E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Moderately-to-severely active Ulcerative Colitis (UC) |
|
E.1.1.1 | Medical condition in easily understood language |
|
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 | 20.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10045365 |
E.1.2 | Term | Ulcerative colitis |
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 assess the safety and tolerability of TD-1473 administered up to 3 years in subjects with moderate to severe UC after participation in the Maintenance Study of Protocol 0157. |
|
E.2.2 | Secondary objectives of the trial |
• To assess clinical remission and response rates over time
• To assess endoscopic healing rates over time
• To assess clinical remission and response in subjects entering the study after experiencing persistent loss of response or recurrent clinical flare after initial loss of response during the Maintenance Study (Protocol 0157)
• To assess clinical remission and response in subjects entering the study after completing the Maintenance Study (Protocol 0157)
• To determine the effect of long-term TD-1473 treatment on major inflammatory bowel disease (IBD)-related events (eg, hospitalizations, surgeries, and procedures)
• To examine the effect of long-term TD-1473 treatment on health-related quality of life (QOL) |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Capable of providing informed consent, which must be obtained prior to
any study-related procedures.
1. One of the following:
a. Those who demonstrated persistent (as confirmed by endoscopy) loss
of response (no improvement approximately 6 to 8 weeks after meeting
loss of response criteria) or
b. two Clinical Flares after an episode (as confirmed by endoscopy) of loss of response during the Maintenance Study.
OR
c. Those who have completed the Maintenance Study (even if the subject
declined endoscopy during a clinical flare assessment during the
Maintenance Study of Protocol 0157) and have a confirmed clinical remission status (in remission or not in remission) with available results
2. During the study and for 7 days after receiving the last dose of the
study drug, females of childbearing potential or men capable of fathering
children must agree to use highly effective birth control measures
(failure rate <1% when used consistently and correctly) or agree to
abstain from sexual intercourse. Females of childbearing potential must
test negative for pregnancy at Day 1.
3. All male subjects must agree to refrain from semen donation during
the study and for 7 days after the last dose of study drug.
4. Must be able and willing to adhere to the study visit schedule and
comply with other study requirements. |
|
E.4 | Principal exclusion criteria |
1. Has current symptoms or signs suggestive of fulminant colitis, toxic
megacolon, intestinal perforation
2. Has a high risk of requiring surgery for UC during the study
3. Has been diagnosed during Protocol 0157 with Crohn's disease,
microscopic colitis, ischemic colitis, radiation colitis, diverticular disease
associated with colitis, indeterminate colitis, or the subject has a current
or past diagnosis of a fistula or abdominal abscess
4. Has dysplasia that was not completely resected or high-grade
dysplasia detected during Protocol 0157; however, subjects with
adenomas with low grade dysplasia that have been completely resected
are eligible
5. Taking any medications/treatments listed in the protocol currently or
previously during Protocol 0157 Maintenance
6. Deemed by the investigator to be inappropriate for this study; or has
any condition which would confound or interfere with the evaluation of
the safety or tolerability of the study drug [e.g., developed unstable or
uncontrolled and clinically significant allergic (except for untreated,
asymptomatic, seasonal allergies), hematological, endocrine/metabolic,
coagulation, immunologic, pulmonary, cardiovascular, hepatic (except
hepatic steatohepatitis), GI (except UC), genitourinary, psychiatric,
oncologic thrombotic (e.g., deep vein thromboses (DVT) or pulmonary
embolism or neurological disease or other medical disorder before,
during or after Protocol 0157]; or is unable or unwilling to comply with
the study protocol.
7. Develops hypersensitivity to excipients or contents of the study drug
as noted in Protocol 0157.
8. Participating in or interested in participating in another
investigational study (exception Protocol 0157)
9. Has clinically significant abnormalities in the results of laboratory
evaluations at the most recent laboratory evaluation prior to LTS Day 1
visit as determined by the investigator, including:
• AST, ALT, or alkaline phosphatase ≥ 2x the upper limit of normal (ULN)
• Total bilirubin > 2x ULN (unless diagnosis of Gilbert's syndrome)
• Creatinine clearance as calculated by the Cockcroft-Gault formula < 30
mL/min
• Total white blood cell count (WBC) < 3 x 10^9/L
• Absolute neutrophil count < 1.5 x 10^9/L
• Absolute lymphocyte count < 0.8 x 10^9/L
• Hemoglobin < 8 g/dL
• Platelet count < 100 x 10^9/L.
10. Subject has had a live viral vaccine (e.g., MMR, varicella zoster,
herpes zoster, oral polio virus, FluMist®, attenuated typhoid fever
vaccine, attenuated rotavirus vaccine, yellow fever vaccine, or any
investigational live vaccine) within 4 weeks prior to Day 1 and/or is
unwilling or unable to avoid live viral vaccines during the Study and for 8
weeks following the last dose of study drug. Subject must be willing to avoid contact with any household member who has been vaccinated with
a live attenuated vaccine within 2 weeks after vaccination.
11. Are pregnant, lactating, breastfeeding or planning to become
pregnant during the Study or within 7 days after the last dose of Study
Drug
12. Within 4 weeks of Day 1, has [1] confirmed severe acute respiratory
syndrome coronavirus 2 (SARS-CoV-2) infection (coronavirus disease
2019 [COVID-19]) (test positive), OR [2] suspected SARS-CoV-2
infection (clinical features without documented test results) unless has a
negative test for SARS-CoV-2 two weeks after resolution of symptoms
and remains asymptomatic until Day 1, OR [3] close contact with a
person with known or suspected SARS-CoV-2 infection unless has a
negative test for SARS-CoV-2 two weeks after contact and remains
asymptomatic until Day 1. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Incidence and severity of treatment-emergent adverse events, changes in laboratory safety tests, ECGs, and vital sign measurements. |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
throughout study duration |
|
E.5.2 | Secondary end point(s) |
• Proportion of subjects who achieve clinical remission by various
definitions at Week 12 among subjects entering the LTS study from
Protocol 0157 Maintenance Study with persistent loss of response or
recurrent clinical flare after loss of response
• Proportion of subjects who achieve clinical response by various
definitions at Week 12 among subjects entering the LTS study from
Protocol 0157 Maintenance Study with persistent loss of response or
recurrent clinical flare after loss of response
• Time to major IBD-related events (hospitalizations, surgeries, or
procedures)
• Changes from baseline in IBDQ, WPAI-UC, and EuroQual (EQ-5D)
scores
• Proportions of subjects achieving clinical remission as defined by
various definitions at scheduled time points.
• Proportions of subjects maintaining clinical response at scheduled time
points by various definitions in subjects who entered the LTS study in
clinical response from the Maintenance Study in Protocol 0157
• Proportion of subjects who enter study in clinical remission and
maintain clinical remission by various definitions at scheduled time
points
• Proportion of subjects who enter the study in clinical response and
maintain clinical response by various definitions at scheduled time
points
• Changes from baseline in partial, adapted, and total Mayo scores at
scheduled time points (both Protocol 0157 Induction and Protocol 0157
Maintenance baseline)
• Proportion of subjects achieving endoscopic healing at scheduled time
points
• Proportion of subjects achieving endoscopic remission at scheduled
time points |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
Week 12 and at scheduled time points throughout study duration |
|
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 | 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) | 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 | No |
E.8.1.1 | Randomised | No |
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 | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
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 | 10 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 100 |
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 |
Georgia |
Serbia |
South Africa |
Bulgaria |
Canada |
Croatia |
Germany |
Greece |
Hungary |
Israel |
Italy |
Japan |
Korea, Republic of |
Poland |
Portugal |
Romania |
Russian Federation |
Slovakia |
Spain |
Taiwan |
Ukraine |
United Kingdom |
United States |
France |
|
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 | 10 |
E.8.9.1 | In the Member State concerned months | 5 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 10 |
E.8.9.2 | In all countries concerned by the trial months | 5 |