Crohn DiseasePhase 3POPARTNCT01629628
Adalimumab for the Management of Post-operative Crohn's Disease (CD)
A Phase 3 study testing Adalimumab and 6 Mercaptopurine in people with Crohn Disease, run by Tel-Aviv Sourasky Medical Center at 1 site in Israel.
Trial summary
This study will be a prospective, open label, randomized, comparative study. Comparing the efficacy of adalimumab with immunomodulator therapy (i.e. 6-mercaptopurine, 6-MP), in maintaining remission of post-operative CD patients, with a high risk of disease recurrence. Read more about this study
- Who is it for?
- Ages 18 to 70 years
- Conditions the study is for
- Crohn Disease
- What is being tested?
- Adalimumab and 6 Mercaptopurine
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 100 participants
- Where
- 1 siteIsrael
- Study dates
- Jul 2012to Jul 2016
- Phase
- Phase 3
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 70 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 18-70 years old at the time of screening
- Male or female
- Firs ileocolonic surgical resection (
- Evidence of both macroscopic as well an microscopic evidence of Crohn's disease in the resected intestinal segment
- Patient able to undergo pre randomization screening no earlier then 14 days and no later then 45 days post operatively.
- Patients may receive anti-TNF-agents (i.g. infliximab or adalimumab)previously
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- Patients may receive corticosteroids, 6MP/AZA, methotrexate, or mesalamine prior to surgery.
- Antibiotics, or mesalamine, must be discontinued within the screening/baseline 4 week period. Patients on steroids may be enrolled as long as steroids are tapered off.
- Remission as defined by a CDAI ≤ 150.
- Women of childbearing potential, and men, must use medically acceptable methods of contraception [surgical sterilization, IUD, hormonal preparations, or double barrier method (e.g. condom or diaphragm, and spermicide)] throughout the study and for a period of 6 months after receiving the last injection.
- Screening lab results must be within prespecified limits: Hemoglobin ≥ 8.8 g/dl; SGOT/SGPT < 3 X the upper limit of normal; Neutrophil count ≥ 1.0 X 109/L \& lymphocyte cont of ≥ 0.5 X 109/L
- Must have a documented PPD ≤ 5 mm, in patients taking steroids, within the month before randomization, or taking immunomodulators 2 months prior to randomization. Other patients must have documented PPD ≤ 10 mm prior to randomization. PPD must be preformed and documented by an appointed member of the investigatory stuff. Patients must have a normal chest radiograph (both posterior-anterior and lateral views), read by a certified radiologist, within 3 months prior to randomization.
- Commitment to adhere to study protocol requirements
- Negative stool cultures for enteric pathogens (Salmonella, Shigella, Campylobacter, Ova \& parasites), and negative clostridium difficile toxin assay in stool.
- Patients are able to self-inject or have a designee or healthcare professional who can inject the study medication at the appropriate intervals.
- Patient's with long standing (>5Y), as well as recently diagnosed Crohn's disease ,will be eligible if they show radiologic (i.e. CT enterography, MR enterography , small bowel follow through) evidence, as well as laboratory (i.e. CRP, platelets level, fecal calprotectin, ESR ) evidence for an active inflammatory process within a 3 months period prior to the qualifying surgery
Who cannot join
- evidence of macroscopic inflammatory disease at the surgical margins or else ware, according to the surgeon
- Patients who discontinued anti TNF-alpha agents due to loss of efficacy or tolerability issues.
- Patients with temporary ileostomy.
- Patients with longstanding quiescent CD undergoing surgery for the treatment of a fibrostenotic lesion, without an active inflammatory disease process in the resected segment.
- Any of the following medications taken within 3 months prior to randomization: cyclosporine, tacrollimus, mycophenolate mofetil, or other investigational anti-inflammatory agents. Medication targeting the reduction of TNF-alpha (infliximab, golimumab, cetrolizumb pegol, etanercept), natalizumab, or other FDA approved biological agents may be administered up until to index surgery.
- Patient who have an ongoing active infection within the baseline period: intra-abdominal abscess, enteric infection as determined by stool cultures for bacteria, parasites and clostridium difficile toxin, other serious systemic bacterial infection within 3 months before randomization (e.g. Pneumonia; pyelonephritis; meningitis).
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- Patients with active TB, patients in close contact to individuals with active TB, patients with latent TB whether receiving or not receiving prophylaxis.
- Patient that have or had an opportunistic infection within the last 6 months
- Patients seropositive to HIV, HBV, or HCV. Patients will be actively screened for HBV vaccination, and will be required to undergo vaccination according to international guidelines.
- Patients having current signs/symptoms of severe or progressive systemic disease: any progressive/uncontrolled renal, hepatic, hematologic, gastrointestinal, endocrine, pulmonary, cardiac, neurologic, or psychiatric illness.
- Patients after organ transplantation
- Any current or known malignancies
- Use of any investigational drug within 60 days prior to randomization
- Current/frequent use of NSAIDS (i.e. regular use of NSAIDS for more than 3 times a week for longer than 7 consecutive days during the trial period).
- Pregnant or lactating women
- Concomitant substance or alcohol abuse
- Subjects unable to self-inject or do not have a designee or healthcare professional who can inject the study medication.
- Subject unable to comply with the planned schedule of study visits and study procedures.
- Patients with short bowel syndrome
- Patients with previous small bowel surgeries
Trial locations and contacts
1 site in 1 country.
Israel1 site
Department of Gastroenterology and Liver Diseases, Tel-Aviv Soursky Medical Center
Tel Aviv, 64239
Erez F Scapa, M.D., 972-52-4266345, erezs@tasmc.health.gov.il
Erez F Scapa, M.D.
About this study
Official title: An Investigator Initiated Prospective, Single Center, Randomized, Open Label Study to Assess the Efficacy of Adalimumab for the Maintenance of Remission in Post-operative CD Patients
This study will be a prospective, open label, randomized, comparative study. Comparing the efficacy of adalimumab with immunomodulator therapy (i.e. 6-mercaptopurine, 6-MP), in maintaining remission of post-operative CD patients, with a high risk of disease recurrence.
Patient assessment for efficacy will be conducted through interval endoscopic surveillance at 24 and 52 weeks.
Read more
Patients in the adalimumab arm, showing endoscopic remission at 52 weeks of therapy, will be re-randomized to either maintain adalimumab therapy for an additional 52 weeks or conclude therapy. A third endoscopic assessment for these patients will be conducted at 104 weeks.
The investigators expect a substantial increase in both endoscopic, as well as clinical remission rate in patients on adalimumab therapy.
- Conditions
- Crohn Disease
- Being tested
- Adalimumab, 6 Mercaptopurine
- Keywords
- Crohn Disease, Colitis Granulomatous, Crohn's Disease, Enteritis Regional, Ileitis Regional, Ileitis Terminal, Ileocolitis
- Medical subject headings
- Crohn Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
AdalimumabDrug
Also called Humira
Subcutaneous adalimumab injections, loading dose of 160 mg and 80 mg on 0 and 2 weeks and maintenance of 40 mg every other week for the duration of the study.
6 MercaptopurineDrug
Also called Purinethol
6MP will be administered orally starting at a dose of 6MP of 50mg/day with escalating doses every 1-2 weeks as tolerated, to a target dose of 1-1.5 mg/kg.
--------------------------------------------------------------------------------
| Study group | Role | What they receive |
|---|---|---|
| Adalimumab | Experimental | Not described Receives: Drug: Adalimumab |
| 6-mercaptopurine | Active comparator | Not described Receives: Drug: 6 Mercaptopurine |
What is being measured
The primary outcome is the main question the study is designed to answer.
The proportion of patients with endoscopic recurrence at 12 months, as evaluated by the Rutgeerts endoscopic scoring system.
Primay outcome measure will assess the efficacy of adalimumab, compared to immunomodulator therapy in maintaining mucosal healing after 52 weeks (1 year).
Measured: 52 weeks
Secondary outcomes (1)
Proportion of patients in clinical remission at 12 months as assessed by the CDAI score.
Measured: 52 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted27 Jun 2012 (estimated)
- Study startJul 2012
- Primary completionJul 2016 (estimated)
- Study completionJul 2016 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Crohn DiseaseStudies of the same condition, open and under way.
- More trials run by Tel-Aviv Sourasky Medical CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 100 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Tel-Aviv Sourasky Medical Center
- Sponsor type
- Other government
- Collaborators
- Abbott
- Responsible party
- Principal investigator, Michal Roll PhD,MBA, Tel-Aviv Sourasky Medical Center
- Investigators
- Erez F Scapa, M.D., Principal investigator, Tel-Aviv Sourasky Medical Center, Affiliated to Tel-Aviv UniversityIris Dotan, M.D., Study director, Tel-Aviv Sourasky Medical Center, Affiliated to Tel-Aviv University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01629628
- Sponsor's protocol ID
- TASMC-10-ES-0446-TLV-CTIL
- Acronym
- POPART
- Status last verified
- Jun 2012
- First submitted
- 19 Jun 2012
- Last updated
- 27 Jun 2012
- Results posted
- No
- Data monitoring committee
- No
Publications
Regueiro M, Schraut W, Baidoo L, Kip KE, Sepulveda AR, Pesci M, Harrison J, Plevy SE. Infliximab prevents Crohn's disease recurrence after ileal resection. Gastroenterology. 2009 Feb;136(2):441-50.e1; quiz 716. doi: 10.1053/j.gastro.2008.10.051. Epub 2008 Oct 31.
PubMed 19109962Hirsch A, Scapa E, Fliss-Isakov N, Tulchinsky H, Itzkowitz E, Kariv Y, Ron Y, Yanai H, White I, Yassin S, Cohen NA, Brazovski E, Dotan I, Maharshak N. Early Initiation of Adalimumab Significantly Diminishes Postoperative Crohn's Disease Endoscopic Recurrence and Is Superior to 6-Mercaptopurine Therapy: An Open-Label, Randomized Controlled Study. J Clin Med. 2023 Dec 10;12(24):7600. doi: 10.3390/jcm12247600.
PubMed 38137669
Study at a glance
From the registry record, last updated by the sponsor on 27 Jun 2012. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- An Investigator Initiated Prospective, Single Center, Randomized, Open Label Study to Assess the Efficacy of Adalimumab for the Maintenance of Remission in Post-operative CD Patients
- ClinicalTrials.gov ID
- NCT01629628
- Acronym / sponsor ID
- POPART / TASMC-10-ES-0446-TLV-CTIL
- Conditions
- Crohn Disease
- Keywords
- Crohn Disease, Colitis Granulomatous, Crohn's Disease, Enteritis Regional, Ileitis Regional, Ileitis Terminal, Ileocolitis
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 100 participants (estimated)
- Lead sponsor
- Tel-Aviv Sourasky Medical CenterOther government
- Collaborators
- Abbott
- Study start
- Jul 2012
- Primary completion
- Jul 2016 (estimated)
- Study completion
- Jul 2016 (estimated)
- First posted
- 27 Jun 2012 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will be a prospective, open label, randomized, comparative study. Comparing the efficacy of adalimumab with immunomodulator therapy (i.e. 6-mercaptopurine, 6-MP), in maintaining remission of post-operative CD patients, with a high risk of disease recurrence.
Patient assessment for efficacy will be conducted through interval endoscopic surveillance at 24 and 52 weeks.
Patients in the adalimumab arm, showing endoscopic remission at 52 weeks of therapy, will be re-randomized to either maintain adalimumab therapy for an additional 52 weeks or conclude therapy. A third endoscopic assessment for these patients will be conducted at 104 weeks.
The investigators expect a substantial increase in both endoscopic, as well as clinical remission rate in patients on adalimumab therapy.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Adalimumab | Experimental | Drug: Adalimumab |
| 6-mercaptopurine | Active comparator | Drug: 6 Mercaptopurine |
Who may qualify
- Ages
- 18 to 70 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (16 listed)
- 18-70 years old at the time of screening
- Male or female
- Firs ileocolonic surgical resection (
- Evidence of both macroscopic as well an microscopic evidence of Crohn's disease in the resected intestinal segment
- Patient able to undergo pre randomization screening no earlier then 14 days and no later then 45 days post operatively.
Key exclusion criteria (20 listed)
- evidence of macroscopic inflammatory disease at the surgical margins or else ware, according to the surgeon
- Patients who discontinued anti TNF-alpha agents due to loss of efficacy or tolerability issues.
- Patients with temporary ileostomy.
- Patients with longstanding quiescent CD undergoing surgery for the treatment of a fibrostenotic lesion, without an active inflammatory disease process in the resected segment.
- Any of the following medications taken within 3 months prior to randomization: cyclosporine, tacrollimus, mycophenolate mofetil, or other investigational anti-inflammatory agents. Medication targeting the reduction of TNF-alpha (infliximab, golimumab, cetrolizumb pegol, etanercept), natalizumab, or other FDA approved biological agents may be administered up until to index surgery.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| AdalimumabAlso: HumiraSubcutaneous adalimumab injections, loading dose of 160 mg and 80 mg on 0 and 2 weeks and maintenance of 40 mg every other week for the duration of the study. | Drug | Adalimumab |
| 6 MercaptopurineAlso: Purinethol6MP will be administered orally starting at a dose of 6MP of 50mg/day with escalating doses every 1-2 weeks as tolerated, to a target dose of 1-1.5 mg/kg. -------------------------------------------------------------------------------- | Drug | 6-mercaptopurine |
Primary outcome
The proportion of patients with endoscopic recurrence at 12 months, as evaluated by the Rutgeerts endoscopic scoring system.
Time frame: 52 weeks
Primay outcome measure will assess the efficacy of adalimumab, compared to immunomodulator therapy in maintaining mucosal healing after 52 weeks (1 year).
1 secondary outcome
Proportion of patients in clinical remission at 12 months as assessed by the CDAI score.
Time frame: 52 weeks
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Jun 2012.
- Background: PubMed 19109962Regueiro M, Schraut W, Baidoo L, Kip KE, Sepulveda AR, Pesci M, Harrison J, Plevy SE. Infliximab prevents Crohn's disease recurrence after ileal resection. Gastroenterology. 2009 Feb;136(2):441-50.e1; quiz 716. doi: 10.1053/j.gastro.2008.10.051. Epub 2008 Oct 31.
- Derived from this study: PubMed 38137669Hirsch A, Scapa E, Fliss-Isakov N, Tulchinsky H, Itzkowitz E, Kariv Y, Ron Y, Yanai H, White I, Yassin S, Cohen NA, Brazovski E, Dotan I, Maharshak N. Early Initiation of Adalimumab Significantly Diminishes Postoperative Crohn's Disease Endoscopic Recurrence and Is Superior to 6-Mercaptopurine Therapy: An Open-Label, Randomized Controlled Study. J Clin Med. 2023 Dec 10;12(24):7600. doi: 10.3390/jcm12247600.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Erez F Scapa, M.D. principal investigator
Tel-Aviv Sourasky Medical Center, Affiliated to Tel-Aviv University
Iris Dotan, M.D. study director
Tel-Aviv Sourasky Medical Center, Affiliated to Tel-Aviv University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Adalimumab and 6 Mercaptopurine in people with Crohn Disease, run by Tel-Aviv Sourasky Medical Center at 1 site in Israel.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 16 inclusion and 20 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 27 Jun 2012. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Israel. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
Contact Erez F Scapa, M.D. (972-52-4266345, erezs@tasmc.health.gov.il), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
The proportion of patients with endoscopic recurrence at 12 months, as evaluated by the Rutgeerts endoscopic scoring system. (time frame: 52 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT01629628, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Jun 2012.