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Fecal Microbial Transplantation and Vedolizumab Treatment of Crohn's Disease

31 marzo 2020 aggiornato da: michal roll, Tel-Aviv Sourasky Medical Center

Fecal Microbial Transplantation for the Optimization of Vedolizumab Treatment in Patients With Crohn's Disease

The investigators postulate that by determining a patient's baseline microbiome and manipulating it through fecal microbial transplantation (FMT) may improve response rates to vedolizumab in Crohn's disease (CD) patients.

Primary objective: To determine whether manipulation of gut microbiome by FMT pre vedolizumab treatment is safe and results in higher remission rates in CD patients.

Study design: A randomized double blinded controlled clinical trial. Study population:CD patients 18-65 YO, men and women, with mild-moderately active disease determined by the Harvey-Bradshaw index (HBI) of 5≤HBI≤15, who were found eligible to commence treatment with vedolizumab.

Study procedure: Study participants will receive FMT within a week prior to first vedolizumab infusion.

All patients will be followed for 46 weeks in 8 visits at the IBD clinic in the GI department of the Tel Aviv Medical Center.

Panoramica dello studio

Stato

Sconosciuto

Condizioni

Intervento / Trattamento

Descrizione dettagliata

Study design: A randomized double blinded controlled clinical trial.

Study population:

CD patients 18-65 YO, men and women, with mild-moderately active disease determined by the Harvey-Bradshaw index (HBI) of 5≤HBI≤15, who were found eligible to commence treatment with vedolizumab (screened for tuberculosis and hepatitis B and without an active infection or an abscess) will be enrolled in the study.

Follow-up: All patients will be followed by physician assessment, sample collection, anthropometric measurements and questionnaires during the scheduled visits at weeks 2, 6, 14, 22, and at week 46, on which they will undergo a colonoscopic examination as part of their regular clinical followup.

Side effects (SE): will be monitored by phone, 3 days post intervention and at vedolizumab infusion visits at weeks 2 and 6. Also, patients will receive direct contact details of both the study coordinator and the study PI.

Tipo di studio

Interventistico

Iscrizione (Anticipato)

80

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Luoghi di studio

  • Israele
      • Tel Aviv, Israele, 64239
        • Reclutamento
        • Department of Gastroentherology
        • Investigatore principale:
          • Nitsan Maharshak, MD
        • Sub-investigatore:
          • Naomi Fliss Isakov, PhD
        • Contatto:
        • Sub-investigatore:
          • Nethaniel Aviv Cohen, MD
      • Tel Aviv, Israele
        • Reclutamento
        • Dep. of Gastroenterology, Tel Aviv Sourasky Medical Center
        • Investigatore principale:
          • Nitsan Maharshak, MD
        • Sub-investigatore:
          • Naomi Fliss Isakov, PhD
        • Contatto:
        • Sub-investigatore:
          • Nathaniel Aviv Cohen, MD

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

Da 18 anni a 65 anni (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Tutto

Descrizione

Inclusion Criteria:

  1. Mild-moderately active disease determined by the Harvey-Bradshaw index (HBI) of 5≤HBI≤15
  2. Found eligible to commence treatment with vedolizumab (screened for tuberculosis and hepatitis B and without an active infection or an abscess)

Exclusion Criteria:

  1. CD patients in remission (HBI<5) or with sever disease (HBI>16)
  2. Patients with a stoma
  3. Hospitalized patients
  4. Patients with an active intestinal infection- positive stool culture or Clostridium difficile infection
  5. Severe disease - malignant disease, hepatic failure, renal failure, cardiovascular, metabolic, neurological disease
  6. Pregnant/lactating women
  7. Inability to sign an informed consent
  8. Inability to complete the study protocol
  9. An ongoing or planned antibiotics therapy
  10. Severe food allergies

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione parallela
  • Mascheramento: Quadruplicare

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Comparatore attivo: Fecal microbial transplantation
FMT capsules fecal capsules on two consecutive days (total of 30 capsules) within a week prior to first vedolizumab infusion. Patients who will be allocated to this treatment arm will be matched to donors according to their CMV status (past exposure - CMV positive donors will be used for CMV positive patients, and CMV negative donors will be used for CMV negative patients).
Altro: Fecal microbial transplantation
Capsules of fecal matter solution (feces from healthy donor, glycerol and saline solution)/
Comparatore placebo: Placebo
Placebo capsules placebo capsules- on two consecutive days (total of 30 capsules) within a week prior to first vedolizumab infusion. Patients who will be allocated to this treatment arm will receive placebo capsules.
Altro: Placebo capsuls
capsules of glycerol and saline (placebo).

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
safety of FMT pre vedolizumab treatment in CD patients
Lasso di tempo: week 14

determine whether manipulation of gut microbiome by FMT pre vedolizumab treatment is safe.

safety of FMT will be measured by disease exacerbations, hospitalizations and surgery rate in treatment versus placebo group.
week 14
safety of FMT pre vedolizumab treatment in CD patients: measured by disease exacerbations, hospitalizations and surgery rate in treatment versus placebo group
Lasso di tempo: week 46

determine whether manipulation of gut microbiome by FMT pre vedolizumab treatment is safe.

safety of FMT will be measured by disease exacerbations, hospitalizations and surgery rate in treatment versus placebo group.
week 46
efficacy of FMT pre vedolizumab treatment in CD patients that results in higher remission rate
Lasso di tempo: week 14

determine whether manipulation of gut microbiome by FMT pre vedolizumab treatment is efficient and results in higher remission rates in CD patients.

Remission rate will be measured by clinical remission rate HBI ≤5 at week 14
week 14
efficacy of FMT pre vedolizumab treatment in CD patients that results in higher remission rate
Lasso di tempo: week 46

determine whether manipulation of gut microbiome by FMT pre vedolizumab treatment is efficient and results in higher remission rates in CD patients.

Remission rate will be measured by clinical remission rate HBI ≤5 at week 46
week 46

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
efficacy of FMT pre vedolizumab treatment in CD patients that results in clinical response rate
Lasso di tempo: week 14
determine whether manipulation of gut microbiome by FMT pre vedolizumab treatment is efficient and results in clinical response rate (reduction in HBI≥3 )
week 14
efficacy of FMT pre vedolizumab treatment in CD patients that results in clinical response rate
Lasso di tempo: week 22
determine whether manipulation of gut microbiome by FMT pre vedolizumab treatment is efficient and results in reduction in HBI≥3
week 22
efficacy of FMT pre vedolizumab treatment in CD patients that results in clinical response rate
Lasso di tempo: week 46
determine whether manipulation of gut microbiome by FMT pre vedolizumab treatment is efficient and results in reduction in HBI≥3
week 46
efficacy of FMT pre vedolizumab treatment in CD patients that results in endoscopic response
Lasso di tempo: week 46
determine whether manipulation of gut microbiome by FMT pre vedolizumab treatment is efficient and results in endoscopic response that will be defined as a decrease of ≥50% in SES-CD score / improvement in Rutgeerts score ≥1, compared to baseline colonoscopy
week 46
efficacy of FMT pre vedolizumab treatment in CD patients that results in endoscopic remission
Lasso di tempo: week 46
determine whether manipulation of gut microbiome by FMT pre vedolizumab treatment is efficient and results in Endoscopic remission at week 46 will be defined as SES-CD ≤2 or Rutgeerts score ≤1 , compared to baseline colonoscopy
week 46
efficacy of FMT pre vedolizumab treatment in CD patients that results in histological healing
Lasso di tempo: week 46
determine whether manipulation of gut microbiome by FMT pre vedolizumab treatment is efficient and results in histological healing compared to week 0
week 46
efficacy of FMT pre vedolizumab treatment in CD patients that results in biological remission
Lasso di tempo: week 14
determine whether manipulation of gut microbiome by FMT pre vedolizumab treatment is efficient and results in biological remission measured as fecal calprotectin<150mg/kg and CRP<5mg/L
week 14
efficacy of FMT pre vedolizumab treatment in CD patients that results in biological remission
Lasso di tempo: week 22
determine whether manipulation of gut microbiome by FMT pre vedolizumab treatment is efficient and results in biological remission measured as fecal calprotectin<150mg/kg and CRP<5mg/L
week 22
efficacy of FMT pre vedolizumab treatment in CD patients that results in biological remission
Lasso di tempo: week 46
determine whether manipulation of gut microbiome by FMT pre vedolizumab treatment is efficient and results in biological remission measured as fecal calprotectin<150mg/kg and CRP<5mg/L
week 46
safety of FMT pre vedolizumab treatment in CD patients that results in low adverse events rate
Lasso di tempo: week 46
determine whether manipulation of gut microbiome by FMT pre vedolizumab treatment is safe and results in lower adverse events rate of intervention versus placebo
week 46

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Tel-Aviv Sourasky Medical Center

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

3 luglio 2018

Completamento primario (Anticipato)

1 aprile 2022

Completamento dello studio (Anticipato)

1 gennaio 2023

Date di iscrizione allo studio

Primo inviato

8 febbraio 2019

Primo inviato che soddisfa i criteri di controllo qualità

31 marzo 2020

Primo Inserito (Effettivo)

1 aprile 2020

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

1 aprile 2020

Ultimo aggiornamento inviato che soddisfa i criteri QC

31 marzo 2020

Ultimo verificato

1 marzo 2020

Maggiori informazioni

Termini relativi a questo studio

Termini MeSH pertinenti aggiuntivi

Altri numeri di identificazione dello studio

  • TASMC-16-NH-0123-CTIL

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

No

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .

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