Crohn Disease Clinical Trial
Official title:
Home basEd faecaL calProtectin Measurements Predicting Adalimumab Induction Destiny
Recently a smartphone application IBDoc® was developed to enable patients to measure faecal
calprotectin at home in an easy way. In this HELP-AID trial we want to evaluate the value of
these home based IBDoc® faecal calprotectin measurements in predicting short- and mid-term
outcome to ADA induction therapy in patients with moderate-to-severe IBD.
Patients known with moderate-to-severe CD and ulcerative colitis starting ADA therapy will be
asked to participate in this study. They will be asked to collect a stool sample at 3
different time points (week 0, 4 and 8). This faecal sample needs to be loaded on a test
cassette with an extraction device. In a second step, the patient can turn his smartphone
into an easy to use test cassette reader by taking a picture and using the CalApp® which is
based on an immunochromatographic test. Finally, the CalApp® will transmit the test results
securely to the health care professional.
In this study we want to evaluate the predictive value of absolute and relative faecal
calprotectin values measured by IBDoc® on clinical, biological and endoscopic outcome at week
12. Furthermore, we want to evaluate the correlation between IBDoc® and classical ELISA
measurements of faecal calprotectin, and the convenience of this system to the patient and
the health care professional.
Adalimumab (Humira®), a fully human monoclonal antibody to TNF, has been given an important
position in the treatment of patients with an inflammatory bowel disease (IBD). However, not
all patients respond adequately to this relatively expensive and potentially toxic therapy.
Adapting the standard treatment regimen to the individual needs of the patient may favor the
short and long term outcome of this therapy.
Following daily clinical practice, patients will receive standard induction therapy with 160
mg adalimumab at week 0, followed by 80 mg adalimumab at week 2. Starting at week 4 patients
will receive a maintenance therapy with 40 mg adalimumab every other week. If a patient shows
an insufficient response, the dose can be increased to 40 mg adalimumab every week.
Defining predictors of response to ADA has become a major objective in scientific research.
One of the predictors of response may be an early decrease in faecal calprotectin. Faecal
calprotectin is a protein which presence in the stool of a patient correlates with endoscopic
disease activity. A persistently elevated faecal calprotectin after start up with adalimumab
treatment may suggest that this patient needs a higher dose.
Recently a smartphone application IBDoc® was developed to enable patients to measure faecal
calprotectin at home in an easy way. In this HELP-AID trial we want to evaluate the value of
these home based IBDoc® faecal calprotectin measurements in predicting short- and mid-term
outcome to ADA induction therapy in patients with moderate-to-severe IBD.
Patients known with moderate-to-severe CD and ulcerative colitis starting ADA therapy will be
asked to participate in this study. They will be asked to collect a stool sample at 3
different time points (week 0, 4 and 8). This faecal sample needs to be loaded on a test
cassette with an extraction device. In a second step, the patient can turn his smartphone
into an easy to use test cassette reader by taking a picture and using the CalApp® which is
based on an immunochromatographic test. Finally, the CalApp® will transmit the test results
securely to the health care professional.
In this study we want to evaluate the predictive value of absolute and relative faecal
calprotectin values measured by IBDoc® on clinical, biological and endoscopic outcome at week
12. Furthermore, we want to evaluate the correlation between IBDoc® and classical ELISA
measurements of faecal calprotectin, and the convenience of this system to the patient and
the health care professional.
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