RecruitingPhase 4NCT05928039

PATHFINDER: Evaluating the Optimal First-Line Treatment Strategy for Moderate-to-Severely Active Ileal-dominant Crohn's Disease

PATHFINDER: A Pragmatic, Active-comparator, Parallel-group, Randomized Trial to Evaluate the Optimal First-line Treatment Strategy for Moderate-to-Severely Active Ileal-dominant Crohn's Disease


Sponsor

University of Calgary

Enrollment

297 participants

Start Date

Oct 25, 2023

Study Type

INTERVENTIONAL

Conditions

Summary

There are currently three classes of biologic treatments approved in Canada for the management of moderate-to-severe Crohn's disease: anti-tumor necrosis factor \[TNF\] alpha, anti-integrin, and anti-interleukin \[IL\]-23 targeted agents. The purpose of this trial is to determine which of these three classes of biologics results in the highest percentage of patients with small bowel (ileal) Crohn's disease entering into endoscopic remission without needing corticosteroids at 1 year. Endoscopic remission means that the ulcers in the small bowel from Crohn's disease have healed. All treatments in this trial are approved by Health Canada. No experimental drugs will be included.


Eligibility

Min Age: 18 Years

Plain Language Summary

Simplified for easier understanding

This study compares different first-line biologic treatments for people with moderate-to-severe Crohn's disease affecting the small intestine (ileum), to determine which type of biologic medication works best as the initial treatment. **You may be eligible if...** - You are 18 or older - You have a confirmed Crohn's disease diagnosis - A recent colonoscopy shows active disease with large ulcers in the small intestine - You have never received a biologic medication for Crohn's disease before - Your doctor agrees you need to start a biologic treatment **You may NOT be eligible if...** - You have a known contraindication to any of the study biologics - You have a serious complication requiring immediate surgery (like a bowel blockage or abscess) - You have had bowel surgery in the past 3 months - You have active hepatitis B, C, HIV, or tuberculosis - You have a history of cancer in the past 5 years - You have previously received any biologic or immune-targeting therapy for any reason Talk to your doctor to see if this trial is right for you.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

BIOLOGICALTNFa Antagonist - Infliximab

• Infliximab 5 mg/kg intravenously \[IV\] at weeks 0, 2, 6, then 5 mg/kg every 8 weeks

BIOLOGICALTNFa Antagonist - Adalimumab

• Adalimumab subcutaneously \[SC\] 160 mg at week 0, 80 mg at week 2, then 40 mg every 2 weeks

BIOLOGICALAnti-IL12/23 or anti-IL23 - Ustekinumab

• Ustekinumab \~6 mg/kg IV x1, then 90 mg SC every 8 weeks

BIOLOGICALAnti-IL12/23 or anti-IL23 - Risankizumab

• Risankizumab 600 mg IV at weeks 0, 4, and 8, then 360 mg SC every 8 weeks

BIOLOGICALAnti-integrin - Vedolizumab IV

• Vedolizumab 300 mg IV at weeks 0, 2, and 6, then every 8 weeks

BIOLOGICALAnti-integrin - Vedolizumab IV and SC

• Vedolizumab 300 mg IV at weeks 0 and 2, then 108 mg SC every 2 weeks


Locations(20)

University of Calgary

Calgary, Alberta, Canada

University of Alberta IBD Clinic

Edmonton, Alberta, Canada

GI Research Institute (G.I.R.I)

Vancouver, British Columbia, Canada

West Coast Gastroenterology

Vancouver, British Columbia, Canada

Nova Scotia Health Victoria

Halifax, Nova Scotia, Canada

GNRR Digestive Clinics and Research Center Inc.

Brampton, Ontario, Canada

Rajbir Rai Medical Corporation

Brantford, Ontario, Canada

McMaster University

Hamilton, Ontario, Canada

London Health Sciences Centre

London, Ontario, Canada

West GTA Research Inc.

Mississauga, Ontario, Canada

ABP Research Services Corp.

Oakville, Ontario, Canada

Taunton Surgical Center

Oshawa, Ontario, Canada

The Ottawa Hospital Research Institute

Ottawa, Ontario, Canada

Thunder Bay Regional Health Research Institute

Thunder Bay, Ontario, Canada

Mount Sinai Hospital

Toronto, Ontario, Canada

TIDHI Clinic

Toronto, Ontario, Canada

Centre Hospitalier de l'Université de Montréal (CHUM)

Montreal, Quebec, Canada

Hôpital du Sacré-Cœur-de-Montréal

Montreal, Quebec, Canada

Research Institute of the McGill University Health Centre (MUHC)

Montreal, Quebec, Canada

Université de Sherbrooke

Sherbrooke, Quebec, Canada

View Full Details on ClinicalTrials.gov

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NCT05928039


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