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Hvidovre Hospital - a part of Copenhagen University Hospital
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A randomised, double-blind, placebo-controlled trial of Trichuris suis ova (TSO) in active Crohn's disease

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  • Jürgen Schölmerich
  • Klaus Fellermann
  • Frank W Seibold
  • Gerhard Rogler
  • Jost Langhorst
  • Stefanie Howaldt
  • Gottfried Novacek
  • Andreas Munk Petersen
  • Oliver Bachmann
  • Harald Matthes
  • Norbert Hesselbarth
  • Niels Teich
  • Jan Wehkamp
  • Jochen Klaus
  • Claudia Ott
  • Karin Dilger
  • Roland Greinwald
  • Ralph Mueller
  • International TRUST-2 Study Group
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BACKGROUND & AIMS: To investigate the efficacy and safety of three different dosages of embryonated, viable eggs of Trichuris suis (TSO) versus placebo for induction of remission in mildly-to-moderately active ileocolonic, uncomplicated Crohn's disease (CD).

METHODS: Adults with active CD (n=252) randomly received six fortnightly doses of 250, 2500 or 7500 TSO/15 ml suspension/day (TSO 250, TSO 2500, TSO 7500), or 15ml placebo solution/day, in a double-blind fashion, with four weeks' follow-up. Primary endpoint was the rate of clinical remission (Crohn's disease activity index [CDAI]<150) at end of treatment, i.e. at week 12 or withdrawal. Secondary endpoints included the course of clinical remission, rate of clinical response, change in CDAI, change in markers of inflammation, mucosal healing, and Physician's Global Assessment.

RESULTS: Clinical remission at week 12 occurred in 38.5%, 35.2%, and 47.2% of TSO 250, TSO 2500, and TSO 7500 patients, respectively and in 42.9% of placebo recipients. TSO induced a dose-dependent immunological response. There was no response regarding laboratory markers of inflammation. Other secondary efficacy variables also showed no advantage of TSO over placebo for treatment of active CD. Administration of TSO did not result in any serious adverse drug reaction. Review of non-serious suspected adverse drug reactions following TSO did not reveal any safety concerns.

CONCLUSION: Administration of 250-7500 TSO fortnightly over 12 weeks was safe and showed a dose-dependent immunological response, but no TSO dose showed a clinically relevant effect over placebo for induction of clinical remission or response in mildly-to-moderately active, ileocolonic CD.

Original languageEnglish
JournalJournal of Crohn's & colitis
Volume11
Issue number4
Pages (from-to)390-399
ISSN1873-9946
DOIs
Publication statusPublished - Apr 2017

ID: 49085616