RecruitingPhase 2 / Phase 3

Precise Infliximab Exposure and Pharmacodynamic Control

Precise Infliximab Exposure and Pharmacodynamic Control to Achieve Deep Remission in Pediatric Crohn's Disease

Who can join

As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.

Age
6 Years to 22 Years
Sex
All sexes
Healthy volunteers
Not accepted
Compensation
Not stated

Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.

What to expect

No one can promise a trial will help you personally — that is what the research is trying to find out.

What participation involves

Not stated in the study description — ask the study team about visits and procedures.

Compensation
Not stated
  • Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
  • Participants are monitored closely by the research team throughout the study.
  • Some participants may receive access to an investigational treatment, which is still being studied.
  • Your participation helps researchers learn whether this approach could help future patients.

About this study

In plain language

This study tests whether a computer program can choose an infliximab dose based on blood test results that works better than standard dosing. It is for people ages 6 to 22 who were recently diagnosed with Crohn’s disease and are starting infliximab.

Approximately 3 million people in the United States are living with inflammatory bowel disease, which includes Crohn's Disease (CD). There are limited treatment options approved for use in children and adults with Crohn's disease. Physicians need better ways to inform decisions on treatment. The main reason for this research study is to determine if a computer program that calculates an individualized dose based on a patient's blood testing results (precision dosing) can better achieve the best possible response to infliximab compared to standard dosing (conventional dosing).

Compensation is read from the study's own description and may be missing — always confirm with the study team.

Eligibility

Who can join

  • Be 6 to 22 years old and starting infliximab. You must not have used an anti-TNF medicine, a type of drug that lowers inflammation.
  • Have Crohn’s disease diagnosed within the past 90 days, affecting the inside of the bowel.
  • If you have an abnormal tunnel or pocket of pus near the anus, it must have been treated with antibiotics for at least 7 days.
  • Have active Crohn’s symptoms and bowel inflammation that meet the study’s rules on recent symptom scores, bowel exams, or stool tests.
  • Have a blood inflammation test called CRP above 1.0 mg/dL in the past 30 days, or a stool inflammation test called calprotectin above 250 μg/g in the past 75 days.
  • Have a negative blood test for tuberculosis (TB). Female patients whose periods have started must also have a negative urine pregnancy test.
  • Give written consent if age 18 or older. For younger patients, a parent or legal guardian must give consent, and the patient must agree in writing when old enough.

Who can't join

  • Have ulcerative colitis or bowel inflammation without a clear type, or have used an anti-TNF medicine before.
  • Have had an abnormal tunnel, pocket of pus, or inflamed lump inside the belly or pelvis in the past 180 days. A current pocket of pus near the anus treated with antibiotics for less than 7 days also rules you out.
  • Have bowel narrowing with swelling before it and surgery planned within 90 days; any Crohn’s surgery planned within 90 days; a bowel opening through the belly or an internal stool pouch; or more than 35 cm of small bowel removed.
  • Are in the hospital for severe Crohn’s problems, or tested positive for a bowel infection within 14 days of screening unless a repeat test is negative and no signs of that infection remain.
  • Plan to take methotrexate, 6-mercaptopurine, or azathioprine during the first 3 infliximab doses, or took another study drug in the past 4 weeks.
  • Have a history of cancer; immune-related liver, bile duct, or thyroid disease; childhood arthritis; TB; HIV; a weak immune system disorder; a disease that damages the protective covering of nerves in the brain or spinal cord; or heart failure.
  • Are being treated for histoplasmosis, a fungal infection, or received antibiotics through a vein for any infection in the past 14 days.
  • Are pregnant, breastfeeding, or planning pregnancy within 1 year; cannot or do not give the required consent or agreement; or have a developmental disability that prevents giving it.

Simplified for readability. The official criteria below are what the study team uses.

Official eligibility criteria

Inclusion Criteria: 1. Written informed consent from the patient (≥18 years old) or from parent/legal guardian if patient is \<18 years old 2. Written informed assent from patient when age appropriate 3. Diagnosis of Crohn's disease within the last 90 days (luminal-only or luminal with a perianal fistula or abscess treated with antibiotics for at least 7 days) 4. ≥6 years to ≤22 years of age, anti-TNF naïve and starting infliximab 5. Clinical activity and luminal inflammation, defined by both (1) and (2) * (1) PCDAI≥10 (\<18 years old) or CDAI ≥150 (≥18 years old) in last 60 days before the decision to start infliximab * (2) SES-CD\>6, or SES-CD\>3 for isolated ileal disease (or a report of large intestinal ulcerations)\* within the last 60 days or a fecal calprotectin \>250 μg/g within last 75 days prior to screening 6. C-reactive protein \>1.0 mg/dL in last 30 days and/or fecal calprotectin \>250 μg/g within last 75 days prior to screening 7. Negative TB (tuberculosis) interferon-gamma release test and a negative urine pregnancy test for female patients (if menstruation has started) Exclusion Criteria: 1. Diagnosis of ulcerative colitis or inflammatory bowel disease-unspecified 2. Prior use of anti-TNF therapy (infliximab, adalimumab, certolizumab pegol, or golimumab) 3. Internal (abdominal/pelvic) penetrating fistula(e) in last 180 days 4. Intra-abdominal abscess/phlegmon/inflammatory mass in the last 180 days 5. Active perianal abscess (receiving oral antibiotics for \<7 days) 6. Intestinal stricture (luminal narrowing with pre-stenotic dilation \>3 cm) and surgery planned in the next 90 days 7. Have tested positive for Clostridium difficile toxin (stool assay) or other intestinal pathogens within 14 days of screening unless a repeat examination is negative and there are no signs of ongoing infection with that pathogen. 8. Current hospitalization for complications of severe Crohn's disease 9. Planned use of methotrexate or 6-mercaptopurine (azathioprine) during the induction (first 3 doses of infliximab) phase 10. Current ileostomy, colostomy, ileoanal pouch, and/or previous extensive small bowel resection (\>35 cm) or any CD surgery planned within the next 90 days 11. History of autoimmune hepatitis, primary sclerosing cholangitis, thyroiditis, or juvenile idiopathic arthritis 12. Treatment with another investigational drug in the last four weeks 13. History of malignancy (including lymphoma or leukemia) 14. Currently receiving treatment for histoplasmosis 15. History of TB, human immunodeficiency virus (HIV), an immunodeficiency syndrome, a central nervous system demyelinating disease, history of heart failure or receiving intravenous antibiotics in last 14 days for any infection 16. Currently pregnant, breast feeding or plans to become pregnant in the next 1 year 17. Inability or failure to provide informed assent/consent 18. Any developmental disabilities that would impede providing assent/consent

Study sites (11)

CA

  • Children's Hospital of Los Angeles · Los Angeles, CA 90027Mallory Chavannes · Study contactMallory Chavannes, MD · Principal investigatorMore trials in Los Angeles
  • Lucile Packard Children's Hospital Stanford · Palo Alto, CA 94304Alka Goyal · Study contactAlka Goyal, MD · Principal investigatorMore trials in Palo Alto
  • Rady Children's Hospital San Diego · San Diego, CA 92123Laura Bauman · Study contactLaura Bauman, MD · Principal investigatorMore trials in San Diego

DE

  • Nemours Children's Health System-Wilmington · Wilmington, DE 19803Zarela Molle-Rios · Study contactZarela Molle-Rios, MD · Principal investigatorMore trials in Wilmington

FL

  • Nemours Children's Health System-Jacksonville · Jacksonville, FL 32207Jill Dorsey · Study contactJill Dorsey, MD · Principal investigatorMore trials in Jacksonville

IN

  • Riley Hospital for Children · Indianapolis, IN 46202Steven Steiner · Study contactSteven Steiner, MD · Principal investigatorMore trials in Indianapolis

OH

  • Cincinnati Children's Hospital · Cincinnati, OH 45229Kimberly Jackson · Study contact · kimberly.jackson@cchmc.orgPhillip Minar, MD, MS · Principal investigatorMore trials in Cincinnati
  • Cleveland Clinic Children's Hospital · Cleveland, OH 44106Jacob Kurowski · Study contactJacob Kurowski, MD · Principal investigatorMore trials in Cleveland
  • Nationwide Children's Hospital · Columbus, OH 43205Brendan Boyle · Study contactBrendan Boyle · Principal investigatorMore trials in Columbus

VA

WI

  • Medical College of Wisconsin, Children's of Wisconsin · Milwaukee, WI 53226Joshua Noe · Study contactJoshua Noe, MD · Principal investigatorMore trials in Milwaukee