Fistula Clinical Trial
Official title:
SPOTLITE: Prospective Observational Study on the Clinical Outcomes of Surgical Interventions in Complex Fistulizing Conditions (CPF-CD, CD-RVF, CCF)
Verified date | April 2024 |
Source | Takeda |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Observational |
In this study, participants with complex fistulizing conditions will be treated with surgical interventions according to their clinic's standard practice. The aim of the study is to generate real-world evidence on standard of care for surgical interventions and related outcomes when treating complex fistulizing conditions. The study sponsor will not be involved in how participants are treated but will provide instructions on how the clinics will record what happens during the study.
Status | Active, not recruiting |
Enrollment | 750 |
Est. completion date | May 2, 2026 |
Est. primary completion date | May 2, 2026 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 18 Years and older |
Eligibility | Inclusion Criteria: Participants with CPF-CD 1. CPF-CD that meets one or more of the following criteria: - High inter-sphincteric, high trans-sphincteric, extra-sphincteric or supra-sphincteric fistula, or - Presence of greater than or equal to (>=) 2 external openings, or - Associated perianal abscess(es) 2. Physician has made the decision to treat with a specific surgical intervention. Procedures may include: - Fistulotomy, fistula plug, fibrin glue, advancement flap (AF), ligation of inter-sphincteric fistula tract (LIFT), flap repair, fistulectomy, proctectomy, stem cell therapy, other; and seton for palliative purposes. Participants with CD-RVF: Rectovaginal fistula per physician diagnosis 1. Physician has made the decision to treat with a specific surgical intervention. Procedures may include: - Fistulotomy, fistula plug, fibrin glue, AF, LIFT, flap repair, fistulectomy, proctectomy, stem cell therapy, gracilis muscle interposition/tissue grafts, martius procedure, abdominal procedures, other; and seton use for palliative purposes. Participants with CCF: 1. Complex cryptoglandular fistula that meets one or more of the following criteria: - Mid or high trans-sphincteric, or - Anterior in women, or - Horseshoe fistula 2. Physician has made the decision to treat with a specific surgical intervention. Procedures may include: - Fistulotomy, fistula plug, fibrin glue, AF, LIFT, flap repair, fistulectomy, proctectomy, stem cell therapy, other; and seton use for palliative purposes Exclusion Criteria: Participants who meet any below mentioned criterion among CPF-CD, CD-RVF, and CCF diagnosis will be excluded from the study. 1. Current participation in interventional clinical trials. 2. Has CPF-CD: fistula connection to bladder or another organ 3. Has CCF: diagnosis of Inflammatory Bowel Disease (IBD), including Ulcerative Colitis, and Crohn's Disease (CD). |
Country | Name | City | State |
---|---|---|---|
Austria | AKH - Medizinische Universitat Wien | Vienna | |
Belgium | UZ Antwerpen | Antwerp | |
Belgium | Cliniques Universitaires Saint-Luc | Brussels | |
Belgium | Jessa Ziekenhuis Hospital | Hasselt | |
Belgium | Clinique CHC MontLegia | Liege | |
Belgium | AZ Delta | Roeselare | |
Canada | St. Pauls Hospital | Vancouver | British Columbia |
Czechia | Fakultni nemocnice Brno | Brno | |
Czechia | Fakultni nemocnice u sv. Anny v Brne | Brno | |
Czechia | NH Hospital a.s.Nemocnice Horovice | Horovice | |
Czechia | Fakultni nemocnice Olomouc | Olomouc | |
France | CHRU Hopital Claude Huriez | Lille | Nord |
France | Groupe Hospitalier Diaconesses - Hopital De La Croix Saint Simon | Paris | |
France | Hopital Saint Joseph - Paris | Paris | |
France | Hospices Civils de Lyon (HCL) - Centre Hospitalier Lyon-Sud | Pierre-Benite | Bouches-du-Rhone |
France | CHU de Rennes - Hopital Pontchaillou | Rennes cedex 09 | Ille Et Vilaine |
France | CHU de Rouen - Hopital Charles Nicolle | Rouen Cedex | Seine Maritime |
France | Fondation Maison Sante Bagatelle | Talence | Gironde |
Israel | Shamir Medical Center (Assaf Harofeh) | Be'er Ya'aqov | |
Israel | Rambam Health Care Center | Haifa | |
Israel | Wolfson Medical Center | Holon | |
Israel | Tel Aviv Sourasky Medical Center | Tel Aviv | |
Italy | Istituto Clinico Humanitas | Rozzano | Milano |
Netherlands | Amsterdam UMC, Locatie AMC | Amsterdam | |
Netherlands | UMC Utrecht | Utrecht | |
United Kingdom | Broomfield Hospital | Chelmsford | Essex |
United Kingdom | Royal Victoria Infirmary. | Newcastle upon Tyne | Tyne & Wear |
United Kingdom | Nottingham University Hospital | Nottingham | Nottinghamshire |
United States | GI Alliance - Baton Rouge | Baton Rouge | Louisiana |
United States | UNC Hospitals | Chapel Hill | North Carolina |
United States | Baylor Research Institute | Dallas | Texas |
United States | Premier Health | Dayton | Ohio |
United States | Colon & Rectal Clinic | Houston | Texas |
United States | Baptist MD Anderson Cancer Center | Jacksonville | Florida |
United States | University of Kansas Medical Center Research Institute, Inc. | Kansas City | Kansas |
United States | Cedars-Sinai Medical Center | Los Angeles | California |
United States | Vanderbilt University Medical Center- GI Endoscopy Lab | Nashville | Tennessee |
United States | Lenox Hill Hospital PRIME | New York | New York |
United States | Penn Medicine PA | Philadelphia | Pennsylvania |
United States | Temple University Hospital | Philadelphia | Pennsylvania |
United States | University of South Florida - PARENT | Tampa | Florida |
Lead Sponsor | Collaborator |
---|---|
Takeda |
United States, Austria, Belgium, Canada, Czechia, France, Israel, Italy, Netherlands, United Kingdom,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Percentage of Participants who Achieve Clinical Remission of Fistula | Clinical remission for Complex perianal fistula in Crohn's Disease (CPF-CD) and Complex Cryptoglandular Fistula (CCF) is defined as closure of all index treated external fistula openings that were draining at baseline as assessed clinically despite gentle finger compression. Clinical remission for Rectovaginal fistula with Crohn's Disease (CD-RVF) is defined as epithelization of the index external fistula opening (vaginal opening) compared to baseline. | Baseline up to 24 months | |
Secondary | Percentage of Participants With Post-surgical Complications | Post-surgical complications for CPF-CD and CCF is defined as post-index surgery perianal pain, bleeding, infection, urinary retention, delayed or poor wound healing, anal stenosis, and fecal incontinence related to index surgery. Post-surgical complications for CD-RVF is defined as post-index surgery vaginal bleeding, infection, urinary retention, urinary tract infections (UTIs), discharge, delayed or poor wound healing, anal stenosis, fecal incontinence, and pain with intercourse or others related to index surgery. | Baseline, 3, 6, 12 and 24 months post-index surgery | |
Secondary | Percentage of Participants who Achieve Combined Remission | Combined remission for CPF-CD and CCF is defined as closure of all index external fistula openings treated with surgery that were draining at baseline as assessed clinically despite gentle finger compression, and absence of fluid collections greater than (>) 2 centimeter (cm) in at least 2 dimensions, as confirmed by pelvic magnetic resonance imaging (MRI) or other imaging procedure. Combined remission for CD-RVF is defined as 100 percent (%) cessation of drainage on both clinical exam with deep palpation (deeper bimanual exam/palpation with speculum and/or anoscope) and epithelization of the index external fistula opening (vaginal opening) compared to baseline; and absence of fluid collection as assessed by MRI or other imaging procedure. | Baseline, 3, 6, 12 and 24 months post-index surgery | |
Secondary | Percentage of Participants who Achieve Cessation of Drainage in Treated Fistula | Cessation of drainage for CPF-CD and CCF is defined as 100% cessation of drainage from index treated fistula, as assessed clinically. Cessation of drainage for CD-RVF is defined as 100% cessation of drainage on clinical exam with deep palpation (deeper bimanual exam/palpation with speculum and/or anoscope) from the index treated fistula. | Baseline, 3, 6, 12 and 24 months post-index surgery | |
Secondary | Percentage of Participants With Relapse of Fistula in Clinical Remission | Relapse for CPF-CD and CCF is defined as reopening of any surgically treated index fistulae as clinically assessed; or the development of a perianal fluid collection >2 cm in at least 2 dimensions of the perianal fistula(s) treated, confirmed by MRI assessment or other imaging procedure; or drainage. Relapse for CD-RVF is defined as reopening of any surgically treated index fistulae as clinically assessed; or appearance of fluid collection as assessed by MRI or other imaging procedure; or drainage. | Baseline, 3, 6, 12 and 24 months post-index surgery | |
Secondary | Percentage of Participants With New Perianal Abscess | Baseline, 3, 6, 12 and 24 months post-index surgery |
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