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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03183076
Other study ID # F2016-1301-72
Secondary ID
Status Completed
Phase N/A
First received May 31, 2017
Last updated June 8, 2017
Start date September 1, 2015
Est. completion date December 30, 2016

Study information

Verified date May 2017
Source Instituto Mexicano del Seguro Social
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The Atkins Diet Modified (ADM) is the best alternative treatment for drug-resistant epilepsy, There is a high prevalence worldwide , especially in Latin American countries, including Mexico.

Low income earners, many of which do not have a social security, must meet the high costs by Antiepileptic Drugs (AEDS), which in addition should be used in conjunction or combination therapy, because monotherapy is insufficient .

The diet adkins makes some changes in the traditional food habits by others that are accessible and not necessarily expensive, whose mechanism allows for better control of the seizures.


Description:

Objective: To assess the efficacy, tolerability and adherence of the modified adkins diet in adult patients with drug-resistent epilepsy Materials and Methods: Clinical trial, made up of patients with drug-resistent epilepsy, selected by convenience, who will be handled pharmacologically with the standard treatment of this condition for a period of not less than 6 months, after which they will be treated with adkins diet modified, prior informed consent, to establish its effect and a comparative analysis later.

The objective of this work is to analyze the efficacy, tolerability and adherence of the modified atkins diet in adult patients with drug-resistant epilepsy.


Recruitment information / eligibility

Status Completed
Enrollment 14
Est. completion date December 30, 2016
Est. primary completion date April 30, 2016
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria:

- Minimum age of 18 years

- Patients that meet the criteria of drug-resistant epilepsy

- Patients treated with Rational polytherapy, a minimum of 6 months, with no changes in their drug refractory condition.

- Patients with drug- resistant epilepsy with informed consent signed by themselves and their proxy.

- Patients with drug-resistant epilepsy of any etiology, except tumor, metabolic, degenerative or progressive.

Exclusion Criteria:

- Patients with drug-resistant epilepsy simultaneous alternate treatment to the Atkins Diet modified.

- Patients with a neurological entity progressive and fatal

- Patients with congenital diseases and difficulty to metabolize fats or that require high amounts of carbohydrates in the diet.

Study Design


Intervention

Other:
modified adkins diet
Patients were assigned to two groups, one of them received modified adkins diet for treatment of drug-resistant epilepsy. It consists in the free intake of proteins and fats, and the restriction of carbohydrates that are gradually being installed. Its mechanism of action that induces a state of ketosis
Drug:
Pharmacotherapy without diet
Patients were assigned to two groups, one of them received conventional treatment with antiepileptic drugs without a special diet

Locations

Country Name City State
Mexico Western Medical Center, Mexican Institute of Social Security Guadalajara Jalisco

Sponsors (1)

Lead Sponsor Collaborator
Instituto Mexicano del Seguro Social

Country where clinical trial is conducted

Mexico, 

References & Publications (29)

Arroyo S. [Evaluation of drug-resistant epilepsy]. Rev Neurol. 2000 May 1-15;30(9):881-6. Review. Spanish. — View Citation

Benbadis SR, Tatum WO, Vale FL. When drugs don't work: an algorithmic approach to medically intractable epilepsy. Neurology. 2000 Dec 26;55(12):1780-4. Review. — View Citation

Berg AT, Kelly MM. Defining intractability: comparisons among published definitions. Epilepsia. 2006 Feb;47(2):431-6. — View Citation

Brodie MJ, Kwan P. Staged approach to epilepsy management. Neurology. 2002 Apr 23;58(8 Suppl 5):S2-8. — View Citation

Callaghan BC, Anand K, Hesdorffer D, Hauser WA, French JA. Likelihood of seizure remission in an adult population with refractory epilepsy. Ann Neurol. 2007 Oct;62(4):382-9. — View Citation

Devinsky O. Patients with refractory seizures. N Engl J Med. 1999 May 20;340(20):1565-70. Review. — View Citation

Duncan JS. The outcome of epilepsy surgery. J Neurol Neurosurg Psychiatry. 2001 Apr;70(4):432. — View Citation

Fisher RS, van Emde Boas W, Blume W, Elger C, Genton P, Lee P, Engel J Jr. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia. 2005 Apr;46(4) — View Citation

Freeman J, Veggiotti P, Lanzi G, Tagliabue A, Perucca E; Institute of Neurology IRCCS C. Mondino Foundation. The ketogenic diet: from molecular mechanisms to clinical effects. Epilepsy Res. 2006 Feb;68(2):145-80. — View Citation

Gomez-Alonso J, Giraldez BG. [Epilepsy: a new definition for an old disease]. Rev Neurol. 2007 Jul 16-31;45(2):126-7. Spanish. — View Citation

Hauser WA. The natural history of drug resistant epilepsy: epidemiologic considerations. Epilepsy Res Suppl. 1992;5:25-8. Review. — View Citation

Hefft S, Jonas P. Asynchronous GABA release generates long-lasting inhibition at a hippocampal interneuron-principal neuron synapse. Nat Neurosci. 2005 Oct;8(10):1319-28. Epub 2005 Sep 11. — View Citation

Hestrin S, Galarreta M. Synchronous versus asynchronous transmitter release: a tale of two types of inhibitory neurons. Nat Neurosci. 2005 Oct;8(10):1283-4. — View Citation

Huttenlocher PR, Wilbourn AJ, Signore JM. Medium-chain triglycerides as a therapy for intractable childhood epilepsy. Neurology. 1971 Nov;21(11):1097-103. — View Citation

Kossoff EH, Zupec-Kania BA, Amark PE, Ballaban-Gil KR, Christina Bergqvist AG, Blackford R, Buchhalter JR, Caraballo RH, Helen Cross J, Dahlin MG, Donner EJ, Klepper J, Jehle RS, Kim HD, Christiana Liu YM, Nation J, Nordli DR Jr, Pfeifer HH, Rho JM, Stafstrom CE, Thiele EA, Turner Z, Wirrell EC, Wheless JW, Veggiotti P, Vining EP; Charlie Foundation, Practice Committee of the Child Neurology Society; Practice Committee of the Child Neurology Society; International Ketogenic Diet Study Group. Optimal clinical management of children receiving the ketogenic diet: recommendations of the International Ketogenic Diet Study Group. Epilepsia. 2009 Feb;50(2):304-17. doi: 10.1111/j.1528-1167.2008.01765.x. Epub 2008 Sep 23. — View Citation

Kwan P, Arzimanoglou A, Berg AT, Brodie MJ, Allen Hauser W, Mathern G, Moshé SL, Perucca E, Wiebe S, French J. Definition of drug resistant epilepsy: consensus proposal by the ad hoc Task Force of the ILAE Commission on Therapeutic Strategies. Epilepsia. — View Citation

Kwan P, Brodie MJ. Definition of refractory epilepsy: defining the indefinable? Lancet Neurol. 2010 Jan;9(1):27-9. doi: 10.1016/S1474-4422(09)70304-7. Epub 2009 Nov 13. — View Citation

Kwan P, Brodie MJ. Early identification of refractory epilepsy. N Engl J Med. 2000 Feb 3;342(5):314-9. — View Citation

Lefevre F, Aronson N. Ketogenic diet for the treatment of refractory epilepsy in children: A systematic review of efficacy. Pediatrics. 2000 Apr;105(4):E46. Review. — View Citation

Marson AG, Appleton R, Baker GA, Chadwick DW, Doughty J, Eaton B, Gamble C, Jacoby A, Shackley P, Smith DF, Tudur-Smith C, Vanoli A, Williamson PR. A randomised controlled trial examining the longer-term outcomes of standard versus new antiepileptic drugs — View Citation

Martínez-Juárez IE, López-Zapata R, Gómez-Arias B, Bravo-Armenta E, Romero-Ocampo L, Estévez-Cruz Z, Hernández-De la Cruz G, Morán-Molina S. [Refractory epilepsy: use of the new definition and related risk factors. A study in the Mexican population of a t — View Citation

Panico LR, Demartini MG, Ríos VG, Carniello MA. [The ketogenic diet in infantile refractory epilepsy: electroclinical response, complications and secondary effects]. Rev Neurol. 2000 Aug 1-15;31(3):212-20. Spanish. — View Citation

Panico LR, Ríos VG, Demartini MG, Carniello MA. [The electroencephalographic evolution of a group of patients on a ketonic diet]. Rev Neurol. 2000 Jan 1-15;30(1):8-15. Spanish. — View Citation

Proposal for revised classification of epilepsies and epileptic syndromes. Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia. 1989 Jul-Aug;30(4):389-99. — View Citation

Sánchez-Alvarez JC, Serrano-Castro P, Cañadillas-Hidalgo F. [Refractory epilepsy in adults]. Rev Neurol. 2002 Nov 16-30;35(10):931-53. Review. Spanish. — View Citation

Serrano Castro PJ, Sánchez Alvarez JC. [Controversies about the new anti-epileptic drugs]. Rev Neurol. 2001 Jan 16-31;32(2):165-71. Review. Spanish. — View Citation

Shorvon SD. The epidemiology and treatment of chronic and refractory epilepsy. Epilepsia. 1996;37 Suppl 2:S1-S3. Review. — View Citation

Vicente-Hernández M, Garcia-Garcia P, Gil-Nagel A, Lopez-Munoz F, Alamo C. [Therapeutic approach to epilepsy from the nutritional view: current status of dietary treatment]. Neurologia. 2007 Oct;22(8):517-25. Review. Spanish. — View Citation

Yudkoff M, Daikhin Y, Melø TM, Nissim I, Sonnewald U, Nissim I. The ketogenic diet and brain metabolism of amino acids: relationship to the anticonvulsant effect. Annu Rev Nutr. 2007;27:415-30. Review. — View Citation

* Note: There are 29 references in allClick here to view all references

Outcome

Type Measure Description Time frame Safety issue
Primary Frequency of epileptic seizures Frequency of epileptic seizures measured according to the clinical criteria of therapeutic evaluation of Huttenlocher 3 months
Secondary Therapeutic response observed in electroencephalogram Panic electroencephalographic criteria on the therapeutic response. Having regard to the standardization, improvement or worsening of the crisis in the electroencephalogram 3 months
Secondary Measurement of quality of life and decrease in seizures Interrogate the patient with a questionnaire of refractory epilepsy drugs. And ask to the patient with this questionnaire if improved their quality of life and have decreased seizures after using the atkins diet modified. 3 months
Secondary Blood tests (Hematic biometry) Take this blood test to assess the general conditions of the patient and see their levels of hemoglobin, hematocrit, leukocyte and platelet count. 3 months
Secondary Blood chemistry (serum electrolytes) It will evaluate the general condition of the patient and with this test rule out the presence of electrolyte imbalance 3 months
Secondary liver function tests Will be evaluated with this test levels of transaminases as can be raised by treatment anticonvulsant and see if there are any changes with the changes in the diet of patients 3 months
Secondary ketonuria It will assess the levels of ketones in urine due to the change in the diet of patients with the Atkins diet 3 months
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