A Study to Learn About the Safety of Vedolizumab and How Well it Works in Children and Teenagers With Active Chronic Pouchitis

Last updated: January 22, 2025
Sponsor: Takeda
Overall Status: Active - Recruiting

Phase

3

Condition

N/A

Treatment

Concomitant Antibiotic Therapy

Vedolizumab

Clinical Study ID

NCT06443502
Vedolizumab-3041
2023-504773-20
2023-504773-20-00
  • Ages 2-17
  • All Genders

Study Summary

When some people have their large bowel removed, a surgeon can make a "pouch" from part of the small bowel to connect it to the back passage (anus). Pouchitis is when the pouch becomes inflamed (swollen) or infected. The main aim of this study is to find out if vedolizumab improves pouchitis symptoms and pouch inflammation. Other aims include to find out if vedolizumab is well tolerated and if it causes any medical problems (adverse events or side effects) and to look for any changes in the well-being of participants during their treatment with vedolizumab.

This study consists of two parts: Part 1 includes the induction and maintenance periods, and Part 2 includes the continued maintenance period. Participants will receive up to 12 infusions of vedolizumab. In Part 1 of the study, first 3 infusions are in first 6 weeks (Day 1, Week 2 and Week 6). Participants who are getting benefit may continue with the treatment for up to 7.5 months (30 weeks) in the maintenance period for Part 1. After completing treatment with vedolizumab in Part 1, participants will visit their clinic for a health check at Week 34.

Participants who show clinical response at Week 34 will continue to Part 2, receiving vedolizumab every 8 weeks for an additional 40 weeks, starting at Week 38 and ending with the last dose being at Week 78. Final efficacy assessments, including a pouchoscopy will be performed at Week 82.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. The participant weighs >=10 kg at the time of screening and first dose.

  2. Has active chronic pouchitis, defined by a mPDAI score >=5 assessed using the 3-dayaverage of participant-reported clinical symptoms prior to the screening endoscopy (that is [ie] video pouchoscopy with biopsy) or bowel preparation for the endoscopyand a minimum mPDAI endoscopic subscore of 2 (outside the staple or suture line) andeither:

  • >=1 previous episodes of pouchitis within 1 year before the screening visit,with symptoms lasting for at least a total of 4 weeks, treated with >=2 weeksof antibiotic or other prescription therapy (ie, other antibiotics, probiotics,immunomodulators, or anti-tumor necrosis factor [TNFs] within 1 year beforescreening). Or

  • Have had an inadequate response with, or lost response to, or be intolerant toantibiotic therapy (ie, requiring maintenance antibiotic therapy taken for >=4weeks immediately before the baseline endoscopy visit or not able to receive orcontinue antibiotic treatment due to intolerance or other contraindication).

  1. The participant is aged 2 to 17 years, inclusive, at the time of screening and firstdose.

  2. The participant has a history of proctocolectomy and ileal pouch-anal anastomosis (IPAA) as treatment for ulcerative colitis (UC), Crohn's disease (CD), familialadenomatous polyposis (FAP), or other underlying conditions, such as Hirschsprung'sdisease, for which construction of a pouch was medically indicated, completed atleast 1 year before the screening visit.

Exclusion

Exclusion Criteria:

The exclusion criteria are divided into 3 categories: active chronic pouchitis exclusion criteria, infectious disease exclusion criteria, and general exclusion criteria.

Active Pouchitis Exclusion Criteria:

  1. Has symptoms believed to be predominantly due to irritable pouch syndrome.

  2. Has isolated cuffitis.

  3. Is found to have dysplasia at the screening endoscopy.

  4. Has mechanical complications of the pouch (for example [e.g.] pouch stricture orpouch fistula).

  5. Currently requires or has a planned surgical intervention during the study.

  6. Has a diverting stoma. Infectious Disease Exclusion Criteria:

  7. Has evidence of an active infection (e.g. sepsis, cytomegalovirus [CMV], orlisteriosis) during screening.

  8. Had a clinically significant infection (e.g. pneumonia, pyelonephritis, coronavirusdisease 2019 [COVID-19]) within 35 days before first dose of study drug.

  9. Has active or latent tuberculosis (TB), as evidenced by a diagnostic TB testperformed within 3 months of screening or during the screening period that ispositive, as defined by:

  • A positive QuantiFERON test or 2 successive indeterminate QuantiFERON tests, or

  • A TB skin test reaction >=5 millimeter (mm). NOTE: If participant have receivedBacillus Calmette-Guérin vaccine, then a QuantiFERON TB Gold test should beperformed instead of the TB skin test. NOTE: Participants with documented previously treated TB with a negative QuantiFERONtest can be included in the study.

  1. Has evidence of positive hepatitis B surface antigen (HBsAg) or hepatitis B coreantibody (HBcAb). Hepatitis B virus (HBV) immune participants (e.g. HBsAg negativeand hepatitis B antibody positive) may, however, be included. NOTE: If a participant tests negative for HBsAg, but positive for HBcAb, theparticipant would be considered eligible if the absence of HBV DNA is confirmed byHBV DNA polymerase chain reaction reflex testing performed in the centrallaboratory.

  2. Has chronic hepatitis C virus (HCV) (ie, positive HCV antibody [HCVAb] and HCVRibonucleic Acid [RNA]). NOTE: Participants who are HCVAb-positive without evidence of HCV RNA may beconsidered eligible (spontaneous viral clearance or previously treated and cured [defined as no evidence of HCV RNA at least 12 weeks before baseline]).

  3. Has any identified congenital or acquired immunodeficiency (e.g. common variableimmunodeficiency, HIV infection, organ transplantation).

  4. Has positive stool studies for ova and/or parasites or stool culture at screeningvisit.

  5. Has positive Clostridium difficile stool test at screening visit. General Exclusion Criteria:

  6. Is taking, has taken, or is required to take any excluded medications.

  7. Has active cerebral/meningeal disease, signs/symptoms, or history of progressivemultifocal leukoencephalopathy (PML) or any other major neurological disorders,including stroke, multiple sclerosis, brain tumor, or neurodegenerative disease.

  8. Has evidence of dysplasia or history of malignancy other than a successfully treatednonmetastatic cutaneous squamous cell or basal cell carcinoma or localized carcinomain situ of the cervix.

  9. Has any unstable or uncontrolled cardiovascular, pulmonary, hepatic, renal, GI,genitourinary, hematologic, coagulation, immunological, endocrine/metabolic,neurologic, or other medical disorder that, in the opinion of the investigator,would confound the study results or compromise participant safety.

Study Design

Total Participants: 30
Treatment Group(s): 2
Primary Treatment: Concomitant Antibiotic Therapy
Phase: 3
Study Start date:
November 19, 2024
Estimated Completion Date:
December 31, 2029

Study Description

The drug being tested in this study is called vedolizumab. This study will look at the efficacy, safety, tolerability, pharmacokinetics (PK), and immunogenicity of vedolizumab in pediatric participants with active chronic pouchitis.

The study will enroll approximately 30 participants. All the participants will be enrolled in a single treatment group to receive treatment with vedolizumab based on participant's weight mentioned as follows:

  • Participants with body weight greater than or equal to (>=) 30 kilogram (kg) will receive vedolizumab, high dose

  • Participants with body weight greater than (>) 15 to less than (<) 30 kg will receive vedolizumab, medium dose

  • Participants with body weight 10 to 15 kg will receive vedolizumab, low dose

All participants will receive vedolizumab intravenous infusion at Day 1, and at Weeks 2, 6, 14, 22, and 30. Participants will also receive concomitant antibiotic treatment (ciprofloxacin, metronidazole, or other antibiotics) from Day 1 through Week 2. Participants with clinical response at the end of Part 1 maintenance at Week 34 will continue to Part 2 of the study and will receive vedolizumab intravenous infusion every 8 weeks from Week 38 through Week 78.

This multi-center trial will be conducted globally. The maximum overall duration of the study is up to approximately 2 years. Participants will be followed up for 18 weeks after the last dose of the study drug for safety.

Connect with a study center

  • UZ Leuven

    Leuven, Vlaams Brabant 3000
    Belgium

    Site Not Available

  • Klinika Za Djecje Bolesti Zagreb

    Zagreb, Grad Zagreb 10000
    Croatia

    Active - Recruiting

  • Fakultni nemocnice v Motole

    Praha, 150 06
    Czechia

    Site Not Available

  • General Hospital of Diseases Thoracos of Athens "Sotiria"

    Athens, Attiki 115 27
    Greece

    Site Not Available

  • Shaare Zedek Medical Center

    Jerusalem, Yerushalayim 9103102
    Israel

    Site Not Available

  • Schneider Childrens Medical Center of Israel Petah Tikvah PIN

    Petach Tikvah, 4920235
    Israel

    Site Not Available

  • AOU dell'Universita degli Studi della Campania Luigi Vanvitelli - Piazza Luigi Miraglia, 2

    Napoli, Campania 80138
    Italy

    Site Not Available

  • IRCCS Materno Infantile Burlo Garofolo - INCIPIT - PIN

    Trieste, Friuli-Venezia Giulia 34137
    Italy

    Site Not Available

  • AOU Policlinico Umberto I-Viale Regina Elena, 324

    Roma, Lazio 00161
    Italy

    Site Not Available

  • IRCCS Ospedale Pediatrico Bambino Gesu - INCIPIT - PIN

    Roma, Lazio 00165
    Italy

    Site Not Available

  • Istituto G Gaslini Ospedale Pediatrico IRCCS - INCIPIT - PIN

    Genova, Liguria 16147
    Italy

    Site Not Available

  • Az Ospedaliera Universitaria Policlinico G Martino

    Messina, Sicilia 98124
    Italy

    Site Not Available

  • Instytut Pomnik Centrum Zdrowia Dziecka

    Warszawa, Mazowieckie 04-736
    Poland

    Site Not Available

  • Collegium Medicum Uniwersytetu Jagiellonskiego

    Krakow, 30-663
    Poland

    Site Not Available

  • Hospital Sant Joan de Deu - PIN

    Esplugues de Llobregat, Barcelona 08950
    Spain

    Site Not Available

  • Hospital Universitari i Politecnic La Fe de Valencia

    Valencia, 46026
    Spain

    Site Not Available

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