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CompletedNCT00167882Updated Sep 11, 2006

The Influence of 5-Aminosalicylates on Thiopurine Metabolite Levels

A Phase 4 interventional study of 5-aminosalicylate (Pentasa, Ferring) in Crohn's Disease, Ulcerative Colitis and Inflammatory Bowel Disease, sponsored by Amsterdam UMC, location VUmc. Completed at 1 site in Netherlands. Open to participants aged 18 Years to 70 Years. Per ClinicalTrials.gov, last updated 2006-09-11.

Sponsored by Amsterdam UMC, location VUmc · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
24
Allocation
Non-randomized
Ages
18 Years to 70 Years
Sex
All
01

Study summary

The purpose of this study is to determine the influence of different 5-aminosalicylate concentrations on the metabolism of azathioprine or 6-mercaptopurine in patients with inflammatory bowel disease.

Read the detailed description

Background:

The concomitant use of 5-aminosalicylates (5ASA) next to azathioprine (AZA) or 6-mercaptopurine (6MP) in the treatment of inflammatory bowel disease (IBD) may lead to an increased effectiveness of therapy as higher levels of the active metabolite of AZA/6MP (6-thioguaninenucleotides (6TGNs) are measured.

Objectives:

To determine the influence of 5-ASA compounds and its metabolites on the metabolites of AZA/6MP (6TGNs + 6-methylmercaptopurine (6MMP).

Methods:

Patients with quiescent disease under AZA/6MP therapy are eligible. Patients will receive three succeeding regimes (5ASA 2 gram/5ASA 4 gram/ no 5ASA) of 4 weeks next to the standard AZA/6MP therapy. At the start and at the end of every regime 5ASA and its major metabolite (N-acetyl-5ASA) will be determined in serum next to the measurement of 6TGNs and 6MMP in erythrocytes. The safety will monitored by standard laboratory parameters every four weeks.

Population:

Patients with IBD in remission and unchanged AZA/6MP dosages for at least 4 weeks.

Medication:

5ASA (Pentasa ® granules; Ferring) will be administered orally in dosages of 2 or 4 grams daily for a period of 4 weeks.

Endpoints:

The rise or decrease in 6TGNs and 6MMP during the different 5ASA regimes. The evaluation of the safety of co-administrating 5ASA next to AZA/6MP.

Risks:

Side effects of 5ASA use are limited and well known. Some case reports have described the potential risk of developing a myelodepression when AZA/6MP and 5ASA are given together due to the rise in 6TGNs. However, in daily practice both drugs are administered together frequently. The risks of the frequent blood draws are minimal and usually self-limiting (haematoma).

02

Conditions studied

  • Crohn's Disease
  • Ulcerative Colitis
  • Inflammatory Bowel Disease

Keywords

  • Crohn's disease
  • Ulcerative colitis
  • Inflammatory bowel disease
  • azathioprine
  • 6-mercaptopurine
  • 5-aminosalicylate
  • metabolism
03

In context

Colitis

1,073 studies on the registry are indexed under Colitis; 131 are open to participants now.

This study's enrollment of 24 is below the median of 60 across 771 interventional studies indexed under Colitis.

Browse Colitis studies →

Lead sponsor

Amsterdam UMC, location VUmc is the lead sponsor of 302 studies on the registry; 84 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
18 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Adult patients, aged between 18 - 70 years
  • Informed consent
  • Diagnosis of CD or UC for at least 6 months (histological and endoscopically confirmed)
  • Steady state AZA of 6-MP use (an unchanged thiopurine regime for at least 4 weeks)
  • Normal liver and kidney function (ALAT / AP / creatinin \< 2 x upper normal limit)
  • Quiescent disease (HBI score ≤ 4 for CD or modified TLWI score ≤ 4 for UC)

Exclusion criteria

Exclusion Criteria:

  • Bone marrow suppression (platelets / leucocytes \< 1 x lower normal level)
  • Presence of active infection (fever and CRP > 1 x upper normal limit)
  • Anemia (hemoglobin \< 6 mmol)
  • Known duodenal Crohn's disease interfering significantly with resorptive area
  • Small bowel surgery interfering significantly with resorptive area
  • Known intolerance to 5-ASA compounds
  • Current use of 5-ASA compounds
  • Use of 5-ASA compounds within the last 30 days
  • Concomitant use of allopurinol, ACE-inhibitors or furosemide
  • Pregnancy, expected pregnancy or lactation within 6 months
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Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Non-randomized
Intervention model
Single group
Masking
Single
Enrollment
24 participants

Interventions

  • Drug5-aminosalicylate (Pentasa, Ferring)
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What researchers measure

Primary outcomes

  1. To determine the influence of 5-ASA compounds and its metabolites on the 6-TGN level during steady state AZA or 6-MP dosages

Secondary outcomes

  1. To determine the influence of 5-ASA compounds and its metabolites on the 6-MMP level during steady state AZA or 6-MP dose

  2. To determine the influence of 5-ASA compounds and its metabolites on the 6-TGMP, 6-TGDP and 6-TGTP levels during steady state AZA or 6-MP dosages

  3. To evaluate the safety of co-administrating 5-ASA and AZA or 6-MP in IBD patients

07

Study locations

1 site
  • Maasland Hospital
    Sittard, Netherlands
08

References and documents

Publications

  • Derijks LJ, Gilissen LP, Engels LG, Bos LP, Bus PJ, Lohman JJ, Curvers WL, Van Deventer SJ, Hommes DW, Hooymans PM. Pharmacokinetics of 6-mercaptopurine in patients with inflammatory bowel disease: implications for therapy. Ther Drug Monit. 2004 Jun;26(3):311-8. doi: 10.1097/00007691-200406000-00016. PubMed 15167634 ↗
  • de Boer NK, de Graaf P, Wilhelm AJ, Mulder CJ, van Bodegraven AA. On the limitation of 6-tioguaninenucleotide monitoring during tioguanine treatment. Aliment Pharmacol Ther. 2005 Sep 1;22(5):447-51. doi: 10.1111/j.1365-2036.2005.02581.x. PubMed 16128683 ↗
  • Al Hadithy AF, de Boer NK, Derijks LJ, Escher JC, Mulder CJ, Brouwers JR. Thiopurines in inflammatory bowel disease: pharmacogenetics, therapeutic drug monitoring and clinical recommendations. Dig Liver Dis. 2005 Apr;37(4):282-97. doi: 10.1016/j.dld.2004.09.029. PubMed 15788214 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 11, 2006, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT00167882
Lead sponsor
Amsterdam UMC, location VUmc
First posted
Sep 14, 2005
Start date
Jul 2005
Completion
Aug 2006
Last update
Sep 11, 2006

Study contacts

K.H.N. de Boer, MD
principal investigator · Amsterdam UMC, location VUmc
View the source record on ClinicalTrials.gov ↗

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