A Trial of Wellbutrin for Crohn's Disease

Study Overview
=================
Brief Summary
-----------------
The investigators are testing the hypothesis that Wellbutrin (bupropion) can give a clinical remission in Crohn's disease.

Detailed Description
-----------------
Wellbutrin (bupropion) is approved for use as an antidepressant. There have been some cases in which people on Wellbutrin had significant improvement clinically in their Crohn's disease. In this trial, the hypothesis that Wellbutrin can induce clinical remission in Crohn's disease will be tested. The investigators will also be looking to see if Wellbutrin can lower levels of the inflammatory cytokine tumor necrosis factor-alpha (TNF).

Official Title
-----------------
A Randomized Controlled Trial of Wellbutrin for Crohn's Disease

Conditions
-----------------
Crohn Disease

Intervention / Treatment
-----------------
* Drug: Wellbutrin (bupropion)


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Moderate to severe Crohn's disease with 220 < CDAI < 400. All patients in the study must have not had any anti-TNF antibodies for at least eight weeks. Exclusion Criteria: Patients will be excluded from the study if they have fulminant Crohn's disease requiring parenteral steroid treatment, hospitalization, or need of surgery imminently. Patients with serious infections in the preceding three months, opportunistic infections within one month, or current signs or symptoms of severe, progressive or uncontrolled renal, hepatic, hematologic, endocrine, pulmonary, cardiac, neurological, or cerebral disease will be excluded. Patients will also be excluded from the study if they have a history of a seizure, epilepsy, presumed current central nervous system tumor, have or have had anorexia nervosa or bulimia, are currently taking or have taken in the last four weeks any drug in the monoamine oxidase inhibitor class, or are allergic to Wellbutrin. Patients with active major depression or suicidal ideation will be excluded, as will patients with a score of 19 or higher on the Beck depression inventory. Patients will be excluded if they are currently or have taken a medicine in the selective serotonin reuptake class, mirtazapine, venlafaxine, a tricyclic antidepressant, a mood stabilizing, or antipsychotic medication in the previous two weeks. Patients will be excluded if they are currently abusing alcohol or have alcohol dependence. Patients will be excluded from the study if their baseline liver function tests are greater than twice the upper limit of normal, or if a clinical investigator believes that their baseline chemistry, liver function tests or complete blood count contraindicates entry into the study. Pregnant or lactating females are excluded.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Placebo Comparator: Sugar pill<br>Placebo (sugar) pill with identical look to bupropion | Drug: Wellbutrin (bupropion)<br>* bupropion 150mg-300mg daily<br>* Other names: Wellbutrin, bupropion;|
| Experimental: buproprion<br>bupropion pill | Drug: Wellbutrin (bupropion)<br>* bupropion 150mg-300mg daily<br>* Other names: Wellbutrin, bupropion;|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients with Crohn's disease activity index (CDAI) < 150 at the end of twelve weeks |  | 0, 2, 4, 8, 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients with CDAI drop of at least 70 points at the end of twelve weeks |  | 0, 12 weeks | 
| Time course of CDAI |  | 0, 2, 4, 8, 12 weeks | 
| Effect of drug and/or placebo on tumor necrosis factor-alpha (TNF) levels |  | 0, 12 weeks | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Crohn disease, TNF-alpha