Long-term Safety With Vedolizumab Intravenous (IV) in Pediatric Participants With Ulcerative Colitis (UC) or Crohn's Disease (CD)

Ulcerative Colitis Clinical Trial

Official title:

A Phase 2b, Extension Study to Determine the Long-term Safety of Vedolizumab IV in Pediatric Subjects With Ulcerative Colitis or Crohn's Disease

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT03196427
• Other study ID #: Vedolizumab-2005
• Secondary ID: 2017-002182-21U1
• Status: Active, not recruiting
• Phase: Phase 2
• Start date: July 30, 2018
• Est. completion date: November 24, 2025

Study information

• Verified date: May 2024
• Source: Takeda
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The purpose of this study is to determine the safety profile of long-term vedolizumab IV treatment in pediatric participants with UC or CD.

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 or CD.

This study will look at the long-term safety profile in participants who take vedolizumab IV. Participants will continue receiving the same dose assigned from the parent study MLN0002-2003 [NCT03138655], which will remain blinded until week 40.

The dosing regimen selected for the long-term study is intended to maintain clinical response at the lowest possible exposure.

At the discretion of the investigator, participants receiving the low dose (150 or 100 milligram [mg]) of vedolizumab IV may be escalated to the high dose (300 or 200 mg) if the participants demonstrate disease worsening at 2 consecutive visits (scheduled or unscheduled).

Participants who experience continued disease worsening during the study despite being administered vedolizumab 300 or 200 mg every 8 weeks (Q8W) will be discontinued from the study.

Study duration will be until vedolizumab IV is commercially available for pediatric indication(s) in the participant's country or until other drug access programs become available (whichever comes first), the participant turns 18 years of age and can be transitioned to commercial drug, the participant withdraws from the study, or the sponsor decides to close the study (up to approximately 8 years).

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 59
• Est. completion date: November 24, 2025
• Est. primary completion date: May 26, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 2 Years to 17 Years

Eligibility

Inclusion Criteria:

1. Is male or female with UC or CD and was between 2 to 17 years, inclusive, at the time of randomization for Study MLN0002-2003.

(Note: A participant remains eligible to participate in this study after they reach 18 years of age if they continue to meet the inclusion criteria and do not meet any exclusion criteria.)

2. Has completed Study MLN0002-2003 and, at Week 22, achieved clinical response as defined by a reduction of partial Mayo score of >=2 points and >=25% from Baseline, or a reduction of the Paediatric Ulcerative Colitis Activity Index (PUCAI) of >=20 points from baseline for participants with UC; or a reduction of the CDAI as defined by a >=70-point decrease from Baseline or a decrease of Pediatric Crohn's Disease Activity Index (PCDAI) of >=15 points for participants with CD.

3. May be receiving a therapeutic dose of the following drugs:

• Oral 5-aminosalicylic acid (5-ASA) compounds.

• Oral corticosteroid therapy (prednisone or equivalent steroid at a dose less than or equal to [<=] 50 milligram per day [mg/day]) provided the participant was receiving this medication during prior participation in MLN0002-2003.

• Topical (rectal) treatment with 5-ASA or corticosteroids.

• Probiotics (example, Saccharomyces boulardii).

• Antidiarrheals (example, loperamide, diphenoxylate with atropine) for control of chronic diarrhea.

• Antibiotics used for the treatment of CD (i.e., ciprofloxacin, metronidazole).

• Azathioprine (AZA) or 6-mercaptopurine (6-MP) or methotrexate (MTX), provided the participant was receiving this medication during prior participation in MLN0002-2003.

4. The participant's vaccinations are up to date as per inclusion criteria number 10 in MLN0002-2003.

Exclusion Criteria:

1. Is female and is lactating or pregnant.

2. Has hypersensitivity or allergies to vedolizumab or any of its excipients.

3. Has withdrawn from Study MLN0002-2003.

4. Has developed any new unstable or uncontrolled cardiovascular, heart failure moderate to severe (New York Class Association III or IV), pulmonary, hepatic, renal, gastrointestinal (GI), genitourinary, hematological, coagulation, immunological, endocrine/metabolic, neurological, or other medical disorder that, in the opinion of the investigator, would confound the study results or compromise participant safety.

5. Has a positive progressive multifocal leukoencephalopathy (PML) subjective symptom checklist prior to the administration of the first dose of study drug.

6. Currently requires major surgical intervention for UC or CD (example, bowel resection), or is anticipated to require major surgical intervention for UC or CD during the study.

7. Has other serious comorbidities that will limit his or her ability to complete the study.

Related Conditions & MeSH terms

• Colitis
• Colitis, Ulcerative
• Crohn Disease
• Crohn's Disease
• Ulcer
• Ulcerative Colitis

Intervention

Drug:
• Vedolizumab
Vedolizumab intravenous infusion

Locations

Country	Name	City	State
Belgium	Hopital Universitaire des Enfants Reine Fabiola	Bruxelles	Brussels
Belgium	Universitair Ziekenhuis Leuven - Campus Gasthuisberg	Leuven	Flemish Brabant
France	Hopital Necker-Enfants Malades - Service de Gastroenterologie-Hepatologie-Nutrition Pediatriques	Paris Cedex 15	Ile-de-france
Hungary	Debreceni Egyetem Klinikai Kozpont	Debrecen	Hajdu-bihar
Hungary	BAZ Megyei Korhaz es Egyetemi Oktatokorhaz	Miskolc	Borsod-abauj-zemplen
Hungary	Szegedi Tudomanyegyetem Szent-Gyorgyi Albert Klinikai Kozpont	Szeged	Csongrad
Israel	Carmel Medical Center	Haifa
Israel	Shaare Zedek Medical Center	Jerusalem
Israel	Schneider Children's Medical Center of Israel	Petach Tiqwa
Israel	The Edmond and Lily Safra Children's Hospital - Sheba Medical Center	Ramat Gan	Tel Aviv
Israel	Tel Aviv Sourasky Medical Center - Dept. of Gastroenterology and Hepatology	Tel Aviv
Israel	Assaf Harofeh Medical Center	Zerifin
Poland	Uniwersytecki Szpital Dzieciecy w Krakowie	Krakow	Malopolskie
Poland	Centralny Szpital Kliniczny Uniwersytetu Medycznego w Lodzi Osrodek Pediatryczny im Marii Konopnicki	Lodz	Lodzkie
Poland	Gabinet Lekarski Dr. Hab. N. Med. Bartosz Korczowski	Rzeszow	Podkarpackie
Ukraine	Kharkiv Regional Clinical Children's Hospital	Kharkiv
United Kingdom	Barts and The London NHS Trust - Children's Clinical Research Facility	London	Englan
United States	Children's Center for Digestive Healthcare	Atlanta	Georgia
United States	Medical Universtiry of South Carolina	Charleston	South Carolina
United States	Connecticut Children's Medical Center	Hartford	Connecticut
United States	Texas Children's Hospital	Houston	Texas
United States	Nemours Childrens Specialty Care - Jacksonville	Jacksonville	Florida
United States	Cedars-Sinai Medical Center	Los Angeles	California
United States	Columbia University Medical Center	New York	New York
United States	Children's Hospital of Orange County	Orange	California
United States	University of California San Francisco	San Francisco	California
United States	Seattle Children's Hospital	Seattle	Washington

Sponsors (2)

Lead Sponsor	Collaborator
Takeda	Takeda Development Center Americas, Inc.

Countries where clinical trial is conducted

United States,  Belgium,  France,  Hungary,  Israel,  Poland,  Ukraine,  United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Percentage of Participants with Treatment-emergent Adverse Events (TEAEs)	An adverse event (AE) is defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (example, a clinically significant abnormal laboratory finding), symptom, or disease temporally associated with the use of a drug, whether or not it is considered related to the drug. A TEAE is defined as an adverse event with an onset that occurs after receiving study drug.	Baseline up to approximately 8 years
Secondary	Percentage of Participants With UC Meeting Clinical Response Based on Complete Mayo Score at Week 32	Clinical response is defined as a continued reduction in complete mayo score of >=3 points from baseline (at initiation of MLN0002-2003) and continued decrease in rectal bleeding subscore of >=1 point from baseline, or absolute rectal bleeding subscore of <=1 point. Mayo score is an instrument designed to measure disease activity of UC. It consists of 4 subscores: stool frequency, rectal bleeding, findings on endoscopy and physician rating of disease activity, each graded from 0 to 3 with higher scores indicating more severe disease. These scores are summed to give a total score range of 0 to 12; where higher scores indicate more severe disease.	Week 32
Secondary	Percentage of Participants With CD Meeting Clinical Response Based on 50 Percent (%) Reduction in Simple Endoscopic Score for Crohn's Disease (SES-CD) Score at Week 32	Clinical response is defined as a 50% reduction in SES-CD score on endoscopy compared to the baseline endoscopy (at initiation of MLN0002-2003) and continued reduction in CDAI that is a >=70 point decrease from the baseline Crohn's Disease Activity Index (CDAI) score at the initiation of MLN0002-2003. CDAI is a research tool used to quantify the symptoms of participants with Crohn's disease. SES-CD consists of 3 variables: ulcer size, ulcerated and affected surfaces and presence of narrowing each graded from 0 to 3 with score of 0 means no colonic lesions or mucosal healing, and SES-CD greater than (>) 1 indicates the presence of mucosal lesions.	Week 32
Secondary	Time to Major Inflammatory Bowel Disease (IBD) - Related Events	Major IBD-related events included hospitalizations, surgeries, or procedures due to UC and CD.	Baseline up to approximately 8 years
Secondary	Change from Baseline in IMPACT-III Total and Subscale Scores at Week 24 and Every 24 weeks, Thereafter up to 8 Years	The IMPACT-III questionnaire is a self-reported measure with 35 closed questions encompassing 6 domains: Bowel Symptoms (7 items), Systemic Symptoms (3 items), Social Functioning (12 items), Body Image (3 items), Treatment/Interventions (3 items), and Emotional Functioning (7 items). The IMPACT-III uses a 5-point Likert scale ranging from 1 to 5 for all answers. The outcome score ranges from 35 to 175, with higher scores suggesting better quality of life.	Baseline up to approximately 8 years
Secondary	Height Velocity at Week 48 and Every 48 weeks, Thereafter up to 8 Years	Height velocity (centimeter per year [cm/year]) is the change in height per year.	Baseline up to approximately 8 years
Secondary	Change from Baseline in Height at Week 24 and Every 24 Weeks, Thereafter up to 8 Years		Baseline up to approximately 8 years
Secondary	Change from Baseline in Weight at Week 24 and Every 24 Weeks, Thereafter up to 8 Years		Baseline up to approximately 8 years
Secondary	Change from Baseline in Body Mass Index (BMI) at Week 24 and Every 24 Weeks, Thereafter up to 8 Years	BMI = Weight (in kilograms)/height^2 (in meters).	Baseline up to approximately 8 years
Secondary	Percentage of Participants Achieving Tanner Stage V	Tanner Stage Evaluation is a scale used to evaluate growth parameters standardized for age, sex, and pubertal development. Female pubertal development staged by pubic hair development and breast size; male pubertal development staged by size of the genitalia and development of pubic hair. Rated in 5 stages: stage 1 (no development) to 5 (adult-like development in quantity and size). Tanner stage is assessed at or before age 16 years for females or 17 years for males.	Baseline up to approximately 8 years

External Links

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