter (or 3 months with the washout procedure)
  • Patient with a congenital or acquired severe immuno-deficiency, a history of cancer or lymphoproliferative disease, or any patient who has received total lymphoid irradiation.
  • Patient who enrolled in any other clinical trial involving off-label use of an investigational drug or device, or any other type of medical research
  • Patient using any biologic agent such as anti-tumor necrosis factor, abciximab, Belimumab or rituximab within 3 months prior to the first dose of treatment.
  • Patient whose BMI(body mass index) under 18.5 kg/m2 or more than 30 kg/m2
  • Patient with history of drug or alcohol abuse

Sites / Locations

  • Department of Rheumatology and Immunology, Peking University People's HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

butyrate supplement

Arm Description

2 capsules butyrate supplement (containing 1200 mg of sodium butyrate ) once a day for 12 weeks Drug: sodium butyrate

Outcomes

Primary Outcome Measures

T-cell subtypes
Evaluating changes of percentage of T-cell subtypes, especially T regulatory cells (Treg) in Peripheral Blood

Secondary Outcome Measures

serum zonulin
Evaluating changes of zonulin concentration in serum.
serum occludin
Evaluating changes of occludin concentration in serum.
serum intestinal Fatty Acid Binding Protein
Evaluating changes of intestinal Fatty Acid Binding Protein(i-FABP) concentration in serum.
serum Lipopolysaccharide-binding protein
Evaluating changes of Lipopolysaccharide-binding protein concentration in serum.
serum tight junction protein 1
Evaluating changes of tight junction protein 1 concentration in serum.
Faecal microbiome
Evaluating changes of faecal microbiome profiling by amplicon sequencing
Disease Activity Score 28-joint count erythrocyte sedimentation rate (DAS28-ESR)
Evaluating changes of the DAS28 index, which was a composite score of weighted components including tender joint counts of 28, swollen joint counts of 28, participant global assessment of disease activity score, and erythrocyte sedimentation rate value. A positive change in score indicates worsening, and a negative change indicates improvement. The score ranges from 0 to ca. 10 points, with > 5.1 indicating high disease activity, < 3.2 indicating low disease activity, and < 2.6 indicating clinical remission. Change from baseline to Week 12 will be used for the confirmation of therapeutic similarity.
Rate of participants with adverse effects associated with experimental drugs
Adverse effects include fever, rash, abnormal liver and kidney function, rate of new-onset infection and any abnormal measures associated with experimental drugs.

Full Information

First Posted
October 7, 2022
Last Updated
October 14, 2022
Sponsor
Peking University People's Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05576597
Brief Title
Effect of Butyrate Supplement on Rheumatoid Arthritis
Official Title
A Pilot Study to Evaluate Efficacy and Safety of Butyrate Supplement in the Treatment of Rheumatoid Arthritis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Recruiting
Study Start Date
August 23, 2022 (Actual)
Primary Completion Date
August 1, 2023 (Anticipated)
Study Completion Date
December 1, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Peking University People's Hospital

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
This study is a pilot study to evaluate the safety and efficacy of administering butyrate supplement on rheumatoid arthritis patients. Ten participants will be included to receive butyrate supplement for 12 weeks. Changes of immune cell subtypes, markers of intestinal damage, intestinal flora and other laboratory indicators will be monitored.
Detailed Description
This is a single center, uncontrolled, open-label study to assess the efficacy and safety of butyrate supplement plus standard therapy in rheumatoid arthritis(RA). The patients will be given 2 sodium butyrate capsules (containing 2400 mg of sodium butyrate) daily as supplemental therapy. The objective is to assess the effects of 12 weeks of sodium butyrate supplementation on intestinal inflammation and immune regulation in patients with RA, specifically changes in T-cell subtypes and biomarkers associated with intestinal injury. Clinical manifestations and other laboratory indices will also be monitored.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Rheumatoid Arthritis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
butyrate supplement
Arm Type
Experimental
Arm Description
2 capsules butyrate supplement (containing 1200 mg of sodium butyrate ) once a day for 12 weeks Drug: sodium butyrate
Intervention Type
Drug
Intervention Name(s)
Sodium Butyrate
Other Intervention Name(s)
TRI-Butyrin Supreme
Intervention Description
2 capsules butyrate supplement once a day for 12 weeks
Primary Outcome Measure Information:
Title
T-cell subtypes
Description
Evaluating changes of percentage of T-cell subtypes, especially T regulatory cells (Treg) in Peripheral Blood
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
serum zonulin
Description
Evaluating changes of zonulin concentration in serum.
Time Frame
12 weeks
Title
serum occludin
Description
Evaluating changes of occludin concentration in serum.
Time Frame
12 weeks
Title
serum intestinal Fatty Acid Binding Protein
Description
Evaluating changes of intestinal Fatty Acid Binding Protein(i-FABP) concentration in serum.
Time Frame
12 weeks
Title
serum Lipopolysaccharide-binding protein
Description
Evaluating changes of Lipopolysaccharide-binding protein concentration in serum.
Time Frame
12 weeks
Title
serum tight junction protein 1
Description
Evaluating changes of tight junction protein 1 concentration in serum.
Time Frame
12 weeks
Title
Faecal microbiome
Description
Evaluating changes of faecal microbiome profiling by amplicon sequencing
Time Frame
12 weeks
Title
Disease Activity Score 28-joint count erythrocyte sedimentation rate (DAS28-ESR)
Description
Evaluating changes of the DAS28 index, which was a composite score of weighted components including tender joint counts of 28, swollen joint counts of 28, participant global assessment of disease activity score, and erythrocyte sedimentation rate value. A positive change in score indicates worsening, and a negative change indicates improvement. The score ranges from 0 to ca. 10 points, with > 5.1 indicating high disease activity, < 3.2 indicating low disease activity, and < 2.6 indicating clinical remission. Change from baseline to Week 12 will be used for the confirmation of therapeutic similarity.
Time Frame
12 weeks
Title
Rate of participants with adverse effects associated with experimental drugs
Description
Adverse effects include fever, rash, abnormal liver and kidney function, rate of new-onset infection and any abnormal measures associated with experimental drugs.
Time Frame
12 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female ≥18 years of age at time of screening, weight≥35kg. Diagnosed with rheumatoid arthritis satisfying the 1987 American College of Rheumatology classification criteria. Stable treatment including DMARDs (Disease Modifying Anti-Rheumatic Drugs), the doses had been stable for at least 3 months before baseline Have given written informed consent Exclusion Criteria: Patient presenting or having a history of other inflammatory joint disease Patient with ongoing or previous Stevens-Johnson syndrome, toxic epidermal necrolysis or erythema multiforme Patient with significantly impaired bone marrow function or significant anemia, leucopenia or thrombocytopenia induced by other disease Patient with persistent infection or severe infection within 3 months before enrollment Patient with uncontrolled hypertension, uncontrolled diabetes, unstable ischemic heart disease, active inflammatory bowel disease, active peptic ulcer disease, terminal illness or other medical condition which would put the patient at risk to participate in the study according to the opinion of investigator Patient with cardiovascular, hepatic, neurological, endocrine, or other major systemic disease which may make implementation of the protocol or interpretation of the study results become difficult Patient who has severe hypoproteinemia (e.g., in case of severe liver disease or nephrotic syndrome), with serum albumin < 30 g/L Patient who has moderate or severe impairment of renal function, as known by serum creatinine > 133μmol/L (or 1.5 mg/dl) Patient with impairment of liver function or persisting Alanine transaminase (ALT) or Aspartate aminotransferase (AST) elevations of more than 2-fold the upper limit of normal Patient with Known HIV positive status or positive serology for hepatitis B or C Pregnant or breastfeeding woman Women of childbearing potential Men wishing to father children during the course of the study or within the 24 months thereafter (or 3 months with the washout procedure) Patient with a congenital or acquired severe immuno-deficiency, a history of cancer or lymphoproliferative disease, or any patient who has received total lymphoid irradiation. Patient who enrolled in any other clinical trial involving off-label use of an investigational drug or device, or any other type of medical research Patient using any biologic agent such as anti-tumor necrosis factor, abciximab, Belimumab or rituximab within 3 months prior to the first dose of treatment. Patient whose BMI(body mass index) under 18.5 kg/m2 or more than 30 kg/m2 Patient with history of drug or alcohol abuse
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Naidi Wang
Phone
+8618811618179
Email
pkuwnd@163.com
First Name & Middle Initial & Last Name or Official Title & Degree
Jing He
Phone
+8618611707347
Email
hejing1105@126.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Zhanguo Li
Organizational Affiliation
Peking University Institute of Rheuamotology and Immunology
Official's Role
Principal Investigator
Facility Information:
Facility Name
Department of Rheumatology and Immunology, Peking University People's Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100044
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jing He
Phone
+8618611707347
Email
hejing1105@126.com

12. IPD Sharing Statement

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Effect of Butyrate Supplement on Rheumatoid Arthritis

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