E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Ulcerative colitis |
rectocolite hémorragique |
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E.1.1.1 | Medical condition in easily understood language |
Ulcerative colitis |
rectocolite hémorragique |
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E.1.1.2 | Therapeutic area | Body processes [G] - Digestive System and Oral Physiological Phenomena [G10] |
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 |
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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 determine whether a non-TNF-targeted biologic (vedolizumab) is superior to infliximab to treat patient with UC losing response or with a primary failure to a first subcutaneous anti-TNF drug at week 14. |
Déterminer si une biothérapie ne ciblant pas le TNF (vedolizumab) est supérieure à l'infliximab pour traiter un patient présentant une perte de réponse ou un échec primaire à un premier médicament anti-TNF sous-cutané |
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E.2.2 | Secondary objectives of the trial |
₋ To assess the rate of clinical response and remission at Week 54 in each group of treatments and the time to clinical response and remission from baseline ; ₋ To assess the changes in faecal calprotectin levels from baseline to week 14 and 54 according to treatment ; ₋ To assess the rate of colectomy and hospitalization in each treatment group ; ₋ To assess the rate of mucosal healing at week 14 and 54 in each group of treatments ; To assess the rate of loss of response To assess the changes of quality of life indexes and the disability index To determine the safety profile To characterize the response according to drug monitoring of the first anti-TNF agent To describe the pharmacokinetics of infliximab and vedolizumab and explore the sources of pharmacokinetic inter-individual variability To identify predictive factors of response to the treatment, including pharmacokinetic features
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₋ Évaluer le taux de réponse clinique et de rémission aux semaines 14, et 54 dans chaque groupe de traitements et le délai de réponse clinique et de rémission ₋ Évaluer les variations de la calprotectine fécale entre le début et les semaines 14 et 54 selon le traitement administré ₋ Évaluer le taux de colectomie et d'hospitalisation dans chaque groupe de traitement ₋ Évaluer le taux de cicatrisation muqueuse aux semaines 14 et 54 dans chaque groupe de traitements Évaluer le taux de perte de réponse Evaluer les variations de qualité de vie Déterminer le profil de sécurité Caractériser la réponse en fonction des données pharmacocinétique à l’arrêt du premier agent anti-TNF Décrire la pharmacocinétique de l'infliximab et du vedolizumab et explorer les sources de la variabilité interindividuelle pharmacocinétique Identifier les facteurs prédictifs de réponse au traitement, incluant les caractéristiques pharmacocinétiques
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
₋ Male or non-pregnant female, non-lactating female; ₋ 18 years of age or older and less than 75 years ; ₋ Documented diagnosis of UC for at least 6 months ; ₋ Left side colitis or pancolitis ; ₋ Moderate to severe disease according to a Mayo score equal or above 6 with a Mayo endoscopic sub-score of 2 or 3 ; ₋ Active disease despite ongoing treatment with adalimumab or golimumab for at least 12 weeks (inadequate response, failure, loss of response or intolerance) ; ₋ Ability of the subject to participate fully in all aspects of this clinical trial ; ₋ Written informed consent must be obtained and documented ; ₋ Naïve to JAK inhibitor ; ₋ Affiliation to the national health insurance.
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- Homme ou femme, âgés de 18 ans inclus à 75 ans exclus - Diagnostic de RCH depuis au moins 6 mois; - Extension colique gauche ou pancolique de la RCH - Maladie modérée à sévère selon le score de Mayo (supérieur ou égal à 6 avec un sous-score endoscopique de Mayo de 2 ou 3 - Maladie active malgré un traitement par adalimumab ou golimumab utilisé pendant au moins 12 semaines (réponse inadéquate, échec, perte de réponse ou intolérance) - Capacité du sujet à comprendre et participer pleinement à tous les aspects de cet essai clinique - Après obtention du consentement éclairé et signé - Naïf d’un traitement inhibiteur des Janus Kinases. - Affiliation à un régime de sécurité sociale
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E.4 | Principal exclusion criteria |
₋ Contraindication to continue TNF antagonist (ongoing abscess(es), clinical suspicion of tuberculosis, past allergic reaction) ; ₋ Contraindication to vedolizumab treatment ; ₋ Steroid treatment > 20 mg/day for at least two weeks before baseline ; ₋ Proctitis ; ₋ Stoma ; ₋ Proctocolectomy or subtotal colectomy ; ₋ Planned surgery within the year of the trial ; ₋ Previous exposure to vedolizumab or infliximab ; ₋ History of cancer during the past 5 years ; ₋ Pregnancy or breastfeeding ₋ Adults legally protected (under judicial protection, guardianship, or supervision), persons deprived of their liberty. ₋ Ongoing participation to another interventional study
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- Contre-indication pour continuer un traitement anti-TNF (suspicion clinique de tuberculose) - Contre-indication au traitement par vedolizumab - Traitement par corticostéroïdes à une dose supérieure à 20 mg par jour pendant les deux semaines précédant l’inclusion - Rectite - Stomie - Antécédent de proctocolectomie ou colectomie subtotale; - Chirurgie prévue dans l'année de l'essai - Exposition antérieure au vedolizumab ou à l'infliximab - Antécédents de cancer sur les 5 dernières années - Femmes enceintes ou allaitantes - Personnes majeures faisant l'objet d'une protection légale (sauvegarde de justice, curatelle, tutelle) et personnes privées de liberté. - Participation à une autre recherche impliquant la personne humaine interventionnelle |
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E.5 End points |
E.5.1 | Primary end point(s) |
The rate of patients with clinical and endoscopic steroid free-remission (Mayo score ≤ 2 without subscore > 1) at week 14. |
Le taux de patient présentant une rémission clinique et endoscopique sans corticoïdes (score de Mayo ≤2 sans sous-score >1) à la semaine 14 |
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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) |
₋ Mayo score at week 54 ; ₋ Faecal calprotectine level at week 14 and 54 ; ₋ Colectomy or hospitalization for disease flare during the study period ; ₋ Endoscopic subscore of the mayo Score at week 14 and 54 ; ₋ Partial Mayo score at week 2, 6, 14, 54 ; ₋ IBDQ index, IBD-Disk and IBD-DI at baseline week 14 and 54 ₋ Rate and type of adverse events during the study period ; ₋ Last trough concentration of the first subcutaneous agent at the time of the loss of response and anti-drug antibodies concentration ; ₋ Trough concentration of infliximab or vedolizumab at each visit and anti-drug antibodies concentration. |
₋ Score de Mayo à la semaine 54 ₋ Concentration de la calprotectine fécale aux semaines 14 et 54 ₋ Colectomie et hospitalisation pour une poussée de la maladie pendant la période de l’essai ₋ Sous score endoscopique du score de Mayo et Ulcerative colitis Endoscopic Index of severity (UCEIS) aux semaines 14 et 54 ₋ Score de Mayo partiel aux semaines 2, 6, 14, 54 ₋ Taux et types d’effets indésirables pendant la période de l’essai ₋ Concentration résiduelle et anticorps anti-médicament au moment de la perte de réponse au premier anti-TNF ₋ Concentration résiduelle et anticorps anti-médicament avant chaque perfusion d’infliximab et de vedolizumab
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
week 2, 6, 14 and 54 |
semaines 2, 6, 14 et 54 |
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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 | No |
E.6.5 | Efficacy | No |
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 | 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) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
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) | Yes |
E.8.2.2 | Placebo | No |
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 | 20 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
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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last visit of the last person who is a subject in the study |
Dernière visite du dernier sujet participant à l'étude |
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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 | |
E.8.9.1 | In the Member State concerned months | 42 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 42 |