학술논문

Personalised azithromycin+metronidazole (PAZAZ), in combination with standard induction therapy, to achieve a faecal microbiome community structure and metagenome changes associated with sustained remission in paediatric Crohn’s disease (CD): protocol of a pilot study
Document Type
article
Source
BMJ Open. 13(2)
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Nutrition
Prevention
Digestive Diseases
Clinical Research
Evaluation of treatments and therapeutic interventions
6.1 Pharmaceuticals
Oral and gastrointestinal
Good Health and Well Being
Humans
Child
Crohn Disease
Azithromycin
Metronidazole
Pilot Projects
Induction Chemotherapy
Metagenome
Bayes Theorem
RNA
Ribosomal
16S
Anti-Bacterial Agents
Remission Induction
Microbiota
Recurrence
Randomized Controlled Trials as Topic
Multicenter Studies as Topic
paediatric gastroenterology
inflammatory bowel disease
clinical trials
microbiology
Public Health and Health Services
Other Medical and Health Sciences
Biomedical and clinical sciences
Health sciences
Psychology
Language
Abstract
IntroductionEarly relapse in Crohn's disease (CD) is associated with a more severe disease course. The microbiome plays a crucial role, yet strategies targeting the microbiome are underrepresented in current guidelines. We hypothesise that early manipulation of the microbiome will improve clinical response to standard-of-care (SOC) induction therapy in patients with a relapse-associated microbiome profile. We describe the protocol of a pilot study assessing feasibility of treatment allocation based on baseline faecal microbiome profiles.Methods and analysisThis is a 52-week, multicentre, randomised, controlled, open-label, add-on pilot study to test the feasibility of a larger multicontinent trial evaluating the efficacy of adjuvant antibiotic therapy in 20 paediatric patients with mild-to-moderate-CD (10Ethics and disseminationThis study was approved by METC-AMC and CCMO (Netherlands) and IWK Health Centre (Canada). The first version of this protocol was approved by North Carolina Children's Hospital (USA), Wolfson Medical Centre (Israel). The FDA (USA), Health Canada and Ministry of Health (Israel) have reviewed and approved the protocol. Results will be published in international peer-reviewed journals and summaries will be provided to the funders and participants.Trial registration numberNCT04186247.