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The Efficacy of Open Label Infliximab for the Induction and Maintenance of Mucosal Healing in Small Bowel Crohn's Disease Assessed Through Wireless Camera Endoscopy

Phase 4
Completed
Conditions
Crohn's Disease
Interventions
Biological: Infliximab 5 mg/kg body weight infused over 2 hours
Registration Number
NCT01181765
Lead Sponsor
Janssen Inc.
Brief Summary

This is a pilot study to estimate the efficacy of infliximab in inducing and maintaining healing of lesions in the mucosa of subjects with Crohn's disease involving their small bowel.

Detailed Description

Landmark trials in Crohn's disease demonstrated the efficacy of infliximab in inducing and maintaining clinical remission. Furthermore, the endoscopic sub-studies within these trials demonstrated the ability of infliximab to rapidly induce and maintain mucosal healing as evidenced by the complete absence of mucosal breaks in the colon and terminal ileum. Unfortunately, conventional colonoscopy does not allow intestinal exploration beyond a very restricted portion of the small bowel (at most 10-15 cm of the terminal ileum). A study that systematically examines the changes in the small bowel mucosa during Crohn's disease symptomatic improvement is clearly needed.

This study consists of 20 subjects and 30 weeks of follow up. All subjects will undergo wireless camera endoscopy at three (3) visits, namely: at Screening, at Week 10 and at Week 26. Infliximab is administered at (5) visits, namely: at Baseline (week 0), Week 2, Week 6, Week 14 and Week 22. In some subjects, an ileal-colonoscopy may be performed at Week 26.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1
Inclusion Criteria
  • 18 years old
  • Established diagnosis of Crohn's disease and evidence of small bowel involvement
  • CDAI score between 220 and 450 inclusively
  • Lewis score of at least 790 at Screening
  • Colonoscopy within the last 6 months
  • Successful excretion of the intact patency capsule Exclusion Criteria
  • Contraindications to anti-TNF therapy (TB, cardiac impairment, etc.)
  • Prior bowel resection
  • Prior anti-TNF exposure
Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Infliximab infusions (5 mg/kg) at weeks 0, 2, 6, 14 and 22Infliximab 5 mg/kg body weight infused over 2 hours-
Primary Outcome Measures
NameTimeMethod
Endoscopic ImprovementWeek 26

Mean change in Lewis score between Baseline and Week 26

Secondary Outcome Measures
NameTimeMethod
Clinical improvementWeek 26

Mean change in Crohn's Disease Activity Index (CDAI) between Baseline and Week 26.

Early endoscopic improvementWeek 10

Mean change in Lewis score between Baseline and Week 10

Clinical ImprovementWeek 10

Mean change in CDAI between Baseline and Week 10

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