Trial record 49 of 84 for:    gastroenterology | Recruiting | Exclude Unknown | United States

Efficacy of CROWN in Repair and Maintenance of the Intestinal Mucosa in Patients With CD Receiving Anti-TNF Therapy (PIONEER-CD)

This study is currently recruiting participants. (see Contacts and Locations)
Verified July 2016 by Prometheus Laboratories
Nestlè Health Science
Nestec Ltd.
Robarts Clinical Trials
Information provided by (Responsible Party):
Prometheus Laboratories Identifier:
First received: June 1, 2016
Last updated: July 13, 2016
Last verified: July 2016
The purpose of this study is to evaluate CROWN's efficacy in supporting the repair and maintenance of the intestinal mucosa of patients with moderately to severely active Crohn's Disease receiving induction anti-Tumor Necrosis Factor (TNF) therapy (infliximab, adalimumab)

Condition Intervention Phase
Crohn's Disease
Drug: CROWN Placebo
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized, Double-Blind, Placebo-Controlled Trial to Evaluate the Effectiveness of a Nutritional Intervention in Improving the Intestinal Mucosal Health Status in Subjects With Crohn's Disease (CD) Receiving Induction Anti-TNF Therapy

Resource links provided by NLM:

Further study details as provided by Prometheus Laboratories:

Primary Outcome Measures:
  • Simple Endoscopic Score - Crohn's Disease (SES-CD) [ Time Frame: Week 24 ] [ Designated as safety issue: No ]
    Measuring intestinal health improvement is the Week 24 change from baseline in Simple Endoscopic Score - Crohn's Disease (SES-CD)

Secondary Outcome Measures:
  • Plasma amino acid level [ Time Frame: Week 12 and at Week 24 ] [ Designated as safety issue: No ]
    Change from baseline in plasma amino acid levels

  • Quality of Life Score - Inflammatory Bowel Disease Questionnaire (IBDQ) [ Time Frame: Weeks 12 and 24 ] [ Designated as safety issue: No ]
    Change from baseline in quality of life score in IBDQ

  • Quality of Life Score - Work Productivity Activity Index - Crohn's Disease(WPAI-CD) [ Time Frame: Weeks 12 and 24 ] [ Designated as safety issue: No ]
    Change from baseline in quality of life score in WPAI-CD

  • Inflammatory biomarkers [ Time Frame: Week 24 ] [ Designated as safety issue: No ]
    Proportion of subjects with a normalization of inflammatory biomarkers (C-Reactive Protein (CRP) and fecal calprotectin)

  • Endoscopic response [ Time Frame: Week 24 ] [ Designated as safety issue: No ]
    Proportion of subjects with endoscopic response based on SES-CD score, defined as a decrease in the SES-CD of at least 3 points from baseline, and no worsening of either component of the PRO2 (abdominal pain or liquid or soft stool frequency)

  • Corticosteroid-free [ Time Frame: Week 12 ] [ Designated as safety issue: No ]
    Proportion of subjects who are corticosteroid-free

Estimated Enrollment: 240
Study Start Date: July 2016
Estimated Study Completion Date: March 2019
Estimated Primary Completion Date: March 2019 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: CROWN
CROWN: A nutritionally based therapy with a high protein content, formulated as a powder. Twice a day, preferable 1 hour before or more than 2 hours after meals, for up to 24 weeks
A nutritionally based therapy, formulated as a powder, administered twice a day, preferable 1 hour before or more than 2 hours after meals, for up to 24 weeks
Placebo Comparator: CROWN Placebo
Placebo: An appearance and volume matched formulated powder. Twice a day, preferable 1 hour before or more than 2 hours after meals, for up to 24 weeks
Drug: CROWN Placebo
Placebo, formulated as a powder, administered twice a day, preferable 1 hour before or more than 2 hours after meals, for up to 24 weeks

Detailed Description:
The purpose of this study is to evaluate the effectiveness of an orally administered medical food (CROWN) in subjects with Crohn's Disease (CD) to support Standard Of Care (SOC) treatment in the repair and maintenance of the intestinal mucosa over a 24 week period. SOC is defined as completion of induction therapy with an anti-Tumor Necrosis Factor (TNF) agent within 24 weeks of its initiation.

Ages Eligible for Study:   18 Years to 75 Years   (Adult, Senior)
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Inclusion Criteria:

Crohn's Disease patient who has derived clinical benefit from the Standard of Care therapy, but continues to have evidence of incomplete healing of the intestinal mucosa.

  1. Adults (18-75 years of age) with a known history of symptomatic CD confirmed by endoscopy or radiology
  2. CDAI score ≤ 300
  3. Active endoscopic disease (SES-CD score ≥ 6) documented during the study screening phase or SES-CD score ≥ 4 if isolated ileal disease
  4. Initiation of induction of infliximab or adalimumab therapy within 24 weeks prior to randomization as part of standard care (induction must be completed prior to randomization)
  5. Able to consume oral nutrition for up to 24 weeks consisting of two 4 oz (120 ml) servings daily
  6. Able to understand the informed consent process, willing to follow study instructions and likely to complete all required visits and procedures, including the use of an electronic device to collect study data, home computer or tablet and internet access to complete online food frequency questionnaire, and undergo 2 endoscopies in a 6 month period

Exclusion Criteria:

Subjects with one or more of the following criteria are excluded from participation in the study:

  1. If female, subject is pregnant, nursing, or planning to become pregnant during the study period or is of childbearing potential and unable or unwilling to use a reliable form of contraception during the study
  2. Fistula known to be contributing to diarrhea
  3. Recent or current history of bowel obstruction
  4. Stricturing disease with evidence of bowel dilation proximal to stricture on imaging
  5. Anticipated need for gastrointestinal surgical therapy in the next 6 months
  6. Current treatment with a systemic corticosteroid at dose greater than 20 mg of prednisone (or equivalent) at screening
  7. Treatment with a topical rectal 5-aminosalicylic acid or topical rectal steroids within 2 weeks prior to screening
  8. Change in any antimetabolite therapy within 8 weeks prior to randomization
  9. Current treatment with antibiotics for CD (ciprofloxacin, metronidazole) at screening
  10. Current ostomy
  11. Serious infection, neoplasia or other medical conditions which would interfere with participation in the study, in the opinion of the Investigator
  12. Evidence of Clostridium difficile infection in the previous 4 weeks
  13. History of non-compliance with clinical protocols
  14. Active participation in another CD trial or received an investigational product within the past 4 weeks
  15. Diagnosis of celiac disease
  16. Known sensitivity to milk or soy protein
  17. In the Investigator's opinion, subject has any condition or situation which makes the subject unsuitable for study participation, may put the subject at significant risk, or may confound the study results
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT02793778

Contact: Patricia Yen 858 768-2260

United States, California
Inland Empire Liver Foundation Recruiting
Rialto, California, United States, 92377
Principal Investigator: Zeid Kayali, MD         
United States, Louisiana
Delta Research, LLC Recruiting
Bastrop, Louisiana, United States, 71220
Principal Investigator: Bal Raj Bhandari, MD         
United States, Massachusetts
Commonwealth Clinical Studies Recruiting
Brockton, Massachusetts, United States, 02302
Principal Investigator: Jerry Stern, MD         
United States, North Carolina
Asheville Gastroenterology Associates Recruiting
Asheville, North Carolina, United States, 28801
Principal Investigator: Jessica M Fisher, MD         
Sponsors and Collaborators
Prometheus Laboratories
Nestlè Health Science
Nestec Ltd.
Robarts Clinical Trials
Study Chair: James Lewis, M.D. University of Pennsylvania
  More Information

Responsible Party: Prometheus Laboratories Identifier: NCT02793778     History of Changes
Other Study ID Numbers: 13.06.CLI 
Study First Received: June 1, 2016
Last Updated: July 13, 2016
Health Authority: United States: Food and Drug Administration
Individual Participant Data  
Plan to Share IPD: No

Keywords provided by Prometheus Laboratories:
Crohn's Disease
Digestive System Diseases
Gastrointestinal Diseases
Intestinal Diseases
mucosal healing
inflammatory bowel disease
Medical Food

Additional relevant MeSH terms:
Crohn Disease
Inflammatory Bowel Diseases
Gastrointestinal Diseases
Digestive System Diseases
Intestinal Diseases processed this record on July 27, 2016