E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
|
E.1.1.1 | Medical condition in easily understood language |
Ulcerative Colitis a form of inflammatory bowel disease. |
|
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.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10045366 |
E.1.2 | Term | Ulcerative colitis, unspecified |
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 of long-term administration of etrasimod in subjects with moderately to severely active ulcerative colitis (UC) |
|
E.2.2 | Secondary objectives of the trial |
To assess the long-term efficacy of etrasimod in subjects with moderately to severely active UC |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Must have met the eligibility criteria and have been enrolled in the qualified Phase 2 and 3 parent studies listed below or other qualified region-specific studies and meet the following additional criteria: a. Subjects previously enrolled in Study APD334-301 or APD334-210 must have either: I. Completed the Week 52 visit or II. completed the Week 12 visit and whose UC condition in the opinion of the Investigator has not improved or has worsened, compared with baseline (Week 0/Day 1 in the parent study), provided their ES is ≥ 2 and they meet one of the following entry criteria: • Rectal bleeding (RB) sub-score ≥ 2 at 2 timepoints at least 7 days and no more than 14 days apart • RB + stool frequency (SF) sub-score ≥ 4 at 2 timepoints at least 7 days and no more than 14 days apart • RB sub-score ≥ 2 or RB + SF sub-scores ≥ 4 (in any order) at 2 timepoints at least 7 days and no more than 14 days apart Note: For subjects discontinuing prior to Week 52, an endoscopic evaluation is required to confirm eligibility for the OLE. An endoscopy should be scheduled upon the appearance of UC symptoms but no more than 14 days after the second timepoint for entry criteria above. A proctosigmoidoscopy does not need to be repeated if performed within the last 4 weeks b. Subjects previously enrolled in study APD334-302 must have completed the Week 12 visit 2. Eligible women of childbearing potential must fulfill the following on Week0/Day 1: a. Have a negative urine beta-human chorionic gonadotropin (β-hCG) pregnancy test b. Not breastfeeding 3. Females must meet either a or b of the following criteria and males must meet criterion c to qualify for the study: a. A nonpregnant female who is not of childbearing potential must meet 1 of the following: - Postmenopausal, defined as no menses for 12 months without an alternative medical cause; - Permanent sterilization procedure, such as hysterectomy, bilateral salpingectomy, or bilateral oophorectomy. b. A female of childbearing potential must agree to using a highly effective contraception method during treatment and for 30 days following treatment that can achieve a failure rate of less than 1% per year when used consistently and correctly. The following are considered highly effective birth control methods: - Combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation, which may be oral, intravaginal, or transdermal. - Progestogen-only hormonal contraception associated with inhibition of ovulation, which may be oral, injected, or implanted. - Intrauterine device (IUD). - Intrauterine hormone-releasing system. - Bilateral tubal occlusion. - Vasectomized partner, provided that partner is the sole sexual partner of the WOCBP trial subject and that the vasectomized partner has received medical assessment of the surgical success. - Sexual abstinence (complete sexual abstinence defined as refraining from heterosexual intercourse for the entire period of risk associated with study treatments). The reliability of sexual abstinence needs to be evaluated in relation to the duration of the clinical study and the preferred and usual lifestyle of the subject. Periodic abstinence (calendar, symptothermal, post-ovulation methods) is not acceptable. c. A male subject with a pregnant or nonpregnant female of childbearing potential partner must agree to using condoms during treatment and for 30 days following treatment. 4. Ability to provide written informed consent or assent (parent or legal guardian must provide consent for a subject < 18 years of age or as required per local regulations who has assented to participate in the study) and to be compliant with the schedule of protocol assessments. Enrollment of subjects < 18 years should be conducted only if acceptable according to local laws and regulations. |
|
E.4 | Principal exclusion criteria |
Subjects who meet ANY of the following exclusion criteria will NOT be eligible for enrollment into the study: 1. the Investigator considers the subject to be unsuitable for any reason to participate in the OLE study Exclusions related to general health: 2. Experienced an adverse event that led to discontinuation (except when such an event is related to worsening disease) from parent study 3. Week0/Day 1 pre-dose sitting vital sign assessment: heart rate (HR) < 50 bpm OR systolic blood pressure (BP) < 90 mm Hg OR diastolic BP < 55 mm Hg 4. Week0/Day 1 pre-dose 12-lead ECG in the supine position showing a second or third-degree AV block, periods of asystole > 3 seconds, PR interval > 200 ms, or Fridericia's corrected QT interval (QTcF) ≥ 450 ms (men) or QTcF ≥ 470 ms (women) 5. Subjects requiring colectomy during the parent study 6. Subjects requiring treatment with prohibited medications as defined in the parent study |
|
E.5 End points |
E.5.1 | Primary end point(s) |
• Incidence of treatment-emergent adverse events (TEAEs) and serious adverse events (SAEs) • Incidence and severity of laboratory abnormalities, and change from treatment baseline in laboratory values (hematology, serum chemistry, coagulation, and urinalysis) • Incidence of vital sign abnormalities and changes from treatment baseline |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
Week 2, 4, 8, 12, 24, 36, 52, 64, 76, 88, 104, 116, 128, 140, 156, 168, 180, 192, 2018, 220, 232, 244, 260, 2-week and 4-week Follow-up visit
|
|
E.5.2 | Secondary end point(s) |
• The proportion of subjects achieving clinical remission at Week 52 and 104 among subjects achieving clinical remission at study entry • The proportion of subjects achieving clinical response at Weeks 52 and 104 • Change from baseline in the Total Mayo Score (TMS) at Weeks 52 and 104 • Change from baseline from Partial Mayo Score (PMS) at Weeks 52, 104, 156, 208 and 260 • The proportion of subjects achieving endoscopic improvement at Weeks 52 and 104 |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
Weeks 52, 104, 156, 208 and 260 |
|
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 | 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 | Yes |
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 | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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 | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
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 | 15 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 129 |
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 |
Argentina |
Chile |
Colombia |
Egypt |
Switzerland |
Moldova, Republic of |
Ukraine |
Australia |
Belarus |
Belgium |
Bulgaria |
Canada |
China |
Croatia |
Czechia |
Denmark |
Estonia |
France |
Georgia |
Germany |
Hungary |
India |
Israel |
Italy |
Japan |
Korea, Republic of |
Latvia |
Lithuania |
Mexico |
Netherlands |
Poland |
Portugal |
Romania |
Russian Federation |
Serbia |
Slovakia |
South Africa |
Spain |
Thailand |
Turkey |
United Kingdom |
United States |
|
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 | 8 |
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 | 8 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |