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Diet Intervention for Crohn's Disease Patient

Primary Purpose

Crohn Disease

Status
Active
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Diet Counseling
CD LFD
Dyadic Psychological Support (DPS)
Sponsored by
University of Miami
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Crohn Disease focused on measuring Inflammatory bowel disease (IBD), Diet, CD, IBD, Psychological support, Family member, Low fat, high fiber, Dyadic

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria for Crohn's disease:

  • Male or Female ≥18 and ≤70 years old and lives with someone that is involved in daily diet
  • Documented diagnosed of Crohn's Disease
  • sCDAI less than 400
  • Patients on oral 5-aminosalicylates, mesalamine or sulfasalazine must be on a stable dose for ≥2 weeks prior to screening
  • Treated with anti-Tumor Necrotic Factors (TNFs) or immunosuppressants (AZA, 6-Mercaptopurine (6-MP), or methotrexate) at screening must have been on a stable dose for ≥4 weeks
  • On steroids can be on no more than prednisone 20 mg daily or budesonide 9 mg daily at the screening. If clinically indicated, tapering of steroids after 4 weeks of intervention may occur. Prednisone may be tapered by no more than 2.5mg/wk and budesonide by no more than 3 mg/wk.
  • No antibiotic use or probiotic use within 2 weeks prior to screening

Exclusion Criteria for Crohn's disease:

Patients with Ulcerative Colitis and Celiac Disease

  • Abdominal abscess, symptomatic Intestinal stricture, patients with altered anatomy: prior total colectomy or proctocolectomy or anticipated colectomy during the study period and presence of ileal pouch or ostomy
  • Other clinically meaningful laboratory abnormalities: pregnancy or lactation, an unstable or uncontrolled medical disorder, colonic dysplasia or adenomas, and malignant neoplasms. Toxic megacolon situations such as Patients with short life expectancy
  • Use of cyclosporine, mycophenolate mofetil, sirolimus, thalidomide or tacrolimus within 2 months prior to screening
  • Need for prednisone > 20 mg daily or budesonide > 9 mg daily at the time of screening. Received intravenous corticosteroids within 2 weeks prior to screening, during screening, or during the study period except as premedication for anti-TNFs
  • Use of Total Parenteral Nutrition at the time of screening and during the study period.
  • Presence of any of the following laboratory abnormalities during screening period or at least <12 weeks; Hemoglobin <8.0g/dl, Albumin <2.8g/dl.
  • Uncooperative behavior or any condition that could make the patient potentially noncompliant to the study procedure
  • Other significant or life-threatening co-morbidities in which low fat/high fiber diet intervention could negatively affect
  • The need for antibiotic use during the study period
  • Known allergy to tree nuts or peanuts
  • Pregnant women

Inclusion and Exclusion Criteria for Family-like Member

Inclusion:

  • Male or Female ≥18 and ≤70 years old
  • Live in the same household and be involved in the patients' daily diet
  • No antibiotic use or probiotic use within 2 weeks prior to screening

Exclusion Criteria

  • Patients with Ulcerative Colitis and Celiac Disease
  • Abdominal abscess, symptomatic Intestinal stricture, patients with altered anatomy: prior total colectomy or proctocolectomy or anticipated colectomy during the study period and presence of ileal pouch or ostomy
  • Other clinically meaningful laboratory abnormalities: pregnancy or lactation, an unstable or uncontrolled medical disorder, colonic dysplasia or adenomas, and malignant neoplasms. Toxic megacolon situations such Uncooperative behavior or any condition that could make the patient potentially noncompliant to the study procedures. Patients with short life expectancy
  • Use of cyclosporine, mycophenolate mofetil, sirolimus, thalidomide or tacrolimus within 2 months prior to screening
  • Use of Total Parenteral Nutrition at the time of screening and during the study period.
  • Other significant or life-threatening co-morbidities in which low fat/high fiber diet intervention could negatively affect
  • The need for antibiotic use during the study period
  • Known allergy to tree nuts or peanuts
  • Pregnant women

Sites / Locations

  • University of Miami

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Experimental

Experimental

Arm Label

Crohn's Disease (CD) Control Group

Experimental CD Low Fat Diet (LFD) Group

Experimental CD LFD + DPS Group

Arm Description

Participants will receive only the one time standard of care in-clinic diet counseling at visit 1.

Participants will be provided catered LFD meals for 8 consecutive weeks consisting of daily breakfast, lunch, dinner and snacks.

Participants and one family member that lives with them will be provided catered LFD meals for 8 consecutive weeks consisting of daily breakfast, lunch, dinner and snacks. In addition, the participant and their family member will receive 12 consecutive weeks of Dyadic Psychological Support (DPS).

Outcomes

Primary Outcome Measures

Change in fat intake
Change in daily fat intake calculated through patient reported diet diary app Nutrihand.
Rate of adherence to fat intake
Adherence to fat intake is measured by the web-based Automated Self-Administered 24-hour diet recall (ASA24).

Secondary Outcome Measures

Change in clinical symptoms as assessed by Patient Reported Outcomes (PRO2).
PRO2 is the sum of the average daily stool frequency and abdominal pain. A weighted total PRO2 score of less than 75 is an indication of remission.
Change in clinical symptoms as assessed by the Harvey Bradshaw Index (HBI)
HBI is a 5-item questionnaire. An HBI score of <5 indicates remission, 5-7 indicates mild disease, 8-16 indicates moderate disease and >16 indicates severe disease.
Change in clinical symptoms as assessed by the Short Crohn's Disease Activity Index (sCDAI).
sCDAI is the sum of the average daily stool frequency, general well-being and abdominal pain. A weighted total sCDAI score of less than 150 indicates remission, 150-219 indicates mild activity, 220-450 indicates moderate activity and > 450 indicates severe activity.
Change in quality of life (QoL) as assessed by the Short Inflammation Bowel Disease Questionnaire (sIBDQ).
sIBDQ is a 10-item shortened version of the original IBDQ assessing QOL with total scores ranging from 1 to 7 with a higher score indicating a better QOL.
Change in quality of life (QoL) as assessed by the Patient-Reported Outcomes Measurement Information System (PROMIS-29).
The PROMIS-29, a generic health-related quality of life survey, assesses each of the 7 PROMIS domains with 4 questions. The questions are ranked on a 5-point Likert Scale. There is also one 11-point rating scale for pain intensity. A score of 50 represents the mean or average of the reference population. A score of 60 means that the person is one standard deviation above the reference population (standard deviation = 10).
Change in the expression of cytokine high-sensitivity C-reactive protein (hsCRP).
Change in the expression of cytokine high-sensitivity C-reactive protein (hsCRP) evaluated in mg/L.
Change in the expression of Serum Amyloid A (SAA).
Change in the expression of SAA evaluated in pg/mL.

Full Information

First Posted
December 24, 2019
Last Updated
September 15, 2023
Sponsor
University of Miami
Collaborators
The Leona M. and Harry B. Helmsley Charitable Trust
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1. Study Identification

Unique Protocol Identification Number
NCT04213729
Brief Title
Diet Intervention for Crohn's Disease Patient
Official Title
A Holistic Diet Intervention for People With Crohn's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
November 26, 2019 (Actual)
Primary Completion Date
March 14, 2024 (Anticipated)
Study Completion Date
March 14, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Miami
Collaborators
The Leona M. and Harry B. Helmsley Charitable Trust

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
The purpose of this study is to determine the effectiveness of a low-fat, high fiber diet (LFD) containing a minimal proportion of fat to improve gastrointestinal symptoms, quality of life and signs of inflammation in blood and stool.

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), Diet, CD, IBD, Psychological support, Family member, Low fat, high fiber, Dyadic

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
300 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Crohn's Disease (CD) Control Group
Arm Type
Active Comparator
Arm Description
Participants will receive only the one time standard of care in-clinic diet counseling at visit 1.
Arm Title
Experimental CD Low Fat Diet (LFD) Group
Arm Type
Experimental
Arm Description
Participants will be provided catered LFD meals for 8 consecutive weeks consisting of daily breakfast, lunch, dinner and snacks.
Arm Title
Experimental CD LFD + DPS Group
Arm Type
Experimental
Arm Description
Participants and one family member that lives with them will be provided catered LFD meals for 8 consecutive weeks consisting of daily breakfast, lunch, dinner and snacks. In addition, the participant and their family member will receive 12 consecutive weeks of Dyadic Psychological Support (DPS).
Intervention Type
Behavioral
Intervention Name(s)
Diet Counseling
Intervention Description
Standard of care diet counseling provided at clinic visit 1.
Intervention Type
Other
Intervention Name(s)
CD LFD
Intervention Description
Daily breakfast, lunch, dinner and snacks LFD catered meals. Meals will have approximately 20% calories from fat, a goal ratio close to 1:1 omega-6/omega-3 fatty acids, and approximately 25-35 grams of fiber per day.
Intervention Type
Behavioral
Intervention Name(s)
Dyadic Psychological Support (DPS)
Intervention Description
The dyadic psychosocial support (DPS) intervention will be provided for a total of 12 weeks. The 12-week DPS intervention consists of eight sessions (main sessions) and two booster sessions. The intervention will incorporate psychoeducational components that combine didactic and behavioral regulatory procedures to promote healthy diet behavior for self-determined reasons.
Primary Outcome Measure Information:
Title
Change in fat intake
Description
Change in daily fat intake calculated through patient reported diet diary app Nutrihand.
Time Frame
Baseline, 8 weeks
Title
Rate of adherence to fat intake
Description
Adherence to fat intake is measured by the web-based Automated Self-Administered 24-hour diet recall (ASA24).
Time Frame
Week 36
Secondary Outcome Measure Information:
Title
Change in clinical symptoms as assessed by Patient Reported Outcomes (PRO2).
Description
PRO2 is the sum of the average daily stool frequency and abdominal pain. A weighted total PRO2 score of less than 75 is an indication of remission.
Time Frame
Baseline, Week 8
Title
Change in clinical symptoms as assessed by the Harvey Bradshaw Index (HBI)
Description
HBI is a 5-item questionnaire. An HBI score of <5 indicates remission, 5-7 indicates mild disease, 8-16 indicates moderate disease and >16 indicates severe disease.
Time Frame
Baseline, Week 8
Title
Change in clinical symptoms as assessed by the Short Crohn's Disease Activity Index (sCDAI).
Description
sCDAI is the sum of the average daily stool frequency, general well-being and abdominal pain. A weighted total sCDAI score of less than 150 indicates remission, 150-219 indicates mild activity, 220-450 indicates moderate activity and > 450 indicates severe activity.
Time Frame
Baseline, Week 8
Title
Change in quality of life (QoL) as assessed by the Short Inflammation Bowel Disease Questionnaire (sIBDQ).
Description
sIBDQ is a 10-item shortened version of the original IBDQ assessing QOL with total scores ranging from 1 to 7 with a higher score indicating a better QOL.
Time Frame
Baseline, Week 8
Title
Change in quality of life (QoL) as assessed by the Patient-Reported Outcomes Measurement Information System (PROMIS-29).
Description
The PROMIS-29, a generic health-related quality of life survey, assesses each of the 7 PROMIS domains with 4 questions. The questions are ranked on a 5-point Likert Scale. There is also one 11-point rating scale for pain intensity. A score of 50 represents the mean or average of the reference population. A score of 60 means that the person is one standard deviation above the reference population (standard deviation = 10).
Time Frame
Baseline, Week 8
Title
Change in the expression of cytokine high-sensitivity C-reactive protein (hsCRP).
Description
Change in the expression of cytokine high-sensitivity C-reactive protein (hsCRP) evaluated in mg/L.
Time Frame
Baseline, Week 8
Title
Change in the expression of Serum Amyloid A (SAA).
Description
Change in the expression of SAA evaluated in pg/mL.
Time Frame
Baseline, Week 8

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria for Crohn's disease: Male or Female ≥18 and ≤70 years old and lives with someone that is involved in daily diet Documented diagnosed of Crohn's Disease sCDAI less than 400 Patients on oral 5-aminosalicylates, mesalamine or sulfasalazine must be on a stable dose for ≥2 weeks prior to screening Treated with anti-Tumor Necrotic Factors (TNFs) or immunosuppressants (AZA, 6-Mercaptopurine (6-MP), or methotrexate) at screening must have been on a stable dose for ≥4 weeks On steroids can be on no more than prednisone 20 mg daily or budesonide 9 mg daily at the screening. If clinically indicated, tapering of steroids after 4 weeks of intervention may occur. Prednisone may be tapered by no more than 2.5mg/wk and budesonide by no more than 3 mg/wk. No antibiotic use or probiotic use within 2 weeks prior to screening Exclusion Criteria for Crohn's disease: Patients with Ulcerative Colitis and Celiac Disease Abdominal abscess, symptomatic Intestinal stricture, patients with altered anatomy: prior total colectomy or proctocolectomy or anticipated colectomy during the study period and presence of ileal pouch or ostomy Other clinically meaningful laboratory abnormalities: pregnancy or lactation, an unstable or uncontrolled medical disorder, colonic dysplasia or adenomas, and malignant neoplasms. Toxic megacolon situations such as Patients with short life expectancy Use of cyclosporine, mycophenolate mofetil, sirolimus, thalidomide or tacrolimus within 2 months prior to screening Need for prednisone > 20 mg daily or budesonide > 9 mg daily at the time of screening. Received intravenous corticosteroids within 2 weeks prior to screening, during screening, or during the study period except as premedication for anti-TNFs Use of Total Parenteral Nutrition at the time of screening and during the study period. Presence of any of the following laboratory abnormalities during screening period or at least <12 weeks; Hemoglobin <8.0g/dl, Albumin <2.8g/dl. Uncooperative behavior or any condition that could make the patient potentially noncompliant to the study procedure Other significant or life-threatening co-morbidities in which low fat/high fiber diet intervention could negatively affect The need for antibiotic use during the study period Known allergy to tree nuts or peanuts Pregnant women Inclusion and Exclusion Criteria for Family-like Member Inclusion: Male or Female ≥18 and ≤70 years old Live in the same household and be involved in the patients' daily diet No antibiotic use or probiotic use within 2 weeks prior to screening Exclusion Criteria Patients with Ulcerative Colitis and Celiac Disease Abdominal abscess, symptomatic Intestinal stricture, patients with altered anatomy: prior total colectomy or proctocolectomy or anticipated colectomy during the study period and presence of ileal pouch or ostomy Other clinically meaningful laboratory abnormalities: pregnancy or lactation, an unstable or uncontrolled medical disorder, colonic dysplasia or adenomas, and malignant neoplasms. Toxic megacolon situations such Uncooperative behavior or any condition that could make the patient potentially noncompliant to the study procedures. Patients with short life expectancy Use of cyclosporine, mycophenolate mofetil, sirolimus, thalidomide or tacrolimus within 2 months prior to screening Use of Total Parenteral Nutrition at the time of screening and during the study period. Other significant or life-threatening co-morbidities in which low fat/high fiber diet intervention could negatively affect The need for antibiotic use during the study period Known allergy to tree nuts or peanuts Pregnant women
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Maria T Abreu, MD
Organizational Affiliation
University of Miami
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Miami
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Diet Intervention for Crohn's Disease Patient

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