A Trial COmparing staNdard of Care Versus Treat to Target With telemonitoRing and Patient Education in Patients With Ulcerative cOlitis Initiating Adalimumab

NCT ID: NCT04183608

Last Updated: 2023-05-31

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

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

238 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-14

Study Completion Date

2028-05-31

Brief Summary

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PHASE: IV

DESCRIPTIVE: Randomized, interventional, open label multicenter trial

POPULATION: Moderate to severe ulcerative colitis

STUDY TREATMENTS: Patients will all receive Adalimumab 160/80/40mg EOW until V1 (W14) followed by 40mg EOW until V2 (W26) and could be optimized up to 80mg EOW (or 40 EW according to patient and/or investigator preference) for two months and then could be optimized up to 80mg EOW (or 40 EW according to patient and/or investigator preference) and azathioprine (2.0/2.5 mg/kg/ day) or methotrexate (25 mg EW) until V3 (W 38).

OBJECTIVES: To assess the impact of a treat to target treatment follow up by e-Monitoring and fecal calprotectin dosing at home associated to an appropriate patient education versus standard treatment follow up at W48 in patients requiring a treatment with adalimumab (Humira®).

Detailed Description

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NUMBER OF PATIENTS : 238 patients in 20 sites in France

RECRUITMENT PERIOD : The trial duration for each patient will be 144 weeks

MAIN ENDPOINT : At week 48 success defined by: Endoscopic remission defined by an endoscopic Mayo score 0

SECONDARY ENDPOINTS:

At W48

* Clinical remission (Clinical remission is defined as a total Mayo score ≤2 points, with no individual sub score \>1, and a Mayo endoscopy sub score of 0 or 1)
* Remission without steroids
* Endoscopic healing rate with Mayo score 0 or 1
* UCEIS score
* Histological healing (Nancy score)
* Remission rate and remission rate without steroids at study visits and W48
* Quality of life evolution (evaluate visit W0 vs W14, W26, W38 and W48)
* Patients satisfaction
* Continuous response
* Safety and tolerability
* Anti-TNF pharmacokinetics
* Number of visits in trial
* Number of UC related hospitalizations
* Number of colectomies
* Treatment compliance (questionnaire)
* Patient adhesion (questionnaire)
* Medico-economic analysis

Conditions

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Ulcerative Colitis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

NONE

Study Groups

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Group Standard of care

In standard of care, patient only visits every 3 months the doctor so the optimization of treatment can be done only at this frequency.

Group Type ACTIVE_COMPARATOR

Adalimumab

Intervention Type DRUG

Patients will all receive Adalimumab 160/80/40mg EOW until V1 (W14) followed by 40mg EOW until V2 (W26)

Groupe T2T with telemonitoring and patient education

Treatment with e-Monitoring, home fecal calprotectin testing and therapy education.

Group Type ACTIVE_COMPARATOR

Adalimumab

Intervention Type DRUG

Patients will all receive Adalimumab 160/80/40mg EOW until V1 (W14) followed by 40mg EOW until V2 (W26)

Calprotectin

Intervention Type DIAGNOSTIC_TEST

Fecal calprotectin dosing at home with IBDoc

e-Monitoring

Intervention Type OTHER

e-Monitoring at Week 6, Week 10, Week 14, Week 18, Week 22, Week 26, Week 34, Week 38, Week 42 and Week 48

The patient must complete the first 2 questions of the Mayo score:

* Stool frequency
* The frequency of bleeding

He must also complete the information on his injections

Therapy Education

Intervention Type OTHER

Patient Education at W0, W2, W14, W26 and W38.

Interventions

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Adalimumab

Patients will all receive Adalimumab 160/80/40mg EOW until V1 (W14) followed by 40mg EOW until V2 (W26)

Intervention Type DRUG

Calprotectin

Fecal calprotectin dosing at home with IBDoc

Intervention Type DIAGNOSTIC_TEST

e-Monitoring

e-Monitoring at Week 6, Week 10, Week 14, Week 18, Week 22, Week 26, Week 34, Week 38, Week 42 and Week 48

The patient must complete the first 2 questions of the Mayo score:

* Stool frequency
* The frequency of bleeding

He must also complete the information on his injections

Intervention Type OTHER

Therapy Education

Patient Education at W0, W2, W14, W26 and W38.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adults with moderately-to-severely active Ulcerative Colitis (UC) who had an inadequate response to or failed to tolerate steroids and thiopurines (azathioprine or 6-mercaptopurine), methotrexate or vedolizumab or adults with moderately-to-severely active UC who had no response to an adequate steroid course
* Age ≥ 18 years and \< 75 years
* Patients scheduled to start a treatment with adalimumab
* Naïve to anti-TNF therapy and other biologics known to be effective for UC (approved or investigational) except for vedolizumab
* Naïve to JAK inhibitors (approved or investigational)
* Moderately-to-severely active UC for at least 3 months with a Mayo score of 6-12 points (endoscopy subscore of at least 2)
* Established diagnosis of UC for at least 3 months (pancolitis, left-sided colitis, proctosigmoiditis and proctitis are allowed).
* Patient has to be treated with oral 5-ASA at time of inclusion regardless of the dose if no contra-indication.
* Azathioprine, 6-mercaptopurine or methotrexate will be stopped two weeks before inclusion.
* A contraceptive method during the whole trial for childbearing potential female
* Patient familiar with Smartphone and internet use

Exclusion Criteria

* Patients unable to give their consent (because of their physical or mental state).
* Absence of written consent.
* Pregnancy or breastfeeding.
* Patients with severe acute colitis or patients at imminent risk for colectomy.
* History of colectomy.
* History of colonic mucosal dysplasia or adenomatous colonic polyps that are not removed.
* Screening stool trial positive for enteric pathogens or Clostridium difficile toxin.
* Oral corticosteroids at a dose \> 40 mg prednisone or its equivalent per day at inclusion (oral steroids should be at stable dose at least 7 days before inclusion)
* Any current or previous use of cyclosporine, tacrolimus, anti-TNF therapy, and other biologics (except vedolizumab), JAK inhibitors (approved or investigational), or any current or previous use of an investigational agent within 5 half-lives of that agent before the first trial agent injection.
* Contraindication to anti-TNF therapy according to drug labeling:

* Active infection.
* Non-treated latent tuberculosis.
* Heart failure (NYHA: Grade III and IV).
* Malignancy during the previous 5 years.
* Demyelinating neurological disease.
* Current or recent (less than 4 weeks) vaccination with attenuated live vaccines
* Patients with a dominant arm deficiency or physical impairment impeding the achievement of the tests
* Patients using a prohibited medication
* Patients participating in another trial or being in a follow-up period for another trial
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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AbbVie

INDUSTRY

Sponsor Role collaborator

Groupe d'Etude Therapeutique des Affections Inflammatoires Digestives

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Centre hospitalier de Cholet

Cholet, Maine Et Loire, France

Site Status ACTIVE_NOT_RECRUITING

CHU Amiens- Picardie (site Sud)

Amiens, , France

Site Status RECRUITING

CHRU de Besançon - Hôpital Jean Minjoz

Besançon, , France

Site Status ACTIVE_NOT_RECRUITING

CHU Caen Hôpital Côte de Nacre

Caen, , France

Site Status WITHDRAWN

CHU Estaing

Clermont-Ferrand, , France

Site Status RECRUITING

APHP - Hôpital Beaujon

Clichy, , France

Site Status RECRUITING

CH Colmar - Hôpital Pasteur

Colmar, , France

Site Status ACTIVE_NOT_RECRUITING

Centre hospitalier de Douai

Douai, , France

Site Status TERMINATED

CHRU Lille Hôpital Claude Huriez

Lille, , France

Site Status RECRUITING

APHM - Hôpital Nord

Marseille, , France

Site Status RECRUITING

GHI Le Raincy-Montfermeil

Montfermeil, , France

Site Status RECRUITING

CHU Montpellier - Hôpital Saint Eloi

Montpellier, , France

Site Status RECRUITING

CHU Nantes - Hôpital Hotel Dieu

Nantes, , France

Site Status RECRUITING

CHU Nice- Hopital l'Archet

Nice, , France

Site Status RECRUITING

CHU Nîmes - Hôpital Universitaire Caremeau

Nîmes, , France

Site Status RECRUITING

CHU Bordeaux - Hôpital Haut Lévêque

Pessac, , France

Site Status RECRUITING

CHU Lyon Sud

Pierre-Bénite, , France

Site Status RECRUITING

CHU Rennes Hôpital Pontchaillou

Rennes, , France

Site Status RECRUITING

CH Saint Etienne Hopital Nord

Saint-Priest-en-Jarez, , France

Site Status NOT_YET_RECRUITING

CH Toulon - CHITS CH Sainte Musse

Toulon, , France

Site Status WITHDRAWN

CHU Toulouse - Hôpital Rangueil

Toulouse, , France

Site Status RECRUITING

CH Tourcoing - Hôpital Gustave Dron

Tourcoing, , France

Site Status NOT_YET_RECRUITING

CHU Nancy - Hôpital de Brabois

Vandœuvre-lès-Nancy, , France

Site Status RECRUITING

APHP - Hôpital du Kremlin-Bicêtre

Le Kremlin-Bicêtre, Île-de-France Region, France

Site Status RECRUITING

Countries

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France

Central Contacts

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Xavier Hebuterne, MD PhD

Role: CONTACT

04 92 03 65 75

Facility Contacts

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Mathurin Fumery

Role: primary

Anthony Buisson

Role: primary

Yoram Bouhnik

Role: primary

Maria Nachury

Role: primary

Mélanie Serrero

Role: primary

Stéphane Nahon

Role: primary

Lucile Boivineau

Role: primary

Caroline Trang

Role: primary

Xavier Hebuterne

Role: primary

Ludovic Caillo

Role: primary

David Laharie

Role: primary

Stéphane Nancey

Role: primary

Guillaume Bouguen

Role: primary

Xavier Roblin

Role: primary

Cyrielle Gilletta

Role: primary

Noemie Tavernier

Role: primary

Laurent Peyrin-Biroulet

Role: primary

Franck CARBONNEL, MD

Role: primary

References

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Tiles-Sar N, Neuser J, de Sordi D, Baltes A, Preiss JC, Moser G, Timmer A. Psychological interventions for treatment of inflammatory bowel disease. Cochrane Database Syst Rev. 2025 Apr 17;4(4):CD006913. doi: 10.1002/14651858.CD006913.pub3.

Reference Type DERIVED
PMID: 40243391 (View on PubMed)

Other Identifiers

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GETAID-2018-01

Identifier Type: -

Identifier Source: org_study_id

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