PouchitisNCT02828410
Nutritional Impact of Serum-Derived Bovine Immunoglobulin Protein Isolate in Subjects With IPAA
A study testing SBI in people with Pouchitis and Irritable Pouch Syndrome, run by Boston Medical Center at 1 site in United States.
Trial summary
This is an open label trial to test the hypothesize that serum bovine immunoglobulin protein isolate (SBI) will improve the nutritional status and quality of life (QOL) of patients with an ileal pouch anal anastomosis (IPAA) and symptoms of pouchitis. Read more about this study
- Who is it for?
- Ages 18 to 75 years
- Conditions the study is for
- Pouchitis, Irritable Pouch Syndrome
- What is being tested?
- SBI
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 6 participants
- Where
- 1 siteUnited States
- Study dates
- Jul 2016to Jun 2018
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 75 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patient is male or female between the ages of 18-75 years, inclusive.
- Patient has history of UC or Crohn's disease (CD) diagnosed by standard clinical, radiographic, endoscopic, and histopathological criteria.
- Patient has undergone total proctocolectomy and IPAA surgery a minimum of 6 months prior to screening.
- Patient has symptoms suggestive of pouchitis including frequent bowel movements of greater than or equal to seven per day (≥7 per day), and one or more of the following: daily rectal bleeding, fecal urgency, abdominal cramps, or fever >37.8oC).
- Patient is capable of understanding the requirements of the study and has signed / dated an IRB approved informed consent form.
Who cannot join
- Patient cannot or will not provide written informed consent.
- Patient has a known allergy or hypersensitivity to beef, beef products, or any ingredient used in EnteraGam.
- Patient has clinical signs and symptoms of an active infection.
- Patient is on antibiotic therapy (other than for pouchitis treatment) at any time in the 30 days prior to screening.
- Patient has active alcohol or drug abuse or psychiatric disorders felt to preclude his / her ability to complete the study.
- Patient who, in the opinion of the investigator, has a poorly controlled / uncontrolled significant medical condition that would interfere with the study.
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- Positive stool test (PCR) for C. difficile.
- Use of antidiarrheal medications (ADM). - Exception: patients who, in the opinion of the Investigator, are on stable treatment with ADMs may be enrolled provided that the administration schedule is intended to be maintained or decreased during the study and the subject has been on stable treatment with ADMs for at least 30 days prior to screening; otherwise, these agents are prohibited in the study.
- Use of an investigational product or participation in a clinical trial within the past three months.
- Use of a biologic (e.g., infliximab, adalimumab) within the last 3 months.
- Patient is pregnant or nursing.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Evaluating the Nutritional Impact of Serum-Derived Bovine Immunoglobulin Protein Isolate in Subjects With Ileal Pouch-Anal Anastomosis
This is an open label trial to test the hypothesize that serum bovine immunoglobulin protein isolate (SBI) will improve the nutritional status and quality of life (QOL) of patients with an ileal pouch anal anastomosis (IPAA) and symptoms of pouchitis. Subjects with symptomatic IPAA will receive two packets of EnteraGam twice daily (total daily dose of 20 g SBI) for up to 24 weeks. The primary objective of this study is to determine whether SBI therapy leads to improved nutritional status and QOL. A secondary objective is to evaluate SBI in the management of their disease, including impact on clinical symptoms.
Read the detailed description
This is an open-label study involving patients who are status post ileal pouch-anal anastomosis age 18 and 75 who receive care at Boston Medical Center's Center for Digestive Disorders (CDD). There is no randomization or use of placebo in this study and patients will be recruited sequentially. This is an open-label, single center study evaluating the effectiveness of SBI or EnteraGam (10.0 g twice per day) on nutritional status and quality of life in patients with ileal pouch-anal anastomosis.
Nutritional status and inflammation be assessed by measuring CBC with differential, vitamin D, vitamin B12, pre-albumin, albumin, ferritin, ESR, CRP, alpha-1-antitrypsin, and fecal calprotectin levels at screening, Day 84, and Day 168. Stool samples from these same time points will also be frozen and stored until the end of the study for potential fecal microbiome analysis depending on the results of other outcome measures.
The effect of SBI on a subject's quality of life (QoL) will be evaluated using the Short Inflammatory Bowel Disease Questionnaire and Cleveland Global Quality of Life scores at baseline, Day 28, Day 84, and End of Study.
The short form of disease specific QoL (s-IBDQ) includes 10 questions derived from the 32 questions IBDQ concerning QoL. It covers four items: bowel symptoms, systemic symptoms, emotional, and social functions. The total score ranges from 10 (worst health) to 70 (best health).
The Cleveland Global Quality of Life (CGOL) score is an instrument specifically designed for patients with ileal pouches. Subjects will be asked to rate each of three items (current QOL, current quality of health, and current energy level) on a scale of 0-10, 0 being the worst and 10 the best. The sum of the three scores divided by 30 will provide the CGQL score.
The Modified Pouchitis Disease Activity Index (mPDAI) will be used to evaluate for pouchitis and assess the overall disease activity for each subject at baseline pouchoscopy. This modified diagnostic instrument consists of two component scores: clinical symptoms (range 0-6 points) and endoscopic appearence (range 0-6 points). Follow-up pouchoscopy is not part of the study protocol. However, if a patient warrants follow-up pouchoscopy at any point during the study period based on standard of care (most likley due to worsening or non-responsive symptoms), then the mPDAI at follow-up pouchoscopy will also be calculated and included in outcomes analysis.
- Conditions
- Pouchitis, Irritable Pouch Syndrome
- Being tested
- SBI
- Keywords
- serum bovine immunoglobulin protein isolate, IPAA, quality of life
- Medical subject headings
- Pouchitis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
SBIDietary supplement
Also called EnteraGam
Serum bovine immunoglobulin protein isolate 10 g twice per day
| Study group | Role | What they receive |
|---|---|---|
| SBI | Experimental | Serum bovine immunoglobulin protein isolate (SBI) Receives: Dietary Supplement: SBI |
What is being measured
The primary outcome is the main question the study is designed to answer.
BMI
Measured: 6 months
Pre-albumin
Measured: 6 months
Albumin
Measured: 6 months
Vitamin D
Measured: 6 months
Vitamin B12
Measured: 6 months
Ferritin
Measured: 6 months
Short Inflammatory Bowel Disease Quality of Life Score
Measured: 6 months
Cleveland Global Quality of Life Score
Measured: 6 months
Secondary outcomes (13)
Nocturnal Bowel Movements
Average number of nightly nocturnal bowel movements over the past week
Measured: 6 months
Concomitant Medications
Measured: 6 months
Abdominal Cramping
Number of days experiencing abdominal cramping over the past week
Measured: 6 months
Consistency of Bowel Movements
Average Bristol Stool Scale score for bowel movements during the previous week
Measured: 6 months
Incontinence
Number of incontinence episodes over the past week
Measured: 6 Months
ESR
Sedimentation Rate
Measured: 6 Months
CRP
C-reactive protein
Measured: 6 Months
Fecal calprotectin
Measured: 6 Months
Alpha-1-antitrypsin
Measured: 6 Months
Number of Bowel Movements
Average number of daily bowel movements over the past week
Measured: 6 Months
Fecal Urgency
Average number of days with fecal urgency over the past week
Measured: 6 Months
Modified Pouchitis Disease Activity Index Score
When applicable
Measured: 6 Months
Rectal Bleeding
Average number of days with rectal bleeding over the past week
Measured: 6 Months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted11 Jul 2016 (estimated)
- Study startJul 2016
- Primary completionJun 2017
- Study completionJun 2018
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for PouchitisStudies of the same condition, open and under way.
- More trials run by Boston Medical CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Enrolment
- 6 participants (actual)
Sponsor and investigators
- Lead sponsor
- Boston Medical Center
- Sponsor type
- University, hospital or other
- Collaborators
- Entera Health, Inc
- Responsible party
- Principal investigator, Francis Farraye, MD, Boston Medical Center
- Investigators
- Francis Farraye, MD, Principal investigator, Boston Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02828410
- Sponsor's protocol ID
- H-33890
- Status last verified
- Aug 2018
- First submitted
- 2 Jul 2016
- Last updated
- 14 Aug 2018
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 14 Aug 2018. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Evaluating the Nutritional Impact of Serum-Derived Bovine Immunoglobulin Protein Isolate in Subjects With Ileal Pouch-Anal Anastomosis
- ClinicalTrials.gov ID
- NCT02828410
- Acronym / sponsor ID
- H-33890
- Conditions
- Pouchitis, Irritable Pouch Syndrome
- Keywords
- serum bovine immunoglobulin protein isolate, IPAA, quality of life
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 6 participants (actual)
- Lead sponsor
- Boston Medical CenterUniversity, hospital or other
- Collaborators
- Entera Health, Inc
- Study start
- Jul 2016 (actual)
- Primary completion
- Jun 2017 (actual)
- Study completion
- Jun 2018 (actual)
- First posted
- 11 Jul 2016 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is an open label trial to test the hypothesize that serum bovine immunoglobulin protein isolate (SBI) will improve the nutritional status and quality of life (QOL) of patients with an ileal pouch anal anastomosis (IPAA) and symptoms of pouchitis. Subjects with symptomatic IPAA will receive two packets of EnteraGam twice daily (total daily dose of 20 g SBI) for up to 24 weeks. The primary objective of this study is to determine whether SBI therapy leads to improved nutritional status and QOL. A secondary objective is to evaluate SBI in the management of their disease, including impact on clinical symptoms.
Detailed description
This is an open-label study involving patients who are status post ileal pouch-anal anastomosis age 18 and 75 who receive care at Boston Medical Center's Center for Digestive Disorders (CDD). There is no randomization or use of placebo in this study and patients will be recruited sequentially. This is an open-label, single center study evaluating the effectiveness of SBI or EnteraGam (10.0 g twice per day) on nutritional status and quality of life in patients with ileal pouch-anal anastomosis.
Nutritional status and inflammation be assessed by measuring CBC with differential, vitamin D, vitamin B12, pre-albumin, albumin, ferritin, ESR, CRP, alpha-1-antitrypsin, and fecal calprotectin levels at screening, Day 84, and Day 168. Stool samples from these same time points will also be frozen and stored until the end of the study for potential fecal microbiome analysis depending on the results of other outcome measures.
The effect of SBI on a subject's quality of life (QoL) will be evaluated using the Short Inflammatory Bowel Disease Questionnaire and Cleveland Global Quality of Life scores at baseline, Day 28, Day 84, and End of Study.
The short form of disease specific QoL (s-IBDQ) includes 10 questions derived from the 32 questions IBDQ concerning QoL. It covers four items: bowel symptoms, systemic symptoms, emotional, and social functions. The total score ranges from 10 (worst health) to 70 (best health).
The Cleveland Global Quality of Life (CGOL) score is an instrument specifically designed for patients with ileal pouches. Subjects will be asked to rate each of three items (current QOL, current quality of health, and current energy level) on a scale of 0-10, 0 being the worst and 10 the best. The sum of the three scores divided by 30 will provide the CGQL score.
The Modified Pouchitis Disease Activity Index (mPDAI) will be used to evaluate for pouchitis and assess the overall disease activity for each subject at baseline pouchoscopy. This modified diagnostic instrument consists of two component scores: clinical symptoms (range 0-6 points) and endoscopic appearence (range 0-6 points). Follow-up pouchoscopy is not part of the study protocol. However, if a patient warrants follow-up pouchoscopy at any point during the study period based on standard of care (most likley due to worsening or non-responsive symptoms), then the mPDAI at follow-up pouchoscopy will also be calculated and included in outcomes analysis.
Study design
- Primary purpose
- Treatment
- Allocation
- Not applicable
- Intervention model
- Single group
- Masking
- None (open label)
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| SBI | Experimental | Dietary Supplement: SBISerum bovine immunoglobulin protein isolate (SBI) |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Patient is male or female between the ages of 18-75 years, inclusive.
- Patient has history of UC or Crohn's disease (CD) diagnosed by standard clinical, radiographic, endoscopic, and histopathological criteria.
- Patient has undergone total proctocolectomy and IPAA surgery a minimum of 6 months prior to screening.
- Patient has symptoms suggestive of pouchitis including frequent bowel movements of greater than or equal to seven per day (≥7 per day), and one or more of the following: daily rectal bleeding, fecal urgency, abdominal cramps, or fever >37.8oC).
- Patient is capable of understanding the requirements of the study and has signed / dated an IRB approved informed consent form.
Key exclusion criteria (11 listed)
- Patient cannot or will not provide written informed consent.
- Patient has a known allergy or hypersensitivity to beef, beef products, or any ingredient used in EnteraGam.
- Patient has clinical signs and symptoms of an active infection.
- Patient is on antibiotic therapy (other than for pouchitis treatment) at any time in the 30 days prior to screening.
- Patient has active alcohol or drug abuse or psychiatric disorders felt to preclude his / her ability to complete the study.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| SBIAlso: EnteraGamSerum bovine immunoglobulin protein isolate 10 g twice per day | Dietary supplement | SBI |
Primary outcome
BMI
Time frame: 6 months
Pre-albumin
Time frame: 6 months
Albumin
Time frame: 6 months
Vitamin D
Time frame: 6 months
Vitamin B12
Time frame: 6 months
Ferritin
Time frame: 6 months
Short Inflammatory Bowel Disease Quality of Life Score
Time frame: 6 months
Cleveland Global Quality of Life Score
Time frame: 6 months
13 secondary outcomes
Nocturnal Bowel Movements
Time frame: 6 months
Concomitant Medications
Time frame: 6 months
Abdominal Cramping
Time frame: 6 months
Consistency of Bowel Movements
Time frame: 6 months
Incontinence
Time frame: 6 Months
ESR
Time frame: 6 Months
CRP
Time frame: 6 Months
Fecal calprotectin
Time frame: 6 Months
Alpha-1-antitrypsin
Time frame: 6 Months
Number of Bowel Movements
Time frame: 6 Months
Fecal Urgency
Time frame: 6 Months
Modified Pouchitis Disease Activity Index Score
Time frame: 6 Months
Rectal Bleeding
Time frame: 6 Months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 14 Aug 2018.
- Individual participant dataSharing planned: No
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Rifaximin for the Secondary Prevention of Recurrent Pouchitis
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Oral Aeromonas sp. MTB Phage Therapy for Pouchitis in Patients With Ulcerative Colitis (UC)
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Etrasimod as Prevention of Pouchitis
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Francis Farraye, MD principal investigator
Boston Medical Center
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing SBI in people with Pouchitis and Irritable Pouch Syndrome, run by Boston Medical Center at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 11 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 14 Aug 2018. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
BMI (time frame: 6 months). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Aug 2018.