NCT05987852

Brief Summary

Chronic intestinal hypoxia and accompanying mucosal inflammation is a hallmark of ulcerative colitis (UC). Hyperbaric oxygen therapy (HBOT) involves breathing 100% oxygen under increased atmospheric pressure to increase tissue oxygenation. Two small prospective randomized controlled trials have demonstrated that the delivery of HBOT to UC patients hospitalized for acute moderate to severe flares results in improved remission rates and avoidance of in-hospital progression to biologics, small molecules, or colectomy. In this larger trial the study aims to confirm the treatment benefits of HBOT for hospitalized UC patients and study the immune-microbe mechanisms underpinning treatment response.

Trial Health

77
On Track

Trial Health Score

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

Enrollment
126

participants targeted

Target at P50-P75 for not_applicable

Timeline
16mo left

Started Jan 2024

Longer than P75 for not_applicable

Geographic Reach
1 country

13 active sites

Status
recruiting

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

Study Progress64%
Jan 2024Sep 2027

First Submitted

Initial submission to the registry

August 1, 2023

Completed
13 days until next milestone

First Posted

Study publicly available on registry

August 14, 2023

Completed
5 months until next milestone

Study Start

First participant enrolled

January 9, 2024

Completed
3.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 1, 2027

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

September 1, 2027

Last Updated

January 8, 2026

Status Verified

January 1, 2026

Enrollment Period

3.6 years

First QC Date

August 1, 2023

Last Update Submit

January 6, 2026

Conditions

Keywords

hyperbaric oxygen therapyHBOTulcerative colitishyperbaric oxygen

Outcome Measures

Primary Outcomes (1)

  • Clinical response defined as complete resolution of rectal bleeding and improvement in stool frequency, without need for in-hospital biologics, small molecules, or colectomy by study day 5

    Proportion of participants achieving clinical response as measured by complete resolution of rectal bleeding (Mayo rectal bleeding sub-score of 0) and improvement in stool frequency (at least 1 point reduction in Mayo stool frequency sub-score), without the need for in-hospital biologics, small molecules, or colectomy, by study day 5.

    Day 5

Secondary Outcomes (12)

  • Clinical Response

    Day 3

  • Change in inflammation, as measured by C-reactive protein

    Day 3

  • Endoscopic response

    Day 5

  • Steroid-free, colectomy-free, clinical remission

    Day 90

  • Endoscopic Improvement

    Day 90

  • +7 more secondary outcomes

Study Arms (2)

Hyperbaric Oxygen Therapy

EXPERIMENTAL

Participants enrolled in the active intervention group receiving HBOT will undergo compression to 2.4 Atmospheres Absolute (ATA; 100% O2) for 90 minutes with two 5-10 minute "air breaks" (breathing room air at the 2.4 ATA) during the session. This is done once a day for 5 days.

Device: Hyperbaric Oxygen Therapy

Sham Hyperbaric Air

SHAM COMPARATOR

This control arm will undergo compression to 1.34 ATA for monoplace chambers and 2.4 ATA for multiplace chambers for the full 90-minute session but 21% oxygen instead of 100% oxygen being administered. These participants will also have two 5-10 minute "air breaks" to mimic the treatment protocol. Multiplace sham sessions will have modified air breaks to avoid decompression sickness. This will happen once a day for 5 days.

Other: Sham Hyperbaric Air

Interventions

Participants enrolled in the active intervention group receiving HBOT will undergo compression to 2.4 Atmospheres Absolute (ATA; 100% O2) for 90 minutes with two 5-10 minute "air breaks" (breathing room air at the 2.4 ATA) during the session. This is done once a day for 5 days.

Hyperbaric Oxygen Therapy

This control arm will undergo compression to 1.34 ATA for monoplace chambers and 2.4 ATA for multiplace chambers for the full 90-minute session but 21% oxygen instead of 100% oxygen being administered. These participants will also have two 5-10 minute "air breaks" to mimic the treatment protocol. Multiplace sham sessions will have modified air breaks to avoid decompression sickness. This will happen once a day for 5 days.

Sham Hyperbaric Air

Eligibility Criteria

Age18 Years - 85 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Participants with known or newly diagnosed UC who require hospitalization for an acute moderate to severe flare
  • Age 18-85
  • Able to fully participate in all aspects of the trial
  • Consented and able to receive first HBOT session within first 48 hours of initiation of intravenous steroids
  • Agreement to not participate in another trial for the duration of the active intervention period

You may not qualify if:

  • Received hyperbaric oxygen therapy either as part of standard of care or through a clinical trial prior to enrollment
  • Complication requiring urgent surgical intervention
  • Requirement for new start of a biologic or small molecule during the hospitalization prior to randomization and/or anticipated requirement for rescue medical or surgical therapy within 48 hours of randomization
  • Toxic megacolon
  • Inability to receive intravenous steroids
  • Historically failed or been exposed to 4 or more classes of advanced therapeutic options
  • Known or suspected diagnosis of Crohn's colitis, indeterminate colitis, ischemic colitis, radiation colitis, diverticular disease associated with colitis, microscopic colitis or infectious colitis
  • Received any investigational drug within 30 days
  • Clinically significant cardiac, renal, neurological, endocrine, respiratory or hepatic impairment that increases the risk for HBOT toxicity
  • Women who are pregnant or nursing
  • Unwillingness to complete course of HBOT

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (13)

University of Alabama Medicine

Birmingham, Alabama, 35233, United States

RECRUITING

University of Los Angeles Health

Los Angeles, California, 90024, United States

RECRUITING

University of Miami Health

Miami, Florida, 33136, United States

RECRUITING

Orlando Health

Orlando, Florida, 32806, United States

RECRUITING

Northwestern Medicine Lake Forest Hospital

Lake Forest, Illinois, 60045, United States

RECRUITING

University of Louisville

Louisville, Kentucky, 40202, United States

RECRUITING

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

RECRUITING

Mayo Clinic

Rochester, Minnesota, 55905, United States

RECRUITING

Dartmouth Hitchcock Medical Center

Lebanon, New Hampshire, 03756, United States

RECRUITING

Cornell University Medical Center

New York, New York, 10065, United States

ACTIVE NOT RECRUITING

State University of New York Upstate Medical University

Syracuse, New York, 13210, United States

RECRUITING

Allegheny Health

Pittsburgh, Pennsylvania, 15090, United States

RECRUITING

University of Pittsburgh Medical Center

Pittsburgh, Pennsylvania, 15213, United States

RECRUITING

Related Publications (1)

  • Bonner LB, Sadler C, Lindholm P, Scholtens DM, Dulai PS; HBOT-UC Consortium. Hyperbaric oxygen therapy for ulcerative colitis patients hospitalized for moderate to severe flares (HBOT-UC): study protocol for a multi-center, randomized, double-blind, sham-controlled trial. Trials. 2025 Jun 22;26(1):220. doi: 10.1186/s13063-025-08932-5.

MeSH Terms

Conditions

Colitis, Ulcerative

Interventions

Hyperbaric Oxygenation

Condition Hierarchy (Ancestors)

ColitisGastroenteritisGastrointestinal DiseasesDigestive System DiseasesInflammatory Bowel DiseasesColonic DiseasesIntestinal Diseases

Intervention Hierarchy (Ancestors)

Oxygen Inhalation TherapyRespiratory TherapyTherapeutics

Study Officials

  • Lauren Balmert Bonner, PhD

    Northwestern University

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
TRIPLE
Who Masked
PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: 5-day intervention period; 12 months observational period through standard of care visits and follow-up
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

August 1, 2023

First Posted

August 14, 2023

Study Start

January 9, 2024

Primary Completion (Estimated)

September 1, 2027

Study Completion (Estimated)

September 1, 2027

Last Updated

January 8, 2026

Record last verified: 2026-01

Data Sharing

IPD Sharing
Will share

Dataset with National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Repository.

Shared Documents
STUDY PROTOCOL, ICF

Locations