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Phase 3 N=215 Randomized Quadruple-blind Treatment

A Study to Evaluate Efficacy and Safety of Ustekinumab Re-induction Therapy in Participants With Moderately to Severely Active Crohn's Disease

Crohn Disease

Enrolled (actual)
215
Serious AEs
10.2%
Results posted
Sep 2023
Primary outcome: Primary: Percentage of Participants With Clinical Response at Week 16 — 49.1; 37.4 Percentage of participants — p=0.089

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
Ustekinumab approximately 6 mg/kg (IV) (Drug); Placebo (SC) (Drug); Placebo (IV) (Drug); Ustekinumab 90 mg (SC) Group 1 (Drug); Ustekinumab 90 mg (SC) Group 2 (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Janssen-Cilag Ltd.
Primary completion
Aug 2022

Outcome Measures

OutcomeResultp-value
PRIMARY
Percentage of Participants With Clinical Response at Week 16
49.1; 37.4 0.089
SECONDARY
Percentage of Participants With Clinical Remission at Week 16
33.3; 27.1 0.338
SECONDARY
Percentage of Participants With Clinical Response at Week 8
51.9; 44.9 0.300
SECONDARY
Percentage of Participants With Clinical Remission at Week 8
35.2; 29.0 0.314
SECONDARY
Percentage of Participants With Normalization of C-reactive Protein (CRP) and/or Normalization of Fecal Calprotectin (fCal) Concentration at Week 16
33.3; 14.9 0.004 sig
SECONDARY
Percentage of Participants With Clinical Remission at Week 24
37.0; 27.1
SECONDARY
Percentage of Participants With Clinical Response at Week 24
47.2; 39.3
SECONDARY
Percentage of Participants With Normalization of C-reactive Protein (CRP) and/or Normalization of Fecal Calprotectin (fCal) Concentration at Week 24
26.9; 21.3
SECONDARY
Percentage of Participants With Treatment-emergent Adverse Events (TEAEs)
70.4; 72.9
SECONDARY
Percentage of Participants With Treatment-emergent Serious Adverse Events (TESAEs)
8.3; 12.1
SECONDARY
Percentage of Participants With Treatment-emergent Infections
33.3; 29.9
SECONDARY
Percentage of Participants With Treatment-emergent Serious Infections
1.9; 1.9
SECONDARY
Change From Baseline in Clinical Laboratory Values for Hematology (Hemoglobin) and Chemistry (Albumin, Total Protein)
2.893; -0.185; 3.245; 0.835; 3.203; -0.400
SECONDARY
Change From Baseline in Clinical Laboratory Values for Hematology (Hematocrit)
0.009; -0.001; 0.010; 0.001; 0.009; 0.001
SECONDARY
Change From Baseline in Clinical Laboratory Values for Hematology (Total White Blood Cell [WBC], Neutrophils, Absolute Lymphocyte, Eosinophils, Platelets)
-0.386; -0.272; -0.329; -0.124; -0.149; 0.104
SECONDARY
Change From Baseline in Clinical Laboratory Values for Chemistry (Alkaline Phosphatase, Alanine Transaminase [ALT], Aspartate Transaminase [AST])
-1.343; -0.582; -0.072; 0.923; -0.296; 0.078
SECONDARY
Change From Baseline in Clinical Laboratory Values for Chemistry (Total Bilirubin, Direct Bilirubin, Creatinine)
0.639; -0.131; 1.476; 0.555; 0.687; 0.254
SECONDARY
Change From Baseline in Clinical Laboratory Values for Chemistry (Sodium, Potassium, Chloride, Blood Urea Nitrogen [BUN]/Urea, Calcium, Phosphate)
0.108; -0.061; -0.165; 0.011; 0.235; -0.117

Summary

The primary purpose of this study is to evaluate the efficacy and safety of a single intravenous (IV) re-induction dose of approximately 6 milligram per kilogram (mg/kg) ustekinumab in participants with secondary loss of response (LoR) to subcutaneous (SC) every 8 Weeks (q8w) 90 mg ustekinumab maintenance therapy.

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 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
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03782376). 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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