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 |
Crohn’s disease is a chronic relapsing, remitting inflammatory disease of the gastrointestinal tract although some patients may have continuously active disease. |
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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 | 14.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10013099 |
E.1.2 | Term | Disease Crohns |
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 |
To evaluate the safety of long-term exposure with AMG 827 in subjects with Crohn’s disease |
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E.2.2 | Secondary objectives of the trial |
Efficacy
• To evaluate the efficacy of AMG 827 as measured by the Harvey-Bradshaw Index (HBI) and the Crohn’s Disease Activity Index (CDAI)
• To evaluate the maintenance of effect as measured by the HBI and CDAI Efficacy analyses will use study 20090072 baseline for primary analyses but will also examine changes from the baseline values of 20100008. Other • To evaluate the change of EQ-5D from baseline at all measured timepoints
• To determine the proportion of subjects who develop anti-AMG 827 antibodies
• To evaluate the effect of treatment on inflammatory markers (C-reactive protein [CRP]) at post-baseline measured timepoints
• To evaluate the pharmacokinetics of AMG 827 with long-term administration |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Subject was randomized into study 20090072 and completed the week 12 evaluation.
• Subject completed the week 12 evaluation in study 20090072 no more than 1 year prior to the planned first visit of AMG 827 in 20100008.
• Subject or subject’s legally acceptable representative has provided informed consent.
• Subject meets regional recommendations for immunizations, eg, United States Centers for Disease Control and Prevention recommendations for subjects enrolled in the United States.
• For subjects with ≥ 3 months between the week 12 visit of 20090072 and the planned first dose of AMG 827 in 20100008: If testing is clinically indicated in the opinion of the investigator (eg, because of known recent exposure), then subject has negative test for hepatitis B, hepatitis C, and/or human immunodeficiency virus (HIV).
• For female subjects with ≤ 4 weeks between the week 12 visit of 20090072 and the planned first dose of AMG 827 in 20100008: Subject has a negative urine pregnancy test at baseline prior to the first dose of AMG 827 in the open-label extension (except those at least 2 years post menopausal or surgically sterile).
• For female subjects with > 4 weeks between the week 12 visit of 20090072 and the planned first dose of AMG 827 in 20100008: Subject has a negative serum pregnancy test within 28 days before initiating AMG 827 and a negative urine pregnancy test at baseline prior to the first dose of AMG 827 in the open-label extension (except those at least 2 years post menopausal or surgically sterile).
• For subjects with ≥ 3 months between the week 12 visit of 20090072 and the planned first dose of AMG 827 in 20100008, if clinically indicated in the opinion of the investigator (eg, because of known recent exposure):
− If the subject entered 20090072 with a negative purified protein derivative (PPD) test: Subject must have a negative PPD test within 30 days prior to the planned first dose of AMG 827. Tuberculin skin tests should be considered positive when they have greater than or equal to 5 mm of induration at 48-72 hours after test is placed.
− If the subject entered 20090072 with a positive PPD: Subject must have a negative Quantiferon test within 30 days prior to the planned first dose of AMG 827. |
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E.4 | Principal exclusion criteria |
AMG 827 specific criteria
• Subject had any serious adverse event reported during study 20090072 and considered to be related to investigational product.
• Subject experienced an adverse event or laboratory abnormality in study 20090072 that, in the opinion of the investigator, could cause extension of treatment to be detrimental to the subject, prevent the subject from completing the study, or interfere with the interpretation of the study results.
• Subject has known sensitivity to any of the products to be administered during dosing. Other medical conditions
• Subject is currently experiencing an infection of Common Terminology Criteria for Adverse Events grade 2 (if requiring oral medication) or higher. Subject is ineligible until the infection resolves.
• Subject has a serious infection, defined as requiring hospitalization or intravenous antibiotics, within 8 weeks before the first dose of AMG 827 in 20100008.
• For subjects with ≥ 3 months between the week 12 visit of 20090072 and the planned first dose of AMG 827 in 20100008: Subject has recurrent or chronic infections, defined as ≥ 3 infections requiring anti-microbials over the past 12 months prior to screening.
• Subject has a significant concurrent medical condition, including
− Type 1 diabetes
− Uncontrolled type 2 diabetes
− Moderate to severe heart failure (New York Heart Association class III or IV)
− Myocardial infarction within the last year
− Current or history of unstable angina pectoris within the last year
− Uncontrolled hypertension as defined by resting blood pressure ≥ 150/90 mmHg prior to first investigational product dose (confirmed by a repeat assessment)
− Severe chronic pulmonary disease (eg, requiring oxygen therapy)
− Major chronic inflammatory disease or connective tissue disease other than Crohn’s disease (eg, systemic lupus erythematosus, rheumatoid arthritis, psoriasis)
− Active malignancy, including evidence of cutaneous basal or squamous cell carcinoma or melanoma
− History of cancer (except successfully treated in situ cervical cancer or squamous or basal cell carcinoma of the skin).
− Any condition that, in the opinion of the investigator, might cause this study to be detrimental to the subject Laboratory abnormalities
• For subjects with > 4 weeks between the week 12 visit of 20090072 and the planned first dose of AMG 827 in 20100008, subject has laboratory abnormalities at screening, including
− Elevated aspartate aminotransferase or alanine aminotransferase (> 2x upper limit of normal)
− Serum direct bilirubin ≥ 1.5x upper limit of normal
− Hemoglobin < 10 g/dL
− Hemoglobin A1c > 8.0 (for subjects with type 2 diabetes)
− Platelet count < 125,000 /mm3
− White blood cell count < 3,000 cells/mm3 − Absolute neutrophil count < 2,000/mm3 − Creatinine clearance < 50 mL/min (Cockroft-Gault formula, central lab will calculate value and provide to sites)
− Any other laboratory abnormality, which, in the opinion of the investigator, could cause extension of treatment to be detrimental to the subject, prevent the subject from completing the study, or interfere with the interpretation of the study results Washouts and non-permitted drugs
• Subject has used Tysabri (natalizumab) subsequent to study 20090072. • Subject received an anti-tumor necrosis factor agent within 8 weeks prior to the first dose of AMG 827 in 20100008.
• Subject received other commercially available biologic agent (eg, ustekinumab) within 12 weeks prior to the first dose of AMG 827 in 20100008.
• Subject received an investigational agent (other than AMG 827), investigational procedure, or participated in an investigational device study subsequent to study 20090072.
• Subject received live vaccines within 12 weeks prior to the first dose of AMG 827 in 20100008.
• Subject received cyclosporine, mycophenolate mofetil, sirolimus (rapamycin), thalidomide, or tacrolimus within 4 weeks prior to the first dose of AMG 827 in 20100008. General or other
• Female subject is not willing to use highly effective contraception during treatment
• Subject is pregnant or breast feeding, or planning to become pregnant while enrolled in the study.
• Subject has any kind of disorder that, in the opinion of the investigator, may compromise the ability of the subject to give written informed consent and/or to comply with all required study procedures.
• Subject will not be available for protocol-required study visits, to the best of the subject and investigator’s knowledge. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Safety Endpoints
• Adverse events
• Change in laboratory parameters (hematology, chemistry and urinalysis profiles) and vital signs |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
week 2, 4, 6, 8, 10, 12, 16, and 20
Week 24 and Every 4 Weeks Thereafter |
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E.5.2 | Secondary end point(s) |
Efficacy Endpoints
• HBI response (reduction of ≥ 3 from baseline of 20090072) and remission (HBI ≤ 4) at all
measured timepoints for all subjects, for subjects with response at baseline of 20100008, and
for subjects in remission at baseline of 20100008
• CDAI response (reduction of ≥ 100 from baseline of 20090072) and remission (CDAI ≤ 150) at all measured timepoints for all subjects, for subjects with response at baseline of
20100008, and for subjects in remission at baseline of 20100008
• HBI and change in HBI at all measured timepoints
• CDAI and change in CDAI at all measured timepoints
• Time to loss of HBI remission or CDAI remission among subjects with remission at baseline of 20100008
• Time to loss of HBI response or CDAI response among subjects with remission at baseline of 20100008
Time to loss of HBI response or CDAI response among subjects with response at baseline of
20100008 |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
week 2, 4, 6, 8, 10, 12, 16, and 20
Week 24 and Every 4 Weeks Thereafter |
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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 | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
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 | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
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 | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.2.4 | Number of treatment arms in the trial | 1 |
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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 22 |
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 |
Australia |
Belgium |
Canada |
France |
Netherlands |
Poland |
Spain |
United States |
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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
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The end of the study is defined as the last visit of the last subject off the study. |
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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 | 2 |
E.8.9.1 | In the Member State concerned months | 7 |
E.8.9.1 | In the Member State concerned days | 14 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 7 |
E.8.9.2 | In all countries concerned by the trial days | 14 |