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    The EU Clinical Trials Register currently displays   43839   clinical trials with a EudraCT protocol, of which   7280   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

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    EudraCT Number:2021-002537-41
    Sponsor's Protocol Code Number:20170104
    National Competent Authority:Netherlands - Competent Authority
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-10-13
    Trial results
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    A. Protocol Information
    A.1Member State ConcernedNetherlands - Competent Authority
    A.2EudraCT number2021-002537-41
    A.3Full title of the trial
    A Phase 2, Dose-finding, Randomized, Double-blind, Placebo-controlled, Multicenter Study to Evaluate the Safety and Efficacy of Efavaleukin Alfa Induction Therapy in Subjects with Moderately to Severely Active Ulcerative Colitis
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Safety and Efficacy of Efavaleukin Alfa in Subjects with Moderately to Severely Active Ulcerative Colitis
    A.4.1Sponsor's protocol code number20170104
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorAmgen Inc.
    B.1.3.4CountryUnited States
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportAmgen Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationAmgen Nederland
    B.5.2Functional name of contact pointMedical Information the Netherlands
    B.5.3 Address:
    B.5.3.1Street AddressMinervum 7061
    B.5.3.2Town/ cityBreda
    B.5.3.3Post code4800 DH
    B.5.4Telephone number+31765732500
    B.5.5Fax number+31765736838
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameEfavaleukin Alfa
    D.3.2Product code AMG 592
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.2Current sponsor codeAMG 592
    D.3.9.4EV Substance CodeSUB195522
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number2
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D. cell therapy medicinal product No
    D. therapy medical product No
    D. Engineered Product No
    D. ATIMP (i.e. one involving a medical device) No
    D. on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboSolution for injection
    D.8.4Route of administration of the placeboSubcutaneous use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Moderate to Severe Active Ulcerative Colitis
    E.1.1.1Medical condition in easily understood language
    Ulcerative Colitis
    E.1.1.2Therapeutic area Body processes [G] - Immune system processes [G12]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level LLT
    E.1.2Classification code 10045365
    E.1.2Term Ulcerative colitis
    E.1.2System Organ Class 10017947 - Gastrointestinal disorders
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To evaluate the effect of efavaleukin alfa on induction of clinical remission
    E.2.2Secondary objectives of the trial
    - To evaluate the effect of efavaleukin alfa on induction of clinical response
    - To evaluate the effect of efavaleukin alfa on induction of endoscopic remission
    - To evaluate the effect of efavaleukin alfa on induction of symptomatic remission
    - To evaluate the effect of efavaleukin alfa as induction therapy on combined endoscopic and histologic remission
    - To evaluate the effect of efavaleukin alfa as induction therapy on change in histological score
    - To evaluate the safety and tolerability of efavaleukin alfa
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    101 Subject has provided informed consent prior to initiation of study.

    102 Age ≥18 years to <80 years at screening visit, except in South Korea where age ≥19 years to <80 years at screening visit.

    103 Diagnosis of UC established ≥3 months prior to enrollment by clinical and endoscopic evidence and corroborated by a histopathology report.

    104 Moderately to severely active UC as defined by a modified Mayo score of 5 to 9, with a centrally read endoscopy subscore ≥2.

    105 Has documentation of
    - A surveillance colonoscopy within 12 months of day 1 visit for subjects with pancolitis of >8 years duration, or subjects with left-sided colitis of >12 years duration, or subjects with primary sclerosing cholangitis.
    - For all other subjects, up-to-date colorectal cancer surveillance. At the discretion of the investigator, a colonoscopy may be performed as the screening endoscopy for this study. Subjects who do not have a colonoscopy report available in source documentation will have a colonoscopy instead of rectosigmoidoscopy performed as the screening endoscopy for the study.

    106 Subjects must have demonstrated inadequate response, loss of response, or intolerance to at least 1 conventional therapy, biologic therapy, or targeted small molecule therapy (ie, JAK-inhibitor).

    1. Conventional therapy failed subjects:
    - Corticosteroids (corticosteroid-refractory colitis, defined as signs and/or symptoms of active UC despite oral prednisone (or equivalent) at doses of at least 30 mg/day for a minimum of 2 weeks; or corticosteroid-dependent colitis, defined as: an inability to reduce corticosteroids below the equivalent of prednisone 10 mg/day within 3 months of starting corticosteroids without a return of signs and/or symptoms of active UC; or a relapse within 3 months of completing a course of corticosteroids
    - History of intolerance of corticosteroids
    - Immunomodulators: signs and/or symptoms of persistently active disease despite at least 3 months treatment with one of the following at locally approved doses: oral azathioprine or 6-mercaptopurine, or oral azathioprine or 6-mercatopurine within a therapeutic range as judged by thioguanine metabolite testing, or a combination of a thiopurine and allopurinol within a therapeutic range as judged by thioguanine metabolite testing
    - History of intolerance to at least 1 immunomodulator and have neither failed nor demonstrated an intolerance to a biological medication (anti-TNF antibody, anti-integrin antibody, or IL-12/23 antagonists) that is indicated for the treatment of UC

    2. Biologic or targeted small molecule therapy failed subjects: those who demonstrated inadequate response or loss of response or intolerance to biologic therapy for UC (eg, anti-TNF antibodies or IL-12/23 antagonists, anti-integrin antibodies) or targeted small molecules (eg, JAK inhibitors or S1P modulators). The therapy used to qualify the subject for entry into this category must be approved for the treatment of UC in the country of use, at the time of use. Subjects must fulfil one of the following criteria:
    - Inadequate response: signs and symptoms of persistently active disease despite induction treatment at the approved induction dosing that was indicated in the product label at the time of use
    - Loss of response: recurrence of signs and symptoms of active disease during approved maintenance dosing following prior clinical benefit (discontinuation despite clinical benefit does not quality as having failed or being intolerant to UC biological therapy or JAK inhibitor or S1P modulator)
    - Intolerance: history of intolerance to infliximab, adalimumab, golimumab, vedolizumab, ustekinumab, tofacitinib or other approved biologicals or JAK inhibitors or S1P modulators (including but not limited to infusion-related event, demyelination, congestive heart failure, or any other drug-related adverse event that led to a reduction in dose or discontinuation of the medication)

    107 If receiving any of the following therapies, subjects must have stable dosage for the specified duration:
    - 5-aminosalicylates (ASAs), stable dosage for ≥ 2 weeks prior to screening endoscopy
    - Oral corticosteroids: prednisone up to 20 mg/day or its equivalent, stable dose for 2 weeks prior to screening endoscopy
    - Budesonide: extended release tablets 9 mg/day [budesonide MMX], stable dose for at least 2 weeks prior to screening endoscopy
    - Beclomethasone dipropionate: gastro-resistant prolonged-release tablet 5 mg/day, stable dose for ≥ 2 weeks prior to screening endoscopy
    - Conventional immunomodulators: azathioprine, 6-mercaptopurine, methotrexate, stable dosage for at least 8 weeks prior to screening endoscopy
    E.4Principal exclusion criteria
    201 Diagnosis of Crohn’s disease, inflammatory bowel disease-unclassified, microscopic colitis, ischemic colitis, or clinical findings suggestive of Crohn’s disease.
    202 Disease limited to the rectum.
    203 Evidence of toxic megacolon, fulminant colitis, intra-abdominal abscess, or stricture/stenosis within the small bowel or colon.
    204 Previous bowel resection or intestinal or intra-abdominal surgery.
    - Have had extensive surgery for UC, or are likely to require surgery for the treatment of UC during the study. Subjects who have had limited surgery for UC may be allowed in the study, if this does not affect the assessment of efficacy. Discussion with the sponsor must occur prior to screening of such subjects.
    - Have had any small bowel or colonic surgery within 6 months of day 1.
    - Have had any nonintestinal intra-abdominal surgery within 3 months of day 1.
    205 Adenoma and dysplasia exclusion criteria:
    - Any current sporadic adenoma without dysplasia that has not been removed. Once completely removed, the subject is eligible for study.
    - Dysplasia occurring in flat mucosa, sporadic adenomas containing dysplasia, and dysplasia-associated lesions or masses will be managed as follows:
    Any history or current evidence of high-grade dysplasia.
    Any history or current evidence of dysplasia occurring in flat mucosa. This includes histopathology reporting indefinite for dysplasia, low-grade dysplasia, and high-grade dysplasia.
    Any history or current evidence of a nonadenoma-like dysplasia-associated lesions or masses, with or without evidence of dysplasia.
    Any current sporadic adenoma containing dysplasia or any current adenoma-like dysplasia-associated lesions or masses that has not been
    removed. Once completely removed, the patient is eligible for the study.
    206 Stool positive for Clostridium difficile toxin at screening and other enteric pathogens including but not limited to ova, parasites, Campylobacter, salmonella, shigella, E coli 0157:H7, and Yersinia enterocolitica.
    207 History or evidence of suicidal ideation (severity of 4 or 5) or any suicidal behavior based on an assessment with the Columbia Suicide Severity Rating Scale (C-SSRS) at screening
    208 Active infection for which anti-infectives were indicated within 2 weeks prior to screening visit OR presence of serious infection, defined as requiring hospitalization or intravenous anti-infectives (IV) within 8 weeks prior to screening visit.
    209 Active tuberculosis or latent tuberculosis with no documented past history of adequate treatment per local standard of care.
    210 Positive test for TB during screening defined as: either a positive or indeterminate QuantiFERON®-TB or T-spot test OR positive purified protein derivative.
    - Subjects with a positive PPD and a history of Bacillus Calmette-Guerin vaccination are allowed to enroll with a negative QuantiFERON®-TB or T-Spot test and negative chest X-ray.
    - Indeterminate QuantiFERON®-TB or T-spot test can be repeated once, based on investigator judgment. Subjects can enroll if second result is negative. Subjects with persistent indeterminate or positive test results must proceed as below.
    - Subjects with a positive PPD test or a positive or indeterminate QuantiFERON®-TB or T-Spot test are allowed to enroll if they meet ALL the following criteria at screening:
    No symptoms per tuberculosis worksheet provided by Amgen
    Documented history of adequate TB treatment or prophylactic treatment for latent TB
    No known exposure to a case of active tuberculosis after most recent treatment/prophylaxis
    Chest X-ray with no new radiographic findings suggestive of active TB
    211 Any history of malignancy
    212 Presence of 1 or more significant concurrent medical conditions per the investigator judgement
    213 Positive for hepatitis B surface antigen (HBsAg); or positive for hepatitis B core antibody or hepatitis B surface antibody in the presence of detectable viral DNA in peripheral blood, assessed by polymerase chain reaction. Subjects positive for HBcAb and/or HBsAb without history of prior vaccination and without detectable serum hepatitis B viral DNA by PCR are allowed to enroll, provided the subject undergoes monitoring of serum hepatitis B viral DNA by PCR at every 2 months during the treatment period and up to 6 weeks after the end of treatment for the study. Subjects with a history of hepatitis B vaccination without history of hepatitis B infection are allowed to enroll.
    214 Positive for hepatitis C antibody in the presence of detectable viral RNA in peripheral blood, assessed by PCR. Subjects positive for HCAb without detectable viral RNA by PCR are allowed to enroll.
    215 Known history of Human Immunodeficiency Virus (HIV) or positive HIV test at screening.
    216 Inherited immunodeficiency syndrome.
    217 Required systemic corticosteroid use for any indication other than UC.
    218 Have had a bone marrow or solid organ transplantation.
    219 Have had extra-abdominal surgery without full recovery prior to screening.
    E.5 End points
    E.5.1Primary end point(s)
    Clinical remission at week 12
    E.5.1.1Timepoint(s) of evaluation of this end point
    Week 12
    E.5.2Secondary end point(s)
    Clinical response at week 12
    Endoscopic remission at week 12
    Symptomatic remission at week 12
    Combined endoscopic remission and histologic remission of the colon tissue at week 12
    Change from baseline in histological score at week 12 as measured by Geboes score
    Treatment-emergent adverse events
    E.5.2.1Timepoint(s) of evaluation of this end point
    Week 12
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E. trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial4
    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.8.4.1Number of sites anticipated in Member State concerned3
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA78
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Korea, Republic of
    United States
    E.8.7Trial 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
    End of long-term treatment (Long-term extension is additional 40 week +6 week follow-up)
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years4
    E.8.9.1In the Member State concerned months1
    E.8.9.1In the Member State concerned days21
    E.8.9.2In all countries concerned by the trial years4
    E.8.9.2In all countries concerned by the trial months3
    E.8.9.2In all countries concerned by the trial days28
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 214
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 106
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state7
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 158
    F.4.2.2In the whole clinical trial 320
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    6 week follow up
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2021-10-13
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2021-12-08
    P. End of Trial
    P.End of Trial StatusOngoing
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