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A Study to Evaluate the Safety and Efficacy of Ustekinumab Induction Therapy in Patients With Moderately to Severely Active Crohn's Disease (UNITI-2)

Primary Purpose

Crohn's Disease, Inflammatory Bowel Disease, IBD

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Group 1: Placebo
Group 2 ustekinumab 130 mg
Group 3: ustekinumab approximately 6 mg/kg
Sponsored by
Janssen Research & Development, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Crohn's Disease focused on measuring ustekinumab, moderately to severely active Crohn's Disease, Stelara, IBD, colitis, crohn, UNITI, Crohn's

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Have Crohn's disease of at least 3 months' duration with colitis, ileitis, or ileocolitis, confirmed at some time in the past by radiography, histology, or endoscopy
  • Have active Crohn's disease, defined as a baseline Crohn Disease Activity Index (CDAI) score of >= 220 and <= 450, with confirmation of active inflammation
  • Has failed conventional therapy as demonstrated by having received corticosteroids and/or immunomodulators(ie, AZA, MTX, or 6-MP) at adequate therapeutic doses OR Have a history of failure to respond to or tolerate an adequate course of corticosteroids and/or immunomodulators (ie, AZA, MTX, or 6-MP) at adequate therapeutic doses OR Is corticosteroid dependent or has had a history of corticosteroid dependency AND Has not previously demonstrated failure of or intolerance to 1 or more TNF-antagonist therapies (ie, infliximab, adalimumab, or certolizumab pegol) per study criteria
  • Have screening laboratory test results within protocol-specified parameters

Exclusion Criteria:

  • Patients who have had any kind of bowel resection within 6 months
  • Are pregnant or planning pregnancy (both men and women) while enrolled in the study or for 20 weeks after receiving study agent
  • Patients who have received infliximab, adalimumab or certolizumab pegol < = 8 weeks before the first administration of study drug
  • Patients with certain complications of Crohn's disease that would make it hard to assess response to study drug
  • Patients with a history of or ongoing chronic or recurrent infectious disease
  • Patients who have previously received a biologic agent targeting IL-12 or IL-23, including but not limited to ustekinumab (CNTO 1275) or briakinumab (ABT-874)

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Experimental

Experimental

Arm Label

Placebo IV

Ustekinumab 130 milligram (mg)

Ustekinumab approximately (~) 6 milligram per kilogram (mg/kg)

Arm Description

Group 1: Placebo Form=solution for injection route=intravenous use in a single dose.

Group 2 ustekinumab 130 mg Type=exact unit=mg number=130 form=solution for injection route= intravenous use in a single dose.

Group 3: ustekinumab approximately 6 mg/kg Type=range unit=mg/kg number=6 form=solution for injection route= intravenous use in a single dose.weight-range based ustekinumab doses approximating ustekinumab 6 mg/kg: 260 mg (weight <= 55 kg) 390 mg (weight > 55 kg and <= 85 kg) and 520 mg (weight > 85 kg).

Outcomes

Primary Outcome Measures

Number of Participants With Clinical Response at Week 6
Clinical response at Week 6 was defined as a reduction from baseline in the Crohn's Disease Activity Index (CDAI) score of greater than or equal (>=) 100 points (in general, CDAI score ranges from 0 to approximately 600; higher score indicates higher disease activities). Participants with a baseline CDAI score of > = 220 to less than or equal (< =) 248 were considered to be in clinical response if a CDAI score of less than (<) 150 was attained. A decrease in CDAI score over time indicates improvement in disease activity.

Secondary Outcome Measures

Number of Participants in Clinical Remission at Week 8
Clinical remission at Week 8 was defined as a Crohn's Disease Activity Index (CDAI) score of <150 points.
Number of Participants in Clinical Response at Week 8
Clinical response at Week 8 was defined as a reduction from baseline in the CDAI score of greater than or equal (>=) 100 points (in general, CDAI score ranges from 0 to approximately 600; higher score indicates higher disease activities). Participants with a baseline CDAI score of > = 220 to less than or equal (< =) 248 were considered to be in clinical response if a CDAI score of less than (<) 150 was attained. A decrease in CDAI score over time indicates improvement in disease activity.
Number of Participants With Crohn's Disease Activity Index (CDAI) 70 Point Response at Week 6
70-point response is defined as at least 70 points reduction in CDAI score (in general, CDAI score ranges from 0 to approximately 600; higher score indicates higher disease activities). The CDAI score is used to quantify the symptoms of participants with Crohn's Disease. A decrease in CDAI over time indicates improvement in disease activity.
Number of Participants With CDAI 70 Point Response at Week 3
70-point response is defined as at least 70 points reduction in CDAI score (in general, CDAI score ranges from 0 to approximately 600; higher score indicates higher disease activities). The CDAI score is used to quantify the symptoms of participants with Crohn's Disease. A decrease in CDAI over time indicates improvement in disease activity.

Full Information

First Posted
June 7, 2011
Last Updated
November 9, 2016
Sponsor
Janssen Research & Development, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT01369342
Brief Title
A Study to Evaluate the Safety and Efficacy of Ustekinumab Induction Therapy in Patients With Moderately to Severely Active Crohn's Disease (UNITI-2)
Official Title
A Phase 3, Randomized, Double-blind, Placebo-controlled, Parallel-group, Multicenter Study to Evaluate the Safety and Efficacy of Ustekinumab Induction Therapy in Subjects With Moderately to Severely Active Crohn's Disease (UNITI-2)
Study Type
Interventional

2. Study Status

Record Verification Date
November 2016
Overall Recruitment Status
Completed
Study Start Date
July 2011 (undefined)
Primary Completion Date
August 2014 (Actual)
Study Completion Date
October 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Janssen Research & Development, LLC

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study (UNITI-2) will compare the effects (both positive and negative) of an initial treatment with ustekinumab to a placebo over 8 weeks in patients with moderately to severely active Crohn's disease.
Detailed Description
This study (CNTO1275CRD3002 or "UNITI-2") examines ustekinumab (an antibody medication that inhibits the inflammatory proteins IL-12 and IL-23) versus a placebo (otherwise identical except without the ustekinumab antibody) given intravenously (by an IV) in adults with moderately to severely active Crohn's disease. Ustekinumab (also known as Stelara) is approved as a treatment for the skin condition of moderate to severe plaque-type psoriasis, but this study will examine if ustekinumab can provide benefit in Crohn's disease and also assess for any risks or side effects. Both the positive and negative outcomes of IV placebo versus two different doses of IV ustekinumab will be tracked and compared over eight weeks, in approximately 612 patients who have previously failed or were intolerant to corticosteroids or immunomodulators (methotrexate, azathioprine, or 6-mercaptopurine) or are dependent on corticosteroid medications. Patients enrolling in this study will be assigned to one of the 3 treatment groups by chance (randomly, like rolling dice), and all will receive a single IV administration of study agent at the first study visit (after the screening period), and then will be asked to return for 3 additional visits through Week 8. Patients who complete this study through the Week 8 visit and remain eligible can enter the maintenance study (CNTO1275CRD3003 or "IM-UNITI"), where they will receive additional study agent, including the administration of ustekinumab in patients who receive placebo in this study and have not had improvement in their Crohn's disease. Patients who do not enter the CNTO1275CRD3003 study will have a final safety follow-up visit approximately 20 weeks after they received study agent when they entered into this study at the Week 0 visit. .All patients will receive a single intravenous (IV) administration of study drug (placebo or ustekinumab) at the start of the study.There are 3 treatment groups in this study: Group 1: Placebo; Group 2: ustekinumab 130 mg, Group 3: weight-range based ustekinumab doses approximating ustekinumab 6 mg/kg: 260 mg (weight <= 55 kg), 390 mg (weight > 55 kg and <= 85 kg), and 520 mg (weight > 85 kg).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Crohn's Disease, Inflammatory Bowel Disease, IBD, Colitis
Keywords
ustekinumab, moderately to severely active Crohn's Disease, Stelara, IBD, colitis, crohn, UNITI, Crohn's

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
640 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo IV
Arm Type
Placebo Comparator
Arm Description
Group 1: Placebo Form=solution for injection route=intravenous use in a single dose.
Arm Title
Ustekinumab 130 milligram (mg)
Arm Type
Experimental
Arm Description
Group 2 ustekinumab 130 mg Type=exact unit=mg number=130 form=solution for injection route= intravenous use in a single dose.
Arm Title
Ustekinumab approximately (~) 6 milligram per kilogram (mg/kg)
Arm Type
Experimental
Arm Description
Group 3: ustekinumab approximately 6 mg/kg Type=range unit=mg/kg number=6 form=solution for injection route= intravenous use in a single dose.weight-range based ustekinumab doses approximating ustekinumab 6 mg/kg: 260 mg (weight <= 55 kg) 390 mg (weight > 55 kg and <= 85 kg) and 520 mg (weight > 85 kg).
Intervention Type
Drug
Intervention Name(s)
Group 1: Placebo
Intervention Description
Form=solution for injection, route=intravenous use, in a single dose.
Intervention Type
Drug
Intervention Name(s)
Group 2 ustekinumab 130 mg
Intervention Description
Type=exact, unit=mg, number=130, form=solution for injection, route= intravenous use, in a single dose.
Intervention Type
Drug
Intervention Name(s)
Group 3: ustekinumab approximately 6 mg/kg
Intervention Description
Type=range, unit=mg/kg, number=6, form=solution for injection, route= intravenous use, in a single dose.weight-range based ustekinumab doses approximating ustekinumab 6 mg/kg: 260 mg (weight <= 55 kg), 390 mg (weight > 55 kg and <= 85 kg), and 520 mg (weight > 85 kg).
Primary Outcome Measure Information:
Title
Number of Participants With Clinical Response at Week 6
Description
Clinical response at Week 6 was defined as a reduction from baseline in the Crohn's Disease Activity Index (CDAI) score of greater than or equal (>=) 100 points (in general, CDAI score ranges from 0 to approximately 600; higher score indicates higher disease activities). Participants with a baseline CDAI score of > = 220 to less than or equal (< =) 248 were considered to be in clinical response if a CDAI score of less than (<) 150 was attained. A decrease in CDAI score over time indicates improvement in disease activity.
Time Frame
Week 6
Secondary Outcome Measure Information:
Title
Number of Participants in Clinical Remission at Week 8
Description
Clinical remission at Week 8 was defined as a Crohn's Disease Activity Index (CDAI) score of <150 points.
Time Frame
Week 8
Title
Number of Participants in Clinical Response at Week 8
Description
Clinical response at Week 8 was defined as a reduction from baseline in the CDAI score of greater than or equal (>=) 100 points (in general, CDAI score ranges from 0 to approximately 600; higher score indicates higher disease activities). Participants with a baseline CDAI score of > = 220 to less than or equal (< =) 248 were considered to be in clinical response if a CDAI score of less than (<) 150 was attained. A decrease in CDAI score over time indicates improvement in disease activity.
Time Frame
Week 8
Title
Number of Participants With Crohn's Disease Activity Index (CDAI) 70 Point Response at Week 6
Description
70-point response is defined as at least 70 points reduction in CDAI score (in general, CDAI score ranges from 0 to approximately 600; higher score indicates higher disease activities). The CDAI score is used to quantify the symptoms of participants with Crohn's Disease. A decrease in CDAI over time indicates improvement in disease activity.
Time Frame
Week 6
Title
Number of Participants With CDAI 70 Point Response at Week 3
Description
70-point response is defined as at least 70 points reduction in CDAI score (in general, CDAI score ranges from 0 to approximately 600; higher score indicates higher disease activities). The CDAI score is used to quantify the symptoms of participants with Crohn's Disease. A decrease in CDAI over time indicates improvement in disease activity.
Time Frame
Week 3

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Have Crohn's disease of at least 3 months' duration with colitis, ileitis, or ileocolitis, confirmed at some time in the past by radiography, histology, or endoscopy Have active Crohn's disease, defined as a baseline Crohn Disease Activity Index (CDAI) score of >= 220 and <= 450, with confirmation of active inflammation Has failed conventional therapy as demonstrated by having received corticosteroids and/or immunomodulators(ie, AZA, MTX, or 6-MP) at adequate therapeutic doses OR Have a history of failure to respond to or tolerate an adequate course of corticosteroids and/or immunomodulators (ie, AZA, MTX, or 6-MP) at adequate therapeutic doses OR Is corticosteroid dependent or has had a history of corticosteroid dependency AND Has not previously demonstrated failure of or intolerance to 1 or more TNF-antagonist therapies (ie, infliximab, adalimumab, or certolizumab pegol) per study criteria Have screening laboratory test results within protocol-specified parameters Exclusion Criteria: Patients who have had any kind of bowel resection within 6 months Are pregnant or planning pregnancy (both men and women) while enrolled in the study or for 20 weeks after receiving study agent Patients who have received infliximab, adalimumab or certolizumab pegol < = 8 weeks before the first administration of study drug Patients with certain complications of Crohn's disease that would make it hard to assess response to study drug Patients with a history of or ongoing chronic or recurrent infectious disease Patients who have previously received a biologic agent targeting IL-12 or IL-23, including but not limited to ustekinumab (CNTO 1275) or briakinumab (ABT-874)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Janssen Research & Development, LLC Clinical Trial
Organizational Affiliation
Janssen Research & Development, LLC
Official's Role
Study Director
Facility Information:
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Tucson
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Oklahoma City
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Tulsa
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Chesapeake
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Virginia Beach
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Bellevue
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Adelaide
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Concord
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Fremantle
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Garran
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Malvern
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Parkville
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Brussel
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Belgium
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Leuven
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Belgium
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Goiânia
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Brazil
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Porto Alegre
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Brazil
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Rio De Janeiro
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Brazil
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Sao Paulo
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Brazil
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Brazil
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Pleven
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Rousse
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Sofia
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Varna
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Bulgaria
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Calgary
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Edmonton
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Canada
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Vancouver
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Brandon
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Kingston
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London
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Toronto
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Montreal
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Saskatoon
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Canada
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Saskatoon N/A
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Canada
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Winnipeg N/A
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Canada
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Osijek
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Croatia
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Rijeka
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Croatia
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Zagreb
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Croatia
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Amiens Cedex 1
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France
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Bordeaux
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France
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Caen Cedex 9
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France
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Lille
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France
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Paris Cedex 18
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France
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Paris
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France
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Rouen
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France
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Vandoeuvre Les Nancy
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France
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Berlin
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Germany
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Bochum
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Germany
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Frankfurt
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Germany
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Halle
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Germany
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Hamburg
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Germany
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Germany
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Haßloch
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Germany
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Heidelberg
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Germany
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Kiel
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Germany
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Germany
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Mannheim
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Germany
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Minden
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Germany
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München
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Germany
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Münster
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Germany
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Regensburg
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Stade
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Germany
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Ulm
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Germany
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Budapest N/A
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Hungary
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Budapest
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Hungary
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Békéscsaba
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Hungary
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Debrecen
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Hungary
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Gyula
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Mosonmagyaróvár
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Hungary
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Pecs
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Hungary
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Szekesfehervar
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Hungary
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Szekszard
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Reykjavik
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Iceland
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Beer Yaakov
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Israel
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Haifa
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Israel
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Jerusalem
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Israel
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Kfar Saba
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Israel
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Petah Tikva
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Israel
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Rehovot
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Israel
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Tel Aviv
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Israel
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Chikushino
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Japan
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Hachioji
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Japan
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Hamamatsu
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Japan
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Hirosaki
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Japan
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Hiroshima
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Japan
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Kagoshima
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Japan
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Nishinomiya
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Japan
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Ohtsu
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Japan
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Oita
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Japan
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Osaka
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Japan
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Sakura
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Japan
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Sapporo
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Japan
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Sendai
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Japan
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Suita-Shi
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Japan
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Tokyo
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Japan
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Tsu
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Japan
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Uruma
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Japan
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Yokkaichi
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Japan
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Yokohama
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Japan
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Yokosuka
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Japan
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Daegu
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Korea, Republic of
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Gyeonggi-Do
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Korea, Republic of
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Seoul
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Korea, Republic of
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Amsterdam Zuidoost
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Netherlands
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Amsterdam
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Netherlands
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Maastricht
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Netherlands
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Rotterdam
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Netherlands
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Auckland
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New Zealand
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Christchurch
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New Zealand
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Dunedin
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New Zealand
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Grafton
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New Zealand
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Hamilton
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New Zealand
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Hastings
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New Zealand
City
Plenty
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New Zealand
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Wellington
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New Zealand
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Bydgoszcz
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Poland
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Elblag
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Poland
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Krakow
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Poland
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Lodz
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Poland
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Warszawa
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Poland
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Moscow
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Russian Federation
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Novosibirsk
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Russian Federation
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Belgrade
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Serbia
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Beograd
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Serbia
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Cape Town
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South Africa
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Durban
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South Africa
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Pretoria
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South Africa
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Madrid
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Spain
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Sabadell
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Spain
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Santiago De Compostela
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Spain
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Birmingham
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United Kingdom
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Brighton
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United Kingdom
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Bristol
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United Kingdom
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Cambridge
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United Kingdom
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Gloucester
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United Kingdom
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Harrow
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United Kingdom
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Liverpool
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United Kingdom
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London
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United Kingdom
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Manchester
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United Kingdom
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Norwich
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United Kingdom
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Nottinghamshirecc
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United Kingdom
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Oxford
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United Kingdom
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Shrewsbury
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United Kingdom
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Southampton
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United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
36150926
Citation
Adedokun OJ, Xu Z, Gasink C, Kowalski K, Sandborn WJ, Feagan B. Population Pharmacokinetics and Exposure-Response Analyses of Ustekinumab in Patients With Moderately to Severely Active Crohn's Disease. Clin Ther. 2022 Oct;44(10):1336-1355. doi: 10.1016/j.clinthera.2022.08.010. Epub 2022 Sep 21.
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Narula N, Aruljothy A, Wong ECL, Homenauth R, Alshahrani AA, Marshall JK, Reinisch W. The impact of ustekinumab on extraintestinal manifestations of Crohn's disease: A post hoc analysis of the UNITI studies. United European Gastroenterol J. 2021 Jun;9(5):581-589. doi: 10.1002/ueg2.12094. Epub 2021 Jun 2.
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Sandborn WJ, Feagan BG, Danese S, O'Brien CD, Ott E, Marano C, Baker T, Zhou Y, Volger S, Tikhonov I, Gasink C, Sands BE, Ghosh S. Safety of Ustekinumab in Inflammatory Bowel Disease: Pooled Safety Analysis of Results from Phase 2/3 Studies. Inflamm Bowel Dis. 2021 Jun 15;27(7):994-1007. doi: 10.1093/ibd/izaa236. Erratum In: Inflamm Bowel Dis. 2021 Jun 15;27(7):1175.
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PubMed Identifier
31279870
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Li K, Friedman JR, Chan D, Pollack P, Yang F, Jacobstein D, Brodmerkel C, Gasink C, Feagan BG, Sandborn WJ, Rutgeerts P, De Hertogh G. Effects of Ustekinumab on Histologic Disease Activity in Patients With Crohn's Disease. Gastroenterology. 2019 Oct;157(4):1019-1031.e7. doi: 10.1053/j.gastro.2019.06.037. Epub 2019 Jul 4.
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Ghosh S, Gensler LS, Yang Z, Gasink C, Chakravarty SD, Farahi K, Ramachandran P, Ott E, Strober BE. Ustekinumab Safety in Psoriasis, Psoriatic Arthritis, and Crohn's Disease: An Integrated Analysis of Phase II/III Clinical Development Programs. Drug Saf. 2019 Jun;42(6):751-768. doi: 10.1007/s40264-019-00797-3. Erratum In: Drug Saf. 2019 Apr 22;:
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29909019
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Rutgeerts P, Gasink C, Chan D, Lang Y, Pollack P, Colombel JF, Wolf DC, Jacobstein D, Johanns J, Szapary P, Adedokun OJ, Feagan BG, Sandborn WJ. Efficacy of Ustekinumab for Inducing Endoscopic Healing in Patients With Crohn's Disease. Gastroenterology. 2018 Oct;155(4):1045-1058. doi: 10.1053/j.gastro.2018.06.035. Epub 2018 Aug 29.
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Adedokun OJ, Xu Z, Gasink C, Jacobstein D, Szapary P, Johanns J, Gao LL, Davis HM, Hanauer SB, Feagan BG, Ghosh S, Sandborn WJ. Pharmacokinetics and Exposure Response Relationships of Ustekinumab in Patients With Crohn's Disease. Gastroenterology. 2018 May;154(6):1660-1671. doi: 10.1053/j.gastro.2018.01.043. Epub 2018 Feb 1.
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29142515
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Hibi T, Imai Y, Murata Y, Matsushima N, Zheng R, Gasink C. Efficacy and safety of ustekinumab in Japanese patients with moderately to severely active Crohn's disease: a subpopulation analysis of phase 3 induction and maintenance studies. Intest Res. 2017 Oct;15(4):475-486. doi: 10.5217/ir.2017.15.4.475. Epub 2017 Oct 23.
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Feagan BG, Sandborn WJ, Gasink C, Jacobstein D, Lang Y, Friedman JR, Blank MA, Johanns J, Gao LL, Miao Y, Adedokun OJ, Sands BE, Hanauer SB, Vermeire S, Targan S, Ghosh S, de Villiers WJ, Colombel JF, Tulassay Z, Seidler U, Salzberg BA, Desreumaux P, Lee SD, Loftus EV Jr, Dieleman LA, Katz S, Rutgeerts P; UNITI-IM-UNITI Study Group. Ustekinumab as Induction and Maintenance Therapy for Crohn's Disease. N Engl J Med. 2016 Nov 17;375(20):1946-1960. doi: 10.1056/NEJMoa1602773.
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A Study to Evaluate the Safety and Efficacy of Ustekinumab Induction Therapy in Patients With Moderately to Severely Active Crohn's Disease (UNITI-2)

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