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] - Immune System Diseases [C20] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
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 |
• To assess the effect of vedolizumab SC maintenance treatment on clinical remission at Week 52 in subjects with moderately to severely active Crohn's disease who achieved clinical response at Week 6 following administration of vedolizumab IV at Weeks 0 and 2. |
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E.2.2 | Secondary objectives of the trial |
• To determine the effect of vedolizumab SC maintenance treatment on enhanced clinical response at Week 52 in subjects who achieved clinical response at Week 6 following administration of vedolizumab IV at Weeks 0 and 2. • To determine the effect of vedolizumab SC maintenance treatment on corticosteroid-free remission at Week 52 in subjects who achieved clinical response at Week 6 following administration of vedolizumab IV at Weeks 0 and 2. • To assess the effect of vedolizumab SC maintenance treatment on clinical remission at Week 52 in subjects who are naïve to TNF-alpha antagonist exposure, and achieved clinical response at Week 6 following administration of vedolizumab IV at Weeks 0 and 2 |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Ileonoscopy Sub-study (Version and Date per Main Study)
Related objective: To determine the effect of vedolizumab SC maintenance treatment on clinical remission at Week 52 in subjects who achieved clinical response at Week 6 following administration of vedolizumab IV at Weeks 0 and 2, using an alternate definition of clinical remission based on endoscopy (using simple endoscopic score for Crohn’s Disease [SES-CD]), abdominal pain (using the CDAI component) and loose/watery stool frequency (using the CDAI component).
Ileocolonoscopy assessments will be performed at sites with appropriate capabilities, in subjects who volunteer at screening. The purpose of this assessment is to explore an alternate definition of clinical remission at Week 52 based on endoscopy (using SES-CD), abdominal pain (using the CDAI component) and loose/watery stool frequency (using the CDAI component). Ileocolonoscopy assessments (including terminal ileum plus ascending, traverse, decending and sigmoid colon and rectum) will be performed prior to Week 0 dosing and at Week 52 by a local endoscopist. |
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E.3 | Principal inclusion criteria |
1. The subject has a diagnosis of Crohn's disease (CD) established at least 3 months prior to screening, by clinical and endoscopic evidence and corroborated by a histopathology report. 2. The subject has moderately to severely active CD. 3. The subject has CD involvement of the ileum and/or colon, at a minimum. 4. The subject has extensive colitis or pancolitis of >8 years duration or limited colitis of >12 years duration must have documented evidence that a surveillance colonoscopy was performed within 12 months of the initial screening visit. 5. Subjects with a family history of colorectal cancer, personal history of increased colorectal cancer risk, age >50 years, or other known risk factors must be up-to-date on colorectal cancer surveillance at screening. 6. The subject has demonstrated an inadequate response to, loss of response to, or intolerance of at least 1 of the following agents: immunomodulators, corticosteroids, or TNF-alpha antagonists. |
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E.4 | Principal exclusion criteria |
1. The subject has evidence of abdominal abscess at the initial Screening Visit. 2. The subject has had extensive colonic resection, subtotal or total colectomy. 3. The subject has a history of >3 small bowel resections or diagnosis of short bowel syndrome. 4. The subject has received tube feeding, defined formula diets, or parenteral alimentation within 28 days prior to the administration of the first dose of study drug. 5. The subject has ileostomy, colostomy, or known fixed symptomatic stenosis of the intestine. 6. The subject has received any of the investigational or approved non-biologic therapies (eg, cyclosporine, tacrolimus, thalidomide, methotrexate, or tofacitinib except for those specifically listed in the protocol) for the treatment of underlying disease within 30 days or 5 half-lives of screening (which ever is longer). 7. The subject has received any investigational or approved biologic or biosimilar agent within 60 days or 5 half-lives of screening (which ever is longer). 8. The subject has used topical (rectal) treatment with 5-ASA or corticosteroid enemas/suppositories within 2 weeks of the administration of the first dose of study drug. 9. The subject requires currently or is anticipated to require surgical intervention for CD during the study. 10. The subject has a history or evidence of adenomatous colonic polyps that have not been removed. 11. The subject has a history or evidence of colonic mucosal dysplasia. 12. The subject has a suspected or confirmed diagnosis of ulcerative colitis, indeterminate colitis, ischaemic colitis, radiation colitis, diverticular disease associated with colitis, or microscopic colitis. 13. The subject has evidence of an active infection during the Screening Period. 14. The subject has evidence of, or treatment for, C. difficile infection or other intestinal pathogen with 28 days prior to first dose of study drug. 15. The subject has chronic hepatitis B virus infection* (HBV) or hepatitis C virus (HCV) infection. *HBV immune subjects (ie, being hepatitis B surface antigen [ HBsAg] negative and hepatitis B surface antibody [HBsAb] positive) may, however, be included. 16. The subject has active or latent TB as evidenced by the following: I. A positive diagnostic TB test within 30 days prior to screening or during the screening period, defined as: 1. A positive QuantiFERON test or 2 successive indeterminate QuantiFERON tests, (or, A positive T-SPOT TB test [Japan only]), OR, Vedolizumab SC 2. A tuberculin skin test reaction >5 mm. Note: if subjects have received BCG vaccine then a QuantiFERON TB Gold test should be performed instead of the tuberculin skin test ii. Chest X-ray within 3 months prior to Week 0 which is suspicious for pulmonary TB, and a positive or 2 successive indeterminate QuantiFERON tests ( or, A positive T-SPOT TB test [ Japan only]) within 30 days prior to Screening or during the Screening Period. Note: subjects with documented previously treated TB with a negative QuantiFERON test with documented can be included in the study. 17. The subject has any identified congenital or acquired immunodeficiency (eg, common variable immunodeficiency, human immunodeficiency virus [HIV] infection, organ transplantation). 18. The subject has received any live vaccinations within 30 days prior to screening. 19. The subject has clinically significant infection (eg, pneumonia, pyelonephritis) within 30 days prior to screening, or ongoing chronic infection. |
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E.5 End points |
E.5.1 | Primary end point(s) |
• Proportion of subjects with clinical remission, defined as Crohn’s Disease Activity Index (CDAI) score ≤150, at Week 52. |
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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) |
• Proportion of subjects with enhanced clinical response, defined as a ≥100 point decrease in CDAI score from Baseline (Week 0), at Week 52. • Proportion of subjects with corticosteroid-free remission, defined as subjects using oral corticosteroids at Baseline (Week 0) who have discontinued oral corticosteroids and are in clinical remission at Week 52. • Proportion of TNF-alpha antagonist naïve subjects who achieved clinical remission, defined as CDAI score ≤150, at Week 52. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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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 | Yes |
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 | Yes |
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) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
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 | 135 |
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 |
Argentina |
Australia |
Belgium |
Bosnia and Herzegovina |
Brazil |
Bulgaria |
Canada |
Czech Republic |
Denmark |
Estonia |
Germany |
Hungary |
Israel |
Italy |
Japan |
Korea, Republic of |
Lithuania |
Mexico |
Netherlands |
Poland |
Romania |
Russian Federation |
Serbia |
Slovakia |
South Africa |
Spain |
Sweden |
Taiwan |
Turkey |
Ukraine |
United Kingdom |
United States |
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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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End of trial will be the date of the last visit of the last subject at the Week 68 Follow-up visit |
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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 | 3 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 9 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 9 |
E.8.9.2 | In all countries concerned by the trial days | 9 |