PillCam® Platform With the PillCam Crohn's Disease Capsule

Phase 1

Completed

Conditions: Crohn's Disease

Interventions: Other: Pillcam colon capsule and PillCam™ Prep Procedure
Device: Ileocolonoscopy

Registration Number: NCT01631435

Lead Sponsor: Medtronic - MITG

Brief Summary: This is a prospective, multi-center (up to 6 sites) study which aims to To establish the effectiveness of the PillCam Platform with the PillCam Crohn's capsule as demonstrated by visualizing the small bowel and colon in patients with active symptoms associated with Crohn's disease (CD).

Detailed Description: This is a prospective, multi-center (up to 6 sites) study which aims to evaluate the diagnostic yield and safety of the PillCam Platform with the CD capsule in subjects with symptoms associated with Crohn's disease. All subjects to be enrolled in this study will have evidence of active symptoms associated with Crohn's disease. Each subject will be required to follow a bowel preparation regimen and will undergo the Crohn's Disease capsule endoscopy procedure and thereafter the ileocolonoscopy procedure on the same day. The ileocolonoscopy procedure may be done the following day per physician discretion. If the ileocolonoscopy procedure is done within 24 hours from the CE procedure, the subject will stay on clear liquid diet. Observations/ assessments to be conducted in the trial detailed in the sections below:

Visit 1; Screening visit

* Informed consent process

* screening for eligibility to participate in the study

* Inclusion/exclusion criteria

* Small bowel patency test

* Demographic data

* Pregnancy test

* General medical history

Visit 2; PillCam® Crohn's capsule ingestion

* PillCam® CD bowel preparation

* Capsule endoscopy Conventional ileocolonoscopy Examination (same day or within 24 hours)

* Ileocolonoscopy with intubation of terminal ileum

Follow up period (5-9 days following visit 2)

• CE Follow up telephone contac

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 75

Inclusion Criteria

Subject ages 18-75 years, inclusive
Subject has known CD and signs and symptoms of active disease including one of the following:
- Chronic diarrhea
- Chronic abdominal pain
- Rectal bleeding
Subject has at least one of the following within three months of enrollment:
- Positive inflammatory marker (ESR, CRP, thrombocytosis, leukocytosis, fecal lactoferrin, fecal alpha-1 antitrypsin)
- Anemia (hemoglobin level below normal reference range)
- Hypoalbuminemia (albumin below normal reference range)
- Weight loss
Proven patency by the Agile capsule or another approach deemed clinically acceptable by the investigator, e.g. CT enterography, performed within the 90 days prior to enrollment.
Subject agrees to sign consent form

Exclusion Criteria

Indeterminate Colitis
Ulcerative Colitis
Antibiotic Associated Colitis
Stool positive for Ova &Parasite and for Clostridium difficile toxin within 3 months of enrollment
Other known infectious cause of increased symptoms
Known history of intestinal obstruction or current obstructive symptoms, such as severe abdominal pain with accompanying nausea or vomiting, based on investigator judgment.
Definite long stricture seen on radiological exam.
Non-steroidal anti-inflammatory drugs including Aspirin, (twice weekly or more) during the 4 weeks preceding enrollment
Suspected GI stricture, followed by Pillcam Patency study or other imaging study that could not prove patency of the GI tract.
Subject has had prior abdominal surgery of the gastrointestinal tract in the last 6 months, other than uncomplicated procedures that would be unlikely to lead to bowel obstruction based on the clinical judgment of the investigator.
Subject is expected to undergo MRI examination within 7 days after ingestion of the capsule.
Subjects with known or suspected delayed gastric emptying
Subjects with known or suspected delayed Small bowel motility
Subject suffers from any condition, such as swallowing problems, which precludes compliance with study and/or device instructions.
Subject has Type I or Type II Diabetes.
Subject has any allergy or other known contraindication to the medications used in the study.
Subject has any condition, which precludes compliance with study and/or device instructions.
Women who are either pregnant or nursing at the time of screening, or are of child-bearing potential and do not practice medically acceptable methods of contraception.
Concurrent participation in another clinical trial using any investigational drug or device.
Subject suffers from a life threatening condition.
Subject with a history or clinical evidence of renal disease and/or previous clinically significant laboratory abnormalities of renal function parameters.

Study & Design

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
bowel prep regimen	Pillcam colon capsule and PillCam™ Prep Procedure	Each study subject will undergo a bowel preparation followed by a PillCam procedure.
bowel prep regimen	Ileocolonoscopy	Each study subject will undergo a bowel preparation followed by a PillCam procedure.

Primary Outcome Measures

Name	Time	Method
Per-subject Diagnostic Yield of the PillCam Platform With the CD Capsule Within the Terminal Ileum and Colon as Compared to the Ileocolonoscopy Diagnostic Yield Within the Terminal Ileum and Colon	All the end points and outcomes measures will be evaluated within 4 months from end of enrollment	the primary outcome will be evalluated as follow: The number of subjects having active Crohn's disease in their terminal ileum and / or colon as detected by the PillCam Platform with the CD capsule and ileocolonoscopy. The analysis related to the primary endpoint was applied for the terminal ileum and colon only due to the limited access of ileocolonoscopy. Each patient was classified as follows: * Active Crohn's disease is likely * Active Crohn's disease is NOT likely "Active Crohn's disease" included the followings lesions: * Aphthous ulceration * Ulcers (other than Aphthous) * Bleeding * Inflammatory stricture Lesions other than the above list were classified as "Non active Crohn's disease."