Celiac Disease Clinical Trial
Official title:
A Prospective Trial of Celiac Disease Screening
The purpose of this study is to see if it makes sense to test people for celiac disease who have a first or second degree relative (parent, sibling, child, grandparent, aunt or uncle) with celiac disease. The investigators will check to see what differences there are in the health and quality of life between those who know they have celiac disease and start the gluten free diet and those who do not.
Our overall hypothesis is that first and second degree relatives of individuals with celiac
disease benefit from screening and diagnosis of celiac disease. Secondary hypotheses are:
1. The number needed to test and cost to benefit one person though celiac disease screening
are within acceptable ranges of 33 tested and < $10,000 spent.
2. Treatment does not lead to adverse metabolic changes.
3. Intestinal biopsy is unnecessary for accurate diagnosis in a substantial subset of
adults.
Aim 1. Determine the effect of screen detected celiac disease on health related quality of
life.
- Evaluate change in health related quality of life at one year in participants randomized
to the screen detected, early diagnosis cohort compared to the screen detected, delayed
diagnosis, clinically detected and non-celiac control cohorts.
- Evaluate change in symptoms, psychological well-being and burden of treatment at one
year in the screen detected, early diagnosis cohort compared to the screen detected,
delayed diagnosis, clinically detected and non-celiac control cohorts.
- Evaluate the cost per diagnosis and the number needed to test for the diagnosis of
individuals who will have a clinically meaningful improvement in health related quality
of life attributable to treatment of celiac disease.
Aim 2: Assess the effect of screen detected celiac disease on nutritional and metabolic
indices.
- Compare changes bone density, body mass index, Reynolds Cardiovascular Risk Score, and
nutritional indices at one year in the screen detected, early diagnosis cohort compared
to the screen detected, delayed diagnosis, clinically detected and non-celiac control
cohorts.
Aim 3: Evaluate the reliability of using serologic tests in combination with intestinal fatty
acid binding protein vs. intestinal biopsy to confirm celiac disease diagnosis in adults.
- Prospectively assess the sensitivity and specificity of a novel non-invasive celiac
diagnostic algorithm in comparison to the current gold standard of small intestinal
biopsy histology.
- Model the cost of modified, non-invasive celiac testing vs. classical testing with
endoscopic biopsy in both screen-detected and clinically identified celiac disease.
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