stella
Crohn's DiseaseMay 2023

What the U-EXCEL Trial Found — Upadacitinib for Crohn's Disease

U-EXCEL and the companion U-EXCEED trial tested upadacitinib, a once-daily oral pill, as a starter treatment in 1,021 adults with moderately to severely active Crohn's. The pill brought significantly more patients into remission and healed visible intestinal inflammation within 12 weeks.

What the trial was testing

The U-EXCEL enrolled 526 patients with crohn's disease. The study was sponsored by AbbVie and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

About 50% reached clinical remission at 12 weeks — roughly twice the placebo rate.

New England Journal of Medicine · 2023 · NCT03345849

These findings — that of patients in clinical remission at 12 weeks on upadacitinib vs. placebo — were published in the New England Journal of Medicine and represent the headline result of the study.

Researchers tracked outcomes across 526 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with crohn's disease, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

Upadacitinib (Rinvoq) is FDA-approved for moderately to severely active Crohn's disease in adults who haven't responded to other treatments and available now. It is taken as a once-daily pill — no injections or infusions. Side effects can include increased infection risk and lab changes; regular monitoring is required. Ask your gastroenterologist whether it fits.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.

Open crohn's disease trials

RecruitingObservational study

Development and Validation of a New Paediatric Inflammatory Bowel Disease NUTrition Risk Score (PIBD-NUTS)

Children with inflammatory bowel disease (IBD) including both Crohn's disease (CD) and ulcerative colitis (UC) can be at high risk of developing malnutrition due to the nature of their condition. It is also believed that some children with IBD, in need of nutritional care, are not identified quickly by their healthcare professionals. This may negatively affect their nutrition, disease progression and general well-being. Hence, it has been proposed that nutritional screening tools or scores (NSTs) should be used to promptly identify children needing further dietetic review and input. Although there are a few NSTs for generic use in sick children at hospital admission, NSTs or scores to use for children with IBD are currently missing. In this study, we would like to test the performance of an existing tool that is routinely used for all sick children at hospital admission (The Paediatric Yorkhill Malnutrition Score or PYMS)(5) and test whether PYMS can detect children with IBD who are at risk of malnutrition. If PYMS doesn't work well, we will develop a specific tool for children with IBD (The Paediatric IBD Nutrition Score or PIBD-NUTS).

Salzburg, Austria +7 more
RecruitingLarge-scale testing

A Study of Vedolizumab in Children and Teenagers With Moderate to Severe Crohn's Disease (CD)

Vedolizumab is a medicine that helps to reduce inflammation and pain in the digestive system. In this study, children and teenagers with moderate to severe Crohn's disease will be treated with vedolizumab. The main aim of the study is to check if participants achieve remission after treatment with the vedolizumab. Remission means symptoms improve or disappear and an endoscopy shows no signs of inflammation. Participants will receive 3 infusions of vedolizumab over 6 weeks. Then, those who have a clinical response will receive either a high dose or low dose of vedolizumab once every 8 weeks. They will receive the same dose every time.

Phoenix, Arizona, United States +24 more