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Trial registered on ANZCTR
Registration number
ACTRN12625000357459
Ethics application status
Approved
Date submitted
12/12/2024
Date registered
24/04/2025
Date last updated
24/04/2025
Date data sharing statement initially provided
24/04/2025
Type of registration
Retrospectively registered
Titles & IDs
Public title
Prospective assessment of the effects of Exclusive Enteral Nutrition on inflammation, epithelial integrity and body composition in patients with Crohn’s disease
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Scientific title
Prospective assessment of the effects of Exclusive Enteral Nutrition on inflammation, epithelial integrity and body composition in patients with Crohn’s disease
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Secondary ID [1]
313535
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None
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Universal Trial Number (UTN)
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Trial acronym
PrEEN
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Crohn's disease
336006
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Condition category
Condition code
Inflammatory and Immune System
332915
332915
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0
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Autoimmune diseases
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Oral and Gastrointestinal
332587
332587
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0
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Crohn's disease
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Diet and Nutrition
332914
332914
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0
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Other diet and nutrition disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Exclusive Enteral Nutrition (EEN) is a dietary therapy used to treat active Crohn's disease. It involves the provision of a specialised liquid nutrition formula (nutritionally complete, fibre free) for 6-8 weeks under the supervision of Inflammatory Bowel Disease (IBD) dietitian and gastroenterologist to reduce intestinal inflammation.
Patients who are commencing EEN at our centre as a part of their treatment, will be offered enrolment in the study. The research dietitian calculates estimated nutrition requirements using equations (that account for weight, gender, age, disease activity and physical activity) and tailors the EEN regime to the estimated requirements (these can be reviewed at each review if there is a change to weight, activity). Participants will be assess at baseline (face-to-face) by the research dietitian and reviewed at week 1, 2, 4 via telehealth/phone with a face-to-face appointment at week 6. Assessment throughout the study comprise anthropometry (including body composition), clinical symptoms, tolerance, adherence, biochemistry and ultrasound. Participants complete a daily diary throughout the study to assess adherence, as well as weekly self reported adherence as per an adherence scale).
EEN intervention: 200ml bottles across the day to meet individuals estimated nutrition requirements (ie. 5-8 bottles daily, depending on individual patient characteristics). This is provided to patients via the standard of care processes for accessing EEN at this institution (ordered by the dietitian and sent to patients home).
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Intervention code [1]
330123
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Treatment: Other
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Sonographic response
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Assessment method [1]
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Gastrointestinal ultrasonographic (GIUS) response as defined as greater than or equal to 25% bowel wall thickness (BWT) reduction from baseline (mm)
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Timepoint [1]
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6 weeks post commencement of EEN
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Secondary outcome [1]
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Epithelial injury
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Assessment method [1]
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by measuring serum iFABP-1
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Timepoint [1]
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Week 6 post EEN commencement
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Secondary outcome [2]
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Adherence
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Assessment method [2]
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Direct questioning, adherence scale, participant diary
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Timepoint [2]
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Week 1,2,4 & 6 post EEN commencement
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Secondary outcome [3]
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Bacterial translocation
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Assessment method [3]
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serum soluble CD14
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Timepoint [3]
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week 6 post EEN commencement
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Secondary outcome [4]
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Muscle quantity
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Assessment method [4]
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Muscle ultrasound at quadriceps
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Timepoint [4]
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Baseline and week 6 after EEN commencement
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Secondary outcome [5]
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Visceral adipose tissue
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Assessment method [5]
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Via bioelectrical impedence and intestinal ultrasound
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Timepoint [5]
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Baseline and 6 weeks after EEN commencement
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Secondary outcome [6]
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Skeletal muscle mass
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Assessment method [6]
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Bioelectrical impedance
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Timepoint [6]
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Baseline, week 6 post EEN commencement
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Secondary outcome [7]
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Adverse effects (ie. poor tolerance to EEN formula including significant nausea, bowel obstruction, worsened diarrhoea)
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Assessment method [7]
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GI symptom scale, direct questioning, significant unintentional weight change (>5%)
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Timepoint [7]
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Baseline and week 1, 2, 4 & 6 after EEN commencement
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Secondary outcome [8]
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Inflammation
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Assessment method [8]
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Measuring serum highly sensitive C-reactive protein
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Timepoint [8]
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Baseline, week 2 & week 6 post EEN commencement
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Secondary outcome [9]
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Clinical disease activity (remission)
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Assessment method [9]
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Harvey Bradshaw Index <5
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Timepoint [9]
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Week 6 post EEN commencement
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Secondary outcome [10]
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Fat mass index
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Assessment method [10]
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Bioelectrical impedence
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Timepoint [10]
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Baseline and week 6 after EEN commencement
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Secondary outcome [11]
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Metabolomic changes
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Assessment method [11]
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Faecal VOC's including short chain and branched chain fatty acids
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Timepoint [11]
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Baseline, 6 weeks after EEN commencement
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Secondary outcome [12]
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Intestinal permeability (small bowel)
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Assessment method [12]
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Lactulose:rhamnose in urine
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Timepoint [12]
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Week 6 post EEN commencement
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Secondary outcome [13]
442641
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Intestinal inflammation
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Assessment method [13]
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Faecal calprotectin
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Timepoint [13]
442641
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Baseline, week 2 & week 6 post EEN commencement
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Secondary outcome [14]
446692
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Fat mass percentage
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Assessment method [14]
446692
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Bioelectrical impedence
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Timepoint [14]
446692
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Baseline and week 6 after EEN commencement
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Secondary outcome [15]
444103
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Fat mass
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Assessment method [15]
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Bioelectrical impedence
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Timepoint [15]
444103
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Baseline and 6 weeks after EEN commencement
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Secondary outcome [16]
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Faecal microbiota
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Assessment method [16]
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Microbiotic 16S rNA sequencing
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Timepoint [16]
442645
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Baseline, week 6 post EEN commencement
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Secondary outcome [17]
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Quality of life
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Assessment method [17]
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IBD-Quality of Life tool
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Timepoint [17]
444091
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Baseline and 6 weeks post EEN commencement
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Secondary outcome [18]
444098
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Muscle quanitity
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Assessment method [18]
444098
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Muscle ultrasound at mid-upper arm
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Timepoint [18]
444098
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Baseline and week 6 after EEN commencement
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Secondary outcome [19]
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Muscle function
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Assessment method [19]
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Handgrip strength via handheld dynamometer
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Timepoint [19]
444099
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Baseline and 6 weeks after EEN commencement
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Eligibility
Key inclusion criteria
Patients with confirmed diagnosis of Crohn's disease with active inflammation necessitating the use of EEN at Alfred Health (IBD clinic or IUS clinic) and stable medical therapy for previous 2 months
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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. Significant medical or cognitive/psychiatric comorbidities that would impair ability to provide consent
2. Ineligibility for Medicare
3. Inability to speak or read English to give informed consent
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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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
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Actual
11/10/2024
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Date of last participant enrolment
Anticipated
31/12/2025
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Actual
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Date of last data collection
Anticipated
31/12/2025
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Actual
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Sample size
Target
50
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Accrual to date
2
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
27383
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The Alfred - Melbourne
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Recruitment postcode(s) [1]
43481
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3004 - Melbourne
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Funding & Sponsors
Funding source category [1]
317991
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University
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Name [1]
317991
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Monash University
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Address [1]
317991
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Country [1]
317991
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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
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Country
Australia
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Secondary sponsor category [1]
320336
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Hospital
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Name [1]
320336
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Alfred Health
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Address [1]
320336
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Country [1]
320336
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
316660
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Alfred Hospital Ethics Committee
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Ethics committee address [1]
316660
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https://www.alfredhealth.org.au/research/ethics-research-governance
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Ethics committee country [1]
316660
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Australia
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Date submitted for ethics approval [1]
316660
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25/07/2024
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Approval date [1]
316660
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07/10/2024
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Ethics approval number [1]
316660
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Summary
Brief summary
Exclusive enteral nutrition (EEN) is a dietary therapy for the treatment of Crohn's disease (CD) well established in reducing inflammation, particularly in paediatric CD. Gaps in knowledge relating to EEN remain, particularly relating to mechanism of action, impact on body composition, quality of life and adherence, particularly in adult cohorts. This study aims to address many of these gaps in knowledge through prospectively evaluating adult patients commenced on EEN, including objective measures of disease activity (biochemical, sonographic), body composition measures, novel biomarkers, adherence and quality of life over 6 weeks. It is hypothesised that EEN will lead to sonographic response, improvements in body composition and muscle strength as well as clinical symptoms and quality of life
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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
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Dr Emma Halmos
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Address
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Alfred Centre, Central Clinical School, Level 5 99 Commercial Rd, Melbourne VIC 3004
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Country
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Australia
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Phone
138570
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+61407324779
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Fax
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Email
138570
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[email protected]
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Contact person for public queries
Name
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Sarah Melton
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Address
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Alfred Centre, Central Clinical School, Level 5 99 Commercial Rd, Melbourne VIC 3004
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Country
138571
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Australia
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Phone
138571
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+613 9903 0270
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Fax
138571
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Email
138571
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[email protected]
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Contact person for scientific queries
Name
138572
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Sarah Melton
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Address
138572
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Alfred Centre, Central Clinical School, Level 5 99 Commercial Rd, Melbourne VIC 3004
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Country
138572
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Australia
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Phone
138572
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+613 9903 0270
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Fax
138572
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Email
138572
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[email protected]
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Data sharing statement
Will the study consider sharing individual participant data?
No
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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