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Completed

NCT Number: NCT00849368

Azathioprine & Allopurinol in Inflammatory Bowel Disease Patients

Main Study Objectives:

The study is conducted to

* evaluate the minimal allopurinol and azathioprine doses that, in combination, produce therapeutic 6-TGN levels * evaluate the safety and tolerability of the different allopurinol/azathioprine dose levels * assess if concomitant allopurinol affects TPMT activity * assess the clinical efficacy of concomitant allopurinol-azathioprine therapy in the included patients

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Key information

Age range

18 year–65 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

Division of Clinical Pharmacology and Toxicology, University Hospital Zurich

Zurich, CH-8091, Switzerland

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Able and willing to give written informed consent before any trial-specific procedures are performed
  • Signed informed consent form
  • Age 18 to 65 years at study entry
  • Body Mass Index 18 - 30 kg/m2
  • Confirmed diagnosis of either CROHN's disease or ulcerative colitis prior to study enrollment by combinations of clinical, endoscopic and histologic criteria generally accepted for CD and UC
  • Normal TPMT activity > 30 nmol MTG/gHb x h
  • Insufficient disease control despite adequate therapy with corticosteroids and/or salicylic acid derivatives, and/or two or more episodes with steroid-requiring disease activity per year, and/or recurrence of disease activity at steroid doses below 15 mg prednisone equivalent, and/or recurrence within 6 weeks after steroid withdrawal.

Exclusion criteria

  • Subjects with confirmed or suspected hypersensitivity towards the study medication
  • Contemporaneous participation in any other study
  • Females only: pregnancy
  • Females only: breast-feeding
  • Prior thiopurine therapy
  • Current and previous immunosuppressive therapy except corticosteroids (e.g. methotrexate, cyclosporine, mycophenolate mofetil, tacrolimus, infliximab or other TNF-alpha blocker therapy) within 3 months before the first drug intake
  • Subjects with any clinically relevant comorbidity beyond the diagnosis of CROHN's disease or ulcerative colitis (as based on extensive medical history, physical examination, vital signs, routine laboratory screen and 12-lead ECG)
  • Haemoglobin < 12 g/dl at the screening examination
  • Leucocytes < 3 x 10E3/µl at the screening examination
  • Lymphocytes < 1.5 x 10E3/µl at the screening examination
  • Thrombocytes < 140 x 10E3/µl at the screening examination
  • Renal disease (creatinine clearance < 60 ml/min, assessed with MDRD formula), history of serious renal disease
  • Liver disease (GGT, alkaline phosphatase, ALAT, ASAT > 2 times the upper limit of normal reference, known or suspected liver cirrhosis)
  • Known or suspected malignancies of any kind
  • Known or suspected active infections, serious infections in the preceding 3 months
  • Active, acute or chronic, or history of, prior hepatitis B infection confirmed by a positive hepatitis B serology (positive HBsAg, Anti-HBc). Patients with a positive hepatitis C screening test (positive anti-HCV). Patients with a positive HIV testing (positive HIV 1 / 2 antibody tests)
  • Active varicella zoster infection (chickenpox, shingles)
  • Known or suspected symptomatic bowel stenoses or strictures, and patients who had a small bowel resection
  • Subjects who are known or suspected not to be capable of understanding and evaluating the information that is given to them as part of the formal information policy (informed consent), in particular regarding the risks and discomfort to which they will be exposed
  • Subjects who are known or suspected not to comply with the study directives and / or known or suspected not to be reliable or trustworthy
  • Subjects who are not willing to comply with the instructions and duties concerning the subject insurance
  • Women of childbearing age and potential who are not willing or capable to use acceptable methods of contraception (oral contraceptives, condoms, diaphragms, intrauterine devices) during the entire study and for up to three months after the end-of-study evaluation.
  • Male patients who do not use acceptable barrier methods of contraception (condoms) during the entire course of the study and up to three months after the end-of-study evaluation

Treatment and study plan

Azathioprine / Allopurinol

Drug

Both drugs are applied orally. A pre-specified dose escalation regimen will be chosen.

Azathioprine: Imurek (R) 50 mg and 25 mg tablets

Allopurinol: Mephanol (R) 100 mg tablets

Other names: Azathioprine: Imurek (R) 50 mg and 25 mg tablets, Allopurinol: Mephanol (R) 100 mg tablets

Primary outcomes

  1. Pharmacokinetics: Quantification of trough concentrations of 6-TGN and 6-MMPN in erythrocytes using HPLC at each dose level.

    Time frame: three times per cycle

Secondary outcomes

  1. Dose escalation: Assessment of the percentage of patients who are in the desired therapeutic range on day 23-25 and on day 26-28 of each dose level.

    Time frame: once per cycle

  2. Efficacy: Change in disease activity score in relationship to the dose level attained.

    Time frame: once per cycle

  3. TPMT activity assessment

    Time frame: once per cycle

  4. Safety and Tolerability: Medical history, adverse events and well-being; laboratory screen, physical examination, vital functions: blood pressure, heart rate, body temperature

    Time frame: screening, up to three times per cycle, follow-up

Sponsors and collaborators

Lead sponsor

University of Zurich

Other

Registry information

Official study title

Dose-effect Relationship Between Allopurinol, Azathioprine and 6-thioguanine Nucleotide Levels (6-TGN) in Inflammatory Bowel Disease Patients.

Important dates

Study start
2009
Primary completion
2011
Study completion
2011
First posted
Feb 23, 2009
Registry last updated
Feb 7, 2012

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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