A Study to Evaluate Posaconazole to Treat Genetically-defined Patients with Active Crohn's Disease

Overview

Información sobre este estudio

The purpose of this study is to evaluate the effects of oral antifungal treatment with posaconazole on disease activity and the burden of Malassezia spp. in CD patients with the CARD9 S12N allele. Further, this project will investigate the hypothesis that the microbial changes induced by antifungal treatment are associated with dampened downstream immune responses in those with a genetic predisposition to developing strong immune responses to Malassezia.  

 

 

Elegibilidad para la participación

Los requisitos de elegibilidad de los participantes incluyen la edad, el sexo, el tipo y el estadio de la enfermedad, y los problemas de salud o tratamientos previos. Las pautas difieren de un estudio a otro e identifican quiénes pueden o no pueden participar. No hay garantía de que cada persona elegible que desee participar en un ensayo se inscribirá. Comunícate con el equipo del estudio para analizar la elegibilidad del estudio y la posible participación.

Inclusion Criteria:

  • Male or female patients aged ≥ 18 years.
  • A diagnosis of CD with minimum disease duration of 6 months with involvement of the ileum and/or colon documented on colonoscopy
  • Have an endoscopically-confirmed active Crohn's disease with active disease defined by SES-CD > 6 (>4 if ileal only), AND active symptoms of Crohn's disease (CDAI score >220) 
  • Homozygous for CARD9 SN12 risk allele, without the protective exon 11 polymorphism
  • Subjects receiving oral aminosalicylates (at a stable dose for 2 weeks prior to baseline), immunomodulators (at a stable dose for 4 weeks prior to baseline), anti-TNF, anti IL12/23, or anti-integrin therapy (at stable maintenance doses for > 8 weeks) may continue their use during the study.
  • Subjects receiving oral corticosteroids may continue their use during the study provided the dose (prednisone up to 20 mg/day, budesonide up to 9 mg/day) has been stable for two weeks prior to screening.
  • Have had age-appropriate and disease-duration-appropriate colon cancer screening1 without unresected dysplasia.
  • Women of childbearing age, excluding those with prior bilateral tubal ligation or at least one-year post-menopause, must not be pregnant, lactating, or planning to become pregnant. They must agree to use effective contraception throughout the study period.
  • Subjects must be able to provide informed consent and understand, agree with, and be able to adhere to daily diary entries, all scheduled visits, tests, procedures, and protocol in English.

Exclusion Criteria:

  • Known hypersensitivity or allergy to posaconazole or other azole antifungal agents
  • Concomitant medications primarily metabolized by CY3PA4 including:
    • HMG-CoA inhibitors primarily metabolized by CY3PA4 (increases risk of rhabdomyolysis);
    • Sirolimus;
    • Ergot alkaloids;
    • Vincristine.
  • Proarrhythmic conditions.
  • Moderate or severe renal impairment (Cr Clearance < 50).
  • Current diagnosis of ulcerative colitis, indeterminate colitis, ischemic colitis, infectious colitis, or microscopic colitis.
  • Fulminant colitis, toxic megacolon, peritonitis, ileostomy or colostomy.
  • Stool sample positive for pathogens including ova and parasites, Salmonella, Shigella, and C. difficile at screening.
  • History of any clinically significant neurological, renal, hepatic, gastrointestinal, pulmonary, metabolic, cardiovascular, psychiatric, endocrine, hematological disorder or disease or any other medical condition that, in the Investigators opinion, would prevent the subject from participation in the study.
  • Treatment with antibiotics, antifungal agents, probiotics, or prebiotics within two weeks of screening.
  • Alcohol or drug abuse (in the opinion of the Investigator) that would interfere with compliance.
  • Any other investigational therapy or treatment within four weeks of screening.

Note: Other protocol defined Inclusion/Exclusion Criteria may apply.

Eligibility last updated 1/25/23. Questions regarding updates should be directed to the study team contact.

Sedes participantes de Mayo Clinic

Los estatus de los estudios cambian con frecuencia. Comunícate con el equipo del estudio para obtener la información más actualizada acerca de la posibilidad de participar.

Sede de Mayo Clinic Estatus Contacto

Rochester, Minn.

Investigador principal de Mayo Clinic

Laura Raffals, M.D.

Abierto para la inscripción

Contact information:

Chad Rypstra

(507) 538-4289

Rypstra.Chad@mayo.edu

More information

Publicaciones

Publications are currently not available
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CLS-20531156

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