Prevalence, Characteristics, Management, and Outcomes of Difficult-to-treat Inflammatory Bowel Disease

NCT ID: NCT06551194

Last Updated: 2024-08-13

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

Total Enrollment

972 participants

Study Classification

OBSERVATIONAL

Study Start Date

2024-06-01

Study Completion Date

2024-12-31

Brief Summary

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Crohn's disease (CD) and ulcerative colitis (UC) are the two main types of chronic inflammatory bowel disease (IBD). Despite recent advances, many patients do not respond to available treatments and or lose response over time.

In 2023, the International Organisation for the Study of IBD (IOIBD) proposed a common definition of 'difficult-to-treat' inflammatory bowel disease (IBD-IBD) to homogenise terminology and promote research into patients most in need of new treatments and therapeutic strategies. According to the IOIBD criteria, IBD is defined by any of the following: failure of two or more advanced treatments with different mechanisms of action, postoperative recurrence of Crohn's disease after two or more bowel resections, pouchitis refractory to antibiotics, complex perianal Crohn's disease, or the presence of psychiatric comorbidity that prevents adequate therapeutic management.

As the definition of DTT-IBD is very recent, the prevalence and risk factors of DTT-IBD are not yet known. This study aims to determine the prevalence of DTT-IBD in the patient population and the risk factors associated with the development of DTT-IBD. The study will be conducted as a retrospective cross-sectional study in two large tertiary care centers, IRCCS Ospedale San Raffaele and IRCCS Humanitas Research Hospital, both in Milan, Italy. The study will evaluate the criteria and risk factors for DTT-IBD in the latest available gastroenterological examination report, provided it was performed in the last 5 years (from 1 January 2019).

Detailed Description

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This is a multicentre retrospective cross-sectional study with two aims:

1. To evaluate the prevalence of difficult-to-treat IBD
2. To evaluate which and how demographic and clinical variables affect the risk of DTT-IBD

The subjects considered are adult patients (≥18 years) diagnosed with UC or CD followed at San Raffaele Hospital and Humanitas Research Hospital.

Crohn's disease (CD) and ulcerative colitis (UC) are the two main types of chronic inflammatory bowel disease (IBD). Despite recent advances, many patients do not respond to available treatments and or lose response over time.

In 2023, the International Organisation for the Study of IBD (IOIBD) proposed a common definition of 'difficult-to-treat' inflammatory bowel disease (IBD-IBD) to homogenise terminology and promote research into patients most in need of new treatments and therapeutic strategies. According to the IOIBD criteria, IBD is defined by any of the following: failure of two or more advanced treatments with different mechanisms of action, postoperative recurrence of Crohn's disease after two or more bowel resections, pouchitis refractory to antibiotics, complex perianal Crohn's disease, or the presence of psychiatric comorbidity that prevents adequate therapeutic management.

As the definition of DTT-IBD is very recent, the prevalence and risk factors of DTT-IBD are not yet known. This study aims to determine the prevalence of DTT-IBD in the patient population and the risk factors associated with the development of DTT-IBD. The study will be conducted as a retrospective cross-sectional study in two large tertiary care centers, IRCCS Ospedale San Raffaele and IRCCS Humanitas Research Hospital, both in Milan, Italy. The study will evaluate the criteria and risk factors for DTT-IBD in the latest available gastroenterological examination report, provided it was performed in the last 5 years (from 1 January 2019).

Conditions

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Assessment of the Criteria and Risk Factors for DTT-IBD

Study Design

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Observational Model Type

CASE_ONLY

Study Time Perspective

RETROSPECTIVE

Study Groups

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UC patients

Adult patients (age ≥18) diagnosed with UC

prevalence of difficult-to-treat IBD

Intervention Type OTHER

To assess the prevalence and risk factors of difficult-to-treat IBD patients

CD patients

Adult patients (age ≥18) diagnosed with UC

prevalence of difficult-to-treat IBD

Intervention Type OTHER

To assess the prevalence and risk factors of difficult-to-treat IBD patients

Interventions

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prevalence of difficult-to-treat IBD

To assess the prevalence and risk factors of difficult-to-treat IBD patients

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Adult patients (age ≥18)
* Diagnosis of IBD: Crohn's disease (CD), ulcerative colitis (UC), or undetermined IBD (IBD-U)
* A least one visit with a gastroenterology specialist after 01/01/2019

Exclusion Criteria

* Unconfirmed IBD diagnosis
* Consultation with non-gastroenterology specialists
* Consultation older than January 1st 2019
* Pediatric patients (Age \<18). Pediatric population will be excluded as the DTT-IBD criteria apply to adult patients only.
Minimum Eligible Age

18 Years

Maximum Eligible Age

69 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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IRCCS Ospedale San Raffaele

OTHER

Sponsor Role lead

Responsible Party

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Tommaso Lorenzo Parigi

MD Gastroenterologist

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Tommaso Lo Parigi, MD

Role: PRINCIPAL_INVESTIGATOR

IRCCS Ospedale San Raffaele

Locations

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IRCCS San Raffaele

Milan, , Italy

Site Status RECRUITING

Countries

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Italy

Central Contacts

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Tommaso Lo Parigi, MD

Role: CONTACT

02 2643 2756 ext. +39-022643275

Facility Contacts

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Tommaso Lo Parigi, MD

Role: primary

0226432756

Other Identifiers

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DTT-IBD

Identifier Type: -

Identifier Source: org_study_id

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