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Nutritional Approaches in Multiple Sclerosis

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ClinicalTrials.gov Identifier: NCT03508414
Recruitment Status : Recruiting
First Posted : April 25, 2018
Last Update Posted : November 29, 2018
Sponsor:
Information provided by (Responsible Party):
Friedemann Paul, Charite University, Berlin, Germany

Brief Summary:
The aim of this project is to characterize the influence of a ketogenic diet and intermittent therapeutical fasting on the course of the disease, as measured by T2-hyperintense cerebral lesions with magnetic resonance tomography (MRT) in patients with multiple sclerosis (RRMS). The investigators expect in both intervention groups fewer cerebral T2 lesions occurring after 18 months in comparison to the control group and as detectable by MRT. According to current recommendations of the German Society of Nutrition (DGE), the control group receives a vegetarian-focused, anti-inflammatory diet.

Condition or disease Intervention/treatment Phase
Multiple Sclerosis Behavioral: ketogenic diet Behavioral: Intermittent therapeutical fasting Behavioral: Active comparator Not Applicable

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 111 participants
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: None (Open Label)
Primary Purpose: Other
Official Title: Nutritional Approaches in Multiple Sclerosis
Actual Study Start Date : April 11, 2017
Estimated Primary Completion Date : December 1, 2020
Estimated Study Completion Date : December 1, 2020

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Ketogenic diet Behavioral: ketogenic diet
Patients receive a ketogenic diet, which is carbohydrate-reduced with a high amount of fat.

Experimental: Intermittent therapeutical fasting Behavioral: Intermittent therapeutical fasting
Patients fast for 1 week every six months. Additionally, the patients do an intermittent fasting, that is to say they do not eat for at least 14 hours a day.

Active Comparator: Control group
The control group is receiving a vegetarian-focused diet according to the current recommendations of the German Society for Nutrition (DGE) for MS patients.
Behavioral: Active comparator
The control group is receiving a vegetarian-focused diet according to the current recommendations of the German Society for Nutrition (DGE) for MS patients.




Primary Outcome Measures :
  1. Change in cerebral T2 lesions from Baseline at 18 months [ Time Frame: Change from baseline at 18 months ]
    Number of new cerebral T2 lesions in MRT after 18 months compared to baseline MRT


Secondary Outcome Measures :
  1. Change in neurological-functional disability: physical and cognitive function [ Time Frame: Change from baseline at 9 and 18 months ]
    influence of the interventions on cognitive and physical disability progression using Multiple Sclerosis Functional Composite (MSFC)

  2. Change in neurological-functional disability : physical function [ Time Frame: Change from baseline at 9 and 18 months ]
    influence of the interventions on physical disability progression using Expanded Disability Status Score (EDSS). The EDSS is assessing the progress of disability in MS patients with a scale between 0-12 points, while 0 indicates no disability and 10 indicates death through MS.

  3. annual relapse rate [ Time Frame: 12 months ]
    relapse rate

  4. progress of brain atrophy [ Time Frame: Change from baseline at 18 months ]
    PBVC = percent brain volume change



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 65 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Existing health insurance, so that in case of random findings these can also be clarified
  • Patients with relapsed-remitting MS according to the MS diagnostic criteria according to McDonald 2010
  • Age 18-65
  • Consent ability and written consent
  • BMI between 19 and 45 kg / m2
  • EDSS <4.5
  • Stable immunomodulatory therapy or no immunomodulatory therapy> 6 months before confinement
  • In the last 2 years ≥ 1 relapse or within the last 2 years ≥ 1 new T2 lesions or ≥ 1 contrast-sensitive lesion in MRT
  • Consent that possible random findings are reported

Exclusion Criteria:

  • Initiation or modification of immunomodulatory therapy during the study
  • Cortisone treatment in the last 30 days before enrollment
  • Relapse in the last 30 days before enrollment
  • Insulin-dependent diabetes mellitus (type I)
  • Intake of Omega 3 fatty acids (DHA, EPA) - more than 1 g / day
  • Significant cognitive impairment, clinically relevant or progressive disease (e.g., liver, kidney, cardiovascular system, respiratory tract, vascular system, brain, metabolism, thyroid) that could affect the course of the study
  • Malignant disease
  • Simultaneous participation in an interventional study or participation in an interventional study in the last two months before study inclusion
  • Clinically relevant addiction or substance abuse disorder (defined as alcohol, drug and drug abuse)
  • Nicotine consumption of > 5 cigarettes per day and no willingness to stop consumption during therapeutic fasting.
  • Insufficient mental possibility of cooperation
  • Eating disorder
  • Kidney stones
  • Known metabolic disorders (e.g., fatty acid oxidation disorders, ketolysis / ketogenesis or glucogenesis disorder, hyperinsulinism (e.g., nesidioblastoma), pyruvate carboxylase deficiency)
  • Therapy with oral anticoagulants (e.g., Marcumar)
  • Pregnancy and breast feeding period
  • Suspected lack of compliance
  • Performing of a diet for weight reduction
  • Special diet for medical reasons
  • Change of the body weight of more than 5 kg within one month before the start of the Intervention
  • Medical, psychiatric or other conditions that restrict the patient's following abilities: to interpret the study information, to give informed consent, to adhere to the rules of the protocol, or to complete the study
  • Contraindications to MRT examinations [persons with metallic implants (e.g., intracranial metal clips) and carriers of electronic devices (e.g., pacemaker) or persons with claustrophobia]

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): NCT03508414


Contacts
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Contact: Lina Bahr, M.Sc. 0049 30 450 539 736 lina.bahr@charite.de
Contact: Judith Bellmann-Strobl, Dr. med. judith.bellmann-strobl@charite.de

Locations
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Germany
Charité - Universitätsmedizin Berlin Recruiting
Berlin, Germany, 10117
Contact: Lina Bahr, M.Sc.    0049 30 450 539736    lina.bahr@charite.de   
Contact: Judith Bellmann-Strobl       judith.bellmann-strobl@charite.de   
Principal Investigator: Friedemann Paul, Dr. med.         
Principal Investigator: Michalsen Andreas, Dr. med.         
Sponsors and Collaborators
Charite University, Berlin, Germany
Investigators
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Principal Investigator: Friedemann Paul, Dr. med. Charite University, Berlin, Germany

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Responsible Party: Friedemann Paul, Principal Investigator, Charite University, Berlin, Germany
ClinicalTrials.gov Identifier: NCT03508414     History of Changes
Other Study ID Numbers: NAMS-study
First Posted: April 25, 2018    Key Record Dates
Last Update Posted: November 29, 2018
Last Verified: November 2018
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Friedemann Paul, Charite University, Berlin, Germany:
Relapse-remitting Multiple Sclerosis

Additional relevant MeSH terms:
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Sclerosis
Multiple Sclerosis
Pathologic Processes
Demyelinating Autoimmune Diseases, CNS
Autoimmune Diseases of the Nervous System
Nervous System Diseases
Demyelinating Diseases
Autoimmune Diseases
Immune System Diseases