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Modified Atkins Diet Plus KetoCal for Adult Epilepsy

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ClinicalTrials.gov Identifier: NCT01834482
Recruitment Status : Completed
First Posted : April 18, 2013
Last Update Posted : January 23, 2018
Sponsor:
Collaborator:
Nutricia Liverpool
Information provided by (Responsible Party):
Mackenzie Cervenka, Johns Hopkins University

Study Description
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Brief Summary:
The modified Atkins diet (MAD) has been shown to be effective in treating children and adults with medically resistant seizures. A recent study in children showed that the use of KetoCal® once per day in addition to the MAD appeared to be beneficial when used during the first month. The investigators hypothesize that including a daily KetoCal® liquid tetrapak with one meal during the initial month of the MAD will produce urinary ketosis in more adult patients than the MAD alone and will lead to greater seizure reduction.

Condition or disease Intervention/treatment Phase
Epilepsy Seizure Medically Resistant Epilepsy Medically Resistant Seizures Dietary Supplement: Modified Atkins diet Dietary Supplement: KetoCal Not Applicable

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 80 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized, Open-label Evaluation of KetoCal® in Initial Combination With the Modified Atkins Diet for the Dietary Management of Intractable Adult Epilepsy.
Study Start Date : March 2013
Actual Primary Completion Date : September 2017
Actual Study Completion Date : September 2017

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Epilepsy Seizures

Arms and Interventions
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Arm Intervention/treatment
Active Comparator: Modified Atkins diet plus KetoCal
Patients will receive the modified Atkins diet in combination with a KetoCal tetrapak daily for the first month. The second month, no tetrapaks will be given.
 Dietary Supplement: Modified Atkins diet
Patients will receive the modified Atkins diet with a 20 gram per day carbohydrate limit and encouragement to consume plenty of fat and eat to satiety.

Dietary Supplement: KetoCal
Patients will receive a KetoCal 4:1 ratio (fat: carbohydrates and protein) liquid daily for the first month (if randomized to this arm of the study). They will also be started on the modified Atkins diet.
Other Names:
  • KetoCal 4:1 liquid
  • KetoCal tetrapak
Active Comparator: Modified Atkins diet
Patients will receive the modified Atkins diet for the first month. The second month, they will be given the choice to also use KetoCal in addition to the modified Atkins diet if they choose to do so.
 Dietary Supplement: Modified Atkins diet
Patients will receive the modified Atkins diet with a 20 gram per day carbohydrate limit and encouragement to consume plenty of fat and eat to satiety.


Outcome Measures
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Primary Outcome Measures :
  1. Ketosis [ Time Frame: 1 month ]
    Time to urinary ketosis in days will be recorded and whether or not patients achieve serum ketosis at 1 month and 2 months.


Secondary Outcome Measures :
  1. Seizure reduction [ Time Frame: 2 months ]
    The percent seizure reduction compared to baseline (1 month before beginning the diet) will be recorded at 1 month and 2 months.

  2. Tolerability and taste [ Time Frame: 2 months ]
    Patients will be asked to rank convenience, taste, texture, and tolerability of the liquid on a 10 point scale (1 = poor, 10 = excellent).

  3. Side effects [ Time Frame: 2 months ]
    Patients will be screened for constipation and asked if they have experienced any side effects related to use of the modified Atkins diet and KetoCal® at 1 and 2 months.

  4. Study completion rate [ Time Frame: 2 months ]

Eligibility Criteria
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Ages Eligible for Study:   18 Years to 100 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Adults ages >17 years.
  • At least weekly seizures (or 4 per month). All seizure types allowed.
  • Tried at least two anticonvulsants.

Exclusion Criteria:

  • Unwilling to restrict carbohydrates
  • Significantly underweight (Body Mass Index <18.5)
  • Prior use of the modified Atkins diet for ≥ 2 days
  • Prior use of KetoCal® at any time for any duration
  • Use of the ketogenic diet within the past year
  • Kidney disease
  • History of hypercholesterolemia (total cholesterol > 300 mg/dl) or hypertriglyceridemia (triglycerides > 200 mg/dl)
  • Metabolic or mitochondrial disorder
  • Pregnancy or breastfeeding
  • Lactose intolerance or milk allergy
  • Aversion to liquids or inability to eat solid food
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01834482


Locations
United States, Maryland
Johns Hopkins University
Baltimore, Maryland, United States, 21287
Sponsors and Collaborators
Johns Hopkins University
Nutricia Liverpool
Investigators
Principal Investigator: Mackenzie C. Cervenka, M.D. Johns Hopkins University
More Information
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Additional Information:
Adult Epilepsy Diet Center at Hopkins website  This link exits the ClinicalTrials.gov site

Publications:

Responsible Party: Mackenzie Cervenka, Assistant Professor of Neurology, Johns Hopkins University
ClinicalTrials.gov Identifier: NCT01834482     History of Changes
Other Study ID Numbers: NA_00068726
First Posted: April 18, 2013    Key Record Dates
Last Update Posted: January 23, 2018
Last Verified: January 2018

Keywords provided by Mackenzie Cervenka, Johns Hopkins University:
seizures
epilepsy
adult
intractable
 medically refractory
Atkins
ketogenic
diet

Additional relevant MeSH terms:
Epilepsy
Seizures
Brain Diseases
Central Nervous System Diseases
 Nervous System Diseases
Neurologic Manifestations
Signs and Symptoms