The Vitamin D in Pediatric Crohn's Disease

Study Purpose

The purpose of this study is to determine if vitamin D as an adjuvant therapy can improve the outcome (i.e. fewer relapses) and the quality of life, including levels of physical activity, in children with newly diagnosed Crohn's disease (CD).

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 9 Years - 18 Years
Gender All
More Inclusion & Exclusion Criteria

Eligibility Criteria:

  • - Diagnosis of CD by the usual clinical, endoscopic and histological criteria and classified according to the Paris classification

    Inclusion Criteria:

    - Age at randomization between 9 and 18 years inclusively - Interval between diagnosis and randomization between 2 weeks and 6 months after the diagnosis - Pediatric Crohn's Disease Activity Index (PCDAI) ≤ 30 at inclusion - Concurrent treatment with corticosteroids and/or enteral nutrition and/or thiopurines (azathioprine, 6-mercaptopurine) and/or methotrexate and/or 5-aminosalicylic acid (5-ASA) and/or TNF-α inhibitors (Infliximab, Adalimumab).

Exclusion Criteria:

  • - Patient diagnosed with severe complex perianal fistulizing CD (defined as the presence at diagnosis of a high intersphincteric, transsphincteric, extrasphincteric, or suprasphincteric complex perianal fistula) - Known chronic liver cholestasis (defined by an elevation of conjugated bilirubin and/or gamma glutamyl transferase > 3 upper limit normal) - Known renal dysfunction requiring chronic dialysis or creatinine ≥ 100 micromol/L.
  • - Known congenital bone disease - Known cystic fibrosis or other exocrine pancreatic insufficiency.
  • - Currently treated with anticonvulsants metabolized through cytochrome P-450 - Unable to take oral capsule form.

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT02186275
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 3
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

St. Justine's Hospital
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

Prevost Jantchou, MD
Principal Investigator Affiliation St. Justine's Hospital
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

OtherOther
Overall Status Recruiting
Countries Canada
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Crohn's Disease
Additional Details

Crohn's disease is a chronic inflammatory condition affecting all segments of the digestive tract from the mouth to the anus. This condition is associated with an increased risk of relapses throughout the course of the disease. Nearly 25% of patients with Crohn's disease are in the pediatric age range. Many epidemiological data are in favor of an increase incidence of pediatric Crohn's disease. Environmental factors could explain this increased incidence. Among them sunlight exposure and vitamin D deficiency have been suggested by many authors. Recent studies have described how varying doses of oral vitamin D supplementation can alter serum levels of 25 hydroxyvitamin D (25(OH)D), but no study has specifically addressed the question as to whether vitamin D supplementation can alter the rate of relapse/complications and/or quality of life in children diagnosed with CD. Current treatments of CD at diagnosis are effective around the time of diagnosis, but in the short and long term, some of these therapies are inefficient or lead to allergic or intolerance reactions. Altogether the rate of relapses in the year after diagnosis is significant. Thus, different therapeutic approaches must be investigated with the aim of lowering the burden of the disease. From November 2012 to July 2013, we conducted an open label pilot cohort study aiming to investigate the bioavailability and tolerance of high doses of vitamin D3 (3,000 IU or 4,000 IU per day) administered orally as an adjunct therapy in 20 children with newly diagnosed pediatric CD (http://clinicaltrials.gov/ct2/show/NCT01692808). Data from laboratory studies, observational research and pilot trials taken together suggest that vitamin D can be of great importance in the genesis and progression of CD. Vitamin D deficiency could be a true risk factor for disease occurrence and/or relapses. The results of our pilot study demonstrate that in children with active CD at diagnosis, a daily dose of 4,000 IU of vitamin D is well tolerated and quickly increases the blood levels of 25OHD3 to 100 nmol/L or above in 100% of children with CD at diagnosis. Moreover a maintenance dosage of 2,000 IU a day is required (and sufficient) for maintaining this target over several months. Currently there is no adequately powered study in the pediatric CD population exploring the relationship between vitamin D therapy at diagnosis and CD outcomes. We propose a randomized controlled trial (RCT) to study the efficacy of high-dose oral vitamin D, as adjunct therapy, in children with newly diagnosed CD, to reduce the relapse rate and to improve patients' quality of life. Primary Efficacy End Point: The proportion of patient with at least one relapse 52 weeks after randomization. Secondary efficacy endpoint: Quality of life scores, Cumulative steroid dose, Time to first relapse, Duration of corticotherapy, Number of relapses, Number of hospitalizations Safety Endpoint : incidence of hypercalcemia (defined as a corrected serum calcium level >2.65 mmol/L), incidence of hypercalciuria (defined as urinary calcium to creatinine molar ratio ≥1.50), incidence of supra-optimal levels of 25OHD3 as defined by a serum level ≥ 250 nmol/L, rate of study discontinuation due to hypercalcemia or hypercalciuria. Efficacy Variable: Occurrence of relapse, Time to relapse, Change in QoL score from baseline to 26 weeks, 52 weeks. Change in physical activity score from baseline to 26 weeks, 52 weeks.

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

International Sites

Centre Hospitalier Universitaire Laval, Québec, Canada

Status

Not yet recruiting

Address

Centre Hospitalier Universitaire Laval

Québec, , G1V 4G2

Site Contact

Julie Castilloux, MD

julie.castilloux@mail.chuq.qc.ca

418-656-4141 #48424

Montreal Children's Hospital (Montreal)., Montréal, Quebec, Canada

Status

Not yet recruiting

Address

Montreal Children's Hospital (Montreal).

Montréal, Quebec, H3H 1P3

Site Contact

Ernest Seidman, MD, PhD

ernest.seidman@mcgill.ca

514-934-1934 #48308

Ste-Justine hospital, Montreal, Quebec, Canada

Status

Recruiting

Address

Ste-Justine hospital

Montreal, Quebec, H3T1C5

Site Contact

Prevost Jantchou, MD, PhD

prevost.jantchou@umontreal.ca

1514 345-4691 #5035

Hospital for Sick Childrens, Toronto, Ontario, Canada

Status

Not yet recruiting

Address

Hospital for Sick Childrens

Toronto, Ontario, M5G 1X8

Site Contact

Anne Marie Griffiths, MD

anne.griffiths@sickkids.ca

416-813-8757

McMaster University, Hamilton, Ontario, Canada

Status

Not yet recruiting

Address

McMaster University

Hamilton, Ontario, L8S4L8

Site Contact

Robert Issenman, MD

issenman@mcmaster.ca

905-521-2100 #75637

IWK Health Centre, Halifax, Nova Scotia, Canada

Status

Not yet recruiting

Address

IWK Health Centre

Halifax, Nova Scotia, B3K 6R8

Site Contact

Anthony Otley, MD

Anthony.Otley@iwk.nshealth.ca

902 470 8746

Janeway Children's Health Centre, St. John's, Newfoundland and Labrador, Canada

Status

Not yet recruiting

Address

Janeway Children's Health Centre

St. John's, Newfoundland and Labrador, A1B 3V6

Site Contact

Jeff Critch, MD

Jeff.critch@easternhealth.ca

(709) 777-4134

Health Science Center Pediatric, Winnipeg, Manitoba, Canada

Status

Not yet recruiting

Address

Health Science Center Pediatric

Winnipeg, Manitoba, R3A 1R9

Site Contact

Wael El-Matary, MD

welmatary@hsc.mb.ca

204-787-1039

University of British Columbia, Vancouver, British Columbia, Canada

Status

Not yet recruiting

Address

University of British Columbia

Vancouver, British Columbia, V6H 3V4

Site Contact

Kevan Jacobson, MD

kjacobson@cw.bc.ca

604-875-2332

Edmonton Clinic Health Academy, Edmonton, Alberta, Canada

Status

Not yet recruiting

Address

Edmonton Clinic Health Academy

Edmonton, Alberta, T6G 1C9

Site Contact

Hien Huynh, MD

hien.huynh@ualberta.ca

(780) 248-5495

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