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Clinical Trial Summary

This is a randomized placebo-controlled trial in Crohn's disease patients before initiation of anti-tumor necrosis factor-α (anti-TNF) therapy that aims to test the effect of a pre-treatment short course of azithromycin therapy on immunogenicity


Clinical Trial Description

Anti-TNF agents are considered the mainstay of therapy for patients with inflammatory bowel diseases (IBD). Still, its efficacy is hampered by the development of anti-drug antibodies (ADA), which lead to non-responsiveness to this medication. A combination with immunosuppressive agents is currently utilized to reduce ADA development but is accompanied by an increased risk of side effects (i.e. malignancy and infections). The investigators have recently found an epidemiologic link between prior antibiotic use and the development of ADA, and shown an antibiotic-specific effect on ADA development in a mouse model. Macrolide antibiotics were specifically associated with ADA prevention and led to increased durability of the treatment. Since the microbiome has been associated with the response to anti-TNF therapy, the investigators hypothesize that microbial manipulation with azithromycin prior to the initiation of anti-TNF therapy will lower ADA development. the investigators propose a randomized controlled study to test our hypothesis and compare it to matched historical cohorts with available clinical and serological data. The primary outcome will be ADA development at 1 year of therapy. ;


Study Design


Related Conditions & MeSH terms


NCT number NCT05599347
Study type Interventional
Source Rambam Health Care Campus
Contact Haggai Bar-Yosef, MD
Phone 050-2064878
Email h_bar-yoseph@rmc.gov.il
Status Recruiting
Phase Phase 2
Start date April 24, 2023
Completion date December 31, 2026

See also
  Status Clinical Trial Phase
Recruiting NCT04100005 - A Pilot Study to Explore the Role of Gut Flora in Crohn's Disease