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Monitoring Disease Activity Using Video Capsule Endoscopy (VCE) in Crohn's Disease (CD) Subjects

Primary Purpose

Known Crohn Disease Subjects

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Capsule endoscopy and Ileocolonoscopy tests
Sponsored by
Medtronic - MITG
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional diagnostic trial for Known Crohn Disease Subjects

Eligibility Criteria

2 Years - 75 Years (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subject ages 2-75 years, inclusive
  2. Subjects with a diagnosis of known Crohn disease
  3. Referred to ileocolonoscopy (up to 4 weeks before the CE procedure)
  4. Proven patency by the Agile capsule or another approach deemed clinically acceptable by the investigator, e.g. CT enterography, MRE (Magenetic Resonance Enteroscopy), performed within the 90 days prior to enrollment.
  5. Subject or parent agrees to sign consent form

Exclusion Criteria:

The presence of any of the following will exclude a subject from study enrollment:

  1. Subjects with change in IBD (Inflammatory Bowel Disease) drug therapy between the baseline ileocolonoscopy and VCE
  2. Subjects with a history of prior ileocecectomy, Ileal Pouch-Anal Anastomosis (IPAA) and J pouch or an ostomy
  3. Stricture seen on radiological exam.
  4. Indeterminate Colitis
  5. Ulcerative Colitis
  6. Antibiotic Associated Colitis
  7. Known history of intestinal obstruction or current obstructive symptoms, such as severe abdominal pain with accompanying nausea or vomiting, based on investigator judgment.
  8. Non-steroidal anti-inflammatory drugs including aspirin (twice weekly or more), not including aspirin up to 81mg daily, during the 4 weeks preceding enrollment
  9. Suspected GI stricture, followed by PillCam® Patency study or other imaging study that could not prove patency of the GI tract.
  10. Subject is expected to undergo MRI examination within 7 days after ingestion of the capsule.
  11. Subjects with known or suspected delayed gastric emptying
  12. Subjects with known or suspected delayed Small bowel motility
  13. Subject has any allergy or other known contraindication to the medications used in the study.
  14. Women who are either pregnant or nursing at the time of screening, or are of child-bearing potential and do not agree to practice medically acceptable methods of contraception.
  15. Unwillingness to use a medically accepted method of contraception throughout duration of study
  16. Concurrent participation in another clinical trial using any investigational drug or device.
  17. Subject has cardiac pacemaker or other implanted electromedical devices
  18. Subject suffers from a life threatening condition.
  19. Subject with a history or clinical evidence of renal disease and/or previous clinically significant laboratory abnormalities of renal function parameters.
  20. Subject suffers from any condition, such as swallowing problems, which precludes compliance with study and/or device instructions.

Sites / Locations

  • Mayo Clinic
  • Cedars Sinai Medical Center
  • Borland-Groover Clinic
  • Shafran Gastroenterology Center
  • Children's Center for Digestive Healthcare
  • The University of Chicago
  • Indiana Unveresity Hospital
  • Iowa Digestive Disease Center
  • University of Maryland Medical Center
  • Metropolitan Gastroenterology Group
  • Digestive Health Center of Michigan
  • Atlantic Health System Morristown Memorial Pediatric GE
  • UNC Chapel Hill
  • Dr. Romeo, Dayton Gastroenterology
  • Gastroenterology Associates of Tidewater

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Capsule endoscopy

Arm Description

Outcomes

Primary Outcome Measures

Mucosal Change in VCE (Video Capsule Endoscopy) Mucosal Scores and PGA (Physician Global Assessment)
To correlate the mucosal change in VCE mucosal score (Lewis score and CECDEIS( Capsule Endoscopy Crohn's Disease Endoscopic Index)) with change in Physician Global Assessment of CD activity 6 months after the first VCE procedure; PGA scale: 0-Normal, 1-Mild disease, 2- Moderate Disease, 3-Severe Disease Lewis Score scale: continuance scale variable, higher score higher disease severity (0- unlimited) remission <135 CECDEIS score scale: continuance scale variable, higher score higher disease severity (0-44) , no "normal range" Studies discuss a drop in the number as indicating healing but not a specific cutoff

Secondary Outcome Measures

Correlation Between SES CD (Simple Endoscopic Score for Chron's Disease) Score and Capsule Scoring Indexes
Evaluate the correlation between SES CD score and capsule scoring indexes (Lewis and CECDEIS) in the TI (Terminal Ileum) at baseline. SES CD score scale 0-12, Higher score=higher disease severity Lewis Score scale: continuance scale variable, higher score higher disease severity (0- unlimited) remission <135 CECDEIS score scale: continuance scale variable, higher score higher disease severity (0-44) , no "normal range" Studies discuss a drop in the number as indicating healing but not a specific
Correlation Between the Change in SES CD Score and the Change in Capsule Scoring Indexes- in Terminal Ileum
Evaluate the correlation between the change in SES CD score and the change in capsule scoring indexes (Lewis and CECDEIS) in the TI after 6 months SES CD score scale 0-12, Higher score=higher disease severity Lewis Score scale: continuance scale variable, higher score higher disease severity (0- unlimited) remission <135 CECDEIS score scale: continuance scale variable, higher score higher disease severity (0-44) , no "normal range" Studies discuss a drop in the number as indicating healing but not a specific cutoff
Evaluate the Entire SB CE Scores
Evaluate the entire SB CE Scores (Lewis & CECDEIS) change as compared to the change at TI in CE Scores (Lewis & CECDEIS). Lewis Score scale: continuance scale variable, higher score higher disease severity (0- unlimited) remission <135 CECDEIS score scale: continuance scale variable, higher score higher disease severity (0-44) , no "normal range" Studies discuss a drop in the number as indicating healing but not a specific
Adverse Events (AE)
To assess safety related to capsule retention and other adverse events

Full Information

First Posted
September 11, 2013
Last Updated
April 30, 2017
Sponsor
Medtronic - MITG
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1. Study Identification

Unique Protocol Identification Number
NCT01942720
Brief Title
Monitoring Disease Activity Using Video Capsule Endoscopy (VCE) in Crohn's Disease (CD) Subjects
Official Title
Monitoring Disease Activity Using Video Capsule Endoscopy (VCE) in Crohn's Disease (CD) Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
August 2016
Overall Recruitment Status
Completed
Study Start Date
August 2013 (undefined)
Primary Completion Date
July 2016 (Actual)
Study Completion Date
July 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Medtronic - MITG

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is designed to evaluate the performance of VCE in the assessment of mucosal inflammation 6 months after the first VCE procedure
Detailed Description
This is a prospective, multi-center (up to 15 sites) study which aims to assess the ability of VCE (Video capsule endoscopy) to detect change in the severity of the small bowel mucosal disease activity in CD subjects after 6 months . Up to 75 subjects will participate in this study. An interim analysis will be done after study completion with 20 subjects. All subjects to be enrolled in this study will be pediatric and\or adult subjects with known Crohn's disease

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Known Crohn Disease Subjects

7. Study Design

Primary Purpose
Diagnostic
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
74 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Capsule endoscopy
Arm Type
Other
Intervention Type
Device
Intervention Name(s)
Capsule endoscopy and Ileocolonoscopy tests
Primary Outcome Measure Information:
Title
Mucosal Change in VCE (Video Capsule Endoscopy) Mucosal Scores and PGA (Physician Global Assessment)
Description
To correlate the mucosal change in VCE mucosal score (Lewis score and CECDEIS( Capsule Endoscopy Crohn's Disease Endoscopic Index)) with change in Physician Global Assessment of CD activity 6 months after the first VCE procedure; PGA scale: 0-Normal, 1-Mild disease, 2- Moderate Disease, 3-Severe Disease Lewis Score scale: continuance scale variable, higher score higher disease severity (0- unlimited) remission <135 CECDEIS score scale: continuance scale variable, higher score higher disease severity (0-44) , no "normal range" Studies discuss a drop in the number as indicating healing but not a specific cutoff
Time Frame
6 months changefrom Baseline
Secondary Outcome Measure Information:
Title
Correlation Between SES CD (Simple Endoscopic Score for Chron's Disease) Score and Capsule Scoring Indexes
Description
Evaluate the correlation between SES CD score and capsule scoring indexes (Lewis and CECDEIS) in the TI (Terminal Ileum) at baseline. SES CD score scale 0-12, Higher score=higher disease severity Lewis Score scale: continuance scale variable, higher score higher disease severity (0- unlimited) remission <135 CECDEIS score scale: continuance scale variable, higher score higher disease severity (0-44) , no "normal range" Studies discuss a drop in the number as indicating healing but not a specific
Time Frame
Baseline
Title
Correlation Between the Change in SES CD Score and the Change in Capsule Scoring Indexes- in Terminal Ileum
Description
Evaluate the correlation between the change in SES CD score and the change in capsule scoring indexes (Lewis and CECDEIS) in the TI after 6 months SES CD score scale 0-12, Higher score=higher disease severity Lewis Score scale: continuance scale variable, higher score higher disease severity (0- unlimited) remission <135 CECDEIS score scale: continuance scale variable, higher score higher disease severity (0-44) , no "normal range" Studies discuss a drop in the number as indicating healing but not a specific cutoff
Time Frame
6 months change from Baseline
Title
Evaluate the Entire SB CE Scores
Description
Evaluate the entire SB CE Scores (Lewis & CECDEIS) change as compared to the change at TI in CE Scores (Lewis & CECDEIS). Lewis Score scale: continuance scale variable, higher score higher disease severity (0- unlimited) remission <135 CECDEIS score scale: continuance scale variable, higher score higher disease severity (0-44) , no "normal range" Studies discuss a drop in the number as indicating healing but not a specific
Time Frame
6 months change from Baseline
Title
Adverse Events (AE)
Description
To assess safety related to capsule retention and other adverse events
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject ages 2-75 years, inclusive Subjects with a diagnosis of known Crohn disease Referred to ileocolonoscopy (up to 4 weeks before the CE procedure) Proven patency by the Agile capsule or another approach deemed clinically acceptable by the investigator, e.g. CT enterography, MRE (Magenetic Resonance Enteroscopy), performed within the 90 days prior to enrollment. Subject or parent agrees to sign consent form Exclusion Criteria: The presence of any of the following will exclude a subject from study enrollment: Subjects with change in IBD (Inflammatory Bowel Disease) drug therapy between the baseline ileocolonoscopy and VCE Subjects with a history of prior ileocecectomy, Ileal Pouch-Anal Anastomosis (IPAA) and J pouch or an ostomy Stricture seen on radiological exam. Indeterminate Colitis Ulcerative Colitis Antibiotic Associated Colitis Known history of intestinal obstruction or current obstructive symptoms, such as severe abdominal pain with accompanying nausea or vomiting, based on investigator judgment. Non-steroidal anti-inflammatory drugs including aspirin (twice weekly or more), not including aspirin up to 81mg daily, during the 4 weeks preceding enrollment Suspected GI stricture, followed by PillCam® Patency study or other imaging study that could not prove patency of the GI tract. Subject is expected to undergo MRI examination within 7 days after ingestion of the capsule. Subjects with known or suspected delayed gastric emptying Subjects with known or suspected delayed Small bowel motility Subject has any allergy or other known contraindication to the medications used in the study. Women who are either pregnant or nursing at the time of screening, or are of child-bearing potential and do not agree to practice medically acceptable methods of contraception. Unwillingness to use a medically accepted method of contraception throughout duration of study Concurrent participation in another clinical trial using any investigational drug or device. Subject has cardiac pacemaker or other implanted electromedical devices Subject suffers from a life threatening condition. Subject with a history or clinical evidence of renal disease and/or previous clinically significant laboratory abnormalities of renal function parameters. Subject suffers from any condition, such as swallowing problems, which precludes compliance with study and/or device instructions.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Jonathan Leighton, MD
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Gil Melmed, MD
Organizational Affiliation
Cyder Cinai LA
Official's Role
Principal Investigator
Facility Information:
Facility Name
Mayo Clinic
City
Scottsdale
State/Province
Arizona
Country
United States
Facility Name
Cedars Sinai Medical Center
City
Los Angeles
State/Province
California
Country
United States
Facility Name
Borland-Groover Clinic
City
Jacksonville
State/Province
Florida
Country
United States
Facility Name
Shafran Gastroenterology Center
City
Winter Park
State/Province
Florida
Country
United States
Facility Name
Children's Center for Digestive Healthcare
City
Atlanta
State/Province
Georgia
Country
United States
Facility Name
The University of Chicago
City
Chicago
State/Province
Illinois
Country
United States
Facility Name
Indiana Unveresity Hospital
City
Indianapolis
State/Province
Indiana
Country
United States
Facility Name
Iowa Digestive Disease Center
City
Clive
State/Province
Iowa
Country
United States
Facility Name
University of Maryland Medical Center
City
Baltimore
State/Province
Maryland
Country
United States
Facility Name
Metropolitan Gastroenterology Group
City
Chevy Chase
State/Province
Maryland
Country
United States
Facility Name
Digestive Health Center of Michigan
City
Michigan
State/Province
Michigan
Country
United States
Facility Name
Atlantic Health System Morristown Memorial Pediatric GE
City
Morristown
State/Province
New Jersey
Country
United States
Facility Name
UNC Chapel Hill
City
Chapel Hill
State/Province
North Carolina
Country
United States
Facility Name
Dr. Romeo, Dayton Gastroenterology
City
Dayton
State/Province
Ohio
ZIP/Postal Code
45440
Country
United States
Facility Name
Gastroenterology Associates of Tidewater
City
Chesapeake
State/Province
Virginia
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
30086261
Citation
Melmed GY, Dubinsky MC, Rubin DT, Fleisher M, Pasha SF, Sakuraba A, Tiongco F, Shafran I, Fernandez-Urien I, Rosa B, Papageorgiou NP, Leighton JA. Utility of video capsule endoscopy for longitudinal monitoring of Crohn's disease activity in the small bowel: a prospective study. Gastrointest Endosc. 2018 Dec;88(6):947-955.e2. doi: 10.1016/j.gie.2018.07.035. Epub 2018 Aug 4.
Results Reference
derived

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Monitoring Disease Activity Using Video Capsule Endoscopy (VCE) in Crohn's Disease (CD) Subjects

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