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Efficacy of Mesalazine Combined With Biologics in the Treatment of Moderate to Severe Ulcerative Colitis

Primary Purpose

Ulcerative Colitis, Efficacy, Self, Biologics

Status
Not yet recruiting
Phase
Phase 4
Locations
China
Study Type
Interventional
Intervention
Infliximab
Vedolizumab
Mesalazine
Sponsored by
Sixth Affiliated Hospital, Sun Yat-sen University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ulcerative Colitis focused on measuring ulcerative colitis, biologics, mesalazine

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients with moderate and severe ulcerative colitis;
  2. Subjects were above 18 years old and below 80 years;
  3. Indications of 5-ASA or biological treatment;
  4. According to the clinical symptoms, ulcerative colitis was diagnosed by endoscopic changes, pathological manifestations. The disease activity of UC was assessed according to the modified Mayo scoring system (modified Mayo: 6~12 for patients with moderate to severe ulcerative colitis);
  5. If the subject is a woman, a pregnancy test at baseline is needed to exclude pregnancy. Female patients must follow the contraceptive recommendations of the project;
  6. Subjects must be able and willing to provide written informed consent and comply with the requirements of this study protocol.

Exclusion Criteria:

  1. No indications of 5-ASA or biological treatment;
  2. ulcerative colitis patients who had previously undergone a partial colectomy;
  3. Patients who are unable to use 5-ASA for a long time;
  4. Patients with severe, progressive, or uncontrolled kidney, liver, blood, or endocrine diseases or symptoms;
  5. Presence of infected persons, Patients with a contraindication to the use of biological agents such as C. difficile infection or other intestinal pathogens, active tuberculosis or intestinal tuberculosis infection, human immunodeficiency virus (HIV) infection, active hepatitis B or hepatitis C (defined as: ① HBV: hepatitis B surface antigen (HBs Ag) positive (+), Or patients with positive for hepatitis B core antibody (HBcAb) and the qualitative test results of HBV deoxyribonucleic acid (DNA) polymerase chain reaction (PCR) meet the detection criteria; ② HCV: Any patient with an anti-HCV antibody (HCV Ab) -positive patient with a detectable HCV ribonucleic acid (RNA);
  6. Patients with a history of gastrointestinal dysplasia, or dysplasia on any biopsy performed on endoscopy, excluding low-grade dysplasia lesions; known history of lymphoproliferative disease (including lymphoma), or signs and symptoms (e. g., lymphadenopathy and / or splenomegaly); patients with current or previous malignancy;
  7. Has been involved in other clinical studies.

Sites / Locations

  • People's Hospital of Chongqing
  • the Sixth Affiliated Hospital of Sun Yat-Sen University
  • First People's Hospital of Foshan
  • Guangzhou Panyu Central Hospital
  • Nanhai Hospital, Southern Medical University
  • Shunde Hospital of Southern Medical University
  • First Affiliated Hospital of Shantou University Medical College
  • The Second Affiliated Hospital of Dalian Medical University
  • Shengjing Hospital
  • General Hospital of Tianjin Medical University
  • Zhejiang University

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Experimental

Arm Label

Biologics group

5-ASA group

Arm Description

Biologics including infliximab and vedolizumab. infliximab: 5mg/kg, intravenously administration at week 0, 2, and 6 as induction therapy; subsequently by maintenance therapy at a dose of 5mg/kg every 8 weeks. vedolizumab: 300mg, intravenously administration at week 0, 2, and 6 as induction therapy; subsequently by maintenance therapy at a dose of 300mg every 8 weeks.

5-ASA combined with biologics (including infliximab and vedolizumab). infliximab: 5mg/kg, intravenously administration at week 0, 2, and 6 as induction therapy; subsequently by maintenance therapy at a dose of 5mg/kg every 8 weeks. vedolizumab: 300mg, intravenously administration at week 0, 2, and 6 as induction therapy; subsequently by maintenance therapy at a dose of 300mg every 8 weeks. mesalazine: at a dose of 4-6g/d systemic or topical therapy

Outcomes

Primary Outcome Measures

endoscopic remission rate at 12 months
endoscopic remission rate at 12 months

Secondary Outcome Measures

normalization rate of serum biomarker at 12 months
normalization rate of serum biomarker at 12 months
normalization rate of serum biomarker at 6 months
normalization rate of serum biomarker at 6 months
clinical remission rate at 12 months
clinical remission rate at 12 months
clinical remission rate at 6 months
clinical remission rate at 6 months
clinical response rate at 12 months
clinical response rate at 12 months
clinical response rate at 6 months
clinical response rate at 6 months
endoscopic remission rate at 6 months
endoscopic remission rate at 6 months
endoscopic response rate at 12 months
endoscopic response rate at 12 months
endoscopic response rate at 6 months
endoscopic response rate at 6 months
life quality changes at 12 months
life quality evaluated by IBDQ (inflammatory bowel disease questionnaire) at 12 months
life quality changes at 6 months
life quality evaluated by IBDQ (inflammatory bowel disease questionnaire) at 6 months

Full Information

First Posted
January 5, 2022
Last Updated
January 11, 2022
Sponsor
Sixth Affiliated Hospital, Sun Yat-sen University
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1. Study Identification

Unique Protocol Identification Number
NCT05205603
Brief Title
Efficacy of Mesalazine Combined With Biologics in the Treatment of Moderate to Severe Ulcerative Colitis
Official Title
Efficacy of Mesalazine Combined With Biologics in the Treatment of Moderate to Severe Ulcerative Colitis: a Multicenter, Prospective, Randomized, Controlled Clinical Study
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
January 15, 2022 (Anticipated)
Primary Completion Date
January 15, 2024 (Anticipated)
Study Completion Date
January 15, 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Sixth Affiliated Hospital, Sun Yat-sen University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Endocopic remission rates of moderate to severe ulcerative colitis are low. Biologics including Vedolizumab, infliximab, and adalimumab are effective in induction and maintainence of ulcerative colitis. The role of 5-ASA in promoting a higher rate of endocsopic remission is unclear. We aim to evaluate the efficacy of combination of 5-ASA and biologics in treating ulcerative colitis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ulcerative Colitis, Efficacy, Self, Biologics, Mesalazine
Keywords
ulcerative colitis, biologics, mesalazine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
438 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Biologics group
Arm Type
Placebo Comparator
Arm Description
Biologics including infliximab and vedolizumab. infliximab: 5mg/kg, intravenously administration at week 0, 2, and 6 as induction therapy; subsequently by maintenance therapy at a dose of 5mg/kg every 8 weeks. vedolizumab: 300mg, intravenously administration at week 0, 2, and 6 as induction therapy; subsequently by maintenance therapy at a dose of 300mg every 8 weeks.
Arm Title
5-ASA group
Arm Type
Experimental
Arm Description
5-ASA combined with biologics (including infliximab and vedolizumab). infliximab: 5mg/kg, intravenously administration at week 0, 2, and 6 as induction therapy; subsequently by maintenance therapy at a dose of 5mg/kg every 8 weeks. vedolizumab: 300mg, intravenously administration at week 0, 2, and 6 as induction therapy; subsequently by maintenance therapy at a dose of 300mg every 8 weeks. mesalazine: at a dose of 4-6g/d systemic or topical therapy
Intervention Type
Drug
Intervention Name(s)
Infliximab
Intervention Description
Infliximab, 5mg/kg at week 0,2,6 and schedule administration at every 8 weeks
Intervention Type
Drug
Intervention Name(s)
Vedolizumab
Intervention Description
Vedolizumab, 300mg at week 0,2,6 and schedule administration at every 8 weeks
Intervention Type
Drug
Intervention Name(s)
Mesalazine
Intervention Description
Mesalazine, 4-6g/d, systemic and/or topical administration
Primary Outcome Measure Information:
Title
endoscopic remission rate at 12 months
Description
endoscopic remission rate at 12 months
Time Frame
12 months after first intervention administration
Secondary Outcome Measure Information:
Title
normalization rate of serum biomarker at 12 months
Description
normalization rate of serum biomarker at 12 months
Time Frame
12 months after first intervention administration
Title
normalization rate of serum biomarker at 6 months
Description
normalization rate of serum biomarker at 6 months
Time Frame
6 months after first intervention administration
Title
clinical remission rate at 12 months
Description
clinical remission rate at 12 months
Time Frame
12 months after first intervention administration
Title
clinical remission rate at 6 months
Description
clinical remission rate at 6 months
Time Frame
6 months after first intervention administration
Title
clinical response rate at 12 months
Description
clinical response rate at 12 months
Time Frame
12 months after first intervention administration
Title
clinical response rate at 6 months
Description
clinical response rate at 6 months
Time Frame
6 months after first intervention administration
Title
endoscopic remission rate at 6 months
Description
endoscopic remission rate at 6 months
Time Frame
6 months after first intervention administration
Title
endoscopic response rate at 12 months
Description
endoscopic response rate at 12 months
Time Frame
12 months after first intervention administration
Title
endoscopic response rate at 6 months
Description
endoscopic response rate at 6 months
Time Frame
6 months after first intervention administration
Title
life quality changes at 12 months
Description
life quality evaluated by IBDQ (inflammatory bowel disease questionnaire) at 12 months
Time Frame
12 months after first intervention administration
Title
life quality changes at 6 months
Description
life quality evaluated by IBDQ (inflammatory bowel disease questionnaire) at 6 months
Time Frame
6 months after first intervention administration

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: Patients with moderate and severe ulcerative colitis; Subjects were above 18 years old and below 80 years; Indications of 5-ASA or biological treatment; According to the clinical symptoms, ulcerative colitis was diagnosed by endoscopic changes, pathological manifestations. The disease activity of UC was assessed according to the modified Mayo scoring system (modified Mayo: 6~12 for patients with moderate to severe ulcerative colitis); If the subject is a woman, a pregnancy test at baseline is needed to exclude pregnancy. Female patients must follow the contraceptive recommendations of the project; Subjects must be able and willing to provide written informed consent and comply with the requirements of this study protocol. Exclusion Criteria: No indications of 5-ASA or biological treatment; ulcerative colitis patients who had previously undergone a partial colectomy; Patients who are unable to use 5-ASA for a long time; Patients with severe, progressive, or uncontrolled kidney, liver, blood, or endocrine diseases or symptoms; Presence of infected persons, Patients with a contraindication to the use of biological agents such as C. difficile infection or other intestinal pathogens, active tuberculosis or intestinal tuberculosis infection, human immunodeficiency virus (HIV) infection, active hepatitis B or hepatitis C (defined as: ① HBV: hepatitis B surface antigen (HBs Ag) positive (+), Or patients with positive for hepatitis B core antibody (HBcAb) and the qualitative test results of HBV deoxyribonucleic acid (DNA) polymerase chain reaction (PCR) meet the detection criteria; ② HCV: Any patient with an anti-HCV antibody (HCV Ab) -positive patient with a detectable HCV ribonucleic acid (RNA); Patients with a history of gastrointestinal dysplasia, or dysplasia on any biopsy performed on endoscopy, excluding low-grade dysplasia lesions; known history of lymphoproliferative disease (including lymphoma), or signs and symptoms (e. g., lymphadenopathy and / or splenomegaly); patients with current or previous malignancy; Has been involved in other clinical studies.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Min Zhi
Phone
13825086505
Email
zhimin@mail.sysu.edu.cn
Facility Information:
Facility Name
People's Hospital of Chongqing
City
Chongqing
State/Province
Chongqing
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hong Guo
Phone
13508389768
Facility Name
the Sixth Affiliated Hospital of Sun Yat-Sen University
City
Guangzhou
State/Province
Guangdong
ZIP/Postal Code
501655
Country
China
Facility Name
First People's Hospital of Foshan
City
Guangzhou
State/Province
Guangdong
Country
China
Facility Name
Guangzhou Panyu Central Hospital
City
Guangzhou
State/Province
Guangdong
Country
China
Facility Name
Nanhai Hospital, Southern Medical University
City
Guangzhou
State/Province
Guangdong
Country
China
Facility Name
Shunde Hospital of Southern Medical University
City
Guangzhou
State/Province
Guangdong
Country
China
Facility Name
First Affiliated Hospital of Shantou University Medical College
City
Shantou
State/Province
Guangdong
Country
China
Facility Name
The Second Affiliated Hospital of Dalian Medical University
City
Dalian
State/Province
Liaoning
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Xiaoying Feng
Phone
17709870699
Facility Name
Shengjing Hospital
City
Shenyang
State/Province
Liaoning
Country
China
Facility Name
General Hospital of Tianjin Medical University
City
Tianjin
State/Province
Tianjin
Country
China
Facility Name
Zhejiang University
City
Hanzhou
State/Province
Zhejiang
Country
China
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yan Chen
Phone
13757118653

12. IPD Sharing Statement

Learn more about this trial

Efficacy of Mesalazine Combined With Biologics in the Treatment of Moderate to Severe Ulcerative Colitis

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