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Efficacy Study of Targeted, Local Delivery of Drugs to Treat Crohn's Disease

Primary Purpose

Crohn's Disease

Status
Completed
Phase
Phase 1
Locations
Israel
Study Type
Interventional
Intervention
Delayed Release 6MP or Calcitriol vs. Purinethol
Sponsored by
Teva GTC
About
Eligibility
Locations
Outcomes
Full info

About this trial

This is an interventional treatment trial for Crohn's Disease focused on measuring Crohn's Disease, Local Ileal Delivery, Delayed-Release Formulations, 6-Mercaptopurine, Calcitriol

Eligibility Criteria

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

Inclusion Criteria: Male or Female patients, aged 18-75 years with moderate Crohn's Disease (CDAI score >=220 and <=400 at screening), with or without adjunctive mesalamine treatment, 12 with involvement of the ileum and three without ileal involvement Definitive diagnosis of active inflammatory CD with fibrostenosing and/or fistulizing/perforating CD types ruled out based on clinical and radiological or endoscopic or pathological findings, within the previous 6 months Exclusion Criteria: Body weight below 42.5 kg Subjects who have received either methotrexate, cyclosporine or anti-TNFalpha (infliximab, Remicade), anti-integrin (namixilab) in the past 3 months Subjects who are taking allopurinol, sulfasalazine, valerian, warfarin and corticosteroids,including budesonide and prednisone within 28 days prior to and throughout the study Previous bowel resection, including prior colostomy, ileostomy or colectomy with ileorectal anastomosis Symptomatic stenosis or ileal strictures; x-ray evidence of fibrosed bowel Subjects with ulcerative colitis or short bowel syndrome Subjects who present with, or with a history of persistent intestinal obstruction, bowel perforation, uncontrolled GI bleed or abdominal abscess or infection, toxic megacolon Subjects with fistulizing CD or isolated small bowel CD Subjects with evidence of other serious infectious, autoimmune, hepatic,nephritic or systemic disease or compromised organ function Subjects with a history of GI tract malignancy or IBD-associated malignant changes in the intestines

Sites / Locations

  • Hadassah Medical Center

Outcomes

Primary Outcome Measures

Remission-defined as a CDAI (Crohn's Disease Activity Index) of <150
Response- defined as a fall in the CDAI by 100 points or more from baseline

Secondary Outcome Measures

Improvement in ESR (Erythrocyte Sedimentation Rate), CRP (C-Reactive Protein) levels, and IBDQ (Inflammatory Bowel Disease Questionnaire) >=180 indicative of remission

Full Information

First Posted
February 2, 2006
Last Updated
July 3, 2008
Sponsor
Teva GTC
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1. Study Identification

Unique Protocol Identification Number
NCT00287170
Brief Title
Efficacy Study of Targeted, Local Delivery of Drugs to Treat Crohn's Disease
Official Title
Pilot, Open-Label, Randomized, Parallel Group Study to Evaluate Clinical/ and Immunological Efficacy/Safety of Locally Delivered 6-MP or Calcitriol vs Purinethol in Non-Steroid Dependent Patients With Active CD
Study Type
Interventional

2. Study Status

Record Verification Date
July 2008
Overall Recruitment Status
Completed
Study Start Date
July 2006 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
December 2007 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Teva GTC

4. Oversight

5. Study Description

Brief Summary
The study is being undertaken to evaluate whether delayed-release medications, designed to begin to open in the lower intestinal tract, the main site of Crohn's Disease, are more effective than standard systemically delivered drugs to promote remission or response in CD patients. It is hypothesized that the delayed-release medications will go right to the injured tissue and heal the disease more quickly. The delayed-release test drugs are 6-mercaptopurine (at a dose of 40 mg daily) or calcitriol (at a dose of 5 mcg three times a week) versus Purinethol (6-MP at a dose of 1-2 mg/kg body weight daily). Calcitriol is a synthetically manufactured replica of a natural substance in the body that is derived from Vitamin D. There is much medical evidence that shows that lack of Vitamin D can be a possible risk factor in developing autoimmune disorders, including Crohn's Disease. Moreover, calcitriol has been shown in animal models to improve the symptoms of Crohn's Disease.
Detailed Description
This pilot clinical study is designed to evaluate the efficacy and safety of oral administration of novel, delayed-release test formulations, for targeted delivery to the ileum in Crohn's Disease patients. The local delivery drugs (delayed-release formulations of 6-mercaptopurine or calcitriol) will be compared to standard Purinethol treatment after 12 weeks of treatment to evaluate: (1) local intestinal mucosal inflammation and damage as shown by markers of biopsy tissue (CDEIS and pathologist review of biopsies); (2) Clinical symptoms of active Crohn's Disease [CDAI scores- remission <150; response- a drop of 100 points from baseline; IBDQ scores- >= 180 indicative of remission]; and (3)Systemic improvement as shown by blood immunological and inflammatory markers (CRP and ESR). It is hypothesized that since CD is a localized autoimmune inflammation of the intestinal mucosa, a far more effective, and potentially safer treatment would be targeted, local delivery of effective drugs directly to the disease site. The drug would be concentrated in the specific area of disease, while unwanted systemic side effects would be minimized. The drugs selected for evaluation are 6-MP (a mainstay of CD treatment for over 30 years) and calcitriol, a synthetically manufactured Vitamin D derivative, which is being evaluated in many studies for its impressive immunomodulatory effects in cancer, MS and other autoimmune disorders.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Crohn's Disease
Keywords
Crohn's Disease, Local Ileal Delivery, Delayed-Release Formulations, 6-Mercaptopurine, Calcitriol

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
15 (Actual)

8. Arms, Groups, and Interventions

Intervention Type
Drug
Intervention Name(s)
Delayed Release 6MP or Calcitriol vs. Purinethol
Primary Outcome Measure Information:
Title
Remission-defined as a CDAI (Crohn's Disease Activity Index) of <150
Time Frame
12 weeks
Title
Response- defined as a fall in the CDAI by 100 points or more from baseline
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Improvement in ESR (Erythrocyte Sedimentation Rate), CRP (C-Reactive Protein) levels, and IBDQ (Inflammatory Bowel Disease Questionnaire) >=180 indicative of remission

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or Female patients, aged 18-75 years with moderate Crohn's Disease (CDAI score >=220 and <=400 at screening), with or without adjunctive mesalamine treatment, 12 with involvement of the ileum and three without ileal involvement Definitive diagnosis of active inflammatory CD with fibrostenosing and/or fistulizing/perforating CD types ruled out based on clinical and radiological or endoscopic or pathological findings, within the previous 6 months Exclusion Criteria: Body weight below 42.5 kg Subjects who have received either methotrexate, cyclosporine or anti-TNFalpha (infliximab, Remicade), anti-integrin (namixilab) in the past 3 months Subjects who are taking allopurinol, sulfasalazine, valerian, warfarin and corticosteroids,including budesonide and prednisone within 28 days prior to and throughout the study Previous bowel resection, including prior colostomy, ileostomy or colectomy with ileorectal anastomosis Symptomatic stenosis or ileal strictures; x-ray evidence of fibrosed bowel Subjects with ulcerative colitis or short bowel syndrome Subjects who present with, or with a history of persistent intestinal obstruction, bowel perforation, uncontrolled GI bleed or abdominal abscess or infection, toxic megacolon Subjects with fistulizing CD or isolated small bowel CD Subjects with evidence of other serious infectious, autoimmune, hepatic,nephritic or systemic disease or compromised organ function Subjects with a history of GI tract malignancy or IBD-associated malignant changes in the intestines
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yaron Ilan, MD
Organizational Affiliation
Hadassah Medical Organization
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hadassah Medical Center
City
Jerusalem
ZIP/Postal Code
91120
Country
Israel

12. IPD Sharing Statement

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Efficacy Study of Targeted, Local Delivery of Drugs to Treat Crohn's Disease

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