ASTIC Autologous Stem Cell Transplantation for Crohn's Disease

NCT ID: NCT00297193

Last Updated: 2020-12-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

45 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-06-30

Study Completion Date

2017-03-31

Brief Summary

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Transplant study for patients with relapsing Crohn's disease demonstrating clear intolerance or toxicity to conventional treatment.

The purpose of this study is to determine whether there is a potential clinical benefit of hematopoietic stem cell mobilisation followed by high dose immuno-ablation and autologous stem cell transplantation versus hematopoietic stem cell mobilisation only followed by best clinical practice.

Detailed Description

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Open label, phase III, randomised, multicentre study comparing early transplantation procedure with transplantation carried out to the same protocol but delayed by one year. The status of patients undergoing early HSCT will be evaluated after one year and compared to those about to undergo delayed HSCT

Patients will be randomised to:

* Hematopoietic stem cell mobilisation followed, within 4 weeks, by high dose immunoablation and autologous stem cell transplantation
* Hematopoietic stem cell mobilisation followed, after 59 weeks, by high dose immunoablation and autologous hematopoietic stem cell transplantation

All patients will be mobilised prior to randomisation. Those receiving early transplantation will be compared over the first year with those whose transplant has been delayed.

Conditions

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Crohn Disease

Keywords

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Crohn's Disease HSCT Autologous EBMT ECCO

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Transplant Arm

Hematopoietic stem cell mobilisation followed, within 4 weeks, by high dose immunoablation and autologous stem cell transplantation

Group Type EXPERIMENTAL

Autologous haematopoietic stem cell transplant

Intervention Type PROCEDURE

All patients will be mobilised prior to randomisation. Those receiving early transplantation will be compared over the first year with those whose transplant has been delayed.

Delayed Transplant

Hematopoietic stem cell mobilisation followed, after 59 weeks, by high dose immunoablation and autologous hematopoietic stem cell transplantation

Group Type EXPERIMENTAL

Autologous haematopoietic stem cell transplant

Intervention Type PROCEDURE

All patients will be mobilised prior to randomisation. Those receiving early transplantation will be compared over the first year with those whose transplant has been delayed.

Interventions

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Autologous haematopoietic stem cell transplant

All patients will be mobilised prior to randomisation. Those receiving early transplantation will be compared over the first year with those whose transplant has been delayed.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

1. Age between 18 and 50 years (Patients aged 50-65 can participate if specially approved by the Trial Steering Committee)
2. Confirmed diagnosis of active Crohn's Disease
3. Unsatisfactory course despite 3 immunosuppressive agents (usually azathioprine, methotrexate and infliximab) in addition to corticosteroids. Patients should have relapsing disease (i.e. \>1 exacerbation/year) despite thiopurines, methotrexate and/or infliximab maintenance therapy or clear demonstration of intolerance / toxicity to these drugs.
4. Impaired function and quality of life, compared to population means, on at least one of the following:

1. IBDQ (Appendix 6)
2. European Questionnaire of Life quality (EuroQOL-5D, Appendix 4)
3. Impaired function on Karnofsky index (Appendix 7)
5. Current problems unsuitable for surgery and patient at risk for developing short bowel syndrome.
6. Informed consent


1. Wherever possible, diseased tissue should be accessible endoscopically for objective histological study but in the case of small bowel disease that is extensive but does not extend to duodenum or terminal ileum, participation without endoscopy is allowed.
2. Smokers may enter the study provided they have received intensive counselling about smoking.
3. Add patients with ileostomy/colostomy and patients with short bowel syndrome

Exclusion Criteria

1. Pregnancy or unwillingness to use adequate contraception during the study
2. Concomitant severe disease
3. Diarrhoea due to short small or large bowel
4. Infection or risk thereof
5. Significant malnutrition: Body Mass Index (BMI) ≤18, serum albumin \<20 g/l
6. Previous poor compliance
7. Concurrent enrolment in any other protocol using an investigational drug or hematopoietic growth factor up to four weeks before study entry.
8. Lack of funding
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Broad Foundation

OTHER

Sponsor Role collaborator

European Society for Blood and Marrow Transplantation

NETWORK

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Christopher J Hawkey

Role: STUDY_CHAIR

Nottingham University Hospital - Wolfson Digestive Diseases Centre

Locations

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University Hospital Gasthuisberg

Leuven, Herestraat 49, Belgium

Site Status

University of Calgery

Calgary, Alberta, Canada

Site Status

Hopital Huriez Chru

Lille, , France

Site Status

Hospital Sanin-Louis

Paris, , France

Site Status

Dipatimento di Medicina Interna E Gastroenterologia

Bologna, , Italy

Site Status

Universita di Bologna Interna e Gastroenterologia Policlinico Saint Orsola

Bologna, , Italy

Site Status

Careggi Hospital

Florence, , Italy

Site Status

Istituto Clinico Humanitas

Milan, , Italy

Site Status

Fondazione IRCCS Ospedale Maggiore Policlinico Mangiagalli e Regina Elena

Milan, , Italy

Site Status

L Sacco University Hopsital

Milan, , Italy

Site Status

Casa Sollievo Della Sofferenza IRCCS Hospital

San Giovanni Rotondo, , Italy

Site Status

Hospital Universitari Germans Trias I Pujol, Dept of Gastroenterology

Badalona, , Spain

Site Status

University Hospital

Basel, , Switzerland

Site Status

Universitätsspital Zürich

Zurich, , Switzerland

Site Status

The John Radcliffe Hospital

Oxford, Headington, United Kingdom

Site Status

Western General Hospital

Edinburgh, , United Kingdom

Site Status

Barts and the London NHS Trust

London, , United Kingdom

Site Status

City Hospital

Nottingham, , United Kingdom

Site Status

Nottingham Digestive Diseases Centre

Nottingham, , United Kingdom

Site Status

Countries

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Czechia Germany Netherlands Belgium Canada France Italy Spain Switzerland United Kingdom

References

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Lindsay JO, Allez M, Clark M, Labopin M, Ricart E, Rogler G, Rovira M, Satsangi J, Farge D, Hawkey CJ; ASTIC trial group; European Society for Blood and Marrow Transplantation Autoimmune Disease Working Party; European Crohn's and Colitis Organisation. Autologous stem-cell transplantation in treatment-refractory Crohn's disease: an analysis of pooled data from the ASTIC trial. Lancet Gastroenterol Hepatol. 2017 Jun;2(6):399-406. doi: 10.1016/S2468-1253(17)30056-0. Epub 2017 Apr 6.

Reference Type DERIVED
PMID: 28497755 (View on PubMed)

Hawkey CJ, Allez M, Clark MM, Labopin M, Lindsay JO, Ricart E, Rogler G, Rovira M, Satsangi J, Danese S, Russell N, Gribben J, Johnson P, Larghero J, Thieblemont C, Ardizzone S, Dierickx D, Ibatici A, Littlewood T, Onida F, Schanz U, Vermeire S, Colombel JF, Jouet JP, Clark E, Saccardi R, Tyndall A, Travis S, Farge D. Autologous Hematopoetic Stem Cell Transplantation for Refractory Crohn Disease: A Randomized Clinical Trial. JAMA. 2015 Dec 15;314(23):2524-34. doi: 10.1001/jama.2015.16700.

Reference Type DERIVED
PMID: 26670970 (View on PubMed)

Other Identifiers

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ASTIC

Identifier Type: -

Identifier Source: secondary_id

EudraCT2005-003337-40

Identifier Type: -

Identifier Source: org_study_id