A Study of Vedolizumab Intravenous (IV) and Adalimumab or Vedolizumab and Ustekinumab in Adults With Crohn's Disease

Purpose

The main aim of this study is to learn about the effect of treatment with vedolizumab IV (vedolizumab) together with adalimumab or vedolizumab (VDZ) together with ustekinumab (UST) 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.

Condition

  • Crohn's Disease

Eligibility

Eligible Ages
Between 18 Years and 70 Years
Eligible Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

Part A: 1. Has a confirmed diagnosis of CD at least 3 months before screening, based on endoscopy results. 2. Has moderately to severely active CD at Screening, defined as an 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 an inadequate response to >2 classes of advanced therapies or >1 agent in the same class are not eligible. Participants who discontinued a third class of advanced therapy for reasons other than inadequate response may be eligible after discussion with the Medical Monitor. Part B: 4. In the investigator's opinion, the participant exhibits a therapeutic benefit at Week 26.

Exclusion Criteria

  1. CDAI score > 450. 2. A current diagnosis of ulcerative colitis or indeterminate colitis. 3. Clinical evidence of an abdominal abscess. 4. Known fistula (other than perianal fistula) or phlegmon. 5. Known perianal fistula with abscess. 6. Ileostomy, colostomy, or severe, or symptomatic stenosis of the intestine. 7. Previous extensive bowel resection with 2 entire segments missing, of the following: terminal ileum, right colon, transverse colon, sigmoid and left colon, and rectum. 8. Short bowel syndrome. 9. Any planned surgical intervention for CD, except for seton placement for perianal fistula without abscess. 10. History or evidence of adenomatous colonic polyps that have not been removed. 11. History or evidence of colonic mucosal dysplasia. 12. Intolerance or contraindication to ileocolonoscopy. 13. Any identified congenital or acquired immunodeficiency (eg, common variable immunodeficiency infection). 14. Active or latent tuberculosis (TB), regardless of treatment history. 15. 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. 16. 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). 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) for the treatment of CD. 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. If the PML IAC deems the participant to have PML, the participant is ineligible.

Study Design

Phase
Phase 4
Study Type
Interventional
Allocation
Non-Randomized
Intervention Model
Parallel Assignment
Primary Purpose
Treatment
Masking
None (Open Label)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Part A, Cohort 1: Vedolizumab + Adalimumab
Participants will receive vedolizumab IV 300 mg, at Weeks 0, 2, and 6, then every 8 weeks (Q8W) until Week 22 and adalimumab SC 160, 80, and 40 mg at Weeks 0, 2, and 4, respectively, then 40 mg every 2 weeks (Q2W) until Week 26.
  • Drug: Vedolizumab
    Vedolizumab intravenous infusion.
    Other names:
    • Entyvio
  • Drug: Adalimumab
    Adalimumab subcutaneous injection.
    Other names:
    • Humira
Experimental
Part A, Cohort 2: Vedolizumab + Ustekinumab
Participants will receive vedolizumab IV 300 mg, at Weeks 0, 2, and 6, then Q8W until Week 22 and ustekinumab IV 520, 390, or 260 mg (weight-based), then SC 90 mg 8 weeks after initial IV dose, then Q8W until Week 24.
  • Drug: Vedolizumab
    Vedolizumab intravenous infusion.
    Other names:
    • Entyvio
  • Drug: Ustekinumab
    Ustekinumab intravenous infusion.
    Other names:
    • Stelara
  • Drug: Ustekinumab
    Ustekinumab subcutaneous injection.
    Other names:
    • Stelara
Experimental
Part B: Vedolizumab Monotherapy
Participants who achieve therapeutic benefit in Part A will receive vedolizumab IV 300 mg monotherapy, Q8W from Week 30 until Week 46 and will be followed up to Week 52.
  • Drug: Vedolizumab
    Vedolizumab intravenous infusion.
    Other names:
    • Entyvio

Recruiting Locations

Digestive Health Specialsits
Dothan 4059102, Alabama 4829764 36301
Contact:
Site Contact
334-836-1212
Ralbares.research@dothangi.com

GI Alliance Sun City
Sun City 5316201, Arizona 5551752 85351
Contact:
Site Contact
623-972-2116
CTrivedi@arizonadigestivehealth.com

University of California San Diego Health (UCSD)
La Jolla 5363943, California 5332921 92037
Contact:
Site Contact
858-246-2544
psinh@health.ucsd.edu

Cedars-Sinai Medical Center
Los Angeles 5368361, California 5332921 90048
Contact:
Site Contact
310-423-4100
Andres.Yarur@cshs.org

Hoag Hospital Newport Beach
Newport Beach 5376890, California 5332921 92663
Contact:
Site Contact
323-442-6151
aroline.hwang@usc.edu

Medical Research Center of Connecticut, LLC
Hamden 4835654, Connecticut 4831725 06518
Contact:
Site Contact
203-281-4463
pfeuerstadt@gastrocenter.org

Clinical Research of Osceola
Kissimmee 4160983, Florida 4155751 34741
Contact:
Site Contact
407-954-4016
batiquzzaman@crosceola.com

Endoscopic Research Inc
Orlando 4167147, Florida 4155751 32803
Contact:
Site Contact
407-896-1726
levinepi@cdhfl.com

Alliance Clinical Research of Tampa, LLC
Tampa 4174757, Florida 4155751 33615
Contact:
Site Contact
813-515-5400
crespo@allianceclinicalresearch.com

Gastroenterology Consultants, P.C.
Roswell 4219934, Georgia 4197000 30076
Contact:
Site Contact
404-596-4480
Mel7315@Yahoo.com

University of Chicago Medicine
Chicago 4887398, Illinois 4896861 60637
Contact:
Site Contact
177-384-7414
kkearney@bsd.uchicago.edu

GI Alliance - Illinois Gastroenterology Group - Glenview
Glenview 4893886, Illinois 4896861 60026
Contact:
Site Contact
847-677-1170
nmerel@illinoisgastro.com

GI Alliance - Illinois Gastroenterology Group LLC - Gurnee
Gurnee 4894861, Illinois 4896861 60031
Contact:
Site Contact
847-244-2960
rosenberg@illinoisgastro.com

University of Kansas Medical Center
Kansas City 4273837, Kansas 4273857 66160
Contact:
Site Contact
913-588-3934
tesfandyari@kumc.edu

Cotton ONeil Clinical Research Center
Topeka 4280539, Kansas 4273857 66606
Contact:
Site Contact
785-270-4864
CUBAUM@stormontvail.org

University of Louisville
Louisville 4299276, Kentucky 6254925 40202
Contact:
Site Contact
502-419-5150
gerald.dryden@louisville.edu

GI Alliance
Metairie 4333177, Louisiana 4331987 70006
Contact:
Site Contact
504-456-8020
catinis@metrogi.com

Tulane University
New Orleans 4335045, Louisiana 4331987 70112
Contact:
Site Contact
352-265-8971
sglover3@tulane.edu

Huron Gastroenterology Associates, P.C.
Ypsilanti 5015688, Michigan 5001836 48197
Contact:
Site Contact
734-434-6262
soofin@hurongastro.com

Mid-America Gastro-Intestinal Consultants
Kansas City 4393217, Missouri 4398678 64111
Contact:
Site Contact
816-561-2000
hbownik@gimagic.com

BVL Clinical Research
Liberty 4395052, Missouri 4398678 64068
Contact:
Site Contact
800-407-9314
c.bartalos@bvlresearch.com

Washington University School of Medicine
St Louis 4407066, Missouri 4398678 63110
Contact:
Site Contact
314-273-1947
Deepak.parakkal@wustl.edu

NYU Langone Health
New York 5128581, New York 5128638 10016
Contact:
Site Contact
646-754-1899
David.Hudesman@nyulangone.org

University of Cincinnati
Cincinnati 4508722, Ohio 5165418 45627
Contact:
Site Contact
513-558-5504
brookln@ucmail.uc.edu

Ohio Gastroenterology group, Inc.
Columbus 4509177, Ohio 5165418 43202
Contact:
Site Contact
614-754-5481
research@ohiogastro.com

Great Lakes Gastroenterology Research, LLC
Mentor 5162645, Ohio 5165418 44060
Contact:
Site Contact
440-205-1225
keyur023@gmail.com

Gastro Intestinal Research Institute of Northern Ohio, LLC.
Westlake 5176517, Ohio 5165418 44145
Contact:
Site Contact
440-250-7630
mnaem@northshoregastro.org

Digestive Disease Specialists, Inc.
Oklahoma City 4544349, Oklahoma 4544379 73114
Contact:
Site Contact
405-702-1246
David.Stokesberry@okddsi.net

Allegheny Health Network
Wexford 5219062, Pennsylvania 6254927 15090
Contact:
Site Contact
412-359-8900
gursimran.kochhar@ahn.org

University Gastroenterology
Providence 5224151, Rhode Island 5224323 02905
Contact:
Site Contact
401-421-8800
Sheldon_lidofsky@brown.edu

Rapid City Medical Center, LLP
Rapid City 5768233, South Dakota 5769223 57701
Contact:
Site Contact
605-342-3280
haugEM@rcmed.net

Texas Digestive Disease Consultants Cedar Park
Cedar Park 4679867, Texas 4736286 78613
Contact:
Site Contact
512-341-0900
jsiddiqui@tddctx.com

GI Alliance - Digestive Health Associates of Texas
Dallas 4684888, Texas 4736286 75044
Contact:
Site Contact
972-265-8201
harry.sarles@gialliance.com

The University of Texas Health Science Center at Houston
Houston 4699066, Texas 4736286 77030
Contact:
Site Contact
713-500-6677
Andrew.Dupont@uth.tmc.edu

Texas Digestive Disease Consultants Lubbock
Lubbock 5525577, Texas 4736286 79410
Contact:
Site Contact
806-793-3141
AHughston@tddctx.com

GI Alliance - Mansfield
Mansfield 4709013, Texas 4736286 76063
Contact:
Site Contact
817-877-0888
moustafa.youssef@dhat.com

Gastroenterology Research of San Antonio, LLC
San Antonio 4726206, Texas 4736286 78229
Contact:
Site Contact
210-615-3848
martinezn2@yahoo.com

Southern Star Research Institute, LLC.
San Antonio 4726206, Texas 4736286 78229
Contact:
Site Contact
210-581-2812
Js_bull@yahoo.com

Texas Digestive Disease Consultants (TDDC), Southlake
Southlake 4733313, Texas 4736286 76092
Contact:
Site Contact
940-367-2316
Tim.Ritter@gialliance.com

Tyler Research Institute, LLC
Tyler 4738214, Texas 4736286 75701
Contact:
Site Contact
903-630-6211
aarond@tylerri.com

GI Alliance - Webster
Webster 4740423, Texas 4736286 77598
Contact:
Site Contact
832-754-8163
NInamdar@tddctx.com

University of Utah Health
Salt Lake City 5780993, Utah 5549030 84108
Contact:
Site Contact
john.valentine@hsc.utah.edu

Washington Gastroenterology- GIA
Tacoma 5812944, Washington 5815135 98405
Contact:
Site Contact
253-272-5127
wholderman@washgi.com

More Details

NCT ID
NCT06045754
Status
Recruiting
Sponsor
Takeda

Study Contact

Takeda Contact
+1-877-825-3327
medinfoUS@takeda.com

Detailed Description

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, and no other biologic/small molecule (Group A); one IL antagonist and either one Janus kinase inhibitor (JAKi) or one TNFi (other than adalimumab) [Group B] (Cohort 1) or one prior tumor necrosis factor inhibitor [TNFi] and no other biologic/small molecule (Group C); one TNFi and either 1 JAKi or one IL antagonist (other than UST) (Group D) (Cohort 2). The study will look at the efficacy and safety of dual targeted therapy. The study will enroll approximately 100 participants. 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 therapeutic benefit 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.