Safety and Efficacy of Efavaleukin Alfa in Participants With Moderately to Severely Active Ulcerative Colitis
Ulcerative Colitis
About this trial
This is an interventional treatment trial for Ulcerative Colitis focused on measuring Ulcerative Colitis, UC, Efavaleukin Alfa
Eligibility Criteria
Key Inclusion Criteria:
- Participant has provided informed consent prior to initiation of any study specific activities or procedures. In Japan, if a participant is younger than 20 years at the time of signing the informed consent, the informed consent must be obtained from both the participant and their legal representative.
- Men and women aged ≥ 18 to < 80 years at screening visit (≥ 19 to < 80 in South Korea).
- Diagnosis of UC established ≥ 3 months prior to enrollment by clinical and endoscopic evidence and corroborated by a histopathology report. If a histopathology report is not available at screening, then additional biopsies may be taken during the screening period for local histopathology analysis to corroborate.
- Moderately to severely active UC as defined by a modified Mayo score of 5 to 9, with a centrally read rectosigmoidoscopy endoscopic subscore ≥ 2 and no subscore < 1 prior to day 1.
Has documentation of:
- A surveillance colonoscopy (performed according to local standard) within 12 months of day 1 visit for participants with pancolitis of > 8 years duration, or participants with left-sided colitis of > 12 years duration, or participants with primary sclerosing cholangitis.
- For all other participants, up-to-date colorectal cancer surveillance (performed according to local standard). Participants who do not have a colonoscopy report available in source documentation will have a colonoscopy instead of rectosigmoidoscopy performed as the screening endoscopy for the study, at the discretion of the investigator.
Participants must have demonstrated inadequate response, loss of response, or intolerance to at least 1 conventional therapy, biologic therapy, or targeted small molecule therapy (ie, Janus kinase [JAK]-inhibitor), as follows:
Conventional therapy failed participants:
- Corticosteroids (corticosteroid-refractory colitis, defined as signs and/or symptoms of active UC despite oral prednisone [or equivalent] at doses of at least 30 mg/day for a minimum of 2 weeks; or corticosteroid-dependent colitis, defined as: an inability to reduce corticosteroids below the equivalent of prednisone 10 mg/day within 3 months of starting corticosteroids without a return of signs and/or symptoms of active UC; or a relapse within 3 months of completing a course of corticosteroids).
- History of intolerance of corticosteroids (including, but not limited to, Cushing's syndrome, osteopenia/ osteoporosis, hyperglycemia, or neuropsychiatric side-effects, including insomnia, associated with corticosteroid treatment).
- Immunomodulators: signs and/or symptoms of persistently active disease despite at least 3 months treatment with one of the following at locally approved doses: oral azathioprine (eg, ≥ 1.5 mg/kg/day) or 6-mercaptopurine (eg, ≥ 0.75 mg/kg/day), or oral azathioprine or 6-mercatopurine within a therapeutic range as judged by thioguanine metabolite testing, or a combination of a thiopurine and allopurinol within a therapeutic range as judged by thioguanine metabolite testing.
- History of intolerance to at least 1 immunomodulator (including but not limited to nausea/vomiting, abdominal pain, pancreatitis, liver function test abnormalities, and lymphopenia) and have neither failed nor demonstrated an intolerance to a biological medication (anti-tumor necrosis factor [TNF] antibody, anti-integrin antibody, or interleukin [IL]-12/23 antagonists) that is indicated for the treatment of UC.
Biologic or targeted small molecule therapy failed participants: those who demonstrated inadequate response or loss of response or intolerance to biologic therapy for UC (eg, anti-TNF antibodies or IL-12/23 antagonists, anti-integrin antibodies) or targeted small molecules (eg, JAK inhibitors). The therapy used to qualify the participant for entry into this category must be approved for the treatment of UC in the country of use, at the time of use. Participants must fulfil one of the following criteria:
- Inadequate response: signs and symptoms of persistently active disease despite induction treatment at the approved induction dosing that was indicated in the product label at the time of use.
- Loss of response: recurrence of signs and symptoms of active disease during approved maintenance dosing following prior clinical benefit (discontinuation despite clinical benefit does not quality as having failed or being intolerant to UC biological therapy or JAK inhibitor).
- Intolerance: history of intolerance to infliximab, adalimumab, golimumab, vedolizumab, ustekinumab, tofacitinib or other approved biologicals or JAK inhibitors (including but not limited to infusion-related event, demyelination, congestive heart failure, or any other drug-related adverse event that led to a reduction in dose or discontinuation of the medication).
If receiving any of the following therapies, participants must have stable dosage for the specified duration:
- 5-aminosalicylates (ASAs), stable dosage for ≥ 2 weeks prior to screening endoscopy.
- Oral corticosteroids: prednisone ≤ 20 mg/day or its equivalent, stable dose for ≥ 2 weeks prior to screening endoscopy.
- Budesonide: extended release tablets 9 mg/day [budensonide MMX], stable dose for ≥ 2 weeks prior to screening endoscopy.
- Conventional immunomodulators: azathioprine, 6-mercaptopurine, methotrexate, stable dosage for ≥ 12 weeks prior to screening endoscopy.
Key Exclusion Criteria:
- Diagnosis of Crohn's disease, inflammatory bowel disease unclassified (indeterminate colitis), microscopic colitis, ischemic colitis, or clinical findings suggestive of Crohn's disease.
- Evidence of toxic megacolon, fulminant colitis, intra-abdominal abscess, or stricture/stenosis within the small bowel or colon.
- Participant has had extensive surgery for UC (for example, subtotal colectomy), or is likely to require surgery for the treatment of UC during the study.
- Currently receiving or had treatment within 12 months prior to screening with T cell depleting agents (eg, antithymocyte globulin, Campath).
Participant has received any of the following prescribed medication or therapy within the specified time period:
- Anti TNF antibodies (eg, infliximab, adalimumab, golimumab) < 8 weeks prior to screening rectosigmoidoscopy.
- Anti integrin antibodies (eg, vedolizumab) < 8 weeks prior to screening rectosigmoidoscopy.
- IL 12/23 antagonist (eg, ustekinumab) < 8 weeks prior to screening rectosigmoidoscopy.
- JAK inhibitors (eg, tofacitinib) < 4 weeks prior to screening rectosigmoidoscopy.
- Any other commercially approved biologic agent or targeted small molecule < 8 weeks prior to screening rectosigmoidoscopy or < 5 half lives prior to screening rectosigmoidoscopy, whichever is longer
- Immunomodulatory medications, including oral cyclosporine, intravenous cyclosporine, tacrolimus, sirolimus, mycophenolate mofetil, thalidomide < 4 weeks prior to screening rectosigmoidoscopy.
- Any investigational biologic therapy within 8 weeks prior to screening rectosigmoidoscopy or < 5 half-lives prior to screening rectosigmoidoscopy, whichever is longer.
- Has used apheresis (eg, Adacolumnâ apheresis) < 2 weeks prior to screening rectosigmoidoscopy.
Sites / Locations
- Digestive Health Specialists of the SoutheastRecruiting
- Birmingham Digestive Health Research, LLCRecruiting
- Arizona Health ResearchRecruiting
- Arizona Arthritis and Rheumatology Research, PLLCRecruiting
- Southern California Research CenterRecruiting
- United Medical DoctorsRecruiting
- Biopharma Informatic IncRecruiting
- Santa Maria Gastroenterology Medical GroupRecruiting
- Gastroenterology Center of Connecticut, PCRecruiting
- West Central GastroenterologyRecruiting
- Homestead Associates In Research IncRecruiting
- Indian Health Service Health ResearchRecruiting
- University of Miami Hospital and ClinicRecruiting
- Ocala Gastrointestinal Research, LLCRecruiting
- Atlanta Gastroenterology AssociatesRecruiting
- Columbus Regional Research Institute, LLC
- Grand Teton Research GroupRecruiting
- Rush University Medical CenterRecruiting
- Digestive Research Alliance of MichianaRecruiting
- University of Kansas Medical CenterRecruiting
- Mid-Atlantic GI Research, LLCRecruiting
- Harvard Medical School - Brigham and Womens HospitalRecruiting
- University of Massachusetts Memorial Medical CenterRecruiting
- University of Michigan Health System
- Clinical Research Institute of MichiganRecruiting
- West Michigan Clinical Research CenterRecruiting
- Southern Therapy and Advanced Research LLC - Jackson
- Gastrointestinal Associates Research, LLCRecruiting
- bvl Clinical ResearchRecruiting
- Interspond - Las Vegas Medical ResearchRecruiting
- Aga Clinical Research Associates LLCRecruiting
- Affiliates in Gastroenterology Digestive Disease ResearchRecruiting
- Atlantic Digestive Health InstituteRecruiting
- Premier Health Research LLCRecruiting
- New York University Langone Medical CenterRecruiting
- Consultants for Clinical ResearchRecruiting
- Digestive Specialists Inc Research, LLCRecruiting
- Options Health Research, LLC
- Guthrie Robert Packer HospitalRecruiting
- Medical University of South CarolinaRecruiting
- Wake Research-ClinSearch, LLCRecruiting
- Digestive Health Research, LLCRecruiting
- Anrc ResearchRecruiting
- Digestive Health AssociatesRecruiting
- Digestive Research of Central Texas, LLCRecruiting
- Digestive Health Research of North Texas LLCRecruiting
- Emeritas Research GroupRecruiting
- Blue Ridge Medical ResearchRecruiting
- North Richmond Health ResearchRecruiting
- GI Select Health Research LLCRecruiting
- Hunter Holmes McGuire Veterans Medical CenterRecruiting
- Wisconsin Center for Advanced ResearchRecruiting
- Centro de Investigaciones Medicas Mar del PlataRecruiting
- Clinica IndependenciaRecruiting
- Cer Instituto MedicoRecruiting
- CardioAlem InvestigacionesRecruiting
- Hospital Privado Centro Medico de Cordoba SARecruiting
- Fundacion Estudios ClinicosRecruiting
- Medizinische Universitaet InnsbruckRecruiting
- Landeskrankenhaus SalzburgRecruiting
- Universitaetsklinikum Allgemeines Krankenhaus WienRecruiting
- Universitair Ziekenhuis AntwerpenRecruiting
- Universitair Ziekenhuis Leuven - Campus GasthuisbergRecruiting
- Centre Hospitalier Universitaire de Liege - Sart TilmanRecruiting
- Second Multiprofile Hospital for Active Treatment - Sofia EADRecruiting
- Diagnostic-Consultative Center Convex EOODRecruiting
- Acibadem City Clinic University Multiprofile Hospital for Active Treatment Mladost EOODRecruiting
- South Edmonton Gastroenterology
- London Health Sciences Centre, University HospitalRecruiting
- TIDHI Innovation IncorporatedRecruiting
- Hepato-Gastroenterologie HK sroRecruiting
- Nemocnice Pardubickeho kraje as, Pardubicka nemocniceRecruiting
- Nemocnice Milosrdnych sester sv Karla Boromejskeho v PrazeRecruiting
- Axon Clinical sroRecruiting
- Krajska zdravotni as - Masarykova nemocnice Usti nad Labem oz
- Aalborg Universitetshospital
- Herlev HospitalRecruiting
- Hvidovre HospitalRecruiting
- Bispebjerg HospitalRecruiting
- Helsinki University Central HospitalRecruiting
- Centre Hospitalier Universitaire Amiens PicardieRecruiting
- Centre Hospitalier Universitaire de Montpellier - Hopital Saint EloiRecruiting
- Centre Hospitalier Universitaire Archet 2Recruiting
- Centre Hospitalier Universitaire Nord de Saint Etienne - Hôpital NordRecruiting
- Gastro-Studien GbR Studienzentrum
- Universitaetsklinikum EssenRecruiting
- Universitaetsklinikum FrankfurtRecruiting
- Universitaetsklinikum Schleswig-HolsteinRecruiting
- Universitaetsklinikum Tuebingen
- Universitaetsklinikum UlmRecruiting
- University General Hospital of AlexandroupolisRecruiting
- General Hospital EvangelismosRecruiting
- Laiko General Hospital of AthensRecruiting
- University Hospital AttikonRecruiting
- Venizeleio General HospitalRecruiting
- University Hospital of HeraklionRecruiting
- University General Hospital of IoanninaRecruiting
- General University Hospital of Patras Panagia i VoithiaRecruiting
- Bekes Varmegyei Kozponti Korhaz Dr Rethy Pal TagkorhazRecruiting
- MIND Klinika KftRecruiting
- Clinexpert KftRecruiting
- Obudai Egeszsegugyi Centrum KftRecruiting
- Szegedi Tudomanyegyetem Szent-Gyorgyi Albert Klinikai Kozpont Altalanos Orvostudomanyi KarRecruiting
- Clinfan KftRecruiting
- Komarom-Esztergom Varmegyei Szent Borbala KorhazRecruiting
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di BresciaRecruiting
- Azienda Ospedaliera Universitaria Renato DulbeccoRecruiting
- Azienda Ospedaliero Universitaria CareggiRecruiting
- Ospedale Policlinico San Martino IRCCSRecruiting
- Fondazione IRCCS Ca Granda Ospedale Maggiore PoliclinicoRecruiting
- IRCCS Ospedale San RaffaeleRecruiting
- Ospedale Sacro Cuore Don CalabriaRecruiting
- Ospedale Sandro PertiniRecruiting
- Tsujinaka Hospital KashiwanohaRecruiting
- Toho University Sakura Medical CenterRecruiting
- Kitakyushu Municipal Medical CenterRecruiting
- Gifu University HospitalRecruiting
- Matsunami General HospitalRecruiting
- Hakodate Central General HospitalRecruiting
- Sapporo Tokushukai HospitalRecruiting
- Aoyama Clinic GI Endoscopy and IBD CenterRecruiting
- Gokeikai Ofuna Chuo HospitalRecruiting
- Takagi ClinicRecruiting
- Miyazaki Prefectural Miyazaki HospitalRecruiting
- Nagasaki University HospitalRecruiting
- Nara Medical University HospitalRecruiting
- National Hospital Organization Okayama Medical CenterRecruiting
- Osaka Metropolitan University HospitalRecruiting
- Tokyo Medical and Dental University HospitalRecruiting
- Kitasato University Kitasato Institute HospitalRecruiting
- Ome Municipal General HospitalRecruiting
- Medical Corporation ENEXT Ikebukuro West Gate HospitalRecruiting
- Yamanashi Prefectural Central HospitalRecruiting
- Inje University Haeundae Paik HospitalRecruiting
- Yeungnam University HospitalRecruiting
- Samsung Medical CenterRecruiting
- The Catholic University of Korea Seoul St Marys HospitalRecruiting
- Wonju Severance Christian HospitalRecruiting
- Pauls Stradins Clinical University HospitalRecruiting
- Digestive Diseases Centre GASTRORecruiting
- Clinicos Asociados BOCM SCRecruiting
- Clinica de Investigacion en Reumatologia y Obesidad SCRecruiting
- Investigacion Biomedica para el Desarrollo de Farmacos SA de CVRecruiting
- CRI Centro Regiomontano de Investigacion SCRecruiting
- Hospital San Jose Tec Salud Fundacion Santos y de la Garza Evia IBPRecruiting
- Centro para el Desarrollo de la Medicina y de Asistencia Medica Especializada SCRecruiting
- Leids Universitair Medisch CentrumRecruiting
- Elisabeth-TweeSteden ZiekenhuisRecruiting
- Universitair Medisch Centrum UtrechtRecruiting
- NZOZ Twoje Zdrowie EL SpzooRecruiting
- Centrum Medyczne Med-Gastr Sp zooRecruiting
- Centrum Badawcze Panaceum Agnieszka Brzezicka Magdalena Lenkiewicz SpzooRecruiting
- Centrum Medyczne Pratia PoznanRecruiting
- BodyClinic spolka z ograniczona odpowiedzialnosciaRecruiting
- Centrum Medyczne Melita MedicalRecruiting
- EuroMediCare Przychodnia Specjalistyczna we WroclawiuRecruiting
- Institutul Clinic FundeniRecruiting
- Spitalul Universitar de Urgenta Militar Central Dr. Carol DavilaRecruiting
- Clinica MedicumRecruiting
- Spitalul de Oncologie Monza SRLRecruiting
- Spitalul Clinic ColentinaRecruiting
- Spitalul Clinic PelicanRecruiting
- Fakultna Nemocnica s poliklinikou FD Roosevelta Banska BystricaRecruiting
- Endomed, sroRecruiting
- Gastro I, sroRecruiting
- Hospital de la Santa Creu i Sant PauRecruiting
- Hospital Universitario de La PrincesaRecruiting
- Hospital General Universitario Gregorio MarañonRecruiting
- Hospital Universitario La PazRecruiting
- Inselspital BernRecruiting
- Intesto BERecruiting
- Kantonsspital St GallenRecruiting
- Universitaetsspital ZuerichRecruiting
- China Medical University HospitalRecruiting
- National Taiwan University HospitalRecruiting
- Taipei Veterans General HospitalRecruiting
- Antalya Egitim ve Arastirma HastanesiRecruiting
- Uludag Universitesi Tip FakultesiRecruiting
- Gaziantep Universitesi Tip FakultesiRecruiting
- Istanbul Universitesi Istanbul Tip FakultesiRecruiting
- Ege Universitesi Tip FakultesiRecruiting
- Dokuz Eylul Universitesi Tip FakultesiRecruiting
- Kocaeli Universitesi Tip FakultesiRecruiting
- Mersin Universitesi Tip FakultesiRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Experimental
Experimental
Experimental
Placebo Comparator
Arm A: Efavaleukin alfa
Arm B: Efavaleukin alfa
Arm C: Efavaleukin alfa
Arm D: Placebo
Efavaleukin alfa Dose 1 administered by SC injection once every two weeks (Q2W)
Efavaleukin alfa Dose 2 administered by SC injection Q2W
Efavaleukin alfa Dose 3 administered by SC injection Q2W
Placebo Q2W