Crohn DiseaseCRIANCT04944797
Crohn and Anal Incontinence
An observational study of Crohn Disease, run by Fondation Hôpital Saint-Joseph.
Trial summary
Anal incontinence affects nearly 5% of the adult population in France. It is defined as the inability for a subject to retain matter and/or gas, outside of voluntary defecation episodes. It results in an uncontrolled loss of gas or stool through the anus. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Crohn Disease
- How many people
- 0 participants
- Where
- No sites listed yet
- Study dates
- 30 Mar 2022to 30 Mar 2022
- Phase
- Observational
- 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 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: The study will be offered to consecutively selected patients who meet the eligibility criteria. These patients will be seen in one of the two study centers (gastroenterology and proctology departments at GHPSJ or gastroenterology department at Louis Mourier Hospital): * either in day hospital to carry out their treatment (infliximab, adalimumab, vedolizumab, ustekinumab, intravenous iron) * or in consultation for their classic follow-up.
Who may be able to join
- Patient whose age ≥ 18 years
- French-speaking patient
- Patient followed for Crohn's disease in one of the participating centers (gastroenterology or proctology departments of the Paris-Saint Joseph Hospital Group, gastroenterology department of the Louis Mourier Hospital). The diagnosis of Crohn's disease is based on clinical, endoscopic, radiological and histological criteria.
Who cannot join
- Patient with a functional stoma
- Patient who objects to participation in the study
- Patient under guardianship or curatorship
- Patient deprived of liberty
- Patient under court protection
About this study
Official title: Prevalence, Risk Factors and Impact of Anal Incontinence in Patients Followed for Crohn's Disease
Anal incontinence affects nearly 5% of the adult population in France. It is defined as the inability for a subject to retain matter and/or gas, outside of voluntary defecation episodes. It results in an uncontrolled loss of gas or stool through the anus. To quantify, anal incontinence clinical scores have been developed of which the most used is the Cleveland score (Jorge and Wexner). A Cleveland score ≥ 5 corresponds to anal incontinence.
Crohn's disease is a chronic inflammatory disease that can affect the entire digestive tract as well as the anus. It leads to destruction of the intestinal wall if not treated early.
Read more
The presence of ano-perineal involvement is a factor of severity and poor prognosis of Crohn's disease. The management of these ano-perineal lesions is particularly difficult because of the risks of destruction of the anal sphincter and recurrence of these lesions, as well as the consequences that they induce on anal continence, sexuality and quality of life.
The prevalence of anal incontinence in Crohn's disease has been assessed in three studies by self-questionnaires. In 2013, it was studied in a cohort of British patients followed for chronic inflammatory bowel disease (IBD) (Hemorrhagic rectocolitis or Crohn's disease). Of the 3264 patients who responded to this questionnaire (32.5% of the cohort), 74% claimed to have anal incontinence and in 40% of cases it occurred regularly or a few times. In a study of 184 patients treated at an IBD expert center in Sri Lanka, anal incontinence was reported to be 26%. Only 5 patients reported regular anal incontinence. Vollebregt et al specifically studied the prevalence of anal incontinence in patients followed for Crohn's disease in a Dutch expert center. Of the 325 responses (62%), 20% of patients reported having had an episode of anal incontinence in the last 4 weeks.
In these studies, the prevalence of anal incontinence varies according to the definition of anal incontinence (qualitative or quantitative estimate) and the population studied. No French study has been published on the prevalence of anal incontinence in Crohn's disease.
Read the detailed description
Many risk factors for anal incontinence have been identified in the general population. In IBD, the risk factors associated with anal incontinence are gender, age, a history of anal stenosis, a history of anal fistula surgery, and a history of colorectal surgery. There is currently only one study that has identified risk factors for anal incontinence specific to Crohn's disease. In this study, the risk factors for anal incontinence were loose stools, a history of colonic or bowel resection related to Crohn's disease, a stenosing phenotype of Crohn's disease, and ano-perineal involvement in Crohn's disease.
The impact of anal incontinence on quality of life is major. Numerous trials show that this handicap is underestimated because of its shameful, embarrassing and intimate nature. The deterioration of quality of life, evaluated by the Inflammatory Bowel Disease Questionnaire (IBDQ) or Fecal Incontinence Quality-of-Life (FIQL) scores, is associated with the severity of anal incontinence in IBD. It is significantly degraded when there are several.
episodes of weekly anal incontinence in patients followed for Crohn's disease. Only one study compared the quality of life of patients with ano-perineal involvement related to Crohn's disease with that of patients with only colonic or intestinal involvement. A significant deterioration in quality of life was reported in those with anoperineal involvement related to Crohn's disease.
One of the therapeutic targets to be achieved in Crohn's disease is the "patient related outcomes" (PRO), i.e. the functional handicap secondary to the disease that is reported by the patient. Anal incontinence is one of the disabilities related to Crohn's disease. The aim of treatment is to stop the handicap and thus to improve the quality of life.
The aim of this study is to evaluate the prevalence, risk factors and impact on quality of life of anal incontinence in a French cohort of patients with Crohn's disease.
- Conditions
- Crohn Disease
- Medical subject headings
- Crohn Disease
What is being measured
The primary outcome is the main question the study is designed to answer.
Determine the prevalence of anal incontinence in patients with Crohn's disease at expert gastroenterology and proctology centers in France. Anal incontinence is defined by a Cleveland or Jorge and Wexner score ≥ 5
Percentage of patients with Crohn's disease with a Cleveland or Jorge and Wexner score ≥ 5
Measured: Day 1
Secondary outcomes (5)
Compare the prevalence of anal incontinence in patients followed for Crohn's disease on gastroenterology services versus patients followed for ano-perineal involvement in Crohn's disease on a proctology service.
Percentages of patients followed for Crohn's disease in gastroenterology departments (Paris Saint-Joseph Hospital Group and Louis Mourier Hospital) with a Jorge and Wexner score ≥ 5 versus patients followed for ano-perineal involvement of Crohn's disease in a proctology department (Paris Saint-Joseph Hospital Group) with a Jorge and Wexner score ≥ 5
Measured: Day 1
Determine independent risk factors for anal incontinence in Crohn's disease regardless of Crohn's disease location
Analysis of risk factors for anal incontinence
Measured: Day 1
Compare the quality of life of patients with anal incontinence vs. patients without anal incontinence with Crohn's disease
Difference in medians of FIQL quality of life score in patients with anal incontinence vs. patients without anal incontinence with Crohn's disease
Measured: Day 1
Compare the quality of life of patients followed for Crohn's disease on gastroenterology services with anal incontinence versus patients followed for ano-perineal involvement of Crohn's disease on a proctology service with anal incontinence
Difference between the medians of the FIQL quality of life score in patients followed up for Crohn's disease in gastroenterology departments (Groupe hospitalier Paris Saint-Joseph and Hôpital Louis Mourier) and presenting anal incontinence compared to patients followed up for ano-perineal involvement of Crohn's disease in a proctology department (Groupe hospitalier Paris Saint-Joseph) and presenting anal incontinence
Measured: Day 1
Compare the quality of life of patients with anoperineal involvement in Crohn's disease and anal incontinence versus patients with exclusive luminal involvement in Crohn's disease and anal incontinence
Difference in medians of FIQL quality of life score in patients with anoperineal involvement of Crohn's disease and anal incontinence vs. patients with exclusive luminal involvement of Crohn's disease and anal incontinence
Measured: Day 1
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted30 Jun 2021
- Study start30 Mar 2022
- Primary completion30 Mar 2022
- Study completion30 Mar 2022
Why it stopped: The project was abandoned.
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Crohn DiseaseStudies of the same condition, open and under way.
- 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
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 0 participants (actual)
Sponsor and investigators
- Lead sponsor
- Fondation Hôpital Saint-Joseph
- Sponsor type
- University, hospital or other
- Collaborators
- Hôpital Louis Mourier
- Responsible party
- Sponsor
- Investigators
- Vincent de Parades, MD, Principal investigator, Fondation Hôpital Saint-Joseph
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04944797
- Sponsor's protocol ID
- CRIA
- Acronym
- CRIA
- Status last verified
- Mar 2022
- First submitted
- 15 Jun 2021
- Last updated
- 7 Apr 2022
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 7 Apr 2022. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Prevalence, Risk Factors and Impact of Anal Incontinence in Patients Followed for Crohn's Disease
- ClinicalTrials.gov ID
- NCT04944797
- Acronym / sponsor ID
- CRIA / CRIA
- Conditions
- Crohn Disease
- Study type
- Observational
- Recruitment status
- WithdrawnReason stopped: The project was abandoned.
- Enrolment
- 0 participants (actual)
- Lead sponsor
- Fondation Hôpital Saint-JosephUniversity, hospital or other
- Collaborators
- Hôpital Louis Mourier
- Study start
- 30 Mar 2022 (actual)
- Primary completion
- 30 Mar 2022 (actual)
- Study completion
- 30 Mar 2022 (actual)
- First posted
- 30 Jun 2021 (actual)
- 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.
Anal incontinence affects nearly 5% of the adult population in France. It is defined as the inability for a subject to retain matter and/or gas, outside of voluntary defecation episodes. It results in an uncontrolled loss of gas or stool through the anus. To quantify, anal incontinence clinical scores have been developed of which the most used is the Cleveland score (Jorge and Wexner). A Cleveland score ≥ 5 corresponds to anal incontinence.
Crohn's disease is a chronic inflammatory disease that can affect the entire digestive tract as well as the anus. It leads to destruction of the intestinal wall if not treated early.
The presence of ano-perineal involvement is a factor of severity and poor prognosis of Crohn's disease. The management of these ano-perineal lesions is particularly difficult because of the risks of destruction of the anal sphincter and recurrence of these lesions, as well as the consequences that they induce on anal continence, sexuality and quality of life.
The prevalence of anal incontinence in Crohn's disease has been assessed in three studies by self-questionnaires. In 2013, it was studied in a cohort of British patients followed for chronic inflammatory bowel disease (IBD) (Hemorrhagic rectocolitis or Crohn's disease). Of the 3264 patients who responded to this questionnaire (32.5% of the cohort), 74% claimed to have anal incontinence and in 40% of cases it occurred regularly or a few times. In a study of 184 patients treated at an IBD expert center in Sri Lanka, anal incontinence was reported to be 26%. Only 5 patients reported regular anal incontinence. Vollebregt et al specifically studied the prevalence of anal incontinence in patients followed for Crohn's disease in a Dutch expert center. Of the 325 responses (62%), 20% of patients reported having had an episode of anal incontinence in the last 4 weeks.
In these studies, the prevalence of anal incontinence varies according to the definition of anal incontinence (qualitative or quantitative estimate) and the population studied. No French study has been published on the prevalence of anal incontinence in Crohn's disease.
Detailed description
Many risk factors for anal incontinence have been identified in the general population. In IBD, the risk factors associated with anal incontinence are gender, age, a history of anal stenosis, a history of anal fistula surgery, and a history of colorectal surgery. There is currently only one study that has identified risk factors for anal incontinence specific to Crohn's disease. In this study, the risk factors for anal incontinence were loose stools, a history of colonic or bowel resection related to Crohn's disease, a stenosing phenotype of Crohn's disease, and ano-perineal involvement in Crohn's disease.
The impact of anal incontinence on quality of life is major. Numerous trials show that this handicap is underestimated because of its shameful, embarrassing and intimate nature. The deterioration of quality of life, evaluated by the Inflammatory Bowel Disease Questionnaire (IBDQ) or Fecal Incontinence Quality-of-Life (FIQL) scores, is associated with the severity of anal incontinence in IBD. It is significantly degraded when there are several.
episodes of weekly anal incontinence in patients followed for Crohn's disease. Only one study compared the quality of life of patients with ano-perineal involvement related to Crohn's disease with that of patients with only colonic or intestinal involvement. A significant deterioration in quality of life was reported in those with anoperineal involvement related to Crohn's disease.
One of the therapeutic targets to be achieved in Crohn's disease is the "patient related outcomes" (PRO), i.e. the functional handicap secondary to the disease that is reported by the patient. Anal incontinence is one of the disabilities related to Crohn's disease. The aim of treatment is to stop the handicap and thus to improve the quality of life.
The aim of this study is to evaluate the prevalence, risk factors and impact on quality of life of anal incontinence in a French cohort of patients with Crohn's disease.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- The study will be offered to consecutively selected patients who meet the eligibility criteria. These patients will be seen in one of the two study centers (gastroenterology and proctology departments at GHPSJ or gastroenterology department at Louis Mourier Hospital): * either in day hospital to carry out their treatment (infliximab, adalimumab, vedolizumab, ustekinumab, intravenous iron) * or in consultation for their classic follow-up.
Key inclusion criteria (3 listed)
- Patient whose age ≥ 18 years
- French-speaking patient
- Patient followed for Crohn's disease in one of the participating centers (gastroenterology or proctology departments of the Paris-Saint Joseph Hospital Group, gastroenterology department of the Louis Mourier Hospital). The diagnosis of Crohn's disease is based on clinical, endoscopic, radiological and histological criteria.
Key exclusion criteria (5 listed)
- Patient with a functional stoma
- Patient who objects to participation in the study
- Patient under guardianship or curatorship
- Patient deprived of liberty
- Patient under court protection
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Determine the prevalence of anal incontinence in patients with Crohn's disease at expert gastroenterology and proctology centers in France. Anal incontinence is defined by a Cleveland or Jorge and Wexner score ≥ 5
Time frame: Day 1
Percentage of patients with Crohn's disease with a Cleveland or Jorge and Wexner score ≥ 5
5 secondary outcomes
Compare the prevalence of anal incontinence in patients followed for Crohn's disease on gastroenterology services versus patients followed for ano-perineal involvement in Crohn's disease on a proctology service.
Time frame: Day 1
Determine independent risk factors for anal incontinence in Crohn's disease regardless of Crohn's disease location
Time frame: Day 1
Compare the quality of life of patients with anal incontinence vs. patients without anal incontinence with Crohn's disease
Time frame: Day 1
Compare the quality of life of patients followed for Crohn's disease on gastroenterology services with anal incontinence versus patients followed for ano-perineal involvement of Crohn's disease on a proctology service with anal incontinence
Time frame: Day 1
Compare the quality of life of patients with anoperineal involvement in Crohn's disease and anal incontinence versus patients with exclusive luminal involvement in Crohn's disease and anal incontinence
Time frame: Day 1
Results and safety
The study was withdrawn before enrolling participants, so there are no results.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 7 Apr 2022.
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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.
Vincent de Parades, MD principal investigator
Fondation Hôpital Saint-Joseph
Questions about this trial
What is this clinical trial studying?
An observational study of Crohn Disease, run by Fondation Hôpital Saint-Joseph.
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 3 inclusion and 5 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: withdrawn, as of the sponsor's last update on 7 Apr 2022. Status can change between updates, so confirm with the study contact before making plans.
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.
Are results available for this study?
The study was withdrawn before enrolling participants, so there are no results.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Determine the prevalence of anal incontinence in patients with Crohn's disease at expert gastroenterology and proctology centers in France. Anal incontinence is defined by a Cleveland or Jorge and Wexner score ≥ 5 (time frame: Day 1). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
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 7 Apr 2022.