Therapeutic Drug Monitoring for Biological Therapy in Pediatric Inflammatory Bowel Disease

NCT ID: NCT06954311

Last Updated: 2025-05-01

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

120 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-02-17

Study Completion Date

2030-02-17

Brief Summary

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Inflammatory Bowel Diseases (IBD), which include Crohn's disease (CD), ulcerative colitis (UC), and the unclassified form referred to as indeterminate colitis, are most commonly diagnosed during adolescence and early adulthood. In recent decades, an increasing incidence of IBD has been observed in this age group.

A wide range of immunomodulatory agents, from corticosteroids to monoclonal antibodies, are now available for the treatment of IBD. These antibodies, known as biologics, target, for example, tumor necrosis factor-alpha (TNF-α; e.g., infliximab and adalimumab), integrin α4β7 (vedolizumab), or interleukin-12/23 (ustekinumab). While infliximab and adalimumab are approved for pediatric use in CD and UC, vedolizumab is only approved for moderate-to-severe UC from the age of 16, and ustekinumab is not approved for pediatric use at all. Nevertheless, vedolizumab and ustekinumab are frequently used off-label in cases of treatment failure with approved therapies, as efficacy has been demonstrated in adult IBD patients, and since 2015, increasing pediatric literature has emerged on their use.

To facilitate appropriate dose adjustment in pediatric clinical practice, biologic therapies can be monitored through measurement of drug trough levels. Current pediatric guidelines already recommend incorporating therapeutic drug monitoring (TDM) of infliximab and adalimumab in the management of CD and UC. Studies on TDM for vedolizumab and ustekinumab have so far been conducted almost exclusively in adult IBD patients, where improved treatment responses have also been demonstrated.

The presented research is a prospective, non-interventional observational study involving pediatric IBD patients at multiple Austrian pediatric gastroenterology centers. The study duration is five years. The aim is to include at least 40 patients receiving induction and maintenance therapy with infliximab or adalimumab, and 20 patients treated with vedolizumab or ustekinumab during both treatment phases. The primary objective is to gain a better understanding of the pharmacokinetic dynamics of these biologics and the associated treatment response in pediatric settings. Data will be collected exclusively from routine clinical assessments. No additional study-related visits or interventions are planned.

Detailed Description

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Conditions

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Ulcerative Colitis (UC) IBD-unclassified (IBD-U)

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Infliximab Group

those who receive Infliximab

No interventions assigned to this group

Adalimumab Group

those who receive Adalimumab

No interventions assigned to this group

Vedolizumab Group

those who receive Vedolizumab

No interventions assigned to this group

Ustekinumab Group

those who receive Ustekinumab

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Pediatric patients with an Inflammatory Bowel Disease (Crohn's disease, ulcerative colitis, and IBD-unclassified) being under 18 years of age
* Treatment with Infliximab, Adalimumab, Vedolizumab, or Ustekinumab during induction or maintenance phase

Exclusion Criteria

\-- Patients with primary (congenital) immunodeficiency
Minimum Eligible Age

0 Years

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Medical University Innsbruck

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Landeskrankenhaus Feldkirch

Feldkirch, , Austria

Site Status RECRUITING

Universitätsklinikum Graz / Medizinische Universität Graz

Graz, , Austria

Site Status RECRUITING

Medical University of Innsbruck

Innsbruck, , Austria

Site Status RECRUITING

Klinikum Klagenfurt

Klagenfurt, , Austria

Site Status NOT_YET_RECRUITING

Kepler Universitätsklinikum Linz

Linz, , Austria

Site Status RECRUITING

Paracelsus Medizinische Privatuniversität

Salzburg, , Austria

Site Status RECRUITING

St. Anna Kinderspital

Vienna, , Austria

Site Status RECRUITING

Universitätsklinik für Kinder- und Jugendheilkunde

Vienna, , Austria

Site Status NOT_YET_RECRUITING

Klinik Donaustadt

Vienna, , Austria

Site Status NOT_YET_RECRUITING

Landeskrankenhaus Villach

Villach, , Austria

Site Status RECRUITING

Countries

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Austria

Central Contacts

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Georg-Friedrich Vogel, Assoz. Prof. Dr. PhD

Role: CONTACT

+43 (0)512/504-82184

Facility Contacts

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Doris Hanfstingl-Sinz

Role: primary

Benno Kohlmaier, PD DDr.

Role: primary

Georg-Friedrich Vogel, Assoz. Prof. Dr. PhD

Role: primary

+43 (0)512/504-82184

Helga Stenzel, Dr.

Role: primary

Elke Minichmayr, Dr.in

Role: primary

Anna-Maria Schneider,, Dr.in

Role: primary

Hubert Kogler, Dr.

Role: primary

Judith Pichler, Doz. Dr.

Role: primary

Christa Kuderna, Dr.

Role: primary

Robert Birnbacher, Univ.-Prof. Dr.

Role: primary

Other Identifiers

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TDMpIBD (1126/2024)

Identifier Type: -

Identifier Source: org_study_id

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