Corticosteroid Dosage for Crohn's Disease Flare
A Prospective, Randomized Trial Comparing the Efficacy of Body-weight Based Versus Fixed Corticosteroid Dosage on Remission in Patients With Moderate to Severe Crohn's Disease Flares
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
- Determine if weight-based corticosteroid (1mg/kg daily) induces remission at a greater rate than fixed corticosteroid dosage.
- Determine if weight-based corticosteroid is associated with greater rate of adverse events than fixed corticosteroid dosage.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
Connecticut
-
New Haven, Connecticut, United States, 06510
- Yale-New Haven Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age ≥ 18
- Established diagnosis of Crohn's disease
- Diagnosis of Crohn's flare
- Decision by treating gastroenterologist to start corticosteroid therapy
Exclusion Criteria:
- Patients in whom corticosteroid therapy is contraindicated: immunocompromised (active cancer on chemotherapy or radiation treatment), severe liver disease (decompensated cirrhosis, active alcoholic hepatitis), end-stage renal disease on dialysis, AIDS or AIDS-defining illness; myocardial infarction within the past year; NYHA Class 4 heart failure
- Patients on systemic corticosteroid therapy currently or within the past 8 weeks
- Patients not on stable doses of immunomodulators or biologics for at least 8 weeks
- Infectious colitis (e.g., C. difficile, CMV, HSV)
- Systemic infections (bacteremia, fungal infections)
- Fulminant Crohn's disease
- Patients who require imminent surgery
- Abscess
- Pregnancy
- Weight <35 kg
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Active Comparator: Weight-based
Corticosteroid dose weight-based at equivalent to 1mg/kg prednisone daily.
|
Subjects will receive prednisone orally; if intravenous corticosteroid required initially they will receive methylprednisolone for the first 3-4 days of therapy.
Other Names:
|
|
Active Comparator: Fixed dose
Corticosteroid dose fixed at equivalent to 40mg prednisone daily.
|
Subjects will receive prednisone orally; if intravenous corticosteroid required initially they will receive methylprednisolone for the first 3-4 days of therapy.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants in Remission at End of 2 Weeks
Time Frame: 2 weeks
|
Number of participants with Harvey Bradshaw Index < 5 at end of 2 weeks.
The minimum score obtainable is 0, suggesting absence of disease or remission, while the maximum score obtainable goes beyond 18 points, depending on the number of stools the patient identifies per day (because 1 point is given for each stool in a day, there is no specific maximum score.
A higher score represents more severe disease.
<5 is determined to be remission.
|
2 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants With Response at End of 2 Weeks
Time Frame: 2 weeks
|
Number of participants with at least a 3-point drop in Harvey-Bradshaw Index at end of 2 weeks
|
2 weeks
|
|
Number of Participants With Response or Remission at End of 1 Week
Time Frame: 1 week
|
Number of participants with Harvey-Bradshaw Index <5 or with a drop in Harvey-Bradshaw Index of at least 3 points at end of 1 week
|
1 week
|
|
Number of Participants With Response or Remission at End of 4 Weeks
Time Frame: 4 weeks
|
Number of participants with Harvey-Bradshaw Index <5 or with a drop in Harvey-Bradshaw Index of at least 3 points at end of 4 weeks
|
4 weeks
|
|
Number of Participants With Response or Remission at End of 12 Weeks
Time Frame: 12 weeks
|
Number of participants with Harvey-Bradshaw Index <5 or with a drop in Harvey-Bradshaw Index of at least 3 points at end of 12 weeks
|
12 weeks
|
|
Number of Participants With Corticosteroid-associated Side Effects
Time Frame: 12 weeks
|
Number of participants with side effects that may be associated with use of corticosteroids such as mood swings, sleep disturbance, edema, acne, bruising, myalgias.
|
12 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Loren Laine, MD, Yale University, Section of Digestive Diseases
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Digestive System Diseases
- Gastrointestinal Diseases
- Gastroenteritis
- Intestinal Diseases
- Inflammatory Bowel Diseases
- Crohn Disease
- Physiological Effects of Drugs
- Autonomic Agents
- Peripheral Nervous System Agents
- Anti-Inflammatory Agents
- Antineoplastic Agents
- Antiemetics
- Gastrointestinal Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Neuroprotective Agents
- Protective Agents
- Methylprednisolone
- Prednisone
Other Study ID Numbers
Other Study ID Numbers
- 1501015143
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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