Surveillance in Ulcerative Colitis: Narrow Band Image Versus Chromoendoscopy for High-risk Groups

NCT ID: NCT04257084

Last Updated: 2020-11-24

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

188 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-12-31

Study Completion Date

2023-01-31

Brief Summary

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The risk of colorectal cancer (CRC) is increased in patients having ulcerative colitis (UC). Patients with long-standing extensive colitis, concomitant primary sclerosing cholangitis, or previous history of dysplasia carry an exceptionally high risk of CRC and require regular and short-interval surveillance colonoscopy. Recent guidelines recommend surveillance colonoscopy based on target biopsy rather than random biopsy applying chromoendoscopy (CE) or narrow band image (NBI) technique in UC at risk for CRC. However, the diagnostic yield of NBI-based surveillance and CE-based surveillance is not extensively investigated in the high-risk UC population. The investigators aimed to compare the dysplasia detection rate of NBI with that of CE in UC patients with a high risk of CRC by performing a multicenter, randomized controlled trial.

Detailed Description

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Conditions

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Ulcerative Colitis Dysplasia

Keywords

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chromoendoscopy narrow band image surveillance

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

a randomized controlled crossover trial
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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CE-NBI

High definition chromoendoscopy with target biopsy, at 1st surveillance colonoscopy during the trial High definition NBI with target biopsy, at 2nd surveillance colonoscopy during the trial

Group Type ACTIVE_COMPARATOR

chromoendoscopy with target biopsy; NBI with target biopsy

Intervention Type DIAGNOSTIC_TEST

Chromoendoscopy with target biopsy: 0.03% indigo carmine solution based chromoendoscopy (using high-definition colonoscopy) will be fulfilled and target biopsies will be taken at all abnormal mucosal lesions suspected dysplasia/neoplasia.

NBI with target biopsy: After inserting a high definition colonoscopy up to cecum, endoscopists observe the colon in combination of white light and NBI (white light first and then NBI). Target biopsies will be taken at all abnormal mucosal lesions suspected dysplasia/neoplasia.

NBI-CE

High definition NBI with target biopsy, at 1st surveillance colonoscopy during the trial High definition chromoendoscopy with target biopsy, at 2nd surveillance colonoscopy during the trial

Group Type ACTIVE_COMPARATOR

chromoendoscopy with target biopsy; NBI with target biopsy

Intervention Type DIAGNOSTIC_TEST

Chromoendoscopy with target biopsy: 0.03% indigo carmine solution based chromoendoscopy (using high-definition colonoscopy) will be fulfilled and target biopsies will be taken at all abnormal mucosal lesions suspected dysplasia/neoplasia.

NBI with target biopsy: After inserting a high definition colonoscopy up to cecum, endoscopists observe the colon in combination of white light and NBI (white light first and then NBI). Target biopsies will be taken at all abnormal mucosal lesions suspected dysplasia/neoplasia.

Interventions

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chromoendoscopy with target biopsy; NBI with target biopsy

Chromoendoscopy with target biopsy: 0.03% indigo carmine solution based chromoendoscopy (using high-definition colonoscopy) will be fulfilled and target biopsies will be taken at all abnormal mucosal lesions suspected dysplasia/neoplasia.

NBI with target biopsy: After inserting a high definition colonoscopy up to cecum, endoscopists observe the colon in combination of white light and NBI (white light first and then NBI). Target biopsies will be taken at all abnormal mucosal lesions suspected dysplasia/neoplasia.

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* At least one of the followings should be satisfied;

1. A patient having extensive ulcerative colitis with 8-year or longer disease duration
2. A patient having both ulcerative colitis and primary sclerosing colitis
3. A patient having a previous history of dysplasia at the colitic segment within recent 5 years

Exclusion Criteria

* All of the following conditions should be excluded for 1st surveillance colonoscopy study

1. A patient who underwent total or segment colectomy.
2. A patient who taking (warfarin or direct oral anticoagulants and cannot stop them for procedures owing to the high thromboembolic risk
3. A patient who has known thrombocytopenia (less than 80,000/µL in recent 6 months
4. A patient who has a coagulopathy
5. A patient who has chronic renal disease evidenced by serum creatinine \> 1.2 mg/dL within 6 months of study participation
6. A patient who has already undergone surveillance colonoscopy within 1 year
* All of the following conditions should be excluded for 2nd surveillance colonoscopy study even if they were included in 1st surveillance study.

1. A patient who underwent total or segment colectomy after 1st surveillance colonoscopy for this trial.
2. A patient who taking (warfarin or direct oral anticoagulants and cannot stop them for procedures owing to the high thromboembolic risk
3. A patient who has known thrombocytopenia (less than 80,000/µL in recent 6 months
4. A patient who has a coagulopathy
5. A patient who has chronic renal disease evidenced by serum creatinine \> 1.2 mg/dL within 6 months of study participation
Minimum Eligible Age

19 Years

Maximum Eligible Age

79 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Yonsei University

OTHER

Sponsor Role collaborator

Samsung Medical Center

OTHER

Sponsor Role collaborator

Sungkyunkwan University

OTHER

Sponsor Role collaborator

Ewha Womans University

OTHER

Sponsor Role collaborator

The Catholic University of Korea

OTHER

Sponsor Role collaborator

Soonchunhyang University Hospital

OTHER

Sponsor Role collaborator

Asan Medical Center

OTHER

Sponsor Role lead

Responsible Party

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Dong-Hoon Yang

Clinical Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Dong-Hoon Yang, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Asan Medical Center

Central Contacts

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Dong-Hoon Yang, MD, PhD

Role: CONTACT

Phone: 82-2-3010-5809

Email: [email protected]

Other Identifiers

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SUNRISE-High

Identifier Type: -

Identifier Source: org_study_id