Crohn's Disease Clinical Trial
Official title:
A Cluster Randomized Controlled Trial of a Treatment Algorithm for the Management of Crohn's Disease
Assess if the implementation of a treatment algorithm will improve the management of Crohn's disease (CD) in comparison to usual care based gastroenterology practices.
Crohn's disease (CD) is a chronic inflammatory disorder of the gastrointestinal tract.
During disease exacerbations, pharmacological or surgical intervention is usually needed to
re-establish remission. Ideally, strategies should be employed to maintain patients in
long-term remission while minimizing exposure to corticosteroids and reduce therapy-related
toxicity.
Nevertheless, in reality many patients with CD do not receive effective therapy and their
disease often remains active, leading to uncontrolled inflammation and complications from
either the underlying disease or corticosteroids. Although treatment guidelines exist, they
do not adequately define treatment goals and the duration of treatment cycles is not
specified Optimizing outcomes in CD requires rapid control of inflammation. Intuitively,
persistent inflammation leads to persistent symptoms, tissue damage, and disease-related
complications. Conventional therapy is frequently ineffective in moderate to severe CD, and
is often continued for a prolonged time. Consequently, many patients are under-treated. An
alternate strategy that minimizes the use of corticosteroids and encourages the earlier use
of immunosuppressive agents and tumour necrosis factor (TNF) antagonists may be optimal.
However it is unknown whether this approach is superior to usual care
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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