Purpose

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.

Condition

Eligibility

Eligible Ages
Between 18 Years and 65 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

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.

Exclusion Criteria

  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.

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 clinical remission in Part A will receive vedolizumab IV 300 mg monotherapy, Q8W from Week 30 until Week 46.
  • Drug: Vedolizumab
    Vedolizumab intravenous infusion.
    Other names:
    • Entyvio

Recruiting Locations

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

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

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

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

Medical Research Center of Connecticut, LLC
Hamden, Connecticut 06518
Contact:
Site Contact
203-281-5161
pginsburg@gastrocenter.org

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

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

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

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

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

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

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

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

Clinical Research Institute of Michigan, LLC
Clinton Township, Michigan 48038
Contact:
Site Contact
586-598-3329
rfogel@researchmi.com

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Gastroenterology Research of San Antonio, LLC
San Antonio, Texas 78229
Contact:
Site Contact
martinezn2@yahoo.com

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

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

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

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

Washington Gastroenterology- GIA
Bellevue, Washington 98004
Contact:
Site Contact
425-454-4768
vmohan@washgi.com

Washington Gastroenterology- GIA
Tacoma, Washington 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 (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.

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.