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Trial registered on ANZCTR
Registration number
ACTRN12624000016538
Ethics application status
Approved
Date submitted
30/11/2023
Date registered
10/01/2024
Date last updated
10/01/2024
Date data sharing statement initially provided
10/01/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Dietary and lifestyle predictors of pouchitis
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Scientific title
Longitudinal study of diet, lifestyle and biomarker predictors of pouchitis
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Secondary ID [1]
311165
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Nil known
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Inflammatory bowel disease
332205
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familial adenomatous polyposis
332206
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Ileoanal pouch
332207
0
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Pouchitis
332208
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Colectomy
332209
0
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Ulcerative colitis
332333
0
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ileal pouch-anal anastomosis
332334
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Condition category
Condition code
Oral and Gastrointestinal
328918
328918
0
0
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Inflammatory bowel disease
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Human Genetics and Inherited Disorders
328919
328919
0
0
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Other human genetics and inherited disorders
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Diet and Nutrition
328921
328921
0
0
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Other diet and nutrition disorders
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
We will be following individuals with an ileoanal pouch over 18 months to identify if dietary factors or psychological stress are environmental factors that can predict the onset or worsening of pouchitis. Participants will complete 3-day food diaries, complete a series of online questionnaires related to their pouch function and stress as well as collecting biological samples. Data will be collected online every 6 months, and biological samples will be collected at home and posted back to researchers.
Secondly, from the data we collected, we will be assessing how useful faecal calprotectin can be used as a prognostic marker for the development or worsening of pouchitis. In order to achieve this, we will be collecting information about what participants eat, how their pouch functions, their stress levels and psychological wellbeing.
Faecal calprotectin in their stools will be collected and hair samples as a retrospective way of looking at the stress hormone, cortisol to identify chronic stress. Dietary intake will be assessed on its overall ‘healthfulness’ and used to find underlying relationships with pouchitis.
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Intervention code [1]
327515
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Not applicable
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Comparator / control treatment
N/a
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Incidence of pouchitis
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Assessment method [1]
336722
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Defined as faecal calprotectin greater than or equal to 350 modified Pouch Disease Activity Index (PDAI) of greater than or equal to 5, where endoscopic data is available or total PDAI is greater than or equal to 7 where histology and endoscopic data is available.
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Timepoint [1]
336722
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Timepoints relevant to participation are: baseline, 6 months, 12 months, 18 months. We will also collect information at 3 monthly intervals if pouchitis has developed.
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Primary outcome [2]
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Change of pouchitis phenotype
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Assessment method [2]
336723
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Defined as progression from a healthy pouch, to antibiotic responsive/dependent to chronic antibiotic-dependent pouchitis (greater than or equal to 4 episodes of pouchitis/year & responsive or requiring ongoing antibiotic treatment), or from chronic antibiotic dependent pouchitis (CADP) to chronic antibiotic refractory pouchitis (CARP). We will be assessing this using the pouchitis disease activity index, where endoscopic data is available.
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Timepoint [2]
336723
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Timepoints relevant to participation include baseline, 6 months, 12 months, 18 months. We will also collect information at 3 monthly intervals related to changes in pouch function.
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Secondary outcome [1]
429476
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Incidence of irritable pouch syndrome
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Assessment method [1]
429476
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Defined as the presence of increased frequency and/or urgency, with a clinical PDAI greater than or equal to 3 with AND endoscopic PDAI of <1 or faecal calprotectin <100 or total PDAI of <7
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Timepoint [1]
429476
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Timepoints relevant to participation include baseline, 6 months, 12, months, 18 months. We will also collect information at 3 monthly intervals related to changes in pouch function.
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Eligibility
Key inclusion criteria
• Living with an ileoanal pouch
• 18-75 years old
• Living in Australia,
• Ability to speak and read English
• Eligible for Medicare
• Internet access
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
• Chronic antibiotic refractory pouchitis (pouchitis refractory to combination antibiotics for greater than or equal to 4 weeks)
• Inability to provide informed consent
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Prospective
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Statistical methods / analysis
Targeted number to recruit: 82 participants as outlined below.
Power calculations (based on Poisson regression) suggests that a minimum sample size of 82 participants completing all 4 time points and therefore, a total of 328 observations will be needed based on an effect size of 1.333, 80% power, two-tailed and a total of 6 predictors. A 20% drop out rate was also included in the sample size calculation. Given this patient cohort is rare, this sample size may be difficult to achieve but we will aim to recruit as many participants as possible to meet the sample size, expanding recruitment to multiple clinical sites across Australia.
Predictive modelling:
Several statistical modelling approaches will be used to assess the relationship between predictors and development / worsening of pouchitis:
A Poisson regression will be used to analyse the relationship between predictors and worsening/development of pouchitis. To do so, each pouchitis episode in the last 6 months will be considered a count and a count distribution will be generated at the end of every - month intervals. These counts will be added up to provide a total count of pouchitis episodes over a 12-month period to yield a mean average of pouchitis episodes. Mean average of pouchitis episodes will be compared between tertiles of intake / levels for each predictor. Risk ratios will be generated.
In addition, the impact of each predictor (whilst controlling for all other predictors) on the count distribution of pouchitis episodes will also be evaluated using marginal means.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
15/01/2024
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Actual
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Date of last participant enrolment
Anticipated
1/07/2025
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Actual
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Date of last data collection
Anticipated
8/07/2025
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Actual
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Sample size
Target
82
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
25897
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The Alfred - Melbourne
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Recruitment postcode(s) [1]
41732
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3004 - Melbourne
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Funding & Sponsors
Funding source category [1]
315325
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University
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Name [1]
315325
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Monash University
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Address [1]
315325
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99 Commercial Rd Melbourne Vic 3004
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Country [1]
315325
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Australia
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Primary sponsor type
University
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Name
Monash University
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Address
99 Commercial Rd Melbourne Vic 3004
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Country
Australia
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Secondary sponsor category [1]
317379
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None
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Name [1]
317379
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Address [1]
317379
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Country [1]
317379
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
314246
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Alfred Hospital Ethics Committee
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Ethics committee address [1]
314246
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55 Commercial Rd Melbourne Vic 3004
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Ethics committee country [1]
314246
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Australia
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Date submitted for ethics approval [1]
314246
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24/08/2023
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Approval date [1]
314246
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09/11/2023
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Ethics approval number [1]
314246
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472/23
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Summary
Brief summary
Pouchitis is the most common inflammatory condition for those living with an ileoanal pouch (whereby the large bowel is removed due to medically unresponsive ulcerative colitis (UC) or familial adenomatous polyposis (FAP) and its cause is largely unknown. We aim to assess whether specific diet components and psychological factors such as stress can predict pouchitis. We also aim to assess whether faecal calprotectin (a marker of inflammation found in faeces) can be used as a test to predict worsening in pouch function or pouchitis. This study will follow patients with an ileoanal pouch prospectively for 18 months to evaluate if diet, stress and faecal calprotectin play a role in predicting pouchitis or worsening of pouchitis. This is important because there are currently no dietary guidelines to help ileoanal pouch patients.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Zaid Ardalan
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Address
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Monash University, Level 6, 99 Commercial Rd Melbourne Vic 3004
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Country
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Australia
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Phone
130922
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+61 409730301
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Fax
130922
0
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Email
130922
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[email protected]
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Contact person for public queries
Name
130923
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Dakota Rhys-Jones
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Address
130923
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Monash University, Level 6, 99 Commercial Rd Vic Melbourne 3004
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Country
130923
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Australia
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Phone
130923
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+61 03 99030367
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Fax
130923
0
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Email
130923
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[email protected]
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Contact person for scientific queries
Name
130924
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Zaid Ardalan
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Address
130924
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Monash University, Level 6, 99 Commercial Rd Melbourne Vic 3004
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Country
130924
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Australia
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Phone
130924
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+61 409730301
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Fax
130924
0
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Email
130924
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
21093
Informed consent form
386966-(Uploaded-30-11-2023-10-17-32)-Study-related document.docx
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF