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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03220841
Registration number
NCT03220841
Ethics application status
Date submitted
6/07/2017
Date registered
18/07/2017
Titles & IDs
Public title
Stricture Definition and Treatment (STRIDENT) Drug Therapy Study
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Scientific title
Stricture Definition and Treatment (STRIDENT) Drug Therapy Study
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Secondary ID [1]
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StVincentsMelbourneSTRIDENT1
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Universal Trial Number (UTN)
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Trial acronym
STRIDENT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Crohn Disease
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Inflammatory Bowel Diseases
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Stricture; Bowel
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Condition category
Condition code
Oral and Gastrointestinal
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Inflammatory bowel disease
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Inflammatory and Immune System
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Other inflammatory or immune system disorders
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Oral and Gastrointestinal
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Crohn's disease
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Other
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Research that is not of generic health relevance and not applicable to specific health categories listed above
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Adalimumab Injection
Treatment: Drugs - Thiopurine
Treatment: Surgery - Endoscopic balloon dilatation
Active comparator: Standard drug therapy - Adalimumab monotherapy, Standard Dose induction (160mg at week 0, 80mg week 2 and 40mg fortnightly thereafter)
Experimental: Intensive drug therapy - Adalimumab in combination with dose optimized thiopurine, Intensive induction (160mg weekly for 4 weeks then 40mg fortnightly). Anti-TNF dose may be increased if ongoing inflammation every 4 months until study endpoint.
Treatment: Drugs: Adalimumab Injection
Standard dose adalimumab induction and maintenance
Treatment: Drugs: Thiopurine
Dose optimized thiopurine
Treatment: Surgery: Endoscopic balloon dilatation
Prior to randomization, suitable patients may undergo endoscopic balloon dilatation. Patients undergoing dilatation will be stratified to ensure equal numbers in each study arm.
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Intervention code [1]
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Treatment: Drugs
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Intervention code [2]
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Treatment: Surgery
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Improvement in obstructive symptoms.
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Assessment method [1]
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Improved pain and or frequency of pain compared to baseline. Obstructive symptoms determined by prospective diary documenting number of episodes of pain in previous 2 weeks and severity of the pain episodes using four-level Likert scale.
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Timepoint [1]
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12 months
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Secondary outcome [1]
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Improvement in symptoms
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Assessment method [1]
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Improved pain and or frequency of pain compared to baseline. Obstructive symptoms determined by prospective diary documenting number of episodes of pain in previous 2 weeks and severity of the pain episodes using four-level Likert scale.
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Timepoint [1]
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4, 8 and 12 months
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Secondary outcome [2]
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Improvement in biochemical inflammatory parameters
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Assessment method [2]
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Serum CRP and fecal calprotectin
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Timepoint [2]
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12 months
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Secondary outcome [3]
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Improvement in imaging parameters (Intestinal ultrasound)
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Assessment method [3]
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Limberg's score
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Timepoint [3]
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12 months
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Secondary outcome [4]
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Improvement in imaging parameters
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Assessment method [4]
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Modified MaRIA score
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Timepoint [4]
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12 months
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Secondary outcome [5]
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Surgery
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Assessment method [5]
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The number of patients that require surgical resection of stricture due to failure of drug therapy.
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Timepoint [5]
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12 months
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Secondary outcome [6]
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Improvement in patient reported outcomes (PROs)
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Assessment method [6]
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SF36
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Timepoint [6]
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12 months
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Secondary outcome [7]
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Improvement in patient reported outcomes (PROs)
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Assessment method [7]
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IBDQ
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Timepoint [7]
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12 months
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Eligibility
Key inclusion criteria
* Inflammatory bowel disease patients with intestinal stricture(s) identified on CT, MRI or endoscopy.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Acute bowel obstruction requiring urgent surgical intervention
* Deemed by treating physician to have high risk of acute bowel obstruction
* Concurrent active perianal sepsis
* Internal fistulising disease in association with strictures (entero-enteric stulas)
* Low rectal or anal strictures
* Evidence of dysplasia or malignancy from stricture biopsies or adjacent mucosal biopsies
* Patients for whom endoscopy is not suitable due to co-morbidities or clinical state
* Inability to give informed consent
* Suspected perforation of the gastrointestinal tract
* Pregnancy
* Inability to undergo MRI small bowel due to a contraindication.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 4
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
UNKNOWN
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
9/10/2017
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
1/09/2021
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Actual
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Sample size
Target
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Accrual to date
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Final
78
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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St. Vincent's Hospital Melbourne - Melbourne
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Recruitment postcode(s) [1]
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3065 - Melbourne
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Funding & Sponsors
Primary sponsor type
Other
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Name
St Vincent's Hospital Melbourne
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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Australasian Gastro Intestinal Research Foundation
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Address [1]
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Country [1]
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Other collaborator category [2]
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Commercial sector/industry
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Name [2]
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AbbVie
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Address [2]
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Country [2]
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Ethics approval
Ethics application status
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Summary
Brief summary
Two thirds of patients with Crohn's disease require intestinal surgery at some time in their life. Intestinal strictures, that is narrowing of the bowel due to inflammation and scarring, are the most common reason for surgery. Despite the high frequency, associated disability, and cost there are no are no treatment strategies that aim to improve the outcome of this disease complication. The STRIDENT (stricture definition and treatment) studies aim to develop such strategies.
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Trial website
https://clinicaltrials.gov/study/NCT03220841
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Trial related presentations / publications
Schulberg JD, Wright EK, Holt BA, Hamilton AL, Sutherland TR, Ross AL, Vogrin S, Miller AM, Connell WC, Lust M, Ding NS, Moore GT, Bell SJ, Shelton E, Christensen B, De Cruz P, Rong YJ, Kamm MA. Intensive drug therapy versus standard drug therapy for symptomatic intestinal Crohn's disease strictures (STRIDENT): an open-label, single-centre, randomised controlled trial. Lancet Gastroenterol Hepatol. 2022 Apr;7(4):318-331. doi: 10.1016/S2468-1253(21)00393-9. Epub 2021 Dec 8.
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Public notes
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Contacts
Principal investigator
Name
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Emily Wright, MBBS PhD
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Address
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St Vincent's Hospital Melbourne
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT03220841