Summary

Eligibility
for people ages 18-65 (full criteria)
Location
at La Jolla, California and other locations
Dates
study started
completion around
Principal Investigator
by Siddharth Singh
Headshot of Siddharth Singh
Siddharth Singh

Description

Summary

The main aim of this study is to learn about the effect of treatment with vedolizumab IV (vedolizumab) together with adalimumab or vedolizumab together with ustekinumab in adults with moderate to severe Crohn's Disease, and the effect of treatment with vedolizumab alone, after the dual targeted treatment.

The study is conducted in two parts. In Part A, participants will receive the dual targeted treatment (vedolizumab together with either adalimumab or ustekinumab). In part B, participants will receive vedolizumab only. Part B will include participants who responded to the treatment in Part A.

Each participant will be followed up for at least 26 weeks after the last dose of treatment.

Official Title

An Open-Label, Phase 4 Study to Evaluate the Efficacy and Safety of Dual Targeted Therapy With Vedolizumab Intravenous (IV) and Adalimumab Subcutaneous (SC) or Vedolizumab IV and Ustekinumab IV/SC in Moderate to Severe Crohn's Disease (CD)

Details

The drug being tested in this study is vedolizumab. Vedolizumab is being tested to treat people with moderate to severe Crohn's disease who have experienced inadequate response, loss of response or intolerance to either one prior interleukin [IL] antagonist (Cohort 1) or one prior tumor necrosis factor inhibitor [TNFi] (Cohort 2). The study will look at the efficacy and safety of dual targeted therapy.

The study will enroll approximately 150 patients. Participants will be assigned to one of the two treatment groups in Part A:

  • Part A, Cohort 1: Vedolizumab + Adalimumab
  • Part A, Cohort 2: Vedolizumab + Ustekinumab

All participants who achieve clinical remission in Part A will receive vedolizumab IV 300 mg monotherapy from Week 30 until Week 46 in Part B. Participants will be followed for a further 20-week safety follow-up period to Week 72 (or 26 weeks post-last dose of study drug).

This multi-center trial will be conducted in the United States and Canada. The overall time to participate in this study is approximately 76 weeks.

Keywords

Crohn's Disease, Drug Therapy, Crohn Disease, Adalimumab, Ustekinumab, Vedolizumab, Vedolizumab Monotherapy

Eligibility

You can join if…

Open to people ages 18-65

Part A:

  1. Has a confirmed diagnosis of CD at least 3 months before baseline, based on endoscopy results.
  2. Has moderately to severely active CD at Screening, defined as a CDAI score ≥220 and a SES-CD ≥6 (≥4 if isolated ileal disease).
  3. Has demonstrated at least 1 of the following (a, b, or c) to at least 1 IL antagonist or at least 1 tumor necrosis factor (TNF) antagonist, at doses approved for the treatment of CD:
    1. Inadequate response after completing the full induction regimen;
    2. Loss of response (recurrence of symptoms during scheduled maintenance dosing after prior clinical benefit); or
    3. Intolerance (a significant adverse event that precluded further use, including but not limited to serious infection including opportunistic infections, malignancy, infusion-related and hypersensitivity reactions including anaphylaxis, and liver injury).

    Note: Participants with primary nonresponse to ≥2 agents are not eligible. Participants with intolerance to 2 agents may be eligible at the investigator's discretion.

    Part B:

  4. Participant is in clinical remission at Week 26. Note: Participants exhibiting a clinical response (defined as a ≥ 100-point decrease in CDAI) at Week 26 may enter Part B at the investigator's discretion.

You CAN'T join if...

  1. A current diagnosis of ulcerative colitis or indeterminate colitis.
  2. Clinical evidence of a current abdominal abscess or a history of prior abdominal abscess.
  3. Known fistula (other than perianal fistula) or phlegmon.
  4. Known perianal fistula with abscess.
  5. Ileostomy, colostomy, or severe, or symptomatic stenosis of the intestine.
  6. Previous extensive colon resection with ≥2 colonic segments remaining, performed ≥ 6 months prior to screening.
  7. Short bowel syndrome.
  8. Any planned surgical intervention for CD, except for seton placement for perianal fistula without abscess.
  9. History or evidence of adenomatous colonic polyps that have not been removed.
  10. History or evidence of colonic mucosal dysplasia.
  11. Intolerance or contraindication to ileocolonoscopy.
  12. Any identified congenital or acquired immunodeficiency (eg, common variable immunodeficiency, human immunodeficiency virus [HIV] infection).
  13. Active or latent tuberculosis (TB), regardless of treatment history.
  14. A positive test for hepatitis B virus (HBV) as defined by the presence of hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) test.
  15. A positive test for hepatitis C virus (HCV), as defined by a positive hepatitis C virus antibody (HCVAb) test and detectable HCV ribonucleic acid (RNA).
  16. Primary nonresponse to ≥2 IL antagonists (Cohort 1) or ≥2 TNF antagonists (Cohort 2) for the treatment of CD.
  17. Received approved or investigational anti-integrin antibodies (i.e., vedolizumab, natalizumab, efalizumab, etrolizumab, abrilumab [AMG 181], anti- mucosal addressin cell adhesion molecule-1 [MAdCAM-1] antibodies, or rituximab).
  18. History of or symptoms of progressive multifocal leukoencephalopathy (PML) in the investigator's opinion. If a participant has symptoms consistent with PML, a PML checklist must be completed and submitted to the PML independent adjudication committee (IAC). If the PML IAC deems the participant to have PML, the participant is ineligible.

Locations

  • University of California San Diego Health (UCSD) not yet accepting patients
    La Jolla California 92037 United States
  • Hoag Hospital Newport Beach not yet accepting patients
    Newport Beach California 92663 United States
  • Cedars-Sinai Medical Center accepting new patients
    Los Angeles California 90048 United States
  • Texas Digestive Disease Consultants Lubbock accepting new patients
    Lubbock Texas 79410 United States

Lead Scientist at UCSD

  • Siddharth Singh
    Associate Professor Of Clinical, Medicine, Vc-health Sciences-schools. Authored (or co-authored) 153 research publications

Details

Status
accepting new patients at some sites,
but this study is not currently recruiting here
Start Date
Completion Date
(estimated)
Sponsor
Takeda
Links
More about this study
ID
NCT06045754
Phase
Phase 4 research study
Study Type
Interventional
Participants
Expecting 150 study participants
Last Updated