A Trial for Prevention of Loss of the Effect of Biological Drugs in Patients With Inflammatory Bowel Disease
Primary Purpose
Inflammatory Bowel Diseases
Status
Unknown status
Phase
Not Applicable
Locations
Study Type
Interventional
Intervention
An App for reminding patients to take their medication
Sponsored by
About this trial
This is an interventional device feasibility trial for Inflammatory Bowel Diseases
Eligibility Criteria
Inclusion Criteria:
- Diagnosis of CD or UC according to validated criteria, with a Crohn's Disease Activity Score (CDAI) of 200-450 at inclusion.
- Patients on a stable dose within the last 6 weeks of any type of anti TNF agent or any other biological agent
- 5-ASA (mesalamine), and immunomodulatory, or immunosuppressive agent, and symptomatic relief (anti-diarrheals) for patients are allowed in a stable dose (6 weeks).
- Non-smoking (by declaration) for a period of at least 6 months.
- Females of childbearing potential must be non-pregnant (as determined by a serum pregnancy test at screening and again, prior to each dosing session) and agree to use adequate contraceptive means throughout the study.
- No known history of significant neurological, renal, cardiovascular, respiratory (asthma), endocrinological, gastrointestinal, primary hematopoietic disease, neoplasm, or any other clinically significant medical disorder other than Crohn's disease and its complications, which in the investigator's judgment contraindicate administration of the study medications.
- No history of drug or alcohol abuse.
- Screening tests must meet the following criteria: HGB ≥8.5 g/dL, platelets ≥ 100,000/ mm³, WBC: 3500-12,000/mm³, serum albumin above 2.5 g/dL, amylase, lipase and total bilirubin within normal limits. ALT, AST, alkaline phosphatase up to 1.5 times normal limits.
- No clinically significant abnormalities in screening physical exam.
- Negative HIV, Hepatitis B and Hepatitis C serology tests within 2 years.
- Patients must be able to adhere to the visit schedule and protocol requirements and be available to complete the study.
- Patients must satisfy a medical examiner about their fitness to participate in the study.
- Patients must provide written informed consent to participate in the study.
Exclusion Criteria:
- Patients with evidence of other serious infectious, autoimmune, hepatic, nephritic or systemic disease or compromised organ function.
- Patients with a present colostomy, ileostomy or subtotal colectomy with ileorectal anastomosis.
- Symptomatic stenosis or ileal strictures, x-ray evidence of fibrosed bowel.
- Patients presenting with, or with a history of persistent intestinal obstruction, bowel perforation, uncontrolled GI bleed or abdominal abscess or infection, toxic megacolon.
- Patients with fistulating CD.
- Short bowel syndrome.
- Patients with a history of GI tract malignancy or IBD-associated malignant changes in the intestines.
- Patients with any clinically significant abnormality upon physical examination or in the clinical laboratory test values.
- A change in the dose of the immunomodulatory or immunosuppressive drug within 6 weeks.
- Over-the-counter drugs, including herbal medications, and prescription drugs (other than those listed above) are not allowed for 7 days prior to first study dosing and throughout the duration of the study
- Receipt of packed RBC's within 3 months prior to the first study dosing and throughout the study.
- Participation in another clinical trial within 30 days prior to first drug administration.
- Patients with an inability to communicate well with the PI and staff (i.e., language problem, poor mental development or impaired cerebral function).
- Patients with any acute medical situation (e.g. acute infection) within 48 hours of first dosing session, which is considered of significance by the Principal Investigator.
- Patients who will be unavailable for the duration of the trial, are likely to be noncompliant with the protocol, or who are felt to be unsuitable by the PI for any other reason.
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Patients with IBD who develop resistance to anti TNF
Arm Description
Patients with inflammatory bowel disease who developed partial or complete resistance to anti TNF based drugs
Outcomes
Primary Outcome Measures
Proportion of subjects with reduction chron's disease activity index score more than 100 points during the study;
Proportion of subjects with reduction chron's disease activity index score more than 100 points during the study;
Secondary Outcome Measures
Proportion of subjects achieving clinical remission or response without steroid rescue therapy during the study;
The secondary efficacy outcome was the proportion of subjects with clinical response at week 10
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03843697
Brief Title
A Trial for Prevention of Loss of the Effect of Biological Drugs in Patients With Inflammatory Bowel Disease
Official Title
A Controlled Trial for the Prevention of Loss of the Effect of Biological Drugs in Patients With Inflammatory Bowel Disease
Study Type
Interventional
2. Study Status
Record Verification Date
February 2019
Overall Recruitment Status
Unknown status
Study Start Date
March 1, 2019 (Anticipated)
Primary Completion Date
January 1, 2020 (Anticipated)
Study Completion Date
January 1, 2020 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Tahel Ilan Ber
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
Trial for IBD patients non-responsive to biological drugs, using medical app reminding patients to take their physician-prescribed medications
Detailed Description
Patients with IBD who developed loss of response to anti-TNF based medications will receive a cell phone based app that will remind them to take the drug with an approved dosing range.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Inflammatory Bowel Diseases
7. Study Design
Primary Purpose
Device Feasibility
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
The study will assess the effect of adding an app which reminds to take an approved therapy in patients who are already on the drug without a change of the physician's predetermined regimen
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Patients with IBD who develop resistance to anti TNF
Arm Type
Experimental
Arm Description
Patients with inflammatory bowel disease who developed partial or complete resistance to anti TNF based drugs
Intervention Type
Device
Intervention Name(s)
An App for reminding patients to take their medication
Other Intervention Name(s)
Oberon APP
Intervention Description
Open-label, single-center study, up to 20 adults (>18) male and female with inflammatory bowel disease (chorn's disease, ulcerative colitis), unresponsive to biological drugs, will participate in a 4-week observation period during which no change in drugs is permitted. The patients will then begin 10-week treatment by taking their medications according to a semi-random schedule that is pre-set for them by the physician using the same drugs the patient is taking and only changing the dose and times of taking them each day while keeping the drugs within their therapeutic window.
Primary Outcome Measure Information:
Title
Proportion of subjects with reduction chron's disease activity index score more than 100 points during the study;
Description
Proportion of subjects with reduction chron's disease activity index score more than 100 points during the study;
Time Frame
10 weeks
Secondary Outcome Measure Information:
Title
Proportion of subjects achieving clinical remission or response without steroid rescue therapy during the study;
Description
The secondary efficacy outcome was the proportion of subjects with clinical response at week 10
Time Frame
10 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Diagnosis of CD or UC according to validated criteria, with a Crohn's Disease Activity Score (CDAI) of 200-450 at inclusion.
Patients on a stable dose within the last 6 weeks of any type of anti TNF agent or any other biological agent
5-ASA (mesalamine), and immunomodulatory, or immunosuppressive agent, and symptomatic relief (anti-diarrheals) for patients are allowed in a stable dose (6 weeks).
Non-smoking (by declaration) for a period of at least 6 months.
Females of childbearing potential must be non-pregnant (as determined by a serum pregnancy test at screening and again, prior to each dosing session) and agree to use adequate contraceptive means throughout the study.
No known history of significant neurological, renal, cardiovascular, respiratory (asthma), endocrinological, gastrointestinal, primary hematopoietic disease, neoplasm, or any other clinically significant medical disorder other than Crohn's disease and its complications, which in the investigator's judgment contraindicate administration of the study medications.
No history of drug or alcohol abuse.
Screening tests must meet the following criteria: HGB ≥8.5 g/dL, platelets ≥ 100,000/ mm³, WBC: 3500-12,000/mm³, serum albumin above 2.5 g/dL, amylase, lipase and total bilirubin within normal limits. ALT, AST, alkaline phosphatase up to 1.5 times normal limits.
No clinically significant abnormalities in screening physical exam.
Negative HIV, Hepatitis B and Hepatitis C serology tests within 2 years.
Patients must be able to adhere to the visit schedule and protocol requirements and be available to complete the study.
Patients must satisfy a medical examiner about their fitness to participate in the study.
Patients must provide written informed consent to participate in the study.
Exclusion Criteria:
Patients with evidence of other serious infectious, autoimmune, hepatic, nephritic or systemic disease or compromised organ function.
Patients with a present colostomy, ileostomy or subtotal colectomy with ileorectal anastomosis.
Symptomatic stenosis or ileal strictures, x-ray evidence of fibrosed bowel.
Patients presenting with, or with a history of persistent intestinal obstruction, bowel perforation, uncontrolled GI bleed or abdominal abscess or infection, toxic megacolon.
Patients with fistulating CD.
Short bowel syndrome.
Patients with a history of GI tract malignancy or IBD-associated malignant changes in the intestines.
Patients with any clinically significant abnormality upon physical examination or in the clinical laboratory test values.
A change in the dose of the immunomodulatory or immunosuppressive drug within 6 weeks.
Over-the-counter drugs, including herbal medications, and prescription drugs (other than those listed above) are not allowed for 7 days prior to first study dosing and throughout the duration of the study
Receipt of packed RBC's within 3 months prior to the first study dosing and throughout the study.
Participation in another clinical trial within 30 days prior to first drug administration.
Patients with an inability to communicate well with the PI and staff (i.e., language problem, poor mental development or impaired cerebral function).
Patients with any acute medical situation (e.g. acute infection) within 48 hours of first dosing session, which is considered of significance by the Principal Investigator.
Patients who will be unavailable for the duration of the trial, are likely to be noncompliant with the protocol, or who are felt to be unsuitable by the PI for any other reason.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Tahel Ilan Ber, MD
Phone
972 53 803463
Email
taheli@oberonsci.com
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
33988944
Citation
Azmanov H, Ross EL, Ilan Y. Establishment of an Individualized Chronotherapy, Autonomic Nervous System, and Variability-Based Dynamic Platform for Overcoming the Loss of Response to Analgesics. Pain Physician. 2021 May;24(3):243-252.
Results Reference
derived
Learn more about this trial
A Trial for Prevention of Loss of the Effect of Biological Drugs in Patients With Inflammatory Bowel Disease
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