NCT02231203

Brief Summary

Ideally, the postoperative inflammatory response is part of a well-orchestrated mechanism that contributes to tissue healing and rapid recovery. An exaggerated uncontrolled inflammatory response, however may lead to catabolism, tissue damage and organ failure. Omega-3 fatty acids may provide a means to alter cellular immune responses to the benefit of the patient. When omega-3 fatty acids are incorporated into membranes of inflammatory cells, they trigger intracellular signalling pathways that result in a less pro-inflammatory response. They modify gene and protein expression, modulate membrane protein activity and act as a reservoir for bioactive molecules. They also have a strong anti-inflammatory effect by mediating resolution of the inflammation. Furthermore, omega-3 fatty acids improve erythrocyte function, which is vital for an adequate microcirculation, tissue oxygenation and wound healing. The investigators hypothesize that the perioperative administration of intravenous omega-3 fatty acids results in a rapid incorporation in immune cells and erythrocytes, thereby reducing the postoperative inflammatory response and improving erythrocyte function in patients undergoing colorectal surgery.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
44

participants targeted

Target at P25-P50 for phase_4

Timeline
Completed

Started Oct 2014

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

July 29, 2014

Completed
1 month until next milestone

First Posted

Study publicly available on registry

September 4, 2014

Completed
27 days until next milestone

Study Start

First participant enrolled

October 1, 2014

Completed
1.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2016

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2016

Completed
Last Updated

July 31, 2018

Status Verified

July 1, 2018

Enrollment Period

1.7 years

First QC Date

July 29, 2014

Last Update Submit

July 28, 2018

Conditions

Keywords

fish oilomega-3 fatty acidspostoperative inflammatory responseerythrocyte function

Outcome Measures

Primary Outcomes (1)

  • Change in ex vivo production of pro-inflammatory cytokine IL-6 in LPS stimulated whole blood

    Ex vivo stimulation of whole blood with LPS (lipopolysaccharide, component of gram negative bacteria) resulting in the production of the pro-inflammatory cytokine IL-6, measured in ng/ml.

    baseline, day of surgery, postoperative day 1,2 and 4

Secondary Outcomes (3)

  • Change in ex vivo production of TNF-α and IL-10 in LPS stimulated whole blood

    baseline, day of surgery, postoperative day 1, 2 and 4

  • Change in erythrocyte function

    baseline, day of surgery, postoperative day 1, 2 and 4

  • Change in in vivo systemic inflammatory response parameters

    baseline, day of surgery, postoperative day 1, 2 and 4

Other Outcomes (2)

  • Postoperative outcome (composite measure of length of stay and complications)

    Registration during admission, follow up 2 and 4 weeks after surgery

  • Cognitive function

    baseline, follow up 2 weeks after surgery

Study Arms (2)

Placebo

PLACEBO COMPARATOR

2 infusions of NaCl, 2 ml/kg, one the night before operation and one the day after operation.

Drug: Placebo

Omegaven

ACTIVE COMPARATOR

2 infusions of 2ml/kg, one the night before surgery and one the day after surgery

Drug: Omegaven

Interventions

2 infusions, 2 ml/kg, one the night before operation and one the day after operation

Also known as: purified fish oil, omega-3 fatty acids, eicosapentaenoicacid (EPA), docosahexaenoicacid (DHA), dl-a- tocopherol (antioxidant), Omegaven-Fresenius
Omegaven

2 infusions, 2 ml/kg, one the night before operation and one the day after operation

Also known as: NaCl 0,9%, Natriumchloride 0,9%, glass container NaCl 0,9% Fresenius Kabi
Placebo

Eligibility Criteria

Age60 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Patients (male or female) undergoing elective laparoscopic surgery for colon cancer
  • Age between 60 and 80 years
  • BMI between 20 kg/m2 and below 30 kg/m2
  • Written informed consent

You may not qualify if:

  • Participation in or having participated in another clinical trial within the previous 3 months
  • Indications for continuously use of anticoagulant medication and no possibility to stop these medication perioperatively, for example patients with an artificial heart valve
  • Pre-operative Hemoglobin\<5.0 mmol/L
  • Metastatic disease
  • Very poor peripheral venous access
  • Current history of inflammatory or infectious disease
  • The use of anti-inflammatory drugs
  • The use of thyroid medication
  • The use of fish oil products or fish consumption more than 2 times a week
  • Contra-indication for the use of Omegaven-Fresenius, including:
  • General contra-indications for parenteral nutrition
  • Allergy to fish or egg protein.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Medical Center of Alkmaar

Alkmaar, North Holland, Netherlands

Location

Related Publications (1)

  • Bakker N, van den Helder RS, Stoutjesdijk E, van Pelt J, Houdijk APJ. Effects of perioperative intravenous omega-3 fatty acids in colon cancer patients: a randomized, double-blind, placebo-controlled clinical trial. Am J Clin Nutr. 2020 Feb 1;111(2):385-395. doi: 10.1093/ajcn/nqz281.

MeSH Terms

Conditions

Colonic Neoplasms

Interventions

fish oil triglyceridesFatty Acids, Omega-3Antioxidants

Condition Hierarchy (Ancestors)

Colorectal NeoplasmsIntestinal NeoplasmsGastrointestinal NeoplasmsDigestive System NeoplasmsNeoplasms by SiteNeoplasmsDigestive System DiseasesGastrointestinal DiseasesColonic DiseasesIntestinal Diseases

Intervention Hierarchy (Ancestors)

Dietary Fats, UnsaturatedDietary FatsFatsLipidsFatty Acids, UnsaturatedFatty AcidsFish OilsOilsBiological FactorsMolecular Mechanisms of Pharmacological ActionPharmacologic ActionsChemical Actions and UsesProtective AgentsPhysiological Effects of DrugsSpecialty Uses of Chemicals

Study Officials

  • A.P.J. Houdijk, Dr.

    Medical Center of Alkmaar

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
PREVENTION
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Dr.

Study Record Dates

First Submitted

July 29, 2014

First Posted

September 4, 2014

Study Start

October 1, 2014

Primary Completion

June 1, 2016

Study Completion

June 1, 2016

Last Updated

July 31, 2018

Record last verified: 2018-07

Locations