E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Digestive System Diseases [C06] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10011401 |
E.1.2 | Term | Crohn's disease |
E.1.2 | System Organ Class | 10017947 - Gastrointestinal disorders |
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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 of the study is to assess the clinical efficacy of TNF-K in adult subjects with moderate to severe active CD. Specifically, the study will assess the induction of clinical remission (CDAI≤150) |
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E.2.2 | Secondary objectives of the trial |
• To assess clinical response by CDAI (CDAI-70 and CDAI-100) • To assess mucosal improvement and healing by ileocolonoscopy • To assess changes in biological markers of disease activity • To assess microscopic and biological changes in ileocolonic mucosal tissue • To evaluate the safety of TNF-K treatment in subjects with moderate to severe active CD • To evaluate the anti-TNF-α and anti-Keyhole Limpet Hemocyanin (anti-KLH) antibody responses induced by TNF K • To evaluate the neutralizing anti-TNF-α antibody response induced by TNF-K |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.Male or female aged 18 to 65 years, inclusive. 2.Have had a diagnosis of Crohn’s disease for at least 6 months. 3.Moderate to severe active Crohn’s disease defined as a Crohn’s Disease Activity Index (CDAI) score ≥ 220 and ≤ 450, and presence of mucosal ulcerations in at least 2 segments, or ulcerations on ≥ 10% of the mucosal surface if only one segment is involved. 4.Either have developed secondary resistance to one or two anti-TNFα therapy. Secondary resistance must have followed at least 6 months of continuous anti-TNFα therapy during which a positive clinical response has been observed, according to the Investigator. and/or Have developed intolerance to one or two anti-TNFα treatment, provided that the observed adverse events are thought to be unrelated to the primary pharmacological effect of these agents (i.e. TNFα blockade). Subjects can have received only one or more anti-TNF-α agent, and must have discontinued this treatment as follows: • Infliximab: a wash-out period of 8 weeks prior to the first administration of study drug; • Adalimumab: a wash-out period of 4 weeks prior to the first administration of study drug; • Certolizumab: a wash-out period of 8 weeks prior to the first administration of study drug; 5.If receiving the medications listed below, must meet the outlined criteria: • Systemic corticosteroids: up to 25 mg/day of prednisone or equivalent, ongoing for at least 8 weeks, and with a stable dose for at least 2 weeks prior to the first administration of study drug; • Budesonide: up to 6 mg/day, ongoing for at least 8 weeks, and with a stable dose for at least 2 weeks prior to the first administration of study drug; • Methotrexate: up to 25 mg/week, ongoing for at least 8 weeks, and with a stable dose for at least 4 weeks prior to the first administration of study drug; • Azathioprine: up to 2.5 mg/kg/day, ongoing for at least 8 weeks, and with a stable dose for at least 4 weeks prior to the first administration of study drug; • Mercaptopurine: up to 1.5 mg/kg/day, ongoing for at least 8 weeks, and with a stable dose for at least 4 weeks prior to the first administration of study drug; • Antibiotics (metronidazole at 15-20 mg/kg per day and/or ciprofloxacin 500 mg bid) are allowed if ongoing for at least 4 weeks, and with a stable dose for at least 2 weeks prior to the first administration of study drug; • Sulfasalazine and mesalazine ongoing for at least 8 weeks, and with a stable dose of maximum 4g per day for at least 4 weeks prior to the first administration of study drug
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E.4 | Principal exclusion criteria |
1.Primary non-response to a previously received treatment directed against TNF α Or Intolerance related to the primary pharmacological effect of anti-TNF-α such as for instance, but not limited to, severe or opportunistic infections and demyelinating or autoimmune diseases. 2.History of severe systemic bacterial, fungal, viral, or parasitic infections within the 3 months prior to screening; or the occurrence of any acute infection within 2 weeks of the first administration of study drug. 3.Treatment with more than 2 doses over 30 mg of rectally administered corticosteroids in the 14 days preceding the first administration of study drug. 4.Treatment with immunosuppressive or immunomodulatory drugs, including, but not limited to: • B-cell depleting therapy (e.g., anti-CD20, anti-CD22) within 1 year of the first administration of study drug; • Cyclophosphamide within 12 weeks of the first administration of study drug; • Cyclosporine within 12 weeks of the first administration of study drug; • TNFα blockers other than infliximab, adalimumab or certolizumab within 12 weeks or 5 half lives of the first administration of study drug, whichever is longer • Biological agents other than TNF-α blockers within 12 weeks or 5 half lives of the first administration of study drug, whichever is longer.
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E.5 End points |
E.5.1 | Primary end point(s) |
Efficacy The same primary efficacy endpoint will be used for the interim and primary analyses, i.e., clinical remission, defined as a CDAI score ≤ 150 points at week 8. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
1. Clinical responses, defined as a decrease of at least 70 points (CDAI- 70)and at least 100 points (CDAI-100) in the CDAI score at week 8 vs baseline 2. Endoscopic response, defined as a reduction of at least 50% in the Crohn's Disease Endoscopic Index of Severity (CDEIS) score or in the Simple Endoscopic Score for Crohn's Disease (SES-CD) at week 12 vs baseline 3. Mucosal healing defined as the disappearance of all ulcerations at week 12 4. Steroid sparing and steroid-free clinical remission by week 28 5. Biological response as defined by a decrease or normalization of calprotectin levels in stool 6. Biological response as defined by a decrease or normalization of CRP levels in serum 7. Time to first occurence of clinical response and of clinical remission 8. Changes in the Quality of Life, as measured by the Inflammatory Bowel Disease Questionnaire (IBDQ). 9. Association between anti-TNFα antibody levels and changes in the CDAI and the endoscopic scores 10. Association between anti-drug-antibodies (ADA) at baseline and changes in the CDAI and the endoscopic scores. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. week 8 2. week 12 3. week 12 4. week 28 8. 4 and 8 weeks after each study product administration |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | Yes |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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 | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 48 |
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 | No |
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 |
Belgium |
Bulgaria |
Croatia |
Czech Republic |
France |
Germany |
Hungary |
Netherlands |
Romania |
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E.8.7 | Trial has a data monitoring committee | Yes |
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
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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 | 6 |
E.8.9.1 | In the Member State concerned days | 0 |
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 | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |