Stop Infliximab in Patients With Crohn's Disease

NCT ID: NCT00571337

Last Updated: 2010-07-23

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

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

126 participants

Study Classification

INTERVENTIONAL

Study Start Date

2005-12-31

Study Completion Date

2010-07-31

Brief Summary

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1 Project summary 1.1 Rational. Accent 1 study has demonstrated the superiority of Infliximab over placebo in a systematic treatment strategy of Crohn 's disease every 8 weeks during one year. However the optimal strategy beyond one year of treatment is not established. Particularly, the need for carrying on systematic treatment with infliximab in all the patients has not been demonstrated.

1.2 Primary objective. Determine factors associated with a low risk of clinical relapse after stopping infliximab in CD patients in remission (CDAI\<150) and regularly treated with infliximab for at least one year.

1.3 Main objective and main judgement criteria. Determine predictive factors for relapse within one year after stopping infliximab. Main judgement criteria is the clinical relapse after stopping infliximab. Clinical relapse is defined either by a CDAI\>250 or by a CDAI between 150 and 250 if this CDAI is confirmed over two consecutive weeks with an increase of at least 70 points over baseline for the two consecutive measures.

1.4 Secondary objectives and judgement criteria. Determine the time to-relapse Determine predictive factors for short-term relapse (\<2 months)after stopping infliximab.

Determine response to infliximab retreatment in these patients. Determine tolerance to infliximab retreatment in these patients. Determine predictive factors for an absence of response to retreatment. Determine predictive factors for infliximab retreatment intolerance. Determine sustained response in the retreated patients.

1.5 Type of study Open-label prospective study of stopping regular treatment. Inclusion period: minimum one year, possibly prolonged to reach 100 patients. Patients will be followed up every two months for at least 18 months after stopping infliximab.

1.6 Justification of the number of patients Number of patients to include is at least 100. This recruitment should be reached within one year. This number should allow to disclose predictive factors associated with a relative risk of at least 2 if this factor is equilibrated (50% at risk patients) or 3 is this factor is disequilibrated (90% at risk patients).

Detailed Description

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Conditions

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Crohn Disease

Study Design

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Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Interventions

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Infliximab

Stopping infliximab in patients having been treated with this drug for at least one year and in stable remission for at least 6 month.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Crohn's disease.
* Age \> 18 years.
* Patient written informed consent.
* Patient having been treated with infliximab for confirmed Crohn's disease with active intestinal lesions.
* Patient treated with infliximab for at least 1 year, associated with an immunosuppressor for at least one year, with a maximum interval between 2 infliximab infusions of 3 months.
* Patient with continuous remission without steroids for at least 6 months, except IV steroids for infusion reaction prophylaxis.
* CDAI\<150.
* Contraception all over the study.

Exclusion Criteria

* Patient having experienced an severe acute infusion reaction to infliximab, defined by an anaphylactoïd reaction (drop in blood pressure, bronchospasm, dyspnea) requiring the arrest of the infliximab infusion.
* Patient having experienced a severe delayed infusion reaction to infliximab, defined by fever, arthralgia, myalgia, requiring a steroid treatment.
* Patient with dominant perianal disease and absence of active intestinal disease at the time of infliximab induction.
* Patient with active perianal disease at the time of inclusion.
* Patient with stoma.
* Patient with debilitating extra-intestinal manifestation at the time of inclusion.
* Non cooperating subjects.
* Pregnant or lactating women.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Groupe d'Etude Therapeutique des Affections Inflammatoires Digestives

OTHER

Sponsor Role lead

Responsible Party

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getaid

Principal Investigators

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Louis Edouard, PhD

Role: PRINCIPAL_INVESTIGATOR

Groupe d'Etude Therapeutique des Affections Inflammatoires Digestives

Locations

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Gent University Hospital

Ghent, , Belgium

Site Status

CHU LIEGE - Sart Tilman

Liège, , Belgium

Site Status

Chu Amiens

Amiens, , France

Site Status

Chu Besancon

Besançon, , France

Site Status

Hopital Saint Andre

Bordeaux, , France

Site Status

CHU CAEN

Caen, , France

Site Status

Hopital Beaujon

Clichy, , France

Site Status

Hopital Louis Mourier

Colombes, , France

Site Status

Hopital Henri Mondor

Créteil, , France

Site Status

CHRU Lille

Lille, , France

Site Status

Chu Marseille - Hopital Nord

Marseille, , France

Site Status

Ch Le Raincy Montfermeil

Montfermeil, , France

Site Status

Chu Montpellier

Montpellier, , France

Site Status

Chu Nantes

Nantes, , France

Site Status

Hopital Lariboisiere

Paris, , France

Site Status

Hopital Saint Louis

Paris, , France

Site Status

Hopital Georges Pompidou

Paris, , France

Site Status

Hopital Haut Leveque

Pessac, , France

Site Status

CHU LYON

Pierre-Bénite, , France

Site Status

Chu Rouen

Rouen, , France

Site Status

Chu Strasbourg

Strasbourg, , France

Site Status

Chu Toulouse

Toulouse, , France

Site Status

Chu Tours

Tours, , France

Site Status

Countries

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Belgium France

References

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Vermeire S, Louis E, Carbonez A, Van Assche G, Noman M, Belaiche J, De Vos M, Van Gossum A, Pescatore P, Fiasse R, Pelckmans P, Reynaert H, D'Haens G, Rutgeerts P; Belgian Group of Infliximab Expanded Access Program in Crohn's Disease. Demographic and clinical parameters influencing the short-term outcome of anti-tumor necrosis factor (infliximab) treatment in Crohn's disease. Am J Gastroenterol. 2002 Sep;97(9):2357-63. doi: 10.1111/j.1572-0241.2002.05991.x.

Reference Type BACKGROUND
PMID: 12358256 (View on PubMed)

Parsi MA, Achkar JP, Richardson S, Katz J, Hammel JP, Lashner BA, Brzezinski A. Predictors of response to infliximab in patients with Crohn's disease. Gastroenterology. 2002 Sep;123(3):707-13. doi: 10.1053/gast.2002.35390.

Reference Type BACKGROUND
PMID: 12198696 (View on PubMed)

Farrell RJ, Alsahli M, Jeen YT, Falchuk KR, Peppercorn MA, Michetti P. Intravenous hydrocortisone premedication reduces antibodies to infliximab in Crohn's disease: a randomized controlled trial. Gastroenterology. 2003 Apr;124(4):917-24. doi: 10.1053/gast.2003.50145.

Reference Type BACKGROUND
PMID: 12671888 (View on PubMed)

Baert F, Noman M, Vermeire S, Van Assche G, D' Haens G, Carbonez A, Rutgeerts P. Influence of immunogenicity on the long-term efficacy of infliximab in Crohn's disease. N Engl J Med. 2003 Feb 13;348(7):601-8. doi: 10.1056/NEJMoa020888.

Reference Type BACKGROUND
PMID: 12584368 (View on PubMed)

Tampo Y, Yonaha M. Antioxidant mechanism of Mn(II) in phospholipid peroxidation. Free Radic Biol Med. 1992;13(2):115-20. doi: 10.1016/0891-5849(92)90072-o.

Reference Type BACKGROUND
PMID: 1516837 (View on PubMed)

Parsi MA, Lashner BA. Safety of infliximab: primum non nocere. The safety profile of infliximab in patients with Crohn's disease: the Mayo Clinic experience in 500 patients. Inflamm Bowel Dis. 2004 Jul;10(4):486-7. doi: 10.1097/00054725-200407000-00028. No abstract available.

Reference Type BACKGROUND
PMID: 15475765 (View on PubMed)

Keane J, Gershon S, Wise RP, Mirabile-Levens E, Kasznica J, Schwieterman WD, Siegel JN, Braun MM. Tuberculosis associated with infliximab, a tumor necrosis factor alpha-neutralizing agent. N Engl J Med. 2001 Oct 11;345(15):1098-104. doi: 10.1056/NEJMoa011110.

Reference Type BACKGROUND
PMID: 11596589 (View on PubMed)

Pierre N, Huynh-Thu VA, Baiwir D, Mazzucchelli G, Fleron M, Trzpiot L, Eppe G, De Pauw E, Laharie D, Satsangi J, Bossuyt P, Vuitton L, Vieujean S, Colombel JF, Meuwis MA, Louis E; GETAID and the SPARE-Biocycle research group. External validation of serum biomarkers predicting short-term and mid/long-term relapse in patients with Crohn's disease stopping infliximab. Gut. 2024 Nov 11;73(12):1965-1973. doi: 10.1136/gutjnl-2024-332648.

Reference Type DERIVED
PMID: 39134391 (View on PubMed)

Louis E, Mary JY, Vernier-Massouille G, Grimaud JC, Bouhnik Y, Laharie D, Dupas JL, Pillant H, Picon L, Veyrac M, Flamant M, Savoye G, Jian R, Devos M, Porcher R, Paintaud G, Piver E, Colombel JF, Lemann M; Groupe D'etudes Therapeutiques Des Affections Inflammatoires Digestives. Maintenance of remission among patients with Crohn's disease on antimetabolite therapy after infliximab therapy is stopped. Gastroenterology. 2012 Jan;142(1):63-70.e5; quiz e31. doi: 10.1053/j.gastro.2011.09.034. Epub 2011 Sep 22.

Reference Type DERIVED
PMID: 21945953 (View on PubMed)

Other Identifiers

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GETAID 2005-1

Identifier Type: -

Identifier Source: org_study_id

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