MultimorbidityPhase 4NCT06726486
Use of a Hypercaloric and Hyperprotein Supplement Enriched with Immunonutrients in Multi-pathological Malnourished Patients to Improve the Incidence and Prevalence of Pressure Sores
A Phase 4 study testing Atémpero in people with Multimorbidity and Comorbidity, run by University of Cadiz at 1 site in Spain.
Trial summary
The goal of this study is to evaluate the efficacy of a hypercaloric, hyperproteic enteral formula enriched with immunonutrients in preventing and treating pressure injuries in hospitalized malnourished patients. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Multimorbidity, Comorbidity, Malnutrition
- What is being tested?
- Atémpero
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 69 participants
- Where
- 1 siteSpain
- Study dates
- 1 Jan 2022to 30 Apr 2023
- Phase
- Phase 4
- 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 Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Hospitalized chronic patients with complex needs in the Internal Medicine Department of a regional hospital.
- Malnourished or at risk of malnutrition.
- Moderate-high risk of developing pressure-related injuries or the presence of pressure-related injuries.
Who cannot join
- Limitations in oral intake (due to pathologies, state of health, among others).
- Contraindications for using the oral route and digestive intolerance or allergy to any of the components of the products.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Use of a Hypercaloric and Hyperprotein Supplement Enriched with Immunonutrients in Multi-pathological Malnourished Patients to Improve the Incidence and Prevalence of Pressure Sores: a Randomized Controlled Trial
The goal of this study is to evaluate the efficacy of a hypercaloric, hyperproteic enteral formula enriched with immunonutrients in preventing and treating pressure injuries in hospitalized malnourished patients.
Participants will take enteral formula (a complete hyperproteic and hypercaloric oral nutritional supplement with a fibre mixture enriched in omega 3, L-arginine and nucleotides, providing vitamin C and Zinc) or a hyperproteic and hypercaloric oral nutritional supplement with fibre mixture every day for 30 days.
- Conditions
- Multimorbidity, Comorbidity, Malnutrition, Pressure Ulcer Prevention
- Being tested
- Atémpero, Control (Standard treatment)
- Keywords
- Multimorbidity, Comorbidity, Malnutrition, Pressure Ulcer, Supplements, Immunonutrients
- Medical subject headings
- Malnutrition, Pressure Ulcer
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AtémperoDietary supplement
A complete hyperproteic and hypercaloric diet with a mixture of fibres enriched in omega 3, L-arginine and nucleotides (which provides vitamin C and Zinc) was administered.
Control (Standard treatment)Dietary supplement
A complete high-protein and high-calorie diet with mixed fibre was administered.
| Study group | Role | What they receive |
|---|---|---|
| Intervention Group (Atémpero) | Experimental | Participants received an arginine-enriched ONS called Atémpero®. Receives: Dietary Supplement: Atémpero |
| Control Group | Active comparator | Participants received a complete high-protein, high-calorie diet with mixed fiber. Receives: Dietary Supplement: Control (Standard treatment) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Presence of pressure-related injuries
Dichotomous variable: Yes/No.
Measured: 15 and 30 days
Risk of developing pressure-related injuries
Measurement instrument: Braden scale (low risk, moderate risk, high risk).
Measured: 15 and 30 days
Categorization of pressure-related injuries
Measurement instrument: PUSH scale (I, II, III, IV).
Measured: 15 and 30 days
Pressure-related injuries healing
Measurement instrument: PUSH scale (closed, epithelial tissue, granulation tissue, sphacelium, necrotic tissue).
Measured: 15 and 30 days
Degree of dependence
Measurement instruments (description): Barthel score (independent, mild, moderate, severe).
Measured: 0, 15, and 30 days.
Weight loss
Measurement instruments (description): Weight scale (kg).
Measured: 0, 15 and 30 days.
% of dietary intake
0%, 25%, 50%, 75%, 100% intake.
Measured: 15 and 30 days.
ONS adherence
0%, 25%, 50%, 75%, 100% intake.
Measured: 15 and 30 days.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted10 Dec 2024
- Study start1 Jan 2022
- Primary completion30 Apr 2023
- Study completion30 Apr 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (23)Papers the sponsor has linked to this study.
- Other trials for MultimorbidityStudies of the same condition, open and under way.
- 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 4
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- A single-blind parallel Randomized Controlled Clinical Trial.
- Masking
- Single blind
- Who is masked
- Investigator
- Enrolment
- 69 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Cadiz
- Sponsor type
- University, hospital or other
- Collaborators
- Vegenat Healthcare, Instituto de investigación e innovación biomédica de Cádiz
- Responsible party
- Principal investigator, Antonio Jesús Marín Paz, University of Cadiz
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06726486
- Sponsor's protocol ID
- 84.21
- Status last verified
- Dec 2024
- First submitted
- 4 Dec 2024
- Last updated
- 10 Dec 2024
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: All data will be available after publication of the study results.
Publications
Liu P, Shen WQ, Chen HL. Efficacy of arginine-enriched enteral formulas for the healing of pressure ulcers: a systematic review. J Wound Care. 2017 Jun 2;26(6):319-323. doi: 10.12968/jowc.2017.26.6.319.
PubMed 28598762Barchitta M, Maugeri A, Favara G, Magnano San Lio R, Evola G, Agodi A, Basile G. Nutrition and Wound Healing: An Overview Focusing on the Beneficial Effects of Curcumin. Int J Mol Sci. 2019 Mar 5;20(5):1119. doi: 10.3390/ijms20051119.
PubMed 30841550Cheshmeh S, Hojati N, Mohammadi A, Rahmani N, Moradi S, Pasdar Y, Elahi N. The use of oral and enteral tube-fed arginine supplementation in pressure injury care: A systematic review and meta-analysis. Nurs Open. 2022 Nov;9(6):2552-2561. doi: 10.1002/nop2.974. Epub 2021 Jun 25.
PubMed 34170617Yatabe J, Saito F, Ishida I, Sato A, Hoshi M, Suzuki K, Kameda T, Ueno S, Yatabe MS, Watanabe T, Sanada H. Lower plasma arginine in enteral tube-fed patients with pressure ulcer and improved pressure ulcer healing after arginine supplementation by Arginaid Water. J Nutr Health Aging. 2011 Apr;15(4):282-6. doi: 10.1007/s12603-010-0306-4.
PubMed 21437560Roberts S, Chaboyer W, Desbrow B. Nutrition care-related practices and factors affecting nutritional intakes in hospital patients at risk of pressure ulcers. J Hum Nutr Diet. 2015 Aug;28(4):357-65. doi: 10.1111/jhn.12258. Epub 2014 Jun 27.
PubMed 24974729Eglseer D, Hodl M, Lohrmann C. Nutritional management of older hospitalised patients with pressure injuries. Int Wound J. 2019 Feb;16(1):226-232. doi: 10.1111/iwj.13016. Epub 2018 Nov 15.
PubMed 30440105Volkert D, Beck AM, Cederholm T, Cruz-Jentoft A, Hooper L, Kiesswetter E, Maggio M, Raynaud-Simon A, Sieber C, Sobotka L, van Asselt D, Wirth R, Bischoff SC. ESPEN practical guideline: Clinical nutrition and hydration in geriatrics. Clin Nutr. 2022 Apr;41(4):958-989. doi: 10.1016/j.clnu.2022.01.024. Epub 2022 Mar 5.
PubMed 35306388Langer G, Wan CS, Fink A, Schwingshackl L, Schoberer D. Nutritional interventions for preventing and treating pressure ulcers. Cochrane Database Syst Rev. 2024 Feb 12;2(2):CD003216. doi: 10.1002/14651858.CD003216.pub3.
PubMed 38345088Mervis JS, Phillips TJ. Pressure ulcers: Prevention and management. J Am Acad Dermatol. 2019 Oct;81(4):893-902. doi: 10.1016/j.jaad.2018.12.068. Epub 2019 Jan 18.
PubMed 30664906Banks MD, Ross LJ, Webster J, Mudge A, Stankiewicz M, Dwyer K, Coleman K, Campbell J. Pressure ulcer healing with an intensive nutrition intervention in an acute setting: a pilot randomised controlled trial. J Wound Care. 2016 Jul 2;25(7):384-92. doi: 10.12968/jowc.2016.25.7.384.
PubMed 27410392Clark RK, Stampas A, Kerr KW, Nelson JL, Sulo S, Leon-Novelo L, Ngan E, Pandya D. Evaluating the impact of using a wound-specific oral nutritional supplement to support wound healing in a rehabilitation setting. Int Wound J. 2023 Jan;20(1):145-154. doi: 10.1111/iwj.13849. Epub 2022 Jun 9.
PubMed 35684975Wood J, Brown B, Bartley A, Margarida Batista Custodio Cavaco A, Roberts AP, Santon K, Cook S. Reducing pressure ulcers across multiple care settings using a collaborative approach. BMJ Open Qual. 2019 Aug 20;8(3):e000409. doi: 10.1136/bmjoq-2018-000409. eCollection 2019.
PubMed 31523723Stracci G, Scarpellini E, Rinninella E, Mignini EV, Clementi N, Boni MV, Valeri MV, Sansoni D, Abenavoli L, Gasbarrini A, Rasetti C, Santori P. Effects of enteral nutrition on patients with pressure lesions: a single center, pilot study. Eur Rev Med Pharmacol Sci. 2020 Feb;24(3):1563-1570. doi: 10.26355/eurrev_202002_20214.
PubMed 32096205Wung Buh A, Mahmoud H, Chen W, McInnes MDF, Fergusson DA. Effects of implementing Pressure Ulcer Prevention Practice Guidelines (PUPPG) in the prevention of pressure ulcers among hospitalised elderly patients: a systematic review protocol. BMJ Open. 2021 Mar 12;11(3):e043042. doi: 10.1136/bmjopen-2020-043042.
PubMed 33712523Jaul E, Barron J, Rosenzweig JP, Menczel J. An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatr. 2018 Dec 11;18(1):305. doi: 10.1186/s12877-018-0997-7.
PubMed 30537947
Study at a glance
From the registry record, last updated by the sponsor on 10 Dec 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Use of a Hypercaloric and Hyperprotein Supplement Enriched with Immunonutrients in Multi-pathological Malnourished Patients to Improve the Incidence and Prevalence of Pressure Sores: a Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT06726486
- Acronym / sponsor ID
- 84.21
- Conditions
- Multimorbidity, Comorbidity, Malnutrition, Pressure Ulcer Prevention
- Keywords
- Multimorbidity, Comorbidity, Malnutrition, Pressure Ulcer, Supplements, Immunonutrients
- Phase
- Phase 4
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 69 participants (actual)
- Lead sponsor
- University of CadizUniversity, hospital or other
- Collaborators
- Vegenat Healthcare, Instituto de investigación e innovación biomédica de Cádiz
- Study start
- 1 Jan 2022 (actual)
- Primary completion
- 30 Apr 2023 (actual)
- Study completion
- 30 Apr 2023 (actual)
- First posted
- 10 Dec 2024 (actual)
- 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.
The goal of this study is to evaluate the efficacy of a hypercaloric, hyperproteic enteral formula enriched with immunonutrients in preventing and treating pressure injuries in hospitalized malnourished patients.
Participants will take enteral formula (a complete hyperproteic and hypercaloric oral nutritional supplement with a fibre mixture enriched in omega 3, L-arginine and nucleotides, providing vitamin C and Zinc) or a hyperproteic and hypercaloric oral nutritional supplement with fibre mixture every day for 30 days.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (investigator)
- Number of arms
- 2
- Model description
- A single-blind parallel Randomized Controlled Clinical Trial.
| Arm | Type | Receives |
|---|---|---|
| Intervention Group (Atémpero) | Experimental | Dietary Supplement: AtémperoParticipants received an arginine-enriched ONS called Atémpero®. |
| Control Group | Active comparator | Dietary Supplement: Control (Standard treatment)Participants received a complete high-protein, high-calorie diet with mixed fiber. |
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (3 listed)
- Hospitalized chronic patients with complex needs in the Internal Medicine Department of a regional hospital.
- Malnourished or at risk of malnutrition.
- Moderate-high risk of developing pressure-related injuries or the presence of pressure-related injuries.
Key exclusion criteria (2 listed)
- Limitations in oral intake (due to pathologies, state of health, among others).
- Contraindications for using the oral route and digestive intolerance or allergy to any of the components of the products.
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 |
|---|---|---|
| AtémperoA complete hyperproteic and hypercaloric diet with a mixture of fibres enriched in omega 3, L-arginine and nucleotides (which provides vitamin C and Zinc) was administered. | Dietary supplement | Intervention Group (Atémpero) |
| Control (Standard treatment)A complete high-protein and high-calorie diet with mixed fibre was administered. | Dietary supplement | Control Group |
Primary outcome
Presence of pressure-related injuries
Time frame: 15 and 30 days
Dichotomous variable: Yes/No.
Risk of developing pressure-related injuries
Time frame: 15 and 30 days
Measurement instrument: Braden scale (low risk, moderate risk, high risk).
Categorization of pressure-related injuries
Time frame: 15 and 30 days
Measurement instrument: PUSH scale (I, II, III, IV).
Pressure-related injuries healing
Time frame: 15 and 30 days
Measurement instrument: PUSH scale (closed, epithelial tissue, granulation tissue, sphacelium, necrotic tissue).
Degree of dependence
Time frame: 0, 15, and 30 days.
Measurement instruments (description): Barthel score (independent, mild, moderate, severe).
Weight loss
Time frame: 0, 15 and 30 days.
Measurement instruments (description): Weight scale (kg).
% of dietary intake
Time frame: 15 and 30 days.
0%, 25%, 50%, 75%, 100% intake.
ONS adherence
Time frame: 15 and 30 days.
0%, 25%, 50%, 75%, 100% intake.
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 10 Dec 2024.
- Background: PubMed 28598762Liu P, Shen WQ, Chen HL. Efficacy of arginine-enriched enteral formulas for the healing of pressure ulcers: a systematic review. J Wound Care. 2017 Jun 2;26(6):319-323. doi: 10.12968/jowc.2017.26.6.319.
- Background: PubMed 30841550Barchitta M, Maugeri A, Favara G, Magnano San Lio R, Evola G, Agodi A, Basile G. Nutrition and Wound Healing: An Overview Focusing on the Beneficial Effects of Curcumin. Int J Mol Sci. 2019 Mar 5;20(5):1119. doi: 10.3390/ijms20051119.
- Background: PubMed 34170617Cheshmeh S, Hojati N, Mohammadi A, Rahmani N, Moradi S, Pasdar Y, Elahi N. The use of oral and enteral tube-fed arginine supplementation in pressure injury care: A systematic review and meta-analysis. Nurs Open. 2022 Nov;9(6):2552-2561. doi: 10.1002/nop2.974. Epub 2021 Jun 25.
- Background: PubMed 21437560Yatabe J, Saito F, Ishida I, Sato A, Hoshi M, Suzuki K, Kameda T, Ueno S, Yatabe MS, Watanabe T, Sanada H. Lower plasma arginine in enteral tube-fed patients with pressure ulcer and improved pressure ulcer healing after arginine supplementation by Arginaid Water. J Nutr Health Aging. 2011 Apr;15(4):282-6. doi: 10.1007/s12603-010-0306-4.
- Background: PubMed 24974729Roberts S, Chaboyer W, Desbrow B. Nutrition care-related practices and factors affecting nutritional intakes in hospital patients at risk of pressure ulcers. J Hum Nutr Diet. 2015 Aug;28(4):357-65. doi: 10.1111/jhn.12258. Epub 2014 Jun 27.
- Background: PubMed 30440105Eglseer D, Hodl M, Lohrmann C. Nutritional management of older hospitalised patients with pressure injuries. Int Wound J. 2019 Feb;16(1):226-232. doi: 10.1111/iwj.13016. Epub 2018 Nov 15.
- Background: PubMed 35306388Volkert D, Beck AM, Cederholm T, Cruz-Jentoft A, Hooper L, Kiesswetter E, Maggio M, Raynaud-Simon A, Sieber C, Sobotka L, van Asselt D, Wirth R, Bischoff SC. ESPEN practical guideline: Clinical nutrition and hydration in geriatrics. Clin Nutr. 2022 Apr;41(4):958-989. doi: 10.1016/j.clnu.2022.01.024. Epub 2022 Mar 5.
- Background: PubMed 38345088Langer G, Wan CS, Fink A, Schwingshackl L, Schoberer D. Nutritional interventions for preventing and treating pressure ulcers. Cochrane Database Syst Rev. 2024 Feb 12;2(2):CD003216. doi: 10.1002/14651858.CD003216.pub3.
- Background: PubMed 30664906Mervis JS, Phillips TJ. Pressure ulcers: Prevention and management. J Am Acad Dermatol. 2019 Oct;81(4):893-902. doi: 10.1016/j.jaad.2018.12.068. Epub 2019 Jan 18.
- Background: PubMed 27410392Banks MD, Ross LJ, Webster J, Mudge A, Stankiewicz M, Dwyer K, Coleman K, Campbell J. Pressure ulcer healing with an intensive nutrition intervention in an acute setting: a pilot randomised controlled trial. J Wound Care. 2016 Jul 2;25(7):384-92. doi: 10.12968/jowc.2016.25.7.384.
- Background: PubMed 35684975Clark RK, Stampas A, Kerr KW, Nelson JL, Sulo S, Leon-Novelo L, Ngan E, Pandya D. Evaluating the impact of using a wound-specific oral nutritional supplement to support wound healing in a rehabilitation setting. Int Wound J. 2023 Jan;20(1):145-154. doi: 10.1111/iwj.13849. Epub 2022 Jun 9.
- Background: PubMed 31523723Wood J, Brown B, Bartley A, Margarida Batista Custodio Cavaco A, Roberts AP, Santon K, Cook S. Reducing pressure ulcers across multiple care settings using a collaborative approach. BMJ Open Qual. 2019 Aug 20;8(3):e000409. doi: 10.1136/bmjoq-2018-000409. eCollection 2019.
- Individual participant dataSharing planned: Yes. All data will be available after publication of the study results.
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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.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 4 study testing Atémpero in people with Multimorbidity and Comorbidity, run by University of Cadiz at 1 site in Spain.
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 3 inclusion and 2 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 10 Dec 2024. 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 Spain. 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.
What does this phase mean?
Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
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?
Presence of pressure-related injuries (time frame: 15 and 30 days). 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?
On the ClinicalTrials.gov record for NCT06726486, which also lists 23 linked publications.
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 10 Dec 2024.