OC-003 No clinical benefit of prebiotics in the treatment of active Crohn's disease: a double-blind, randomised, placebo-controlled trial
IntroductionThe intestinal microbiota drive inflammation associated with Crohn's disease.1 The composition of the intestinal microbiota can be influenced by prebiotic's such as fructo-oligosaccharides (FOS). Preliminary data suggest that FOS can increase colonic bifidobacteria and induce i...
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| Veröffentlicht in: | Gut 2010-04, Vol.59 (Suppl 1), p.A1-A2 |
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| description | IntroductionThe intestinal microbiota drive inflammation associated with Crohn's disease.1 The composition of the intestinal microbiota can be influenced by prebiotic's such as fructo-oligosaccharides (FOS). Preliminary data suggest that FOS can increase colonic bifidobacteria and induce immunoregulatory dendritic cell (DC) epithelial responses.2MethodsTo assess the impact of a diet supplemented with FOS in patients with active Crohn's disease using an appropriately powered randomised, double-blind, placebo-controlled trial. Patients with active Crohn's disease (CDAI ≥ 220, plus one marker of inflammation) were randomised to receive 15 g/day FOS or placebo for 4 weeks. The primary endpoint was clinical response at week 4 (change in CDAI of −70 in the intention-to-treat (ITT) population). Multiple pre-specified secondary endpoints were analysed, including intracellular cytokine staining assessed by flow cytometry (n=27).ResultsIn total, 103 patients were randomised to receive FOS (n=54) or placebo (n=49). The mean (SD) baseline CDAI was 283 (61.1) and 286 (61.5) in the FOS and placebo groups, respectively (p=0.79). Significantly more patients receiving FOS (n=14.26%) than placebo (n=4.8%) withdrew before the 4-week endpoint (p=0.018). There was no significant clinical benefit of FOS compared to placebo (Abstract 003). Patients receiving FOS, but not placebo, had a reduced proportion of IL-6+ intestinal DC, and increased DC staining of IL-10 (both p |
| doi_str_mv | 10.1136/gut.2009.208934c |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2043356132</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2043356132</sourcerecordid><originalsourceid>FETCH-LOGICAL-b1522-a5b091be5a9fc2e0b98b27e30e25d297a11a4bac516b02c2dd180aa5eada0ad13</originalsourceid><addsrcrecordid>eNqFkD1PwzAQhi0EEqWwM1piYIDA2U7ahA1VfEkIFpijs30BV2lcbBeJjYWJf8kvwVB2lruT3o-THsb2BZwIoSanT6t0IgGaPOpGlWaDjUQ5qQsl63qTjQDEtKimZbPNdmKcA0BdN2LEPu9nBYD6ev-489z0bnAGe65poM4l7ju-DKSdT85E7gaenomnQJgWNPzKaJJ7JT4L_nk4jNy6SBjpjCO3fqV7KnTutMc84GD9Iqv5XvZoSPvC-CEF3_dkc6fDfpdtddhH2vvbY_Z4efEwuy5u769uZue3hRaVlAVWGhqhqcKmM5JAN7WWU1JAsrKymaIQWGo0lZhokEZaK2pArAgtAlqhxuxg3bsM_mVFMbVzvwpDftlKKJWqJkLJ7IK1ywQfY6CuXQa3wPDWCmh_kLcZefuDvP1DniNH64hezP93fwNzt4SX</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2043356132</pqid></control><display><type>article</type><title>OC-003 No clinical benefit of prebiotics in the treatment of active Crohn's disease: a double-blind, randomised, placebo-controlled trial</title><source>BMJ Journals - NESLi2</source><source>PubMed Central</source><creator>Benjamin, J L ; Hedin, C R H ; Koutsoumpas, A ; Ng, S C ; Hart, A L ; Kamm, M A ; Sanderson, J D ; Knight, S C ; Forbes, A ; Stagg, A J ; Whelan, K ; Lindsay, J O</creator><creatorcontrib>Benjamin, J L ; Hedin, C R H ; Koutsoumpas, A ; Ng, S C ; Hart, A L ; Kamm, M A ; Sanderson, J D ; Knight, S C ; Forbes, A ; Stagg, A J ; Whelan, K ; Lindsay, J O</creatorcontrib><description>IntroductionThe intestinal microbiota drive inflammation associated with Crohn's disease.1 The composition of the intestinal microbiota can be influenced by prebiotic's such as fructo-oligosaccharides (FOS). Preliminary data suggest that FOS can increase colonic bifidobacteria and induce immunoregulatory dendritic cell (DC) epithelial responses.2MethodsTo assess the impact of a diet supplemented with FOS in patients with active Crohn's disease using an appropriately powered randomised, double-blind, placebo-controlled trial. Patients with active Crohn's disease (CDAI ≥ 220, plus one marker of inflammation) were randomised to receive 15 g/day FOS or placebo for 4 weeks. The primary endpoint was clinical response at week 4 (change in CDAI of −70 in the intention-to-treat (ITT) population). Multiple pre-specified secondary endpoints were analysed, including intracellular cytokine staining assessed by flow cytometry (n=27).ResultsIn total, 103 patients were randomised to receive FOS (n=54) or placebo (n=49). The mean (SD) baseline CDAI was 283 (61.1) and 286 (61.5) in the FOS and placebo groups, respectively (p=0.79). Significantly more patients receiving FOS (n=14.26%) than placebo (n=4.8%) withdrew before the 4-week endpoint (p=0.018). There was no significant clinical benefit of FOS compared to placebo (Abstract 003). Patients receiving FOS, but not placebo, had a reduced proportion of IL-6+ intestinal DC, and increased DC staining of IL-10 (both p<0.05). No effect on DC IL-12 was seen. Throughout the intervention patients receiving FOS had a significantly greater severity of flatulence (FOS mean 10.8, SD 5.7 vs placebo 7.3, 3.6, p=0.004) and rumbling gut (mean 8.3, SD 5.0 vs 6.1, 4.1, p=0.029) compared with placebo.ConclusionAn adequately powered trial of a diet supplemented with FOS in a well defined population of patients with active Crohn's disease showed no clinical benefit despite impacting on DC immunology. Patient withdrawal was greater in patients receiving FOS. Abstract OC-003Clinical resultsFOSPlacebop ValueResponse, n (%) intention-to-treat12 (22)19 (39)0.067Per protocol, n (%)12 (30)19 (42)0.243Remission, n (%) intention-to-treat6 (11)10 (20)0.193Per protocol, n (%)6 (15)10 (22)0.395Change in calprotectin, mean (SD)62 (301)296 (494)0.092</description><identifier>ISSN: 0017-5749</identifier><identifier>EISSN: 1468-3288</identifier><identifier>DOI: 10.1136/gut.2009.208934c</identifier><language>eng</language><publisher>London: BMJ Publishing Group LTD</publisher><subject>Clinical trials ; Crohn's disease ; Dendritic cells ; Diet ; Flow cytometry ; Immunoregulation ; Interleukin 10 ; Interleukin 12 ; Interleukin 6 ; Intestinal microflora ; Intestine ; Microbiota ; Motivation ; Oligosaccharides ; Patients ; Remission</subject><ispartof>Gut, 2010-04, Vol.59 (Suppl 1), p.A1-A2</ispartof><rights>2010, Published by the BMJ Publishing Group Limited For permission to use, (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright: 2010 © 2010, Published by the BMJ Publishing Group Limited For permission to use, (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b1522-a5b091be5a9fc2e0b98b27e30e25d297a11a4bac516b02c2dd180aa5eada0ad13</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://gut.bmj.com/content/59/Suppl_1/A1.3.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttp://gut.bmj.com/content/59/Suppl_1/A1.3.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,776,780,3183,23550,27901,27902,77569,77600</link.rule.ids></links><search><creatorcontrib>Benjamin, J L</creatorcontrib><creatorcontrib>Hedin, C R H</creatorcontrib><creatorcontrib>Koutsoumpas, A</creatorcontrib><creatorcontrib>Ng, S C</creatorcontrib><creatorcontrib>Hart, A L</creatorcontrib><creatorcontrib>Kamm, M A</creatorcontrib><creatorcontrib>Sanderson, J D</creatorcontrib><creatorcontrib>Knight, S C</creatorcontrib><creatorcontrib>Forbes, A</creatorcontrib><creatorcontrib>Stagg, A J</creatorcontrib><creatorcontrib>Whelan, K</creatorcontrib><creatorcontrib>Lindsay, J O</creatorcontrib><title>OC-003 No clinical benefit of prebiotics in the treatment of active Crohn's disease: a double-blind, randomised, placebo-controlled trial</title><title>Gut</title><description>IntroductionThe intestinal microbiota drive inflammation associated with Crohn's disease.1 The composition of the intestinal microbiota can be influenced by prebiotic's such as fructo-oligosaccharides (FOS). Preliminary data suggest that FOS can increase colonic bifidobacteria and induce immunoregulatory dendritic cell (DC) epithelial responses.2MethodsTo assess the impact of a diet supplemented with FOS in patients with active Crohn's disease using an appropriately powered randomised, double-blind, placebo-controlled trial. Patients with active Crohn's disease (CDAI ≥ 220, plus one marker of inflammation) were randomised to receive 15 g/day FOS or placebo for 4 weeks. The primary endpoint was clinical response at week 4 (change in CDAI of −70 in the intention-to-treat (ITT) population). Multiple pre-specified secondary endpoints were analysed, including intracellular cytokine staining assessed by flow cytometry (n=27).ResultsIn total, 103 patients were randomised to receive FOS (n=54) or placebo (n=49). The mean (SD) baseline CDAI was 283 (61.1) and 286 (61.5) in the FOS and placebo groups, respectively (p=0.79). Significantly more patients receiving FOS (n=14.26%) than placebo (n=4.8%) withdrew before the 4-week endpoint (p=0.018). There was no significant clinical benefit of FOS compared to placebo (Abstract 003). Patients receiving FOS, but not placebo, had a reduced proportion of IL-6+ intestinal DC, and increased DC staining of IL-10 (both p<0.05). No effect on DC IL-12 was seen. Throughout the intervention patients receiving FOS had a significantly greater severity of flatulence (FOS mean 10.8, SD 5.7 vs placebo 7.3, 3.6, p=0.004) and rumbling gut (mean 8.3, SD 5.0 vs 6.1, 4.1, p=0.029) compared with placebo.ConclusionAn adequately powered trial of a diet supplemented with FOS in a well defined population of patients with active Crohn's disease showed no clinical benefit despite impacting on DC immunology. Patient withdrawal was greater in patients receiving FOS. Abstract OC-003Clinical resultsFOSPlacebop ValueResponse, n (%) intention-to-treat12 (22)19 (39)0.067Per protocol, n (%)12 (30)19 (42)0.243Remission, n (%) intention-to-treat6 (11)10 (20)0.193Per protocol, n (%)6 (15)10 (22)0.395Change in calprotectin, mean (SD)62 (301)296 (494)0.092</description><subject>Clinical trials</subject><subject>Crohn's disease</subject><subject>Dendritic cells</subject><subject>Diet</subject><subject>Flow cytometry</subject><subject>Immunoregulation</subject><subject>Interleukin 10</subject><subject>Interleukin 12</subject><subject>Interleukin 6</subject><subject>Intestinal microflora</subject><subject>Intestine</subject><subject>Microbiota</subject><subject>Motivation</subject><subject>Oligosaccharides</subject><subject>Patients</subject><subject>Remission</subject><issn>0017-5749</issn><issn>1468-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNqFkD1PwzAQhi0EEqWwM1piYIDA2U7ahA1VfEkIFpijs30BV2lcbBeJjYWJf8kvwVB2lruT3o-THsb2BZwIoSanT6t0IgGaPOpGlWaDjUQ5qQsl63qTjQDEtKimZbPNdmKcA0BdN2LEPu9nBYD6ev-489z0bnAGe65poM4l7ju-DKSdT85E7gaenomnQJgWNPzKaJJ7JT4L_nk4jNy6SBjpjCO3fqV7KnTutMc84GD9Iqv5XvZoSPvC-CEF3_dkc6fDfpdtddhH2vvbY_Z4efEwuy5u769uZue3hRaVlAVWGhqhqcKmM5JAN7WWU1JAsrKymaIQWGo0lZhokEZaK2pArAgtAlqhxuxg3bsM_mVFMbVzvwpDftlKKJWqJkLJ7IK1ywQfY6CuXQa3wPDWCmh_kLcZefuDvP1DniNH64hezP93fwNzt4SX</recordid><startdate>201004</startdate><enddate>201004</enddate><creator>Benjamin, J L</creator><creator>Hedin, C R H</creator><creator>Koutsoumpas, A</creator><creator>Ng, S C</creator><creator>Hart, A L</creator><creator>Kamm, M A</creator><creator>Sanderson, J D</creator><creator>Knight, S C</creator><creator>Forbes, A</creator><creator>Stagg, A J</creator><creator>Whelan, K</creator><creator>Lindsay, J O</creator><general>BMJ Publishing Group LTD</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope></search><sort><creationdate>201004</creationdate><title>OC-003 No clinical benefit of prebiotics in the treatment of active Crohn's disease: a double-blind, randomised, placebo-controlled trial</title><author>Benjamin, J L ; Hedin, C R H ; Koutsoumpas, A ; Ng, S C ; Hart, A L ; Kamm, M A ; Sanderson, J D ; Knight, S C ; Forbes, A ; Stagg, A J ; Whelan, K ; Lindsay, J O</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b1522-a5b091be5a9fc2e0b98b27e30e25d297a11a4bac516b02c2dd180aa5eada0ad13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Clinical trials</topic><topic>Crohn's disease</topic><topic>Dendritic cells</topic><topic>Diet</topic><topic>Flow cytometry</topic><topic>Immunoregulation</topic><topic>Interleukin 10</topic><topic>Interleukin 12</topic><topic>Interleukin 6</topic><topic>Intestinal microflora</topic><topic>Intestine</topic><topic>Microbiota</topic><topic>Motivation</topic><topic>Oligosaccharides</topic><topic>Patients</topic><topic>Remission</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Benjamin, J L</creatorcontrib><creatorcontrib>Hedin, C R H</creatorcontrib><creatorcontrib>Koutsoumpas, A</creatorcontrib><creatorcontrib>Ng, S C</creatorcontrib><creatorcontrib>Hart, A L</creatorcontrib><creatorcontrib>Kamm, M A</creatorcontrib><creatorcontrib>Sanderson, J D</creatorcontrib><creatorcontrib>Knight, S C</creatorcontrib><creatorcontrib>Forbes, A</creatorcontrib><creatorcontrib>Stagg, A J</creatorcontrib><creatorcontrib>Whelan, K</creatorcontrib><creatorcontrib>Lindsay, J O</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><jtitle>Gut</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Benjamin, J L</au><au>Hedin, C R H</au><au>Koutsoumpas, A</au><au>Ng, S C</au><au>Hart, A L</au><au>Kamm, M A</au><au>Sanderson, J D</au><au>Knight, S C</au><au>Forbes, A</au><au>Stagg, A J</au><au>Whelan, K</au><au>Lindsay, J O</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>OC-003 No clinical benefit of prebiotics in the treatment of active Crohn's disease: a double-blind, randomised, placebo-controlled trial</atitle><jtitle>Gut</jtitle><date>2010-04</date><risdate>2010</risdate><volume>59</volume><issue>Suppl 1</issue><spage>A1</spage><epage>A2</epage><pages>A1-A2</pages><issn>0017-5749</issn><eissn>1468-3288</eissn><abstract>IntroductionThe intestinal microbiota drive inflammation associated with Crohn's disease.1 The composition of the intestinal microbiota can be influenced by prebiotic's such as fructo-oligosaccharides (FOS). Preliminary data suggest that FOS can increase colonic bifidobacteria and induce immunoregulatory dendritic cell (DC) epithelial responses.2MethodsTo assess the impact of a diet supplemented with FOS in patients with active Crohn's disease using an appropriately powered randomised, double-blind, placebo-controlled trial. Patients with active Crohn's disease (CDAI ≥ 220, plus one marker of inflammation) were randomised to receive 15 g/day FOS or placebo for 4 weeks. The primary endpoint was clinical response at week 4 (change in CDAI of −70 in the intention-to-treat (ITT) population). Multiple pre-specified secondary endpoints were analysed, including intracellular cytokine staining assessed by flow cytometry (n=27).ResultsIn total, 103 patients were randomised to receive FOS (n=54) or placebo (n=49). The mean (SD) baseline CDAI was 283 (61.1) and 286 (61.5) in the FOS and placebo groups, respectively (p=0.79). Significantly more patients receiving FOS (n=14.26%) than placebo (n=4.8%) withdrew before the 4-week endpoint (p=0.018). There was no significant clinical benefit of FOS compared to placebo (Abstract 003). Patients receiving FOS, but not placebo, had a reduced proportion of IL-6+ intestinal DC, and increased DC staining of IL-10 (both p<0.05). No effect on DC IL-12 was seen. Throughout the intervention patients receiving FOS had a significantly greater severity of flatulence (FOS mean 10.8, SD 5.7 vs placebo 7.3, 3.6, p=0.004) and rumbling gut (mean 8.3, SD 5.0 vs 6.1, 4.1, p=0.029) compared with placebo.ConclusionAn adequately powered trial of a diet supplemented with FOS in a well defined population of patients with active Crohn's disease showed no clinical benefit despite impacting on DC immunology. Patient withdrawal was greater in patients receiving FOS. Abstract OC-003Clinical resultsFOSPlacebop ValueResponse, n (%) intention-to-treat12 (22)19 (39)0.067Per protocol, n (%)12 (30)19 (42)0.243Remission, n (%) intention-to-treat6 (11)10 (20)0.193Per protocol, n (%)6 (15)10 (22)0.395Change in calprotectin, mean (SD)62 (301)296 (494)0.092</abstract><cop>London</cop><pub>BMJ Publishing Group LTD</pub><doi>10.1136/gut.2009.208934c</doi></addata></record> |
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| subjects | Clinical trials Crohn's disease Dendritic cells Diet Flow cytometry Immunoregulation Interleukin 10 Interleukin 12 Interleukin 6 Intestinal microflora Intestine Microbiota Motivation Oligosaccharides Patients Remission |
| title | OC-003 No clinical benefit of prebiotics in the treatment of active Crohn's disease: a double-blind, randomised, placebo-controlled trial |
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