Tailored Therapeutic Model According to the Expression of Genes in Inflammatory Bowel Disease Patients
ID: NCT03719118
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This study is a randomized controlled study conducted at five tertiary university hospitals. Patients who are 20-80 years old, diagnosed as having Inflammatory Bowel Disease(IBD) and who are planned to start thiopurines for the first time for the treatment of IBD are enrolled. Patients are assigned to the genotyping group or to the non-genotyping group. The patients who carry any heterozygotic variant among the three genes receive 50 mg azathioprine (AZA) or 25 mg of 6-mercaptopurine, while those who have any homozygotic variant are recommended to take other alternative drugs. The patients who do not carry any genetic variant or are assigned in non-genotyping group receive the standard dose of thiopurines based on the conventional approach. Patients in the non-genotyping group receive the standard dose of thiopurines based on the conventional approach.
Patients who carry any heterozygotic variants receive 50 mg AZA or 25 mg 6-mercaptopurine (6-MP), while those who have any homozygotic variants are recommended to take other alternative drugs instead of thiopurines
Patients receive standard doses of thiopurines based on the conventional regimen without pretreatment genotyping. Conventional regimen starts with 50 mg of AZA, then the dose is increased by 25 mg in every 1-2 weeks to 2.0-2.5 mg/kg along with regular monitoring of general blood tests including WBC counts.
Treatment Arms Description
The patients undergo pretreatment of genotyping for three genes (TPMT, NUDT15 and FTO)
Patients receive standard doses of thiopurines based on the conventional regimen without pretreatment genotyping.
- 20-80 years old
- Patients who were diagnosed as having IBD based on clinical, endoscopic, radiographic, and histological assessments,
- Patients who were planned to start thiopurines for the first time for the treatment of IBD.
- Patients who had previous use of thiopurine
- Those who had abnormal laboratory findings prior to screening, including white blood cell (WBC) count \< 3,000/μL, platelet (PLT) count \< 100/μL, or elevation of aminotransferase more than twice the upper normal limits
- Those who were diagnosed other infectious diseases at the time of screening or receiving antibiotics within the previous 7 days;
- Those who were pregnant or lactating.
Primary Outcome Measures
- Cumulative incidence of myelosuppression — Time Frame: 1 year
This trial is recruiting at 5 study facilities worldwide. Click below to see if there is a clinic or hospital in your area:
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- Chang JY, Park SJ, Jung ES, Jung SA, Moon CM, Chun J, Park JJ, Kim ES, Park Y, Kim TI, Kim WH, Cheon JH. Genotype-based Treatment With Thiopurine Reduces Incidence of Myelosuppression in Patients With Inflammatory Bowel Diseases. Clin Gastroenterol Hepatol. 2020 Aug;18(9):2010-2018.e2. doi: 10.1016/j.cgh.2019.08.034. Epub 2019 Aug 22.PubMed ↗
View Official Medical/Scientific Title
Effectiveness of Tailored Therapeutic Model According to the Expression of Genes Related to Immunomodulator-induced Myelosuppression in Inflammatory Bowel Disease Patients