Crohn Disease Clinical Trial
Official title:
Management of Moderate POstoperative Recurrence in Crohn's Disease: a randoMizEd contROLled Trial of Therapeutic Escalation, the POMEROL Trial. (POMEROL)
Study type : A 30 months, multicentre, open-label strategic randomized controlled trial Population : Chron's Disease (CD) patients with an i2 endoscopic postoperative recurrence in the year following ileocolonic resection (6-12months after ileocolonic resection). Treatments : Stratification at inclusion according to prophylactic therapy. Patients randomized in 2 arms: - Status quo arm: if the patient received no prophylactic therapy, no treatment will be started; if the patient received a prophylactic therapy, the same will be continued at the same dose. - Therapy escalation arm: infliximab-CT-P13 will be started with two intravenous infusions of 5 mg per kg bodyweight at week 0 and week 2 and subcutaneous injections of 120 mg every 2 weeks from week 6 onwards. Main objective : To evaluate the proportion of CD patients without endoscopic postoperative recurrence (i0-i1) at 12 months in the arm receiving therapy escalation compared to status quo arm in patients having an i2 endoscopic postoperative recurrence 6-12months after ileocolonic anastomosis with restoration of faecal stream.
Number of patients : 360 patients in approximatively 25 sites in France. Recruitement period : The trial duration for each patients will be 12 months from radomization (18 to 24 months from screening (ie : post-operatively)) Endpoints: Primary endpoints: Proportion of patients with an i0-i1 modified Rutgeerts score at 12 months. Secondary endpoints: - Proportion of patients with an i3-i4 modified Rutgeerts score at 12 months - Proportion of patients with an i2b-i3-i4 modified Rutgeerts score at 12 months - Proportion of patients with an i0 modified Rutgeerts score at 12 months - PRO2 score at 12 months - Clinical postoperative recurrence within 12 months: average daily SF ≥ 3.5 and average daily AP score ≥ 1.5, AND - increased CRP compared to inclusion, at least + 10 mg/l - OR increased fecal calprotectin compared to inclusion, at least + 250 μg/g - Surgical recurrence within 12 months: need for a new ileocolonic resection - Endoscopic dilatation within 12 months: need for a balloon insufflation at the ileocolonic anastomosis during an ileocolonoscopy when a non-passable stenosis was present in patient having obstructive symptoms (CDOS > 4) before endoscopy - Time to clinical postoperative recurrence - Serious adverse events - Quality of life: EQ5D-5L questionnaire - Work productivity: Work Productivity and Activity Impairment questionnaire ;
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