NCT03531528

Brief Summary

Chronic plaque psoriasis is frequently associated with obesity and previous studies have shown that a calorie-controlled diet inducing body weight loss improves symptoms and increases the response to pharmacologic treatment. Besides, clinical improvement has been directly correlated with the amount of weight loss. Short-term very low-calorie ketogenic diets are responsible for substantial weight loss and attenuate systemic inflammation to a higher extent than moderately hypocaloric diets. This intervention has been recently demonstrated to restore, after only 4 week, the response to biological therapy in a patient suffering from relapsing moderate-to-severe plaque psoriasis and obesity-related metabolic syndrome. We investigated the efficacy of an aggressive weight loss program with a ketogenic induction phase in a single-arm trial that could provide the rationale for a large randomized trial.

Trial Health

87
On Track

Trial Health Score

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

Enrollment
37

participants targeted

Target at P25-P50 for not_applicable

Timeline
Completed

Started May 2018

Shorter than P25 for not_applicable

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

April 4, 2018

Completed
2 months until next milestone

First Posted

Study publicly available on registry

May 21, 2018

Completed
Same day until next milestone

Study Start

First participant enrolled

May 21, 2018

Completed
5 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

October 29, 2018

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

October 29, 2018

Completed
Last Updated

October 31, 2018

Status Verified

October 1, 2018

Enrollment Period

5 months

First QC Date

April 4, 2018

Last Update Submit

October 29, 2018

Conditions

Outcome Measures

Primary Outcomes (1)

  • Reduction in Psoriasis Area and Severity Index

    Change in score (on continuous scale) at the end of study

    10 weeks

Secondary Outcomes (15)

  • Reduction in Psoriasis Area and Severity Index

    4 weeks

  • Reduction in Psoriasis Area and Severity Index >=75%

    10 weeks

  • Reduction in Psoriasis Area and Severity Index >=75%

    4 weeks

  • Reduction in Psoriasis Area and Severity Index >=50%

    10 weeks

  • Reduction in Psoriasis Area and Severity Index >=50%

    4 weeks

  • +10 more secondary outcomes

Study Arms (1)

Experimental

EXPERIMENTAL

A 4-week protein-sparing, very low-calorie, ketogenic diet and a subsequent 6-week hypocaloric, low glycemic index, Mediterranean-like diet

Other: Diet

Interventions

DietOTHER

A 4-week protein-sparing, very low-calorie, ketogenic diet and a subsequent 6-week hypocaloric, low glycemic index, Mediterranean-like diet

Experimental

Eligibility Criteria

Age18 Years - 75 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Stable chronic plaque psoriasis
  • Overweight/obese (body mass index \>25 kg/m2)

You may not qualify if:

  • pregnancy and/or lactation
  • insulin-dependent diabetes mellitus
  • a psychiatric disorder
  • current or previous (\<1 year since last chemo- or radiotherapy) neoplastic disease
  • established vascular disease
  • recent (6 months), history of diet-induced or unintentional weight loss
  • moderate-to-severe heart failure
  • arrhythmia or conduction disorder
  • renal failure (creatinine \>1.5 mg/dL)
  • liver failure (Child-Pugh ≥ A)
  • any type of gastrointestinal disease
  • moderate-severe hypoalbuminemia (\<3.0 g/dL)
  • altered serum electrolytes
  • refusal to give written informed consent

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

A.O.R.N. "San Giuseppe Moscati"

Avellino, Italy

Location

Related Publications (4)

  • Castaldo G, Galdo G, Rotondi Aufiero F, Cereda E. Very low-calorie ketogenic diet may allow restoring response to systemic therapy in relapsing plaque psoriasis. Obes Res Clin Pract. 2016 May-Jun;10(3):348-52. doi: 10.1016/j.orcp.2015.10.008. Epub 2015 Nov 11.

    PMID: 26559897BACKGROUND
  • Castaldo G, Monaco L, Castaldo L, Galdo G, Cereda E. An observational study of sequential protein-sparing, very low-calorie ketogenic diet (Oloproteic diet) and hypocaloric Mediterranean-like diet for the treatment of obesity. Int J Food Sci Nutr. 2016 Sep;67(6):696-706. doi: 10.1080/09637486.2016.1186157. Epub 2016 May 18.

    PMID: 27193396BACKGROUND
  • Castaldo G, Palmieri V, Galdo G, Castaldo L, Molettieri P, Vitale A, Monaco L. Aggressive nutritional strategy in morbid obesity in clinical practice: Safety, feasibility, and effects on metabolic and haemodynamic risk factors. Obes Res Clin Pract. 2016 Mar-Apr;10(2):169-77. doi: 10.1016/j.orcp.2015.05.001. Epub 2015 Jun 1.

    PMID: 26044613BACKGROUND
  • Monaco L, Monaco M, Di Tommaso L, Stassano P, Castaldo L, Castaldo G. Aortomesenteric fat thickness with ultrasound predicts metabolic diseases in obese patients. Am J Med Sci. 2014 Jan;347(1):8-13. doi: 10.1097/MAJ.0b013e318288f795.

    PMID: 24366220BACKGROUND

MeSH Terms

Conditions

Psoriasis

Interventions

Diet

Condition Hierarchy (Ancestors)

Skin Diseases, PapulosquamousSkin DiseasesSkin and Connective Tissue Diseases

Intervention Hierarchy (Ancestors)

Nutritional Physiological PhenomenaDiet, Food, and NutritionPhysiological Phenomena

Study Officials

  • Giuseppe Castaldo, MD

    A.O.R.N. "San Giuseppe Moscati", Avellino, Italy

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NA
Masking
NONE
Purpose
TREATMENT
Intervention Model
SINGLE GROUP
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

April 4, 2018

First Posted

May 21, 2018

Study Start

May 21, 2018

Primary Completion

October 29, 2018

Study Completion

October 29, 2018

Last Updated

October 31, 2018

Record last verified: 2018-10

Locations