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 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
- Crohn's Disease
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
- 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
Arm | Description | Assigned 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. |
|
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. |
|
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. |
|
Recruiting Locations
Dothan, Alabama 36301
Sun City, Arizona 85351
Los Angeles, California 90048
Newport Beach, California 92663
Hamden, Connecticut 06518
Orlando, Florida 32803
Tampa, Florida 33615
Roswell, Georgia 30076
Chicago, Illinois 60637
Glenview, Illinois 60026
Gurnee, Illinois 60031
Topeka, Kansas 66606
Clinton Township, Michigan 48038
Ypsilanti, Michigan 48197
Kansas City, Missouri 64111
Liberty, Missouri 64068
Saint Louis, Missouri 63110
Cincinnati, Ohio 45627
Columbus, Ohio 43202
Mentor, Ohio 44060
Westlake, Ohio 44145
Oklahoma City, Oklahoma 73114
Providence, Rhode Island 02905
Rapid City, South Dakota 57701
Cedar Park, Texas 78613
Dallas, Texas 75044
Lubbock, Texas 79410
Mansfield, Texas 76063
San Antonio, Texas 78229
San Antonio, Texas 78229
Southlake, Texas 76092
Tyler, Texas 75701
Bellevue, Washington 98004
Tacoma, Washington 98405
More Details
- NCT ID
- NCT06045754
- Status
- Recruiting
- Sponsor
- Takeda
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.