| Title: |
P1131 A randomised placebo-controlled dietary advice trial of the Four Strategies to SUlphide Reduction (4-SURE) diet in adults with mild-moderately active ulcerative colitis |
| Authors: |
Day, A; Portmann, L; Goodsall, T; Saxon, S; Mathias, R; Fon, J; Bibb, L; Uylaki, W; Slater, R; Young, R; Davis, R; Bogatic, D; Edwards, S; Joyce, P; Yao, C; Wheeler, R; Forster, S; Costello, S; Probert, C; Gibson, P; Bryant, R V |
| Source: |
Journal of Crohn’s and Colitis ; volume 20, issue Supplement_1 ; ISSN 1873-9946 1876-4479 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2026 |
| Description: |
Background There is increasing interest in microbial-derived production of hydrogen sulphide (H2S) as a biochemical therapeutic target for ulcerative colitis (UC). This study aimed to determine whether the Four strategies to SUlphide REduction (4-SURE) diet was superior to a Sham diet at inducing clinical and endoscopic response in adults with mild-moderately active UC within 8 weeks. Methods This was a double-blind placebo-controlled trial (ANZCTR 12621001568808). Adults with mild-moderately active UC (Total Mayo 3-10 inclusive of an endoscopic sub score ≥1) on stable therapy were block randomised 1:1 to 4-SURE and Sham dietary advice. The diets were dietitian-taught and nutritionally adequate except differences in key nutrients of interest (fermentable fibres, total and sulphated proteins, food additives). The composite primary endpoint was clinical and endoscopic response (defined as a reduction in Total Mayo score ≥3 inclusive of endoscopic Mayo ≥1) at 8 weeks. Secondary endpoints included clinical response (reduction in partial Mayo ≥2), remission (partial Mayo ≥2), segmental healing (reduction in endoscopic Mayo segmental score ≥1), regression of proximal disease extent (centimeters), histological healing (reduction in Nancy Histology Index ≥1). Adherence was assessed via self-report, 7-day food diaries and faecal H2S concentration. Regression analyses evaluated differences between diets. Results Of 237 screened, 53 commenced 4-SURE (n = 26) and Sham (n = 27) diets. Five withdrew mid-trial (2 4-SURE, 3 Sham). Baseline characteristics were comparable. Four met the primary outcome at 8 weeks (ITT: 15% each diet; p = 0.95; PP 17% each diet; p = 1.00). Clinical response (54% vs 54%; p = 1.00) and endoscopic response (25% vs 21%; p = 0.73) were similar. Segmental healing occurred with both diets (46% vs 42%; p = 0.772). Disease extent regressed by 7.4 (95% CI 0.5-14.2) cm with 4-SURE (p = 0.036) vs 7.2 (0.3-14.0) cm with Sham (p = 0.042) (Fig 1). No serious adverse events occurred. No participant had ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/ecco-jcc/jjaf231.1312 |
| Availability: |
https://doi.org/10.1093/ecco-jcc/jjaf231.1312; https://academic.oup.com/ecco-jcc/article-pdf/20/Supplement_1/jjaf231.1312/66501960/jjaf231.1312.pdf |
| Rights: |
https://academic.oup.com/pages/standard-publication-reuse-rights |
| Accession Number: |
edsbas.B2208EF2 |
| Database: |
BASE |