A biomarker-stratified comparison of top-down versus accelerated step-up treatment strategies for patients with newly diagnosed Crohn's disease (PROFILE): a multicentre, open-label randomised controlled trial

Noor, Nurulamin M; Lee, James C; Bond, Simon; Dowling, Francis; Brezina, Biljana; Patel, Kamal V; Ahmad, Tariq; Banim, Paul J; Berrill, James W; Cooney, Rachel; De La Revilla Negro, Juan; de Silva, Shanika; Din, Shahida; Durai, Dharmaraj; Gordon, John N; Irving, Peter M; Johnson, Matthew; Kent, Alexandra J; Kok, Klaartje B; Moran, Gordon W; Mowat, Craig; Patel, Pritash; Probert, Chris S; Raine, Tim; Saich, Rebecca; Seward, Abigail; Sharpstone, Dan; Smith, Melissa A; Subramanian, Sreedhar; Upponi, Sara S; Wiles, Alan; Williams, Horace R T; van den Brink, Gijs R; Vermeire, Séverine; Jairath, Vipul; D'Haens, Geert R; McKinney, Eoin F; Lyons, Paul A; Lindsay, James O; Kennedy, Nicholas A; Smith, Kenneth G C; Parkes, Miles; Noor, Nurulamin; Lee, James; Bond, Simon; Dowling, Francis; Brezina, Biljana; Patel, Kamal; Ahmad, Tariq; Banim, Paul; Berrill, James; Cooney, Rachel; De La Revilla Negro, Juan; de Silva, Shanika; Din, Shahida; Durai, Dharmaraj; Gordon, John; Irving, Peter; Johnson, Matthew; Kent, Alexandra; Kok, Klaartje Bel; Moran, Gordon; Mowat, Craig; Patel, Pritash; Probert, Chris; Raine, Tim; Saich, Rebecca; Seward, Abigail; Sharpstone, Dan; Smith, Melissa; Subramanian, Sreedhar; Upponi, Sara; Wiles, Alan; Williams, Horace; van Den Brink, Gijs; Vermeire, Severine; Jairath, Vipul; D'Haens, Geert; McKinney, Eoin; Lyons, Paul; Lindsay, James; Kennedy, Nicholas; Smith, Kenneth; Parkes, Miles; Allcock, Clare; Bhatti, Suhaylah; Blackwell, Jonathan; Boulton-Jones, Robert; Brookes, Matthew; Butcher, Rhys; Butterworth, Jeffrey; Champion, Karlena; Chaudhary, Rakesh; Cole, Andy; Derikx, Lauranne; Dhar, Anjan; Flowerdew, Mary; Goel, Rishi; Hart, Ailsa; Hughes, Rory; Javaid, Babur; Knight, Paul; Lee, Jacinta; Lees, Charlie; Levell, Emma; Li, Andy; Murray, Charles; O'Brien, Leisha; Parkes, Gareth; Pollok, Richard; Powles, Sam; Ramdas, Arvind; Smith, Philip; Speight, Richard Ally; Travis, Simon; Weaver, Sean; Wesley, Emma

doi:10.1016/s2468-1253(24)00034-7

Cited by 32 publications

(1 citation statement)

References 30 publications

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“… 12 The prognostic utility of this assay was explored in the recently reported trial: Predicting outcomes for Crohn’s disease using a molecular biomarker (PROFILE). 13 …”

Section: Introductionmentioning

confidence: 99%

Nordic inflammatory bowel disease treatment strategy trial: protocol for the NORDTREAT randomised controlled biomarker-strategy trial

Rejler,

Füchtbauer,

Davíðsdóttir

et al. 2024

BMJ Open

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IntroductionThe absence of reliable prognostic markers poses a challenge to the management of inflammatory bowel disease (IBD). Patients with aggressive disease may not receive sufficient treatment with conventional ‘step-up’ therapy, whereas a top-down approach may expose patients with indolent disease to unnecessary treatment-related toxicity. The objective of the Nordic IBD treatment strategy trial (NORDTREAT) is to assess the feasibility of personalised therapy by stratifying patients according to a prognostic serum protein signature at diagnosis.Methods and analysisNORDTREAT is a multicentre, biomarker-strategy design, open-label controlled trial. After screening consent, eligible patients are randomised (1:1) into one of two groups: a group with access to the protein signature and a group without access. In the access to protein signature group, patients displaying a protein signature suggestive of an increased risk of an aggressive disease course will be treated in line with a top-down treatment algorithm (anti-tumour necrosis factor agent with/without an immunomodulator). In contrast, those with a protein signature indicative of indolent disease will be excluded from the trial. Patients not in the access group receive treatment based on clinical management. This traditional management involves a stepwise escalation of treatment as determined by the investigator after failure of first-line treatment. After 52 weeks, outcomes are assessed in the subgroup of patients with a protein profile indicating a potentially severe disease trajectory. The primary endpoint is a composite of the proportion of patients with corticosteroid-free clinical and endoscopic remission at week 52. Surgical intervention due to IBD during follow-up will be defined as treatment failure.Ethics and disseminationEthical approval has been obtained, and recruitment is underway at sites in four participating Nordic countries (Denmark, Iceland, Norway and Sweden). Following trial completion and data analysis, the trial results will be submitted for publication in peer-reviewed journals and presented at international conferences.Trial registration numberNCT05180175; Pre-results. EudraCT number: 2019-002942-19.

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“… 12 The prognostic utility of this assay was explored in the recently reported trial: Predicting outcomes for Crohn’s disease using a molecular biomarker (PROFILE). 13 …”

Section: Introductionmentioning

confidence: 99%