3TR (Taxonomy, Treatment, Targets and Remission in Patients with IBD)

  • Research type

    Research Study

  • Full title

    Identification of the Molecular Mechanisms of non-response to Treatments, Relapses and Remission in Autoimmune, Inflammatory, and Allergic Conditions (3-TR)

  • IRAS ID

    312090

  • Contact name

    Sreedhar Subramanian

  • Contact email

    sreedhar.subramanian@addenbrookes.nhs.uk

  • Sponsor organisation

    Cambridge University Hospitals NHS Foundation Trust

  • Duration of Study in the UK

    5 years, 0 months, 1 days

  • Research summary

    Inflammatory bowel diseases (IBD) comprises of two conditions: Crohn's disease (CD) and ulcerative colitis (UC). Both are chronic inflammatory diseases of the gut which often requires long-term treatments which suppress the immune system. For instance, patients are treated with biological drugs such as anti-tumour necrosis factor (TNF) agents (infliximab, adalimumab or golimumab) which target the inflammatory molecule TNF, anti-adhesion drugs such as vedolizumab which block the migration of inflammatory cells to the gut or ustekinumab, a drug which blocks the inflammatory proteins interleukins-12 and -23. Non-biological drugs such as tofacitnib which blocks inflammatory proteins are also used for treating UC. Response to these drugs is variable with typical response rates of approximately 50%. There are no clear indicators of which patient is likely to respond to one or the other class of biological agent making the choice arbitrary. Identifying accurate predictors has several advantages including avoidance of adverse reactions from unnecessary exposure to treatment, minimising time spent with active disease and, finally, cost-savings. Currently available predictive technologies have poor accuracy. In this multi-centre European observational study, we plan to systematically collect biological samples (blood, stool, colonic biopsies) from IBD patients before they start treatment and at certain time points after they start treatment. If patients are switched over to another treatment due to lack of response, we will collect additional samples from these patients. Additional biopsies will be collected when the patients undergo a sigmoidoscopy or colonoscopy test (camera examination of the bowel) as part of their standard clinical care.

  • REC name

    East of England - Cambridgeshire and Hertfordshire Research Ethics Committee

  • REC reference

    22/EE/0170

  • Date of REC Opinion

    26 Sep 2022

  • REC opinion

    Further Information Favourable Opinion