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Ulcerative Colitis (UC)Phase 4NCT07686757

INSIGHT-IBD Pragmatic Study

A Phase 4 study testing Mirikizumab, Anti-TNF agents and anti-integrin antibodies in people with Ulcerative Colitis (UC) and Crohn Disease (CD), run by Specialty Networks Research. at 11 sites in United States.

Enrolling by invitation

Enrolling by invitation. The study team selects and invites participants, usually from an existing group of patients.

Sites and contacts
Official record
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Trial summary

The goal of this study is to evaluate the real-world effectiveness of treatments for inflammatory bowel disease (IBD) within routine clinical practice. The study population includes adult patients (≥21 years) with ulcerative colitis (UC) or Crohn's disease (CD) receiving care in community gastroenterology practices in… Read more about this study

Who is it for?
Ages 21 years and older
Conditions the study is for
Ulcerative Colitis (UC), Crohn Disease (CD)
What is being tested?
Mirikizumab, Anti-TNF agents and anti-integrin antibodies
Could I receive a placebo?
No, everyone receives an active treatment
How many people
400 participants
Where
11 sitesUnited States
Study dates
12 Aug 2026to Jun 2028
Phase
Phase 4
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥21 years at the time of enrollment
  • Confirmed diagnosis of ulcerative colitis (UC) or Crohn's disease (CD)
  • Eligible for treatment with biologic therapy for IBD, defined as failure of prior conventional therapy and/or prior biologic therapy (excluding IL-23p19 antagonists)
  • No prior exposure to mirikizumab and no contraindications to mirikizumab
  • Ability to provide informed consent
  • Willingness to comply with study procedures and follow-up requirements

Who cannot join

  • Prior exposure to IL-23p19 antagonists (e.g., mirikizumab, risankizumab, guselkumab)
  • Prior exposure to small molecule targeted therapies for IBD (e.g., JAK inhibitors or S1P receptor modulators)
  • Participation in an interventional clinical trial within 90 days prior to enrollment
  • History of extensive colorectal resection, including:
  • Total proctocolectomy (for UC), or
  • Surgical removal of two or more intestinal segments (for CD)
  • Any condition that, in the investigator's judgment, may compromise patient safety, data integrity, or ability to participate in the study

Trial locations and contacts

11 sites in 1 country. Contact the study team or a site near you to ask about taking part.

11 sites in 1 country

United States11 sites
  • Texas Digestive Disease Consultants

    Cedar Park, Texas, 78613

  • Texas Digestive Disease Consultants

    Fort Worth, Texas, 76104

  • GI Alliance of Illinois

    Glenview, Illinois, 60005

  • Lake Shore Gastro-Gurnee Research

    Gurnee, Illinois, 60031

  • Digestive Health Associates

    Houston, Texas, 77024

  • Texas Digestive Disease Consultants: Plano

    Plano, Texas, 75093

  • GI Alliance Richmond

    Richmond, Virginia, 23229

  • Gastroenterology Group of Rochester

    Rochester, New York, 14618

  • Texas Digestive Disease Consultants: San Antonio

    San Antonio, Texas, 78215

  • Texas Digestive Disease Consultants: San Marcos

    San Marcos, Texas, 78666

  • Arizona Digestive Health

    Sun City, Arizona, 85351

Other trials in United States

About this study

Official title: INSIGHT-IBD Pragmatic Study: Investigation of Mirikizumab in Real World Settings for Mirikizumab

The goal of this study is to evaluate the real-world effectiveness of treatments for inflammatory bowel disease (IBD) within routine clinical practice.

The study population includes adult patients (≥21 years) with ulcerative colitis (UC) or Crohn's disease (CD) receiving care in community gastroenterology practices in the United States.

Read more

The main questions it aims to answer are:

  • Does treatment with mirikizumab reduce the proportion of patients requiring an increase in IBD disease management (e.g., unplanned visits, dose escalation, therapy switch, emergency department visits, or hospitalization)?
  • Does treatment with mirikizumab improve clinical outcomes, including disease activity, clinical remission, and patient-reported outcomes, compared to standard biologic therapy?
  • Researchers will compare patients treated with mirikizumab within the IBD Clinical Care Pathway versus patients receiving standard biologic therapies to see if mirikizumab leads to improved disease control and reduced healthcare utilization.

Participants will:

  • Receive either mirikizumab or standard biologic therapy as part of routine clinical care
  • Attend follow-up visits at approximately 3, 6, 12, and 18 months
  • Have clinical data collected from electronic health records and healthcare utilization sources
  • Complete patient-reported outcome questionnaires assessing symptoms, quality of life, and daily functioning
  • Undergo routine laboratory tests and clinical assessments as part of standard care
Being tested
Mirikizumab, Anti-TNF agents, anti-integrin antibodies, IL-12, IL-23
Medical subject headings
Colitis, Ulcerative, Crohn Disease

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • MirikizumabDrug

    Mirikizumab administered according to approved dosing regimens for ulcerative colitis and Crohn's disease.

  • Anti-TNF agentsDrug

    Biologic therapies administered per routine clinical care, including anti-TNF agents, anti-integrins, IL-12/23 antagonists, and IL-23p19 antagonists.

  • anti-integrin antibodiesDrug

    Biologic therapies administered per routine clinical care, including anti-TNF agents, anti-integrins, IL-12/23 antagonists, and IL-23p19 antagonists.

  • IL-12Drug

    Biologic therapies administered per routine clinical care, including anti-TNF agents, anti-integrins, IL-12/23 antagonists, and IL-23p19 antagonists.

  • IL-23Drug

    Biologic therapies administered per routine clinical care, including anti-TNF agents, anti-integrins, IL-12/23 antagonists, and IL-23p19 antagonists.

Study groups in NCT07686757
Study groupRoleWhat they receive
Mirikizumab Clinical Care PathwayActive comparatorParticipants receive mirikizumab as part of the IBD Clinical Care Pathway in routine clinical practice. Dosing and administration follow the approved prescribing information for ulcerative colitis or Crohn's disease, with treatment and monitoring per standard of care.
Receives: Drug: Mirikizumab
Standard Biologic Therapy Clinical Care PathwayActive comparatorParticipants receive standard biologic therapies for IBD as part of the IBD Clinical Care Pathway according to physician discretion and routine clinical practice. Therapies may include anti-TNF agents, anti-integrins, IL-12/23 antagonists, or IL-23p19 antagonists.
Receives: Drug: Anti-TNF agents; Drug: anti-integrin antibodies; Drug: IL-12; Drug: IL-23

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proportion of Patients Requiring an Increase in IBD Disease Management

    The proportion of patients requiring an increase in inflammatory bowel disease (IBD) disease management, defined as a composite of treatment and healthcare resource use, while receiving index therapy.

    Measured: Up to 18 months following initiation of therapy

Secondary outcomes (17)
  1. Change in Disease Activity Measured by Crohn's Disease PRO2 Scores

    Change from baseline in disease activity assessed using validated patient-reported outcome measures:

    Crohn's Disease Patient-Reported Outcome 2 (CD PRO2), composed of:

    Abdominal pain score (range 0-3) Stool frequency (number of bowel movements per day; higher values indicate worse disease activity)

    Changes in PRO2 component scores and composite disease activity will be evaluated over time, with decreases from baseline indicating improvement in disease activity.

    Measured: Baseline, 6 months, 12 months, and 18 months

  2. Change in Disease Activity Measured by Ulcerative Colitis PRO2 Scores

    Change from baseline in disease activity assessed using validated patient-reported outcome measures:

    Ulcerative Colitis Patient-Reported Outcome 2 (UC PRO2), composed of:

    Stool frequency score (range 0-3) Rectal bleeding score (range 0-3) Total possible combined score range: 0-6, with higher scores indicating worse disease activity

    Changes in PRO2 component scores and composite disease activity will be evaluated over time, with decreases from baseline indicating improvement in disease activity.

    Measured: Baseline, 6 months, 12 months, and 18 months

  3. Proportion of Participants Achieving Endoscopic Remission Measured by Simple Endoscopic Score for Crohn's Disease (SES-CD)

    Proportion of participants achieving endoscopic remission assessed using validated endoscopic scoring system:

    Simple Endoscopic Score for Crohn's Disease (SES-CD) (range 0-56), where lower scores indicate less endoscopic disease activity and endoscopic remission is defined as a score ≤2

    Endoscopic findings are collected as part of routine clinical care, when available.

    Measured: Up to 18 months (as available from routine clinical care)

  4. Proportion of Participants Achieving Endoscopic Remission Measured by Modified Baron Score.

    Proportion of participants achieving endoscopic remission assessed using validated endoscopic scoring systems:

    Modified Baron Score (ulcerative colitis) (range 0-4), where lower scores indicate less mucosal inflammation and endoscopic remission is defined as a score of 0 (normal mucosa with no visible inflammation)

    Endoscopic findings are collected as part of routine clinical care, when available.

    Measured: Up to 18 months (as available from routine clinical care)

  5. Treatment Persistence

    Duration of time from treatment initiation to discontinuation of index therapy for any reason, including continued use at pre-specified timepoints.

    Measured: Up to 18 months

  6. Proportion of Patients with Dose Escalation

    Proportion of patients who discontinue index therapy and/or initiate a subsequent IBD therapy during the study period.

    Measured: Up to 18 months

  7. Time to Next Treatment

    Time from initiation of index therapy to initiation of a subsequent therapy or discontinuation of index therapy.

    Measured: Up to 18 months

  8. Concomitant Medication Use

    Proportion of patients receiving concomitant corticosteroids, immunomodulators, or aminosalicylates at baseline and during follow-up, including initiation and discontinuation patterns.

    Measured: Baseline through 18 months

  9. Corticosteroid-Free Time

    Duration of time patients remain free from corticosteroid use while receiving index therapy.

    Measured: Up to 18 months

  10. Healthcare Resource Utilization

    Frequency and rate of IBD-related healthcare utilization

    Measured: Up to 18 months

  11. Change in Patient-Reported Outcomes Measured by SIBDQ

    Change from baseline in patient-reported outcomes assessed using validated instrument:

    Short Inflammatory Bowel Disease Questionnaire (SIBDQ) (range 10-70), where higher scores indicate better health-related quality of life

    Changes in scores over time will be evaluated to assess symptom burden, quality of life, and functional outcomes.

    Measured: Baseline, 6 months, 12 months, and 18 months

  12. Change in Patient-Reported Outcomes Measured by UNRS

    Change from baseline in patient-reported outcomes assessed using validated instrument:

    Bowel Urgency Numeric Rating Scale (UNRS) (range 0-10), where higher scores indicate worse bowel urgency

    Changes in score over time will be evaluated to assess symptom burden, quality of life, and functional outcomes.

    Measured: Baseline, 6 months, 12 months, and 18 months

  13. Change in Patient-Reported Outcomes Measured by PROMIS Global Health

    Change from baseline in patient-reported outcomes assessed using validated instrument:

    PROMIS Global Health (PROMIS-GH) (T-score standardized, mean 50), where higher scores indicate better overall health status

    Changes in score over time will be evaluated to assess symptom burden, quality of life, and functional outcomes.

    Measured: Baseline, 6 months, 12 months, and 18 months

  14. Change in Patient-Reported Outcomes Measured by SAA

    Change from baseline in patient-reported outcomes assessed using validated instrument:

    Sexual Activity Avoidance (SAA), where higher scores indicate greater avoidance of sexual activity

    Changes in scores over time will be evaluated to assess symptom burden, quality of life, and functional outcomes.

    Measured: Baseline, 6 months, 12 months, and 18 months

  15. Change in Patient-Reported Outcomes Measured by WPAI:SHP

    Change from baseline in patient-reported outcomes assessed using validated instrumens:

    Work Productivity and Activity Impairment: Specific Health Problem (WPAI:SHP) (0-100%), where higher percentages indicate greater impairment

    Changes in score over time will be evaluated to assess symptom burden, quality of life, and functional outcomes.

    Measured: Baseline, 6 months, 12 months, and 18 months

  16. Proportion of Participants Achieving Clinical Remission Based on Ulcerative Colitis PRO2.

    Proportion of participants achieving clinical remission based on validated patient-reported outcome measures:

    Ulcerative Colitis Patient-Reported Outcome 2 (UC PRO2), composed of:

    Stool frequency score (range 0-3) Rectal bleeding score (range 0-3) Lower scores indicate less disease activity; clinical remission is defined as rectal bleeding score = 0 and stool frequency score ≤1

    These thresholds represent minimal or no symptoms consistent with clinical remission.

    Measured: Baseline, 6 months, 12 months, and 18 months

  17. Proportion of Participants Achieving Clinical Remission Based on Crohn's Disease PRO2.

    Proportion of participants achieving clinical remission based on validated patient-reported outcome measures: Crohn's Disease Patient-Reported Outcome 2 (UC PRO2), composed of: Stool frequency score (range 0-3) Rectal bleeding score (range 0-3) Lower scores indicate less disease activity; clinical remission is defined as rectal bleeding score = 0 and stool frequency score ≤1 These thresholds represent minimal or no symptoms consistent with clinical remission.

    Measured: Baseline, 6 months, 12 months, and 18 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted7 Jul 2026
  2. Study start12 Aug 2026
  3. Primary completionJun 2028 (estimated)
  4. Study completionJun 2028 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Health services research
Allocation
Randomised
Intervention model
Parallel groups
Model description
This is a cluster randomized, parallel-group study in which participating community gastroenterology practices are randomized to either a mirikizumab treatment pathway or a standard biologic therapy pathway. All eligible patients enrolled at a given site receive the treatment assigned to that site. Patients are followed prospectively under routine clinical care without crossover between treatment groups.
Masking
None (open label)
Enrolment
400 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07686757
Sponsor's protocol ID
103899
Status last verified
Oct 2026
First submitted
18 Jun 2026
Last updated
2 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No: This study does not plan to share Individual Participant Data (IPD)

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Mirikizumab, Anti-TNF agents and anti-integrin antibodies in people with Ulcerative Colitis (UC) and Crohn Disease (CD), run by Specialty Networks Research. at 11 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: enrolling by invitation, as of the sponsor's last update on 2 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 11 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of Patients Requiring an Increase in IBD Disease Management (time frame: Up to 18 months following initiation of therapy). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Oct 2026.

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