Approximately 3 million people in the United States are living with inflammatory bowel disease, which includes Crohn's Disease, with many of those being young children and adolescents. Physicians need better ways to inform decisions on treatment. The main reason for this research study is to determine if a computer program that formulates a dose based on a patient's blood testing results can better achieve the optimal drug level as compared to standard dosing.
This is a Pilot study to evaluate safety, feasibility and efficacy of utilizing pharmacokinetic modeling to provide an individualized infliximab induction regimen in children and young adults with moderate to severe Crohn's disease. This clinical study is designed with the hypothesis that treatment regimens that account for individual (patient) drug clearance (pharmacokinetic modeling) will not only be safe and cost-effective, but also more effective in reducing intestinal inflammation than as-labeled dosing (ALD) regimens.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
6
The RoadMAB Dashboard is a real-time decision support system that incorporates PK model-informed Bayesian estimation to provide precision dosing at the point of care.
The trial is testing whether precision dosing can more reliably achieve the targeted trough concentrations compared to standard dosing
Cincinnati Children's Hospital
Cincinnati, Ohio, United States
Obtain safety data for optimal dosing strategy and sample size estimation
Number of adverse and/or serious adverse events
Time frame: 2 years
Enrollment feasibility
Evaluate the rate of recruitment
Time frame: 2 years
Completion feasibility
Number of patients that complete the study
Time frame: 2 years
Rate of patient adherence to stool and blood sample collections
patient adherence to stool and blood sample collections
Time frame: 2 years
RoadMAB Usability
Evaluate rate of physician adherence to RoadMAB dosing recommendation
Time frame: 2 years
RoadMAB Efficacy
Rate of achieving infus3 (Visit 4) infliximab concentration between 16-24 μg/ml as a dichotomous outcome
Time frame: 2 years
Evaluate accuracy of infliximab concentration targets - Median difference infus3
Median difference of infus3 (Visit 4) levels between cases and controls
Time frame: 2 years
Evaluate accuracy of infliximab concentration targets - Incidence
Incidence of achieving infus2 (Visit 3) level between target range of 26-34 μg/ml as a dichotomous outcome
Time frame: 2 years
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Evaluate accuracy of infliximab concentration targets - Median difference infus2
Median difference of infus2 (Visit 3) levels between cases and controls
Time frame: 2 years
Evaluate accuracy of infliximab concentration targets - Maintenance
Rates of achieving maintenance targets infus4-6 (Visits 5-7) between 5-10 μg/ml
Time frame: 2 years
Evaluate accuracy of infliximab concentration targets
Rate of development of antiinfliximab antibodies at any infusion between cases and controls
Time frame: 2 years
Infus4 (Visit 5) and infus6 (Visit 7): Clinical Response
Improvement in baseline wPCDAI by \>17.5 or a wPCDAI\<12.5
Time frame: 2 years
Infus4 (Visit 5) and infus6 (Visit 7): Clinical Remission
wPCDAI \<12.5 and off corticosteroids
Time frame: 2 years
Sustained Remission
wPCDAI \<12.5 and off prednisone for all visits from infus4 (Visit 5) to infus6 (Visit 7)
Time frame: 2 years
Infus4 (Visit 5) and Infus6 (Visit 7): Fecal Biochemical Response
≥50% improvement in fecal calprotectin
Time frame: 2 years
Infus4 (Visit 5) and Infus6 (Visit 7): Fecal Biochemical Remission
fecal calprotectin \<250 μg/g
Time frame: 2 years
Infus6 (Visit 7): Rate of transmural ileal
ileum subscore stage 0 (score = 0)
Time frame: 2 years
Infus6 (Visit 7): Rate of colonic healing
all segments of colon subscore stage 0 (score = 0)
Time frame: 2 years
Infus6 (Visit 7): Rate of total bowel healing
total ileum and colonic subscore is not greater than stage 0 on either individual score
Time frame: 2 years