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Effect of Intravenous (IV) Vedolizumab on Mucosal Healing in Crohn's Disease

31 augusti 2018 uppdaterad av: Takeda

An Open-Label Phase 3b Study to Assess Mucosal Healing in Subjects With Moderately to Severely Active Crohn's Disease Treated With Vedolizumab IV

The purpose of this study is to evaluate endoscopic remission at Week 26 as assessed by ileocolonoscopy.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

The drug being tested in this study is called vedolizumab. Vedolizumab is being tested to treat people who have Crohn's disease. This study will look at mucosal healing in people who take vedolizumab.

The study will enroll approximately 100 patients and will be conducted in 2 Parts. Part A will consist of a 26-week treatment period and all participants will receive vedolizumab 300 mg intravenously (IV) on Day 1 and at Weeks 2, 6, 14 and 22. Part B will consist of a 26-week extension treatment period and all participants will receive vedolizumab 300 mg IV at Weeks 30, 38, and 46.

This multi-center trial will be conducted worldwide. The overall time to participate in this study is approximately 70 weeks for Parts A, B and 18-Week Follow-up combined. Participants will make multiple visits to the clinic. All participants included in the study will also have a 6 month safety follow-up telephone call following his/her last dose of study drug.

Studietyp

Interventionell

Inskrivning (Faktisk)

101

Fas

  • Fas 3

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Belgien
      • Bonheiden, Belgien
      • Bruxelles, Belgien
      • Herentals, Belgien
      • Kortrijk, Belgien
      • Leuven, Belgien
      • Roeselare, Belgien
  • Frankrike
      • Lille Cedex, Frankrike
      • Nantes Cedex 1, Frankrike
      • Nice Cedex 3, Frankrike
      • Pessac, Frankrike
      • Reims, Frankrike
      • Saint Etienne, Frankrike
      • Toulouse Cedex 09, Frankrike
    • Alpes Maritimes
      • Nice Cedex 3, Alpes Maritimes, Frankrike
    • Gironde
      • Pessac, Gironde, Frankrike
    • Loire
      • Saint Etienne, Loire, Frankrike
    • Marne
      • Reims, Marne, Frankrike
    • Nord
      • Lille cedex, Nord, Frankrike
  • Förenta staterna
    • California
      • La Jolla, California, Förenta staterna
    • Connecticut
      • Hamden, Connecticut, Förenta staterna
    • Florida
      • Gainesville, Florida, Förenta staterna
      • Inverness, Florida, Förenta staterna
      • Maitland, Florida, Förenta staterna
      • Miami, Florida, Förenta staterna
      • Winter Park, Florida, Förenta staterna
    • Georgia
      • Macon, Georgia, Förenta staterna
      • Suwanee, Georgia, Förenta staterna
    • Kansas
      • Topeka, Kansas, Förenta staterna
    • Louisiana
      • Baton Rouge, Louisiana, Förenta staterna
    • Maryland
      • Columbia, Maryland, Förenta staterna
    • Massachusetts
      • Boston, Massachusetts, Förenta staterna
    • Michigan
      • Ann Arbor, Michigan, Förenta staterna
    • Missouri
      • Saint Louis, Missouri, Förenta staterna
    • New York
      • Manhasset, New York, Förenta staterna
      • Poughkeepsie, New York, Förenta staterna
    • North Carolina
      • Winston-Salem, North Carolina, Förenta staterna
    • Ohio
      • Cleveland, Ohio, Förenta staterna
    • Oklahoma
      • Tulsa, Oklahoma, Förenta staterna
    • Oregon
      • Portland, Oregon, Förenta staterna
    • Tennessee
      • Germantown, Tennessee, Förenta staterna
  • Italien
      • Bologna, Italien
      • Firenze, Italien
      • Napoli, Italien
      • Padova, Italien
      • Roma, Italien
      • Rozzano, Italien
      • San Donato Milanese, Italien
      • San Giovanni Rotondo, Italien
    • Foggia
      • San Giovanni Rotondo, Foggia, Italien
    • Milano
      • Rozzano, Milano, Italien
      • San Donato Milanese, Milano, Italien
  • Kanada
    • British Columbia
      • Vancouver, British Columbia, Kanada
      • Victoria, British Columbia, Kanada
    • Nova Scotia
      • Halifax, Nova Scotia, Kanada
    • Ontario
      • London, Ontario, Kanada
      • Vaughan, Ontario, Kanada
  • Polen
      • Bialystok, Polen
      • Elblag, Polen
      • Poznan, Polen
      • Warszawa, Polen
      • Wroclaw, Polen
  • Tjeckien
      • Hradec Kralove, Tjeckien
      • Kladno, Tjeckien
      • Pardubice, Tjeckien
      • Praha 10, Tjeckien
      • Praha 4, Tjeckien
      • Praha 7, Tjeckien
  • Ungern
      • Bekescsaba, Ungern
      • Budapest, Ungern
      • Debrecen, Ungern
      • Gyongyos, Ungern
      • Gyula, Ungern
      • Jaszbereny, Ungern
      • Kistarcsa, Ungern
      • Miskolc, Ungern
      • Mosonmagyarovar, Ungern
      • Pecs, Ungern
      • Szeged, Ungern
      • Szekesfehervar, Ungern
      • Szekszard, Ungern
      • Vac, Ungern

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 80 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  1. In the opinion of the investigator, the participant is capable of understanding and complying with protocol requirements.
  2. Signs and dates a written, informed consent form and any required privacy authorization prior to the initiation of any study procedures.
  3. Has a diagnosis of moderately to severely active Crohn's disease (CD) at least 3 months prior to enrollment, with a Crohn's Disease Activity Index (CDAI) score of 220-450 during the Screening Period, a simple endoscopic score for Crohn's Disease (SES-CD) score of ≥7 and presence of at least one mucosal ulceration documented by recorded ileocolonoscopy at Screening assessed by the central reader.
  4. Has CD with involvement of the ileum and/or colon that can be assessed by ileocolonoscopy.
  5. Is male or female and aged 18 to 80 years, inclusive.
  6. A male participant who is nonsterilized and sexually active with a female partner of childbearing potential agrees to use adequate contraception from signing of informed consent throughout the duration of the study and for 18 weeks after last dose.
  7. A female participant of childbearing potential who is sexually active with a nonsterilized male partner agrees to use routinely adequate contraception from signing of informed consent throughout the duration of the study and for 18 weeks after last dose.

  8. Has demonstrated an inadequate response to, loss of response to, or intolerance of at least 1 of the following agents as defined below:

    • Immunomodulators:

      i. Has signs and symptoms of persistently active disease despite a history of at least one 12-week regimen of oral azathioprine (≥1.5 mg/kg) or 6-mercaptopurine (≥0.75 mg/kg), OR ii. Has a history of intolerance (including but not limited to nausea/vomiting, abdominal pain, pancreatitis, liver function test abnormalities, lymphopenia, thiopurine S-methyltransferase non wild type [where wild type is defined as thiopurine S-methyltransferase (TPMT)*1/*1], infection) to at least 1 immunomodulator.

    • Tumor necrosis factor- alpha (TNF-α) antagonists:

      i. Has signs and symptoms of persistently active disease despite a history of at least 1 induction with:

      1. Infliximab: 4-week regimen of 5 mg/kg, 2 doses at 2 weeks apart, OR
      2. Adalimumab: 2-week regimen of 160 mg on Day 1 and 80 mg on Day 15, OR
      3. Certolizumab: 4-week regimen of 400 mg initially at Weeks 0, 2, 4 OR ii. Has recurrence of symptoms during maintenance dosing following prior clinical benefit (discontinuation despite clinical benefit does not qualify), OR iii. Has a history of intolerance of infliximab, adalimumab, or certolizumab, including but not limited to, infusion-related reaction, demyelination, congestive heart failure, or infection.
    • Corticosteroids i. Signs and symptoms of persistently active disease despite a history of at least one 4-week induction regimen that included a dose equivalent to prednisone 30 mg daily orally for 2 weeks or intravenous(ly) (IV) for 1 week, OR ii. Signs and symptoms of persistently active disease despite treatment with budesonide 9 mg daily or 6 mg daily for maintenance, OR iii. At least one failed attempt to taper corticosteroids to below a dose equivalent to prednisone 10 mg daily orally, OR iv. History of intolerance to corticosteroids (including, but not limited to, Cushing's syndrome, osteopenia/osteoporosis, hyperglycemia, insomnia, and infection).
  9. May be receiving a stable therapeutic dose of conventional therapies for CD (excluding other biologic agents 60 days before enrollment).
  10. Has a family history of colorectal cancer, personal history of increased colorectal cancer risk, age >50 years, or other known risk factors must be up-to-date on colorectal cancer surveillance (may be performed during Screening).

Exclusion Criteria:

  1. Has received a diagnosis of ulcerative colitis or indeterminate colitis.
  2. Has clinical evidence of abdominal abscess.
  3. Has a history of >3 small bowel resections or diagnosis of short bowel syndrome.
  4. Has extensive colonic resection, ie, subtotal or total colectomy with <15 cm colon remaining.
  5. Has ileostomy, colostomy, or known fixed symptomatic stenosis of the intestine.
  6. Has a history or evidence of adenomatous colonic polyps that have not been removed.
  7. Has a history or evidence of colonic mucosal dysplasia.
  8. Has intolerance or contraindication to undergo ileocolonoscopy.

  9. Has active or latent tuberculosis, regardless of treatment history, as evidenced by any of the following:

    a. History of tuberculosis (TB). b. A diagnostic TB test performed during screening that is positive, as defined by: i. A positive QuantiFERON® test or 2 successive indeterminate QuantiFERON tests OR ii. A tuberculin skin test reaction ≥10 mm (≥5 mm in participants receiving the equivalent of >15 mg/day prednisone).

  10. Has chronic hepatitis B (HBV) or hepatitis C (HCV) infection.
  11. Has any identified congenital or acquired immunodeficiency (eg, common variable immunodeficiency, human immunodeficiency virus [HIV] infection, organ transplantation).
  12. Has evidence of active C. difficile infection or is having treatment for C. difficile infection or other intestinal pathogens during Screening.
  13. Has evidence of an active infection during Screening.
  14. Currently requires or has a planned surgical intervention for CD during the study.
  15. Has received any investigational compound within 60 days of enrollment.
  16. Has received any biologics within 60 days of enrollment.
  17. Has received any live vaccinations within 30 days prior to enrollment.
  18. Has conditions which, in the opinion of the investigator, may interfere with the participant's ability to comply with the study procedures.
  19. Has any unstable or uncontrolled cardiovascular, pulmonary, hepatic, renal, gastrointestinal (GI), genitourinary, hematological, coagulation, immunological, endocrine/metabolic, or other medical disorder that, in the opinion of the investigator, would confound the study results or compromise participant safety.
  20. Has a history of hypersensitivity or allergies to vedolizumab or its components.
  21. Has had prior exposure to vedolizumab, natalizumab, efalizumab, or rituximab.
  22. Had a surgical procedure requiring general anesthesia within 30 days prior to screening or is planning to undergo major surgery during the study period.
  23. Has a history of malignancy, except for the following: adequately-treated nonmetastatic basal cell skin cancer; squamous cell skin cancer that has been adequately treated and that has not recurred for at least 1 year prior to Screening; and history of cervical carcinoma in situ that has been adequately treated and that has not recurred for at least 3 years prior to screening. Participants with a remote history of malignancy (eg, >10 years since completion of curative therapy without recurrence) will be considered based on the nature of the malignancy and the therapy received and must be discussed with the sponsor on a case-by-case basis prior to enrollment.
  24. Has a history of any major neurological disorders, including stroke, multiple sclerosis, brain tumor, or neurodegenerative disease.
  25. Has a positive progressive multifocal leukoencephalopathy (PML) subjective symptom checklist during Screening or prior to the administration of study drug.

  26. Has any of the following laboratory abnormalities during the Screening Period:

    i. Hemoglobin level <8 g/dL. ii. White blood cell (WBC) count <3*10^9/L. iii. Lymphocyte count <0.5*10^9/L. iv. Platelet count <100*10^9/L or >1200*10^9/L. v. Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >3*the upper limit of normal (ULN).

    vi. Alkaline phosphatase >3*ULN. vii. Serum creatinine >2*ULN.

  27. Has a history of drug abuse (defined as any illicit drug use) or a history of alcohol abuse within 1 year prior to enrollment.
  28. Has an active psychiatric problem that, in the investigator's opinion, may interfere with compliance with study procedures.
  29. Is unable to attend all the study visits or comply with study procedures.
  30. If female, the participant is pregnant or lactating or intending to become pregnant before, during, or within 18 weeks after participating in this study; or intending to donate ova during such time period.
  31. If male, the participant intends to donate sperm during the course of this study or for 18 weeks thereafter.
  32. Is an immediate family member, study site employee, or is in a dependent relationship with a study site employee who is involved in conduct of this study (eg, spouse, parent, child, sibling) or may consent under duress.

  33. Participants who are at sites participating in the magnetic resonance enterography (MREn) substudy may not participate if they have intolerance or contraindication to the procedure or if any of the following exclusions apply:

    1. Has certain implanted medical devices, such as pacemakers or implantable cardioverter defibrillators (ICDs), or ferromagnetic metallic foreign bodies, such as shrapnel or certain tattoos.
    2. Has allergy to gadolinium-based magnetic resonance (MR) IV contrast agents.
    3. Has known claustrophobia.
    4. Has estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m^2 at Screening.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: N/A
  • Interventionsmodell: Enskild gruppuppgift
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Vedolizumab 300 mg
Part A: Vedolizumab 300 mg, intravenously (IV), once on Day 1 and Weeks 2, 6, 14 and 22, followed by Part B: Vedolizumab 300 mg, intravenously (IV), once at Weeks 30, 38, and 46.
Läkemedel: Vedolizumab
Vedolizumab intravenous injection
Andra namn:
  • MLN0002

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Part A: Percentage of Participants Achieving Endoscopic Remission at Week 26
Tidsram: Week 26
Endoscopic remission is defined as a simple endoscopic score for Crohn's Disease (SES-CD) score of ≤4. The SES-CD evaluates 4 endoscopic variables (ulcer size, proportion of the surface area that is ulcerated, proportion of the surface area affected, and stenosis in 5 segments evaluated during ileocolonoscopy (ileum, right colon, transverse colon, left colon, and rectum). The score for each endoscopic variable is the sum of values obtained for each segment. The SES-CD total is the sum of the 4 endoscopic variable scores from 0 to 56, where higher scores indicate more severe disease.
Week 26

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Part A: Percentage of Participants Achieving Complete Mucosal Healing at Week 26
Tidsram: Week 26
Complete mucosal healing is defined as absence of ulceration.
Week 26
Part B: Percentage of Participants Achieving Complete Mucosal Healing at Week 52
Tidsram: Week 52
Complete mucosal healing is defined as absence of ulceration.
Week 52
Part A: Percentage of Participants Achieving Endoscopic Remission at Week 14
Tidsram: Week 14
Endoscopic remission is defined as a SES-CD score of ≤4. The SES-CD evaluates 4 endoscopic variables (ulcer size, proportion of the surface area that is ulcerated, proportion of the surface area affected, and stenosis in 5 segments evaluated during ileocolonoscopy (ileum, right colon, transverse colon, left colon, and rectum). The score for each endoscopic variable is the sum of values obtained for each segment. The SES-CD total is the sum of the 4 endoscopic variable scores from 0 to 56, where higher scores indicate more severe disease.
Week 14
Part B: Percentage of Participants Achieving Endoscopic Remission at Week 52
Tidsram: Week 52
Endoscopic remission is defined as a SES-CD score of ≤4. The SES-CD evaluates 4 endoscopic variables (ulcer size, proportion of the surface area that is ulcerated, proportion of the surface area affected, and stenosis in 5 segments evaluated during ileocolonoscopy (ileum, right colon, transverse colon, left colon, and rectum). The score for each endoscopic variable is the sum of values obtained for each segment. The SES-CD total is the sum of the 4 endoscopic variable scores from 0 to 56, where higher scores indicate more severe disease.
Week 52
Part A: Percentage of Participants With Endoscopic Response at Week 14
Tidsram: Baseline and Week 14
Endoscopic response is defined as a reduction in SES-CD from Baseline by ≥50%. The SES-CD evaluates 4 endoscopic variables (ulcer size, proportion of the surface area that is ulcerated, proportion of the surface area affected, and stenosis in 5 segments evaluated during ileocolonoscopy (ileum, right colon, transverse colon, left colon, and rectum). The score for each endoscopic variable is the sum of values obtained for each segment. The SES-CD total is the sum of the 4 endoscopic variable scores from 0 to 56, where higher scores indicate more severe disease.
Baseline and Week 14
Part A: Percentage of Participants With Endoscopic Response at Week 26
Tidsram: Baseline and Week 26
Endoscopic response is defined as a reduction in SES-CD from Baseline by ≥50%. The SES-CD evaluates 4 endoscopic variables (ulcer size, proportion of the surface area that is ulcerated, proportion of the surface area affected, and stenosis in 5 segments evaluated during ileocolonoscopy (ileum, right colon, transverse colon, left colon, and rectum). The score for each endoscopic variable is the sum of values obtained for each segment. The SES-CD total is the sum of the 4 endoscopic variable scores from 0 to 56, where higher scores indicate more severe disease.
Baseline and Week 26
Part B: Percentage of Participants With Endoscopic Response at Week 52
Tidsram: Baseline and Week 52
Endoscopic response is defined as a reduction in SES-CD from Baseline by ≥50%. The SES-CD evaluates 4 endoscopic variables (ulcer size, proportion of the surface area that is ulcerated, proportion of the surface area affected, and stenosis in 5 segments evaluated during ileocolonoscopy (ileum, right colon, transverse colon, left colon, and rectum). The score for each endoscopic variable is the sum of values obtained for each segment. The SES-CD total is the sum of the 4 endoscopic variable scores from 0 to 56, where higher scores indicate more severe disease.
Baseline and Week 52
Part A: Percentage of Participants Achieving Clinical Response at Week 10
Tidsram: Baseline and Week 10
Clinical response is defined as Crohn's Disease Activity Index (CDAI) decrease from Baseline of ≥100 points. CDAI is a scoring system for the assessment of Crohn's Disease Activity, index values of 150 and below are associated with quiescent disease; values above that indicate active disease and values above 450 are seen with extremely severe disease.
Baseline and Week 10
Part A: Percentage of Participants Achieving Clinical Response at Week 26
Tidsram: Baseline and Week 26
Clinical response is defined as CDAI decrease from Baseline of ≥100 points. CDAI is a scoring system for the assessment of Crohn's Disease Activity, index values of 150 and below are associated with quiescent disease; values above that indicate active disease and values above 450 are seen with extremely severe disease.
Baseline and Week 26
Part B: Percentage of Participants Achieving Clinical Response at Week 52
Tidsram: Baseline and Week 52
Clinical response is defined as CDAI decrease from Baseline of ≥100 points. CDAI is a scoring system for the assessment of Crohn's Disease Activity, index values of 150 and below are associated with quiescent disease; values above that indicate active disease and values above 450 are seen with extremely severe disease.
Baseline and Week 52
Part A: Percentage of Participants Achieving Clinical Remission at Week 10
Tidsram: Week 10
Clinical remission is defined as CDAI score of ≤150 points. CDAI is a scoring system for the assessment of Crohn's Disease Activity, index values of 150 and below are associated with quiescent disease; values above that indicate active disease and values above 450 are seen with extremely severe disease.
Week 10
Part A: Percentage of Participants Achieving Clinical Remission at Week 26
Tidsram: Week 26
Clinical remission is defined as CDAI score of ≤150 points. CDAI is a scoring system for the assessment of Crohn's Disease Activity, index values of 150 and below are associated with quiescent disease; values above that indicate active disease and values above 450 are seen with extremely severe disease.
Week 26
Part B: Percentage of Participants Achieving Clinical Remission at Week 52
Tidsram: Week 52
Clinical remission is defined as CDAI score of ≤150 points. CDAI is a scoring system for the assessment of Crohn's Disease Activity, index values of 150 and below are associated with quiescent disease; values above that indicate active disease and values above 450 are seen with extremely severe disease.
Week 52
Part B: Percentage of Participants With Durable Clinical Remission
Tidsram: Weeks 26 and 52
Durable clinical remission is defined as clinical remission at both Week 26 and Week 52. Clinical remission is defined as CDAI score of ≤150 points. CDAI is a scoring system for the assessment of Crohn's Disease Activity, index values of 150 and below are associated with quiescent disease; values above that indicate active disease and values above 450 are seen with extremely severe disease. The percentage of participants assessed at Week 52 who had clinical remission at Week 26 of Part A and also had clinical remission at Week 52 is reported.
Weeks 26 and 52

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Takeda

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

30 mars 2015

Primärt slutförande (Faktisk)

2 juni 2017

Avslutad studie (Faktisk)

21 februari 2018

Studieregistreringsdatum

Först inskickad

26 mars 2015

Först inskickad som uppfyllde QC-kriterierna

20 april 2015

Första postat (Uppskatta)

23 april 2015

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

14 september 2018

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

31 augusti 2018

Senast verifierad

1 augusti 2018

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • MLN0002-3028
  • U1111-1159-5806 (Registeridentifierare: WHO)
  • 2014-003509-13 (EudraCT-nummer)
  • 183974 (Registeridentifierare: HC-CTD)

Denna information hämtades direkt från webbplatsen clinicaltrials.gov utan några ändringar. Om du har några önskemål om att ändra, ta bort eller uppdatera dina studieuppgifter, vänligen kontakta register@clinicaltrials.gov. Så snart en ändring har implementerats på clinicaltrials.gov, kommer denna att uppdateras automatiskt även på vår webbplats .

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