The Use of Certolizumab Pegol for Treatment of Active Crohn's Disease in Children and Adolescents (NURTURE)
Primary Purpose
Crohn's Disease
Status
Terminated
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
Certolizumab Pegol
Certolizumab Pegol
Sponsored by
About this trial
This is an interventional treatment trial for Crohn's Disease focused on measuring Certolizumab Pegol, Cimzia ®, Crohn's Disease
Eligibility Criteria
Inclusion Criteria:
- Subjects with active Crohn's Disease (CD) confirmed 3 months prior to Screening
- Subjects with a Pediatric Crohn's Disease Activity Index (PCDAI) score of > 30 at Week 0
- Subjects between the ages of 6 and 17, inclusive, prior to baseline dosing
- Subjects must weigh > 20 kg (44 lbs)
- Subjects must have normal Electrocardiogram (ECG) or no medically relevant abnormalities as assessed by the investigator
- Subjects must meet Tuberculosis (TB) screening criteria
- Subjects taking corticosteroids, antibiotics and analgesics must have stable dosing, as defined, for one week
Exclusion Criteria:
- Subjects who score > 5 on the perirectal disease item of the PCDAI at Baseline
- Subjects who have had an active enterocutaneous fistulae within 3 months prior to Baseline
- Subjects with non-enterocutaneous fistulae, signs or symptoms of bowel obstruction or short bowel syndrome
- Subjects with a functional colostomy or ileostomy
- Subjects who have had surgical bowel resection within 6 months prior to Baseline or who may be planning any resection while enrolled in the study
- Subjects with clinical suspicion of intraabdominal abscesses
- Subjects with a positive stool result for enteric pathogens and/or parasites
- Subject has received any investigational biological therapies (within or outside a clinical trial) within 12 weeks prior to Screening or has been dosed in any clinical trial using non biological therapies within 4 weeks prior to Screening
- Subjects who have lost response to another Tumor Necrosis Factor (TNF) agent
- Subjects may not use another TNF agent within 12 weeks of Screening Visit
- Subjects with any prior exposure to natalizumab
- Subjects who have received mycophenolate or thalidomide within 4 weeks prior to Screening
- Subjects who have received cyclosporin or tacrolimus within 6 months prior to Screening
- Subjects who have received parenteral corticosteroids within 2 weeks prior to Screening
- Subjects who have received corticosteroids or corticotrophins for indications other than CD within 2 weeks of Screening
- Subject has a current or recent history (within 6 months prior to Screening) of significant and severe renal, hepatic, hematological, gastrointestinal (other than CD), endocrine, pulmonary, cardiac, neurological, or cerebral disease including blood dyscrasia (eg, pancytopenia, aplastic anemia), demyelinating disease (eg, multiple sclerosis, myelitis, optic neuritis), or ischemic heart disease
- Subjects with a current sign or symptom indicating recent or chronic infections (including herpes zoster)
- Subject has negative test for Immunoglobulin G (IgG) against Varicella zoster (chicken pox)
- Subjects who have not completed their primary vaccination series, or are planning to have a live vaccine administered during the study period or up to 3 months after last dose of study drug
- Subject has a history of TB or a positive chest x-ray suggestive of TB
- Subjects with known concurrent viral hepatitis or Acquired Immune Deficiency Syndrome (AIDS) or known Human Immunodeficiency Virus (HIV) infection
- Subjects with concurrent malignancy or history of malignancy, excluding treated squamous cell carcinoma of the skin
- Subject has concurrent bowel dysplasia or a history of bowel dysplasia in the 5 years prior to Screening
- Subjects with a history lymphoproliferative disorder including lymphoma or signs and symptoms suggestive of lymphoma at any time
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
Maintenance High-Dose
Maintenance Low-Dose
Arm Description
Maintenance High-Dose group: 400 mg Certolizumab Pegol for subjects ≥ 40 kg or 200 mg Certolizumab Pegol for subjects 20 to < 40 kg
Maintenance Low-Dose group: 200 mg Certolizumab Pegol for subjects ≥ 40 kg or 100 mg Certolizumab Pegol for subjects 20 to < 40 kg
Outcomes
Primary Outcome Measures
Percentage of Subjects in Clinical Remission at Week 62
Clinical remission is defined as a Pediatric Crohn's Disease Activity Index (PCDAI) score ≤ 10.
The Pediatric Crohn's Disease Activity Index (PCDAI) consists of 4 domains (laboratory, height/weight, examination, and history) with several assessments that are converted into a PCDAI score which can range from 0 to 100 points, with a higher score indicating more severe disease activity.
Secondary Outcome Measures
Absolute Pediatric Crohn's Disease Activity Index (PCDAI) Scores at Week 62
The Pediatric Crohn's Disease Activity Index (PCDAI) consists of 4 domains (laboratory, height/weight, examination, and history) with several assessments that are converted into a PCDAI score which can range from 0 to 100 points, with a higher score indicating more severe disease activity.
Change in Pediatric Crohn's Disease Activity Index (PCDAI) Scores From Week 0 to the End of the Study (Week 62)
The Pediatric Crohn's Disease Activity Index (PCDAI) consists of 4 domains (laboratory, height/weight, examination, and history) with several assessments that are converted into a PCDAI score which can range from 0 to 100 points, with a higher score indicating more severe disease activity.
A negative value in change from Baseline indicates an improvement from Baseline to Week 62.
Percentage of Subjects Achieving Clinical Response From Week 0 to the End of the Study (Week 62)
Clinical response is defined as a decrease from Week 0 in Pediatric Crohn's Disease Activity Index (PCDAI) score of ≥ 15 points and a total PCDAI score ≤ 30 points.
The Pediatric Crohn's Disease Activity Index (PCDAI) consists of 4 domains (laboratory, height/weight, examination, and history) with several assessments that are converted into a PCDAI score which can range from 0 to 100 points, with a higher score indicating more severe disease activity.
C-Reactive Protein (CRP) Levels at Week 62
The C-Reactive Protein (CRP) is a considered marker of inflammation in subjects with Crohn's Disease (CD)
Change in C-Reactive Protein (CRP) Levels From Week 0 to the End of the Study (Week 62)
The C-Reactive Protein (CRP) is a considered marker of inflammation in subjects with Crohn's Disease (CD).
Changes from Baseline in CRP levels are expressed as a ratio with the value measured at Baseline as the denominator.
Erythrocyte Sedimentation Rate (ESR) at Week 62
The Erythrocyte Sedimentation Rate (ESR) is a considered biomarker of inflammation in subjects with Crohn's Disease (CD).
Change in Erythrocyte Sedimentation Rate (ESR) From Week 0 to the End of the Study (Week 62)
The Erythrocyte Sedimentation Rate (ESR) is a considered biomarker of inflammation in subjects with Crohn's Disease (CD).
Changes from Baseline in CRP levels are expressed as a ratio with the value measured at baseline as the denominator.
Change in Growth Scores (Tanner Stage [Assessing Puberty]) From Week 0 to the End of the Study (Week 62)
The Tanner stage is an assessment of developmental stage on external genitalia and pubic hair (boys), and on breast and pubic hair (girls). Values range from 1 to 5 where a higher number indicates more development.
Percentage of Subjects Who Initiated Steroid Tapering
Subjects receiving corticosteroids at Screening may start a defined tapering schedule between Weeks 2 and 8. Corticosteroid tapering must start at the latest by Week 8. Corticosteroid doses are tapered at different rates depending on the subject's dose.
Percentage of Subjects in Corticosteroid-free Remission at the End of the Study
Corticosteroid use at end of study is defined as 84 days past the last dose of study medication. Remission is assessed at the last visit where Pediatric Crohn's Disease Activity index (PCDAI) data is available.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00899678
Brief Title
The Use of Certolizumab Pegol for Treatment of Active Crohn's Disease in Children and Adolescents
Acronym
NURTURE
Official Title
A Phase 2, Open-label, Multicenter Study to Assess the Safety and Efficacy of Certolizumab Pegol in Children and Adolescents With Active Crohn's Disease (NURTURE Study)
Study Type
Interventional
2. Study Status
Record Verification Date
March 2015
Overall Recruitment Status
Terminated
Why Stopped
higher than projected discontinuation rate during Maintenance Phase
Study Start Date
April 2009 (undefined)
Primary Completion Date
July 2012 (Actual)
Study Completion Date
July 2012 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
UCB Celltech
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to evaluate the safety, efficacy, pharmacokinetics, and immunogenicity of certolizumab pegol treatment in pediatric subjects, aged 6 to 17, with moderately to severely active Crohn's disease. The target enrollment is 160 subjects.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Crohn's Disease
Keywords
Certolizumab Pegol, Cimzia ®, Crohn's Disease
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
99 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Maintenance High-Dose
Arm Type
Active Comparator
Arm Description
Maintenance High-Dose group: 400 mg Certolizumab Pegol for subjects ≥ 40 kg or 200 mg Certolizumab Pegol for subjects 20 to < 40 kg
Arm Title
Maintenance Low-Dose
Arm Type
Active Comparator
Arm Description
Maintenance Low-Dose group: 200 mg Certolizumab Pegol for subjects ≥ 40 kg or 100 mg Certolizumab Pegol for subjects 20 to < 40 kg
Intervention Type
Drug
Intervention Name(s)
Certolizumab Pegol
Other Intervention Name(s)
Cimzia, CDP870
Intervention Description
400 mg administered subcutaneously at once every 4 weeks for subjects ≥ 40 kg or 200 mg for subjects 20 to < 40 kg
*prior to this dosing regimen, subjects will undergo an induction of Certolizumab Pegol administered subcutaneously every 2 weeks (total 3 injections) at of either 400 mg for subjects ≥ 40 kg or 200 mg for subjects 20 to < 40 kg
Intervention Type
Drug
Intervention Name(s)
Certolizumab Pegol
Other Intervention Name(s)
Cimzia, CDP870
Intervention Description
200 mg administered subcutaneously at once every 4 weeks for subjects ≥ 40 kg or 200 mg for subjects 20 to < 40 kg
*prior to this dosing regimen, subjects will undergo an induction of Certolizumab Pegol administered subcutaneously every 2 weeks (total 3 injections) at of either 400 mg for subjects ≥ 40 kg or 200 mg for subjects 20 to < 40 kg
Primary Outcome Measure Information:
Title
Percentage of Subjects in Clinical Remission at Week 62
Description
Clinical remission is defined as a Pediatric Crohn's Disease Activity Index (PCDAI) score ≤ 10.
The Pediatric Crohn's Disease Activity Index (PCDAI) consists of 4 domains (laboratory, height/weight, examination, and history) with several assessments that are converted into a PCDAI score which can range from 0 to 100 points, with a higher score indicating more severe disease activity.
Time Frame
Week 62
Secondary Outcome Measure Information:
Title
Absolute Pediatric Crohn's Disease Activity Index (PCDAI) Scores at Week 62
Description
The Pediatric Crohn's Disease Activity Index (PCDAI) consists of 4 domains (laboratory, height/weight, examination, and history) with several assessments that are converted into a PCDAI score which can range from 0 to 100 points, with a higher score indicating more severe disease activity.
Time Frame
Week 62
Title
Change in Pediatric Crohn's Disease Activity Index (PCDAI) Scores From Week 0 to the End of the Study (Week 62)
Description
The Pediatric Crohn's Disease Activity Index (PCDAI) consists of 4 domains (laboratory, height/weight, examination, and history) with several assessments that are converted into a PCDAI score which can range from 0 to 100 points, with a higher score indicating more severe disease activity.
A negative value in change from Baseline indicates an improvement from Baseline to Week 62.
Time Frame
From Week 0 to Week 62
Title
Percentage of Subjects Achieving Clinical Response From Week 0 to the End of the Study (Week 62)
Description
Clinical response is defined as a decrease from Week 0 in Pediatric Crohn's Disease Activity Index (PCDAI) score of ≥ 15 points and a total PCDAI score ≤ 30 points.
The Pediatric Crohn's Disease Activity Index (PCDAI) consists of 4 domains (laboratory, height/weight, examination, and history) with several assessments that are converted into a PCDAI score which can range from 0 to 100 points, with a higher score indicating more severe disease activity.
Time Frame
From Week 0 to Week 62
Title
C-Reactive Protein (CRP) Levels at Week 62
Description
The C-Reactive Protein (CRP) is a considered marker of inflammation in subjects with Crohn's Disease (CD)
Time Frame
Week 62
Title
Change in C-Reactive Protein (CRP) Levels From Week 0 to the End of the Study (Week 62)
Description
The C-Reactive Protein (CRP) is a considered marker of inflammation in subjects with Crohn's Disease (CD).
Changes from Baseline in CRP levels are expressed as a ratio with the value measured at Baseline as the denominator.
Time Frame
From Week 0 to Week 62
Title
Erythrocyte Sedimentation Rate (ESR) at Week 62
Description
The Erythrocyte Sedimentation Rate (ESR) is a considered biomarker of inflammation in subjects with Crohn's Disease (CD).
Time Frame
Week 62
Title
Change in Erythrocyte Sedimentation Rate (ESR) From Week 0 to the End of the Study (Week 62)
Description
The Erythrocyte Sedimentation Rate (ESR) is a considered biomarker of inflammation in subjects with Crohn's Disease (CD).
Changes from Baseline in CRP levels are expressed as a ratio with the value measured at baseline as the denominator.
Time Frame
From Week 0 to Week 62
Title
Change in Growth Scores (Tanner Stage [Assessing Puberty]) From Week 0 to the End of the Study (Week 62)
Description
The Tanner stage is an assessment of developmental stage on external genitalia and pubic hair (boys), and on breast and pubic hair (girls). Values range from 1 to 5 where a higher number indicates more development.
Time Frame
From Week 0 to Week 62
Title
Percentage of Subjects Who Initiated Steroid Tapering
Description
Subjects receiving corticosteroids at Screening may start a defined tapering schedule between Weeks 2 and 8. Corticosteroid tapering must start at the latest by Week 8. Corticosteroid doses are tapered at different rates depending on the subject's dose.
Time Frame
From Week 2 up to Week 8
Title
Percentage of Subjects in Corticosteroid-free Remission at the End of the Study
Description
Corticosteroid use at end of study is defined as 84 days past the last dose of study medication. Remission is assessed at the last visit where Pediatric Crohn's Disease Activity index (PCDAI) data is available.
Time Frame
Last/Withdrawal Visit (up to Week 62)
10. Eligibility
Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subjects with active Crohn's Disease (CD) confirmed 3 months prior to Screening
Subjects with a Pediatric Crohn's Disease Activity Index (PCDAI) score of > 30 at Week 0
Subjects between the ages of 6 and 17, inclusive, prior to baseline dosing
Subjects must weigh > 20 kg (44 lbs)
Subjects must have normal Electrocardiogram (ECG) or no medically relevant abnormalities as assessed by the investigator
Subjects must meet Tuberculosis (TB) screening criteria
Subjects taking corticosteroids, antibiotics and analgesics must have stable dosing, as defined, for one week
Exclusion Criteria:
Subjects who score > 5 on the perirectal disease item of the PCDAI at Baseline
Subjects who have had an active enterocutaneous fistulae within 3 months prior to Baseline
Subjects with non-enterocutaneous fistulae, signs or symptoms of bowel obstruction or short bowel syndrome
Subjects with a functional colostomy or ileostomy
Subjects who have had surgical bowel resection within 6 months prior to Baseline or who may be planning any resection while enrolled in the study
Subjects with clinical suspicion of intraabdominal abscesses
Subjects with a positive stool result for enteric pathogens and/or parasites
Subject has received any investigational biological therapies (within or outside a clinical trial) within 12 weeks prior to Screening or has been dosed in any clinical trial using non biological therapies within 4 weeks prior to Screening
Subjects who have lost response to another Tumor Necrosis Factor (TNF) agent
Subjects may not use another TNF agent within 12 weeks of Screening Visit
Subjects with any prior exposure to natalizumab
Subjects who have received mycophenolate or thalidomide within 4 weeks prior to Screening
Subjects who have received cyclosporin or tacrolimus within 6 months prior to Screening
Subjects who have received parenteral corticosteroids within 2 weeks prior to Screening
Subjects who have received corticosteroids or corticotrophins for indications other than CD within 2 weeks of Screening
Subject has a current or recent history (within 6 months prior to Screening) of significant and severe renal, hepatic, hematological, gastrointestinal (other than CD), endocrine, pulmonary, cardiac, neurological, or cerebral disease including blood dyscrasia (eg, pancytopenia, aplastic anemia), demyelinating disease (eg, multiple sclerosis, myelitis, optic neuritis), or ischemic heart disease
Subjects with a current sign or symptom indicating recent or chronic infections (including herpes zoster)
Subject has negative test for Immunoglobulin G (IgG) against Varicella zoster (chicken pox)
Subjects who have not completed their primary vaccination series, or are planning to have a live vaccine administered during the study period or up to 3 months after last dose of study drug
Subject has a history of TB or a positive chest x-ray suggestive of TB
Subjects with known concurrent viral hepatitis or Acquired Immune Deficiency Syndrome (AIDS) or known Human Immunodeficiency Virus (HIV) infection
Subjects with concurrent malignancy or history of malignancy, excluding treated squamous cell carcinoma of the skin
Subject has concurrent bowel dysplasia or a history of bowel dysplasia in the 5 years prior to Screening
Subjects with a history lymphoproliferative disorder including lymphoma or signs and symptoms suggestive of lymphoma at any time
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
UCB Clinical Trial Call Center
Organizational Affiliation
+1 877 822 9493 (UCB)
Official's Role
Study Director
Facility Information:
City
Phoenix
State/Province
Arizona
Country
United States
City
Los Angeles
State/Province
California
Country
United States
City
Orange
State/Province
California
Country
United States
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San Francisco
State/Province
California
Country
United States
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Aurora
State/Province
Colorado
Country
United States
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Hartford
State/Province
Connecticut
Country
United States
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Orlando
State/Province
Florida
Country
United States
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Atlanta
State/Province
Georgia
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United States
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Chicago
State/Province
Illinois
Country
United States
City
Indianapolis
State/Province
Indiana
Country
United States
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Lexington
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Kentucky
Country
United States
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Shreveport
State/Province
Louisiana
Country
United States
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Baltimore
State/Province
Maryland
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United States
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Boston
State/Province
Massachusetts
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United States
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Rochester
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Minnesota
Country
United States
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Morristown
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New Jersey
Country
United States
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New Hyde Park
State/Province
New York
Country
United States
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Cincinnati
State/Province
Ohio
Country
United States
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Philadelphia
State/Province
Pennsylvania
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United States
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Nashville
State/Province
Tennessee
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United States
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Dallas
State/Province
Texas
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United States
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Houston
State/Province
Texas
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United States
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Seattle
State/Province
Washington
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United States
City
Milwaukee
State/Province
Wisconsin
Country
United States
City
Randwick
State/Province
New South Wales
Country
Australia
City
Herston
State/Province
Queensland
Country
Australia
City
Parkville
State/Province
Victoria
Country
Australia
City
Edmonton
State/Province
Alberta
Country
Canada
City
Vancouver
State/Province
British Columbia
Country
Canada
City
Halifax
State/Province
Nova Scotia
Country
Canada
City
Hamilton
State/Province
Ontario
Country
Canada
City
London
State/Province
Ontario
Country
Canada
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Toronto
State/Province
Ontario
Country
Canada
City
Grafton
State/Province
Auckland
Country
New Zealand
City
Christchurch
State/Province
Canterbury
Country
New Zealand
12. IPD Sharing Statement
Links:
URL
http://www.fda.gov/Safety/MedWatch/SafetyInformation/default.htm
Description
FDA Safety Alerts and Recalls
Learn more about this trial
The Use of Certolizumab Pegol for Treatment of Active Crohn's Disease in Children and Adolescents
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