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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT04033809
Other study ID # USM/JEPeM/19010081
Secondary ID
Status Completed
Phase N/A
First received
Last updated
Start date May 30, 2019
Est. completion date December 31, 2019

Study information

Verified date May 2023
Source Universiti Sains Malaysia
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The objective of this study is to evaluate the effect of high fiber multigrain supplementation on the level of clinical disease severity measures, blood inflammatory molecules, and nutritional status changes in RA patients.


Description:

Rheumatoid Arthritis (RA) is a chronic inflammatory, autoimmune rheumatic disease, resulting in progressive joint inflammation and destruction. At present, there is no known cure for this disease. As a consequence of the potential side effects, many RA patients turn to other alternative remedies such as specialised diets and/or dietary supplements in a bid to relieve their symptoms. Therefore, the current study aims to examine the effectiveness of high fiber multigrain supplementation on the level of clinical disease severity measures, blood inflammatory molecules, together with the nutritional status changes in RA patients, as compare with conventional drug treatments.


Recruitment information / eligibility

Status Completed
Enrollment 54
Est. completion date December 31, 2019
Est. primary completion date September 30, 2019
Accepts healthy volunteers No
Gender All
Age group 21 Years to 70 Years
Eligibility Inclusion Criteria: - RA patients according to the American College of Rheumatology (ACR) - Moderate (DAS 28 = 3.2 - 5.1) and severe (DAS 28 > 5.1) RA manifestation - Chronological age: 21 years and above - Stable RA patients who are receiving NSAIDs, glucocorticoids/DMARDs (for example leflunomide, methotrexate, sulfasalazine and hydroxychloroquine) for at least 3 months prior to entering the study - Not taking antioxidant/antiinflammatory supplements (Example of antioxidant: vitamin C, vitamin E, grape seed extract, garlic capsule, ginkgo biloba) (Example of anti-inflammatory supplement: fish oil, curcumin extract, ginger extract, spirulina) Exclusion Criteria: - Having liver (chronic liver failure, cirrhosis, all types of hepatitis), kidney (chronic kidney disease, haemodialysis) or haematological (anaemia, thalassemia, haemophilia) disorders - Active gastric/duodenal ulcer - Psychiatric disease/mental retardation (bipolar disorder, depression, schizophrenia) - Cancer (all types), Diabetes Mellitus (Type I and II), uncontrolled hypertension (BP at 140/90 mmHg for the past 3 months), and endocrine disorders (Cushing's disease, gigantism and hyperthyroidism). - Alcohol and drug abuse (self-mentioned or as recorded in the medical card) - Other autoimmune/inflammatory diseases (systemic lupus erythematosus, multiple sclerosis, gout, psoriasis, chronic inflammatory demyelinating polyneuropathy) - Pregnancy/lactation - Hormone replacement therapy (for at least 3 months prior to entering the study) - Herbal remedies (any parts from the plants such as flowers, rhizome, seeds, roots, leaves, fruits, stems) - Vegetarian patient (pure vegan) - Gluten intolerance - Participations from another supplementary program

Study Design


Related Conditions & MeSH terms


Intervention

Dietary Supplement:
Multigrain powder (S)
A twice daily high fiber multigrain powder supplementation for 12 weeks

Locations

Country Name City State
Malaysia Universiti Sains Malaysia Kubang Kerian Kelantan

Sponsors (1)

Lead Sponsor Collaborator
Universiti Sains Malaysia

Country where clinical trial is conducted

Malaysia, 

Outcome

Type Measure Description Time frame Safety issue
Primary Disease Activity Score-28 (DAS-28) The DAS-28 is a system developed and validated by the EULAR (European League Against Rheumatism) to measure the progress and improvement of Rheumatoid Arthritis. DAS-28 values range from 2.0 to 10.0, while higher values mean a higher disease activity. The complex mathematical calculation is calculated by incorporating the value of erythrocyte sedimentation rate (ESR) and Visual Analog Scale (VAS). ESR (mm/hr) determines the severity of inflammatory response and monitor the effect of treatment. VAS is an indicator for pain intensity and patient global health, and the following cut points have been recommended: no pain (0-4 mm), mild pain (5-44 mm), moderate pain (45-74 mm), and severe pain (75- 100 mm).
DAS-28 = 0.56 * sqrt(tender28) + 0.28 * sqrt(swollen28) + 0.70 * ln(ESR) + 0.014 * GH
The scale categorises RA manifestations as mild (DAS-28: <3.2), moderate (DAS-28: 3.2-5.1) or severe (DAS-28: >5.1)
Baseline and 12 weeks
Primary Health Assessment Questionnaire-Disability Index (HAQ-DI) The HAQ-DI is used to measure physical functionality. The HAQ-DI is usually analyzed by calculating scores. The single scales range from 0 (no difficulty) to 3 (unable to do). The total score ranges from 0-24, and higher score indicates severe disability. Baseline and 12 weeks
Secondary Blood glucose level Blood glucose is measured in mmol/L Baseline and 12 weeks
Secondary Glycated hemoglobin (HbA1c) Glycated hemoglobin (HbA1c) is measured in % Baseline and 12 weeks
Secondary White blood cell (WBC) count White blood cell (WBC) differential count is measured in x10^9/L Baseline and 12 weeks
Secondary Red blood cell (RBC) count Red blood cell (RBC) count is measured in x10^12/L Baseline and 12 weeks
Secondary Hemoglobin (Hb) Hemoglobin (Hb) is measured in g/dl Baseline and 12 weeks
Secondary Hematocrit (Hct) Hematocrit (Hct) is measured in % Baseline and 12 weeks
Secondary Mean corpuscular volume (MCV) Mean corpuscular volume (MCV) is measured in l/cell Baseline and 12 weeks
Secondary Mean corpuscular hemoglobin (MCH) Mean corpuscular hemoglobin (MCH) is measured in g/cell Baseline and 12 weeks
Secondary Platelet (PLT) count Platelet (PLT) count is measured in x10^9/L Baseline and 12 weeks
Secondary Total cholesterol Total cholesterol is measured in mmol/L Baseline and 12 weeks
Secondary Low density lipoprotein (LDL)-cholesterol Low density lipoprotein (LDL)-cholesterol is measured in mmol/L Baseline and 12 weeks
Secondary High density lipoprotein (HDL)-cholesterol High density lipoprotein (HDL)-cholesterol is measured in mmol/L Baseline and 12 weeks
Secondary Triglyceride (Tg) Triglyceride (Tg) is measured in mmol/L Baseline and 12 weeks
Secondary Sodium level Sodium level is measured in mmol/L Baseline and 12 weeks
Secondary Potassium level Potassium level is measured in mmol/L Baseline and 12 weeks
Secondary Chloride level Chloride level is measured in mmol/L Baseline and 12 weeks
Secondary Blood urea nitrogen (BUN) level Blood urea nitrogen (BUN) level is measured in mmol/L Baseline and 12 weeks
Secondary Serum creatinine level Serum creatinine level is measured in umol/L Baseline and 12 weeks
Secondary Calcium level Calcium level is measured in mmol/L Baseline and 12 weeks
Secondary Uric acid level Uric acid level is measured in umol/L Baseline and 12 weeks
Secondary Phosphorus level Phosphorus level is measured in mmol/L Baseline and 12 weeks
Secondary Albumin Albumin is measured in g/L Baseline and 12 weeks
Secondary Total protein Total protein is measured in g/L Baseline and 12 weeks
Secondary Total bilirubin Total bilirubin is measured in umol/L Baseline and 12 weeks
Secondary Alkaline phosphatase (ALP) Alkaline phosphatase (ALP) is measured in U/L Baseline and 12 weeks
Secondary Alanine transaminase (ALT) Alanine transaminase (ALT) is measured in U/L Baseline and 12 weeks
Secondary Aspartate transaminase (AST) Aspartate transaminase (AST) is measured in U/L Baseline and 12 weeks
Secondary Serum interleukin-6 (IL-6) Interleukin-6 (IL-6) is a pleiotropic cytokine with a pivotal role in the pathophysiology of rheumatoid arthritis. The level correlates with the disease activity and joint destruction. Serum IL-6 is measured in pg/ml Baseline and 12 weeks
Secondary Serum interleukin 1ß (IL-1ß) Interleukin 1ß is among the most important proin?ammatory cytokines in rheumatoid arthritis. Serum IL-1ß is measured in pg/ml Baseline and 12 weeks
Secondary Tumor necrosis factor-alpha (TNF-a) Tumor necrosis factor-alpha (TNF-a) is a proinflammatory cytokine that plays a pivotal role in regulating the inflammatory response in rheumatoid arthritis. Serum IL-1ß is measured in pg/ml Baseline and 12 weeks
Secondary High sensitivity-C-Reactive Protein (hs-CRP) High sensitivity-C-Reactive Protein (hs-CRP) is a disease activity marker in rheumatoid arthritis. Serum hs-CRP is measured in pg/ml Baseline and 12 weeks
Secondary Serum matrix metalloproteinase-3 (MMP-3) MMP-3 is increased in rheumatoid arthritis, and has been proposed as a marker of joint damage and systemic inflammation. Serum MMP-3 is measured in ng/ml Baseline and 12 weeks
Secondary Body mass index (BMI) Body weight (in kilograms) and standing height (in meters) will be measured to indicate nutritional status. The weight and height will be combined to report BMI in kg/m^2 12 weeks
Secondary Waist hip ratio Waist (in cm) and hip (in cm) circumferences will be measured to indicate obesity. This is calculated as waist measurement divided by hip measurement. 12 weeks
Secondary Body fat Body fat is measured in % Baseline and 12 weeks
Secondary Fat mass Fat mass is measured in % Baseline and 12 weeks
Secondary Fat free mass Fat free mass is measured in % Baseline and 12 weeks
Secondary Total body water Total body water is measured in L Baseline and 12 weeks
Secondary Estimated average required energy Estimated average required energy is measured in kcal Baseline and 12 weeks
Secondary Tolerability assessment The participant's complaints of gastrointestinal discomfort upon supplement consumption such as heart burn, diarrhea, nausea, vomiting and headache will be recorded, and it will be reported as the frequency (n) of discomfort episodes. At 4 weeks, 8 weeks and 12 weeks
Secondary Compliance assessment Remaining sachet counting: The remaining sachet/unfinished sachet will be counted, and compliance will be reported as %. At 4 weeks, 8 weeks and 12 weeks
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