Characterization of the Intestinal Microbiota in Patients With Inflammatory Bowel Disease and/or Spondyloarthritis and Study of the Impact of an Anti-TNF Alpha Therapy

NCT ID: NCT03359642

Last Updated: 2022-05-26

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

NA

Total Enrollment

23 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-06-05

Study Completion Date

2021-09-16

Brief Summary

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Spondyloarthritis and inflammatory bowel diseases are common diseases, frequently met together in overlap syndromes. Their physiopathology remains puzzling. A strong role of gut microbiota has been recently put forward to explain the development of inflammatory bowel diseases, and is suspected to play an important role in rheumatoid diseases. Anti-Tumor Necrosis Factor (anti-TNF) alpha are effective and safe drugs in the treatment of both digestive and rheumatoid inflammatory diseases. The way they work is unclear, and the clinical response to this treatment is variable. A better understanding of the pathophysiology of inflammatory bowel diseases and of the action of anti-TNF alpha is essential to an optimized care.

Our hypothesis is that the efficacy of anti-TNF alpha in spondyloarthritis and in inflammatory bowel diseases is at least partly due to its restoring action of homeostasis at the interface between gastrointestinal mucosa and intestinal microbiota, either by primary action on the digestive epithelium, allowing it to regain its control and tolerance functions toward mucosal microbiota, either by direct action on the intestinal microbiota, via an inter-reigns regulation.

The main objective of our study is to assess quantitative and qualitative changes in fecal microbiota before (D0) and 3 months after initiation of anti-TNF alpha.

Detailed Description

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The investigators propose to conduct an exploratory study, on 10 spondyloarthritis and 20 inflammatory bowel diseases patients (10 Crohn's disease and 10 ulcerative colitis (UC), in which a first anti-TNF alpha treatment is indicated. At D0 and M3, intestinal microbiota will be studied by DNA16S sequencing and qPCR, via a stool sampling. Volatile Organic Compounds (VOCs) profile will be obtained by mass spectrometry. Blood lymphocytes profile will be obtained by flux cytometry. In addition, a colonoscopy will be performed at D0 for UC patients, with an endoscopic and histological assessment. A second short colonoscopy will be performed for UC patients at M3. At each time, clinical assessment will be performed.

A mirror group of 10 spondyloarthritis and 20 inflammatory bowel diseases patients (10 Crohn's disease and 10 ulcerative colitis), in which an "all but anti-TNF alpha or biotherapy" treatment is indicated will be included to distinguish the specific effects on microbiota of anti-TNF alpha.

12 patients by group will be included at M0 by anticipating that some patients will stop their treatment between M0 and M3, and consequently will be excluded from M3 sampling and from final analysis. Final analysis will be performed on 10 patients by group.

Conditions

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Spondyloarthritis Crohn Disease Ulcerative Colitis

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Patients with anti-TNF alpha

12 spondyloarthritis and 24 inflammatory bowel diseases patients (12 Crohn's disease and 12 ulcerative colitis), in which a first anti-TNF alpha treatment is indicated.

Group Type EXPERIMENTAL

blood sample

Intervention Type OTHER

14 ml whole blood for Peripheral blood mononuclear cell (PBMC) and monocytes isolation

stool samples

Intervention Type OTHER

Study of the fecal microbiota

food questionnaire

Intervention Type OTHER

food questionnaire on the seven days before the collection

colonoscopy

Intervention Type OTHER

Only for patients with ulcerative colitis (in routine care)

VOCs profile

Intervention Type OTHER

Volatile Organic Compounds (VOCs) profile obtained by mass spectrometry

mirror group

A mirror group of 12 spondyloarthritis and 24 inflammatory bowel diseases patients (12 Crohn's disease and 12 ulcerative colitis), in which an "all but anti-TNF alpha or biotherapy" treatment is indicated will be included to distinguish the specific effects on microbiota of anti-TNF alpha.

Group Type ACTIVE_COMPARATOR

blood sample

Intervention Type OTHER

14 ml whole blood for Peripheral blood mononuclear cell (PBMC) and monocytes isolation

stool samples

Intervention Type OTHER

Study of the fecal microbiota

food questionnaire

Intervention Type OTHER

food questionnaire on the seven days before the collection

colonoscopy

Intervention Type OTHER

Only for patients with ulcerative colitis (in routine care)

VOCs profile

Intervention Type OTHER

Volatile Organic Compounds (VOCs) profile obtained by mass spectrometry

Interventions

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blood sample

14 ml whole blood for Peripheral blood mononuclear cell (PBMC) and monocytes isolation

Intervention Type OTHER

stool samples

Study of the fecal microbiota

Intervention Type OTHER

food questionnaire

food questionnaire on the seven days before the collection

Intervention Type OTHER

colonoscopy

Only for patients with ulcerative colitis (in routine care)

Intervention Type OTHER

VOCs profile

Volatile Organic Compounds (VOCs) profile obtained by mass spectrometry

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients aged over 18 years
* Patients with the following conditions :

* Ulcerative colitis (UC) fulfilling the ECCO criteria
* Crohn's disease (CD) fulfilling the ECCO criteria
* Axial or peripheral spondyloarthritis (SpA) fulfilling the Assessment of SpondyloArthritis (ASAS) criteria
* Patients naïve to anti-TNF alpha, justifying the initiation of an anti-TNF alpha treatment according to current guidelines (ECCO Inflammatory bowel disease (IBD) recommendations, the recommendations of the French Society of Rheumatology for SpA)
* Patients agreeing to sign the informed consent

Exclusion Criteria

* Patient with an inflammatory disease other than UC, CD or SpA
* History of bowel resection or digestive stoma
* Taking antibiotics in the three months preceding the stool collection
* Patients with contraindication to treatment
* Pregnancy or breast feeding
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Bordeaux

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Thomas BAZIN, MD

Role: STUDY_DIRECTOR

Assistance Publique - Hôpitaux de Paris

Rodolphe THIEBAUT, Prof

Role: STUDY_CHAIR

University Hospital, Bordeaux

Pauline RIVIERE, MD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Bordeaux

Locations

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CHU de Bordeaux - service d'Hépato-gastroentérologie

Pessac, , France

Site Status

Countries

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France

Other Identifiers

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CHUBX 2017/28

Identifier Type: -

Identifier Source: org_study_id

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