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Safety, Dosage, and Microbiome Engraftment Study of MGT-006 for Ulcerative Colitis (ROOT Study) (ROOT)

27. Oktober 2026 aktualisiert von: Metagen Therapeutics, Inc.

Phase 1b/2a Study of MGT-006 in Patients With Ulcerative Colitis: A Dose and Preparation Regimen Selection Trial to Assess Safety and Microbiome Engraftment (ROOT Study)

Ulcerative colitis is a condition that causes inflammation and ulcers in the large intestine. MGT-006 is an investigational oral capsule containing viable gut microbiota from screened human donors. This study will evaluate the safety and tolerability of MGT-006 in adults with moderately active ulcerative colitis. It will also examine whether gut microbiota from MGT-006 engraft in participants' intestines and explore changes in ulcerative colitis symptoms and inflammation.

The study has two parts. In Phase 1b, participants will be randomly assigned to receive MGT-006 either without antibiotic pretreatment or after five days of oral vancomycin or AFM (Amoxicillin/Fosfomycin/Metronidazole) pretreatment. MGT-006 will be taken for eight weeks, followed by four weeks of observation. Phase 2a is planned to explore different doses and potentially different dosing regimens of MGT-006, using the pretreatment approach selected from Phase 1b. The final Phase 2a design will depend on the Phase 1b findings and will be specified in an amended protocol before Phase 2a begins.

Studienübersicht

Status

Rekrutierung

Bedingungen

Intervention / Behandlung

Detaillierte Beschreibung

The study is a multicenter, randomized, exploratory Phase 1b/2a study planned at approximately 30 sites in Japan and the United States. The study is intended to evaluate the safety and tolerability of repeated oral administration of MGT-006, select an appropriate pretreatment approach, and explore dose and regimen options for further development.

In Phase 1b, participants will be randomized in three cohots, MGT-006 without pretreatment antibiotics or to oral vancomycin or AFM (Amoxicillin/Fosfomycin/Metronidazole) pretreatment followed by MGT-006. Randomization will be stratified by country. The planned sample size is approximately 18 participants, with additional enrollment permitted as needed to obtain at least six evaluable participants per group meeting the protocol-defined adherence criteria.

Progression to Phase 2a is conditional on the safety and microbiome engraftment review specified in the protocol. The sponsor will make the transition decision taking into account the independent Data Safety Monitoring Board's recommendations, as applicable. Approximately 36 participants across three MGT-006 dose groups are provisionally planned for Phase 2a. The number of groups, doses, dosing regimens, sample size, and treatment duration may be modified based on Phase 1b findings and will be specified in an amended protocol before initiation of Phase 2a.

Treatment administration is open-label. Endoscopic efficacy assessments will be performed centrally without knowledge of treatment allocation. Safety data will be reviewed by an independent Data Safety Monitoring Board. Analyses will be descriptive and exploratory; the study is not designed for confirmatory hypothesis testing or to ensure statistical power for between-group comparisons.

Studientyp

Interventionell

Einschreibung (Geschätzt)

54

Phase

  • Phase 2
  • Phase 1

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

  • Name: Metagen Therapeutics Clinical development devision
  • Telefonnummer: +81-235-33-9966
  • E-Mail: mgtx_cdu@metagentx.com

Studienorte

    • Fukuoka
      • Fukuoka, Fukuoka, Japan, 814-0180
        • Rekrutierung
        • Fukuoka University Hospital
    • Hokkaido
      • Sapporo, Hokkaido, Japan, 060-8543
        • Rekrutierung
        • Sapporo Medical University Hospital
    • Okayama-ken
      • Kurashiki, Okayama-ken, Japan, 701-0192
        • Rekrutierung
        • Kawasaki Medical School Hospital
    • Osaka
      • Hirakata, Osaka, Japan, 573-1191
        • Rekrutierung
        • Kansai Medical University Hospital
    • Shizuoka
      • Hamamatsu, Shizuoka, Japan, 431-3192
        • Rekrutierung
        • Hamamatsu University Hospital
    • Tokyo
      • Bunkyō-Ku, Tokyo, Japan, 113-8431
        • Rekrutierung
        • Juntendo University Hospital
      • Minato-Ku, Tokyo, Japan, 105-0003
        • Rekrutierung
        • The Jikei University Hospital
      • Minato-Ku, Tokyo, Japan, 108-8642
        • Rekrutierung
        • Kitasato University Kitasato Institute Hospital
      • Mitaka, Tokyo, Japan, 181-8611
        • Rekrutierung
        • Kyorin University Hospital
    • Florida
      • Naples, Florida, Vereinigte Staaten, 34102
        • Noch keine Rekrutierung
        • GI PROS, Inc.
    • Massachusetts
      • Boston, Massachusetts, Vereinigte Staaten, 02115
        • Noch keine Rekrutierung
        • Brigham and Women's Hospital
    • New York
      • New York, New York, Vereinigte Staaten, 10016
        • Noch keine Rekrutierung
        • NYU Langone Health

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

18 Jahre bis 75 Jahre (Erwachsene, Älterer Erwachsener)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  1. Patients who understand the contents of this clinical study, sign a written informed consent form, and possess the willingness and capability to participate in all medical examinations, evaluations, and follow-ups related to the study.
  2. Patients aged 18 to 75 years at the time of informed consent
  3. Patients who have been diagnosed with UC through endoscopic and histological examination for at least 12 weeks at the time of final registration
  4. Patients with a modified Mayo Score of 4 to 7 at the time of final registration

Exclusion Criteria:

  1. Patients with any of the following medical history or complications, or those undergoing concomitant therapy, which the investigator (sub-investigator) to be serious or clinically significant

  2. Patients with past or concurrent malignant tumors; however, cured basal cell carcinoma of the skin is allowed for registration. In addition, breast cancer in remission for >= 10 years without recurrence is allowed for registration, and other malignant tumors in remission for >= 5 years are allowed for registration if no therapeutic intervention is required and they are in stable condition, as determined by the investigator (sub-investigator).

  3. Patients with pancolitis of > 8 years' duration or left-sided colitis of > 8 years' duration who have not undergone a surveillance flexible sigmoidoscopy or total colonoscopy (performed according to local standard of care) within 12 months prior to screening to rule out colorectal dysplasia/cancer.

  4. Patients with suspected or confirmed colorectal cancer or high-grade dysplasia.

  5. Patients with any of the following abnormal values in clinical laboratory tests performed within 4 weeks prior to final registration in this clinical study:

    • Patients with a serum creatinine level of >= 2.0 mg/dL or a BUN level of >= 25 mg/dL
    • Patients with a total bilirubin level of >= 3.0 mg/dL, or an AST (GOT) or ALT (GPT) level of >= 100 IU/L
  6. Patients with any of the following will be excluded:

    • HBsAg positive
    • HCV antibody positive
    • HIV-1/2 Ag/Ab screening-positive
  7. Patients currently receiving inpatient treatment for UC

  8. Patients suspected to have concurrent active intestinal obstruction or infectious enteritis

  9. Patients with Clostridioides difficile infection (C. difficile infection) (patients in whom the presence or absence of infection is confirmed by NAAT and the result is positive)

  10. Patients with a history of hypersensitivity or allergy to excipients in MGT-006

  11. Patients with any of the following conditions that affect the lower gastrointestinal function

  12. Patients who have failed or been intolerant to >= 3 advanced-therapy mechanistic classes for ulcerative colitis (e.g., anti-TNF, anti-integrin, anti-IL-12/23, JAK inhibitor, S1P modulator)

  13. Patients who have used another investigational product within 12 weeks prior to informed consent

  14. Patients with serious allergies or contraindications to any drug used in this study

  15. (Females only) Patients in whom the result of a pregnancy test performed within 4 weeks prior to final registration is positive (if a urine hCG test is positive, a negative serum pregnancy test result should be confirmed)

  16. (Females only) Patients who are pregnant or breastfeeding, or females of childbearing potential unable to use appropriate contraceptive methods from the date of informed consent to 12 weeks post-treatment. (e.g., intrauterine device, diaphragm, partner's use of condom)

  17. (Males only) Patients who are males of reproductive potential (including partners of childbearing potential) unable to use at least one effective contraceptive method from the time of informed consent until 12 weeks after the end of investigational drug administration

  18. Patients judged by the investigator (sub-investigator) to be inappropriate as subjects of this study

  19. (Phase 2a only) Participants who have previously received MGT-006

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Single

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Phase 1b: MGT-006 Without Antibiotic Pretreatment

Participants receive no antibiotic pretreatment. MGT-006 is administered orally at four capsules per dose, three times daily before meals, for 56 days. Participants are observed for four weeks after completion of MGT-006 treatment.

MGT-006 is an investigational enteric-coated oral capsule filled with lyophilized human fecal material containing viable gut microbiota. In Phase 1b, four capsules are taken three times daily before meals for 56 days (12 capsules per day). Dose reduction, interruption, discontinuation, and re-escalation may occur according to protocol-defined safety rules. Phase 2a doses, dosing frequency, and treatment duration will be determined based on Phase 1b findings and specified in an amended protocol.

Experimental: Phase 1b: Vancomycin Pretreatment Followed by MGT-006

Participants receive oral vancomycin hydrochloride at a total daily dose of 500 mg (as vancomycin), divided into four daily administrations, for five days. MGT-006 is then administered orally at four capsules per dose, three times daily before meals, for 56 days, followed by four weeks of observation. MGT-006 starts within two days after completion of vancomycin pretreatment.

MGT-006 is an investigational enteric-coated oral capsule filled with lyophilized human fecal material containing viable gut microbiota. In Phase 1b, four capsules are taken three times daily before meals for 56 days (12 capsules per day). Dose reduction, interruption, discontinuation, and re-escalation may occur according to protocol-defined safety rules. Phase 2a doses, dosing frequency, and treatment duration will be determined based on Phase 1b findings and specified in an amended protocol.

Vancomycin hydrochloride is administered orally as pretreatment at a total daily dose of 500 mg (as vancomycin), divided into four daily administrations, for five days before MGT-006. In Phase 1b, it is administered only to participants randomized to the vancomycin pretreatment arm. Its use in Phase 2a depends on the pretreatment approach selected from Phase 1b.

Experimental: Phase 1b: AFM Pretreatment Followed by MGT-006

Subjects allocated to the AFM group will receive pretreatment antibiotics for 5 days after final registration. Amoxicillin hydrate 1500 mg/day (as amoxicillin), fosfomycin calcium hydrate 3000 mg/day (as fosfomycin), and metronidazole 750 mg/day will be orally administered three times a day for 5 days.

MGT-006 is an investigational enteric-coated oral capsule filled with lyophilized human fecal material containing viable gut microbiota. In Phase 1b, four capsules are taken three times daily before meals for 56 days (12 capsules per day). Dose reduction, interruption, discontinuation, and re-escalation may occur according to protocol-defined safety rules. Phase 2a doses, dosing frequency, and treatment duration will be determined based on Phase 1b findings and specified in an amended protocol.

Subjects allocated to the AFM group will receive pretreatment antibiotics for 5 days after final registration. Amoxicillin hydrate 1500 mg/day (as amoxicillin), fosfomycin calcium hydrate 3000 mg/day (as fosfomycin), and metronidazole 750 mg/day will be orally administered three times a day for 5 days. Its use in Phase 2a depends on the pretreatment approach selected from Phase 1b.

Experimental: Phase 2a: High-Dose MGT-006

The dosage/administration and duration of treatment are subject to change depending on the Phase 1b progress.

MGT-006 is an investigational enteric-coated oral capsule filled with lyophilized human fecal material containing viable gut microbiota. In Phase 1b, four capsules are taken three times daily before meals for 56 days (12 capsules per day). Dose reduction, interruption, discontinuation, and re-escalation may occur according to protocol-defined safety rules. Phase 2a doses, dosing frequency, and treatment duration will be determined based on Phase 1b findings and specified in an amended protocol.

Vancomycin hydrochloride is administered orally as pretreatment at a total daily dose of 500 mg (as vancomycin), divided into four daily administrations, for five days before MGT-006. In Phase 1b, it is administered only to participants randomized to the vancomycin pretreatment arm. Its use in Phase 2a depends on the pretreatment approach selected from Phase 1b.

Subjects allocated to the AFM group will receive pretreatment antibiotics for 5 days after final registration. Amoxicillin hydrate 1500 mg/day (as amoxicillin), fosfomycin calcium hydrate 3000 mg/day (as fosfomycin), and metronidazole 750 mg/day will be orally administered three times a day for 5 days. Its use in Phase 2a depends on the pretreatment approach selected from Phase 1b.

Experimental: Phase 2a: Medium-Dose MGT-006

The dosage/administration and duration of treatment are subject to change depending on the Phase 1b progress.

MGT-006 is an investigational enteric-coated oral capsule filled with lyophilized human fecal material containing viable gut microbiota. In Phase 1b, four capsules are taken three times daily before meals for 56 days (12 capsules per day). Dose reduction, interruption, discontinuation, and re-escalation may occur according to protocol-defined safety rules. Phase 2a doses, dosing frequency, and treatment duration will be determined based on Phase 1b findings and specified in an amended protocol.

Vancomycin hydrochloride is administered orally as pretreatment at a total daily dose of 500 mg (as vancomycin), divided into four daily administrations, for five days before MGT-006. In Phase 1b, it is administered only to participants randomized to the vancomycin pretreatment arm. Its use in Phase 2a depends on the pretreatment approach selected from Phase 1b.

Subjects allocated to the AFM group will receive pretreatment antibiotics for 5 days after final registration. Amoxicillin hydrate 1500 mg/day (as amoxicillin), fosfomycin calcium hydrate 3000 mg/day (as fosfomycin), and metronidazole 750 mg/day will be orally administered three times a day for 5 days. Its use in Phase 2a depends on the pretreatment approach selected from Phase 1b.

Experimental: Phase 2a: Low-Dose MGT-006

The dosage/administration and duration of treatment are subject to change depending on the Phase 1b progress.

MGT-006 is an investigational enteric-coated oral capsule filled with lyophilized human fecal material containing viable gut microbiota. In Phase 1b, four capsules are taken three times daily before meals for 56 days (12 capsules per day). Dose reduction, interruption, discontinuation, and re-escalation may occur according to protocol-defined safety rules. Phase 2a doses, dosing frequency, and treatment duration will be determined based on Phase 1b findings and specified in an amended protocol.

Vancomycin hydrochloride is administered orally as pretreatment at a total daily dose of 500 mg (as vancomycin), divided into four daily administrations, for five days before MGT-006. In Phase 1b, it is administered only to participants randomized to the vancomycin pretreatment arm. Its use in Phase 2a depends on the pretreatment approach selected from Phase 1b.

Subjects allocated to the AFM group will receive pretreatment antibiotics for 5 days after final registration. Amoxicillin hydrate 1500 mg/day (as amoxicillin), fosfomycin calcium hydrate 3000 mg/day (as fosfomycin), and metronidazole 750 mg/day will be orally administered three times a day for 5 days. Its use in Phase 2a depends on the pretreatment approach selected from Phase 1b.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Safety and tolerability of MGT-006 (adverse events, adverse reactions)
Zeitfenster: Phase 1b: From first administration of study medication(MGT-006 or antibiotics) through four weeks after completion of MGT-006 treatment.

The number and percentage of subjects experiencing the AEs will be calculated for each group and overall. If a subject experiences multiple AEs, the subject will be counted only once per category. Similar summaries will be provided for adverse events related to the study drugs or procedures. These related adverse events will be summarized together in a single table by the source of relationship (i.e., MGT-006, pretreatment antibiotics, and study procedures).

Phase 1b: From first administration of study medication(MGT-006 or antibiotics) through four weeks after completion of MGT-006 treatment.

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Engraftment of MGT-006-derived gut microbiota by 12 weeks after the start of MGT-006 administration
Zeitfenster: Up to 12 weeks after the first MGT-006 administration.

Engraftment is defined at the strain (clonal) level. Specifically, a strain detected in the MGT-006 product lot is considered engrafted when it is detected in the participant after dosing. Detection sensitivity depends on the genetic distance between the product-derived strain and a baseline endogenous strain of the same species retained by the participant, as measured by the number of SNVs in species-specific marker genes.

Up to 12 weeks after the first MGT-006 administration.
The following efficacy endpoints at 8 weeks after the start of MGT-006 administration based on central imaging assessment: (1) Clinical remission rate (2) Clinical response rate (3) Endoscopic improvement rate
Zeitfenster: Week 8 after the first MGT-006 administration.
  1. Clinical remission rate is the percentage of subjects who achieved all of the following scores based on the MMS:

    • Stool frequency subscore of ≤1 and no greater than baseline
    • Rectal bleeding subscore of 0 points
    • Endoscopic subscore of ≤1 point
  2. Clinical response rate is the percentage of subjects who achieved all of the following scores based on the MMS:

    • MMS decreased by ≥2 points and ≥30% from baseline
    • Rectal bleeding subscore decreased ≥1 point from baseline or became ≤1 point.
  3. Endoscopic improvement rate is the percentage of subjects whose endoscopic subscore is ≤1 point.

For efficacy parameters in this clinical study, the MMS will be used.

Week 8 after the first MGT-006 administration.

Andere Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Changes in MMS score, endoscopic subscore, and UCEIS from baseline to 8 weeks after the start of MGT-006 administration based on central imaging assessment
Zeitfenster: Baseline to Week 8 after the first MGT-006 administration.

<Endoscopic Subscore> At the time of confirmation of subject enrollment criteria (Visit 1), the investigator (sub-investigator) will evaluate the endoscopic subscore.

The endoscopic subscore as an efficacy endpoint (Visit 1, Visit 7) will be evaluated by the Central Evaluation Committee.

<UCEIS> The Central Imaging Evaluation Committee will evaluate three items: vascular pattern, bleeding, and erosions and ulcers.

The following will be used for evaluation in this study:

  • UCEIS endoscopic remission rate: Score of 0 at 8 weeks after the start of MGT-006 administration
  • UCEIS endoscopic improvement rate: Score decreased by 2 or more from baseline at 8 weeks after the start of MGT-006 administration
Baseline to Week 8 after the first MGT-006 administration.
Changes in Partial Mayo Score and each subscore from baseline to 12 weeks after the start of MGT-006 administration
Zeitfenster: Baseline to Week 12 after the first MGT-006 administration.

Partial Mayo score: Total score of 3 subscores excluding endoscopic subscore among the Mayo scores (0 to 12) Summary statistics will be calculated for the measured values and changes from baseline in the Partial Mayo Score at each evaluation time point.

Baseline to Week 12 after the first MGT-006 administration.
Changes in gut microbiota from baseline to 12 weeks after the start of MGT-006 administration
Zeitfenster: Baseline to Week 12 after the first MGT-006 administration.

Change from baseline is calculated per participant as the value at each post-dose timepoint minus the value at baseline, for the following indices: species richness, Shannon index, Bray-Curtis dissimilarity to donor, and Jaccard similarity to donor.

Baseline to Week 12 after the first MGT-006 administration.
Dietary surveys in subjects at baseline and at 12 weeks after the start of MGT-006 administration
Zeitfenster: Baseline and Week 12 after the first MGT-006 administration.

A dietary survey of subjects will be conducted by questionnaire according to "Appendix 4 Survey Items for Dietary Survey."

Baseline and Week 12 after the first MGT-006 administration.
Patient acceptability assessment of MGT-006 as a patient-reported outcome (PRO) at 12 weeks after the start of MGT-006 administration
Zeitfenster: Week 12 after the first MGT-006 administration.

A patient acceptability assessment of MGT-006 will be conducted by questionnaire according to "Appendix 5 Patient Acceptability Assessment of MGT-006 as a Patient-Reported Outcome (PRO)."

Week 12 after the first MGT-006 administration.
Medication adherence status for MGT-006 and pretreatment antibiotics (for subjects assigned to pretreatment antibiotics).
Zeitfenster: Baseline through Week 12 after the first MGT-006 administration.

Subjects will record administration of study medications in a medication diary, including:

  • Pretreatment antibiotics (if assigned, e.g., vancomycin)
  • Investigational product (MGT-006) The diary will capture, at minimum, the date of administration and any missed doses.

For the FAS, PPS and SAS, the medication adherence rate for the entire pretreatment antibiotics administration period will be calculated. For the AFM group, the adherence rate will be calculated and summarized for each drug (amoxicillin, fosfomycin, and metronidazole) separately.

Baseline through Week 12 after the first MGT-006 administration.

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

9. Juli 2026

Primärer Abschluss (Geschätzt)

31. März 2028

Studienabschluss (Geschätzt)

30. September 2028

Studienanmeldedaten

Zuerst eingereicht

27. Oktober 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

27. Oktober 2026

Zuerst gepostet (Tatsächlich)

3. November 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

3. November 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

27. Oktober 2026

Zuletzt verifiziert

1. Oktober 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • MGT-006-UC-G1201
  • jRCT2071260030 (Registrierungskennung: Ministry of Health, Labour and Welfare, Japan)

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Ja

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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