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] - 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 |
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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 evaluate the safety and tolerability of repeat doses of GSK2831781. - To characterise the efficacy dose response of GSK2831781 during the Induction Phase. |
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E.2.2 | Secondary objectives of the trial |
- To investigate the effect of repeat doses of GSK2831781 on clinical efficacy including endoscopic mucosal healing during the Induction Phase. - To investigate the effect of repeat doses of GSK2831781 on UC histologic disease activity during the Induction Phase. - To investigate the effect of repeat doses of GSK2831781 on biomarkers of UC disease activity during the Induction Phase. - To investigate the pharmacokinetics of GSK2831781 following repeat intravenous and subcutaneous dosing. - To investigate the immunogenicity of repeat doses of GSK2831781. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
AGE and WEIGHT: Participant must be 18 years of age or older and >40kg at the time of signing the informed consent.
TYPE OF PARTICIPANT AND DISEASE CHARACTERISTICS: Participants who have a: -Diagnosis of ulcerative colitis, established at least 3 months prior to screening, as documented by diagnostic sigmoidoscopy or colonoscopy, and biopsy. -Complete Mayo Score of 6 to 12, with disease extending ≥15cm from the anal verge, with a centrally read endoscopic subscore of ≥2 at screening endoscopy, and a rectal bleeding subscore ≥1. -A history of at least one of the following: (1) Inadequate response to, loss of response to, or intolerance to azathioprine or mercaptopurine (including thiopurine methyltransferase (TPMT) genetic mutation precluding use), ciclosporin, tacrolimus or methotrexate. (2) Inadequate response to, intolerance to, or demonstrated dependence on oral corticosteroids. (3) Inadequate response to, loss of response to, or intolerance to one biologic class ONLY for the treatment of UC: either one or more anti-TNF therapies (e.g. infliximab, adalimumab, golimumab, or biosimilar) OR vedolizumab. - Surveillance colonoscopy (performed according to local standards) within 12 months of screening (or during screening, if required) for participants with: (1) Pancolitis of >8 years duration; or (2) Patients with left-sided colitis of >12 years duration; or (3) Patients with primary sclerosing cholangitis. (4) For patients for whom this criterion does not apply, colorectal cancer surveillance should be undertaken according to local or national guidelines for patients with age ≥50, or with other known risk factors for colorectal cancer.
SEX Female participants: - A female participant is eligible to participate if she is not pregnant, not breastfeeding, and at least one of the following conditions applies: (1) Not a woman of childbearing potential (WOCBP), OR (2) A WOCBP who agrees to use a highly effective contraceptive method for at least 4 weeks prior to dosing, until the Follow-Up visit.
INFORMED CONSENT -Capable of giving signed informed consent as described in the protocol
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E.4 | Principal exclusion criteria |
Medical Conditions: (1) Current diagnosis of indeterminate colitis, inflammatory bowel disease-unclassified, Crohn's Disease, infectious colitis, or ischaemic colitis (2) Fulminant UC (as defined by 6 bloody stools daily AND 1 or more of: i) body temperature ≥100.4°F (or 38°C) or ii) heart rate >90 beats per minute), or toxic megacolon (3) Prior extensive colonic resection, subtotal or total colectomy, or proctocolectomy, or planned surgery for UC (4) Any uncontrolled medical conditions, other than active UC, that in the opinion of the investigator put the participant at unacceptable risk or interfere with study assessments or integrity of the data. Other medical conditions should be stable at the time of screening and be expected to remain stable for the duration of the study (5) Unstable lifestyle factors, such as alcohol use to excess or recreational drug use, to the extent that in the opinion of the investigator they would interfere with the ability of a participant to complete the study (6) An active infection or a history of serious infections as described fully in the protocol. (7) Current or history of chronic liver or biliary disease (with the exception of Gilbert’s syndrome, asymptomatic gallstones or uncomplicated fatty liver disease) (8) Hereditary or acquired immunodeficiency disorder, including immunoglobulin deficiency (unless the participant has a documented history of selective IgA deficiency) (9) A major organ transplant or haematopoietic stem cell/marrow transplant (10) Any planned major surgical procedure during the study (11) A history of malignant neoplasm within the last 5 years, except for adequately treated non-metastatic basal or squamous cell cancers of the skin (within 1 year) or carcinoma in situ of the uterine cervix (within 3 years) that has been fully treated and shows no evidence of recurrence
PRIOR/CONCOMITANT THERAPY: (12) A change in dose of oral sulfasalazine or aminosalicylate within 2 weeks prior to baseline endoscopy (13) Greater than 20mg/day oral prednisolone (or equivalent), or a change in dose of corticosteroid within 2 weeks prior to baseline endoscopy, or be unable to maintain a stable dose of corticosteroids (≤20mg oral prednisolone or equivalent) until Week 12 (14) Topical (rectal) corticosteroids or topical (rectal) aminosalicylate within 2 weeks prior to baseline endoscopy (15) Initiation or a change in dose of mercaptopurine or azathioprine (including initiation or discontinuation of allopurinol) or methotrexate within 8 weeks prior to baseline endoscopy (16) Treatment with ciclosporin, tacrolimus or thalidomide within 4 weeks prior to baseline endoscopy (17) Treatment with an anti-TNF biologic within 8 weeks prior to baseline endoscopy, or vedolizumab within 12 weeks prior to baseline endoscopy (18) History of treatment with vedolizumab AND an anti-TNF biologic, regardless of treatment response (unless exposure to one or both drugs was only within a clinical trial setting) (19) History of treatment with a monoclonal antibody therapy or targeted small molecule therapy for the treatment of UC not listed above (20) Received live vaccination within 4 weeks of Day 1 or plan to receive during the study until Follow-Up
PRIOR/CONCURRENT CLINICAL STUDY EXPERIENCE: (21) Participated in a clinical trial and received an IP within the following time period prior to the first dosing day in the current study: 3 months, 5 half-lives, or twice the duration of the biological effect of the IP (whichever is longer)
DIAGNOSTIC ASSESSMENTS: (22) Absolute neutrophil count <1.5x10^9/L or a haemoglobin <80g/L or lymphocyte count <0.8x10^9/L (23) Estimated GFR by Chronic Kidney Disease Epidemiology Collaboration equation calculation <60ml/min/1.73m^2 at screening (24) ALT >2xULN and bilirubin >1.5xULN (isolated bilirubin >1.5xULN is acceptable if bilirubin is fractionated and direct bilirubin <35%) at screening (25) Other clinically significant abnormalities of lab assessments, as judged by the investigator and/or GSK Medical Monitor, that could affect the safety of the participant, or the interpretation of the data from the study (26) Presence of hep-B surface antigen or Hep-B core antibody, or positive hep-C antibody result at screening (NB. participants with positive Hep-C antibody due to prior resolved disease can be enrolled only if a confirmatory negative Hep-C RNA test is obtained) (27) Positive serology for HIV at screening (28) Where participation in the study would result in donation of blood or blood products in excess of 500ml within 3 months (29) QTc >450msec or QTc >480msec for participants with bundle branch block at screening and Day 1. The QTc is the QT interval corrected for heart rate according to either Bazett’s formula, Fridericia’s formula, or another method, machine or over read
Other Exclusion Criteria: (30) Participants with hypersensitivity to GSK2831781 or any excipients in the clinical formulation of GSK2831781
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E.5 End points |
E.5.1 | Primary end point(s) |
- Adverse events, vital signs, clinical laboratory values (haematology, clinical chemistry, and urinalysis), 12-lead ECG. - Change from baseline in Mayo score at Week 10. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Week 10 (mayo score) and end of study (safety endpoints) |
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E.5.2 | Secondary end point(s) |
- The proportion of participants who achieve a Mayo endoscopic score of 0 or 1 at Week 10. - Proportion of participants who achieve Mayo clinical remission at Week 10. - Proportion of participants who achieve Mayo clinical response at Week 10. - Change from baseline in partial Mayo score over time. - Change from baseline in Mayo endoscopic score and Ulcerative Colitis Endoscopic Index of Severity (UCEIS) at Week 10. - Change from baseline in histological severity as determined by the Robarts Histopathology Index, Nancy Histological Index and Geboes Score at Week 10. - Change from baseline in serum C-reactive protein over time. - Change from baseline in faecal calprotectin over time. - GSK2831781 PK concentrations and parameters: AUC(0-tau), Cmax, tmax. - Soluble LAG3 (sLAG3) concentrations. - Anti-drug antibodies over time. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Week 10 (mayo score) and end of study (safety endpoints) |
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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 | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | Yes |
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) | 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 | 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 | 5 |
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 | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 38 |
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 |
Bulgaria |
Canada |
Czech Republic |
Estonia |
France |
Hungary |
India |
Korea, Republic of |
Lithuania |
Netherlands |
Poland |
Russian Federation |
Serbia |
Slovakia |
Slovenia |
South Africa |
Ukraine |
United Kingdom |
United States |
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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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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 | 0 |
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 | 1 |
E.8.9.2 | In all countries concerned by the trial days | 0 |