E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
In the present study, the corticosteroid-sparing effect of certolizumab pegol will be assessed in patients with moderate to severe Crohn’s disease who have received initial acute corticosteroid therapy (prednisone or prednisolone) for induction of remission. |
|
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 8.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10011401 |
E.1.2 | Term | Crohn's disease |
|
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective is to compare certolizumab pegol and placebo treatments for the proportion of patients who have been successfully withdrawn from corticosteroids (prednisone or prednisolone) according to the tapering schedule of the protocol and have remained off corticosteroids and in disease remission as defined by a Crohn's Disease Activity Index (CDAI) of <=150 at Week 38 of treatment. |
|
E.2.2 | Secondary objectives of the trial |
·Proportion of patients with remission (CDAI <=150) off steroids at each study visit·Proportion of patients with continuous remission (CDAI <=150) off steroids at each study visit · Cumulative proportion of patients with relapse/treatment failure at each study visit after Week 0, with relapse/treatment failure defined as a CDAI >150 and an increase in CDAI of >=70 points vs. Week 0 ·Time to relapse/treatment failure· Per-patient median weekly dose and cumulative dose of corticosteroids over the duration of the study, and change from baseline in the median weekly dose· CDAI scores at each study visit and changes from Week 0· Change from baseline in the health-related quality of life (HRQOL) as assessed by the Inflammatory Bowel Disease Questionnaire (IBDQ) total score at Week 38·Safety |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Patient is able to understand the information provided to them and who have given written informed consent to the study. Patient is able to understand and complete self-administered questionnaires. Men and women, age 18 years or older A diagnosis of moderate to severe Crohn's disease (CDAI score of >= 220 - < =450) during the run-in period. The patient is a candidate for treatment with prednisone or prednisolone therapy, but is not on maintenance corticosteroid therapy If the patient is on an immunosuppressant (azathioprine, 6-mercaptopurine and methotrexate are allowed immunosuppressants), the dose has to have been stable for at least 8 weeks prior to screening and is expected to remain stable during the study. If the patient is on a 5-ASA analogue for Crohn’s disease, the dose has to have been stable for at least 4 weeks prior to screening and is expected to remain stable during the study. If female, the patient is either postmenopausal for at least one year, surgically incapable of childbearing, or effectively practicing an acceptable method of contraception (oral or parenteral hormonal contraceptive; intrauterine device; barrier and spermicide—abstinence is not an acceptable method). Patients must agree to use adequate contraception during the study and for 12 weeks after the last dose of certolizumab.
|
|
E.4 | Principal exclusion criteria |
Patients who were primary non-responders to previous treatment with an anti-TNF drug are excluded. Patients with previous certolizumab pegol exposure are excluded. If a patient received ≤ 3 injections of anti-TNF therapy (other than certolizumab pegol) and responded to treatment, but discontinued that treatment for reasons other than loss of response or hypersensitivity reaction, the patient may be included in the study. Any patient receiving ≤ 3 injections of anti-TNF (other than certolizumab pegol) in the past 6 months must be reviewed by the UCB Study Physician prior to being included in the study.
Active or draining fistula present at screening. On maintenance corticosteroid therapy. Symptomatic obstructive intestinal strictures. Functional colostomy or ileostomy (patients who have a temporary stoma in the past, which has been reversed, are eligible to enter the study). Bowel resection within 3 months of starting the study medication. Current total parenteral nutrition.Short bowel syndrome. Positive stool laboratory results for pathogens.Antibiotic treatment for Crohn’s Disease within 2 weeks prior to screening.
Patients with a history of tuberculosis, or positive chest X-ray for tuberculosis, or positive PPD skin test result (defined as an induration of ≥5 mm) can not be enrolled in the study. Patients with a history of BCG vaccination having a positive PPD skin test, but no clinical or radiographic evidence of TB (confirmed by a radiologist) may be enrolled. Patient for which latent TB can not be ruled out are ONLY eligible for study entry if they are prophilactically treat with isoniazid initiated at least 1 month prior to re-screening and agree to maintain isoniazid therapy for six months.
Patients with a previous history of blood dyscrasias are excluded from study participation.
|
|
E.5 End points |
E.5.1 | Primary end point(s) |
The primary efficacy variable will be the proportion of patients who have been withdrawn from prednisone or prednisolone therapy according to the corticosteroid-tapering schedule and have remained off corticosteroids and in disease remission (CDAI <= 150) at Week 38. |
|
E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | Information not present in EudraCT |
E.6.2 | Prophylaxis | Information not present in EudraCT |
E.6.3 | Therapy | Information not present in EudraCT |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | Information not present in EudraCT |
E.6.8 | Bioequivalence | Information not present in EudraCT |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | Information not present in EudraCT |
E.6.12 | Pharmacoeconomic | Yes |
E.6.13 | Others | Information not present in EudraCT |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Information not present in EudraCT |
E.7.1.1 | First administration to humans | Information not present in EudraCT |
E.7.1.2 | Bioequivalence study | Information not present in EudraCT |
E.7.1.3 | Other | Information not present in EudraCT |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Information not present in EudraCT |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | Information not present in EudraCT |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Information not present in EudraCT |
E.8.1.3 | Single blind | Information not present in EudraCT |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Information not present in EudraCT |
E.8.1.6 | Cross over | Information not present in EudraCT |
E.8.1.7 | Other | Information not present in EudraCT |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 5 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
|
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
For each subject, the study may last for up to 54 weeks [a run-in period of up to 6 weeks, treatment injections through Week 36, a final evaluation visit at Week 38, and telephone contact at Week 48 (or 12 weeks after treatment discontinuation). |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 9 |