Purified fatty acids for endometriosis clinical trial

ISRCTN ISRCTN44202346
DOI https://doi.org/10.1186/ISRCTN44202346
EudraCT/CTIS number 2013-004938-15
Secondary identifying numbers Version 4
Submission date
01/05/2017
Registration date
30/05/2017
Last edited
14/06/2023
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Urological and Genital Diseases
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Background and study aims
Endometriosis is a common condition where tissue that behaves like the lining of the womb (endometrium) is found in other parts of the body. It affects 6-10% of women and causes severe pelvic pain. Endometriosis can be treated surgically or medically. However, symptoms often come back after surgery and the currently available medical treatments are hormones which have undesirable side effects and are contraceptive. Omega-3 purified fatty acid (PUFA) supplements may reduce endometriosis-associated pain, have minimal side effects and no effects on fertility. The aim of this small study is to assess the feasibility of conducting a larger study of PUFA for endometriosis-associated pain.

Who can participate?
Patients aged 18-50 with endometriosis

What does the study involve?
Participants are randomly allocated to receive soft gelatin capsules containing either omega-3 purified fatty acids (fish oil) or olive oil, and are advised to take two capsules per day, one in the morning and one in the evening for 8 weeks. Pain is measured at the start and end of the study and blood samples are collected to measure fatty acid levels.

What are the possible benefits and risks of participating?
PUFAs are a dietary supplement and may reduce endometriosis-associated pain. They have minimal side effects and no effects on fertility.

Where is the study run from?
Royal Infirmary of Edinburgh (UK)

When is the study starting and how long is it expected to run for?
October 2013 to May 2017

Who is funding the study?
University of Edinburgh (UK)

Who is the main contact?
1. Mrs Ann Doust (public)
ann.doust@ed.ac.uk
2. Prof. Andrew Horne (scientific)

Contact information

Mrs Ann Doust
Public

University of Edinburgh
51 Little France Crescent
Edinburgh Eh16 4SA
Edinburgh
EH16 4SA
United Kingdom

Phone +44 (0)131 242 9492
Email ann.doust@ed.ac.uk
Prof Andrew Horne
Scientific

QMRI
47 Little France Crescent
Edinburgh
EH16 4TJ
United Kingdom

Study information

Study designRandomised controlled double-blind feasibility study
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details to request a patient information sheet
Scientific titlePurFECT: PURified Fatty acids for Endometriosis Clinical Trial: a randomised controlled trial
Study acronymPurFECT
Study hypothesisEndometriosis (womb lining outside the womb) affects 6-10% of women and is associated with debilitating chronic pelvic pain. It costs the UK >£2.8 billion per year in loss of productivity. Endometriosis is managed surgically or medically. However, ~75% symptoms recur after surgery and available medical treatments (‘anti-hormones’) have undesirable side effects and are contraceptive. Omega-3 purified fatty acids (PUFA) have been shown in animal models to reduce factors that are thought to lead to endometriosis-associated pain, have minimal side effects and no effects on fertility. The trialists plan to perform a feasibility study to inform planning of a future multicentre trial to evaluate the efficacy of PUFA in the management of endometriosis-associated pain.
Ethics approval(s)South East Scotland Research Ethics Committee 01, 02/02/2016, ref: 16/SS/0010
ConditionEndometriosis-related pain
InterventionParticipants are randomised to receive either omega-3 purified fatty acids (fish oil) or olive oil soft gelatin (placebo) capsules, with a dose of 1000 mg each, and advised to take two capsules per day, one in the morning and one in the evening for 8 weeks. The outcomes are measured at baseline and at the end of the study (i.e., 8 weeks).
Intervention typeSupplement
Primary outcome measure1. The proportion of screened women who are eligible for the trial
2. The proportion of eligible patients randomised into the study
3. The proportion of randomised patients who take the supplement and complete questionnaires at final follow up

The outcomes will be measured at baseline and at the end of the study (i.e., 8 weeks).
Secondary outcome measuresThe remaining outcomes will be used to refine the research methodology of a future large RCT:
1. Pain, measured using the Numerical Rating Score (NRS) collected via text message during the screening phase (-1 to -4 weeks) and last 4 weeks (weeks 5-8) of the treatment phase
2. Eicosapentaenoic acid, arachidonic acid and docosahexaenoic acid concentrations measured from peripheral venous blood samples at baseline and 8 weeks
3. Quality of life, measured using SF-12 at baseline and 8 weeks
4. Pain, measured using the Brief Pain Inventory (BPI) at baseline and 8 weeks
5. Pain catastrophizing, measured using the Pain Catastrophising Questionnaire (PCQ) at baseline and 8 weeks
5. Pain, measures using the PainDETECT™ questionnaire at baseline and 8 weeks
6. Sexual activity, measured using the Sexual Activity Questionnaire (SAQ) at baseline and 8 weeks
7. Fatigue, measured using the Brief Fatigue Inventory (BFI) at baseline and 8 weeks
8. General health, measures using the General Health Questionnaire -12 (GHQ-12) at baseline and 8 weeks
9. Work and productivity activity impairment, measured using the Work and Productivity Activity Impairment Questionnaire- Specific Health Problem version 2.0 (WPAI-SHP) at baseline and 8 weeks
10. Acceptability of proposed methods of recruitment, randomisation, treatments and questionnaires, measured using a questionnaire at 8 weeks
Overall study start date28/10/2013
Overall study end date01/03/2018

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
Upper age limit50 Years
SexFemale
Target number of participants40
Total final enrolment33
Participant inclusion criteria1. Aged 18-50 years
2. Known endometriosis diagnosed from previous laparoscopy
3. Pain of at least 3 months duration located in the true pelvis
4. Worst pain score ≥4 over 4 weeks as measured by Numerical Rating Score (NRS)
5. Ability to provide informed consent
Participant exclusion criteria1. Unable to take/allergic to fish/PUFA/peanuts/soyabean
2. Insulin dependent diabetes
3. Pregnant
4. Taking contraindicated medications (anticoagulants)
5. Breastfeeding
Recruitment start date30/06/2016
Recruitment end date31/12/2017

Locations

Countries of recruitment

  • Scotland
  • United Kingdom

Study participating centre

Royal Infirmary of Edinburgh
51 Little France Crescent
Edinburgh
EH16 4SA
United Kingdom

Sponsor information

University of Edinburgh and NHS Lothian
University/education

ACCORD Office
QMRI
47 Little France Crescent
Edinburgh
EH16 4TJ
Scotland
United Kingdom

ROR logo "ROR" https://ror.org/03q82t418

Funders

Funder type

University/education

University Of Edinburgh
Government organisation / Universities (academic only)
Alternative name(s)
Universitas Academica Edinburgensis, Oilthigh Dhùn Èideann, The University of Edinburgh, University of Edinburgh in United Kingdom, Edin, Tounis College, King James' College, Athens of the North, ED, Edin
Location
United Kingdom

Results and Publications

Intention to publish date01/05/2018
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryData sharing statement to be made available at a later date
Publication and dissemination planThe target is to use the clinical study report for publication and presentation at scientific meetings.
IPD sharing planThe current data sharing plans for the current study are unknown and will be made available at a later date.

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 01/12/2018 Yes No
Results article results 17/01/2020 20/01/2020 Yes No
Protocol file version 2.0 25/01/2016 14/06/2023 No No
HRA research summary 28/06/2023 No No

Additional files

ISRCTN44202346_Protocol_v2.0_25January2016.pdf

Editorial Notes

14/06/2023: Uploaded protocol (not peer reviewed).
20/01/2020: The following changes have been made:
1. Publication reference added.
2. The final enrolment number has been added from the reference.
30/04/2018: Publication reference added.
01/09/2017: The overall trial end date was changed from 01/05/2017 to 01/03/2018. Recruitment end date changed from 21/03/2017 to 31/12/2017.