E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Subjects with moderate to severe crohn's disease |
|
E.1.1.1 | Medical condition in easily understood language |
Subjects with moderate to severe crohn's disease |
|
E.1.1.2 | Therapeutic area | Body processes [G] - Immune system processes [G12] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10013099 |
E.1.2 | Term | Disease Crohns |
E.1.2 | System Organ Class | 100000004856 |
|
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 and tolerability of MT-1303 in subjects with moderate to severe active CD
• To evaluate the clinical efficacy of MT-1303 in subjects with moderate to severe active CD.
|
|
E.2.2 | Secondary objectives of the trial |
• To explore the pharmacokinetics (PK) of MT-1303 in subjects with moderate to severe active CD
• To explore the pharmacodynamic (PD) effect of MT 1303 in subjects with moderate to severe active CD.
|
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Able to provide written informed consent and to comply with the requirements of the Protocol
2. Male or female subjects aged between 18 and 65 years (inclusive). For subjects of reproductive potential, two methods of contraception must be used throughout the study and for 12 weeks after cessation of study medication. At least one of the methods of contraception must be a barrier method.
3. Diagnosis of CD (involving small intestine and/or colon), confirmed at the time by endoscopy and histology at least 3 months prior to Visit 1 (Screening)
4. Previous use of corticosteroids or immunosuppressants (such as azathioprine [AZA]/ 6-mercaptopurine [6-MP] or methotrexate [MTX]) or anti-TNF-alpha agents (such as infliximab, adalimumab or certolizumab pegol) for the treatment of CD
5. Moderate to severe active CD defined by a CDAI score of ≥220 to ≤450 points at Visit 1
6. C-reactive protein (CRP) ≥5 mg per litre (/L) and/or faecal calprotectin ≥250 µg/g
7. A negative stool test result for Clostridium difficile (C. difficile) toxin at Visit 1
8. Negative results for both QuantiFERON-TB Gold (or T-SPOT) test and chest x-ray (i.e., no evidence of tuberculosis [TB]) at Visit 1
For detailed information, please refer to the Protocol. |
|
E.4 | Principal exclusion criteria |
1. Diagnosis of ulcerative colitis, indeterminate colitis, pseudomembranous colitis or coeliac disease
2. Enterocutaneous, abdominal or pelvic active fistulae, abscesses or fistulae likely to require surgery during the study
3. Gastrointestinal (GI) surgery (including appendectomy) within 12 weeks prior to Visit 2 (Baseline) or has surgery planned or deemed likely to require surgery for CD during the study
4. History or evidence of ileostomy, colostomy, rectal pouch, significant stenosis or extensive resection in GI tract that could impair the drug absorption or interfere with the objectives of the study, as judged by the Investigator
5. History or evidence of unresected adenomatous colonic polyps or colonic mucosal dysplasia
6. Chronic use of opioid for chronic pain which, in the opinion of the Investigator, would influence the subject reported CDAI parameters.
7. Use of concomitant medications as described in the protocol.
8. Presence or history of clinically significant disease (except CD) that could interfere with the objectives of the study or the safety of the subject, as judged by the Investigator
9. Body weight ≤35 kg at Visit 1
10. Presence or history of any of cardiovascular diseases as decsribed in the protocol.
11. Need for, or likely need for treatment with Class I or Class III anti-arrhythmic drugs, or with beta-blockers or heart-rate-lowering calcium-channel blockers, or with any other drugs which can reduce the heart rate
12. Known high risk for QT/QTc prolongation such as a family history of long QT syndrome or sudden death
13. History or known presence of cerebrovascular diseases
14. Presence or history (within 5 years prior to initial screening) of malignancy, except for successfully treated basal cell and in situ squamous cell carcinomas of the skin
15. Known history of recurrent or chronic infection such as TB, hepatitis B, hepatitis C or human immunodeficiency virus (HIV)
16. Receipt of live vaccine within 4 weeks prior to Visit 2
17. Diagnosis of diabetes mellitus (Type I or II)
18. Presence or prior history of macular oedema, uveitis or evolutive retinopathy, or any other condition that could increase the risk of macular oedema in the opinion of the Investigator
19. History of substance abuse (drug or alcohol) or any other factor that limits the subject’s ability to cooperate with the study procedures.
20. Known history of allergy, hypersensitivity or any serious reaction to any component of the study medication
21. Previous treatment with any investigational agent within 12 weeks prior to Visit 1 OR five half-lives of the investigational product, whichever is the longer.
22. WBC count <3,500/µL at Visit 1
23. Lymphocyte count <800/µL at Visit 1
24. LFT (aspartate aminotransferase [AST] or alanine aminotransferase [ALT]) ≥2 x ULN at Visit 1
25. HbA1c >6.5% at Visit 1
26. Negative or indeterminate results for antibodies (IgG) to Varicella Zoster virus (VZV) at Visit 1
27. [For female subjects only] A positive pregnancy test at Visit 1 (serum beta-human chorionic gonadotropin [hCG] level or urine dipstick) or Visit 2 (urine dipstick)
28. Low heart rate (<50 beats per minute [bpm]) in 12-lead ECG at Visit 1 or Visit 2 (pre-dose)
29. QTcF interval ≥450 milliseconds (msec) in 12-lead ECG at Visit 1 or Visit 2 (pre-dose)
30. Clinically significant abnormal findings in 12-lead ECG (at Visit 1 or Visit 2 [pre-dose]) and/or in Holter ECG (at Visit 1) that the Investigator considers may jeopardise the subject's health
For detailed information, please refer to the Protocol. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
The proportion of subjects who achieve a 100-point decrease from Baseline in CDAI score (i.e., CDAI 100) at Visit 6 (Week 12) |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
Various time points throughout the study - please refer to the detailed ‘Time and Events Schedule’ table in the protocol for full details. |
|
E.5.2 | Secondary end point(s) |
Efficacy
• Proportion of subjects who achieve a 70-point decrease from Baseline in CDAI score (i.e., CDAI 70) at Protocol-scheduled visits.
• Proportion of subjects who achieve a 100-point decrease from Baseline in CDAI score (i.e., CDAI 100) at other Protocol-scheduled visits.
• Proportion of subjects who achieve clinical remission (i.e., CDAI score of <150) at Protocol-scheduled visits.
• CDAI score and change from Baseline in CDAI score at Protocol-scheduled visits.
Pharmacodynamics
• Lymphocyte count and lymphocyte subsets, their change from Baseline, and percentage of Baseline at Protocol-scheduled visits.
Pharmacokinetics
• PK concentration of MT-1303 and its active metabolite MT-1303-P at Protocol-scheduled visits.
Exploratory Endpoints:
• Time to the first clinical remission during the study
• Time to the first clinical response of CDAI 100 during the study
• Time to the first clinical response of CDAI 70 during the study
• Change from Baseline in CDAI sub-scores
• CRP and faecal calprotectin value and their change from Baseline at Protocol-scheduled visits.
Safety
• Incidence and severity of adverse events (AEs)
• Physical examination
• 12-lead ECG parameters
• 24-h/48-h Holter ECG parameters
• Vital signs (pulse rate, systolic and diastolic blood pressure [BP], and body temperature)
• Safety laboratory parameters
• Optical coherence tomography (OCT). |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
Various time points throughout the study - please refer to the detailed ‘Time and Events Schedule’ table in the protocol for full details. |
|
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 | Yes |
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 | Yes |
E.6.13.1 | Other scope of the trial description |
|
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 | Yes |
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) | 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 | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 47 |
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 |
Czech Republic |
France |
Germany |
Hungary |
Israel |
Italy |
Japan |
Netherlands |
Poland |
Slovakia |
Ukraine |
|
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
|
|
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 | 5 |
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 | 7 |
E.8.9.2 | In all countries concerned by the trial days | 0 |