De-escalation of Ustekinumab Therapy in Patients With Crohn's Disease and Ulcerative Colitis
Pilot Study to Assess De-escalation of Ustekinumab Therapy in Patients With Crohn's Disease and Ulcerative Colitis
The goal of this clinical trial is to evaluate whether disease remission can be maintained when biologic therapy is reduced in patients with Crohn"s disease (CD) and ulcerative colitis (UC) taking ustekinumab (UST).
The main question it aims to answer is:
Can we de-escalate UST subcutaneous dose either from every 4 weeks (Q4) to every 8 weeks (Q8) or every 8 weeks (Q8) to every 12 weeks (Q12) in CD or UC patients in deep remission without loosing their response? Researchers will follow UST blood levels, inflammation markers and intestinal mucosa integrity and to see if UST dose can be reduced while maintaining clinical remission.
Participants will:
Change UST dosing from Q4 to Q8 or from Q8 to Q12. Visit the clinic once every 12 weeks for checkups and tests.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Waqqas Afif, MD
- Phone Number: 36536 514-934-1943
- Email: waqqas.afif@mcgill.ca
Study Locations
-
-
Quebec
-
Montreal, Quebec, Canada, H3G1A4
- Recruiting
- MUHC - Montreal General Hospital
-
Contact:
- Waqqas Afif, MD
- Phone Number: 36536 514-934-1934
- Email: miirecherche.ibdresearch@muhc.mcgill.ca
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Clinical remission
- Biochemical remission
- Endoscopy remission
- Not on corticosteroid
- A woman must be ;
- not of childbearing potential
- of childbearing potential and practicing a medically accepted method of contraception.
- Able t provide informed consent
Exclusion Criteria:
- On more than one biologics drug
- Use of oral or topical steroids within 6months of study entry
- pregnancy
- Any issue that could lead to non-compliance, as alcohol, drug use
- Unable to provide consent or t comply with follw-up visit
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Non-Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Other: Ustekinumab Q4w
|
Sub-group switching from Q4w to Q8w
|
|
Other: Ustekinumab Q8w
|
Sub-group switching from Q8w to Q12w
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Loss of clinical remission
Time Frame: From treatment switch to end of participation (12 months)
|
Proportion of patients experiencing loss of remission
|
From treatment switch to end of participation (12 months)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Time-to-loss of Remission
Time Frame: From treatment switch to end of participation (12 months)
|
From treatment switch to end of participation (12 months)
|
|
|
Change from Baseline in the C-reactive protein (CRP) level at loss of remission.
Time Frame: 12 months
|
To define if CRP level is a predictor of loss of remission.
|
12 months
|
|
Change from Baseline in the calprotectin level at loss of remission.
Time Frame: 12 months
|
To define if calprotectin level is a predictor of loss of remission.
|
12 months
|
|
Disease duration before loss of remission.
Time Frame: Up to 50 years.
|
Define if disease duration is a predictor of loss of remission.
|
Up to 50 years.
|
|
Change in drug concentration before loss of remission.
Time Frame: 12 months
|
Define if drug concentration in blood is a predictor of loss of remission.
|
12 months
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
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
- Intestinal Diseases
- Digestive System Diseases
- Gastrointestinal Diseases
- Colonic Diseases
- Gastroenteritis
- Inflammatory Bowel Diseases
- Colitis
- Colitis, Ulcerative
- Crohn Disease
- Amino Acids, Peptides, and Proteins
- Proteins
- Antibodies, Monoclonal, Humanized
- Antibodies, Monoclonal
- Antibodies
- Immunoglobulins
- Immunoproteins
- Blood Proteins
- Serum Globulins
- Globulins
- Ustekinumab
Other Study ID Numbers
Other Study ID Numbers
- 2020-5567
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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