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 inflammatory disease of the gastrointestinal tract that causes significant morbidity, impact on quality of life, and health care expenditures. |
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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.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10011398 |
E.1.2 | Term | Crohn's |
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 |
• Objective: To assess the effect of BMS-986165 on clinical remission and endoscopic response at the end of the Induction Period |
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E.2.2 | Secondary objectives of the trial |
• Objective: To assess the effect of BMS-986165 on endoscopic remission at Week 12 (Day 85)
• Objective: To assess the effect of BMS-986165 on clinical response at end of the Induction Period (Week 12 [Day 85])
• Objective: To assess the effect of BMS-986165 on clinical response through end of the Maintenance Period (Week 52 [Day 365])
• Objective: To assess the effect of BMS-986165 on clinical remission through the end of the Maintenance Period (Week 52 [Day 365])
• Objective: To endoscopically assess the effect of BMS-986165 on gut mucosal disease activity
• Objective: To assess the effect of BMS-986165 on deep remission
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1) Signed Written Informed Consent
a) Willing to participate in the study and sign the ICF.
b) Willing and able to complete all study-specific procedures and visits.
2)T ype of Subject and Target Disease Characteristics
a) Documented diagnosis of CD of at least 3 months’ duration, with colitis, ileitis, or ileocolitis, confirmed by:
• Source: Medical records with report of an ileocolonoscopy (full colonoscopy with the intubation of terminal ileum) which shows features consistent with CD, as determined by the procedure performing physician, AND
• Source: Medical record documentation of a histopathology report showing features consistent with CD, as determined by the local pathologist.
Note: If no previous confirmation of diagnosis is available or if previous diagnosis is not deemed conclusive, at time of baseline endoscopy, histology must be performed and read locally to confirm diagnosis of CD before proceeding to randomization.
b)Must have active moderate to severe CD, as defined by:
• CDAI score of 220 to 450 AND
• PRO 2: Average daily score for abdominal pain ≥ 2 OR average daily number of very soft (loose) or liquid (watery) stools (BSS Type 6 or 7 only) ≥ 4, as collected in a 7-day diary, AND
• Evidence of active inflammation in at least 1 of the 5 ileocolonic segments (based on central reading) with total SES-CD ≥ 6 or SES-CD ≥ 4 if only isolated ileitis is present on baseline endoscopy
c) Must have had an inadequate response, loss of response, or intolerance to a standard treatment course of 1 or more of the following standard of care medications as below:
• Oral aminosalicylates: (eg, mesalamine, sulfasalazine, olsalazine, balsalazine) at or above the approved label dose for induction therapy for at least 6 weeks prior to randomization,
• Oral CS: Prednisone 20 mg/day or equivalent for at least 2 weeks, and/or 2 failed attempts to taper oral CS below prednisone or equivalent 10 mg daily
• IV Corticosteroids: hydrocortisone ≥ 400 mg/day or equivalent for at least 1 week,
• Immunomodulators (AZA ≥ 2 mg/kg/day, 6-MP ≥ 1 mg/kg/day, MTX ≥ 25 mg/week, or documentation of a therapeutic concentration of 6 thioguanine nucleotide) for at least 12 weeks, or
• Biologics (eg, infliximab, adalimumab, certolizumab pegol, vedolizumab, natalizumab). Subjects can be included if treatment with a biologic was stopped due to primary or secondary nonresponse
(responded initially but then lost response with continued therapy), or were intolerant to treatment.
d) This study permits the rescreening of a subject that has been deemed as ineligible (screen failure) during the Screening Period (ie, subject has not been randomized/has not been treated; Section 6.5). If re enrolled, the subject must be re-consented (ie, re-signing of the ICF) and rescreened (if outside the 28-day Screening Period window). Only 1 re enrollment per subject is permissible.
3) Age and Reproductive Status
a) Men and women aged 18 to 75 years inclusive at the time of screening
b) Women of childbearing potential (WOCBP) must have a negative serum or urine pregnancy test (minimum sensitivity 25 IU/L or equivalent units of beta-human chorionic gonadotropin) within 24 hours prior to the start of study treatment.
c) Women must not be breastfeeding
d) WOCBP must agree to follow instructions for method(s) of contraception for the duration of treatment with study treatment(s) (BMS-986165 or placebo) plus 5 half-lives of study treatment (3 days) plus 30 days (duration of ovulatory cycle) for a total of 33 days post treatment completion
e) WOCBP who are not heterosexually active are exempt from contraceptive requirements, and still must undergo pregnancy testing as described in this section
f) Investigators shall counsel WOCBP and men who are sexually active with WOCBP, on the importance of pregnancy prevention and the implications of an unexpected pregnancy. Investigators shall advise on the use of highly effective methods of contraception, which have a failure rate of < 1% when used consistently and correctly.
g) Men who are sexually active with WOCBP must agree to follow instructions for method(s) of contraception for the duration of treatment with study treatment BMS-986165 or placebo plus 5 half-lives of the study treatment (3 days) after the final dose of study treatment.
h) Azoospermic males are exempt from contraceptive requirements. WOCBP who are continuously not heterosexually active are also exempt from contraceptive requirements, and still must undergo pregnancy testing as described in this section.
i) Male subjects must be willing to refrain from sperm donation during the entire duration of treatment plus 5 half-lives of study treatment (3 days) after the final dose of study treatment. |
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E.4 | Principal exclusion criteria |
1) Target Population
a) Severe or fulminant colitis that is likely to require surgery or hospitalization
b) Presence of a diagnosis of alternative forms of colitis (infectious, inflammatory including ulcerative colitis, malignant, toxic, indeterminate, etc.) other than CD
c) Presence of a stoma, gastric or ileoanal pouch, previous proctocolectomy or total colectomy, symptomatic, obstructive disease such as stenosis or obstructive strictures, abscess or suspected abscess, pouchitis, short bowel syndrome, or history of bowel perforation
d) History of intra-abdominal abscess within the last 60 days
• Previous intra-abdominal abscess that has been drained and successfully treated with a local standard course of antimicrobial therapy is permitted (The course must have completed at least 60 days prior to Day 1)
e)History of diverticulitis within the last 60 days
• Previous diverticulitis that has been successfully treated with a local standard course of antimicrobial therapy is permitted. (The course must have completed at least 60 days prior to Day 1)
f) Receiving tube feeding, defined formula diets, or total parenteral alimentation
g) Current colonic dysplasia or past colonic dysplasia that has not been definitively treated
h) History of infectious (bacterial, viral, fungal, parasitic, etc.) colitis within past 30 days; must be fully treated to rescreen
i) Use of therapeutic enema or suppository, other than required for ileocolonoscopy, within 7 days prior to screening or during the Screening Period
j) Prior treatment with specific lymphocyte-depleting agents, such as alemtuzumab, rituximab, and other agents such as ustekinumab, are prohibited within 12 months prior to the first dose of study treatment during the Induction Period. Please note that lack of response to ustekinumab (as well as other anti-12/23 p40 antibodies) or anti-IL-23 p19 antibodies is criteria for exclusion (also see exclusion criterion 3.b).
k) Receipt of either lymphocyte apheresis or selective monocyte, granulocyte apheresis (eg, Cellsobra®) is prohibited within 12 months prior to the first dose of study treatment during the Induction Period
l) Previous exposure to BMS-986165 in any study
m) Previous stem cell transplantation
n) Previous treatment with investigational agents within 12 weeks or 5 half-lives (whichever is longer) prior to the first dose of study treatment during the Induction Period |
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E.5 End points |
E.5.1 | Primary end point(s) |
Co-primary endpoints:
Proportion of subjects achieving clinical remission at Week 12 (Day 85)
Proportion of subjects achieving endoscopic response at Week 12 (Day 85)
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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) |
o Endpoint: Proportion of subjects who achieve endoscopic remission at Week 12 (Day 85)
o Endpoint: Proportion of subjects who achieve a clinical response at Week 12 (Day 85)
o Endpoint: Proportion of subjects who achieve a clinical response through Week 52 (Day 365)
o Endpoint: Proportion of subjects achieving clinical remission at Week 52 (Day 365)
o Endpoints:
Proportion of subjects achieving endoscopic remission at Week 52 (Day 365)
Proportion of subjects who achieve an endoscopic response at Week 52 (Day 365)
Proportion of subjects achieving complete mucosal healing at Weeks 12 and 52
Change from baseline in SES-CD at Weeks 12 and 52
o Endpoints:
Proportion of subjects achieving deep remission at Week 12 (Day 85)
Proportion of subjects maintaining deep remission at Week 52 (Day 365)
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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 | Yes |
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 | Yes |
E.6.10 | Pharmacogenetic | Yes |
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) | 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 | 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 | 4 |
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 | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 90 |
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 |
Australia |
Brazil |
Canada |
China |
Japan |
Korea, Republic of |
Mexico |
Taiwan |
United States |
France |
Poland |
Sweden |
Netherlands |
Romania |
Spain |
Czechia |
Germany |
Italy |
Croatia |
Hungary |
Slovakia |
Ukraine |
United Kingdom |
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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 | 3 |
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 | 3 |
E.8.9.2 | In all countries concerned by the trial months | 5 |
E.8.9.2 | In all countries concerned by the trial days | 0 |