- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03351647
Predictive Factors of Clinical Response to Ustekinumab in Active Crohn's Disease (SAFARI)
Identification of Biological Predictive Factors of Clinical Response to Ustekinumab in Patients With Anti-Tumor Necrosis Factor (TNF) Antagonists Refractory Crohn's Disease: Interest of Dosage of C Reactive Protein (CRP), Calprotectin, Ustekinumab Through Levels and Antibodies
Ustekinumab is a fully human Immune Globulin Gk (IgGk) monoclonal antibody against the common p40 subunit of interleukin-12 and interleukin-23, which are implicated in the pathogenesis of inflammatory bowel disease. Its efficiency to induce and maintain clinical response in patients with anti TNF resistant Crohn's disease has been proved in several clinical trials, and the profile of safety of this treatment was good, but the investigators have few data about biological characteristics of patients treated by Ustekinumab, particularly about ustekinumab through levels and rate of patients developing anti ustekinumab antibodies during the induction and maintenance stages, and no predictive factors of clinical response have been identified yet.
The aim of this study will be to assess the evolution of biological markers of inflammation and ustekinumab trough levels and antibodies, in responders and non responders patients treated by ustekinumab, in order to identify predictive factors of clinical response.
The investigators will perform a prospective observational study, including the patients followed in the University hospital center of Lyon and treated by ustekinumab for a moderate to severe Crohn's disease (with a HBI score≥4 ). All the patients included will have been previously treated by at least one anti TNF and/or Vedolizumab, with specified criteria for a primary non response, a secondary loss of response or unacceptable side effects.
Then, clinical and biological data will be collected for each patient at the inclusion, and then at weeks 4, 8, 16, 24: HBI score, sides effects, extra intestinal manifestations, steroids withdraw, CRP, calprotectin, ustekinumab trough levels and ustekinumab antibodies.
The investigators will compare responding and non responding patients at week 16 (end of the induction period) according to these data.
The hypothesis the investigators state is that an early and significant decrease of the inflammation markers in blood and stools associated with a high ustekinumab through level in blood is associated with a clinical response at week 16 in the patients treated by ustekinumab
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
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Pierre-Bénite, France, 69495
- Centre Hospitalier Lyon Sud
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Age > 18 years old
- Man or non pregnant woman
- Diagnostic attested of Crohn's disease
- Active Crohn's disease, with HBI score ≥ 4
- Previous treatment by at least one anti TNF and / or vedolizumab,, with primary non response, secondary loss of response or unacceptable side effects
- Formal indication of treatment by ustekinumab
- Patient informed and not opposed to his participation at the study
Exclusion Criteria:
- Pregnancy
- Evolutive cancer
- Evolutive and uncontrolled infection
- Psychiatric pathology that could interfere with the follow-up
- Refusal of the patient
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
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Group Ustekinumab
Patients presenting an active crohn's disease (HBI score ≥ 4) with an indication of treatment by ustekinumab because of failure or unacceptable side effects of previous treatments, and who have already been treated by at least one anti TNF The patients must be 18 years old or older.
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The clinical response is defined as a decrease in the Crohn's Disease Activity Index (CDAI) score ≥ 100 points or a decrease in the HBI score ≥ 3 points.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Measurement of serum ustekinumab trough concentrations (expressed in microg/mL) at week 8.
Time Frame: Week 8
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Dosage of ustekinumab through level and ustekinumab antibodies: one 4ml blood sample
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Week 8
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Measurement of serum ustekinumab trough concentrations (expressed in microg/mL) at week 4.
Time Frame: Week 4
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Dosage of ustekinumab through level and ustekinumab antibodies: one 4ml blood sample
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Week 4
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Measurement of serum ustekinumab trough concentrations (expressed in microg/mL) at week 16.
Time Frame: Week 16
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Dosage of ustekinumab through level and ustekinumab antibodies: one 4ml blood sample
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Week 16
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Measurement of serum ustekinumab trough concentrations (expressed in microg/mL) at week 24.
Time Frame: Week 24
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Dosage of ustekinumab through level and ustekinumab antibodies: one 4ml blood sample
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Week 24
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Dosage in blood at week 4
Time Frame: Week 4
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-Inflammation markers are evaluated : Dosage of CRP and leucocytes in blood: two 4ml blood sample
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Week 4
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Dosage in blood at week 8
Time Frame: Week 8
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-Inflammation markers are evaluated : Dosage of CRP and leucocytes in blood: two 4ml blood sample
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Week 8
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Dosage in blood at week 16
Time Frame: Week 16
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-Inflammation markers are evaluated : Dosage of CRP and leucocytes in blood: two 4ml blood sample
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Week 16
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Dosage in blood at week 24
Time Frame: Week 24
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-Inflammation markers are evaluated : Dosage of CRP and leucocytes in blood: two 4ml blood sample
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Week 24
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Dosage of calprotectin in stools at week 4
Time Frame: Week 4
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-Inflammation markers are evaluated : Dosage of calprotectin in stools: one about 50 mg stools sample
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Week 4
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Dosage of calprotectin in stools at week 8
Time Frame: Week 8
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-Inflammation markers are evaluated : Dosage of calprotectin in stools: one about 50 mg stools sample
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Week 8
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Dosage of calprotectin in stools at week 16
Time Frame: Week 16
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-Inflammation markers are evaluated : Dosage of calprotectin in stools: one about 50 mg stools sample
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Week 16
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Dosage of calprotectin in stools at week 24
Time Frame: Week 24
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-Inflammation markers are evaluated : Dosage of calprotectin in stools: one about 50 mg stools sample
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Week 24
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Physical evaluation at week 4
Time Frame: Week 4
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Clinical evaluation is realized by a medical visit with physical examination
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Week 4
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Physical evaluation at week 8
Time Frame: Week 8
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Clinical evaluation is realized by a medical visit with physical examination
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Week 8
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Physical evaluation at week 16
Time Frame: Week 16
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Clinical evaluation is realized by a medical visit with physical examination
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Week 16
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Physical evaluation at week 24
Time Frame: Week 24
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Clinical evaluation is realized by a medical visit with physical examination
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Week 24
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Clinical evaluation at week 4
Time Frame: Week 4
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Clinical evaluation is realized by a medical visit with evaluation of:
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Week 4
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Clinical evaluation at week 8
Time Frame: Week 8
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Clinical evaluation is realized by a medical visit with evaluation of:
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Week 8
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Clinical evaluation at week 16
Time Frame: Week 16
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Clinical evaluation is realized by a medical visit with evaluation of:
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Week 16
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Clinical evaluation at week 24
Time Frame: Week 24
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Clinical evaluation is realized by a medical visit with evaluation of:
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Week 24
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Collaborators and Investigators
Sponsor
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 (Actual)
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
Other Study ID Numbers
- 69HCL17_0218
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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