Curcumin Supplementation as an Add on Treatment for Patients With Inflammatory Bowel Diseases Treated With Vedolizumab
- Conditions
- Inflammatory Bowel Diseases
- Interventions
- Dietary Supplement: CurcuminDietary Supplement: Placebo
- Registration Number
- NCT03500653
- Lead Sponsor
- Henit Yanai
- Brief Summary
Introduction: The pathogenesis of inflammatory bowel diseases (IBD) is characterized by dysregulation of the innate immune response it's associated with Th1, Th17 up-regulation, reflected by increased cytokine secretion including TNF-α. A main effective therapeutic interventions is blocking TNFα. Vedolizumab, an anti integrin, is a new class of treatment designed to block trafficking of lymphocytes in the gut. Clinical trials and real life experience response rates at week 6 range between 30-45%. Curcumin suppresses NFκβ levels via alteration of TLR2/4 pathways lowering TNF-α upstream. Curcumin is safe and efficacious in inducing response and remission in mild-moderate Ulcerative colitis (UC) and maintaining remission when used as an add-on to 5ASA derivatives, only with strict adherence to treatment overtime.
Objectives: Facing the low rate of response to therapies in IBD, the need for new treatments and the use of combination strategies lead us to believe that combining vedolizumab and curcumin may have a synergistic effect and will enable optimal immunomodulation.
Hypothesis: Concomitant oral curcumin in IBD patients with colonic involvement will augment remission rates as well as clinical and biochemical response.
Type of research and methods of data collection: A randomized controlled trial in 84 adults with colonic IBD (UC and CD). Eligible patients are during vedolizumab induction, patients will randomized will be into curcumin or placebo. Data will managed by investigators.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 100
-
Established inflammatory bowel disease
-
Age ≥18 years old
-
At inclusion all patients must have a documented active colonic involvement based on either endoscopy or imaging:
-
Commencing vedolizumab therapy according to the treating physician or on active therapy up to 6-weeks.
-
Active luminal disease:
CD- HBI ≥325, 26 UC- partial Mayo ≥227
-
Evident active disease on endoscopy or imaging within 2-week from inclusion or elevated inflammatory markers at screening (CRP> 0.5 mg/dl, or fecal calprotectin>100 μgr/gr stool or ESR >40).
- CD- isolated small bowel disease (L1) UC- proctitis (E1)
- Perianal disease
- Pregnancy
- Biliary obstruction
- Concomitant treatment with beta blockers, anti-coagulants, and norfloxacin (relative contra indications to curcumin therapy).
- Curcumin supplementations within the last 6 months.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Active Curcumin 4 gr Curcumin daily for 1 year in addition to vedolizumab 300 mg per infusion (standard of care) Sham Placebo 4 gr placebo daily for 1 year in addition to vedolizumab300 mg per infusion (standard of care)
- Primary Outcome Measures
Name Time Method Clinical remission- ulcerative colitis patients 52 weeks Disease activity index - partial Mayo score less than 2
Clinical remission- Crohn's disease patients 52 weeks Crohn's disease patients - disease activity indexe: Harvey Bradshow index (HBI) less that 3
- Secondary Outcome Measures
Name Time Method Biochemical remission 52 weeks C reactive protein (CRP) less thn 0.5 mg/dl
Disease response- Crohn's disease patients 52 weeks Disease activity index- Harvey Bradshow index (HBI ) a drop of 3 points
Disease response- ulcerative colitis patients 52 weeks Disease activity index -partial Mayo score a drop of 2 points
Trial Locations
- Locations (1)
Rabin Medical Center
🇮🇱Petah tikva, Israel