E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Crohn’s Disease After Surgical Resection
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E.1.1.1 | Medical condition in easily understood language |
Inflammatory bowel disease (IBD) |
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E.1.1.2 | Therapeutic area | Diseases [C] - Immune System Diseases [C20] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10011401 |
E.1.2 | Term | Crohn's disease |
E.1.2 | System Organ Class | 10017947 - Gastrointestinal disorders |
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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 efficacy of guselkumab treatment versus placebo in preventing endoscopic recurrence of CD in participants after surgery
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E.2.2 | Secondary objectives of the trial |
- To evaluate clinical remission without disease recurrence in participants treated with guselkumab versus placebo after surgery - To evaluate disease recurrence in participants treated with guselkumab versus placebo after surgery - To evaluate symptoms such as stool frequency and abdominal pain scores in guselkumab versus placebo after surgery - To evaluate the safety of guselkumab in participants with CD in the postoperative period - The evaluate the efficacy of guselkumab in limiting steroid use and preventing clinical recurrence of patients in clinical remission
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Participants ≥18 (or the legal age of consent in the jurisdiction in which the study is taking place). 2. Have a documented diagnosis of CD confirmed by endoscopic, histologic, and/or radiologic studies prior to resection or by tissue obtained at resection. 3. Have undergone an ileocolonic surgical resection (ie, an intestinal resection with an ileocolonic anastomosis) for CD with the following criteria: - Have no known active CD anywhere in the gastrointestinal (GI) tract, including the findings at surgery, - Be able to undergo randomization no later than 49 days after surgery, and at least 10 days after surgery (or 8 days after resumption of bowel activity, eg, in case of postoperative ileus), - Ileocolonic resection was not for the purpose of removing known dysplasia, - If ileocolonic resection occurs > 10 years since the diagnosis of CD and only fibrostenotic stricturing is present, then length of stricture must be > 10 cm 4. Have a baseline CDAI < 200.
Please refer to protocol for the complete list of inclusion criteria.
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E.4 | Principal exclusion criteria |
1. Has complications of CD, such as symptomatic strictures or stenoses, short bowel syndrome, a draining (ie, functioning) stoma or ostomy, or any other manifestation, that might be anticipated to require surgery, could preclude the use of the CDAI to assess response to therapy, or would possibly confound the ability to assess the effect of treatment with guselkumab. 2. Currently has or is suspected to have an abscess. Recent cutaneous and perianal abscesses are not exclusionary if drained and adequately treated at least 3 weeks before baseline, or 8 weeks before baseline for intra-abdominal abscesses, provided that there is no anticipated need for any further surgery. 3. Have had any active perianal disease within 3 months of screening (except skin tags) or have had any draining fistula within 3 months of screening unless the fistula was removed at the index surgery. 4. Had, in association with their most recent intra-abdominal surgery, postoperative complications such as, but not limited to, postoperative intraabdominal abscess, wound dehiscence, anastomotic leak, the need for a second operation, or have evidence of macroscopically active CD which was not resected at the time of surgery or had active CD in regions beyond the site of surgery in the GI tract within 1 year of the time of enrolment.
7. Has or has had any other clinically significant infection (eg, hepatitis, sepsis, pneumonia, or pyelonephritis, enteric infection), within 8 weeks before the first dose of study intervention. Treated and resolved infections, not considered clinically significant at the discretion of the investigator need not be exclusionary (ie, acute upper respiratory tract infection, uncomplicated urinary tract infection, and clinically resolved infections related to the participant’s Crohn’s-related surgical resection).
Please refer to protocol for the complete list of exclusion criteria.
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E.5 End points |
E.5.1 | Primary end point(s) |
Endoscopic Recurrence as defined by a modified Rutgeerts score of i2a or greater |
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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) |
- Clinical remission without disease recurrence at Week 48 - Time-to-disease recurrence at the main study database lock - Abdominal pain free at Week 48 - Time-to-recurrence of symptoms - Frequency and type of AEs and serious adverse events - Steroid free clinical remission at Week 48
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Week 48 or as otherwise noted |
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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 | 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 | 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 | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 88 |
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 |
Canada |
Korea, Republic of |
United States |
Austria |
France |
Poland |
Netherlands |
Spain |
Czechia |
Germany |
Italy |
Belgium |
Hungary |
United Kingdom |
Serbia |
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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 | 2 |
E.8.9.1 | In the Member State concerned months | 11 |
E.8.9.1 | In the Member State concerned days | 15 |
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 | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |