Study Investigating Tailored Treatment With Infliximab for Active Crohn's Disease

NCT ID: NCT01442025

Last Updated: 2015-08-11

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

121 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-06-30

Study Completion Date

2015-07-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

To investigate whether sustained trough levels of IFX can be achieved using IFX (Infliximab) trough level measurements and adjustment of dosing based upon these levels by means of two different standardized algorithms in comparison with 'standard of care' IFX treatment and its effects on clinical and endoscopic outcomes.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Crohn's Disease

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Cohort 1 =Control Group

the dose of IFX will be increased by 5 mg/kg (maximally 1 time) based on symptom relapse (usual clinical practice) Dose will be kept stable ofr the rest of the trial Dose decreases will not be allowed.

Group Type PLACEBO_COMPARATOR

Infliximab

Intervention Type DRUG

Perfusion of IFX 5mg/kg to be increased to 10 mg/kg based on clinical symptoms

Cohort 2

Dose of IFX will be increased by 2.5 mg/kg (maximally 2 times) if the following criteria are met A dose increase is maintained for the following infusions

Group Type ACTIVE_COMPARATOR

Infliximab

Intervention Type DRUG

Perfusion of IFX 5mg/kg or 10 mg/kg if dose increase criteria are met (biological)

Cohort 3

Dose of IFX will be increased by 5 mg/kg (maximally 1 time) if the following criteria are met A dose increase is maintained for the following infusions

Group Type ACTIVE_COMPARATOR

Infliximab

Intervention Type DRUG

Perfusion of IFX 5mg/kg or 7,5 mg/kg if dose increase criteria are met (biological)and 10mg/kg if dose increase criteria are met for a second time

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Infliximab

Perfusion of IFX 5mg/kg to be increased to 10 mg/kg based on clinical symptoms

Intervention Type DRUG

Infliximab

Perfusion of IFX 5mg/kg or 10 mg/kg if dose increase criteria are met (biological)

Intervention Type DRUG

Infliximab

Perfusion of IFX 5mg/kg or 7,5 mg/kg if dose increase criteria are met (biological)and 10mg/kg if dose increase criteria are met for a second time

Intervention Type DRUG

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

IFX IFX IFX

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Age \> 18 years
* Active CD (CDAI\>220) and signs of active inflammation as evidenced by elevated serum hsCRP levels (\>5 mg/L) and/or elevated fecal calprotectin levels (\>250 µg/g) and endoscopically visible ulcers.
* Patients must be naïve to biologics with indication for starting anti-TNF therapy in accordance with national reimbursement criteria.
* Patients must be naïve to thiopurines or have failed therapy with thiopurines (in which case AZA will be continued).
* Ongoing steroids are allowed if at stable dose for at least 2 weeks and at a maximum of prednisone 40 mg/d or budesonide 9 mg/day.
* Patients who consent to receiving Infliximab 5 mg/kg at week 0, 2 and 6 and further on every 8 weeks in conjunction with azathioprine (2,5 mg/kg/day). Patients who develop AZA intolerance during the trial are continued in the trial without AZA (ie IFX monotherapy).

Exclusion Criteria

* Absence of endoscopically visible ulcers
* Prior exposure to infliximab (other biologics allowed)
* Ongoing steroid therapy at doses \> 40 mg/d prednisolone equivalent
* Previous intolerance to azathioprine leading to drug discontinuation
* Ongoing infections
* Positive tuberculosis screen per local guidelines
* Serious other diseases including cancer in the 5 years prior to inclusion excluding non-melanoma skin cancer
* Indication for immediate surgery
* Pregnant or breast-feeding woman.
* Positive fecal culture for Salmonella, Shigella, Yersinia and Campylobacter and/or presence of Clostridium difficile B toxin in the stools
* Active tuberculosis
* Untreated latent tuberculosis (see national recommendations. Appendix 2).
* Non-compliant subjects.
* Participation in another therapeutic study.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Groupe d'Etude Therapeutique des Affections Inflammatoires Digestives

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Geert D'Haens, PhD

Role: STUDY_DIRECTOR

Groupe d'Etude Therapeutique des Affections Inflammatoires Digestives

David Laharie

Role: PRINCIPAL_INVESTIGATOR

Groupe d'Etude Therapeutique des Affections Inflammatoires Digestives

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Chu Amiens

Amiens, , France

Site Status

Chu Clermont-Ferrand

Clermont-Ferrand, , France

Site Status

Hopital Beaujon

Clichy, , France

Site Status

CHRU Lille

Lille, , France

Site Status

CHU NICE

Nice, , France

Site Status

Hopital Saint Louis

Paris, , France

Site Status

CHU Bordeaux - Pessac

Pessac, , France

Site Status

Chu Reims

Reims, , France

Site Status

Chu Rennes

Rennes, , France

Site Status

Chu Toulouse

Toulouse, , France

Site Status

Chu Tours

Tours, , France

Site Status

Chu Nancy

Vandœuvre-lès-Nancy, , France

Site Status

Countries

Review the countries where the study has at least one active or historical site.

France

References

Explore related publications, articles, or registry entries linked to this study.

Hanauer SB, Feagan BG, Lichtenstein GR, Mayer LF, Schreiber S, Colombel JF, Rachmilewitz D, Wolf DC, Olson A, Bao W, Rutgeerts P; ACCENT I Study Group. Maintenance infliximab for Crohn's disease: the ACCENT I randomised trial. Lancet. 2002 May 4;359(9317):1541-9. doi: 10.1016/S0140-6736(02)08512-4.

Reference Type BACKGROUND
PMID: 12047962 (View on PubMed)

Sands BE, Anderson FH, Bernstein CN, Chey WY, Feagan BG, Fedorak RN, Kamm MA, Korzenik JR, Lashner BA, Onken JE, Rachmilewitz D, Rutgeerts P, Wild G, Wolf DC, Marsters PA, Travers SB, Blank MA, van Deventer SJ. Infliximab maintenance therapy for fistulizing Crohn's disease. N Engl J Med. 2004 Feb 26;350(9):876-85. doi: 10.1056/NEJMoa030815.

Reference Type BACKGROUND
PMID: 14985485 (View on PubMed)

Lemann M, Mary JY, Duclos B, Veyrac M, Dupas JL, Delchier JC, Laharie D, Moreau J, Cadiot G, Picon L, Bourreille A, Sobahni I, Colombel JF; Groupe d'Etude Therapeutique des Affections Inflammatoires du Tube Digestif (GETAID). Infliximab plus azathioprine for steroid-dependent Crohn's disease patients: a randomized placebo-controlled trial. Gastroenterology. 2006 Apr;130(4):1054-61. doi: 10.1053/j.gastro.2006.02.014.

Reference Type BACKGROUND
PMID: 16618399 (View on PubMed)

D'Haens G, Baert F, van Assche G, Caenepeel P, Vergauwe P, Tuynman H, De Vos M, van Deventer S, Stitt L, Donner A, Vermeire S, Van De Mierop FJ, Coche JR, van der Woude J, Ochsenkuhn T, van Bodegraven AA, Van Hootegem PP, Lambrecht GL, Mana F, Rutgeerts P, Feagan BG, Hommes D; Belgian Inflammatory Bowel Disease Research Group; North-Holland Gut Club. Early combined immunosuppression or conventional management in patients with newly diagnosed Crohn's disease: an open randomised trial. Lancet. 2008 Feb 23;371(9613):660-667. doi: 10.1016/S0140-6736(08)60304-9.

Reference Type BACKGROUND
PMID: 18295023 (View on PubMed)

Baert F, Moortgat L, Van Assche G, Caenepeel P, Vergauwe P, De Vos M, Stokkers P, Hommes D, Rutgeerts P, Vermeire S, D'Haens G; Belgian Inflammatory Bowel Disease Research Group; North-Holland Gut Club. Mucosal healing predicts sustained clinical remission in patients with early-stage Crohn's disease. Gastroenterology. 2010 Feb;138(2):463-8; quiz e10-1. doi: 10.1053/j.gastro.2009.09.056. Epub 2009 Oct 8.

Reference Type BACKGROUND
PMID: 19818785 (View on PubMed)

Louis E, Vernier-Massouille G, Grimaud JC, et al. Infliximab discontinuation in Crohn's disease patients in stable remission on combined therapy with immunosuppressors: a prospective ongoing cohort study. Gastroenterology 2009, 136:A-146

Reference Type BACKGROUND

Rutgeerts P, Diamond RH, Bala M, Olson A, Lichtenstein GR, Bao W, Patel K, Wolf DC, Safdi M, Colombel JF, Lashner B, Hanauer SB. Scheduled maintenance treatment with infliximab is superior to episodic treatment for the healing of mucosal ulceration associated with Crohn's disease. Gastrointest Endosc. 2006 Mar;63(3):433-42; quiz 464. doi: 10.1016/j.gie.2005.08.011.

Reference Type BACKGROUND
PMID: 16500392 (View on PubMed)

Colombel JF, Sandborn WJ, Reinisch W, Mantzaris GJ, Kornbluth A, Rachmilewitz D, Lichtiger S, D'Haens G, Diamond RH, Broussard DL, Tang KL, van der Woude CJ, Rutgeerts P; SONIC Study Group. Infliximab, azathioprine, or combination therapy for Crohn's disease. N Engl J Med. 2010 Apr 15;362(15):1383-95. doi: 10.1056/NEJMoa0904492.

Reference Type BACKGROUND
PMID: 20393175 (View on PubMed)

Maser EA, Villela R, Silverberg MS, Greenberg GR. Association of trough serum infliximab to clinical outcome after scheduled maintenance treatment for Crohn's disease. Clin Gastroenterol Hepatol. 2006 Oct;4(10):1248-54. doi: 10.1016/j.cgh.2006.06.025. Epub 2006 Aug 22.

Reference Type BACKGROUND
PMID: 16931170 (View on PubMed)

Seow CH, Newman A, Irwin SP, Steinhart AH, Silverberg MS, Greenberg GR. Trough serum infliximab: a predictive factor of clinical outcome for infliximab treatment in acute ulcerative colitis. Gut. 2010 Jan;59(1):49-54. doi: 10.1136/gut.2009.183095.

Reference Type BACKGROUND
PMID: 19651627 (View on PubMed)

Van Moerkercke W, Ackaert C, Compernolle G, Jürgens M, Cleynen I, Van Assche G, Rutgeerts P, Gils A, Vermeire S. High infliximab trough levels are associated with mucosal healing in Crohn's disease. Gastroenterology 2010; 138 (Supp 1), S-60.

Reference Type BACKGROUND

Louis E, Collard A, Oger AF, Degroote E, Aboul Nasr El Yafi FA, Belaiche J. Behaviour of Crohn's disease according to the Vienna classification: changing pattern over the course of the disease. Gut. 2001 Dec;49(6):777-82. doi: 10.1136/gut.49.6.777.

Reference Type BACKGROUND
PMID: 11709511 (View on PubMed)

Vermeire S, van Assche G, Rutgeerts P. Review article: Altering the natural history of Crohn's disease--evidence for and against current therapies. Aliment Pharmacol Ther. 2007 Jan 1;25(1):3-12. doi: 10.1111/j.1365-2036.2006.03134.x.

Reference Type BACKGROUND
PMID: 17229216 (View on PubMed)

Schnitzler F, Fidder H, Ferrante M, Noman M, Arijs I, Van Assche G, Hoffman I, Van Steen K, Vermeire S, Rutgeerts P. Mucosal healing predicts long-term outcome of maintenance therapy with infliximab in Crohn's disease. Inflamm Bowel Dis. 2009 Sep;15(9):1295-301. doi: 10.1002/ibd.20927.

Reference Type BACKGROUND
PMID: 19340881 (View on PubMed)

D'haens G, Van Deventer S, Van Hogezand R, Chalmers D, Kothe C, Baert F, Braakman T, Schaible T, Geboes K, Rutgeerts P. Endoscopic and histological healing with infliximab anti-tumor necrosis factor antibodies in Crohn's disease: A European multicenter trial. Gastroenterology. 1999 May;116(5):1029-34. doi: 10.1016/s0016-5085(99)70005-3.

Reference Type BACKGROUND
PMID: 10220494 (View on PubMed)

Froslie KF, Jahnsen J, Moum BA, Vatn MH; IBSEN Group. Mucosal healing in inflammatory bowel disease: results from a Norwegian population-based cohort. Gastroenterology. 2007 Aug;133(2):412-22. doi: 10.1053/j.gastro.2007.05.051. Epub 2007 Jun 2.

Reference Type BACKGROUND
PMID: 17681162 (View on PubMed)

Rimola J, Rodriguez S, Garcia-Bosch O, Ordas I, Ayala E, Aceituno M, Pellise M, Ayuso C, Ricart E, Donoso L, Panes J. Magnetic resonance for assessment of disease activity and severity in ileocolonic Crohn's disease. Gut. 2009 Aug;58(8):1113-20. doi: 10.1136/gut.2008.167957. Epub 2009 Jan 9.

Reference Type BACKGROUND
PMID: 19136510 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

GETAID 2010-2

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Treg Immunotherapy in Crohn's Disease
NCT03185000 UNKNOWN PHASE1