A Study of Vedolizumab in Children and Teenagers With Moderate to Severe Ulcerative Colitis (UC)

  • STATUS
    Recruiting
  • End date
    May 30, 2024
  • participants needed
    120
  • sponsor
    Takeda
Updated on 7 October 2022
corticosteroids
remission
methotrexate
endoscopy
adalimumab
infliximab
tumor necrosis factor
mercaptopurine
vedolizumab
azathioprine
tumor necrosis factor alpha
tumour necrosis
proctitis
immunomodulators
hematochezia
pancolitis

Summary

Vedolizumab is a medicine that helps to reduce inflammation and pain in the digestive system. In this study, children and teenagers with moderate to severe ulcerative colitis will be treated with vedolizumab.

The main aim of the study is to check if participants achieve remission after treatment with vedolizumab. Remission means symptoms improve or disappear and an endoscopy shows no or limited signs of disease.

Participants will receive 3 infusions of vedolizumab over 6 weeks. Then, those who have a clinical response will receive 1 of 3 doses of vedolizumab once every 8 weeks. They will receive the same dose every time.

Description

The drug being tested in this study is called vedolizumab. Vedolizumab is being tested to treat pediatric participants who have moderately to severely active UC. Participants to be enrolled must have failed response to, lost response to, or been intolerant to at least 1 of the current standard of care (SOC) induction and maintenance therapies for CD including exclusive and/or partial enteral nutrition therapy, immunomodulators (eg, azathioprine [AZA], 6-mercaptopurine [6-MP], methotrexate [MTX]), and tumor necrosis factor-alpha (TNF-α) antagonists.

The study will enroll approximately 120 patients.

During the Induction Period participants will receive 3 doses of vedolizumab IV infusion at Day 1, Week 2, and Week 6 based on their weight at Baseline:

  • Participants ≥30 kg, Vedolizumab 300 mg
  • Participants >15 to <30 kg, Vedolizumab 200 mg
  • Participants 10 to 15 kg, Vedolizumab 150 mg

At Week 14, participants who achieve clinical response will be randomly assigned (by chance, like flipping a coin) in a 1:1 ratio to 2 double-blind dose groups (high dose and low dose), stratified by previous exposure/failure to TNF-α antagonists therapy or naive to TNF-α antagonists therapy, and by weight group. Participants will receive vedolizumab IV infusions every 8 weeks (Q8W) up to Week 46 during the Maintenance Period as follows:

  • Participants ≥30 kg, Vedolizumab 300 mg (High dose)
  • Participants ≥30 kg, Vedolizumab 150 mg (Low dose)
  • Participants >15 to <30 kg, Vedolizumab 200 mg (High dose)
  • Participants >15 to <30 kg, Vedolizumab 100 mg (Low dose)
  • Participants 10 to 15 kg, Vedolizumab 150 mg (High dose)
  • Participants 10 to 15 kg, Vedolizumab 100 mg (Low dose)

The dose will remain blinded to the participant and study doctor during the study (unless there is an urgent medical need). All participants will be administered vedolizumab via IV infusion. In participants who demonstrate lack of maintenance of clinical response during the Maintenance Period the dose will be escalated in a blinded fashion based on the weight at the time of the worsening of disease. In addition one-time rescue therapy with corticosteroids is allowed.

This multi-center trial will be conducted worldwide. After the Week 54, participants may be eligible to participate in extension study. Participants who do not roll over in the extension study will undergo a safety visit 18 weeks after the last dose of vedolizumab followed by 2 years of long term follow-up (up to 104 weeks). During this period a safety survey by telephone will be performed every 6 months for 2 years after the last dose of study drug.

Details
Condition Colitis, Ulcerative
Treatment Vedolizumab
Clinical Study IdentifierNCT04779307
SponsorTakeda
Last Modified on7 October 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

Has moderately to severely active UC, unresponsive or intolerant to their current standard of care (SOC)
Weighs ≥10 kg at the time of screening and enrollment into the study
Has moderately to severely active UC diagnosed at least 1 month before screening, defined by a modified Mayo score of 5 to 9 (sum of Mayo endoscopic subscore, stool frequency subscore, and rectal bleeding subscore) with a Mayo endoscopic subscore of ≥2 (with the presence of mucosal friability excluding an endoscopic subscore 1 and mandating a score of at least 2)
Has failed, lost response to, or been intolerant to treatment with at least 1 of the following agents: corticosteroids (eg, azathioprine [AZA], 6-mercaptopurine [6-MP], methotrexate [MTX]), immunomodulators, and/or tumor necrosis factor alpha (TNF-α) antagonist therapy (eg, infliximab, adalimumab). This includes participants who are dependent on corticosteroids to control symptoms and who are experiencing worsening of disease in the moderate-to-severe range when attempting to wean off corticosteroids
Has evidence of UC extending proximal to the rectum (i.e., not limited to proctitis), at a minimum
Has extensive colitis or pancolitis of >8 years' duration or left-sided colitis of >12 years' duration must have documented evidence of a negative surveillance colonoscopy within 12 months before screening
Participants with vaccinations that are up-to-date based on the countrywide, accepted schedule of childhood vaccines

Exclusion Criteria

Has previous exposure to approved or investigational anti-integrins including, but not limited to natalizumab, efalizumab, etrolizumab, or Abrilumab (AMG 181), or mucosal addressin cell adhesion molecule-1 (MAdCAM-1) antagonists or rituximab
Has received an investigational biologic within 60 days or 5 half-lives before screening (whichever is longer); or an approved biologic or biosimilar agent within 2 weeks before the first dose of study drug or at any time during the screening period
Has active cerebral/meningeal disease, signs/symptoms or history of progressive multifocal leukoencephalopathy (PML) or any other major neurological disorders including stroke, multiple sclerosis, brain tumor or neurodegenerative disease
Has had clinically significant infection (eg, pneumonia, pyelonephritis, coronavirus disease 2019 [COVID-19]) within 30 days prior to first dose of study drug
Has received any live vaccinations within 30 days prior to first dose of study drug
Participants who currently require surgical intervention or are anticipated to require surgical intervention for UC during this study
Has had subtotal or total colectomy or have a jejunostomy, ileostomy, colostomy, ileo-anal pouch, or known fixed stenosis of the intestine
Participants with a current diagnosis of indeterminate colitis
Participants with clinical features suggesting monogenic very early onset inflammatory bowel disease
Participant with active or latent tuberculosis (TB), as evidenced by a diagnostic TB test performed within 30 days of screening or during the screening period that is positive, defined as
Positive QuantiFERON test or 2 successive indeterminate QuantiFERON tests, OR
A TB skin test reaction ≥5 mm. NOTE: If participants have received Bacillus Calmette-Guérin vaccine then a QuantiFERON TB Gold test should be performed instead of the TB skin test
Has chronic hepatitis B virus (HBV) infection or chronic hepatitis C virus infection
HBV immune participants (ie, being hepatitis B surface antigen negative and hepatitis B antibody positive) may be included, however
Has positive stool studies for ova and/or parasites or stool culture at screening visit
The participant has evidence of dysplasia or history of malignancy other than a
Has positive Clostridium difficile stool test at screening visit
successfully treated nonmetastatic cutaneous squamous cell or basal cell
carcinoma or localized carcinoma in situ of the cervix
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