A study to evaluate efficacy and safety of Vedolizumab in pediatric subjects with moderately to severely active Ulcerative Colitis

• Register: EUCTR
• Last refreshed on: 10 June 2024
• Main ID: EUCTR2020-004300-34-CZ
• Date of registration: 28/04/2021
• Prospective Registration: Yes
• Primary sponsor: Takeda Development Center Americas, Inc.
• Public title: A study to evaluate efficacy and safety of Vedolizumab in pediatric subjects with moderately to severely active Ulcerative Colitis
• Scientific title: A Randomized, Double-Blind, Phase 3 Study to Evaluate the Efficacy and Safety of Vedolizumab Intravenous as Maintenance Therapy in Pediatric Subjects with Moderately to Severely Active Ulcerative Colitis Who Achieved Clinical Response Following Open–Label Vedolizumab Intravenous Therapy
• Target sample size: 120
• Recruitment status: Not Recruiting
• URL: https://www.clinicaltrialsregister.eu/ctr-search/search?query=eudract_number:2020-004300-34
• Study type: Interventional clinical trial of medicinal product
• Study design: Controlled: yes Randomised: yes Open: no Single blind: no Double blind: yes Parallel group: yes Cross over: yes Other: no If controlled, specify comparator, Other Medicinial Product: no Placebo: no Other: yes Other specify the comparator: Different doses of IMP are used in treatment arms Number of treatment arms in the trial: 3
• Phase: Human pharmacology (Phase I): no Therapeutic exploratory (Phase II): no Therapeutic confirmatory - (Phase III): yes Therapeutic use (Phase IV): no

Countries of recruitment

Australia, Belgium, Canada, China, Croatia, Czech Republic, Czechia, Greece, Hungary, Israel, Italy, Japan, Korea, Republic of, Lithuania, Poland, Slovakia, Spain, United Kingdom, United States

Contacts

• Name: Director, Clinical Operations
• Affiliation: Takeda Development Center Americas, Inc.

• Name: Director, Clinical Operations
• Affiliation: Takeda Development Center Americas, Inc.

Key inclusion & exclusion criteria

Inclusion criteria:
1. The subjects aged 2 to 17 years, inclusive, at the time of screening and enrollment into the maintenance phase of the study.
2. The subject weighs =10 kg at the time of screening and enrollment into the study.
3. Subjects with diagnosed at least 1 month before screening, Subjects with moderately to severely active UC based on a modified Mayo score of 5 to 9 (sum of Mayo endoscopic subscore, stool frequency subscore, and rectal bleeding subscore) with a Mayo endoscopic subscore of =2 (with the presence of mucosal friability excluding an endoscopic subscore of 1 and mandating a score of at least 2) at screening endoscopy.
4. Subjects who have failed, lost response to, or been intolerant to treatment with at least 1 of the following agents: corticosteroids, immunomodulators (eg, azathioprine, 6-mercaptopurine, methotrexate), and/or TNF-a antagonist therapy (eg, infliximab, adalimumab). This includes subjects who are dependent on corticosteroids to control symptoms and who are experiencing worsening of disease when attempting to wean off corticosteroids.
5. Subjects with evidence of UC extending proximal to the rectum (ie, not limited to proctitis), at a minimum.
6. Subjects with extensive colitis or pancolitis of >8 years’ duration or left-sided colitis of >12 years’ duration must have documented evidence of a negative surveillance colonoscopy within 12 months before screening.
7. Subjects with vaccinations that are up-to-date based on the countrywide, accepted schedule of childhood vaccines.
Are the trial subjects under 18? yes
Number of subjects for this age range: 120
F.1.2 Adults (18-64 years) no
F.1.2.1 Number of subjects for this age range
F.1.3 Elderly (>=65 years) no
F.1.3.1 Number of subjects for this age range

Exclusion criteria:
1. Subjects who have had previous exposure to approved or investigational anti-integrins including, but not limited to natalizumab, efalizumab, etrolizumab, or AMG 181, or mucosal addressin cell adhesion molecule-1 antagonists or rituximab.
2. Subjects who have had prior exposure to vedolizumab.
3. Subjects with hypersensitivity or allergies to vedolizumab or any of its excipients.
4. Subjects who have received either (1) an investigational biologic (other than those listed in Exclusion Criterion #1) within 60 days or 5 half-lives before screening (whichever is longer); or (2) an approved biologic or biosimilar agent within 2 weeks before the first dose of study drug or at any time during the screening period.
5. Subjects with active cerebral/meningeal disease, signs/symptoms or history of progressive multifocal leukoencephalopathy (PML) or any other major neurological disorders including stroke, multiple sclerosis, brain tumor or neurodegenerative disease.
6. Subjects who currently require surgical intervention or are anticipated to require surgical intervention for UC during this study.
7. Subjects who have had subtotal or total colectomy or have a jejunostomy, ileostomy, colostomy, ileo-anal pouch, or known fixed stenosis of the intestine.
8. Subjects with a current diagnosis of indeterminate colitis.
9. Subjects with clinical features suggesting monogenic very early onset inflammatory bowel disease.
10. The subject has other serious comorbidities that will limit his or her ability to complete the study


Age minimum:
Age maximum:
Gender:
Female: yes
Male: yes

Health Condition(s) or Problem(s) studied

Moderately to severely active Ulcerative Colitis (UC)
MedDRA version: 20.1 Level: LLT Classification code 10066678 Term: Acute ulcerative colitis System Organ Class: 100000004856

Therapeutic area: Diseases [C] - Digestive System Diseases [C06]

Intervention(s)

Trade Name: ENTYVIO
Product Name: Vedolizumab
Pharmaceutical Form: Powder for concentrate for solution for infusion
INN or Proposed INN: Vedolizumab
CAS Number: 943609-66-3
Other descriptive name: MLN0002
Concentration unit: mg milligram(s)
Concentration type: equal
Concentration number: 300-

Primary Outcome(s)

Main Objective: To evaluate the efficacy of 2 different dose regimens of vedolizumab IV in pediatric subjects with moderately to severely active UC during maintenance therapy, based on clinical remission at Week 54.

Timepoint(s) of evaluation of this end point: Week 54

Primary end point(s): The primary endpoint is clinical remission at Week 54, where clinical remission based on the modified Mayo score is defined as:
• Stool frequency subscore 0 to 1 and a decrease of 1 or more from baseline;
• Rectal bleeding subscore of 0;
• Endoscopy subscore 0 to 1 (modified so that a score of 1 does not include friability).

Secondary Objective: To evaluate efficacy of high and low doses of vedolizumab (Vedo)IV:
-In pediatric subjects with moderately to severely active UC, based on clinical remission on W14
-As measured by sustained clinical remission and sustained clinical response at W14&54
-As measured by sustained endoscopic remission W14&54
-As measured by endoscopic response at W14&54
To evaluate of high & low doses of vedolizumab IV:
-On achieving corticosteroid-free remission at W54
-On clinical response and efficacy measured by clinical remission over time up to W54
To evaluate:
-VedoPK in pediatric subjects with moderately to severely active UC after IV admin
-Safety in pediatric subjects on maintenance therapy up to W54
-The immunogenicity of vedolizumab in pediatric subjects with moderately to severely active UC treated with vedoIV
-The effect of vedolizumab on patterns of growth and pubertal development in pediatric subjects with moderately to severely active UC during their participation in the study.

Secondary Outcome(s)

Secondary end point(s): • Clinical remission at Week 14, where a subject achieves clinical remission if he or she meets the definition described in the primary endpoint.
• Sustained clinical remission at Week 54, where a subject achieves sustained clinical remission if he or she achieved clinical remission (as defined by primary endpoint) at Week 14 and at Week 54.
• Sustained endoscopic remission, defined as Mayo endoscopic score (MES) of =1 point, at Week 14 and at Week 54.
• Endoscopic response, defined as a decrease in MES =1 point at Week 14.
Endoscopic response, defined as a decrease in MES =1 point at Week 54.
• Corticosteroid-free clinical remission at Week 54, where a subject achieves corticosteroid-free clinical remission at Week 54 if he or she meets the definition described in the primary endpoint and was off corticosteroids at least 12 weeks before Week 54.
• Clinical remission based on complete Mayo score at Week 54, where a subject achieves clinical remission if he or she achieved a complete Mayo score =2 points with no individual subscore >1 at Week 54.
• Serum trough concentrations of vedolizumab over time.
• Positive antivedolizumab antibodies (AVA) and positive neutralizing AVA during the study.
• Sustained clinical response of subjects at Weeks 14 and 54, where a subject meets clinical response if he or she has a reduction in complete Mayo score (see Appendix G) of =3 points and =30% from baseline with an accompanying decrease in rectal bleeding subscore of =1 point or absolute rectal bleeding subscore of =1 point.
• Clinical response at Weeks 2, 6, 10, 14, 22, 30, 38, 46, and 54 where a subject achieves clinical response if he or she meets the following definition:
• Reduction of =2 points and =25% from the baseline partial Mayo score, including a =1-point decrease in the Mayo stool frequency subscore and a =1-point reduction in the rectal bleeding subscore or absolute rectal bleeding subscore of =1 point.
Clinical remission at weeks 2, 6, 10, 14, 22, 30, 38, 46, and 54where a subject achieves clinical remission based on partial Mayo score (a partial Mayo score of = points and no individual subscore >1 point).
• Safety assessments: descriptions of adverse events (AEs); serious adverse events (SAEs); and adverse events of special interest (AESIs), including evaluation of opportunistic infection, such as PML, liver injury, malignancies, infusion-related reactions, and hypersensitivity.
• Change from baseline in weight gain and linear growth z-score during the course of dosing with vedolizumab.
• Tanner Stage V at Week 54, where a subject achieves Tanner Stage V at Week 54 based on progression of pubertal changes from baseline.

Timepoint(s) of evaluation of this end point: Timepoints of secondary end points are provided in E.5.2.

Secondary ID(s)

2020-004300-34-LT

009125

MLN0002-3024

Source(s) of Monetary Support

Takeda Development Center Americas, Inc.