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Efficacy and Safety of Adalimumab for the Induction of Clinical Response in Ulcerative Colitis

Primary Purpose

Ulcerative Colitis

Status
Unknown status
Phase
Phase 3
Locations
Israel
Study Type
Interventional
Intervention
Adalimumab
Sponsored by
Clalit Health Services
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ulcerative Colitis focused on measuring Ulcerative colitis, biological treatment, anti-TNF

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female ≥ 18 years of age.
  2. Diagnosis of ulcerative colitis for greater than 90 days prior to Baseline.
  3. Diagnosis of active UC confirmed by colonoscopy with biopsy or flexible sigmoidoscopy with biopsy during the Screening Period, with exclusion of infection.
  4. Active UC with a Mayo score of 6 to 12 points and endoscopy subscore of 2 to 3 points, despite concurrent treatment with at least 1 of the following (oral corticosteroids or immunosuppressants or both as defined below):

    • Stable oral corticosteroid dose (prednisone dose of >= 20 mg/day or equivalent) for at least 14 days prior to Baseline or stable oral corticosteroid dose (prednisone of < 20 mg/day) for at least 40 days prior to Baseline, and/or
    • At least a consecutive 90 day course of azathioprine or 6-mercaptopurine (6 MP) prior to Baseline, with a dose of azathioprine >= 1.5 mg/kg/day or 6 MP >= 1 mg/kg/day (rounded to the nearest available tablet formulation), or a dose that is the highest tolerated by the participant (e.g., due to leukopenia, elevated liver enzymes, nausea) during that time. Participant was to be on a stable dose for at least 28 days prior to Baseline.
  5. Concurrent therapy was not required for participants who were previously treated with corticosteroids or immunosuppressants (azathioprine or 6-MP) during the previous 5 years and, in the judgment of the investigator, have failed to respond to or could not tolerate their treatment.
  6. Has to be able to self-administer subcutaneous injections or has caregiver who can reliably administer subcutaneous injections.
  7. Has to be able and willing to give written informed consent and to comply with the requirements of this study protocol.

Exclusion Criteria:

  1. History of subtotal colectomy with ileorectostomy or colectomy with ileoanal pouch, Koch pouch, or ileostomy for UC or is planning bowel surgery.
  2. Received previous treatment with adalimumab or previous participation in an adalimumab clinical study.
  3. Received cyclosporine, tacrolimus, or mycophenolate mofetil, within 30 days prior to Baseline.
  4. Received intravenous corticosteroids within 14 days prior to Screening or during the Screening Period.
  5. Received therapeutic enema or suppository, other than required for endoscopy, within 14 days prior to the Screening endoscopy and during the remainder of Screening Period.
  6. Current diagnosis of fulminant colitis and/or toxic megacolon.
  7. Subject with disease limited to the rectum (ulcerative proctitis).
  8. Current diagnosis of indeterminate colitis.
  9. Current diagnosis and/or history of Crohn's disease.
  10. Currently receiving total parenteral nutrition (TPN).
  11. Subject using aminosalicylates for less than 90 days prior to Baseline or not on a stable dose for at least 28 days prior to Baseline or discontinued use within 28 days of Baseline.
  12. Subject with positive Clostridium difficile (C. difficile) stool assay.
  13. Subject who has previously used infliximab or any anti-TNF agent within 56 days of Baseline.
  14. Subject who has previously used infliximab or any anti-TNF agent and has not clinically responded at any time ("primary non-responder") unless subject experienced a treatment limiting reaction.

Sites / Locations

  • Sherutey Briuth Clalit / Clalit HMO
  • Lev Talpiot Clinic, Clalit health ServicesRecruiting
  • Zevulun Clinic, Clalit Health ServicesRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Adalimumab

Arm Description

Adalimumab 40 mg

Outcomes

Primary Outcome Measures

Proportion of subjects with clinical response per Mayo Score, at Week 12

Secondary Outcome Measures

Proportion of subjects with remission per Mayo Score at Week 12.

Full Information

First Posted
December 15, 2011
Last Updated
October 28, 2012
Sponsor
Clalit Health Services
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1. Study Identification

Unique Protocol Identification Number
NCT01494857
Brief Title
Efficacy and Safety of Adalimumab for the Induction of Clinical Response in Ulcerative Colitis
Official Title
Open-Label, Non-Randomized, Single Patient Group, Multi-Center Study to Evaluate the Efficacy and Safety of Adalimumab for the Induction of Clinical Response in Moderately to Severely Active Ulcerative Colitis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2012
Overall Recruitment Status
Unknown status
Study Start Date
January 2012 (undefined)
Primary Completion Date
December 2013 (Anticipated)
Study Completion Date
December 2013 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Clalit Health Services

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to assess the clinical benefit and tolerability of adalimumab, a fully human monoclonal antibody to tumor necrosis factor α (TNF- α), in patients with ulcerative colitis (UC) naive to treatment with biologics.
Detailed Description
Ulcerative colitis (UC) is one of the two primary forms of idiopathic inflammatory bowel disease (IBD). Recent studies have shown that TNF- α may play a major role in the etiopathogenesis of UC, justifying the use of anti-TNF-α therapies. Adalimumab is an immunoglobulin G1 that specifically binds to TNF-α, and neutralizes its function; it also modulates the biological response, induced and regulated by TNF-α. Conventional UC therapy quite commonly does not bring satisfactory results; therefore, interest in new treatment methods has been growing recently. Biological therapy is a highly promising prospect, since it enables to discontinue the use of glucocorticosteroids and immunosuppressives or their dose reduction, shortens the hospitalization period, allows to avoid surgical treatment, extends the clinical response, the remission period and improves the patient's quality of life. Thus, the present study assesses the clinical response of active ulcerative colitis to adalimumab treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ulcerative Colitis
Keywords
Ulcerative colitis, biological treatment, anti-TNF

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
200 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Adalimumab
Arm Type
Experimental
Arm Description
Adalimumab 40 mg
Intervention Type
Drug
Intervention Name(s)
Adalimumab
Other Intervention Name(s)
Brand name - Humira (Abbott Pharmaceuticals)
Intervention Description
Adalimumab 40 mg from 4 to 1 injection once in two weeks. Total Treatment period - 10 weeks.
Primary Outcome Measure Information:
Title
Proportion of subjects with clinical response per Mayo Score, at Week 12
Time Frame
week 12
Secondary Outcome Measure Information:
Title
Proportion of subjects with remission per Mayo Score at Week 12.
Time Frame
week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female ≥ 18 years of age. Diagnosis of ulcerative colitis for greater than 90 days prior to Baseline. Diagnosis of active UC confirmed by colonoscopy with biopsy or flexible sigmoidoscopy with biopsy during the Screening Period, with exclusion of infection. Active UC with a Mayo score of 6 to 12 points and endoscopy subscore of 2 to 3 points, despite concurrent treatment with at least 1 of the following (oral corticosteroids or immunosuppressants or both as defined below): Stable oral corticosteroid dose (prednisone dose of >= 20 mg/day or equivalent) for at least 14 days prior to Baseline or stable oral corticosteroid dose (prednisone of < 20 mg/day) for at least 40 days prior to Baseline, and/or At least a consecutive 90 day course of azathioprine or 6-mercaptopurine (6 MP) prior to Baseline, with a dose of azathioprine >= 1.5 mg/kg/day or 6 MP >= 1 mg/kg/day (rounded to the nearest available tablet formulation), or a dose that is the highest tolerated by the participant (e.g., due to leukopenia, elevated liver enzymes, nausea) during that time. Participant was to be on a stable dose for at least 28 days prior to Baseline. Concurrent therapy was not required for participants who were previously treated with corticosteroids or immunosuppressants (azathioprine or 6-MP) during the previous 5 years and, in the judgment of the investigator, have failed to respond to or could not tolerate their treatment. Has to be able to self-administer subcutaneous injections or has caregiver who can reliably administer subcutaneous injections. Has to be able and willing to give written informed consent and to comply with the requirements of this study protocol. Exclusion Criteria: History of subtotal colectomy with ileorectostomy or colectomy with ileoanal pouch, Koch pouch, or ileostomy for UC or is planning bowel surgery. Received previous treatment with adalimumab or previous participation in an adalimumab clinical study. Received cyclosporine, tacrolimus, or mycophenolate mofetil, within 30 days prior to Baseline. Received intravenous corticosteroids within 14 days prior to Screening or during the Screening Period. Received therapeutic enema or suppository, other than required for endoscopy, within 14 days prior to the Screening endoscopy and during the remainder of Screening Period. Current diagnosis of fulminant colitis and/or toxic megacolon. Subject with disease limited to the rectum (ulcerative proctitis). Current diagnosis of indeterminate colitis. Current diagnosis and/or history of Crohn's disease. Currently receiving total parenteral nutrition (TPN). Subject using aminosalicylates for less than 90 days prior to Baseline or not on a stable dose for at least 28 days prior to Baseline or discontinued use within 28 days of Baseline. Subject with positive Clostridium difficile (C. difficile) stool assay. Subject who has previously used infliximab or any anti-TNF agent within 56 days of Baseline. Subject who has previously used infliximab or any anti-TNF agent and has not clinically responded at any time ("primary non-responder") unless subject experienced a treatment limiting reaction.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Timna Naftali, MD
Phone
972-3-6923660
Email
Timna.Naftali@clalit.org.il
Facility Information:
Facility Name
Sherutey Briuth Clalit / Clalit HMO
City
Herzlyia
Country
Israel
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Timna Naftali, MD
Phone
972-9-9620782
Email
Timna.Naftali@clalit.org.il
First Name & Middle Initial & Last Name & Degree
Timna Naftali, MD
Facility Name
Lev Talpiot Clinic, Clalit health Services
City
Jerusalem
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Olga Gourin
Phone
+972-50-6260450
First Name & Middle Initial & Last Name & Degree
Dan Keret, M.D.
Facility Name
Zevulun Clinic, Clalit Health Services
City
Qiryat Bialik
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Lili Merdler
Phone
972-4-8787955
First Name & Middle Initial & Last Name & Degree
Lili Merdler, M.D.

12. IPD Sharing Statement

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Efficacy and Safety of Adalimumab for the Induction of Clinical Response in Ulcerative Colitis

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