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Trial registered on ANZCTR
Registration number
ACTRN12614000726651
Ethics application status
Approved
Date submitted
19/06/2014
Date registered
8/07/2014
Date last updated
8/07/2014
Type of registration
Retrospectively registered
Titles & IDs
Public title
The role of wheat gluten in the genesis of gastrointestinal symptoms and mental health in patients with non-coeliac gluten sensitivity: Understanding the mechanism of action.
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Scientific title
The role of wheat gluten in the genesis of gastrointestinal symptoms and mental health in patients with non-coeliac gluten sensitivity: Understanding the mechanism of action.
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Secondary ID [1]
284836
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NIL
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Non-coeliac gluten sensitivity
292226
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Condition category
Condition code
Diet and Nutrition
292560
292560
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0
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Other diet and nutrition disorders
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Oral and Gastrointestinal
292620
292620
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Food is supplemented with gluten: Participants will be asked to consume 2 muesli bars per day for two weeks. Each muesli bar will contain 8g of gluten. Participants will keep a food diary to monitor compliance. A two week 'wash out' period will be applied between treatment arms.
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Intervention code [1]
289630
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Diagnosis / Prognosis
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Intervention code [2]
289631
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Behaviour
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Comparator / control treatment
Food is not supplemented (placebo): Participants will be asked to consume 2 muesli bars per day for two weeks. The muesli bars will not have any additional supplements.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Change in psychological state following the consumption of gluten. Psychological state will be assessed using the Depression Anxiety and Stress Scale
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Assessment method [1]
292423
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Timepoint [1]
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Following treatment exposure (day 14)
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Primary outcome [2]
292500
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Change in psychological state following the consumption of gluten. Psychological state will be assessed using the State Trait Personality Inventory
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Assessment method [2]
292500
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Timepoint [2]
292500
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Following treatment exposure (day 14)
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Primary outcome [3]
292501
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Change in psychological state following the consumption of gluten. Psychological state will be assessed using the Irritable Bowel Syndrome Quality of Life Questionnaire
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Assessment method [3]
292501
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Timepoint [3]
292501
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Following treatment exposure (day 14)
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Secondary outcome [1]
308907
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Primary outcome: Change in cognitive function following the consumption of gluten. Cognitive function will be assessed using the Subtle Cognitive Impairment Test
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Assessment method [1]
308907
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Timepoint [1]
308907
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Primary timepoint: Following treatment exposure (day 14)
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Secondary outcome [2]
309276
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Change in gastrointestinal symptoms following the consumption of gluten. Gastrointestinal symptoms will be assessed using a 100mm visual analogue scale. Gastrointestinal symptoms will be reported as a composite secondary outcome.
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Assessment method [2]
309276
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Timepoint [2]
309276
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Following treatment exposure (day 14)
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Eligibility
Key inclusion criteria
(1) Following a gluten-free diet has relieved gut symptoms
(2) Following a gluten-free diet makes patient 'feel better'
(3) Patient has had coeliac disease excluded
(4) Patient is currently adherent to a gluten-free diet
(5) Patient has well-controlled symptoms on a gluten-free diet
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
(1) Marsh 1 or 2 lesions
(2) Other significant gastrointestinal disease
(3) Other clinically significant co-morbidity
(4) Psychiatric disease
(5) Pregnancy
(6) Alcoholism
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Participants who meet inclusion criteria will be invited to participate. Allocation of the subject for inclusion in the trial will be based on central randomisation by computer.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated list
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
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Intervention assignment
Crossover
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/04/2014
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Actual
22/04/2014
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Date of last participant enrolment
Anticipated
1/04/2015
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
49
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment postcode(s) [1]
8316
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3004 - Melbourne
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Funding & Sponsors
Funding source category [1]
289443
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Government body
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Name [1]
289443
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National Health and Medical Research Council
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Address [1]
289443
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Level 1/16 Marcus Clarke Street
Canberra ACT 2601
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Country [1]
289443
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Australia
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Funding source category [2]
289444
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Other
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Name [2]
289444
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Andrea Joy Logan Scholarship
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Address [2]
289444
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Provided by a private family
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Country [2]
289444
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Australia
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Primary sponsor type
University
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Name
Monash University
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Address
Department of Gastroenterology
Level 6, The Alfred Centre
99 Commercial Road
Melbourne VIC 3004
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Country
Australia
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Secondary sponsor category [1]
288133
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None
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Name [1]
288133
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Address [1]
288133
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Country [1]
288133
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
291202
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The Alfred Ethics and Research Governance
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Ethics committee address [1]
291202
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The Alfred Hospital, 55 Commercial Road, Melbourne, Victoria 3004, Australia
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Ethics committee country [1]
291202
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Australia
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Date submitted for ethics approval [1]
291202
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28/06/2012
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Approval date [1]
291202
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17/09/2012
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Ethics approval number [1]
291202
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232/12
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Summary
Brief summary
Gluten is believed to be poorly tolerated by many Australians and is often blamed for causing a wide range of gastrointestinal and psychological symptoms. Commonly reported gastrointestinal symptoms include; abdominal pain, bloating, flatulence and altered bowel habit, as frequently reported by people suffering from irritable bowel syndrome. Commonly reported psychological symptoms include; anxiety, depression and a reduction in quality of life. The best studied ‘gluten intolerance’ is coeliac disease. Coeliac disease is an auto-immune condition that occurs in 1% of the Australian population. The only available treatment for coeliac disease is life-long strict avoidance of gluten containing foods (including wheat, rye and barley). While the average daily gluten intake in a Western diet is 10-20 g (equivalent to 2-5 slices of wheat-bread), in people with coeliac disease, 50 mg (equivalent to 1/100th of one slice of wheat-bread) gluten can cause damage to the lining of the small intestine. Non-coeliac Gluten Sensitivity: There is another (much larger) group of individuals, however, who believe that gluten can also cause these types of symptoms and yet, after extensive investigations by doctors and specialists, are shown not to have coeliac disease. This group of people are often referred to as having ‘non coeliac gluten sensitivity’. This condition, however, is very poorly understood and recognised by the medical profession. Evidence for the Existence of Non-coeliac Gluten Sensitivity: Recently completed dietary studies undertaken by our research team have found conflicting evidence for the induction of gastrointestinal symptoms following the ingestion of gluten in people believing they have ‘non-coeliac gluten sensitivity’. While an original study found good evidence that gluten can indeed cause gastrointestinal symptoms in some individuals who do not have coeliac disease this finding was not confirmed in subsequent studies. Furthermore, our most recent study showed convincing evidence for a specific effect of gluten on mental health. In this study results indicated that short term exposure to gluten specifically induced current feelings of depression. Such findings suggest that a major effect of gluten amongst this population may be on mental health and not necessarily on gastrointestinal symptoms. This finding would also explain why participants report feeling better on the gluten-free diet despite the continuation of gastrointestinal symptoms. Outcomes and Significance: The purpose of this study is to investigate the role that gluten has in causing gastrointestinal symptoms and changes to mental health in people who believe they have ‘non-coeliac gluten sensitivity’. The results from this study will provide us with a more comprehensive understanding of the relationship between gluten and its influence on gastrointestinal symptoms and mental health.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
49334
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Prof Peter Gibson
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Address
49334
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Department of Gastroenterology
Level 6, The Alfred Centre
99 Commercial Road
Melbourne VIC 3004
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Country
49334
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Australia
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Phone
49334
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+61, 03, 9076 3325
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Fax
49334
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Email
49334
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[email protected]
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Contact person for public queries
Name
49335
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Simone Peters
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Address
49335
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Department of Gastroenterology
Level 6, The Alfred Centre
99 Commercial Road
Melbourne VIC 3004
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Country
49335
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Australia
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Phone
49335
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+61, 03, 9903 0262
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Fax
49335
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Email
49335
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[email protected]
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Contact person for scientific queries
Name
49336
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Simone Peters
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Address
49336
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Department of Gastroenterology
Level 6, The Alfred Centre
99 Commercial Road
Melbourne VIC 3004
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Country
49336
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Australia
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Phone
49336
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+61, 03, 9903 0262
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Fax
49336
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Email
49336
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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