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Long-term Safety With Vedolizumab Intravenous (IV) in Pediatric Participants With Ulcerative Colitis (UC) or Crohn's Disease (CD)

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ClinicalTrials.gov Identifier: NCT03196427
Recruitment Status : Not yet recruiting
First Posted : June 22, 2017
Last Update Posted : June 7, 2018
Sponsor:
Information provided by (Responsible Party):
Takeda

Brief Summary:
The purpose of this study is to determine the safety profile of long-term vedolizumab IV treatment in pediatric participants with UC or CD.

Condition or disease Intervention/treatment Phase
Ulcerative Colitis Crohn's Disease Drug: Vedolizumab Phase 2

Detailed Description:

The drug being tested in this study is called Vedolizumab. Vedolizumab is being tested to treat pediatric participants who have moderately to severely active UC or CD.

This study will look at the long-term safety profile in participants who take vedolizumab IV. Participants will be randomly assigned (by chance, like flipping a coin) which will remain undisclosed to the participant and investigator during this double blind study (up to Week 40) maintaining the dose at study entry and escalating the dose at disease worsening.

The dosing regimen selected for the long-term study is intended to maintain clinical response at the lowest possible exposure.

At the discretion of the investigator, participants receiving the low dose (150 or 100 mg) of vedolizumab IV may be escalated to the high dose (300 or 200 mg) if the participants demonstrate disease worsening at 2 consecutive visits (scheduled or unscheduled).

Participants who experience continued disease worsening during the study despite being administered vedolizumab 300 or 200 mg every 8 weeks (Q8W) will be discontinued from the study.

Study duration is expected to be up to 5 years, depending on the enrollment rate in the previous randomized double blind study (MLN0002-2003).


Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 80 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Phase 2b, Extension Study to Determine the Long-term Safety of Vedolizumab IV in Pediatric Subjects With Ulcerative Colitis or Crohn's Disease
Estimated Study Start Date : August 6, 2018
Estimated Primary Completion Date : February 8, 2025
Estimated Study Completion Date : June 14, 2025

Resource links provided by the National Library of Medicine

Drug Information available for: Vedolizumab

Arm Intervention/treatment
Experimental: Vedolizumab High Dose Group
Participants with UC or CD having baseline weight of greater than or equal to (>=) 30 kilogram (kg) will receive Vedolizumab 300 milligram (mg) and participants with UC or CD having baseline weight of less than (<) 30 kg will receive Vedolizumab 200 mg, intravenous infusion, every 8 weeks for up to 5 years.
Drug: Vedolizumab
Vedolizumab intravenous infusion.
Other Names:
  • MLN0002
  • ENTYVIO
  • KYNTELES

Experimental: Vedolizumab Low Dose Group
Participants with UC or CD having baseline weight of >= 30 kg will receive Vedolizumab 150 mg and participants with UC or CD having baseline weight of < 30 kg will receive Vedolizumab 100 mg intravenous infusion, every 8 weeks for up to 5 years.
Drug: Vedolizumab
Vedolizumab intravenous infusion.
Other Names:
  • MLN0002
  • ENTYVIO
  • KYNTELES




Primary Outcome Measures :
  1. Percentage of Participants with Treatment-emergent Adverse Events (TEAEs) [ Time Frame: Baseline up to 5 years ]
    An adverse event (AE) is defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (example, a clinically significant abnormal laboratory finding), symptom, or disease temporally associated with the use of a drug, whether or not it is considered related to the drug. A treatment-emergent adverse event (TEAE) is defined as an adverse event with an onset that occurs after receiving study drug.


Secondary Outcome Measures :
  1. Time to Major Inflammatory Bowel Disease (IBD) - Related Events [ Time Frame: Baseline up to 5 years ]
    Major IBD-related events included hospitalizations, surgeries, or procedures due to UC and CD.

  2. Change from Baseline in IMPACT-III Total and Subscale Scores at Week 24 and Every 24 weeks, Thereafter up to 5 years [ Time Frame: Baseline up to 5 years ]
    The IMPACT-III questionnaire is a self-reported measure with 35 closed questions encompassing 6 domains: Bowel Symptoms (7 items), Systemic Symptoms (3 items), Social Functioning (12 items), Body Image (3 items), Treatment/Interventions (3 items), and Emotional Functioning (7 items). The IMPACT-III uses a 5-point Likert scale ranging from 1 to 5 for all answers. The outcome score ranges from 35 to 175, with higher scores suggesting better quality of life.

  3. Height Velocity at Week 48 and Every 48 weeks, Thereafter up to 5 years [ Time Frame: Baseline up to 5 years ]
    Height velocity (cm/year) is the change in height per year.

  4. Change from Baseline in Height at Week 24 and Every 24 Weeks, Thereafter up to 5 years [ Time Frame: Baseline up to 5 years ]
  5. Change from Baseline in Weight at Week 24 and Every 24 Weeks, Thereafter up to 5 years [ Time Frame: Baseline up to 5 years ]
  6. Change from Baseline in Body Mass Index (BMI) at Week 24 and Every 24 Weeks, Thereafter up to 5 years [ Time Frame: Baseline up to 5 years ]
    BMI = Weight (in kilograms)/height^2 (in meters).

  7. Percentage of Participants Achieving Tanner Stage V Scale [ Time Frame: Baseline up to 5 years ]
    Tanner Stage Evaluation is a scale used to evaluate growth parameters standardized for age, sex, and pubertal development. Female pubertal development staged by pubic hair development and breast size; male pubertal development staged by size of the genitalia and development of pubic hair. Rated in 5 stages: stage 1 (no development) to 5 (adult-like development in quantity and size). Tanner stage is assessed at or before age 16 years for females or 17 years for males.

  8. Percentage of Participants With UC Meeting Complete Mayo Score Response at Week 32 [ Time Frame: Week 32 ]
    Clinical response is defined as a continued reduction in complete mayo score of >=3 points from baseline (at initiation of MLN0002-2003) and continued decrease in rectal bleeding subscore of >=1 point from baseline, or absolute rectal bleeding subscore of <=1 point. Mayo score is an instrument designed to measure disease activity of UC. It consists of 4 subscores: stool frequency, rectal bleeding, findings on endoscopy and physician rating of disease activity, each graded from 0 to 3 with higher scores indicating more severe disease. These scores are summed to give a total score range of 0 to 12; where higher scores indicate more severe disease.

  9. Percentage of Participants With CD Meeting 50 Percent (%) Reduction in Simple Endoscopic Score for Crohn's Disease (SES-CD) Score at Week 32 [ Time Frame: Week 32 ]
    Clinical response is defined as a 50% reduction in SES-CD score on endoscopy compared to the baseline endoscopy (at initiation of MLN0002-2003) and continued reduction in CDAI that is a >=70 point decrease from the baseline Crohn's disease activity index (CDAI) score at the initiation of MLN0002-2003. CDAI is a research tool used to quantify the symptoms of participants with Crohn's disease. SES-CD consists of 3 variables: ulcer size, ulcerated and affected surfaces and presence of narrowing each graded from 0 to 3 with score of 0 means no colonic lesions or mucosal healing, and SES-CD greater than (>) 1 indicates the presence of mucosal lesions.



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Ages Eligible for Study:   2 Years to 17 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Is male or female with Ulcerative Colitis or Crohn's Disease and was between 2 to 17 years, inclusive, at the time of randomization for Study MLN0002-2003.

    (Note: A participant remains eligible to participate in this study after they reach 18 years of age if they continue to meet the inclusion criteria and do not meet any exclusion criteria.)

  2. Has completed Study MLN0002-2003 and, at Week 22, achieved clinical response as defined by a reduction of partial Mayo score of >= 2 points and >= 25% from Baseline, or a reduction of the paediatric ulcerative colitis activity index (PUCAI) of >= 20 points from baseline for participants with UC; or a reduction of the CDAI as defined by a >= 70-point decrease from Baseline or a decrease of pediatric crohn's disease activity index (PCDAI) of >= 15 points for participants with CD.
  3. May be receiving a therapeutic dose of the following drugs:

    • Oral 5-aminosalicylic acid (5-ASA) compounds.
    • Oral corticosteroid therapy (prednisone or equivalent steroid at a dose less than or equal to [<=] 50 milligram per day [mg/day], budesonide at a dose <= 9 mg/day).
    • Topical (rectal) treatment with 5-ASAs or corticosteroids.
    • Probiotics (example, Saccharomyces boulardii).
    • Antidiarrheals (example, loperamide, diphenoxylate with atropine) for control of chronic diarrhea.
    • Antibiotics used for the treatment of CD (i.e., ciprofloxacin, metronidazole).
    • Azathioprine (AZA) or 6-mercaptopurine (6-MP) or methotrexate (MTX), provided the participant was receiving this medication during prior participation in MLN0002-2003.
  4. The participant's vaccinations are up to date as per inclusion criteria number 10 in MLN0002-2003.

Exclusion Criteria:

  1. Is female and is lactating or pregnant.
  2. Has hypersensitivity or allergies to vedolizumab or any of its excipients.
  3. Has withdrawn from Study MLN0002-2003.
  4. Has developed any new unstable or uncontrolled cardiovascular, heart failure moderate to severe (New York Class Association III or IV), pulmonary, hepatic, renal, gastrointestinal (GI), genitourinary, hematological, coagulation, immunological, endocrine/metabolic, neurological, or other medical disorder that, in the opinion of the investigator, would confound the study results or compromise participant safety.
  5. Has a positive progressive multifocal leukoencephalopathy (PML) subjective symptom checklist prior to the administration of the first dose of study drug.
  6. Currently requires major surgical intervention for ulcerative colitis (UC) or CD (example, bowel resection), or is anticipated to require major surgical intervention for UC or CD during the study.
  7. Has other serious comorbidities that will limit his or her ability to complete the study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03196427


Contacts
Contact: Takeda Study Registration Call Center +1-877-825-3327 medicalinformation@tpna.com

Sponsors and Collaborators
Takeda
Investigators
Study Director: Medical Director Takeda

Responsible Party: Takeda
ClinicalTrials.gov Identifier: NCT03196427     History of Changes
Other Study ID Numbers: Vedolizumab-2005
2017-002182-21 ( EudraCT Number )
U1111-1176-5741 ( Other Identifier: WHO )
17/NE/0258 ( Registry Identifier: NRES )
MOH_2017-09-18_000649 ( Other Identifier: CRS )
First Posted: June 22, 2017    Key Record Dates
Last Update Posted: June 7, 2018
Last Verified: June 2018

Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Takeda:
Drug Therapy

Additional relevant MeSH terms:
Crohn Disease
Colitis
Ulcer
Colitis, Ulcerative
Inflammatory Bowel Diseases
Gastroenteritis
Gastrointestinal Diseases
Digestive System Diseases
Intestinal Diseases
Colonic Diseases
Pathologic Processes
Vedolizumab
Gastrointestinal Agents