RecruitingPhase 2NCT05599347

Pre-treatment With Azithromycin to Reduce Immunogenicity to to Anti-TNF Agents in Patients With Crohn's Disease

Pre-treatment With Azithromycin to Reduce Immunogenicity to Anti-Tumor Necrosis Factor-α Agents in Patients With Crohn's Disease


Sponsor

Rambam Health Care Campus

Enrollment

180 participants

Start Date

Apr 24, 2023

Study Type

INTERVENTIONAL

Conditions

Summary

This is a randomized placebo-controlled trial in Crohn's disease patients before initiation of anti-tumor necrosis factor-α (anti-TNF) therapy that aims to test the effect of a pre-treatment short course of azithromycin therapy on immunogenicity


Eligibility

Min Age: 18 Years

Inclusion Criteria5

  • Ability to provide written informed consent prior to any study procedures and willing and able to attend all study visits, comply with the study procedures, read and write in order to complete questionnaires, and be able to complete the study period.
  • Aged 18 to 80 years of age, inclusive, at the time of signing the informed consent.
  • Diagnosis of CD with an onset of symptoms for a minimum of 3 months prior to Screening as determined by the investigator based on clinical history, exclusion of infectious causes, and characteristic endoscopic and histologic findings.
  • Prior decision of starting infliximab or adalimumab therapy (including biosimilar drugs).
  • Thiopurine and corticosteroid co-therapy will be permitted.

Exclusion Criteria17

  • Inclusion in another interventional study
  • Patients who cannot provide informed consent and do not have a legal guardian
  • Patients with perianal involvement who are expected to require antibiotic therapy for their disease
  • Patients on chronic antibiotic therapy due to any cause
  • Patients with ongoing fluid collection/abscess either internal or perianal
  • Known history of allergy to the study intervention formulation or any of its excipients or components of the delivery device
  • Prolonged QTc interval or conditions leading to additional risk for QT prolongation
  • Chronic kidney disease stage 5 (GFR \< 10)
  • Crohn's Disease complication requiring surgical treatment
  • Planned/ongoing methotrexate co-therapy
  • Fecal microbiota transplantation within 8 weeks prior to randomization
  • Participant has any disorder that, in the opinion of the investigator, may compromise the ability to participate in the study
  • Pregnancy
  • Patients who received azithromycin therapy in the previous year (we will not exclude prior use of other antibiotic therapy)
  • Patients who received any antibiotic treatment within 4 weeks prior to randomization
  • Re-induction of the same anti-TNF medication
  • Patients who are on chronic therapy which cannot be withheld in one of these medications: colchicine, phenytoin, and digoxin

Interventions

DRUGAzithromycin Pill

Tablet - 500 mg azithromycin (as dihydrate)

OTHERPlacebo

Placebo tablet identical in shape and appearance to the azithromycin tablet used in the treatment arm


Locations(9)

Rabin Medical Center

Petah Tikva, Israel

Soroka University Medical Center

Beersheba, Israel

Bnei Zion

Haifa, Israel

Carmel Medical Center

Haifa, Israel

Rambam Health Care Campus

Haifa, Israel

Wolfson Medical Center

Holon, Israel

Hadassah Medical Center

Jerusalem, Israel

Shaare Zedek

Jerusalem, Israel

Zvulun

Kiryat Bialik, Israel

View Full Details on ClinicalTrials.gov

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NCT05599347


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