PROACTIVE study aims to improve the care of patients with perianal fistulising Crohn's disease

The PROACTIVE study, co-led by Associate Professor John Nik Ding at St Vincent’s Hospital and Associate Professor Susan Connor of Liverpool Hospital, aims to improve the care of patients with perianal fistulising Crohn's disease, a debilitating phenotype of inflammatory bowel disease with significant morbidity and reduced quality of life.

Improved rates of fistula healing have been observed with higher infliximab drug levels. It is hypothesised that adopting an individualised dosing algorithm, whereby the dose of infliximab is proactively increased to target higher infliximab drug levels, will improve rates of fistula healing with a subsequent reduction in symptom burden and indirect economic costs. The PROACTIVE study aims to evaluate the efficacy of individually optimised infliximab therapy to achieve higher drug level targets guided by routinely performed drug levels, compared to standard fixed dosing schedules. The study will recruit from over 22 tertiary hospitals around Australia with novel endpoints including radiological and patient reported outcomes.

Associate Professor John Nik Ding - an honorary in the Department of Medicine - is the principal investigator in IBD trials at St Vincent’s Hospital Melbourne. Prior to this, he was based at London Imperial College where he completed his PhD project in inflammatory bowel disease and had an appointment as a clinical lecturer.