- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04612621
MILESTONE-CD -A Prospective Multiomic Inception Real -Life Study To Evaluate Predictors of Disease Outcomes & respoNse to Biologic Treatment in Crohn's Disease (MILESTONE-CD)
Crohn's' disease (CD) is a lifelong-chronic inflammatory condition of the digestive tract. CD frequently manifests during the 2nd or 3rd decade; prolonged disease duration frequently results in major structural complications such as strictures and fistulae, leading to surgery for control of complications in at least 30% of the patients. The course of disease is extremely diverse, ranging from a very mild disease to a devastating and incapacitating course. The burden of inflammatory bowel disease is growing each disease, reaching 400 billion USD for lifetime in US. In Israel, there are currently over 50000 IBD patients, with one of the highest incidences in the word, multiple treatment modalities and medications are available for Crohn's disease, however the efficacy is limited and the costs- very high. Furthermore, long-term exposure to some of the therapeutic agents poses an increased risk of infections and cancer.
Some of the major challenges in IBD include prediction of disease course (some patients will require early and aggressive treatment while others may just need observation and follow-up), and treatment personalization (right drug for the right patient at the right time). Unfortunately, individualized predictors of disease course and response to treatment are currently very limited. Some clues can be derived from imaging and endoscopy data, transcriptomics, genomic and microbiome, however those are still very premature and impractical. Moreover, large-scale studies with sophisticated predictive models that incorporate multilayered and multilayered clinical and omic data are severely lacking.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Goal:
Create comprehensive patient-multiomic profile (PRO-Visualosome-microbiome-transcriptome-pharmacokineticome) to develop algorithm-based personalized IBD therapy
Design Prospective observational cohort study.
Study aim To detect predictors of response to biologics using a layered multiomic approach
Cohort size Up to 140 patients in 2 years
Study duration -Patients will be followed up to 2 years (possible extension) or until treatment discontinuation or intestinal surgery
Study procedures All study procedures will be performed for the purpose of the study
Baseline
Disease activity using Harvey Bradshaw score at all timepoints and visits
- baseline PROS -PROMIS10/SIBDQ/IBD control/PRO2 using DATOS app
- colonoscopy with Intestinal biopsies
- Blood for transcriptomics
- Blood/serum for serum and cellular markers
- Stool for microbiome/metabolomics (if colonoscopy done- a rectal swab during colonoscopy will be performed)
- Pillcam CD following patency capsule - if failed patients still will be included and continue follow- up without capsule endoscopy
- MRE
- IUS
- Fecal calprotectin home kit with CALPROSMART
- Basic chemistry
- Joint US (if joint symptoms) Repeated assessment -every month
- PROMIS10/SIBDQ/IBD control/-via DATOS app (during the first 14-16 weeks- PRO2 will be evaluated weekly) Continuous monitoring (mobile device via DATOS app)
First follow-up visit (12-14 weeks)
- Calprotectin
- Microbiome
- Blood for transcriptomics
- Blood/serum for serum and cellular markers, drug levels, CRP
Every 3 months
- Home calprotectin (Calprosmart) +microbiome
Every 6 months
- Clinic visit
- Pillcam CD
- IUS
- Blood for transcriptomics
- Blood/serum for serum and cellular markers, drug levels, CRP
- Calprotectin (home +ELISA) + microbiome
Upon failure (need to switch medication -defined by treating physician) or end of study
- Clinic visit
- Calprotectin *Home +ELISA)
- Microbiome
- Serum for transriptomics, metabolomics
- Blood/serum for serum and cellular markers, drug levels, CRP
- Repeat Pillcam CD (if not done within 6 months)
- Repeat IUS +thermal imaging (if not done within 6 months)
MRE
- Drug levels will be done at every infusion for IV drugs and every 6 months for SC biologics and at the end of induction (week 8-16)
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
-
Ramat Gan, Israel
- Sheba Medical Center
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Crohn's disease
- Start of first-line biological therapy
Exclusion Criteria:
- Previous biologic therapy
- Previous surgery
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Other
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
failure of first biologic
Time Frame: 2 years
|
cessation or switch of first biologic as per decision of the treating physician (documentation of change of therapy from the first biologic for any reason)
|
2 years
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- SHEBA-20-7346-UK-CTIL
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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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