The Comprehensive Clinical Trials Unit at UCL



1 November 2018

MRI for early response prediction to anti-TNF therapy
Crohn’s disease (CD) is one of the main types of inflammatory bowel disease (IBD), a name given to long-term conditions which causes inflammation (swelling) in the digestive system (gut). Although it can affect any part of the gut, it is most common at the end of the ileum (the last part of the small intestine) or the colon (the large intestine). This can lead to abdominal (belly) pain and diarrhoea, fatigue (extreme tiredness), loss of appetite and weight loss, and feeling generally unwell. People who have severe symptoms of CD are sometimes treated with powerful medicines called anti-TNFs which can be very effective. However, anti-TNFs can occasionally cause life-threatening side effects and are very expensive. Although many patients do improve on these medicines, about half the patients who start treatment will show no improvement after a year, and many continue to be given the medication for long periods of time, with no benefit. It is therefore important to identify a way, at an early stage, to see if the treatment is going to work and, if not, change to a different treatment. This will help patients and may reduce costs to the NHS. The study team has developed a new test using MRI scanning and computer software (mMRI) to monitor the movement of the bowel motility. The more inflamed the bowel is, the less it moves, and initial data suggests that if the motility improves, this might predict a successful response to treatment. The aim of this study is to find out if the changes in motility measuring using MRI (the new test), is better and quicker than current tests (based on blood and stool samples) in predicting if the anti-TNF medicines will still be working after a year.
Trial status: Ongoing. Recruitment open.
Funder: National Institute for Health Research
Sponsor: University College London