Extracorporeal Photopheresis of Patients With Crohn's Disease Using 5-aminolevulinic Acid
Crohn Disease
About this trial
This is an interventional treatment trial for Crohn Disease focused on measuring Crohns Disease, Photopheresis, 5-aminolevulinic acid, Gliolan, UVA-PIT
Eligibility Criteria
Inclusion Criteria:
- Provision of informed consent
- Age above 18
- Male or female patient with active Crohn's disease (6)
- Women of childbearing potential (WOCBP) will have to use highly effective methods of contraception throughout the entire study.
Inadequate response (a) or intolerance to biological therapy
a. Inadequate response on ongoing treatment is defined as: i. Progressive disease: increasing Harvey Bradshaw Index/Calprotectin/Simple Endoscopic Score for Crohns Disease and/or worsening of radiologic images after 6 months.
ii. Stable disease: no-response after 6 months
Active inflammation in the gut documented by
- Harvey Bradshaw Index >5 and
- Endoscopy with Simple Endoscopic Score for Crohns Disease equal to or above 6 points or equal to or above 4 points if only isolated ileitis is present and/or
- Inflammatory marker; fecal calprotectin > 250 and/or C reactive protein > 5
Exclusion Criteria:
- Photosensitive comorbidities, porphyria or known hypersensitivity to 5-aminolevulinic acid or porphyrins
- Patients with aphakia
- Pregnant or breast-feeding women. A negative urine pregnancy test must be demonstrated in female patients of child-bearing potential at the Screening Visit and before every treatment.
- Ongoing cardiac and pulmonary diseases or aspartate transaminase alanine aminotransferase, Bilirubin or International Normalized Ratio value ≥ 3x upper limit of normal or clinically significant electrocardiogram findings
- Subjects with polyneuropathy
- Uncontrolled infection or fever
- History of heparin-induced thrombocytopenia, absolute neutrophil count <1x109, platelet count <20x10 9
- Body weight below 40 kg
- Investigator considers subject unlikely to comply with study procedures, restrictions and requirements.
- Presence of other gastrointestinal diseases potentially influencing the study endpoints
- History of any clinically significant disease or disorder which in the opinion of the investigator, may either put the patient at risk because of participation in the study, or influence the result or the patient's ability to participate in the study.
Sites / Locations
- Akershus University HospitalRecruiting
Arms of the Study
Arm 1
Experimental
5-ALA photopheresis
All patients will receive 5-aminolevulinic acid (5-ALA) in combination with blue light photopheresis. The investigators will collect mononuclear cells by connecting patient to Spectra Optia with CMNC (continuous mononuclear cell collection protocol), and these cells will include active T-lymphocytes. 5-ALA will be incubated for 1 hour to produce photoactive protoporphyrin-IX (PpIX) before light exposure.