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Treatment With Specific Carbohydrate Diet in Children With Juvenile Idiopathic Arthritis

Not Applicable
Conditions
Juvenile Idiopathic Arthritis
Interventions
Other: Specific carbohydrate diet
Registration Number
NCT04205500
Lead Sponsor
Uppsala University
Brief Summary

The aim of this study is to explore if an already established diet with anti-inflammatory effect in paediatric inflammatory bowel disease would have an anti-inflammatory effect in children with JIA. The diet is called specific carbohydrate diet.

Detailed Description

Children classified with JIA, in a low-to-medium disease activity and without having changed DMARD or bDMARD in the last 12 weeks are included. Only motivated children and parents can participate. Before inclusion the family are informed orally about the study plan, the diet and practical issues regarding the study and they receive written information including for example a product list and a recipe booklet. A dietician and the principal investigator follows the child and parents during visits, by mail and phone. After the baseline visit, the family has two weeks to get used to the new diet. At baseline, after two, four and twelve weeks on the diet the child is examined, blood exams are performed and blood is stored at -70, fecal samples and urine is also collected. At inclusion and after four weeks saliva sample for bacteria is collected. The child fills in the child health assessment questionnaire, (CHAQ) for a score of the physical ability and DisabKids for an overall assessment of the childs well-being.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Participants should fulfill criteria for JIA according to the ILAR criteria
  • Participants should not be older than 16 years at onset of disease
  • Participants should have a low-medium disease activity with an E-SR of 30 at the most and/or no more than two active joints at inclusion.
  • DMARD and bDMARD should not have been changed within the last 12 weeks before inclusion.
  • Any gastro- intestinal complaints should be investigated before inclusion.
  • Fecal calprotectin should be normal.
  • The child as well as the parents need to be motivated for the child to try a dietary intervention for at least four weeks, preferably longer.

Exclusion criteria:

  • Children with the systemic category of JIA.
  • Children with an unstable inflammatory situation with > 2 inflamed joints and/or an E-SR of more than 30.
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Children with juvenile idiopathic arthritisSpecific carbohydrate dietThe specific carbohydrate diet has been shown to have beneficial effects on IBD and has been implemented in Seattle Children's IBD centre, with some patients using SCD either as primary or complementary therapy. The SCD is a nutritionally balanced diet focused on removing many complex carbohydrates such as grains, dairy products except for yoghurt fermented over 24 hours, vegetables rich in starch and sugars except for monosaccharides like in honey. Participants can eat meat but since it has to be unprocessed food the investigator's experience is that the amounts of meat are not very big. Fish, eggs, sea-food is allowed. Bread is baked from nut and almond flour.
Primary Outcome Measures
NameTimeMethod
Change in number of inflamed jointsAt baseline compared to four weeks of intervention

Physical examination

Change in assessment of pain: visual analogue scaleAt baseline compared to four weeks of intervention

Global assessment visual analogue scale (VAS) for Pain, min-max, 0-10 cm. A higher score means more pain

Change in overall well-beingAt baseline compared to four weeks of intervention

Global assessment visual analogue scale (VAS), for the patient min-max, 0-10 cm. A higher score means worse overall well-being

Change in assessment of morning stiffnessAt baseline compared to four weeks of intervention

Number of minutes

Change in CHAQ, child health assessment questionnaireAt baseline compared to four weeks of intervention

A questionnaire for assessment of physical function, min-max, 0-3. A higher score means worse physical function

Secondary Outcome Measures
NameTimeMethod
Change in Microbiota in fecal samplesAt baseline compared to four weeks of intervention

16sSrRNA and Metagenomics

Change in Short chain fatty acids in fecal samplesAt baseline compared to four weeks of intervention

Analysed, using a HPLC-machine, Agilent technology 1100-series, presented in mg/gr

Trial Locations

Locations (1)

Unit of Pediatric Rheumatology, Akademiska hospital

πŸ‡ΈπŸ‡ͺ

Uppsala, Sweden

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