Predicting Response to Standardized Pediatric Colitis Therapy

Completed · Phase 4

Conditions studied: Ulcerative Colitis

In brief

This is a multi-center, open-label study to determine the safety and effectiveness (how well it works) of two standardized treatments called "mesalamine" (Pentasa®) and "prednisone" in children with newly diagnosed Ulcerative Colitis (UC). Standardized treatments are types of treatments agreed upon and used by many qualified doctors. The medications being used in this study are considered "standard of care". Currently the ways in which these medicines are used (doses, frequency of dosing) may vary from site to site. This study will determine response to a standardized way of giving these medicines. This study will also identify biomarkers for ulcerative colitis. Biomarkers are things that doctors can find in blood, stool, or bowel tissue that indicate how much inflammation there is in the bowel, how the inflammation is produced, and whether the inflammation is responding to treatment. Collecting response and remission (free of symptoms) information on these standardized treatments and the "biomarkers" can possibly help doctors create a model, or plan to know which children with UC may respond quickly, or which children may develop complications.

Key facts

Study ID

NCT01536535

Run by

Connecticut Children's Medical Center

People needed

431

Starts

2012-07-10

Expected to finish

2018-04-30

Last updated by the study team

2019-09-20

Who can join

Age: 4 and older, up to 17. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age ≥ 4years and ≤17 years at initiation of therapy (achieved 4th birthday, not yet 18th)
• Weight ≥15 kg
• New diagnosis of ulcerative colitis established by standard clinical, endoscopic, and histologic features at the PROTECT study site
• Colitis extending beyond the rectosigmoid (Paris classification E2, E3, or E4)[144]. If a patient is seriously ill and the clinician does not advance the colonoscope beyond the sigmoid colon but the clinical condition of the patient highly suggests more extensive disease then that patient is eligible for study.
• Disease activity by PUCAI of ≥10 at diagnosis
• No therapy previously initiated to treat the newly diagnosed ulcerative colitis
• Stool culture negative for routine enteric pathogens (Salmonella, Shigella, Campylobacter, E. coli 0157:H7) and Clostridium difficile toxin. Recent successful treatment for Clostridium difficile does not exclude a patient if toxin now absent. However, the patient must be a minimum of 5 weeks from the time treatment was started at the time toxin is absent.
• Stool study negative for enteric parasites (ova and parasites)
• Parent/guardian consent and patient assent
• Ability to remain in follow-up for a minimum of one year from diagnosis
• Female patients of child bearing age must have a negative urine pregnancy test and practice acceptable contraception (e.g., abstinence, intramuscular or hormonal contraception, two barrier methods (e.g., condom, diaphragm, or spermicide), intrauterine device, verbal report of the partner with history of vasectomy, or be surgically sterile). All female patients of childbearing potential (post-menarche) will undergo urine pregnancy testing at screening and must not be lactating.

You may not qualify if…

• Clinical, endoscopic, radiologic, or histologic evidence suggesting Crohn's disease (CD) consistent with Paris and North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) criteria [144, 145]
• A previous diagnosis of inflammatory bowel disease for which treatment was given
• Evidence of any active enteric infection at the time of study entry
• Use of any oral CS for non-gastrointestinal indication within the past 4 weeks (e.g., asthma). Use of inhaled CS does not exclude a patient.
• History of use of IM or anti-TNFα agent for other medical conditions (e.g., juvenile rheumatoid arthritis) within the past 6 months
• Use of Accutane within the past 4 weeks
• Use of any investigational drug within the past four weeks
• Use of any 5-aminosalicylate within the past 4 weeks
• Pregnancy
• Subjects with poorly controlled medical conditions (e.g. diabetes, congestive heart failure)
• Proctitis or proctosigmoiditis only (Paris classification E1) on colonoscopic evaluation
• Chronic renal disease (BUN and serum creatinine >1.5 times the upper normal limit)
• Hepatic disease (AST or Alkaline phosphatase (ALP) greater than 3 times the upper normal limit in the absence of concomitant liver disease associated with IBD following full evaluation)
• History of allergy or hypersensitivity to salicylates, aminosalicylates, or any component of the Pentasa capsule.
• History of coexisting chronic illness or evidence of significant organic or psychiatric disease on medical history or physical examination, which, in the Investigator's opinion, would prevent participation in the study
• History or presence of any condition causing malabsorption or an effect on gastrointestinal (GI) motility, or history of extensive small bowel resection (greater than half the length of the small intestine).
• The finding of Helicobacter pylori at the time of evaluation does not exclude the patient from the study. Whether to treat this patient for Helicobacter pylori and when will be left to the discretion of the site.

Where it is running

• UCLA Medical Center — Los Angeles, California, United States
• University of California at San Francisco — San Francisco, California, United States
• Connecticut Children's Medical Center — Hartford, Connecticut, United States
• Nemours Children's Clinic — Jacksonville, Florida, United States
• Emory Children's Center — Atlanta, Georgia, United States
• Ann & Robert H. Lurie Children's Hospital of Chicago — Chicago, Illinois, United States
• Riley Children's Hospital — Indianapolis, Indiana, United States
• John Hopkins Children's Hospital — Baltimore, Maryland, United States
• Children's Hospital of Boston — Boston, Massachusetts, United States
• University of Minnesota Medical Center — Minneapolis, Minnesota, United States
• Goryeb Children's Hospital / Atlantic Health — Morristown, New Jersey, United States
• Women and Children's Hospital of Buffalo — Buffalo, New York, United States
• Cohen Children's Medical Center — New Hyde Park, New York, United States
• Mt Sinai Hospital — New York, New York, United States
• Morgan Stanley Children's Hospital — New York, New York, United States
• Golisano Children's Hospital SUNY Upstate Medical University — Syracuse, New York, United States
• University of North Carolina at Chapel HIll — Chapel Hill, North Carolina, United States
• Cincinnati Children's Hospital Medical Center — Cincinnati, Ohio, United States
• Nationwide Children's Hospital — Columbus, Ohio, United States
• Children's Hospital of Philadelphia — Philadelphia, Pennsylvania, United States
• Children's Hospital of Pittsburgh of UPMC — Pittsburgh, Pennsylvania, United States
• Hasbro Children's Hospital — Providence, Rhode Island, United States
• Monroe Carell Jr. Children's Hospital at Vanderbilt — Nashville, Tennessee, United States
• UT Southwestern — Dallas, Texas, United States
• Primary Children's Medical Center (University of Utah) — Salt Lake City, Utah, United States

Full record on ClinicalTrials.gov

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