This study will compare two different dosing methods of azathioprine (IMURAN) in participants with Crohn's disease who are currently taking steroids (e.g. prednisone or budesonide)or who have just started steroids. The study can be up to 54 weeks long. All participants enrolled will receive active drug. Participants will take doses either based upon weight or based on the patient's ability to breakdown the drug (monitored by 6-thioguanine nucleotides (6-TGN) metabolite levels in the blood). All patients enrolled in the study will receive active study drug.
This multi-center, double blind (patients and doctors do not know treatment group assignment), randomized (patients are put in 1 of 2 groups) clinical trial which will compare two 52-week-long azathioprine(AZA) dosing methods. The patients enrolled will all be taking steroids (prednisone or budesonide)or have just been prescribed a steroid. The patients will be either in remission on steroids, but cannot taper off without a flare, patients who are on steroids and are still having Crohn's symptoms, or patients who need to start taking steroids. After a two week screening period, patients fitting enrollment criteria will be begin taking study drug. Patients will begin to taper steroids per a set schedule, and taper off steroids completely by week 13. Patients who need to go back on steroids because of returned symptoms are allowed to, per a set schedule in the protocol. Patients will have monthly visits that include physical exams, blood tests and a quality of life questionnaire. Patients will be required to keep a diary of abdominal pain, liquid or soft stools and general well being. After 6 months, only patients in remission (patients not on steroids, and not having active symptoms) will be allowed to continue for last 6 months of the study. Study visits during the last 6 months will be every 2 months, and include physical exams and blood tests, and a quality of life questionnaire. Patients in the study may receive dose changes, and this will require additional blood tests for safety.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
Cedars-Sinai Medical Center
Los Angeles, California, United States
Atlanta Gastroenterology Associates, LLC
Atlanta, Georgia, United States
Proportion of subjects achieving clinical remission at week #16.
For the steroid-dependent subjects, clinical remission was defined as complete withdrawal of corticosteroids, and Crohn's Disease Activity Index (CDAI) score \<150 in adults, or modified CDAI (mCDAI) score \<150 in children. For the steroid-refractory and the steroid-naıve subjects, clinical remission was defined as CDAI score \<150 (or mCDAI \<150 in children), and a reduction of at least 70 points from the baseline score (CDAI or mCDAI), and complete withdrawal of corticosteroids.
Time frame: 16 weeks
Proportion of subjects maintaining clinical remission at week #28
Time frame: 28 weeks
Proportion of subjects maintaining clinical remission at week #52
Time frame: 52 weeks
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QUADRUPLE
Enrollment
50
University of Chicago Pediatric Gastroenterology
Chicago, Illinois, United States
University of Chicago
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Duluth, Minnesota, United States
Mayo Clinic
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...and 5 more locations