Cytokines and Genes in Therapeutic Response in Crohn's Disease

NCT ID: NCT03266471

Last Updated: 2023-04-14

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

Total Enrollment

96 participants

Study Classification

OBSERVATIONAL

Study Start Date

2017-10-13

Study Completion Date

2022-05-03

Brief Summary

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

Inflammatory bowel disease (IBD), consisting of two major forms, Crohn's disease (CD) and ulcerative colitis (UC), affects more than 1.6 million people in the United States alone. Though the precise mechanisms underlying the inflammation and immune responses in IBD are still being investigated, various inflammatory mediators, including pro-inflammatory cytokines, and genes have been implicated in the disease process. At present, there are no reliable mechanisms to predict response to individual IBD medications. The investigators seek to evaluate whether inflammatory cytokines change longitudinally during treatment with anti-cytokine agents in both treatment primary responders and primary non-responders. In addition, the investigators will be evaluating the pharmacogenetics of treatment response to these agents.

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.

Inflammatory Bowel Diseases

Study Design

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

Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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

Crohn's disease Patients

Patients that are seen in the Inflammatory Bowel Disease clinic with CD confirmed by endoscopy or radiology assessment who are initiating either an anti-tumor necrosis factor (TNF)-α agent (infliximab, adalimumab, certolizumab, or infliximab biosimilar), ustekinumab, or vedolizumab as part of their routine clinical care will be asked to provide blood samples, stool samples, and intestinal biopsies from standard of care colonoscopy at baseline and post therapy of at least 6 weeks duration but not more than 52 weeks.

Baseline blood sample

Intervention Type DIAGNOSTIC_TEST

Blood sample for cytokine measurements and genetics.

Baseline intestinal biopsies

Intervention Type DIAGNOSTIC_TEST

Up to 20 additional biopsies will be obtained at the time of standard of care colonoscopy. It is not felt that additional biopsies substantially increases the risk of a colonoscopy. Cytokine measurements will be performed on the tissue collected.

Crohn's disease activity index (CDAI)

Intervention Type OTHER

To determine response, a Crohn's Disease Activity Index (CDAI) score will be obtained at time point 1 and time point 2 in all enrolled CD patients. The CDAI is a well validated symptom index for CD which assesses 8 factors including stool frequency, abdominal pain, general well being, CD complications, HCT, and deviation from ideal body weight.

Post treatment blood sample

Intervention Type DIAGNOSTIC_TEST

Blood sample for cytokine measurements after patients have been on therapy for at least 6 weeks but no more than 52 weeks.

Post treatment intestinal biopsies

Intervention Type DIAGNOSTIC_TEST

Up to 20 additional biopsies will be obtained at the time of standard of care colonoscopy at least 6 weeks but no more than 52 weeks after initiation of therapy. It is not felt that additional biopsies substantially increases the risk of a colonoscopy. Cytokine measurements will be performed on the tissue collected.

Baseline stool sample

Intervention Type DIAGNOSTIC_TEST

Stool sample for inflammatory markers or microbiome analysis.

Post treatment stool sample

Intervention Type DIAGNOSTIC_TEST

Stool sample for inflammatory markers or microbiome analysis.

Controls

Healthy adults without IBD undergoing colonoscopy for colorectal cancer screening or other non-IBD related indication will be asked to provide blood samples, stool samples and intestinal biopsies from standard of care colonoscopy.

Baseline blood sample

Intervention Type DIAGNOSTIC_TEST

Blood sample for cytokine measurements and genetics.

Baseline intestinal biopsies

Intervention Type DIAGNOSTIC_TEST

Up to 20 additional biopsies will be obtained at the time of standard of care colonoscopy. It is not felt that additional biopsies substantially increases the risk of a colonoscopy. Cytokine measurements will be performed on the tissue collected.

Baseline stool sample

Intervention Type DIAGNOSTIC_TEST

Stool sample for inflammatory markers or microbiome analysis.

Interventions

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

Baseline blood sample

Blood sample for cytokine measurements and genetics.

Intervention Type DIAGNOSTIC_TEST

Baseline intestinal biopsies

Up to 20 additional biopsies will be obtained at the time of standard of care colonoscopy. It is not felt that additional biopsies substantially increases the risk of a colonoscopy. Cytokine measurements will be performed on the tissue collected.

Intervention Type DIAGNOSTIC_TEST

Crohn's disease activity index (CDAI)

To determine response, a Crohn's Disease Activity Index (CDAI) score will be obtained at time point 1 and time point 2 in all enrolled CD patients. The CDAI is a well validated symptom index for CD which assesses 8 factors including stool frequency, abdominal pain, general well being, CD complications, HCT, and deviation from ideal body weight.

Intervention Type OTHER

Post treatment blood sample

Blood sample for cytokine measurements after patients have been on therapy for at least 6 weeks but no more than 52 weeks.

Intervention Type DIAGNOSTIC_TEST

Post treatment intestinal biopsies

Up to 20 additional biopsies will be obtained at the time of standard of care colonoscopy at least 6 weeks but no more than 52 weeks after initiation of therapy. It is not felt that additional biopsies substantially increases the risk of a colonoscopy. Cytokine measurements will be performed on the tissue collected.

Intervention Type DIAGNOSTIC_TEST

Baseline stool sample

Stool sample for inflammatory markers or microbiome analysis.

Intervention Type DIAGNOSTIC_TEST

Post treatment stool sample

Stool sample for inflammatory markers or microbiome analysis.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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

Inclusion Criteria

* Patients that are seen in the Inflammatory Bowel Disease clinic with Crohn's disease who are initiating either treatment as part of their routine clinical care.
* Healthy adults without IBD undergoing colonoscopy for colorectal cancer screening or other non-IBD related indication.

Exclusion Criteria

* pregnant
* have a known coagulopathy or bleeding disorder
* have known renal or hepatic impairment
* have a history of organ transplantation
* CD patients who are being seen in consultation and do not plan to receive longitudinal care through initiation their new therapy at the Vanderbilt IBD center will be excluded.
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.

Vanderbilt University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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

Elizabeth Scoville

Principal Investigator

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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

Elizabeth Scoville, MD

Role: PRINCIPAL_INVESTIGATOR

Vanderbilt University Medical Center

Locations

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

Inflammatory Bowel Disease Clinic, Vanderbilt University Medical Center

Nashville, Tennessee, United States

Site Status

Vanderbilt University Medical Center Endoscopy Laboratory

Nashville, Tennessee, United States

Site Status

Countries

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

United States

Other Identifiers

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

171198

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
Response Assessment in SB CD
NCT03646708 RECRUITING