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Not yet recruitingNCT07795476AIFOR-CDUpdated Oct 1, 2026

Artificial Intelligence For Outcomes Research in Crohn's Disease: Digital Pathology Assessment of Fibrosis and Association With Patient History and Clinical Outcomes

An observational study in Crohn Disease, Fibrostenotic Crohn's Disease and CD - Crohn's Disease, sponsored by PharmaNest, Inc. Not yet recruiting at 2 sites in Spain. Open to participants aged 18 Years to 80 Years. Per ClinicalTrials.gov, last updated 2026-10-01.

Sponsored by PharmaNest, Inc · Observational

Updated Oct 1, 2026Study documents postedStart date moved+6 moreGo to Updates ↓
Study type
Observational
Model
Cohort
Time perspective
Retrospective
Enrollment
100
Ages
18 Years to 80 Years
Sex
All
01

Study summary

The goal of this retrospective observational study is to learn whether artificial intelligence-based digital pathology can measure intestinal fibrosis and help identify patients with Crohn's disease who may be at greater risk of disease progression and surgery.

The main questions the study aims to answer are:

Does the FibroNest Phenotypic Fibrosis Composite Score [Ph-FCS(Muc)], measured from routinely collected ileal biopsies, reflect the severity of fibrosis assessed by a pathologist?

  • Is Ph-FCS(Muc) associated with Crohn's disease characteristics and history?
  • Can Ph-FCS(Muc) help predict whether a patient will subsequently require a first ileal surgical resection for fibrostenotic Crohn's disease?

Researchers will retrospectively analyze previously collected ileal biopsies and medical information from adults with Crohn's disease. Biopsy slides will be digitized and analyzed using FibroNest digital pathology, and the resulting fibrosis measurements will be compared with pathologist assessments, clinical characteristics, disease history, and subsequent clinical outcomes.

Read the detailed description

Crohn's disease is a chronic inflammatory bowel disease that can lead to progressive intestinal fibrosis. Fibrosis contributes to structural bowel damage, strictures and obstruction and is an important cause of surgical intervention. However, intestinal fibrosis remains difficult to quantify objectively, particularly from routinely collected endoscopic biopsies, and there are limited validated tools to identify tissue fibrosis phenotypes associated with subsequent disease progression.

AIFOR-CD (Artificial Intelligence for Outcomes Research in Crohn's Disease) is a retrospective observational study evaluating the use of artificial intelligence-based digital pathology to quantify and characterize fibrosis in routinely collected ileal biopsies from patients with Crohn's disease.

The study uses the FibroNest Phenotypic Fibrosis Composite Score [Ph-FCS(Muc)], a continuous quantitative digital pathology biomarker derived from histological features of fibrosis measured in the mucosa of ileal biopsies. The study is organized around three complementary objectives: to validate Ph-FCS(Muc) against pathologist-assessed mucosal fibrosis severity; to investigate its relationship with Crohn's disease characteristics and history; and to explore whether quantitative fibrosis phenotypes in ileal biopsies can identify patients at increased risk of subsequent first ileal surgical resection for fibrostenotic Crohn's disease.

The study will use previously collected histological specimens and retrospective clinical information. Digital pathology analyses will be performed using pseudonymized whole-slide images of ileal biopsies, with appropriate blinding between biomarker measurements and the reference assessments or clinical outcomes when applicable.

AIFOR-CD is intended to determine whether quantitative assessment of fibrosis from routinely obtained endoscopic biopsies can provide objective information on intestinal fibrotic burden and contribute to the characterization and risk stratification of patients with Crohn's disease.

02

Conditions studied

  • Crohn Disease
  • Fibrostenotic Crohn's Disease
  • CD - Crohn's Disease

Keywords

  • Digital Pathology
  • Fibrosis
  • Artificial Intelligence
03

In context

Crohn Disease

1,992 studies on the registry are indexed under Crohn Disease; 478 are open to participants now.

This study's planned enrollment of 100 is below the median of 185 across 645 observational studies indexed under Crohn Disease.

Browse Crohn Disease studies →

Lead sponsor

PharmaNest, Inc is the lead sponsor of 3 studies on the registry; 1 is open to participants now.

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

04

Who can participate

Ages eligible
18 Years to 80 Years
Sexes eligible
All
Accepts healthy volunteers
No
Sampling method
Non-probability sample

Study population

The study population consists of adults (≥18 years) with a diagnosis of Crohn's disease and an available ileal endoscopic biopsy suitable for digital pathology analysis. The overall AIFOR-CD population includes patients spanning varying degrees of mucosal fibrosis and disease characteristics. For the outcomes component, patients without prior gastrointestinal surgery or endoscopic intervention are selected according to whether they underwent a first ileal surgical resection for fibrostenotic Crohn's disease within 6-24 months after the index biopsy or remained free of ileal resection or endoscopic intervention for at least 4 years after the index biopsy.

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Adult pts (>=18 years old) diagnosed with Crohn's disease based on Investigator's assessment.
  • Ileal with fibrosis Masson's Trichome staining available for digitization or already digitized at 40X ( or \~0.25micron per pixel)
  • The cohort will contain patients with various levels of intensity and distribution of fibrosis as defined by the pathologist with a minimum of 7 patients for any level of intensity and distribution for being required.
  • Minimum information available for each patient (see Appendix 2, table 1)

Exclusion criteria

Exclusion Criteria:

  • History of gastrointestinal endoscopic interventions and/or surgery for Crohn's disease management such as endoscopic balloon dilation, strictureplasty, stricturectomy or bowel resection prior to the index .
  • History of gastrointestinal surgery for any indication
Terms in these criteria, in plain language(1)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Biopsy and archival tissue

A biopsy takes a small piece of tissue to examine. “Archival tissue” is a sample already taken, for example at diagnosis, and kept by the hospital.

Whether a stored sample will do depends on when it was taken, how much there is and what the study needs. Ask whether the study accepts your stored sample or needs a new biopsy.

05

Study design

Observational model
Cohort
Time perspective
Retrospective
Enrollment
100 participants (estimated)
Patient registry
No

Groups and cohorts

  • Patients with surgical intervention 24 Months after index biopsy

    Patients with with Crohn's Disease (CD) and ileal biopsy that underwent a first ileal surgical resection for ileal fibro-stenotic Crohn's disease within a maximum of 24 months after the index biopsy. No endoscopic procedure (balloon dilation, strictureplasty or stricturectomy) is permitted between the index biopsy and the first ileal surgical resection.

    Diagnostic Test: Ph-FCS(Muc) fibrosis severity Digital Pathology biomarker

  • Patients without surgical intervention within 4 years after index biopsy

    Patients with Crohn's Disease and ileal biopsy that did NOT undergo first ileal resection or ileal endoscopic procedure (balloon dilation, strictureplasty or stricturectomy) within 4 years after the index biopsy.

    Diagnostic Test: Ph-FCS(Muc) fibrosis severity Digital Pathology biomarker

Interventions

  • Diagnostic testPh-FCS(Muc) fibrosis severity Digital Pathology biomarker

    Ph-FCS(Muc) is a continuous, quantitative digital pathology biomarker that integrates multiple histological features of mucosal fibrosis into a single fibrosis severity score, providing a more granular assessment than conventional ordinal histological staging.

06

What researchers measure

Primary outcomes

  1. Occurrence of the First ileal surgical resection for ileal fibro-stenotic Crohn's

    Occurrence (and date of occurrence) of the First ileal surgical resection for ileal fibro-stenotic Crohn's , and No endoscopic procedure (balloon dilation, strictureplasty or stricturectomy)

    Time frame: 24 months

07

Study locations

2 sites
08

References and documents

Publications

  • Denise Ng et al. (2026). Digital Pathology Quantifies Mucosal Fibrosis and Aligns with Pathologist Scoring in IBD Biopsies; Submitted UEG 2026 (refused on the basis of small N=20) and resubmitted DDW2027
  • Chen Li et al. (2026) Evaluation of a Novel Structured, Layer-Specific Framework for Histologic Fibrosis Staging in IBD. Chen L. et Al. Gastrointestinal Endoscopy, Vol. 103, Issue 5, Supplement S-1055-S-1056, May, 2026 - doi. 10.1016/S0016-5107(26)02658-1-
  • Miha Jerala, Chen L, Drobne D, Petitjean M, Zidar N. Quantifying fibrosis in inflammatory bowel diseases - contribution of digital pathology. Dig Liver Dis. 2025 Oct;57(10):1938-1946. doi: 10.1016/j.dld.2025.08.002. Epub 2025 Aug 20. PubMed 40841237 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: Undecided

09

Updates

1 registry update since Sep 25, 2026
Sites
2 sites added, 1 site removed
Show 2 added (2 Spain)
  • University Hospital Virgen del Rocio · Seville, Spain
  • University Hosptal Virgen Macarena · Seville, Spain
Show 1 removed
  • Hospital Universitario Virgen del Rocio · Seville, Spain
Oct 1, 2026
Start date
Oct 1, 2026→Nov 1, 2026
Oct 1, 2026
Primary completion
Feb 15, 2027→Mar 15, 2027
Oct 1, 2026
Interventions
Arm changed Patients with surgical intervention 6-24 Months after index biopsy→Patients with surgical intervention 24 Months after index biopsy
Oct 1, 2026
Primary outcomes
1 edited
What changed in the outcomes
  • EditedOccurrence of the First ileal surgical resection for ileal fibro-stenotic Crohn'sTime frame: 24 months
Oct 1, 2026
Documents
Oct 1, 2026
Sponsor
Collaborators added: University Hospital of Nuestra Señora de Valve·University Hospital of Virgen del Rocio·University Hospital of Virgen Macarena; collaborators removed: Hospital Universitario Virgen del Rocio, Seville Spain·Hospital Universitario Virgen Macarena Seville, Spain·Hanauer IBD Center at Northwestern Medicine, Chicago, IL, USA·IBD Center, Department of Gastroenterology San Raffaele Hospital, Milan, Italy
Oct 1, 2026
Show all 1 update
  1. Oct 1, 2026
    Documents Study protocol ↗ posted
    2 sites added, 1 site removed
    Show 2 added (2 Spain)
    • University Hospital Virgen del Rocio · Seville, Spain
    • University Hosptal Virgen Macarena · Seville, Spain
    Show 1 removed
    • Hospital Universitario Virgen del Rocio · Seville, Spain
    Start date Oct 1, 2026→Nov 1, 2026
    Primary completion Feb 15, 2027→Mar 15, 2027
    Primary outcomes 1 edited
    What changed in the outcomes
    • EditedOccurrence of the First ileal surgical resection for ileal fibro-stenotic Crohn'sTime frame: 24 months
    Interventions Arm changed Patients with surgical intervention 6-24 Months after index biopsy→Patients with surgical intervention 24 Months after index biopsy
    Sponsor Collaborators added: University Hospital of Nuestra Señora de Valve·University Hospital of Virgen del Rocio·University Hospital of Virgen Macarena; collaborators removed: Hospital Universitario Virgen del Rocio, Seville Spain·Hospital Universitario Virgen Macarena Seville, Spain·Hanauer IBD Center at Northwestern Medicine, Chicago, IL, USA·IBD Center, Department of Gastroenterology San Raffaele Hospital, Milan, Italy
    + 3 other changes: verification date, description and conditions

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

10

Registry details

Key details

Study ID
NCT07795476
Lead sponsor
PharmaNest, Inc
Collaborators
University Hospital of Nuestra Señora de Valve, University Hospital of Virgen del Rocio, University Hospital of Virgen Macarena
Responsible party
Sponsor
First posted
Aug 31, 2026
Start date
Nov 1, 2026 (estimated)
Primary completion
Mar 15, 2027 (estimated)
Completion
May 15, 2027 (estimated)
Last update
Oct 1, 2026

Study contacts

Helene Petitjean P. Clinical Study Director, MD
Contact
info@pharmaenst.com
+1 609 375 2003
Li Chen, Study Director, Ph.D.
Contact
info@pharmaenst.com
+1 609 375 2003
Manuel Romero Gomes, MD
principal investigator · Hospital Universitario Virgen del Rocio, Seville Spain

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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