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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04624230
Other study ID # A3921210
Secondary ID 2018-002378-30OV
Status Recruiting
Phase Phase 3
First received
Last updated
Start date August 12, 2021
Est. completion date December 21, 2026

Study information

Verified date June 2024
Source Pfizer
Contact Pfizer CT.gov Call Center
Phone 1-800-718-1021
Email ClinicalTrials.gov_Inquiries@pfizer.com
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study, A3921210 is designed to evaluate the efficacy, safety and pharmacokinetics (PK) of tofacitinib in pediatric participants with moderately to severely active UC. In the US and EU, patients with prior TNFi failure or intolerance will be enrolled. Outside of the US or EU, patients having had inadequate response or intolerance to oral or IV corticosteroids or azathioprine or 6-mercaptopurine or TNFi will be enrolled. All eligible participants will initially receive open label tofacitinib at a dose expected to produce equivalent systemic exposure to that observed in adults receiving 5 mg BID with the option for individual dose increase to 10 mg BID adult dose equivalent if dose escalation criteria are met. The primary objective of this study is to evaluate the efficacy of tofacitinib based on remission in pediatric participants with moderately to severely active UC. The primary endpoint is remission by central read Mayo score following 44 weeks in the maintenance phase. Remission is defined by a Mayo score of 2 points or lower, with no individual subscore exceeding 1 point and a rectal bleeding subscore of 0. The study Design is an open-label Phase 3 study that includes a screening period of up to 4-weeks duration, an 8-week or 16-week induction phase, a 44-week maintenance phase, and a 24-month extension phase for pediatric participants with moderately to severely active UC. Participants will have a follow-up visit 4 weeks after the last dose of study intervention and a telephone contact 8 weeks later to assess for any adverse events (AEs)/serious adverse events (SAEs). The total maximum duration of this study will be up to 180 weeks.


Recruitment information / eligibility

Status Recruiting
Enrollment 120
Est. completion date December 21, 2026
Est. primary completion date December 21, 2026
Accepts healthy volunteers No
Gender All
Age group 2 Years to 17 Years
Eligibility Inclusion Criteria: - Evidence of a personally signed and dated informed consent document and assent document. - Males and females 2 to less than18 years old and weighing at least 10 kg. - Having a pathology report that confirms colonic inflammation consistent with UC with a clinical diagnosis of UC for at least 12 weeks prior to baseline, with biopsy report supporting the diagnosis of UC. - Participants diagnosed with UC at age less than 6 years old, must have had testing and be negative for monogenic disorders associated with very early onset IBD. - Moderately to severely active UC as defined (via screening colonoscopy) by a Mayo score of at least 6, with a rectal bleeding score of at least 1 and an endoscopic subscore of at least 2. - Pediatric Ulcerative Colitis Activity Index (PUCAI) score greater or equal to 35 . - No history of dysplasia or colon cancer. - No evidence or history of untreated or inadequately treated active or latent infection with Mycobacterium Tuberculosis. - For participants outside of the United States or the European Union: have had an inadequate response or been intolerant to at least one prior therapy as listed below or have a medical contraindication to such therapies: - Oral or intravenous (IV) corticosteroids; - Azathioprine or 6-mercaptopurine; - TNF inhibitors or anti integrin therapy. - For participants in the United States and the European Union: have had an inadequate response or intolerance to TNF inhibitors. - Stable doses of the following therapies for UC: - Oral 5 Aminosalicyclic acids (ASA) or sulfasalazine - Oral corticosteroids equivalent to prednisone at most 1 mg/kg up to a maximum of 20 mg/day or budesonide up to 9 mg/day. - female participant is eligible if she is not pregnant or breastfeeding, If she is a woman of child bearing potential, she needs to be using a contraceptive method that is highly effective (with a failure rate of <1% per year). Exclusion Criteria: - Diagnosis of indeterminate colitis, isolated proctitis, microscopic colitis, infectious colitis, Crohn's disease, or clinical findings suggestive of Crohn's disease. - History of symptomatic obstructive intestinal strictures or active ostomy, or history of colectomy, extensive small bowel resection ( greater than100 centimetres) or short bowel syndrome, or hospitalization for UC related reason(s) within 2 weeks of baseline visit. - Any factors or clinical characteristics potentially related to the risk of venous thromboembolism that may increase the risk associated with study participation or study intervention administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the participant inappropriate for entry into this study. - Participants who have previously received tofacitinib or another Janus Kinase inhibitor. - Vaccination or exposure to a live or attenuated vaccine within the 6 weeks prior to the first dose of study drug, or who are expected to be vaccinated or to have household exposure to these vaccines during treatment or during the 6 weeks following discontinuation of study drug. - Participants having received azathioprine, 6-mercaptopurine, methotrexate, thioguanine, infliximab, adalimumab, golimumab, ustekinumab, interferon, cyclosporine, mycophenolate, tacrolimus, IV or rectally administered corticosteroids, natalizumab, vedolizumab, other antiadhesion molecules, or investigational drugs during the specified time periods prior to baseline whereby they may still have pharmacokinetic and/or pharmacodynamic effect in the body of the participant. - Previous treatment by leukocyte apheresis including selective lymphocyte, monocyte, or granulocyte apheresis, or plasma exchange within 6 months prior to baseline. - Treatment by specified prohibited concomitant medications, including moderate to potent CYP3A inducers or inhibitors in the specified time periods prior to the first dose of study drug or are expected to receive any of these medications during the study period. - Chronic and frequent use of antimotility agents for control of diarrhea (ie, diphenoxylate hydrochloride with atropine sulfate or loperamide). - History of bowel surgery, including cholecystectomy within 6 months prior to baseline, history of appendectomy within 3 months prior to baseline, or significant trauma or major surgery within 4 weeks of screening visit are excluded. - Participants with the following laboratory values at screening: - Hemoglobin level lower than 9.0 g/Dl. - Absolute white blood cell (WBC) count lower than 3000/mm3. - Absolute neutrophil count lower than 1200/mm3. - Absolute lymphocyte count lower than 750/mm3. - Thrombocytopenia as defined by a platelet count lower than 100,000/mm3. - Estimated bedside Schwartz Glomerular filtration rate (GFR) lower or equal to 40 mL/min/1.73 m2. - Total bilirubin, aspartate aminostransferase (AST) or alanine aminotransferase (ALT) more than 1.5 times the upper limit of normal. - Positive stool examinations for enteric pathogens, pathogenic ova or parasites, or C. difficile toxin at screening. - Participants infected with human immunodeficiency virus (HIV) or hepatitis B or C viruses. - History of more than one episode of HZ, a history of disseminated HZ or disseminated herpes simplex. - History or current symptoms of any lymphoproliferative disorder (eg, Epstein Barr Virus (EBV) related lymphoproliferative disorder, lymphoma, leukemia, myeloproliferative disorders, multiple myeloma, or signs and symptoms suggestive of currently lymphatic disease). - Clinically significant infections currently or within 3 months prior to baseline (eg, those requiring hospitalization or parenteral antimicrobial therapy or opportunistic infections), a history of any infection requiring antimicrobial therapy within 2 weeks of baseline, or a history of any infection otherwise judged by the investigator to have the potential for exacerbation by participation in the study. - Any malignancies or with a history of malignancies, with the exception of adequately treated or excised nonmetastatic basal cell or squamous cell cancer of the skin. - Investigator site staff members directly involved in the conduct of the study and their family members, site staff members otherwise supervised by the investigator, or participants who are employees of the Sponsor, including their family members, directly involved in the conduct of the study. - Participation in other studies involving investigational drug(s) within 2 months prior to study entry and/or during study participation. - Other acute or chronic medical or psychiatric condition including recent (within the past year) or active suicidal ideation or behavior or laboratory abnormality that may increase the risk associated with study participation or study intervention administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the participant inappropriate for entry into this study. - Pregnant female participants; breastfeeding female participants; fertile female participants of childbearing potential who are unwilling or unable to use a highly effective method of contraception as outlined in this protocol for the duration of the study and through the telephone follow up visit. - History of allergies, intolerance or hypersensitivity to lactose or tofacitinib, or any other excipients of the investigational medicinal products, including placebos.

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
tofacitinib
Open label tofacitinib 5 mg BID weight based adult equivalent with the option for individual dose increase to 10 mg BID weight based adult equivalent for a limited time if dose escalation criteria are met, prior to returning to 5 mg BID.

Locations

Country Name City State
Australia Women's and Children's Hospital, Women's and Children's Health Network Inc. North Adelaide South Australia
Australia The Royal Children's Hospital Parkville Victoria
Belgium Universitair Ziekenhuis Brussel Brussel
Belgium Cliniques Universitaires Saint-Luc Brussels
Belgium Hôpital Universitaire Des Enfants Reine Fabiola Brussels
Belgium Universitaire Ziekenhuizen Leuven Leuven Vlaams Brabant
Canada Stollery Children's Hospital University of Alberta Edmonton Alberta
Canada IWK Health Centre Halifax Nova Scotia
Canada London Health Sciences Centre - Children's Hospital London Ontario
Canada CHU Sainte-Justine Montreal Quebec
Canada The Hospital for Sick Children - Division of Gastroenterology, Hepatology and Nutrition Toronto Ontario
Canada British Columbia Children's Hospital Vancouver British Columbia
Finland Tampereen yliopistollinen sairaala Tampere
France CHU de Lyon - Hôpital Femme Mère Enfant BRON Cedex
France Hôpital Necker Enfants Malades Paris
Germany Dr. von Haunersches Kinderspital, LMU Munich Bavaria
Hungary Debreceni Egyetem Klinikai Kozpont Debrecen Hajdú-bihar
Hungary Debreceni Egyetem Klinikai Kozpont Debrecen
Hungary Borsod- Abauj- Zemplen Megyei Kozponti Korhaz es Egyetemi Oktatokorhaz Miskolc
Hungary Szegedi Tudomanyegyetem Szent-Gyorgyi Albert Klinikai Kozpont Szeged
Israel Shamir Medical Center (Assaf Harofeh) Be'er Ya'akov
Israel Lady Davis Carmel Medical Center Haifa
Israel Shaare Zedek Medical Center Jerusalem
Israel Schneider Children's Medical Center of Israel Petah Tikva
Israel Tel-Aviv Sourasky Medical Center Tel Aviv
Italy ASST Papa Giovanni XXIII Epatologia e Gastroenterologia Pediatrica e dei Trapianti Bergamo BG
Italy Azienda USL di Bologna - IRCCS ISNB - Programma Gastroenterologia Pediatrica Bologna
Italy A.O.U. Federico II Napoli Naples
Italy A.O.U. Policlinico Umberto I Roma RM
Japan Juntendo University Hospital Bunkyo-ku Tokyo
Japan Osaka Women's and Children's Hospital Izumi Osaka
Japan Kurume University Hospital Kurume-shi Fukuoka
Japan Gunma University Hospital Maebashi Gunma
Japan Aichi Children's Health and Medical Center Obu-shi Aichi
Japan Saitama Prefectural Children's Medical Center Saitama-shi Saitama
Japan Miyagi Children's Hospital Sendai-shi Miyagi
Japan National Center for Child Health and Development Setagaya-ku Tokyo
Japan Jichi Medical University Hospital Shimotsuke Tochigi
Japan Osaka Medical and Pharmaceutical University Hospital Takatsuki-shi Osaka
Netherlands Amsterdam UMC, location VUmc Boelelaan Amsterdam
Netherlands Erasmus Medical Center - Sophia Children's Hospital Rotterdam
Poland Szpital Uniwersytecki nr 1 im. dr. A. Jurasza w Bydgoszczy Bydgoszcz
Poland Instytut "Centrum Zdrowia Matki Polki" Lodz
Poland Korczowski Bartosz, Gabinet Lekarski Rzeszow
Poland WIP Warsaw IBD Point Profesor Kierkus Warsaw
Poland Instytut "Pomnik - Centrum Zdrowia Dziecka" Warszawa
Poland WIP Warsaw IBD Point Profesor Kierkus Warszawa
Poland Uniwersytecki Szpital Kliniczny im. Jana Mikulicza-Radeckiego we Wroclawiu Wroclaw
Slovakia Narodny ustav detskych chorob Bratislava
Spain Hospital Sant Joan de Déu Esplugues de Llobregat Barcelona
Spain Hospital Infantil Universitario Niño Jesus Madrid
Spain Hospital Materno-Infantil de Málaga (Hospital Regional Universitario de Málaga) Malaga Málaga
Sweden Sahlgrenska Sjukhuset, Drottning Silvias Barn- och Ungdomssjukhus Göteborg
Sweden Karolinska Universitetssjukhuset Barngastroenterologi, hepatologi och nutrition Stockholm
Sweden Sachsska Children's and Youth Hospital/South General Hospital Stockholm
United Kingdom Birmingham Women's and Children's NHS Foundation Trust Birmingham WEST Midlands
United Kingdom Birmingham Women's and Children's NHS Foundation Trust Birmingham WEST Midlands
United Kingdom NHS Lothian Edinburgh
United Kingdom Royal Hospital for Children Glasgow
United Kingdom Bart's Health NHS Trust London
United Kingdom Bart's Health NHS Trust London
United Kingdom King's College Hospital NHS Foundation Trust London Greater London
United Kingdom Royal London Children's Hospital London
United Kingdom Royal London Children's Hospital London
United States Outpatient Pediatric Research Center Children's Healthcare of Atlanta Atlanta Georgia
United States Boston Children's Hospital Boston Massachusetts
United States Cincinnati Children's Hospital Medical Center Cincinnati Ohio
United States Duke University Health System Durham North Carolina
United States Connecticut Children's Ambulatory Surgical Center Farmington Connecticut
United States Connecticut Children's Infusion Center Farmington Connecticut
United States Connecticut Children's Medical Center Hartford Connecticut
United States Texas Children's Hospital - Clinical Research Center Houston Texas
United States Texas Children's Hospital - Feigin Tower (Administrative Offices - Research Administrative Offices) Houston Texas
United States Texas Children's Hospital - RRO Regulatory (Administrative Offices - Regulatory Location) Houston Texas
United States Texas Children's Hospital - Wallace Tower Houston Texas
United States Texas Children's Hospital - West Tower Houston Texas
United States Northwell Health - Cohen Children's Medical Center Lake Success New York
United States Children's Hospital Los Angeles Los Angeles California
United States Nicklaus Children's Hospital Miami Florida
United States Children's Wisconsin Milwaukee Wisconsin
United States Atlantic Children's Health-Pediatric Gastroenterology & Nutrition Morristown New Jersey
United States Atlantic Health System- Morristown Medical Center (Pharmacy) Morristown New Jersey
United States Goryeb Children's Hospital (Endoscopy only) Morristown New Jersey
United States Northwell Health - Cohen Children's Medical Center New Hyde Park New York
United States Columbia University Irving Medical Center New York New York
United States CUIMC Research Pharmacy - Milstein Hospital (Pharmacy Only) New York New York
United States Morgan Stanley Children's Hospital, CUIMC New York New York
United States Mount Sinai Hospital (Investigational Drug Pharmacy) New York New York
United States Mount Sinai Hospital Endoscopy Center (Endoscopy Only) New York New York
United States Susan and Leonard Feinstein Inflammatory Bowel Disease Clinical Center at Mount Sinai New York New York
United States Weill Cornell Medicine - New York Presbyterian Hospital New York New York
United States Buerger Center for Advanced Pediatric Care Philadelphia Pennsylvania
United States Children's Hospital of Philadelphia Philadelphia Pennsylvania
United States Roberts Center for Pediatric Research Philadelphia Pennsylvania
United States Phoenix Children's Hospital Phoenix Arizona
United States University of California, San Francisco Benioff Children's Hospital San Francisco California
United States University of California, San Francisco Pediatric Clinical Research Center (PCRC) San Francisco California
United States Seattle Children's Hospital Seattle Washington

Sponsors (1)

Lead Sponsor Collaborator
Pfizer

Countries where clinical trial is conducted

United States,  Australia,  Belgium,  Canada,  Finland,  France,  Germany,  Hungary,  Israel,  Italy,  Japan,  Netherlands,  Poland,  Slovakia,  Spain,  Sweden,  United Kingdom, 

References & Publications (7)

Benchimol EI, Bernstein CN, Bitton A, Carroll MW, Singh H, Otley AR, Vutcovici M, El-Matary W, Nguyen GC, Griffiths AM, Mack DR, Jacobson K, Mojaverian N, Tanyingoh D, Cui Y, Nugent ZJ, Coulombe J, Targownik LE, Jones JL, Leddin D, Murthy SK, Kaplan GG. T — View Citation

Kelsen JR, Sullivan KE, Rabizadeh S, Singh N, Snapper S, Elkadri A, Grossman AB. North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition Position Paper on the Evaluation and Management for Patients With Very Early-onset Inflammato — View Citation

Konstantinides SV, Meyer G, Becattini C, Bueno H, Geersing GJ, Harjola VP, Huisman MV, Humbert M, Jennings CS, Jimenez D, Kucher N, Lang IM, Lankeit M, Lorusso R, Mazzolai L, Meneveau N, Ni Ainle F, Prandoni P, Pruszczyk P, Righini M, Torbicki A, Van Bell — View Citation

Marcovitch L, Nissan A, Mack D, Otley A, Hussey S, Mclean B, Lewis M, Croft N, Barakat FM, Griffiths AM, Turner D. Item Generation and Reduction Toward Developing a Patient-reported Outcome for Pediatric Ulcerative Colitis (TUMMY-UC). J Pediatr Gastroente — View Citation

Otley A, Smith C, Nicholas D, Munk M, Avolio J, Sherman PM, Griffiths AM. The IMPACT questionnaire: a valid measure of health-related quality of life in pediatric inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2002 Oct;35(4):557-63. doi: 10.109 — View Citation

Taylor SJ, Whincup PH, Hindmarsh PC, Lampe F, Odoki K, Cook DG. Performance of a new pubertal self-assessment questionnaire: a preliminary study. Paediatr Perinat Epidemiol. 2001 Jan;15(1):88-94. doi: 10.1046/j.1365-3016.2001.00317.x. — View Citation

Turner D, Otley AR, Mack D, Hyams J, de Bruijne J, Uusoue K, Walters TD, Zachos M, Mamula P, Beaton DE, Steinhart AH, Griffiths AM. Development, validation, and evaluation of a pediatric ulcerative colitis activity index: a prospective multicenter study. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Remission by central read Mayo score following 44 weeks in the maintenance phase. Remission is defined by central endoscopy read Mayo score of 2 points or lower, with no individual subscore exceeding 1 point and a rectal bleeding subscore of 0.
The primary outcome Mayo score is the summation of 4 subscores as listed below :
patient reported stool frequency (scored 0 to 3)
patient reported rectal bleeding (scored 0 to 3)
central read findings on endoscopy (scored 0 to 3)
physician's global assessment (scored 0 to 3)
The Mayo score has a scale from 0 to 12 points, with the lower score indicating lower ulcerative colitis (UC) disease activity.
Outcome measured at the end of the 44 weeks of the maintenance phase.
Secondary Response by Mayo score Response by Mayo score is defined by a decrease from baseline in Mayo score of at least 3 points and at least 30%, with an accompanying decrease in the subscore for rectal bleeding of at least 1 point or absolute subscore for rectal bleeding of 0 or 1. Outcome measured at induction Week 8, induction Week 16, and maintenance Week 44
Secondary Remission by Mayo score Remission by Mayo score with local and central endoscopy read (induction Week 8, induction Week 16), and with local endoscopy read only (maintenance week 44). Outcome measured at induction Week 8, induction Week 16, and maintenance Week 44
Secondary Change from baseline in Mayo score. Outcome measured at induction Week 8, induction Week 16, and maintenance Week 44
Secondary Response measured by Partial Mayo Score Response is defined by a partial Mayo score decrease of 2 points or more from baseline. This score is based on the summation of the following subscores :
stool frequency (scored 0 to 3)
rectal bleeding (scored 0 to 3)
physician global assessment (PGA) (scored 0 to 3)
The partial Mayo score has a scale from 0 to 9, with the lower score indicating lower ulcerative colitis (UC) disease activity.
Outcome measured through study completion, an average of 3 and a half years
Secondary Change from baseline in Partial Mayo score Change in partial Mayo score. This score is the summation of 3 distinct dimensions as listed below :
stool frequency (scored 0 to 3)
rectal bleeding (scored 0 to 3)
physician global assessment (PGA) (scored 0 to 3)
The partial Mayo score has a scale from 0 to 9, with the lower score indicating lower ulcerative colitis (UC) disease activity.
Outcome measured through study completion, an average of 3 and a half years
Secondary Response by PUCAI score The Pediatric Ulcerative Colitis Activity Index (PUCAI) score is the summation of 6 dimensions that are all reported by the investigator. The PUCAI score varies from 0 to 85 points, with the lower score indicating lower ulcerative colitis (UC) disease activity. The 6 dimensions of the PUCAI score are as follows :
abdominal pain
rectal bleeding
stool consistency of most stools
number of stools per 24 hours
nocturnal stools
activity level
Response is defined by a PUCAI score decrease of 20 points or more.
Outcome measured through study completion, an average of 3 and a half years
Secondary Change from baseline in PUCAI score The Pediatric Ulcerative Colitis Activity Index (PUCAI) score is the summation of 6 dimensions that are all reported by the investigator
abdominal pain
rectal bleeding
stool consistency of most stools
number of stools per 24 hours
nocturnal stools
activity level
The PUCAI score varies from 0 to 85 points, with the lower score indicating lower ulcerative colitis (UC) disease activity.
Outcome measured through study completion, an average of 3 and a half years
Secondary Percentage of Participants Achieving Endoscopic Improvement at Week 8, 16, and 44 Endoscopic improvement is defined by Mayo endoscopic sub-score of 0 or 1. The Mayo endoscopic sub-score is used to assess ulcerative colitis activity, and ranges from 0 to 3, and is based on the findings during endoscopy. A lower score is indicative of a lower ulcerative colitis (UC) disease activity. Outcome measured at induction Week 8, induction Week 16, and maintenance Week 44
Secondary Time to flare Outcome measured from 2 to 4 months in the study, through study completion, an average of 3 and a half years
Secondary Change from baseline in fecal calprotectin levels Outcome measured through study completion, an average of 3 and a half years
Secondary Change from baseline in serum high sensitivity C-Reactive Protein (hsCRP) levels Outcome measured through study completion, an average of 3 and a half years
Secondary Corticosteroid free remission by Partial Mayo Score Remission is defined by a partial Mayo score of 2 points or lower, with no individual subscore exceeding 1 point and rectal bleeding subscore of 0.
The subscores of the partial Mayo score are:
stool frequency (scored 0 to 3)
rectal bleeding (scored 0 to 3)
physician global assessment (PGA) (scored 0 to 3)
Outcome measured through study completion, an average of 3 and a half years
Secondary Average plasma concentration of tofacitinib (Cavg) Outcome measured at baseline, induction Week 8, induction Week 16, maintenance Week 16, maintenance Week 44
Secondary Evaluation of taste acceptability of tofacitinib oral solution, and acceptability of film coated tablet by choosing one of 5 choices Taste acceptability will be assessed by asking the participant to select one of 5 choices which most adequately reflects the participant's response to taste. Age appropriate tools (using wording and/or graphic facial expressions) will be used to assess taste acceptability. Outcome measured at induction week 2
Secondary Peak (maximum) plasma concentration of tofacitinib (Cmax) Outcome measured at baseline, induction Week 8, induction Week 16, maintenance Week 16, maintenance Week 44
Secondary Percentage of Participants Achieving Endoscopic Remission at Week 8, 16, and 44 Endoscopic remission is defined by a Mayo endoscopic subscore of 0, out of a maximum of 3 points.
The Mayo endoscopic sub-score is used to assess ulcerative colitis activity, and ranges from 0 to 3, and is based on the findings during endoscopy. A lower score is indicative of a lower ulcerative colitis (UC) disease activity.
Outcome measured at induction Week 8, induction Week 16, and maintenance Week 44
Secondary Remission by PUCAI score The Pediatric Ulcerative Colitis Activity Index (PUCAI) score is the summation of 6 dimensions that are all reported by the investigator. The PUCAI score varies from 0 to 85 points, with the lower score indicating lower ulcerative colitis (UC) disease activity. The 6 dimensions of the PUCAI score are as follows :
abdominal pain
rectal bleeding
stool consistency of most stools
number of stools per 24 hours
nocturnal stools
activity level
Remission is defined by a PUCAI score of less than 10 points.
Outcome measured through study completion, an average of 3 and a half years
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