NCT04504136

Brief Summary

The objective of the current study is to compare non-healing colonic ulcers in patients with inflammatory bowel disease (IBD) with iatrogenic colonic ulcers (biopsy sites) in healthy control patients and patients with rheumatoid or psoriatic arthritis. Patients will be biopsied at baseline and again at a follow-up visit in a "biopsy of the biopsy" approach. These biopsies will be used to reveal patterns about gene expression and mitochondrial function during ulcer healing.

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
60

participants targeted

Target at P25-P50 for not_applicable

Timeline
0mo left

Started Apr 2021

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

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Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

August 4, 2020

Completed
3 days until next milestone

First Posted

Study publicly available on registry

August 7, 2020

Completed
9 months until next milestone

Study Start

First participant enrolled

April 30, 2021

Completed
5.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

June 1, 2026

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

June 1, 2026

Last Updated

June 8, 2025

Status Verified

June 1, 2025

Enrollment Period

5.1 years

First QC Date

August 4, 2020

Last Update Submit

June 4, 2025

Conditions

Keywords

mucosalrheumatoid arthritispsoriatic arthritisulcercolitisCrohn'smitochondriabiopsywoundbiologicanti-TNF

Outcome Measures

Primary Outcomes (5)

  • Change in mitochondrial DNA copy number

    Mitochondrial DNA copy number will be measured in epithelial cells collected from biopsies taken during the initial colonoscopy and at the follow-up colonoscopy.

    35 days

  • Change in expression levels of cMyc

    Relative expression of cMyc (mRNA) will be measured in epithelial cells collected from biopsies taken during the initial colonoscopy and at the follow-up colonoscopy.

    35 days

  • Change in expression levels of PGC-1 alpha

    Relative expression of PGC-1 alpha (mRNA) will be measured in epithelial cells collected from biopsies taken during the initial colonoscopy and at the follow-up colonoscopy.

    35 days

  • Change in expression levels of Ki67

    Relative expression of Ki67 alpha (mRNA) will be measured in epithelial cells collected from biopsies taken during the initial colonoscopy and at the follow-up colonoscopy.

    35 days

  • Number of visible ulcers

    The number of visible ulcers will be assessed during the follow-up endoscopy for healthy patients and rheumatoid/psoriatic arthritis patients only.

    1 day (at follow-up visit)

Secondary Outcomes (2)

  • Change in Mayo Endoscopic Score

    35 days

  • Change in Segmental SES-CD Score

    35 days

Other Outcomes (1)

  • Fecal calprotectin levels

    35 days

Study Arms (3)

Healthy Controls

EXPERIMENTAL

Participants in this group will be healthy (not diagnosed with inflammatory bowel disease).

Procedure: Serial Biopsy

Inflammatory Bowel Disease

EXPERIMENTAL

Participants in this group will have been diagnosed with ulcerative colitis (UC) or Crohn's disease (CD) and have either failed treatment with biologics or be naive to biologic therapy.

Procedure: Serial Biopsy

Rheumatoid/Psoriatic Arthritis

EXPERIMENTAL

Participants in this group will have been diagnosed with rheumatoid (RA) or psoriatic arthritis (PsA) and will be receiving anti-TNF antibody therapy at the time of enrollment.

Procedure: Serial Biopsy

Interventions

Serial BiopsyPROCEDURE

During the initial colonoscopy, 16-20 biopsies will be collected in addition to standard of care biopsies, and biopsy sites will be tattoed. Patients will return for a follow-up colonoscopy 4-35 days later. An additional 16-20 biopsies will be collected in a "biopsy of the biopsy" approach.

Healthy ControlsInflammatory Bowel DiseaseRheumatoid/Psoriatic Arthritis

Eligibility Criteria

Age18 Years - 90 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Diagnosed ulcerative colitis or Crohn's disease
  • Biologic failure or naive to biologic treatment
  • Eligible to be treated with anti-TNF therapy
  • Diagnosed rheumatoid or psoriatic arthritis
  • Receiving anti-TNF antibody therapy at the time of enrollment
  • Endoscopically unremarkable colonic mucosa
  • Absence of inflammatory bowel disease

You may not qualify if:

  • Classified in an anesthesia risk group, ASA Class =4
  • History of bleeding diathesis or coagulopathy
  • Stroke or transient neurological attack with the last 6 months
  • Pregnant
  • Receiving anticoagulants or anti-platelet medications other than low-dose aspirin
  • Receiving steroid therapy or metformin
  • HIV positive
  • Incarceration
  • History of total proctocolectomy
  • History of system chemotherapy within 18 months
  • Uncontrolled intercurrent illness

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

University of Kentucky

Lexington, Kentucky, 40536, United States

RECRUITING

MeSH Terms

Conditions

Inflammatory Bowel DiseasesArthritis, RheumatoidArthritis, PsoriaticUlcerColitisWounds and Injuries

Condition Hierarchy (Ancestors)

GastroenteritisGastrointestinal DiseasesDigestive System DiseasesIntestinal DiseasesArthritisJoint DiseasesMusculoskeletal DiseasesRheumatic DiseasesConnective Tissue DiseasesSkin and Connective Tissue DiseasesAutoimmune DiseasesImmune System DiseasesSpondylarthropathiesSpondylarthritisSpondylitisSpinal DiseasesBone DiseasesPsoriasisSkin Diseases, PapulosquamousSkin DiseasesPathologic ProcessesPathological Conditions, Signs and SymptomsColonic Diseases

Study Officials

  • Terrence Barrett, MD

    University of Kentucky

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Terrence A Barrett, MD

CONTACT

Neeraj Kapur, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
NON RANDOMIZED
Masking
NONE
Purpose
BASIC SCIENCE
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Professor

Study Record Dates

First Submitted

August 4, 2020

First Posted

August 7, 2020

Study Start

April 30, 2021

Primary Completion (Estimated)

June 1, 2026

Study Completion (Estimated)

June 1, 2026

Last Updated

June 8, 2025

Record last verified: 2025-06

Data Sharing

IPD Sharing
Will not share

Locations