Clinical Trials Logo

Clinical Trial Details — Status: Not yet recruiting

Administrative data

NCT number NCT05439135
Other study ID # DELIV2022N002
Secondary ID
Status Not yet recruiting
Phase N/A
First received
Last updated
Start date July 1, 2022
Est. completion date July 1, 2023

Study information

Verified date June 2022
Source The Second Hospital of Nanjing Medical University
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This is a prospective, randomized, multicenter study to evaluate WMT in improving nutritional status in malnourished patients who underwent upper gastrointestinal rerouting surgery. In this multicenter trial, fifty-six patients will be enrolled in four Chinese sites. Participants will be randomized at a ratio of 1:1 to receive three WMTs through either mid-gut tube or colonic TET. After WMT, each participant will receive free diet plus 50% PEN. PEN should last for 4 weeks at home, with stool samples taken and stored at baseline, week 1, and 4 after WMT.


Description:

Background: Malnutrition is a common complication of upper gastrointestinal rerouting surgery. The potential of washed microbiota transplantation (WMT) in improving nutritional status have been reported. The surgery procedure alters the anatomy and physiology of the digestive tract, which might impact the efficacy and safety of WMT when choosing different delivery way. This study aims to explore the optimal delivery of WMT in malnourished patients after rerouting of the upper gastrointestinal tract. Methods and design: This multicenter, open-label, and randomized controlled trial will be conducted at four tertiary hospitals in China. Enteral nutrition (EN) will be administrated at enrollment. Participants will be then randomized at a ratio of 1:1 to receive three WMTs through either mid-gut tube or colonic transendoscopic enteral tubing (TET). Then the patients will receive free diet coupled with partial enteral nutrition (PEN) for 4 weeks in both groups, with stool samples taken and stored at baseline, week 1, and 4 after WMT. The observation duration is 4 weeks. The primary outcomes include clinical response rate (serum albumin ≥ 35 g/L at week 4 after WMT) and clinical remission rate (body mass index increased by 5% at week 4 after WMT). The secondary outcomes include nutritional status, appetite, laboratory parameters, adverse events and comprehensive analysis of the fecal microbiota. Conclusion: It is estimated that WMT would help relieve emaciation and improve nutrition status. Moreover, this trial has the potential to identify the optimal delivery of WMT for patients undergoing upper gastrointestinal rerouting surgery.


Recruitment information / eligibility

Status Not yet recruiting
Enrollment 56
Est. completion date July 1, 2023
Est. primary completion date June 1, 2023
Accepts healthy volunteers No
Gender All
Age group 18 Years to 65 Years
Eligibility Inclusion Criteria: - Patients undergone upper gastrointestinal rerouting surgery (Billroth-II or Roux-en-Y reconstruction); - Aged between 18 and 65 years old; - Weight loss > 5% over past 6 months (in absence of simple starvation) or weight loss > 2% in those who have a BMI < 20; - 20 g/L = Albumin < 30 g/L; - Malnutrition as assessed by NRS2002 score = 3; - Written informed consent. Exclusion Criteria: - Expected survival time < 3 months; - Known organic gastrointestinal disease (e.g., gastrointestinal infection, inflammatory bowel disease, or radiation enteritis); - Still on anti-tumor therapy (chemotherapy, radiotherapy, immunotherapy); - Taking Antibiotics within four weeks before enrollment; - Complicated with contraindications of EN such as ileus, active gastrointestinal bleeding, and shock; - Cannot tolerate gastroscopy or colonoscopy; - Severe comorbidities (e.g., diabetes, cardiopulmonary failure, severe liver or kidney diseases); - Food intolerance; - Mental disorder; - Women who are pregnant or breastfeeding; - Participating in another clinical trial.

Study Design


Related Conditions & MeSH terms


Intervention

Other:
washed microbiota transplantation
Each patient will receive two units of washed microbiota each day for three consecutive days. After WMT, participants will receive free diet plus 50% PEN (providing 50% calculated energy requirement) at home for 4 weeks.

Locations

Country Name City State
China Medical Center for Digestive Diseases, Second Affiliated Hospital of Nanjing Medical University Nanjing Jiangsu

Sponsors (4)

Lead Sponsor Collaborator
The Second Hospital of Nanjing Medical University Sir Run Run Hospital, Nanjing Medical University, The First Affiliated Hospital of Guangdong Pharmaceutical University, Wuxi No. 2 People's Hospital

Country where clinical trial is conducted

China, 

References & Publications (6)

Csendes A, Burgos AM, Smok G, Burdiles P, Braghetto I, Díaz JC. Latest results (12-21 years) of a prospective randomized study comparing Billroth II and Roux-en-Y anastomosis after a partial gastrectomy plus vagotomy in patients with duodenal ulcers. Ann Surg. 2009 Feb;249(2):189-94. doi: 10.1097/SLA.0b013e3181921aa1. — View Citation

Levine A, Wine E, Assa A, Sigall Boneh R, Shaoul R, Kori M, Cohen S, Peleg S, Shamaly H, On A, Millman P, Abramas L, Ziv-Baran T, Grant S, Abitbol G, Dunn KA, Bielawski JP, Van Limbergen J. Crohn's Disease Exclusion Diet Plus Partial Enteral Nutrition Induces Sustained Remission in a Randomized Controlled Trial. Gastroenterology. 2019 Aug;157(2):440-450.e8. doi: 10.1053/j.gastro.2019.04.021. Epub 2019 Jun 4. — View Citation

Nishizaki D, Ganeko R, Hoshino N, Hida K, Obama K, Furukawa TA, Sakai Y, Watanabe N. Roux-en-Y versus Billroth-I reconstruction after distal gastrectomy for gastric cancer. Cochrane Database Syst Rev. 2021 Sep 15;9:CD012998. doi: 10.1002/14651858.CD012998.pub2. Review. — View Citation

Peng Z, Xiang J, He Z, Zhang T, Xu L, Cui B, Li P, Huang G, Ji G, Nie Y, Wu K, Fan D, Zhang F. Colonic transendoscopic enteral tubing: A novel way of transplanting fecal microbiota. Endosc Int Open. 2016 Jun;4(6):E610-3. doi: 10.1055/s-0042-105205. Epub 2016 Apr 28. — View Citation

Xiang L, Yu Y, Ding X, Zhang H, Wen Q, Cui B, Zhang F. Exclusive Enteral Nutrition Plus Immediate vs. Delayed Washed Microbiota Transplantation in Crohn's Disease With Malnutrition: A Randomized Pilot Study. Front Med (Lausanne). 2021 Oct 22;8:666062. doi: 10.3389/fmed.2021.666062. eCollection 2021. — View Citation

Zhang F, Luo W, Shi Y, Fan Z, Ji G. Should we standardize the 1,700-year-old fecal microbiota transplantation? Am J Gastroenterol. 2012 Nov;107(11):1755; author reply p.1755-6. doi: 10.1038/ajg.2012.251. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Clinical response rate serum albumin = 35 g/L week 4 after WMT
Primary Clinical remission rate body mass index (BMI) increased by 5% (weight and height will be combined to report BMI in kg/m^2) week 4 after WMT
See also
  Status Clinical Trial Phase
Completed NCT04448041 - CRANE Feasibility Study: Nutritional Intervention for Patients Undergoing Cancer Surgery in Low- and Middle-Income Countries
Completed NCT03268902 - Early Life Interventions for Childhood Growth and Development In Tanzania Phase 2/Phase 3
Active, not recruiting NCT04746664 - Effects of Nutrition Counselling on Old Age People's Nutritional Status and Quality of Life in Bahir Dar City, North West Ethiopia N/A
Completed NCT04608656 - Livestock for Health Project N/A
Completed NCT06009198 - Nutritional, and WASH Related Education Intervention to Address Malnutrition of Early Adolescents in Pakistan N/A
Recruiting NCT05417672 - Assessment of Relationship Between Preoperative Nutritional Status and Perioperative/Postoperative Conditions in Patients With Lung Cancer Scheduled for Lobectomy
Recruiting NCT05257980 - Evaluation of Four New Ready to Drink Oral Nutritional Supplements: Adult ONS Trial N/A
Completed NCT05015647 - Low Protein Diet in CKD Patients at Risk of Malnutrition N/A
Completed NCT03628196 - A Nutrition-Focused QIP in Outpatient Clinics
Enrolling by invitation NCT04675229 - Extending the Validation of SCREEN to Persons Living With Dementia or in Retirement Homes
Recruiting NCT04627376 - Multimodal Program for Cancer Related Cachexia Prevention N/A
Not yet recruiting NCT05860556 - Sustainable Eating Pattern to Limit Malnutrition in Older Adults
Not yet recruiting NCT06047054 - Incidence Rate and Risk Factors of Malnutrition in ICU
Not yet recruiting NCT04398836 - Preoperative Nutrition for Crohn's Disease Patients Phase 3
Not yet recruiting NCT04183075 - Impact of a Nutritional Supplement on the Recovery of the Nutritional Status of Patients With Spontaneous Hip Fracture N/A
Not yet recruiting NCT03150927 - Clinical Study of Novel Probiotic Microbial Composite™ to Treat Undernourished Young Children N/A
Recruiting NCT03408067 - Evaluation of the Efficacy of Nutritional Risk Screening Tests, NRS 2002 and SGA, to Identifying Malnourished Patients N/A
Recruiting NCT02833740 - Comparing Performance of Simplified Mid-Upper Arm Circumference Devices ("Click-MUACs") to Detect Acute Malnutrition N/A
Completed NCT02938247 - Tolerance and Compliance of a High Caloric, High Protein Oral Nutritional Supplement - Scheduled Intake N/A
Completed NCT02938234 - Tolerance and Compliance of a High Caloric, High Protein Oral Nutritional Supplement - Free Intake N/A