Proactive Infliximab Optimization Using a Pharmacokinetic Dashboard Versus Standard of Care in Patients With Inflammatory Bowel Disease: The OPTIMIZE Trial

Running, not enrolling · Phase 4

Conditions studied: Crohn Disease, Ulcerative Colitis, Inflammatory Bowel Diseases

In brief

The OPTIMIZE Trial compares whether iDose dashboard-driven infliximab dosing (iDose-driven dosing) is more effective and safer than standard infliximab dosing for inducing and maintaining disease remission in inflammatory bowel disease.

Key facts

Study ID

NCT04835506

Run by

Beth Israel Deaconess Medical Center

People needed

124

Starts

2021-11-01

Expected to finish

2026-09-01

Last updated by the study team

2026-03-05

Who can join

Age: 16 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Males or nonpregnant, nonlactating females aged 16 to 80 years inclusive.
• Diagnosis of IBD prior to screening using standard endoscopic, histologic, or radiologic criteria. Participants with patchy colonic inflammation initially diagnosed as indeterminate colitis would meet inclusion criteria, if the investigator feels that the findings are consistent with CD or UC. Enrollment of participants with UC will be capped at 49% of the planned study population (maximum 61 participants).
• Moderately to severely active IBD, defined by a total CDAI score between 220 and 450 points for CD or a partial Mayo Score (PMS) > 4 for UC (including a rectal bleeding subscore [RBS] ≥ 1), and at least 1 of the following:
• Elevated CRP (> upper limit of normal)
• Elevated FC (> 250 μg/g)
• SES-CD > 6 (SES-CD > 3 for isolated ileal disease) for CD only and a Mayo endoscopic subscore (MES) ≥ 2 for UC only.
• Physician intends to prescribe IFX as part of the usual care of the subject.
• No previous use of IFX prior to enrolment in the current study, unless the participant received 1 prior dose of IFX (within 2.5 weeks of enrolment) and met all eligibility criteria at the time of starting IFX and IFX was administered according to the requirements outlined in this protocol
• Able to participate fully in all aspects of this clinical trial.
• Written informed consent must be obtained and documented.

You may not qualify if…

• Participants with any of the following IBD-related complications:
• Abdominal or pelvic abscess, including perianal
• Presence of stoma, ileal pouch-anal anastomosis, or ostomy
• Isolated perianal disease
• Obstructive disease, such as obstructive stricture
• Short gut syndrome
• Toxic megacolon or any other complications that might require surgery, or any other manifestation that precludes or confounds the assessment of disease activity (CDAI or SES-CD for CD or PMS, PRO2, or MES for UC)
• Total colectomy.
• History or current diagnosis of ulcerative proctitis (UC extending < 15 cm from the anal verge), acute severe (fulminant) UC, hospitalised IV steroid-refractory UC, indeterminate colitis, microscopic colitis, ischemic colitis, colonic mucosal dysplasia, or untreated bile acid malabsorption.
• Current bacterial or parasitic pathogenic enteric infection, according to SOC assessments, including: Clostridioides difficile; tuberculosis; known infection with hepatitis B or C virus; known infection with HIV; sepsis; abscesses. History of the following: opportunistic infection within 6 months prior to screening; any infection requiring antimicrobial therapy within 2 weeks prior to screening; more than 1 episode of herpes zoster or any episode of disseminated zoster; any other infection requiring hospitalization or intravenous antimicrobial therapy within 4 weeks prior to screening.
• Has any malignancy or lymphoproliferative disorder other than nonmelanoma cutaneous malignancies or cervical carcinoma in situ that has been treated with no evidence of recurrence within the last 5 years.
• Known primary or secondary immunodeficiency.
• PNR to adalimumab, defined as no objective evidence of clinical benefit after 14 weeks of therapy.
• Subjects with failure to a prior biologic, defined as PNR or SLR, will be excluded when a maximum of 40% of the planned enrollment (approximately 78 subjects) have failure to prior biologic exposure.
• Concomitant use of oral corticosteroid therapy exceeding prednisone 40 mg/day, budesonide 9 mg/day, or equivalent, unless a tapering schedule is initiated with a plan to be off CS by Week 14
• Presence of any medical condition or use of any medication that is a contraindication for IFX use, as outlined on the product label.
• A concurrent clinically significant, serious, unstable, or uncontrolled underlying cardiovascular, pulmonary, hepatic, renal, GI, genitourinary, hematological, coagulation, immunological, endocrine/metabolic, or other medical disorder that, in the opinion of the investigator, might confound the study results, pose additional risk to the subject, or interfere with the subject's ability to participate fully in the study.
• Pregnant or lactating women, to be excluded based on the physician's usual practice for determining pregnancy or lactation status.
• Known intolerance or hypersensitivity to IFX or other murine proteins.

Where it is running

• Yale University School of Medicine — New Haven, Connecticut, United States
• University of Miami — Miami, Florida, United States
• University of Chicago Medicine — Chicago, Illinois, United States
• Northwestern University — Evanston, Illinois, United States
• Rockford GI — Rockford, Illinois, United States
• University of Maryland Medical Center — Baltimore, Maryland, United States
• Boston Children's Hospital — Boston, Massachusetts, United States
• Beth Israel Deaconess Medical Center — Boston, Massachusetts, United States
• Lahey Hospital and Medical Center — Burlington, Massachusetts, United States
• University of Minnesota — Minneapolis, Minnesota, United States
• Dartmouth-Hitchcock Medical Center — Lebanon, New Hampshire, United States
• NYU Langone Health — New York, New York, United States
• Icahn School of Medicine at Mount Sinai — New York, New York, United States
• Weill Cornell Medical College — New York, New York, United States
• Atrium Health Center for Digestive Health — Charlotte, North Carolina, United States
• Cleveland Clinic — Cleveland, Ohio, United States
• Children's Hospital of Philadelphia — Philadelphia, Pennsylvania, United States
• LifeSpan Brown University — Providence, Rhode Island, United States
• Medical University of South Carolina — Charleston, South Carolina, United States
• Vanderbilt University Medical Center — Nashville, Tennessee, United States
• University of Texas Southwestern Medical Center — Dallas, Texas, United States
• University of Utah — Salt Lake City, Utah, United States
• Medical College of Wisconsin — Milwaukee, Wisconsin, United States
• London Health Sciences Centre - Children's Hospital — London, Canada
• McGill University Health Centre (MUHC) Montreal General Hospital — Montreal, Canada

Full record on ClinicalTrials.gov

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