A Study of Vedolizumab Intravenous (IV) and Adalimumab or Vedolizumab and Ustekinumab in Adults With Crohn's Disease

Last updated: March 17, 2026
Sponsor: Takeda
Overall Status: Active - Recruiting

Phase

4

Condition

Crohn's Disease

Ulcerative Colitis

Inflammatory Bowel Disease

Treatment

Adalimumab

Vedolizumab

Ustekinumab

Clinical Study ID

NCT06045754
Vedolizumab-4051
EXPLORER 2.0
MACS-2022-120102
  • Ages 18-70
  • All Genders

Study Summary

The main aim of this study is to learn about the effect of treatment with vedolizumab IV (vedolizumab) together with adalimumab or vedolizumab (VDZ) together with ustekinumab (UST) in adults with moderate to severe Crohn's Disease, and the effect of treatment with vedolizumab alone, after the dual targeted treatment.

The study is conducted in two parts. In Part A, participants will receive the dual targeted treatment (vedolizumab together with either adalimumab or ustekinumab). In part B, participants will receive vedolizumab only. Part B will include participants who responded to the treatment in Part A.

Each participant will be followed up for at least 26 weeks after the last dose of treatment.

Eligibility Criteria

Inclusion

Inclusion Criteria:

Part A:

  1. Has a confirmed diagnosis of CD at least 3 months before screening, based onendoscopy results.

  2. Has moderately to severely active CD at Screening, defined as an SES-CD >=6 (>=4 ifisolated ileal disease).

  3. Has demonstrated at least 1 of the following (a, b, or c) to at least 1 ILantagonist or at least 1 tumor necrosis factor (TNF) antagonist, at doses approvedfor the treatment of CD:

  4. Inadequate response after completing the full induction regimen;

  5. Loss of response (recurrence of symptoms during scheduled maintenance dosingafter prior clinical benefit); or

  6. Intolerance (a significant adverse event that precluded further use, includingbut not limited to serious infection including opportunistic infections,malignancy, infusion-related and hypersensitivity reactions includinganaphylaxis, and liver injury). Note: Participants with an inadequate response to >2 classes of advanced therapiesor >1 agent in the same class are not eligible. Participants who discontinued athird class of advanced therapy for reasons other than inadequate response may beeligible after discussion with the Medical Monitor. Part B:

  7. In the investigator's opinion, the participant exhibits a therapeutic benefit atWeek 26.

Exclusion

Exclusion Criteria:

  1. CDAI score > 450.

  2. A current diagnosis of ulcerative colitis or indeterminate colitis.

  3. Clinical evidence of an abdominal abscess.

  4. Known fistula (other than perianal fistula) or phlegmon.

  5. Known perianal fistula with abscess.

  6. Ileostomy, colostomy, or severe, or symptomatic stenosis of the intestine.

  7. Previous extensive bowel resection with 2 entire segments missing, of the following:terminal ileum, right colon, transverse colon, sigmoid and left colon, and rectum.

  8. Short bowel syndrome.

  9. Any planned surgical intervention for CD, except for seton placement for perianalfistula without abscess.

  10. History or evidence of adenomatous colonic polyps that have not been removed.

  11. History or evidence of colonic mucosal dysplasia.

  12. Intolerance or contraindication to ileocolonoscopy.

  13. Any identified congenital or acquired immunodeficiency (eg, common variableimmunodeficiency infection).

  14. Active or latent tuberculosis (TB), regardless of treatment history.

  15. A positive test for hepatitis B virus (HBV) as defined by the presence of hepatitisB surface antigen (HBsAg) or hepatitis B core antibody (HBcAb) test.

  16. A positive test for hepatitis C virus (HCV), as defined by a positive hepatitis Cvirus antibody (HCVAb) test and detectable HCV ribonucleic acid (RNA).

  17. Received approved or investigational anti-integrin antibodies (i.e., vedolizumab,natalizumab, efalizumab, etrolizumab, abrilumab [AMG 181], anti- mucosal addressincell adhesion molecule-1 [MAdCAM-1] antibodies, or rituximab) for the treatment ofCD.

  18. History of or symptoms of progressive multifocal leukoencephalopathy (PML) in theinvestigator's opinion. If a participant has symptoms consistent with PML, a PMLchecklist must be completed and submitted to the PML independent adjudicationcommittee. If the PML IAC deems the participant to have PML, the participant isineligible.

Study Design

Total Participants: 100
Treatment Group(s): 3
Primary Treatment: Adalimumab
Phase: 4
Study Start date:
April 18, 2024
Estimated Completion Date:
June 28, 2027

Study Description

The drug being tested in this study is vedolizumab. Vedolizumab is being tested to treat people with moderate to severe Crohn's disease who have experienced inadequate response, loss of response or intolerance to either one prior interleukin [IL] antagonist, and no other biologic/small molecule (Group A); one IL antagonist and either one Janus kinase inhibitor (JAKi) or one TNFi (other than adalimumab) [Group B] (Cohort 1) or one prior tumor necrosis factor inhibitor [TNFi] and no other biologic/small molecule (Group C); one TNFi and either 1 JAKi or one IL antagonist (other than UST) (Group D) (Cohort 2). The study will look at the efficacy and safety of dual targeted therapy.

The study will enroll approximately 100 participants. Participants will be assigned to one of the two treatment groups in Part A:

  • Part A, Cohort 1: Vedolizumab + Adalimumab

  • Part A, Cohort 2: Vedolizumab + Ustekinumab

All participants who achieve therapeutic benefit in Part A will receive vedolizumab IV 300 mg monotherapy from Week 30 until Week 46 in Part B. Participants will be followed for a further 20-week safety follow-up period to Week 72 (or 26 weeks post-last dose of study drug).

This multi-center trial will be conducted in the United States and Canada. The overall time to participate in this study is approximately 76 weeks.

Connect with a study center

  • Covenant Health

    Edmonton, Alberta T5K 2K4
    Canada

    Active - Recruiting

  • Covenant Health

    Edmonton 5946768, Alberta 5883102 T5K 2K4
    Canada

    Site Not Available

  • London Health Sciences Centre

    London, Ontario N6A 5A5
    Canada

    Active - Recruiting

  • West GTA Endoscopy Inc.

    Mississauga, Ontario L5M 7N4
    Canada

    Active - Recruiting

  • Viable Clinical Research - North Bay

    North Bay, Ontario P1B 2H3
    Canada

    Active - Recruiting

  • Toronto Immune and Digestive Health Institute Inc. (TIDHI)

    North York, Ontario M6A3B4
    Canada

    Active - Recruiting

  • ABP Research Services Corp.

    Oakville, Ontario L6L 5L7
    Canada

    Active - Recruiting

  • Taunton Surgical Centre

    Oshawa, Ontario L1J 0C7
    Canada

    Site Not Available

  • Toronto Digestive Disease Associates (TDDA) Inc.

    Vaughan, Ontario L4L 4Y7
    Canada

    Active - Recruiting

  • Toronto Digestive Disease Associates (TDDA) Specialty Research

    Vaughan, Ontario L4L 4Y7
    Canada

    Site Not Available

  • London Health Sciences Centre

    London 6058560, Ontario 6093943 N6A 5A5
    Canada

    Site Not Available

  • West GTA Endoscopy Inc.

    Mississauga 6075357, Ontario 6093943 L5M 7N4
    Canada

    Site Not Available

  • Viable Clinical Research - North Bay

    North Bay 6089426, Ontario 6093943 P1B 2H3
    Canada

    Site Not Available

  • ABP Research Services Corp.

    Oakville 6092122, Ontario 6093943 L6L 5L7
    Canada

    Site Not Available

  • Taunton Surgical Centre

    Oshawa 6094578, Ontario 6093943 L1J 0C7
    Canada

    Site Not Available

  • Toronto Digestive Disease Associates (TDDA) Inc.

    Vaughan 6173577, Ontario 6093943 L4L 4Y7
    Canada

    Site Not Available

  • Toronto Digestive Disease Associates (TDDA) Specialty Research

    Vaughan 6173577, Ontario 6093943 L4L 4Y7
    Canada

    Active - Recruiting

  • McGill University Health Centre Montreal General Hospital

    Montreal, Quebec H3G 1A4
    Canada

    Site Not Available

  • The Research Institute of the McGill University Health Centre

    Montreal, Quebec H3G 1A4
    Canada

    Active - Recruiting

  • McGill University Health Centre Montreal General Hospital

    Montreal 6077243, Quebec 6115047 H3G 1A4
    Canada

    Site Not Available

  • The Research Institute of the McGill University Health Centre

    Montreal 6077243, Quebec 6115047 H3G 1A4
    Canada

    Site Not Available

  • Digestive Health Specialsits

    Dothan, Alabama 36301
    United States

    Active - Recruiting

  • Digestive Health Specialsits

    Dothan 4059102, Alabama 4829764 36301
    United States

    Site Not Available

  • GI Alliance Sun City

    Sun City, Arizona 85351
    United States

    Active - Recruiting

  • GI Alliance Sun City

    Sun City 5316201, Arizona 5551752 85351
    United States

    Site Not Available

  • University of California San Diego Health (UCSD)

    La Jolla, California 92037
    United States

    Active - Recruiting

  • Cedars-Sinai Medical Center

    Los Angeles, California 90048
    United States

    Active - Recruiting

  • Hoag Hospital Newport Beach

    Newport Beach, California 92663
    United States

    Active - Recruiting

  • University of California San Diego Health (UCSD)

    La Jolla 5363943, California 5332921 92037
    United States

    Site Not Available

  • Cedars-Sinai Medical Center

    Los Angeles 5368361, California 5332921 90048
    United States

    Site Not Available

  • Hoag Hospital Newport Beach

    Newport Beach 5376890, California 5332921 92663
    United States

    Site Not Available

  • Medical Research Center of Connecticut, LLC

    Hamden, Connecticut 06518
    United States

    Active - Recruiting

  • Medical Research Center of Connecticut, LLC

    Hamden 4835654, Connecticut 4831725 06518
    United States

    Site Not Available

  • Clinical Research of Osceola

    Kissimmee, Florida 34741
    United States

    Active - Recruiting

  • Endoscopic Research Inc

    Orlando, Florida 32803
    United States

    Active - Recruiting

  • Alliance Clinical Research of Tampa, LLC

    Tampa, Florida 33615
    United States

    Active - Recruiting

  • University of South Florida

    Tampa, Florida 33612
    United States

    Site Not Available

  • Clinical Research of Osceola

    Kissimmee 4160983, Florida 4155751 34741
    United States

    Site Not Available

  • Endoscopic Research Inc

    Orlando 4167147, Florida 4155751 32803
    United States

    Site Not Available

  • Alliance Clinical Research of Tampa, LLC

    Tampa 4174757, Florida 4155751 33615
    United States

    Active - Recruiting

  • University of South Florida

    Tampa 4174757, Florida 4155751 33612
    United States

    Site Not Available

  • Gastroenterology Consultants, P.C.

    Roswell, Georgia 30076
    United States

    Active - Recruiting

  • Gastroenterology Consultants, P.C.

    Roswell 4219934, Georgia 4197000 30076
    United States

    Site Not Available

  • University of Chicago Medicine

    Chicago, Illinois 60637
    United States

    Active - Recruiting

  • GI Alliance - Illinois Gastroenterology Group - Glenview

    Glenview, Illinois 60026
    United States

    Active - Recruiting

  • GI Alliance - Illinois Gastroenterology Group LLC - Gurnee

    Gurnee, Illinois 60031
    United States

    Active - Recruiting

  • University of Chicago Medicine

    Chicago 4887398, Illinois 4896861 60637
    United States

    Site Not Available

  • GI Alliance - Illinois Gastroenterology Group - Glenview

    Glenview 4893886, Illinois 4896861 60026
    United States

    Site Not Available

  • GI Alliance - Illinois Gastroenterology Group LLC - Gurnee

    Gurnee 4894861, Illinois 4896861 60031
    United States

    Site Not Available

  • University of Kansas Medical Center

    Kansas City, Kansas 66160
    United States

    Active - Recruiting

  • Cotton ONeil Clinical Research Center

    Topeka, Kansas 66606
    United States

    Active - Recruiting

  • University of Kansas Medical Center

    Kansas City 4273837, Kansas 4273857 66160
    United States

    Site Not Available

  • Cotton ONeil Clinical Research Center

    Topeka 4280539, Kansas 4273857 66606
    United States

    Site Not Available

  • University of Louisville

    Louisville, Kentucky 40202
    United States

    Active - Recruiting

  • University of Louisville

    Louisville 4299276, Kentucky 6254925 40202
    United States

    Site Not Available

  • GI Alliance

    Metairie, Louisiana 70006
    United States

    Active - Recruiting

  • Tulane University

    New Orleans, Louisiana 70112
    United States

    Active - Recruiting

  • GI Alliance

    Metairie 4333177, Louisiana 4331987 70006
    United States

    Site Not Available

  • Tulane University

    New Orleans 4335045, Louisiana 4331987 70112
    United States

    Site Not Available

  • Capital Digestive Care - MGG Group - Chevy Chase Clinical Research

    Chevy Chase, Maryland 20815
    United States

    Site Not Available

  • Clinical Research Institute of Michigan, LLC

    Clinton Township, Michigan 48038
    United States

    Site Not Available

  • Huron Gastroenterology Associates, P.C.

    Ypsilanti, Michigan 48197
    United States

    Active - Recruiting

  • Huron Gastroenterology Associates, P.C.

    Ypsilanti 5015688, Michigan 5001836 48197
    United States

    Site Not Available

  • Mid-America Gastro-Intestinal Consultants

    Kansas City, Missouri 64111
    United States

    Active - Recruiting

  • BVL Clinical Research

    Liberty, Missouri 64068
    United States

    Active - Recruiting

  • Washington University School of Medicine

    Saint Louis, Missouri 63110
    United States

    Site Not Available

  • Washington University School of Medicine

    St Louis, Missouri 63110
    United States

    Active - Recruiting

  • Mid-America Gastro-Intestinal Consultants

    Kansas City 4393217, Missouri 4398678 64111
    United States

    Site Not Available

  • BVL Clinical Research

    Liberty 4395052, Missouri 4398678 64068
    United States

    Site Not Available

  • Washington University School of Medicine

    St Louis 4407066, Missouri 4398678 63110
    United States

    Site Not Available

  • Inflammatory Bowel Disease Center at NYU Langone

    New York, New York 10016
    United States

    Site Not Available

  • NYU Langone Health

    New York, New York 10016
    United States

    Active - Recruiting

  • NYU Langone Health

    New York 5128581, New York 5128638 10016
    United States

    Site Not Available

  • Wake Research Associates, LLC

    Raleigh, North Carolina 27612
    United States

    Site Not Available

  • University of Cincinnati

    Cincinnati, Ohio 45627
    United States

    Active - Recruiting

  • Ohio Gastroenterology group, Inc.

    Columbus, Ohio 43202
    United States

    Active - Recruiting

  • Great Lakes Gastroenterology Research, LLC

    Mentor, Ohio 44060
    United States

    Active - Recruiting

  • Gastro Intestinal Research Institute of Northern Ohio, LLC.

    Westlake, Ohio 44145
    United States

    Active - Recruiting

  • University of Cincinnati

    Cincinnati 4508722, Ohio 5165418 45627
    United States

    Site Not Available

  • Ohio Gastroenterology group, Inc.

    Columbus 4509177, Ohio 5165418 43202
    United States

    Site Not Available

  • Great Lakes Gastroenterology Research, LLC

    Mentor 5162645, Ohio 5165418 44060
    United States

    Site Not Available

  • Gastro Intestinal Research Institute of Northern Ohio, LLC.

    Westlake 5176517, Ohio 5165418 44145
    United States

    Site Not Available

  • Digestive Disease Specialists, Inc.

    Oklahoma City, Oklahoma 73114
    United States

    Active - Recruiting

  • Hightower Clinical - SSM Health

    Oklahoma City, Oklahoma 73102
    United States

    Active - Recruiting

  • Digestive Disease Specialists, Inc.

    Oklahoma City 4544349, Oklahoma 4544379 73114
    United States

    Site Not Available

  • Thomas Jefferson University Hospital

    Philadelphia, Pennsylvania 19107
    United States

    Site Not Available

  • Allegheny Health Network

    Wexford, Pennsylvania 15090
    United States

    Active - Recruiting

  • Thomas Jefferson University Hospital

    Philadelphia 4560349, Pennsylvania 6254927 19107
    United States

    Site Not Available

  • Allegheny Health Network

    Wexford 5219062, Pennsylvania 6254927 15090
    United States

    Site Not Available

  • University Gastroenterology

    Providence, Rhode Island 02905
    United States

    Active - Recruiting

  • University Gastroenterology

    Providence 5224151, Rhode Island 5224323 02905
    United States

    Site Not Available

  • Rapid City Medical Center, LLP

    Rapid City, South Dakota 57701
    United States

    Active - Recruiting

  • Rapid City Medical Center, LLP

    Rapid City 5768233, South Dakota 5769223 57701
    United States

    Site Not Available

  • Texas Digestive Disease Consultants Cedar Park

    Cedar Park, Texas 78613
    United States

    Active - Recruiting

  • GI Alliance - Digestive Health Associates of Texas

    Dallas, Texas 75044
    United States

    Active - Recruiting

  • The University of Texas Health Science Center at Houston

    Houston, Texas 77030
    United States

    Active - Recruiting

  • Texas Digestive Disease Consultants Lubbock

    Lubbock, Texas 79410
    United States

    Active - Recruiting

  • GI Alliance - Mansfield

    Mansfield, Texas 76063
    United States

    Active - Recruiting

  • Gastroenterology Research of San Antonio, LLC

    San Antonio, Texas 78229
    United States

    Active - Recruiting

  • Southern Star Research Institute, LLC.

    San Antonio, Texas 78229
    United States

    Active - Recruiting

  • Texas Digestive Disease Consultants (TDDC), Southlake

    Southlake, Texas 76092
    United States

    Active - Recruiting

  • Tyler Research Institute, LLC

    Tyler, Texas 75701
    United States

    Active - Recruiting

  • GI Alliance - Webster

    Webster, Texas 77598
    United States

    Active - Recruiting

  • Texas Digestive Disease Consultants Cedar Park

    Cedar Park 4679867, Texas 4736286 78613
    United States

    Site Not Available

  • GI Alliance - Digestive Health Associates of Texas

    Dallas 4684888, Texas 4736286 75044
    United States

    Site Not Available

  • The University of Texas Health Science Center at Houston

    Houston 4699066, Texas 4736286 77030
    United States

    Site Not Available

  • Texas Digestive Disease Consultants Lubbock

    Lubbock 5525577, Texas 4736286 79410
    United States

    Site Not Available

  • GI Alliance - Mansfield

    Mansfield 4709013, Texas 4736286 76063
    United States

    Site Not Available

  • Gastroenterology Research of San Antonio, LLC

    San Antonio 4726206, Texas 4736286 78229
    United States

    Active - Recruiting

  • Southern Star Research Institute, LLC.

    San Antonio 4726206, Texas 4736286 78229
    United States

    Site Not Available

  • Texas Digestive Disease Consultants (TDDC), Southlake

    Southlake 4733313, Texas 4736286 76092
    United States

    Site Not Available

  • Tyler Research Institute, LLC

    Tyler 4738214, Texas 4736286 75701
    United States

    Site Not Available

  • GI Alliance - Webster

    Webster 4740423, Texas 4736286 77598
    United States

    Site Not Available

  • University of Utah Health

    Salt Lake City, Utah 84108
    United States

    Active - Recruiting

  • University of Utah Health

    Salt Lake City 5780993, Utah 5549030 84108
    United States

    Site Not Available

  • Washington Gastroenterology- GIA

    Bellevue, Washington 98004
    United States

    Site Not Available

  • Virginia Mason Medical Center

    Seattle, Washington 98101-2756
    United States

    Site Not Available

  • Washington Gastroenterology- GIA

    Tacoma, Washington 98405
    United States

    Active - Recruiting

  • Washington Gastroenterology- GIA

    Bellevue 5786882, Washington 5815135 98004
    United States

    Site Not Available

  • Washington Gastroenterology- GIA

    Tacoma 5812944, Washington 5815135 98405
    United States

    Site Not Available

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