Comparison of the Efficacy of Different Biologic Agents in Preventing Postoperative Endoscopic Recurrence of Crohn's Disease
Studie Overzicht
Toestand
Toestand
Conditie
Conditie
Interventie / Behandeling
Interventie / Behandeling
Gedetailleerde beschrijving
Studietype
Studietype
Inschrijving (Geschat)
Inschrijving
Contacten en locaties
Studie Locaties
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Shanghai Municipality
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Shanghai, Shanghai Municipality, China, 201505
- Werving
- The Tenth People's Hospital of Shanghai
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Contact:
- Xiaolei Wang, MD, PhD
- Telefoonnummer: 13817267967
- E-mail: wangxiaolei@tongji.edu.cn
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Contact:
- E-mail: wangxiaolei@tongji.edu.cn
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Deelname Criteria
Geschiktheidscriteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Volwassen
- Oudere volwassene
Accepteert gezonde vrijwilligers
Bemonsteringsmethode
Studie Bevolking
Beschrijving
Inclusion Criteria:
- Age ≥18 years.
- Diagnosis of Crohn's disease according to the European Crohn's and Colitis Organisation (ECCO) guideline criteria, based on clinical, laboratory, endoscopic, radiologic, and histopathologic findings.
- Underwent Crohn's disease-related intestinal resection, including ileocolonic resection, segmental small bowel resection, or segmental colonic resection.
- Initiated postoperative prophylactic biologic therapy within 6 weeks after surgery.
- Maintained postoperative prophylactic biologic therapy for at least 3 to 6 months.
- Completed at least one evaluable postoperative ileocolonoscopy within 6 to 12 months after surgery for assessment of the Rutgeerts score, or had available clinical, radiologic, ultrasonographic, or laboratory data for evaluation of clinical recurrence.
Exclusion Criteria:
- Diagnosis of other intestinal diseases, including intestinal Behçet's disease, ulcerative colitis, intestinal tuberculosis, or intestinal malignancy.
- Intestinal surgery mainly performed for non-IBD conditions, such as intestinal malignancy.
- No postoperative endoscopic evaluation within 6 to 12 months after surgery, or endoscopic quality insufficient for Rutgeerts score assessment, and lack of adequate clinical, radiologic, ultrasonographic, or laboratory data for recurrence assessment.
- Irregular use of postoperative prophylactic therapy due to severe comorbidities, serious infection, or other reasons, making treatment efficacy difficult to evaluate.
- Other conditions considered by the investigators to be inappropriate for inclusion.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Aantal groepen / cohorten
Cohorten en interventies
Groep / CohortGroep / Cohort |
Interventie / BehandelingInterventie / Behandeling |
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Postoperative anti-TNF biologics group
Patients with Crohn's disease who underwent CD-related intestinal resection and initiated postoperative prophylactic anti-TNF biologic therapy within 6 weeks after surgery, including infliximab or adalimumab.
All treatments were prescribed as part of routine clinical care, and this retrospective observational study did not assign any intervention.
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Infliximab was used as postoperative prophylactic biologic therapy for Crohn's disease according to routine clinical practice.
The recommended regimen was 5 mg/kg intravenously at weeks 0, 2, and 6, followed by maintenance treatment every 8 weeks.
Adalimumab was used as postoperative prophylactic biologic therapy for Crohn's disease according to routine clinical practice.
The recommended regimen was 160 mg subcutaneously at week 0, 80 mg at week 2, and 40 mg every 2 weeks from week 4 onward.
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Postoperative non-anti-TNF biologics group
Patients with Crohn's disease who underwent CD-related intestinal resection and initiated postoperative prophylactic non-anti-TNF biologic therapy within 6 weeks after surgery, including vedolizumab or ustekinumab.
All treatments were prescribed as part of routine clinical care, and this retrospective observational study did not assign any intervention.
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Vedolizumab was used as postoperative prophylactic biologic therapy for Crohn's disease according to routine clinical practice.
The recommended regimen was 300 mg intravenously at weeks 0, 2, and 6, followed by maintenance treatment every 8 weeks.
Ustekinumab was used as postoperative prophylactic biologic therapy for Crohn's disease according to routine clinical practice.
The recommended regimen included a weight-based intravenous induction dose, followed by 90 mg subcutaneously every 8 weeks.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Endoscopic recurrence rate
Tijdsspanne: 6 to 12 months after surgery
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The proportion of patients with endoscopic recurrence, defined as a Rutgeerts score ≥ i2 on ileocolonoscopy performed 6 to 12 months after CD-related intestinal resection.
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6 to 12 months after surgery
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Secundaire uitkomstmaten
Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Severe endoscopic recurrence rate
Tijdsspanne: 6 to 12 months after surgery
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The proportion of patients with severe endoscopic recurrence, defined as a Rutgeerts score ≥ i3 on postoperative ileocolonoscopy.
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6 to 12 months after surgery
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Clinical recurrence rate
Tijdsspanne: Up to 5 years after surgery
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The proportion of patients with clinical recurrence, defined as worsening Crohn's disease-related symptoms supported by endoscopic, radiologic, ultrasonographic, laboratory, or medical record evidence, or requiring treatment escalation, hospitalization, or reoperation due to Crohn's disease activity.
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Up to 5 years after surgery
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Long-term endoscopic recurrence rate
Tijdsspanne: 3 and 5 years after surgery
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The proportion of patients with endoscopic recurrence during long-term follow-up, defined as a Rutgeerts score ≥ i2 on follow-up endoscopy.
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3 and 5 years after surgery
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Crohn's disease-related rehospitalization rate
Tijdsspanne: Up to 5 years after surgery
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The proportion of patients requiring rehospitalization due to Crohn's disease activity, complications, or treatment-related problems during follow-up.
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Up to 5 years after surgery
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Crohn's disease-related reoperation rate
Tijdsspanne: Up to 5 years after surgery
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The proportion of patients requiring repeat abdominal surgery due to Crohn's disease recurrence or related complications during follow-up.
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Up to 5 years after surgery
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Drug persistence
Tijdsspanne: Up to 5 years after treatment initiation
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Time from initiation of postoperative prophylactic biologic therapy to treatment discontinuation, switch to another biologic or immunomodulator, or discontinuation due to intolerance or adverse events.
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Up to 5 years after treatment initiation
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Medewerkers en onderzoekers
Sponsor
Sponsor
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Studie start
Primaire voltooiing (Geschat)
Primaire voltooiing
Studie voltooiing (Geschat)
Studie voltooiing
Studieregistratiedata
Eerst ingediend
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Eerst geplaatst
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update geplaatst
Laatste update ingediend die voldeed aan QC-criteria
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Aanvullende relevante MeSH-voorwaarden
- Pathologische processen
- Ziekte attributen
- Darmziekten
- Ziekten van het spijsverteringsstelsel
- Gastro-intestinale aandoeningen
- Gastro-enteritis
- Inflammatoire darmziekten
- Pathologische aandoeningen, tekenen en symptomen
- Herhaling
- Ziekte van Crohn
- Aminozuren, peptiden en eiwitten
- Eiwitten
- Antilichamen, monoklonaal, gehumaniseerd
- Antilichamen, monoklonaal
- Antilichamen
- Immunoglobulinen
- Immunoproteïnen
- Bloedeiwitten
- Serum -globulines
- Globulines
- Adalimumab
- Infliximab
- Ustekinumab
- vedolizumab
Andere studie-ID-nummers
Andere studie-ID-nummers
- SHSY-IEC-6.0/26K14/P01
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
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