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Phase 3 N=386 Randomized Quadruple-blind Treatment

Safety and Efficacy of Adalimumab Versus Ustekinumab for One Year

Crohn Disease

Enrolled (actual)
386
Serious AEs
17.4%
Results posted
Jan 2022
Primary outcome: Primary: Percentage of Participants With Clinical Remission at Week 52 — 61.0; 64.9 percentage of participants

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
Placebo for Ustekinumab (Biological); Placebo for Adalimumab (Biological); Ustekinumab (6 mg/kg) (Biological); Ustekinumab (90 mg) (Biological); Adalimumab (40 mg) (Biological)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Janssen Scientific Affairs, LLC
Primary completion
Dec 2020

Outcome Measures

OutcomeResultp-value
PRIMARY
Percentage of Participants With Clinical Remission at Week 52
61.0; 64.9
SECONDARY
Percentage of Participants With Corticosteroid-free Remission at Week 52
57.4; 60.7
SECONDARY
Percentage of Participants With Clinical Response at Week 52
66.2; 72.3
SECONDARY
Percentage of Participants in Patient Reported Outcome (PRO)-2 Symptom Remission at Week 52
55.4; 56.5
SECONDARY
Percentage of Participants With Clinical Remission at Week 16
60; 57.1
SECONDARY
Percentage of Participants With Endoscopic Remission at Week 52
30.7; 28.5
SECONDARY
Percentage of Participants With Clinical Remission Through Week 52
28.7; 23.0; 47.7; 50.3; 60.0; 57.1
SECONDARY
Percentage of Participants With Clinical Response Through Week 52
46.2; 38.2; 66.2; 68.1; 72.3; 73.3
SECONDARY
Percentage of Participants With Durable Clinical Response at Week 52
60.5; 65.4
SECONDARY
Percentage of Participants With Durable Clinical Remission at Week 52
51.8; 50.8
SECONDARY
Percentage of Participants With Abdominal Pain (AP) Improvement Through Week 52
29.9; 23.0; 54.1; 53.9; 62.9; 59.2
SECONDARY
Percentage of Participants With Reduction in Frequency of Diarrhea Through Week 52
33.3; 30.7; 52.7; 60.3; 53.8; 60.9
SECONDARY
Percentage of Participants With Clinical and Biomarker Remission at Weeks 8, 16 and 52
19.5; 14.1; 29.7; 18.8; 27.2; 20.9
SECONDARY
Percentage of Participants With Adverse Events (AEs)
77.9; 80.1; 80.0; 81.7
SECONDARY
Percentage of Participants With Infections
40.5; 34.0; 43.1; 37.2
SECONDARY
Percentage of Participants With Serious Infections
2.6; 2.1; 3.1; 3.7
SECONDARY
Percentage of Participants With Serious Adverse Events (SAEs)
16.4; 13.1; 0; 0; 19.5; 15.2
SECONDARY
Percentage of Participants With Anti-drug Antibodies
74.4; 2.1

Summary

The purpose of this study is to compare the efficacy of treatment with ustekinumab or adalimumab in biologic naive participants with moderately-to-severely active Crohn's disease (CD) who have previously failed or were intolerant to conventional therapy (corticosteroids and/or immunomodulators, such as azathioprine, 6-mercaptopurine, or methotrexate), as measured by clinical remission at one year.

Eligibility Criteria

Inclusion Criteria

  • Has Crohn's Disease (CD) or fistulizing CD of at least 3 months' duration, with colitis, ileitis, or ileocolitis, confirmed at some time in the past by radiography, histology, and/or endoscopy
  • Has moderately-to-severely active CD with a baseline Crohn's disease activity index (CDAI) score of greater than or equal to (>=) 220 and less than or equal to (<=) 450
  • Has one or more ulceration on screening ileocolonoscopy (which by definition, would result in an Simple Endoscopic Score for Crohn's Disease [SES-CD] of at least 3)
  • Has failed or was intolerant to conventional therapy (corticosteroids, azathioprine [AZA], 6-mercaptopurine [6-MP] and/or methotrexate [MTX]) at adequate doses or is corticosteroid dependent
  • Has not previously received an approved biologic for Crohn's Disease (i.e., infliximab, adalimumab, certolizumab pegol, ustekinumab, natalizumab, vedolizumab or approved biosimilars of these agents)
  • Participants on oral corticosteroids (e.g., prednisone, budesonide) at a prednisone-equivalent dose of <=40 or milligram/day (mg/day) or <=9 mg/day of budesonide are budesonide <=9 mg/day are permitted if doses are stable for 3 weeks prior to baseline
  • Participants on AZA, 6-MP, or MTX at screening (or recently prior), must discontinue these medications at least 3 weeks prior to baseline

Exclusion Criteria

  • Has complications of CD that are likely to require surgery or would confound the ability to assess the effect of ustekinumab or adalimumab treatment using the CDAI, such as: active stoma; short-gut syndrome and severe or symptomatic strictures or stenosis
  • 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 prior to baseline, or 8 weeks prior for intra-abdominal abscesses, if 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 present
  • Has had any kind of bowel resection within 6 months prior to baseline or other intra-abdominal surgery or a hospital admission for bowel obstruction within 3 months prior to baseline
  • Has a stool culture or other examination positive for an enteric pathogen, including Clostridium difficile toxin, in the last 4 months unless a repeat examination is negative and there are no signs of ongoing infection with that pathogen
  • Has received a Bacillus Calmette-Guerin (BCG) vaccination within 12 months or any other live bacterial or live viral vaccination within 2 weeks of baseline
  • Has a history of, or ongoing, chronic or recurrent infectious disease, including but not limited to, chronic renal infection, chronic chest infection, recurrent urinary tract infection (eg, recurrent pyelonephritis or chronic nonremitting cystitis), or infected skin wounds or ulcers
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03464136). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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