- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01696396
Abrilumab (AMG 181) in Adults With Moderate to Severe Crohn's Disease
A Randomized, Double-blind, Placebo-controlled Study to Evaluate the Safety, Tolerability, and Efficacy of AMG 181 in Subjects With Moderate to Severe Crohn's Disease
Study Overview
Detailed Description
The study consisted of a 24-week double-blind treatment period, a 108-week open-label treatment period, and a 2-year safety follow-up period.
Participants who did not reach minimal improvement, or experienced disease worsening after initial response, had the option to receive open-label abrilumab 210 mg every 3 months (Q3M) beginning at double-blind period week 12 or after. Not reaching minimal improvement was defined as not having an improvement in CDAI score of ≥ 70 points from baseline on 2 consecutive visits (at or after week 8) at least 2 weeks apart. Disease worsening after week 8 (or week 12) response was defined as having an increase in CDAI score of ≥ 70 points from the week 8 (or week 12) CDAI score on 2 consecutive visits at least 2 weeks apart, and a CDAI score of > 150.
Participants were planned to be randomized in a 2:1:2:1 ratio to SC placebo or abrilumab at 21 mg, 70 mg (on day 1, week 2, week 4, and every 4 weeks thereafter until week 24), or 210 mg (on day 1 followed by placebo in weeks 2 and 4 and every 4 weeks thereafter until week 24), respectively. Due to a consistent discrepancy between the investigational product (IP) instruction manual (IPIM) description of vial positions and the actual vial positions in the IP package participants were initially randomized to 3 arms (placebo, 70 mg, and 210 mg) with a randomization ratio of 3:2:1. The study was temporarily paused while this issue was investigated. Once the discrepancy was corrected, Protocol Amendment 3 implemented, and affected participants completed their double-blind treatment period, the study resumed enrollment and randomization per protocol. Neither the randomization nor study blind was compromised and therefore the intent-to-treat principle was maintained.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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Innsbruck, Austria, 6020
- Research Site
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St Veit an der Glan, Austria, 9300
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Wien, Austria, 1090
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Wien, Austria, 1050
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Bonheiden, Belgium, 2820
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Brussels, Belgium, 1200
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Gent, Belgium, 9000
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Leuven, Belgium, 3000
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Alberta
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Edmonton, Alberta, Canada, T6G 2X8
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British Columbia
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Vancouver, British Columbia, Canada, V5Z 1M9
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Manitoba
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Winnipeg, Manitoba, Canada, R3A 1R9
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Ontario
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London, Ontario, Canada, N6A 5A5
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Sudbury, Ontario, Canada, P3E 1H5
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Toronto, Ontario, Canada, M5G 1X5
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Saskatchewan
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Saskatoon, Saskatchewan, Canada, S7N 0W8
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Hradec Kralove, Czechia, 500 12
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Praha 4, Czechia, 140 21
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Praha 4, Czechia, 140 59
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Praha 5, Czechia, 150 06
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Praha 7, Czechia, 170 04
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Usti nad Labem, Czechia, 401 13
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Aalborg, Denmark, 9000
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Herlev, Denmark, 2730
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Hvidovre, Denmark, 2650
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Køge, Denmark, 4600
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Odense C, Denmark, 5000
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Århus C, Denmark, 8000
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Amiens Cedex 1, France, 80054
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Caen Cedex 9, France, 14033
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Clichy, France, 92110
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Lille, France, 59037
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Nice Cedex 3, France, 06202
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Paris Cedex 10, France, 75475
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Paris cedex 12, France, 75571
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Pessac Cedex, France, 33604
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Vandoeuvre les Nancy, France, 54511
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Hamburg, Germany, 20148
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Leipzig, Germany, 04105
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Minden, Germany, 32423
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Stuttgart, Germany, 70376
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Bekescsaba, Hungary, 5600
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Budapest, Hungary, 1125
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Budapest, Hungary, 1088
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Debrecen, Hungary, 4032
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Miskolc, Hungary, 3526
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Szekszard, Hungary, 7100
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Amsterdam, Netherlands, 1105 AZ
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Breda, Netherlands, 4818 CK
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Leiden, Netherlands, 2333 ZA
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Maastricht, Netherlands, 6229 HX
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Rotterdam, Netherlands, 3015 CE
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Basel, Switzerland, 4031
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Bern, Switzerland, 3010
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Zurich, Switzerland, 8091
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Birmingham, United Kingdom, B18 7QH
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Coventry, United Kingdom, CV2 2DX
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London, United Kingdom, NW1 2BU
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Manchester, United Kingdom, M8 5RB
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Norwich, United Kingdom, NR4 7UY
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Torquay, United Kingdom, TQ2 7AA
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Alabama
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Birmingham, Alabama, United States, 35216
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Dothan, Alabama, United States, 36305
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Mobile, Alabama, United States, 36608
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Arizona
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Goodyear, Arizona, United States, 85395
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Phoenix, Arizona, United States, 85012
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California
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La Jolla, California, United States, 92093
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Florida
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Jacksonville, Florida, United States, 32256
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Sanford, Florida, United States, 32771
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Georgia
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Atlanta, Georgia, United States, 30342
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Illinois
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Arlington Heights, Illinois, United States, 60005
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Michigan
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Ann Arbor, Michigan, United States, 48109
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Chesterfield, Michigan, United States, 48047
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Minnesota
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Rochester, Minnesota, United States, 55905
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Missouri
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Mexico, Missouri, United States, 65265
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New York
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Great Neck, New York, United States, 11021
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New York, New York, United States, 10029
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New York, New York, United States, 10029
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North Carolina
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Charlotte, North Carolina, United States, 28210
- Research Site
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Greenville, North Carolina, United States, 27834
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Ohio
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Mentor, Ohio, United States, 44060
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Oklahoma
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Oklahoma City, Oklahoma, United States, 73103
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
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Tennessee
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Germantown, Tennessee, United States, 38138
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Washington
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Seattle, Washington, United States, 98101
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Diagnosed with ileal, ileo-colonic, or colonic Crohn's disease for a minimum of 6 months prior to baseline
- Moderately to severely active Crohn's disease defined by a CDAI score ≥ 220 and ≤ 450 at baseline
- Evidence of active inflammation within 12 weeks prior to baseline
- Demonstrated an inadequate response to, loss of response to, or intolerance to at least one of the following agents: Immunomodulators and/or anti-tumor necrosis factor (TNF) agents or to corticosteroids (non-US sites only).
- Neurological exam free of clinically significant, unexplained signs or symptoms during screening and no clinically significant change prior to randomization
- Subject has no known history of active tuberculosis and has a negative test for tuberculosis during screening
Exclusion Criteria:
- Short bowel syndrome
- Stricture with obstructive symptoms within 3 months
- Bowel surgery within 12 weeks prior baseline, or has planned bowel surgery within 24 weeks from baseline
- Ileostomy and/or colostomy
- Any gastric or intestinal pouch
- Evidence of an infected abscess
- Bowel perforation or evidence of non-inflammatory obstruction during the 6 months prior to baseline
- Stool positive for C. difficile toxin at screening
- Any uncontrolled or clinically significant systemic disease
- Known to have tested positive for hepatitis B virus surface antigen, hepatitis C virus antibody, or human immunodeficiency virus (HIV)
- Any underlying condition that predisposes subject to infections
- Subject has malignancy (other than resected cutaneous basal or cutaneous squamous cell carcinoma, or treated in situ cervical cancer considered cured) within 5 years of baseline
- Received an anti-TNF agent, cyclosporine, mycophenolate mofetil, sirolimus (rapamycin), thalidomide, tacrolimus, topical (rectal) aminosalicylic acid (eg, mesalamine) or topical (rectal) steroids, intravenous or intramuscular corticosteroids within protocol-specified time periods.
- Any prior exposure to antagonists of integrins or integrin ligands (eg, natalizumab, efalizumab, or vedolizumab), rituximab, or TNF kinoid immunotherapies, AMG 181, or any form of cell-based transplantation
- Received treatment of infection with intravenous (within 30 days of baseline) or oral (within 14 days prior to baseline) antibiotics, antivirals, or antifungals
- Significant laboratory abnormalities
- Pregnant or breast feeding
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Placebo Comparator: Placebo Q4W/Abrilumab 210 mg Q3M
Participants received placebo by subcutaneous injection on day 1, week 2, week 4, and every 4 weeks thereafter until week 24. During the open-label period, participants received abrilumab 210 mg once every 3 months (Q3M) for 108 weeks. |
Placebo matching to abrilumab administered by subcutaneous injection
Administered by subcutaneous injection.
Other Names:
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Experimental: Abrilumab 70 mg Q4W/Abrilumab 210 mg Q3M
Participants received 70 mg abrilumab by subcutaneous injection on day 1, week 2, week 4, and every 4 weeks thereafter until week 24. During the open-label period, participants received abrilumab 210 mg once every 3 months (Q3M) for 108 weeks. |
Administered by subcutaneous injection.
Other Names:
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Experimental: Abrilumab 21 mg Q4W/Abrilumab 210 mg Q3M
Participants received 21 mg abrilumab by subcutaneous injection on day 1, week 2, week 4, and every 4 weeks (Q4W) thereafter until week 24. During the open-label period, participants received abrilumab 210 mg once every 3 months (Q3M) for 108 weeks. |
Administered by subcutaneous injection.
Other Names:
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Experimental: Abrilumab 210 mg/Abrilumab 210 mg Q3M
Participants received a single dose of 210 mg abrilumab by subcutaneous injection on day 1, followed by placebo at week 2, week 4, and every 4 weeks thereafter until week 24. During the open-label period, participants received abrilumab 210 mg once every 3 months (Q3M)for 108 weeks. |
Placebo matching to abrilumab administered by subcutaneous injection
Administered by subcutaneous injection.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percentage of Participants With Remission at Week 8
Time Frame: Week 8
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Remission was defined as a Crohn's Disease Activity Index (CDAI) score < 150 at week 8. The CDAI is a weighted, composite index of 8 disease variables (stool frequency, severity of abdominal pain, degree of general well-being, presence or absence of extra-intestinal manifestations or fistula, use or non-use of antidiarrheal agents, presence or absence of an abdominal mass, hematocrit, and body weight). Scores range from approximately 0 to 600, with a higher score indicating more-severe disease activity. The remission rate (percentage of participants with remission) was calculated based on observed data (unadjusted remission rate) and also after applying a logistic regression model including the factors of treatment group, stratification factors (prior anti-TNF use and pre- versus post-Protocol Amendment 3) and baseline CDAI Score (adjusted remission rate). |
Week 8
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Percentage of Participants With Remission at Week 12
Time Frame: Week 12
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Remission was defined as a Crohn's Disease Activity Index (CDAI) score < 150. The CDAI is a weighted, composite index of 8 disease variables (stool frequency, severity of abdominal pain, degree of general well-being, presence or absence of extra-intestinal manifestations or fistula, use or non-use of antidiarrheal agents, presence or absence of an abdominal mass, hematocrit, and body weight). Scores range from approximately 0 to 600, with a higher score indicating more-severe disease activity. The remission rate (percentage of participants with remission) was calculated based on observed data (unadjusted remission rate) and also after applying a logistic regression model including the factors of treatment group, stratification factors (prior anti-TNF use and pre- versus post-Protocol Amendment 3) and baseline CDAI Score (adjusted remission rate). |
Week 12
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Percentage of Participants With Response at Week 12
Time Frame: Baseline and week 12
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Response was defined as either remission (a CDAI score < 150) or a decrease from baseline in the CDAI score of ≥ 100 points. The CDAI is a weighted, composite index of 8 disease variables (stool frequency, severity of abdominal pain, degree of general well-being, presence or absence of extra-intestinal manifestations or fistula, use or non-use of antidiarrheal agents, presence or absence of an abdominal mass, hematocrit, and body weight). Scores range from approximately 0 to 600, with a higher score indicating more-severe disease activity. The response rate (percentage of participants with response) was calculated based on observed data (unadjusted response rate) and also after applying a logistic regression model including the factors of treatment group, stratification factors (prior anti-TNF use and pre- versus post-Protocol Amendment 3) and baseline CDAI score (adjusted response rate). |
Baseline and week 12
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Percentage of Participants With Response at Week 8
Time Frame: Baseline and week 8
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Response was defined as either remission (a CDAI score < 150) or a decrease from baseline in the CDAI score of ≥ 100 points. The CDAI is a weighted, composite index of 8 disease variables (stool frequency, severity of abdominal pain, degree of general well-being, presence or absence of extra-intestinal manifestations or fistula, use or non-use of antidiarrheal agents, presence or absence of an abdominal mass, hematocrit, and body weight). Scores range from approximately 0 to 600, with a higher score indicating more-severe disease activity. The response rate (percentage of participants with response) was calculated based on observed data (unadjusted response rate) and also after applying a logistic regression model including the factors of treatment group, stratification factors (prior anti-TNF use and pre- versus post-Protocol Amendment 3) and baseline CDAI score (adjusted response rate). |
Baseline and week 8
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Percentage of Participants With Sustained Remission at Both Week 12 and Week 24
Time Frame: Week 12 and week 24
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Remission was defined as a Crohn's Disease Activity Index (CDAI) score < 150. Sustained remission was defined as achieving the criteria for remission at both week 12 and week 24. The CDAI is a weighted, composite index of 8 disease variables (stool frequency, severity of abdominal pain, degree of general well-being, presence or absence of extra-intestinal manifestations or fistula, use or non-use of antidiarrheal agents, presence or absence of an abdominal mass, hematocrit, and body weight). Scores range from approximately 0 to 600, with a higher score indicating more-severe disease activity. The remission rate (percentage of participants with sustained remission) was calculated based on observed data (unadjusted remission rate) and also after applying a logistic regression model including the factors of treatment group, stratification factors (prior anti-TNF use and pre- versus post-Protocol Amendment 3) and baseline CDAI Score (adjusted remission rate). |
Week 12 and week 24
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Percentage of Participants With Sustained Remission at Both Week 8 and Week 24
Time Frame: Week 8 and week 24
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Remission was defined as a Crohn's Disease Activity Index (CDAI) score < 150. Sustained remission was defined as achieving the criteria for remission at both week 8 and week 24. The CDAI is a weighted, composite index of 8 disease variables (stool frequency, severity of abdominal pain, degree of general well-being, presence or absence of extra-intestinal manifestations or fistula, use or non-use of antidiarrheal agents, presence or absence of an abdominal mass, hematocrit, and body weight). Scores range from approximately 0 to 600, with a higher score indicating more-severe disease activity. The remission rate (percentage of participants with sustained remission) was calculated based on observed data (unadjusted remission rate) and also after applying a logistic regression model including the factors of treatment group, stratification factors (prior anti-TNF use and pre- versus post-Protocol Amendment 3) and baseline CDAI Score (adjusted remission rate). |
Week 8 and week 24
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Change From Baseline in CDAI Score at Week 12
Time Frame: Baseline and week 12
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The CDAI is a weighted, composite index of 8 disease variables (stool frequency, severity of abdominal pain, degree of general well-being, presence or absence of extra-intestinal manifestations or fistula, use or non-use of antidiarrheal agents, presence or absence of an abdominal mass, hematocrit, and body weight).
Scores range from approximately 0 to 600, with a higher score indicating more-severe disease activity.
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Baseline and week 12
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Change From Baseline in CDAI Score at Week 8
Time Frame: Baseline and week 8
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The CDAI is a weighted, composite index of 8 disease variables (stool frequency, severity of abdominal pain, degree of general well-being, presence or absence of extra-intestinal manifestations or fistula, use or non-use of antidiarrheal agents, presence or absence of an abdominal mass, hematocrit, and body weight).
Scores range from approximately 0 to 600, with a higher score indicating more-severe disease activity.
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Baseline and week 8
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Collaborators and Investigators
Sponsor
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 20110232
- 2012-000529-31 (EudraCT Number)
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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