Actively Recruiting

Phase 4
Age: 18Years +
All Genders
NCT06180382

Comparison of Vedolizumab Treatment to Adalimumab Dose Intensification in Crohn's Disease Patients With Loss of Response or Biomarker Activity to Adalimumab on First Line With Therapeutic Drug Concentration.

Led by Centre Hospitalier Universitaire de Saint Etienne · Updated on 2026-05-05

220

Participants Needed

12

Research Sites

208 weeks

Total Duration

On this page

Sponsors

C

Centre Hospitalier Universitaire de Saint Etienne

Lead Sponsor

T

Takeda France

Collaborating Sponsor

AI-Summary

What this Trial Is About

A substantial fraction of IBD patients with an initial response to infliximab or adalimumab later experience re-emerging active disease despite ongoing anti-Tumour Necrosis Factor (TNF) agents maintenance therapy. The optimal intervention in patients with secondary loss-of-response (LOR) is still poorly defined, as there are still scant data on how best to choose the next intervention from among dose-intensification, switch to another anti-TNF or switch out of the anti-TNF class. Moreover, according to STRIDE 2 recommendations and CALM study, optimize patients based solely on lack of biological remission (CRP, calprotectin) can be discuss. If CALM study has showed that the intervention arm based on regular monitoring fecal calprotectin, CRP and/or CDAI to optimize patients under adalimumab was significantly associated to an increase rate of mucosal healing that the standard of care strategy based on only clinical activity, TDM was not available to guide drug optimization strategy.

CONDITIONS

Official Title

Comparison of Vedolizumab Treatment to Adalimumab Dose Intensification in Crohn's Disease Patients With Loss of Response or Biomarker Activity to Adalimumab on First Line With Therapeutic Drug Concentration.

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Major patient and having given consent to participate in the study
  • Patients with Crohn's disease who have responded primary to Adalimumab princeps or similar bio with loss of response to Adalimumab (40 mg every two weeks)
  • Patient affiliated to or entitled under a social security scheme
Not Eligible

You will not qualify if you...

  • Pregnant woman
  • Patient unable to perform MRI or VCE or ileocolonoscopy or ultrasound less than one month before inclusion
  • Previous or current use of vedolizumab or ustekinumab for Crohn's disease or participation in a biological study
  • Concomitant use of immunomodulators
  • Patients on corticosteroid therapy
  • History of cancer
  • History of human immunodeficiency virus (HIV), immunodeficiency syndrome, central nervous system (CNS) demyelinating disease (including myelitis), neurological symptoms suggestive of demyelinating disease, chronic recurrent infection, active tuberculosis (received or untreated), severe infections such as sepsis and opportunistic infections
  • Patient with ileoanal pouchitis or ileorectal anastomosis
  • Patient with short small bowel syndrome as determined by investigator
  • Patients receiving total parenteral nutrition (TPN)
  • Patients receiving enteral nutrition
  • Patient under legal protection or unable to give consent
  • Hemorrhagic rectocolitis or indeterminate colitis
  • Patients treated with concomitant immunosuppressive agents
  • Patient treated with an optimized dose of adalimumab
  • Primary non-responder to Adalimumab
  • Patient previously treated with infliximab or ustekinumab before adalimumab
  • Severe relapse defined by CDAI > 330
  • Patient with anoperineal Crohn's disease
  • Crohn's disease patient with transient or permanent stoma

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Trial Site Locations

Total: 12 locations

1

APHP - Hôpital Bicêtre

Le Kremlin-Bicêtre, PARIS, France, 94270

Actively Recruiting

2

CHU Amiens

Amiens, France, 80000

Actively Recruiting

3

CHRU Lille

Lille, France, 59037

Actively Recruiting

4

Chu Limoges

Limoges, France, 87000

Actively Recruiting

5

APHM

Marseille, France, 13000

Actively Recruiting

6

CHU Montpellier

Montpellier, France, 34295

Actively Recruiting

7

Hôpital de l'Archet II

Nice, France, 06202

Actively Recruiting

8

Assistance Publique - Hôpitaux de Paris

Paris, France, 75004

Actively Recruiting

9

CHU Bordeaux

Pessac, France, 33604

Actively Recruiting

10

Ch Lyon Sud

Pierre-Bénite, France, 69230

Actively Recruiting

11

CHU Rennes

Rennes, France, 35033

Actively Recruiting

12

CHU de Saint-Etienne

Saint-Etienne, France, 42055

Actively Recruiting

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Research Team

M

Mathilde BARRAU, MD

CONTACT

S

Sandra COURNIER, project manager

CONTACT

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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