RecruitingNCT06505304

AI-enabled Endoscopic Prediction of Post-operative Recurrence in Crohn's Disease

Endoscopic Multimodal Assessment Using Advanced Imaging Integrated AI to Predict Recurrence in pOSt-oPerativE CRohn's Disease - PROSPER Study


Sponsor

University College Cork

Enrollment

225 participants

Start Date

May 1, 2024

Study Type

OBSERVATIONAL

Conditions

Summary

This is a multicentre prospective international observational study. This study aims to introduce a novel multidimensional approach to precision imaging, enabling the identification and stratification of high-risk patients who can potentially benefit from early treatments to halt the progression of Crohn's disease (CD). The investigators will develop a novel endoscopic assessment system using endoscopic enhanced imaging (EEI) to evaluate early post-surgical changes and predict post-operative CD recurrence (POCr). By integrating with immune marker profiling, clinical data, and AI assessment of EEI and histology, the investigators further plan to improve risk stratification and reduce interobserver variability.


Eligibility

Min Age: 18 YearsMax Age: 75 Years

Plain Language Summary

Simplified for easier understanding

This study tests whether an AI-powered system used during bowel endoscopy (colonoscopy) can accurately predict the likelihood of Crohn's disease coming back after intestinal surgery. The aim is to help doctors make better decisions about follow-up treatment. **You may be eligible if...** - You are 18–75 years old with a confirmed diagnosis of Crohn's disease (at least 6 months ago) - You have had intestinal surgery within the last 3 months or have surgery planned - You are able to provide consent **You may NOT be eligible if...** - You have serious other medical conditions that make colonoscopy unsafe - You have a stoma (bowel diversion bag) - You are pregnant or breastfeeding - You cannot have a colonoscopy or biopsies - For a specific part of the study (pCLE): you have an allergy to nuts or shellfish, severe asthma, or take beta blockers 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

PROCEDUREColonoscopy

The colonoscopy will be performed at 3 or 6 months after surgery according to FC: * In patients with FCP \>=150µg/g at around 3 months after surgery, a colonoscopy will be immediately performed * In patients with FCP \<150µg/g at around 3 months after surgery, the colonoscopy will be organized at 6 months after surgery Colonoscopy will be performed using high definition white-light endoscopy (HD-WLE) followed by virtual chromoendoscopy (VCE). The neoterminal ileum, ileocolic anastomosis and right colon will be assessed. A follow-up colonoscopy will be performed within 18 months after index colonoscopy, as standard of care.

PROCEDUREIntestinal biopsies

During index colonoscopy, at least 2 biopsies from each of the segments will be taken as standard of practice to assess inflammation in post-operative CD. Only in Irish sites, twelve biopsies - four in the area of ileocolonic anastomosis, four in the neo-terminal ileum and four in the colon just distal to the anastomosis- will be taken for research purposes, in addition to standard-of-care biopsies.

PROCEDUREConfocal laser endomicroscopy

pCLE with fluorescein injection will be performed during index colonoscopy, in centres where is available, to assess early alteration of the barrier function.

PROCEDUREIntestinal ultrasound

All patients will undergo a cross-sectional imaging test as part of their standard of care at 3 and 6 months after surgery. A follow-up IUS will be performed within 18 months after index colonoscopy, as standard of care.

DIAGNOSTIC_TESTStool

Stool samples will be collected at 3 and 6 months after surgery and used for faecal calprotectin analysis. Research stool will be collected during the visit of index colonoscopy and at 12 months after index colonoscopy for metagenomics (only in Irish sites).

DIAGNOSTIC_TESTBlood

Blood will be collected at 3 and 6 months after surgery and used as standard of care. Research blood will be collected during the visit of index colonoscopy and at 12 months after index colonoscopy for research - i.e. proteomic, genomic, cell experiments (only in Irish sites).

DIAGNOSTIC_TESTSaliva

Saliva will be collected during the visit of index colonoscopy and at 12 months after surgery for research - i.e. optical spectroscopy (only in Irish site)

OTHERClinical follow-up

Patients will be followed-up at 6, 12 and 24 months after index endoscopy. Patients will be evaluated in clinic or by telephone call and the disease will be reassessed. The following scores will be repeated: Harvey Bradshaw Index (HBI) and CD Activity Index score (CDAI). Participants will give an update on their medication use.


Locations(15)

University of Leuven

Leuven, Belgium

University of Calgary

Calgary, Canada

University Hospital Erlangen

Erlangen, Germany

Cork University Hospital

Cork, Ireland

Mercy University Hospital

Cork, Ireland

University College Dublin

Dublin, Ireland

University College Hospitals Galway

Galway, Ireland

Rabin Medical Centre

Tel Aviv, Israel

Istituto Clinico Humanitas

Rozzano, Milan, Italy

ASST Spedali Civili

Brescia, Italy

ASST Fatebenefratelli Sacco

Milan, Italy

IRCCS Cà Granda Ospedale Maggiore

Milan, Italy

University Vita-Salute San Raffaele

Milan, Italy

University Federico II

Naples, Italy

IRCCS San Matteo

Pavia, Italy

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