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Use of a Home Test for Gluten Detection in Urine and Its Effect on Gluten-free Diet Adherence

Study Purpose

The use of a home rapid test for the detection of gluten immunogenic peptides (GIP) in urine of treated adolescent patients with celiac disease (CD) could facilitate the adherence to the gluten-free diet (GFD) and contribute to symptoms control and quality of life improvement. This single centre, randomized, unblinded, controlled study consists of 4 run-in weeks period followed by 8-weeks study period in which patients will be randomized to intervention group (home urine GIP testing) or the control group (no home urine GIP testing). The 12-week study will involve surveys, home stool and urine collection, home urine GIP test performance, and two study visits with the gastroenterologists. The main outcome is to determine whether the self-monitoring of the GFD with GIP testing in urine improves adherence to the GFD in treated adolescent patients with CD (measured by CDAT-Celiac Dietary Adherence Test, GFD adherence evaluation by gastroenterologist and rates of gluten exposure in urine and/or stool measured at a central laboratory) and subsequently improves quality of life (CDDUX-Coeliac Disease Dutch Questionnaire) and reduces symptoms (CSI-Celiac Symptoms Index questionnaire).

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

 No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

 Interventional
Eligible Ages 12 Years - 18 Years
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

  • - Willingness to take part in the study.
  • - Signed informed consent.
  • - Diagnosis of CD confirmed by biopsy and/or serology.
  • - Ability to: provide urine and stool samples, perform the home tests, and register results.

Exclusion Criteria:

  • - Not precise diagnostic of CD.
  • - Comorbid condition that in the opinion of the investigator would interfere with the study.
  • - Lack of willingness to take part in the study.
  • - Inability to use the test or provide samples.
  • - Frequent voluntary GFD transgressions.
  • - To provide less than 70% of the required samples.

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

 NCT05119322
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

 N/A
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

 Biomedal S.L.
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

 Laura Coto AlonsoÁngel Cebolla RamírezJoaquín Reyes Andrade
Principal Investigator Affiliation Biomedal S.L.Biomedal S.L.Fundación IHP
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

 Other
Overall Status Recruiting
Countries Spain
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

 Celiac Disease, Treatment Adherence, Adolescent
Study Website: View Trial Website
Additional Details

Hypothesis: the use of a home rapid test for the detection of gluten immunogenic peptides (GIP) in urine of treated adolescent patients with celiac disease (CD) could facilitate the adherence to the gluten-free diet (GFD) and contribute to symptoms control and quality of life improvement. Objectives: Primary objective: to determine in adolescent patients with CD whether the self-monitoring of the GFD with GIP testing in urine changes treatment adherence (intervention group) in comparison with patients that do not use the test (control group) measured by 1

  • - CDAT-Celiac Dietary Adherence Test; 2 - GFD adherence evaluation by gastroenterologist; 3- Detection rates of GIP in urine and/or stool (to be measured at a central laboratory); 4- Detection rates of GIP in urine (to be measured by home rapid tests).
Secondary objectives: to determine whether the use of the home test for GIP detection in urine samples of treated patients with CD leads to 1
  • - change of quality of life (CDDUX-Coeliac Disease Dutch Questionnaire); 2- change of symptoms (CSI-Celiac Symptoms Index questionnaire).
Study design: Single centre, randomized, unblinded, controlled, study. The study will consist of 4 run-in weeks period followed by 8-weeks study period in which patients will be randomized to intervention (home urine GIP testing) or the control group (no home urine GIP testing). Study participants: adolescent patients with CD, diagnosed by European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines, that have been following a strict GFD for at least 2 years. Study procedure: 1. Patient enrolment. 2. Run-in period (4 weeks): all participants will: A- complete quality of life questionnaire (CDDUX); B
  • - complete GFD adherence questionnaire (CDAT); C - complete food diary for 4 consecutive days and GFD adherence will be evaluated by gastroenterologist; D - complete symptom questionnaire (CSI); E - be instructed in the use of the tests and sample collection; F - collect at the beginning and end of the period urine and stool samples.
3. Study weeks (8): patients will be randomized to either the control or the study group by block randomization (size 4) using WINPEPI (Programs for epidemiologists for Windows) v11.65 (Abramson, J.H.). The study group will receive home use tests for GFD monitoring to be used at their discretion (but using at least 8 tests during the study period (1/week) so that they may receive immediate qualitative feedback regarding the presence of biomarkers of gluten exposure in their urine and they will have to register the results obtained. The control group will not receive the tests. Additionally, all patients will collect a urine and a stool sample every 4 weeks with the purpose of evaluating their adherence to the GFD. All collected samples will be kept frozen until their analysis and will be brought to the centre by the patients at the end of the study. All samples will be sent to a central laboratory for their analysis (Biomedal S.L., Seville, Spain). 4. At the end of the study, patients will be evaluated as in the run-in period (post-intervention). Number of participants: with an alpha risk of 5%, a beta risk of 20% (80% of statistical power) and an estimated rate reduction of 0.33 the sample size needed was 66 subjects (33 subjects per group). The calculation was made using the tool Calculadora de Grandària Mostral (GRANMO) v7.12 April 2012 (Municipal Institute of Medical Research, Barcelona, Spain). Measurements: 1- Home rapid test (GlutenDetect, Biomedal S.L., Seville, Spain) for GIP determination in urine samples, laboratory rapid test (iVYCHECK GIP Urine, Biomedal S.L., Seville, Spain) for GIP determination in urine samples and ELISA test (iVYLISA GIP Stool, Biomedal S.L., Seville, Spain) for GIP determination in stool samples; 2- CD related symptoms (CSI questionnaire); 3- quality of life questionnaire (CDDUX); 4- GFD adherence questionnaire (CDAT); 5- GFD adherence evaluation by specialist (questionnaire and food diary); 6
  • - test results for the study group.
Samples will be analysed in a central laboratory (Biomedal S.L., Seville, Spain). Statistical analysis: Will be done with IBM SPSS Statistics 25.0 for Windows (IBM Corporation, Armonk, New York, United States). 1- Difference in all parameters between and within the control and the study groups. Results will be compared at baseline, week 4 and week 12. 2- Differences in all parameters between patients with positive GIP testing compared to those with negative GIP testing (both home and laboratory GIP measurements). 3
  • - number of additional tests used by the patients since they will receive 24 tests and they must perform only 8 tests.
They can use the additional test at their discretion.

Arms & Interventions

Arms

Experimental: GlutenDetect home urine test

The GlutenDetect home urine test group will receive home use tests for GIP detection in urine to self-monitor the GFD. Tests will be used at their discretion, but using at least 8 tests during the study period (1/week), so that they may receive immediate qualitative feedback regarding the presence of biomarkers of gluten exposure in their urine and they will have to register the results obtained. Additionally, patients will collect a urine and a stool sample every 4 weeks to evaluate their adherence to the GFD in the laboratory.

No Intervention: Control group

The control group will not receive any home urine tests but will collect a urine and a stool sample every 4 weeks with the purpose of evaluating their adherence to the GFD in the laboratory.

Interventions

Diagnostic Test: - GlutenDetect home urine test

GFD compliance self-asessment using a home rapid test for GIP detection in urine.

Contact a Trial Team

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International Sites

Grupo IHP, Seville, Spain

Status

Recruiting

Address

Grupo IHP

Seville, , 41013

Site Contact

Joaquín Reyes Andrade

joaquinreyes@ihppediatria.com

954 61 00 22

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