A Study to Evaluate Efficacy and Safety of Ustekinumab Re-induction Therapy in Participants With Moderately to Severely Active Crohn's Disease (POWER)
Crohn Disease
About this trial
This is an interventional treatment trial for Crohn Disease
Eligibility Criteria
Inclusion criteria:
- A history of Crohn's disease or fistulizing Crohn's disease of at least 3 months' duration, with colitis, ileitis, or ileocolitis, confirmed at any time in the past by radiography, histology, and/or endoscopy
- Currently receiving subcutaneous 90 mg every 8 weeks (q8w) ustekinumab maintenance therapy and initially responded to ustekinumab induction therapy, administered according to the local label, followed by secondary loss of response (LoR) to ustekinumab. Secondary LoR to ustekinumab is defined as active disease at study baseline, proven by a Crohn's Disease Activity Index (CDAI) score of greater than or equal to (>=) 220 and <=450 with at least one of the following: Elevated C-reactive protein (CRP) (>3.0 milligram per liter [mg/L]); and/or elevated Fecal calprotectin (fCal) >250 milligram per kilogram [mg/kg]); and/or endoscopy (performed less than or equal to (<=) 3 months before baseline) with evidence of active Crohn's disease, (defined as one or more ulcerations in the ileum and/or colon)
- Participants receiving either oral 5-aminosalicylic acid (5-ASA) compounds, oral corticosteroids (for example {e.g.}, prednisone, budesonide) at a prednisone-equivalent dose of <=40 mg/day or <=9 mg/day of budesonide, antibiotics used as the primary treatment of Crohn's disease, or conventional immunomodulators (i.e., azathioprine [AZA], 6-mercaptopurine [6-MP], or methotrexate [MTX]) are permitted providing the doses indicated are stable before baseline or have been discontinued before baseline within the protocol defined durations
Exclusion Criteria:
- Complications of Crohn's disease, such as symptomatic strictures or stenoses, short gut syndrome, or any other manifestation that might be anticipated to require surgery, could preclude the use of the CDAI to assess response to therapy, or would possibly confound the ability to assess the effect of treatment with ustekinumab
- Currently has or is suspected to have an abscess. Recent cutaneous and perianal abscesses are not exclusionary if drained and adequately treated at least 3 weeks before baseline (or 8 weeks before baseline for intra-abdominal abscesses) provided there is no anticipated need for any further surgery. Participants with active fistulas may be included if there is no anticipation of a need for surgery and there are currently no abscesses identified
- Any kind of bowel resection within 6 months or any other intra-abdominal surgery within 3 months before baseline
- A draining (i.e., functioning) stoma or ostomy
- Received ustekinumab intravenous re-induction after the initial weight-tiered-based IV induction dose of ustekinumab
- Any known history of shortened frequency of SC dose administration (<q8w) for a secondary loss of response where the participant did not, in the opinion of the treating physician, benefit from the dose interval shortening
Sites / Locations
- University of California, San Diego
- Peak Gastroenterology Associates
- Florida Research Network, LLC
- Mayo Clinic Jacksonville
- Advent Health
- Florida Hospital Tampa
- Emory University
- Atlanta Gastroenterology Associates, (AGA) LLC - Emory Saint Joseph's
- Atlanta Gastroenterology Specialists
- University of Kentucky Chandler Medical Center
- Chevy Chase Clinical Research
- Brigham & Women's Hospital
- University of Mississippi Medical Center
- Washington University School of Medicine
- Mount Sinai School of Medicine
- Ohio State University Hospital
- Northshore Gastroenterology Research, LLC
- Oklahoma Digestive Disease Specialists
- Medical University of South Carolina
- Vanderbilt University Medical Center
- Texas Digestive Disease Consultants
- Baylor College of Medicine
- Houston Methodist Hospital
- Gastroenterology Research of America, LLC
- Tyler Research Institute, LLC
- Virginia Mason Medical Center
- University of Washington
- Washington Gastroenterology, PLLC
- Krankenhaus der Barmherzigen Brüder
- Medizinische Universität Wien
- Hepato-gastroenterologie HK, s.r.o.
- ISCARE a.s.
- Hopital Beaujon
- CHRU de Lille - Hopital Claude Huriez
- CHRU Montpellier - Hopital Saint-Eloi
- CHU Hopital Saint Antoine
- Hospices Civils de Lyon HCL
- CHRU Hopital de Pontchaillou
- CHU de Nancy_ Hopital Brabois
- Klinikum Augsburg
- GASTRO-Studien
- Charite - Universitatsmedizin Berlin (CCM)
- Medizinisches Versorgungszentrum (MVZ) Dachau
- University Hospital Dresden
- Agaplesion Frankfurter Diakonie Kliniken GmbH, Markus Krankenhaus
- Universitatsklinikum Frankfurt/ Medizinische Klinik 1
- Universitatsklinikum Freiburg
- Städtisches Krankenhaus Martha-Maria Halle-Dölau gGmbH
- Hamburgisches Forschungsinstitut fuer CED, HaFCED e.K.
- Gastroenterologie Opernstrasse
- Universitatsklinikum Schleswig-Holstein - Kiel
- Staedtisches Klinikum Lueneburg
- Universitätsklinikum Otto-von-Guericke-Universität Magdeburg
- Medizinische Fakultät Mannheim der Universität Heidelberg
- Gastroenterologische Gemeinschaftspraxis Minden
- Klinikum der Universitaet Muenchen
- Praxis Dr. med. Ulf Helwig
- Zentrum für Gastroenterologie Saar MVZ GmbH
- Universitaetsklinik Tuebingen
- Universitaetsklinikum Ulm, Klinik fuer Innere Medizin II
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
- Ospedale Villa Sofia-Cervello
- Azienda Ospedaliera G.Salvini Ospedale di Rho
- Fondazione Policlinico Gemelli Università Cattolica
- Istituto Clinico Humanitas
- AO Ordine Mauriziano
- Inje University Haeundae Paik Hospital
- Seoul National University Hospital
- Severance Hospital, Yonsei University Health System
- Asan Medical Center
- KyungHee University Hospital
- Onze Lieve Vrouwe Gasthuis
- Leiden University Medical Center
- Maastricht Universitair Medisch Centrum
- Radboudumc
- Erasmus MC
- Sint Franciscus Gasthuis
- Irkutsk State Medical Academy of Postgraduate Education
- Olla-Med, Llc
- City Clinical Hospital #31
- GBUZ Respublican Clinical Hospital n.a. GG Kuvatova
- Hosp. Univ. Fundacion Alcorcon
- Hosp. Arquitecto Marcide
- Hosp. Gral. Univ. Gregorio Maranon
- Hosp. Univ. La Paz
- Hosp. Univ. Virgen de La Arrixaca
- Hosp. Virgen de La Victoria
- Hosp. de Navarra
- Hosp. Montecelo
- Corporacio Sanitari Parc Tauli
- Hosp. Clinico Univ. de Salamanca
- Hosp. Univ. Marques de Valdecilla
- Hosp. Clinico Univ. de Valencia
- Hosp. Alvaro Cunqueiro
- Hosp. Clinico Univ. Lozano Blesa
- Hosp. Univ. Miguel Servet
- Gastromottagningen
- Gastromottagningen
- Pennine Acute Hospitals-Fairfield General Hospital
- Gloucestershire Hospitals NHS Foundation Trust - Cheltenham
- Royal Devon & Exeter Hospital
- King's College Hospital NHS Foundation Trust
- St George's Hospital
- Southampton University Hospitals NHS Trust
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Group 1: Ustekinumab (IV re-induction)
Group 2: Ustekinumab (Continuous q8w SC maintenance)
Participants who experience a secondary loss of response (LoR) to 90 mg ustekinumab maintenance treatment, administered subcutaneously every 8 weeks (q8w) will receive a weight-tiered based ustekinumab IV re-induction dose of approximately 6 mg/kg and matching placebo subcutaneously at Week 0. At Weeks 8 and 16, all participants will receive SC maintenance injections of 90 mg ustekinumab. Participants will resume their standard-of-care therapy at Week 24 at the discretion of the treating physician.
Participants who experience a secondary LoR to 90 mg ustekinumab maintenance treatment, administered subcutaneously q8w will receive ustekinumab 90 mg subcutaneously and matching placebo intravenously at Week 0. At Weeks 8 and 16, all participants will receive SC maintenance injections of 90 mg ustekinumab. Participants will resume their standard-of-care therapy at Week 24 at the discretion of the treating physician.