- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00113503
Imuran Dosing in Crohn's Disease Study
A Multi-site Trial of Azathioprine Dosing in Crohn's Disease
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This multi-center, double blind (patients and doctors do not know treatment group assignment), randomized (patients are put in 1 of 2 groups) clinical trial which will compare two 52-week-long azathioprine(AZA) dosing methods.
The patients enrolled will all be taking steroids (prednisone or budesonide)or have just been prescribed a steroid. The patients will be either in remission on steroids, but cannot taper off without a flare, patients who are on steroids and are still having Crohn's symptoms, or patients who need to start taking steroids.
After a two week screening period, patients fitting enrollment criteria will be begin taking study drug. Patients will begin to taper steroids per a set schedule, and taper off steroids completely by week 13. Patients who need to go back on steroids because of returned symptoms are allowed to, per a set schedule in the protocol. Patients will have monthly visits that include physical exams, blood tests and a quality of life questionnaire. Patients will be required to keep a diary of abdominal pain, liquid or soft stools and general well being.
After 6 months, only patients in remission (patients not on steroids, and not having active symptoms) will be allowed to continue for last 6 months of the study. Study visits during the last 6 months will be every 2 months, and include physical exams and blood tests, and a quality of life questionnaire.
Patients in the study may receive dose changes, and this will require additional blood tests for safety.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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Alberta
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Edmonton, Alberta, Canada, T6G2X8
- University of Alberta
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Ontario
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London, Ontario, Canada, N6A5A5
- London Health Sciences Centre
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Toronto, Ontario, Canada, M5G 1X8
- Hospital for Sick Children
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California
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Los Angeles, California, United States, 90048
- Cedars-Sinai Medical Center
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Georgia
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Atlanta, Georgia, United States, 30342
- Atlanta Gastroenterology Associates, LLC
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Illinois
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Chicago, Illinois, United States, 60637
- University of Chicago
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Chicago, Illinois, United States, 60637
- University of Chicago Pediatric Gastroenterology
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Maryland
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Baltimore, Maryland, United States, 21287
- Johns Hopkins University
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Minnesota
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Duluth, Minnesota, United States, 55805
- Duluth Clinic
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Rochester, Minnesota, United States, 55905
- Mayo Clinic
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New York
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Great Neck, New York, United States, 11021
- Long Island Clinical Research Assoc.
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New York, New York, United States, 10029
- Mt. Sinai Medical Center
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North Carolina
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Chapel Hill, North Carolina, United States, 27514
- University of North Carolina Chapel Hill
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Ohio
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Cincinnati, Ohio, United States, 45229
- Cincinnati Children's Hospital
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Pennsylvania
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Pittsburgh, Pennsylvania, United States, 15213
- University of Pittsburgh
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- 10-70 years-old., Weigh 20-100 kg (44-220 lbs).
- CD of the ileum, colon or ileocolon, verified by colonoscopy, barium enema, or small bowel series performed within 36 months
- Perianal fistulae will be eligible provided that the perianal disease does not account for the preponderance of symptoms.
Have steroid-dependent, steroid-refractory or steroid naive CD.
- Steroid-dependent CD: CDAI or mCDAI of < 150 while receiving prednisone 10-40 mg/day or budesonide 3-9 mg/day for at least 12 weeks prior to screening, but unable to taper prednisone below 10 mg/day or budesonide below 3 mg/day without experiencing a flare within the previous 6 months. Steroids must be at a stable dose for 2 weeks prior to screening (week #-2), prednisone at a dose of 10-40 mg/day and budesonide at a dose of 3-9 mg/day.
- Steroid-refractory CD: currently moderately active CD (CDAI or mCDAI 200 - 450) despite treatment with 40 kg) or 0.5 mg/kg/day (if weighing 20 mg/day (if weighing prednisone <40 9 mg/day for the previous 4 weeks prior to the screening kg), or budesonide evaluation. Prednisone or budesonide must be at a stable dose for 2 weeks prior to screening (week #-2).
Steroid-naïve CD: currently moderately active CD, (CDAI or mCDAI 200 - 450) and one of the following:
- Despite treatment with aminosalicylates and/or antibiotics for the previous 4 weeks prior to the screening evaluation, who are candidates for prednisone or budesonide.
- Not currently on therapy, who are candidates for prednisone or budesonide
- Patients with prior exposure to steroids, who have not been treated with steroids for 4 weeks prior to screening, and are candidates for prednisone or budesonide Prednisone or budesonide will be started at the screening visit, at a dose of 40 mg/day or 9 mg/day and tapered per the steroid taper.
Patients who have started steroids up to 14 days prior to screening will also qualify as steroid naïve, however patient needs to be on 40 mg prednisone or 9 mg budesonide.
- Discontinue oral or rectal 5-Aminosalicylic acid (5-ASA) therapies, rectal steroids, ciprofloxacin or metronidazole at the screening visit.
Exclusion Criteria:
- CDAI > 450
- CD requiring hospitalization and intravenous (iv) corticosteroids, iv antibiotics or total parenteral nutrition (TPN).
- TPN or enteral nutrition of >1000 Calories/day (both TPN and elemental diets impact the CDAI).
- History of resection of more than 100 cm of small bowel, total proctocolectomy, or subtotal colectomy with ileorectal anastomosis
- Ileostomy or colostomy
- Severe fixed symptomatic stenosis of the small or large intestine
- Blood transfusion within 3 months before screening
- Treatment with 6-MP or AZA within the 6 months prior to screening
- Immunosuppressants or biologics 3 months before screening
Treatment 2 weeks before screening:
- Allopurinol;
- Trimethoprim-sulfamethoxazole;
- NSAIDs or aspirin >81mg/day;
- Cholestyramine or other drugs interfering with enterohepatic circulation;
- Furosemide and thiazide diuretics;
- Fish-oil preparations.
- Discontinue use at screening: Oral or rectal 5-ASA, rectal steroids, metronidazole or quinolones
- Any prior treatment with natalizumab
- Presence of abnormal laboratory parameters:
- Carriage of hepatitis B surface antigen or positive hepatitis C antibody
- Lack of one acceptable form of contraception while receiving AZA
- Low TPMT activity
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: QUADRUPLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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ACTIVE_COMPARATOR: Azathioprine weight-based dose
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Other Names:
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EXPERIMENTAL: Azathioprine individualised dose
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Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Proportion of subjects achieving clinical remission at week #16.
Time Frame: 16 weeks
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For the steroid-dependent subjects, clinical remission was defined as complete withdrawal of corticosteroids, and Crohn's Disease Activity Index (CDAI) score <150 in adults, or modified CDAI (mCDAI) score <150 in children.
For the steroid-refractory and the steroid-naıve subjects, clinical remission was defined as CDAI score <150 (or mCDAI <150 in children), and a reduction of at least 70 points from the baseline score (CDAI or mCDAI), and complete withdrawal of corticosteroids.
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16 weeks
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Secondary Outcome Measures
Outcome Measure |
Time Frame |
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Proportion of subjects maintaining clinical remission at week #28
Time Frame: 28 weeks
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28 weeks
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Proportion of subjects maintaining clinical remission at week #52
Time Frame: 52 weeks
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52 weeks
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Stephen B Hanauer, MD, University of Chicago
Publications and helpful links
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ESTIMATE)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Digestive System Diseases
- Gastrointestinal Diseases
- Gastroenteritis
- Intestinal Diseases
- Inflammatory Bowel Diseases
- Crohn Disease
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Antirheumatic Agents
- Antimetabolites, Antineoplastic
- Antimetabolites
- Antineoplastic Agents
- Immunosuppressive Agents
- Immunologic Factors
- Azathioprine
Other Study ID Numbers
- DK60083 (terminated)
- U01DK060083 (NIH)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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