Effectiveness and Tolerance of IV vs SC Biological Drugs in Gastrointestinal Diseases

Last updated: September 18, 2024
Sponsor: Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Overall Status: Active - Recruiting

Phase

N/A

Condition

Ulcers

Gastrointestinal Diseases And Disorders

Treatment

N/A

Clinical Study ID

NCT06604728
BIOES - 5713
  • Ages > 18
  • All Genders

Study Summary

Biologics are effective pharmacological treatments for Inflammatory Bowel Disease (IBD). To date, in the context of these pathologies, the formulations that can be administered subcutaneously are available for all the biological agents on the market (infliximab, adalimumab, golimumab, vedolizumab and ustekinumab) and can guarantee self-administration of the therapy at home with a reduction in hospital admissions , improved pharmacokinetics and pharmacoeconomic benefits For these reasons, the consolidation of the clinical practice of switching biological drugs to subcutaneous administration in patients with IBD in clinical remission could be a good strategy in terms of therapeutic efficacy and tolerability.

To date, intravenous and subcutaneous therapy for the biologics considered in the present study is considered equivalent both from a pharmacokinetic point of view ("bioequivalence" of the drug) and from a clinical point of view due to the available efficacy and safety data. The clinical choice of one or the other formulation generally takes into consideration the patient's concern, the subject's venous availability and the experience of the prescribing doctor. This protocol aims to collect the "real life" clinical experience and describe the clinical progress of the patients.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Age ≥ 18 years;

  • Confirmed diagnosis of IBD (Crohn's disease, ulcerative colitis or indeterminatecolitis)

  • Intravenous therapy with vedolizumab or infliximab; OR

  • Patients who for clinical reasons initiated subcutaneous vedolizumab or infliximabtherapy at least 2 and up to 8 weeks after intravenous therapy with the same drugsfor the prospective cohort and patients on subcutaneous vedolizumab and infliximabtherapy for more than 8 weeks after intravenous therapy with the same drugs for theretrospective cohort;

  • Stable (at least 12 weeks) steroid-free IBD clinical remission, defined as a findingof Harvey Bradshaw Index3 (HBI) scores < 5 or Partial Mayo Score 4.5 (PMS) < 2 forpatients with Crohn's disease or colitis ulcerative, respectively, assessed at thetime of switching the drug to subcutaneous administration;

  • Ability to sign informed consent for participation in the study and to comply withthe schedule of scheduled visits.

Exclusion

Exclusion Criteria:

  • Patients with dietary or medication changes during the study period (for theprospective group) or who experienced dietary or medication changes in the 48 weeksbetween drug switching from intravenous to subcutaneous administration (for theretrospective group only) ;

  • Patients undergoing colectomy or with cutaneous ostomy;

  • Patients scheduled for hospitalization or surgery within the period of studyparticipation;

  • Concomitant enrollment in other interventional experimental protocols;

  • Unstable personality or unable to adhere to protocol procedures;

  • Any clinical condition which, in the opinion of the investigators, maycontraindicate enrollment in the study;

  • Refusal to sign informed consent to participate in the study.

Study Design

Total Participants: 400
Study Start date:
September 04, 2023
Estimated Completion Date:
September 01, 2025

Study Description

The study is designed as a prospective, retrospective, 24-month observational cohort study. Patients' eligibility for enrolment will be assessed during the baseline visit at the Centre for Diseases of the Digestive System (CEMAD), Agostino Gemelli University Polyclinic Foundation IRCCS Università Cattolica del Sacro Cuore. Subjects meeting all inclusion criteria will be enrolled, and all subjects meeting at least one exclusion criterion will be excluded.

A cohort of patients suffering from IBD undergoing therapy with biological drugs, already undergoing (retrospective cohort) or who will undergo (prospective cohort) for clinical practice reasons a switch from the intravenous formulation to the corresponding subcutaneous formulation (in particular, from intravenous vedolizumab or infliximab to subcutaneous vedolizumab or infliximab) will be considered.

Connect with a study center

  • Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC CEMAD

    Roma, 00168
    Italy

    Active - Recruiting

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