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    Clinical Trial Results:
    A Randomized, Double-blind, Placebo-controlled Phase 2 Study to Evaluate the Testicular Safety of Filgotinib in Adult Males with Moderately to Severely Active Inflammatory Bowel Disease

    Summary
    EudraCT number
    2017-000402-38
    Trial protocol
    GB   DE   AT   PT   NL   SE   BE   ES   RO  
    Global end of trial date

    Results information
    Results version number
    v2(current)
    This version publication date
    02 Dec 2023
    First version publication date
    20 Jul 2023
    Other versions
    v1
    Version creation reason
    • New data added to full data set
    unblinded safety data

    Trial information

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    Trial identification
    Sponsor protocol code
    GS-US-418-4279
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03201445
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Galapagos NV
    Sponsor organisation address
    Generaal De Wittelaan L11 A3, Mechelen, Belgium, 2800
    Public contact
    Galapagos Medical Information, Galapagos NV, medicalinfo@glpg.com
    Scientific contact
    Galapagos Medical Information, Galapagos NV, medicalinfo@glpg.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Interim
    Date of interim/final analysis
    20 Nov 2020
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    No
    General information about the trial
    Main objective of the trial
    The main aim of this study is to evaluate the testicular safety of filgotinib in adult males with moderately to severely active inflammatory bowel disease (IBD).
    Protection of trial subjects
    This study is being conducted under a US investigational new drug (IND) application and in accordance with recognized international scientific and ethical standards, including but not limited to the International Council for Harmonisation (ICH) guideline for Good Clinical Practice (GCP), and the original principles embodied in the Declaration of Helsinki. These standards are consistent with the requirements of the US Code of Federal Regulations (CFR) Title 21, Part 312 (21CFR312), and the EU Clinical Trials Directive 2001/20/EC as well as other local legislation.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    11 Jul 2017
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Poland: 9
    Country: Number of subjects enrolled
    Romania: 1
    Country: Number of subjects enrolled
    United Kingdom: 1
    Country: Number of subjects enrolled
    Austria: 2
    Country: Number of subjects enrolled
    Germany: 5
    Country: Number of subjects enrolled
    India: 75
    Country: Number of subjects enrolled
    United States: 20
    Country: Number of subjects enrolled
    Ukraine: 17
    Country: Number of subjects enrolled
    Russian Federation: 7
    Country: Number of subjects enrolled
    Australia: 1
    Country: Number of subjects enrolled
    New Zealand: 1
    Worldwide total number of subjects
    139
    EEA total number of subjects
    17
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    139
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    The first participant was screened on 11 July 2017. A total of 323 participants were screened of which 139 participants were randomized. Results are based on primary data cut-off date 20 November 2020 (up to Week 26/OL Week 13 analysis) and adverse events were collected and reported until data cut-off date 11 June 2021 (up to Week 182).

    Pre-assignment
    Screening details
    Study has 5 parts: Part A: Double-Blind Phase (DB Phase; Day 1 up to Week 13); Part B: DB Phase (Week 13 up to Week 26); Open-label (OL) Phase (13 weeks); Monitoring Phase (MP; up to 52 weeks); and Long-term Extension (LTE) Phase (after Week 26 or end of OL Phase for up to 195 weeks).

    Period 1
    Period 1 title
    Part A DB Phase (Through Week 13)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Filgotinib
    Arm description
    Participants received filgotinib 200 milligrams (mg) tablet, orally, once daily up to Week 13 in the DB phase (Part A).
    Arm type
    Experimental

    Investigational medicinal product name
    Filgotinib
    Investigational medicinal product code
    GS-6034
    Other name
    Jyseleca®
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    200-mg tablet administered orally once daily

    Arm title
    Placebo
    Arm description
    Participants received placebo (matched to filgotinib) tablet, orally, once daily up to Week 13 in the DB phase (Part A).
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo to match filgotinib tablet administered orally once daily.

    Number of subjects in period 1
    Filgotinib Placebo
    Started
    69
    70
    Completed
    68
    67
    Not completed
    1
    3
         Consent withdrawn by subject
    -
    2
         Protocol Violation
    -
    1
         Lost to follow-up
    1
    -
    Period 2
    Period 2 title
    Part B DB Phase (Week 13 to 26)
    Is this the baseline period?
    No
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Filgotinib
    Arm description
    At Week 13, participants who were IBD responders, without meeting prespecified sperm decrease thresholds, continued DB treatment up to Week 26.
    Arm type
    Experimental

    Investigational medicinal product name
    Filgotinib
    Investigational medicinal product code
    GS-6034
    Other name
    Jyseleca®
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    200-mg tablet administered orally once daily

    Arm title
    Placebo
    Arm description
    At Week 13, participants who were IBD responders, without meeting prespecified sperm decrease thresholds, continued DB treatment up to Week 26.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo to match filgotinib tablet administered orally once daily.

    Number of subjects in period 2 [1]
    Filgotinib Placebo
    Started
    45
    38
    Completed
    42
    38
    Not completed
    3
    0
         Adverse event, non-fatal
    1
    -
         Progressive Disease
    2
    -
    Notes
    [1] - The number of subjects starting the period is not consistent with the number completing the preceding period. It is expected the number of subjects starting the subsequent period will be the same as the number completing the preceding period.
    Justification: Not all participants who completed the preceding period entered this period.
    Period 3
    Period 3 title
    OL Phase (13 Weeks)
    Is this the baseline period?
    No
    Allocation method
    Not applicable
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Filgotinib
    Arm description
    Participants who were IBD non-responders at Week 13 (end of Part A) or had disease worsening after Week 13 and prior to Week 26 (in Part B), and did not meet a prespecified sperm decrease threshold, entered OL Phase and received OL filgotinib 200 mg, once daily for up to Week 13.
    Arm type
    Experimental

    Investigational medicinal product name
    Filgotinib
    Investigational medicinal product code
    GS-6034
    Other name
    Jyseleca®
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    200-mg tablet administered orally once daily

    Arm title
    Placebo
    Arm description
    Participants who were IBD non-responders at Week 13 (end of Part A) or had disease worsening after Week 13 and prior to Week 26 (in Part B), and did not meet a prespecified sperm decrease threshold, entered OL Phase and received OL filgotinib 200 mg, once daily for up to Week 13.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Placebo to match filgotinib tablet administered orally once daily.

    Number of subjects in period 3 [2]
    Filgotinib Placebo
    Started
    24
    23
    Completed
    22
    20
    Not completed
    2
    3
         Consent withdrawn by subject
    2
    1
         Adverse event, non-fatal
    -
    2
    Notes
    [2] - The number of subjects starting the period is not consistent with the number completing the preceding period. It is expected the number of subjects starting the subsequent period will be the same as the number completing the preceding period.
    Justification: Not all participants who completed the preceding period entered this period.

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Filgotinib
    Reporting group description
    Participants received filgotinib 200 milligrams (mg) tablet, orally, once daily up to Week 13 in the DB phase (Part A).

    Reporting group title
    Placebo
    Reporting group description
    Participants received placebo (matched to filgotinib) tablet, orally, once daily up to Week 13 in the DB phase (Part A).

    Reporting group values
    Filgotinib Placebo Total
    Number of subjects
    69 70 139
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    36 ( 8.5 ) 34 ( 8.4 ) -
    Gender categorical
    Units: Subjects
        Female
    0 0 0
        Male
    69 70 139
    Ethnicity
    Not Permitted = local regulators did not allow collection of race or ethnicity information.
    Units: Subjects
        Not Hispanic or Latino
    68 68 136
        Hispanic or Latino
    1 1 2
        Not Permitted
    0 1 1
    Race
    Not Permitted = local regulators did not allow collection of race or ethnicity information.
    Units: Subjects
        American Indian or Alaska Native
    2 0 2
        Asian
    37 38 75
        Black or African American
    1 0 1
        White
    29 31 60
        Not Permitted
    0 1 1
    Sperm Concentration
    Units: million sperm cells/milliliter (mL)
        arithmetic mean (standard deviation)
    63.4 ( 34.34 ) 61.8 ( 34.96 ) -
    Total Sperm Count
    Units: million sperm cells/ejaculate
        arithmetic mean (standard deviation)
    190.6 ( 107.08 ) 171.1 ( 100.74 ) -
    Sperm Total Motility
    Units: percentage of motile sperm
        arithmetic mean (standard deviation)
    59.6 ( 11.33 ) 58.6 ( 10.94 ) -
    Ejaculate Volume
    Units: mL
        arithmetic mean (standard deviation)
    3.2 ( 1.20 ) 3.0 ( 1.48 ) -
    Percent Normal Sperm Morphology
    Units: percentage of normal sperm
        arithmetic mean (standard deviation)
    41 ( 6.4 ) 41 ( 5.5 ) -

    End points

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    End points reporting groups
    Reporting group title
    Filgotinib
    Reporting group description
    Participants received filgotinib 200 milligrams (mg) tablet, orally, once daily up to Week 13 in the DB phase (Part A).

    Reporting group title
    Placebo
    Reporting group description
    Participants received placebo (matched to filgotinib) tablet, orally, once daily up to Week 13 in the DB phase (Part A).
    Reporting group title
    Filgotinib
    Reporting group description
    At Week 13, participants who were IBD responders, without meeting prespecified sperm decrease thresholds, continued DB treatment up to Week 26.

    Reporting group title
    Placebo
    Reporting group description
    At Week 13, participants who were IBD responders, without meeting prespecified sperm decrease thresholds, continued DB treatment up to Week 26.
    Reporting group title
    Filgotinib
    Reporting group description
    Participants who were IBD non-responders at Week 13 (end of Part A) or had disease worsening after Week 13 and prior to Week 26 (in Part B), and did not meet a prespecified sperm decrease threshold, entered OL Phase and received OL filgotinib 200 mg, once daily for up to Week 13.

    Reporting group title
    Placebo
    Reporting group description
    Participants who were IBD non-responders at Week 13 (end of Part A) or had disease worsening after Week 13 and prior to Week 26 (in Part B), and did not meet a prespecified sperm decrease threshold, entered OL Phase and received OL filgotinib 200 mg, once daily for up to Week 13.

    Subject analysis set title
    Filgotinib/DB Filgotinib (Responder)
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants received filgotinib 200 mg tablet, orally, once daily up to Week 13 in the DB phase (Part A). At Week 13, participants who were IBD responders, without meeting pre-specified sperm decrease thresholds, continued DB phase treatment up to Week 26 (Part B).

    Subject analysis set title
    Filgotinib/OL Filgotinib (Nonresponder)
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants received filgotinib 200 mg tablet, orally, once daily up to Week 13 in the DB phase (Part A). Participants who were IBD non-responders at Week 13 (end of Part A) or had disease worsening after Week 13 and prior to Week 26 (in Part B), and whose sperm parameters did not meet a prespecified decrease threshold, entered the OL Phase and received OL filgotinib 200 mg, tablet, orally, once daily for up to Week 13 during the OL phase.

    Subject analysis set title
    Placebo/DB Placebo (Responder)
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants received placebo (matched to filgotinib) tablet, orally, once daily up to Week 13 in the DB phase (Part A). At Week 13, participants who were IBD responders, without meeting pre-specified sperm decrease thresholds, continued DB phase treatment up to Week 26 (Part B).

    Subject analysis set title
    Placebo/OL Filgotinib (Nonresponder)
    Subject analysis set type
    Sub-group analysis
    Subject analysis set description
    Participants received placebo (matched to filgotinib) tablet, orally, once daily up to Week 13 in the DB phase (Part A). Participants who were IBD non-responders at Week 13 (end of Part A) or had disease worsening after Week 13 and prior to Week 26 (in Part B), and whose sperm parameters did not meet a prespecified decrease threshold, entered the OL Phase and received OL filgotinib 200 mg, tablet, orally, once daily for up to Week 13 during the OL phase.

    Primary: Percentage of Participants With a ≥ 50% Decrease From Baseline in Sperm Concentration at Week 13

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    End point title
    Percentage of Participants With a ≥ 50% Decrease From Baseline in Sperm Concentration at Week 13
    End point description
    Baseline for sperm/semen parameters was the mean of 2 evaluable semen samples at screening. The normal range for sperm concentration is ≥15 million sperm cells/mL. Percentage change = ([mean at Week 13 − baseline] / baseline) × 100; value at Week 13 was the mean of 2 evaluable samples collected at Week 13. The Semen Analysis Set included all randomized and treated (≥ 1 dose of double-blind study drug) participants who had 2 semen samples that were eligible for mean calculation at baseline and at the Week 13 analysis visit with the date of the first chronologic semen sample used for purposes of assigning analysis visit windows.
    End point type
    Primary
    End point timeframe
    Baseline to Week 13
    End point values
    Filgotinib Placebo
    Number of subjects analysed
    66
    67
    Units: percentage of participants
        number (not applicable)
    1.5
    9.0
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Difference in percentage and 95% confidence interval (CI) was based on a stratified Mantel-Haenszel test.
    Comparison groups
    Filgotinib v Placebo
    Number of subjects included in analysis
    133
    Analysis specification
    Pre-specified
    Analysis type
    other
    Method
    Parameter type
    Difference in Percentage
    Point estimate
    -7.8
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -16.3
         upper limit
    0.7

    Secondary: Percentage of Participants With a ≥ 50% Decrease From Baseline in Sperm Concentration at Week 26

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    End point title
    Percentage of Participants With a ≥ 50% Decrease From Baseline in Sperm Concentration at Week 26
    End point description
    IBD responder: For ulcerative colitis (UC), a participant who had a reduction of ≥ 2 in partial Mayo Clinic Score (pMCS) compared with baseline at specified time. For Crohn's disease (CD), a participant who had a reduction of ≥ 100 points in total Crohn's Disease Activity Index (CDAI) score compared with baseline at specified time. A participant with a baseline total CDAI score of ≥ 220 to ≤250 was considered an IBD responder if a CDAI score of <150 was attained at specified time. IBD nonresponder: For UC or CD, a participant who did not fulfil the definition of IBD responder at specified time. pMCS score: Sum of 3 subscores (rectal bleeding, stool frequency, and physician's global assessment) excluding endoscopic subscore; ranging from 0 (none) to 9 (severe disease). CDAI score: A weighted sum of 8 disease activity variables with scores ranging from 0 to over 600, where higher score = higher disease activity. The normal range for sperm concentration is ≥15 million sperm cells/mL.
    End point type
    Secondary
    End point timeframe
    Baseline to Week 26
    End point values
    Filgotinib/DB Filgotinib (Responder) Filgotinib/OL Filgotinib (Nonresponder) Placebo/DB Placebo (Responder) Placebo/OL Filgotinib (Nonresponder)
    Number of subjects analysed
    40
    21
    38
    17
    Units: percentage of participants
        number (not applicable)
    5.0
    0
    7.9
    11.8
    No statistical analyses for this end point

    Secondary: Change From Baseline in Sperm Total Motility at Week 13

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    End point title
    Change From Baseline in Sperm Total Motility at Week 13
    End point description
    The normal range for sperm total motility is ≥40%. Participants in the Semen Analysis Set were analyzed.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 13
    End point values
    Filgotinib Placebo
    Number of subjects analysed
    66
    67
    Units: percentage of motile sperms
        median (confidence interval 95%)
    -0.3 (-1.6 to 1.7)
    0.4 (-1.3 to 1.5)
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Difference in Medians and 95% CI for change from baseline at Week 13 was based on quantile regression.
    Comparison groups
    Filgotinib v Placebo
    Number of subjects included in analysis
    133
    Analysis specification
    Pre-specified
    Analysis type
    other
    Method
    Parameter type
    Median difference (final values)
    Point estimate
    -0.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.1
         upper limit
    1.8

    Secondary: Change From Baseline in Sperm Total Motility at Week 26

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    End point title
    Change From Baseline in Sperm Total Motility at Week 26
    End point description
    IBD responder: For UC, a participant who had a reduction of ≥ 2 in pMCS compared with baseline at specified time. For CD, a participant who had a reduction of ≥ 100 points in total CDAI score compared with baseline at specified time. A participant with a baseline total CDAI score of ≥ 220 to ≤ 250 was considered an IBD responder if a CDAI score of <150 was attained at specified time. IBD nonresponder: For UC or CD, a participant who did not fulfil the definition of IBD responder at specified time. pMCS score: Sum of 3 subscores (rectal bleeding, stool frequency, and physician's global assessment) excluding endoscopic subscore; ranging from 0 (none) to 9 (severe disease). CDAI score: A weighted sum of 8 disease activity variables with scores ranging from 0 to over 600, where higher score = higher disease activity. The normal range for sperm total motility is ≥40%. Participants in the Week 26 Semen Analysis Set with available data were analyzed.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 26
    End point values
    Filgotinib/DB Filgotinib (Responder) Filgotinib/OL Filgotinib (Nonresponder) Placebo/DB Placebo (Responder) Placebo/OL Filgotinib (Nonresponder)
    Number of subjects analysed
    40
    21
    36
    17
    Units: percentage of motile sperms
        median (confidence interval 95%)
    -2.3 (-4.7 to -0.3)
    -1.5 (-5.8 to 2.6)
    0.0 (-3.4 to 2.4)
    0.8 (-7.3 to 5.8)
    No statistical analyses for this end point

    Secondary: Change From Baseline in Total Sperm Count at Week 13

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    End point title
    Change From Baseline in Total Sperm Count at Week 13
    End point description
    The normal range for total sperm count is ≥ 39 million sperm cells/ejaculate. Participants in the Semen Analysis Set were analyzed.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 13
    End point values
    Filgotinib Placebo
    Number of subjects analysed
    66
    67
    Units: million sperm cells/ejaculate
        median (confidence interval 95%)
    -11.6 (-19.8 to 9.7)
    -9.5 (-23.8 to 0.6)
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Difference in medians and 95% CI for change from baseline at Week 13 was based on quantile regression.
    Comparison groups
    Filgotinib v Placebo
    Number of subjects included in analysis
    133
    Analysis specification
    Pre-specified
    Analysis type
    other
    Method
    Parameter type
    Median difference (final values)
    Point estimate
    5.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -13.4
         upper limit
    24.7

    Secondary: Change From Baseline in Total Sperm Count at Week 26

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    End point title
    Change From Baseline in Total Sperm Count at Week 26
    End point description
    IBD responder: For UC, a participant who had a reduction of ≥ 2 in pMCS compared with baseline at specified time. For CD, a participant who had a reduction of ≥ 100 points in total CDAI score compared with baseline at specified time. A participant with a baseline total CDAI score of ≥ 220 to ≤ 250 was considered an IBD responder if a CDAI score of <150 was attained at specified time. IBD nonresponder: For UC or CD, a participant who did not fulfil the definition of IBD responder at specified time. pMCS score: Sum of 3 subscores (rectal bleeding, stool frequency, and physician's global assessment) excluding endoscopic subscore; ranging from 0 (none) to 9 (severe disease). CDAI score: A weighted sum of 8 disease activity variables with scores ranging from 0 to over 600, where higher score = higher disease activity. The normal range for total sperm count is ≥ 39 million sperm cells/ejaculate. Participants in the Week 26 Semen Analysis Set with available data were analyzed.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 26
    End point values
    Filgotinib/DB Filgotinib (Responder) Filgotinib/OL Filgotinib (Nonresponder) Placebo/DB Placebo (Responder) Placebo/OL Filgotinib (Nonresponder)
    Number of subjects analysed
    40
    21
    38
    17
    Units: million sperm cells/ejaculate
        median (confidence interval 95%)
    2.0 (-19.6 to 17.2)
    -4.6 (-42.3 to 18.3)
    -4.1 (-39.8 to 15.9)
    12.7 (-61.4 to 40.8)
    No statistical analyses for this end point

    Secondary: Change From Baseline in Sperm Concentration at Week 13

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    End point title
    Change From Baseline in Sperm Concentration at Week 13
    End point description
    The normal range for sperm concentration is ≥15 million sperm cells/mL. Participants in the Semen Analysis Set were analyzed.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 13
    End point values
    Filgotinib Placebo
    Number of subjects analysed
    66
    67
    Units: million sperm cells/mL
        median (confidence interval 95%)
    1.0 (-2.2 to 3.9)
    0.7 (-2.7 to 1.7)
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Difference in Medians and 95% CI for change from baseline at Week 13 was based on quantile regression.
    Comparison groups
    Filgotinib v Placebo
    Number of subjects included in analysis
    133
    Analysis specification
    Pre-specified
    Analysis type
    other
    Method
    Parameter type
    Median difference (final values)
    Point estimate
    1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.8
         upper limit
    4.9

    Secondary: Change From Baseline in Sperm Concentration at Week 26

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    End point title
    Change From Baseline in Sperm Concentration at Week 26
    End point description
    IBD responder: For UC, a participant who had a reduction of ≥ 2 in pMCS compared with baseline at specified time. For CD, a participant who had a reduction of ≥ 100 points in total CDAI score compared with baseline at specified time. A participant with a baseline total CDAI score of ≥ 220 to ≤ 250 was considered an IBD responder if a CDAI score of <150 was attained at specified time. IBD nonresponder: For UC or CD, a participant who did not fulfil the definition of IBD responder at specified time. pMCS score: Sum of 3 subscores (rectal bleeding, stool frequency, and physician's global assessment) excluding endoscopic subscore; ranging from 0 (none) to 9 (severe disease). CDAI score: A weighted sum of 8 disease activity variables with scores ranging from 0 to over 600, where higher score = higher disease activity. The normal range for sperm concentration is ≥15 million sperm cells/mL. Participants in the Week 26 Semen Analysis Set with available data were analyzed.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 26
    End point values
    Filgotinib/DB Filgotinib (Responder) Filgotinib/OL Filgotinib (Nonresponder) Placebo/DB Placebo (Responder) Placebo/OL Filgotinib (Nonresponder)
    Number of subjects analysed
    40
    21
    38
    17
    Units: million sperm cells/mL
        median (confidence interval 95%)
    1.2 (-3.2 to 10.8)
    -0.6 (-8.5 to 23.0)
    0.8 (-2.4 to 5.3)
    -3.7 (-11.1 to 15.7)
    No statistical analyses for this end point

    Secondary: Change From Baseline in Ejaculate Volume at Week 13

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    End point title
    Change From Baseline in Ejaculate Volume at Week 13
    End point description
    The normal range for ejaculate volume is ≥1.5 mL. Participants in the Semen Analysis Set were analyzed.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 13
    End point values
    Filgotinib Placebo
    Number of subjects analysed
    66
    67
    Units: mL
        median (confidence interval 95%)
    -0.2 (-0.3 to 0.1)
    -0.1 (-0.3 to 0.0)
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Difference in Medians and 95% CI for change from baseline at Week 13 was based on quantile regression.
    Comparison groups
    Filgotinib v Placebo
    Number of subjects included in analysis
    133
    Analysis specification
    Pre-specified
    Analysis type
    other
    Method
    Parameter type
    Median difference (final values)
    Point estimate
    0.1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.1
         upper limit
    0.3

    Secondary: Change From Baseline in Ejaculate Volume at Week 26

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    End point title
    Change From Baseline in Ejaculate Volume at Week 26
    End point description
    IBD responder: For UC, a participant who had a reduction of ≥ 2 in pMCS compared with baseline at specified time. For CD, a participant who had a reduction of ≥ 100 points in total CDAI score compared with baseline at specified time. A participant with a baseline total CDAI score of ≥ 220 to ≤ 250 was considered an IBD responder if a CDAI score of <150 was attained at specified time. IBD nonresponder: For UC or CD, a participant who did not fulfil the definition of IBD responder at specified time. pMCS score: Sum of 3 subscores (rectal bleeding, stool frequency, and physician's global assessment) excluding endoscopic subscore; ranging from 0 (none) to 9 (severe disease). CDAI score: A weighted sum of 8 disease activity variables with scores ranging from 0 to over 600, where higher score = higher disease activity. The normal range for ejaculate volume is ≥1.5 mL. Participants in the Week 26 Semen Analysis Set with available data were analyzed.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 26
    End point values
    Filgotinib/DB Filgotinib (Responder) Filgotinib/OL Filgotinib (Nonresponder) Placebo/DB Placebo (Responder) Placebo/OL Filgotinib (Nonresponder)
    Number of subjects analysed
    40
    21
    38
    17
    Units: mL
        median (confidence interval 95%)
    0.0 (-0.5 to 0.2)
    -0.3 (-0.8 to 0.2)
    -0.2 (-0.5 to 0.1)
    -0.1 (-0.7 to 0.4)
    No statistical analyses for this end point

    Secondary: Change From Baseline in Percent Normal Sperm Morphology at Week 13

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    End point title
    Change From Baseline in Percent Normal Sperm Morphology at Week 13
    End point description
    The normal range for percent normal sperm morphology is ≥30% normal sperms. Participants in the Semen Analysis Set were analyzed.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 13
    End point values
    Filgotinib Placebo
    Number of subjects analysed
    66
    67
    Units: percentage of normal sperms
        median (confidence interval 95%)
    2 (-1 to 4)
    1 (-1 to 2)
    Statistical analysis title
    Statistical Analysis 1
    Statistical analysis description
    Difference in Medians and 95% CI for change from baseline at Week 13 was based on quantile regression.
    Comparison groups
    Filgotinib v Placebo
    Number of subjects included in analysis
    133
    Analysis specification
    Pre-specified
    Analysis type
    other
    Method
    Parameter type
    Median difference (final values)
    Point estimate
    2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0
         upper limit
    4

    Secondary: Change From Baseline in Percent Normal Sperm Morphology at Week 26

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    End point title
    Change From Baseline in Percent Normal Sperm Morphology at Week 26
    End point description
    IBD responder: For UC, a participant who had a reduction of ≥ 2 in pMCS compared with baseline at specified time. For CD, a participant who had a reduction of ≥ 100 points in total CDAI score compared with baseline at specified time. A participant with a baseline total CDAI score of ≥ 220 to ≤ 250 was considered an IBD responder if a CDAI score of <150 was attained at specified time. IBD nonresponder: For UC or CD, a participant who did not fulfil the definition of IBD responder at specified time. pMCS score: Sum of 3 subscores (rectal bleeding, stool frequency, and physician's global assessment) excluding endoscopic subscore; ranging from 0 (none) to 9 (severe disease). CDAI score: A weighted sum of 8 disease activity variables with scores ranging from 0 to over 600, where higher score = higher disease activity. The normal range for percent normal sperm morphology is ≥30% normal sperms. Participants in the Week 26 Semen Analysis Set with available data were analyzed.
    End point type
    Secondary
    End point timeframe
    Baseline, Week 26
    End point values
    Filgotinib/DB Filgotinib (Responder) Filgotinib/OL Filgotinib (Nonresponder) Placebo/DB Placebo (Responder) Placebo/OL Filgotinib (Nonresponder)
    Number of subjects analysed
    40
    21
    38
    17
    Units: percentage of normal sperms
        median (confidence interval 95%)
    3 (1 to 5)
    1 (-2 to 3)
    2 (-4 to 5)
    2 (-2 to 3)
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From first dose up to Week 182
    Adverse event reporting additional description
    All on-treatment safety data starting during the study through the data cutoff (11 June 2021, maximum up to Week 182) were reported under the treatment received at the onset of the event (As-treated set).
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    24.0
    Reporting groups
    Reporting group title
    Filgotinib 200 mg
    Reporting group description
    Participants received filgotinib 200 mg tablet, orally once daily (OD) up to Week 13 in DB phase (Part A). At Week 13, IBD responders, without meeting pre-specified sperm decrease thresholds, continued DB phase treatment up to Week 26 (Part B). IBD non-responders at Week 13 (end of Part A) or had disease worsening after Week 13 and prior to Week 26 (in Part B), and whose sperm parameters did not meet prespecified decrease threshold, entered the OL Phase, and received OL filgotinib 200 mg, tablet orally OD for up to Week 13 during the OL phase. At Week 26/OL Week 13, IBD responders and who had not experienced disease worsening, and whose sperm parameters did not meet prespecified decrease threshold, continued receiving the same study drug they were responding to, as part of LTE for up to 195 weeks. Participants who met prespecified sperm decrease threshold(s) discontinued study drug and switched to SOC regimen selected by investigator and entered the MP for up to 52 weeks.

    Reporting group title
    Placebo
    Reporting group description
    Participants received placebo (matched to filgotinib) tablet, orally OD up to Week 13 in DB phase (Part A). At Week 13, IBD responders, without meeting pre-specified sperm decrease thresholds, continued DB phase treatment up to Week 26 (Part B). IBD non-responders at Week 13 (end of Part A) or had disease worsening after Week 13 and prior to Week 26 (in Part B), and whose sperm parameters did not meet prespecified decrease threshold, entered the OL Phase, and received OL filgotinib 200 mg, tablet orally OD for up to Week 13 during the OL phase. At Week 26/OL Week 13, IBD responders and who had not experienced disease worsening, and whose sperm parameters did not meet prespecified decrease threshold, continued receiving the same study drug they were responding to, as part of LTE for up to 195 weeks. Participants who met prespecified sperm decrease threshold(s) discontinued study drug and switched to SOC regimen selected by investigator and entered the MP for up to 52 weeks.

    Serious adverse events
    Filgotinib 200 mg Placebo
    Total subjects affected by serious adverse events
         subjects affected / exposed
    3 / 92 (3.26%)
    2 / 70 (2.86%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Gastrointestinal disorders
    Colitis ulcerative
         subjects affected / exposed
    1 / 92 (1.09%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Crohn's disease
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Infections and infestations
    COVID-19
         subjects affected / exposed
    0 / 92 (0.00%)
    1 / 70 (1.43%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    1 / 92 (1.09%)
    0 / 70 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Filgotinib 200 mg Placebo
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    29 / 92 (31.52%)
    17 / 70 (24.29%)
    Gastrointestinal disorders
    Colitis ulcerative
         subjects affected / exposed
    13 / 92 (14.13%)
    3 / 70 (4.29%)
         occurrences all number
    14
    3
    Abdominal pain
         subjects affected / exposed
    2 / 92 (2.17%)
    4 / 70 (5.71%)
         occurrences all number
    3
    4
    Infections and infestations
    COVID-19
         subjects affected / exposed
    5 / 92 (5.43%)
    3 / 70 (4.29%)
         occurrences all number
    5
    3
    Latent tuberculosis
         subjects affected / exposed
    4 / 92 (4.35%)
    4 / 70 (5.71%)
         occurrences all number
    4
    4
    Nasopharyngitis
         subjects affected / exposed
    15 / 92 (16.30%)
    3 / 70 (4.29%)
         occurrences all number
    17
    4
    Furuncle
         subjects affected / exposed
    1 / 92 (1.09%)
    4 / 70 (5.71%)
         occurrences all number
    1
    4

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    06 Jul 2017
    It included following changes: - Increased the target enrollment number from 200 to 250 to account for potential dropouts; - Clarified IBD nonresponders as those with a decrease in pMCS of < 2 points or an increase in pMCS; - After the Week 13 visit, IBD nonresponders discontinued study drug and commenced OL filgotinib 200 mg once daily; and at Week 26, if they did not have a ≥ 50% decrease in sperm concentration from baseline, had the option to continue receiving OL filgotinib as part of the LTE; - Any participants who demonstrated a ≥ 50% decrease in sperm concentration from baseline entered the MP regardless of when it occurred; - Clarified that participants would be allowed on conventional immunomodulators as defined by the inclusion criteria; - LTE defined as Week 26 to Week 221; - Updated the 30-day follow-up visit and the posttreatment visit to a safety follow-up visit; - Added a required safety follow-up visit 30 days after last dose of study drug at the end of the LTE and after an ET visit; - Clarified the inclusion criteria for tumor necrosis factor alpha (TNFα) antagonists; - Clarified for participants at screening who were taking allowed therapies for UC that they had to remain on stable doses for the noted times; - Excluded ustekinumab 12 weeks prior to screening; - Updated the inclusion criteria to require that semen volume be ≥ 1.5 mL, total sperm per ejaculate to be ≥ 39 M, and that participants be up to date on colorectal cancer surveillance as per local guidelines prior to screening; - Updated participants meeting the disease worsening criteria to be offered the option to commence OL filgotinib; - End of study defined as when the last participant completed the Week 225 visit or the last participant completed their last visit, whichever was sooner; - Updated study visit windows to ± 5 days for the primary study and ± 10 days during the LTE.
    22 Aug 2018
    It included following changes: - Revised study title from UC to IBD to encompass CD; - Increased the number of study centers from approximately 150 centers to approximately 175 centers worldwide; - Broadened the age range from 25 to 55 years of age (inclusive) to 21 to 65 years of age (inclusive); - Included ≥ 50% decrease in sperm total motility and/or sperm morphology as decision criteria for participants to enter the MP; - Removed Week 28 and Week 32 visits from LTE; - Amended the definition of evaluable participants; - Added the option of pooling the results of this study with a separate study being conducted in participants with rheumatic diseases (Study GLPG0634-CL-227 [2018-003933-14]) with the same objective, and having the total planned number of participants in both studies combined of up to approximately 250 participants.
    18 Jan 2019
    It included following changes: - Updated ejaculation-free period from ≥ 48 hours and < 5 days to ≥ 48 hours and ≤ 7 days, per the recommendation of the updated Food and Drug Administration (FDA) guidance for industry on testicular toxicity studies; - Clarified OL Week 13 study visit and visit schedule of LTE; - Amended lower threshold of baseline sperm concentration for inclusion (≥ 10 million sperm cells/mL changed to ≥ 15 million sperm cells/mL) in line with FDA recommendation, and amended corresponding sperm concentration randomization strata (lower range of stratum changed from 10 to 20 million sperm cells/mL to 15 to 25 million sperm cells/mL); - Added the option for an unblinded interim analyses when 200 participants (eg, pooled data from Studies GS-US-418-4279 and GLPG0634-CL-227) and/or when some defined subset(s) of participants had completed their Week 13 assessments.
    17 Mar 2020
    It included following changes: - Included discontinuation criteria for thromboembolic events; - Included a criterion to trigger an ad-hoc data monitoring committee (DMC) meeting; - Clarified that the CDAI score calculation excluded days that involved an endoscopy procedure or preparation for that procedure; - Added section on blinding procedures.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
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