Crohn's DiseasePhase 3GEMINI IINCT00783692
Study of Vedolizumab (MLN0002) in Patients With Moderate to Severe Crohn's Disease
A Phase 3 study testing vedolizumab in people with Crohn's Disease, run by Millennium Pharmaceuticals, Inc. at 114 sites in 3 countries.
Trial summary
The primary purpose of this study was to determine the effect of vedolizumab induction treatment on clinical response and remission at 6 weeks and to determine the effect of vedolizumab maintenance treatment on clinical remission at 52 weeks. Read more about this study
- Who is it for?
- Ages 18 to 80 years
- Conditions the study is for
- Crohn's Disease
- What is being tested?
- vedolizumab
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 1,116 participants
- Where
- 114 sitesin 3 countries
- Study dates
- Dec 2008to May 2012
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Age 18 to 80
- Diagnosis of moderately to severely active Crohn's disease (CD)
- CD involvement of the ileum and/or colon
- Demonstrated, over the previous 5 year period, an inadequate response to, loss of response to, or intolerance of at least 1 of the following agents, within protocol-specified parameters:
- Immunomodulators
- Tumor necrosis factor-alpha (TNFα) antagonists
- Corticosteroids
- May be receiving a therapeutic dose of conventional therapies for irritable bowel disease (IBD) defined by the protocol
Who cannot join
- Evidence of abdominal abscess at the initial screening visit, other than a minimum of 10 aphthous ulcerations involving a minimum of 10 contiguous cm of intestine
- Extensive colonic resection, subtotal or total colectomy
- History of >3 small bowel resections or diagnosis of short bowel syndrome
- Ileostomy, colostomy, or known fixed symptomatic stenosis of the intestine
- Have received non permitted IBD therapies within either 30 or 60 days, depending on the medication, as stated in the protocol
- Chronic hepatitis B or C infection
- Active or latent tuberculosis
Trial locations and contacts
114 sites in 3 countries.
114 sites in 3 countries
United States110 sites
Asheville Gastroenterology Associates, P.A.
Asheville, North Carolina, 28801
Atlanta Gastroenterology Associates
Atlanta, Georgia, 30342
University of Colorado Health Sciences Center
Aurora, Colorado, 80045
Austin Gastroenterology, PA
Austin, Texas, 78705
Gastroenterology Associates
Baton Rouge, Louisiana, 70809
Hepatobiliary Associates of New York
Bayside, New York, 11358
Northwest Gastroenterology Associates
Bellevue, Washington, 98004
University of Alabama at Birmingham
Birmingham, Alabama, 35233
Apex Clinical Trials
Birmingham, Alabama, 35234
Massachusetts General Hospital
Boston, Massachusetts, 02114
Boston Medical Center
Boston, Massachusetts, 02118
Connecticut Gastroenterology Institute
Bristol, Connecticut, 06010
University of North Carolina at Chapel Hill
Chapel Hill, North Carolina, 27599
Medical University Of SC CAR
Charleston, South Carolina, 29425
Charlotte Gastroentology and Hepatology, P.L.L.C
Charlotte, North Carolina, 28207
University of Virginia Health System
Charlottesville, Virginia, 22908
Digestive Health Physician
Cheektowaga, New York, 14225
Metropolitan Gastroenterology Group, P.C.
Chevy Chase, Maryland, 20815
Rush University Medical Center
Chicago, Illinois, 60612
University of Chicago Medical Center
Chicago, Illinois, 60637
Consultants for Clinical Research Inc.
Cincinnati, Ohio, 45219
Cleveland Clinic Foundation
Cleveland, Ohio, 44195
Digestive & Liver Consultants
Clive, Iowa, 50325
Iowa Digestive Disease Center
Clive, Iowa, 50325
Consultants in Gastroenterology
Columbia, South Carolina, 29203
Southeast Regional Research Group
Columbus, Georgia, 31904
Dayton Science Institute
Dayton, Ohio, 45415
The Center for Clinical Studies
Dearborn, Michigan, 48124
Atlanta Center for Gastroenterology, P.C.
Decatur, Georgia, 30033
Puget Sound Medical Research
Edmonds, Washington, 98026
Northwest Piedmont Clinical Research, Inc.
Elkin, North Carolina, 28621
Gastroenterology Associates of Northern Virginia
Fairfax, Virginia, 22031
University of Florida
Gainesville, Florida, 32608
Gastroenterology Center of the MidSouth, PC
Germantown, Tennessee, 38138
Rocky Mountain Clinical Research, LLC
Golden, Colorado, 80401
Long Island Clinical Research Associates
Great Neck, New York, 11021
Gastroenterology Center of Connecticut, P.C.
Hamden, Connecticut, 06518
Bayou City Research, Ltd.
Houston, Texas, 77024
Gastroenterology Consultants
Houston, Texas, 77034
Jacon Medical Research Associates
Houston, Texas, 77090
Indianapolis Gastroenterology & Hepatology, Inc.- ARC
Indianapolis, Indiana, 46237
University of Florida, Jacksonville
Jacksonville, Florida, 32209
East Coast Institute for Research
Jacksonville, Florida, 32223
Borland-Groover Clinic
Jacksonville, Florida, 32256
University Of Kansas
Kansas City, Kansas, 66160
Truman Medical Center
Kansas City, Missouri, 64108
Gastroenterology of the Rockies
Lafayette, Colorado, 80026
Dartmouth-Hitchcock Medical Center
Lebanon, New Hampshire, 03756
University of Kentucky Medical Center
Lexington, Kentucky, 40536
Arapahoe Gastroenterology Associates P.C.
Littleton, Colorado, 80120
South Denver Gastroenterology
Lone Tree, Colorado, 80124
Gastrointestinal Bioscience
Los Angeles, California, 90067
University Of Louisville
Louisville, Kentucky, 40202
Gastroenterology Associates of Central Georgia
Macon, Georgia, 31201
Pharmaseek, LLC
Madison, Wisconsin, 53717
Center for Advanced Gastroenterology
Maitland, Florida, 32751
Osler Clinical Research
Melbourne, Florida, 32901
Long Island Gastroenterology Group, P.C.
Merrick, New York, 11566
Center for Digestive and Liver Diseases, Inc.
Mexico, Missouri, 65265
University of Miami Miller School of Medicine
Miami, Florida, 33136
Wisconsin Center for Advanced Research
Milwaukee, Wisconsin, 53215
Medical College Of Wisconsin
Milwaukee, Wisconsin, 53226
Paramount Medical Specialty
Montebello, California, 90640
Burke Research Associates
Morganton, North Carolina, 28655
Affiliates in Gastroenterology PA
Morristown, New Jersey, 07960
Vanderbilt University Medical Center
Nashville, Tennessee, 37232
University of Medicine and Dentistry of New Jersey-NJMS
New Brunswick, New Jersey, 08903
United Medical Research Institute
New Smyrna Beach, Florida, 32168
New York Presbyterian Hospital
New York, New York, 10021
Present Chapman Marion Steinlauf MD PC
New York, New York, 10028
Digestive Research Associates
Newnan, Georgia, 30263
Digestive and Liver Disease Specialist Ltd.
Norfolk, Virginia, 23502
Compass Research LLC
Orlando, Florida, 32806
Internal Medicine Specialists
Orlando, Florida, 32806
Digestive Health Center
Pasadena, Texas, 77504
University of Pittsburgh Medical Center - Cancer Centers
Pittsburgh, Pennsylvania, 15213
Kim, Chung MD (Private Practice)
Pittsford, New York, 14534
Minnesota Gastroenterology, P.A.
Plymouth, Minnesota, 55486
The Oregon Clinic-West Hills Gastroenterology
Portland, Oregon, 97225
Shah Associates
Prince Frederick, Maryland, 20678
Lynn Institute of Pueblo
Pueblo, Colorado, 81007
Hunter Holmes McGuire VA Medical Center
Richmond, Virginia, 23249
Mayo Clinic
Rochester, Minnesota, 55905
University of Rochester
Rochester, New York, 14642
Capital Gastroenterology Consultants Medical Group
Sacramento, California, 95815
Alamo Medical Research
San Antonio, Texas, 78215
Gastroenterology Clinic of San Antonio
San Antonio, Texas, 78229
Stone Oak Research Foundation
San Antonio, Texas, 78258
Clinical Applications Laboratories Inc.
San Diego, California, 92103
Desta Digestive Disease Medical Center
San Diego, California, 92114
Granite Peaks Gastroenterology
Sandy City, Utah, 84094
St. Joseph's/Candler Health System
Savannah, Georgia, 31405
Long Island Digestive Disease Consultants
Setauket, New York, 11733
DLW Research System
Snellville, Georgia, 30039
Washington University
St Louis, Missouri, 63110
St. Louis Center for Clinical Research
St Louis, Missouri, 63128
SUNY Stony Brook University Medical Center
Stony Brook, New York, 11794
Syracuse Gastroenterological Associates
Syracuse, New York, 13210
University of South Florida
Tampa, Florida, 33606
West Wind'r Research & Development, LLC
Tampa, Florida, 33607
Cotton O'Neil Digestive Health Center
Topeka, Kansas, 66606
Center for Digestive Health
Troy, Michigan, 48098
Options Health Research
Tulsa, Oklahoma, 74104
Digestive Health Specialists
Tupelo, Mississippi, 38801
Digestive Health Specialists of Tyler
Tyler, Texas, 75701
Carle Clinic Association P.C.
Urbana, Illinois, 58150
The Gastroenterology Group of South Jersey
Vineland, New Jersey, 08360
Wake Forest University Baptist Medical Center
Winston-Salem, North Carolina, 27157
Shafran Gastroenterology Center
Winter Park, Florida, 32789
Gastroenterology Associates of Western Michigan, P.L.C.
Wyoming, Michigan, 49519
Canada3 sites
GI Research
Edmonton, Alberta, T5H4B9
Zeidler Ledcor Center-Univerisity of Alberta
Edmonton, Alberta, T6G2X8
Royal University Hospital
Saskatoon, Saskatchewan, S7N 0W8
About this study
Official title: A Phase 3, Randomized, Placebo-Controlled, Blinded, Multicenter Study of the Induction and Maintenance of Clinical Response and Remission by Vedolizumab (MLN0002) in Patients With Moderate to Severe Crohn's Disease
The primary purpose of this study was to determine the effect of vedolizumab induction treatment on clinical response and remission at 6 weeks and to determine the effect of vedolizumab maintenance treatment on clinical remission at 52 weeks.
Read the detailed description
Study C13007 comprised 2 randomized, double-blind, placebo-controlled studies conducted under 1 protocol which, operationally, consisted of 2 phases.
- The Induction Phase, designed to establish the efficacy and safety of vedolizumab for the induction of clinical response and clinical remission, and
- The Maintenance Phase, designed to establish the efficacy and safety of vedolizumab for the maintenance of clinical response and clinical remission.
The 6-week Induction Phase contained 2 cohorts of participants: Cohort 1 participants were randomized and treated with double-blind study drug, and Cohort 2 participants were treated with open-label vedolizumab. The second cohort was enrolled to ensure that the sample size of Induction Phase responders randomized into the Maintenance Study provided sufficient power for the Maintenance Study primary efficacy analysis. These participants did not contribute to the efficacy analyses performed for the Induction Study. Participants in both cohorts were assessed for treatment response at Week 6.
In the Maintenance Phase vedolizumab-treated participants from both Cohort 1 and Cohort 2 who demonstrated a clinical response were randomized in a 1:1:1 ratio to double-blind treatment with vedolizumab administered every 4 weeks (Q4W), vedolizumab administered every 8 weeks (Q8W), or placebo. Vedolizumab-treated participants who did not demonstrate response at Week 6 continued treatment with open-label vedolizumab, administered Q4W. Participants treated with double-blind placebo in the Induction Phase continued on double-blind placebo during the Maintenance Phase, regardless of treatment response during induction. The Maintenance Phase began at Week 6 and concluded with Week 52 assessments.
After the Week 52 assessments, participants may have been eligible to enroll in Study C13008 (NCT00790933; Long-term Safety Study) to receive open-label vedolizumab treatment. Participants who withdrew early (prior to Week 52) due to sustained nonresponse, disease worsening, or the need for rescue medications may have been eligible to enroll in Study C13008. Participants who did not enroll into Study C13008 were to complete a final on-study safety assessment at Week 66 (or Final Safety visit 16 weeks after the last dose) in the Maintenance Phase of Study C13007.
- Conditions
- Crohn's Disease
- Being tested
- vedolizumab, Placebo
- Medical subject headings
- Crohn Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
vedolizumabDrug
Also called Entyvio, MLN0002, MLN02, LDP-02
Vedolizumab for intravenous infusion
PlaceboOther
Placebo intravenous infusion
| Study group | Role | What they receive |
|---|---|---|
| Vedolizumab | Experimental | In the Induction Phase participants received vedolizumab 300 mg, administered by intravenous infusion at Week 0 and Week 2 (Days 1 and 15).
In the Maintenance Phase, participants who demonstrated a clinical response at Week 6 according to protocol-specified criteria were randomized in a 1:1:1 ratio to double-blind treatment with vedolizumab administered every 4 weeks, vedolizumab administered every 8 weeks, or placebo for up to Week 50. Participants who did not demonstrate response at Week 6 of the Induction Phase continued treatment with vedolizumab, administered every 4 weeks during the Maintenance Phase. Receives: Drug: vedolizumab |
| Placebo | Placebo comparator | In the Induction Phase participants received placebo intravenous infusion at Week 0 and Week 2 (Days 1 and 15). Participants continued to receive placebo during the Maintenance Phase, regardless of treatment response during Induction. Receives: Other: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Induction Phase: Percentage of Participants Achieving Clinical Remission at Week 6
Clinical remission is defined as a Crohn's Disease Activity Index (CDAI) score ≤ 150 points.
The CDAI is used to quantify the symptoms of patients with Crohn's disease and consists of eight factors, each summed after adjustment with a weighting factor. The components of the CDAI are:
- Number of liquid or soft stools each day for 7 days;
- Abdominal pain (graded from 0-3 on severity) each day for 7 days;
- General well-being, subjectively assessed from 0 (well) to 4 (terrible) each day for 7 days;
- Presence of complications;
- Taking Lomotil or opiates for diarrhea;
- Presence of an abdominal mass (0 as none, 2 as questionable, 5 as definite);
- Hematocrit of < 0.47 in men and < 0.42 in women;
- Percentage deviation from standard weight.
The total score ranges from 0 to approximately 600 and with higher scores indicating greater disease activity.
All participants who prematurely discontinued for any reason were considered as not achieving clinical remission.
Measured: Week 6
Induction Phase: Percentage of Participants With Enhanced Clinical Response at Week 6
Enhanced clinical response is defined as a CDAI score at least 100 points lower than Baseline. The CDAI is used to quantify the symptoms of patients with Crohn's disease and consists of eight factors, each summed after adjustment with a weighting factor. The components of the CDAI are:
- Number of liquid or soft stools each day for 7 days;
- Abdominal pain (graded from 0-3 on severity) each day for 7 days;
- General well-being, subjectively assessed from 0 (well) to 4 (terrible) each day for 7 days;
- Presence of complications;
- Taking Lomotil or opiates for diarrhea;
- Presence of an abdominal mass (0 as none, 2 as questionable, 5 as definite);
- Hematocrit of < 0.47 in men and < 0.42 in women;
- Percentage deviation from standard weight.
The total score ranges from 0 to 600 with higher scores indicating greater disease activity.
All participants who prematurely discontinued for any reason were considered as not achieving enhanced clinical response.
Measured: Baseline and Week 6
Maintenance Phase: Percentage of Participants Achieving Clinical Remission at Week 52
Clinical remission is defined as a CDAI score ≤ 150. The CDAI is used to quantify the symptoms of patients with Crohn's disease and consists of eight factors, each summed after adjustment with a weighting factor. The components of the CDAI are:
- Number of liquid or soft stools each day for 7 days;
- Abdominal pain (graded from 0-3 on severity) each day for 7 days;
- General well-being, subjectively assessed from 0 (well) to 4 (terrible) each day for 7 days;
- Presence of complications;
- Taking Lomotil or opiates for diarrhea;
- Presence of an abdominal mass (0 as none, 2 as questionable, 5 as definite);
- Hematocrit of < 0.47 in men and < 0.42 in women;
- Percentage deviation from standard weight.
The total score ranges from 0 to 600 with higher scores indicating greater disease activity.
All participants who prematurely discontinued for any reason were considered as not achieving clinical remission.
Measured: Week 52
Secondary outcomes (4)
Induction Phase: Change From Baseline in C-Reactive Protein (CRP) Levels at Week 6
C-reactive protein (CRP) is a protein found in the blood, the levels of which rise in response to inflammation. Normal concentration in healthy human serum is usually lower than 10 mg/L, slightly increasing with age. Higher levels indicate mild inflammation (10-40 mg/L) and active inflammation (40-200 mg/L).
Measured: Baseline and Week 6
Maintenance Phase: Percentage of Participants With Enhanced Clinical Response at Week 52
Enhanced clinical response is defined as a CDAI score at least 100 points lower than the Baseline value. The CDAI is used to quantify the symptoms of patients with Crohn's disease and consists of eight factors, each summed after adjustment with a weighting factor. The components of the CDAI are:
- Number of liquid or soft stools each day for 7 days;
- Abdominal pain (graded from 0-3 on severity) each day for 7 days;
- General well-being, subjectively assessed from 0 (well) to 4 (terrible) each day for 7 days;
- Presence of complications;
- Taking Lomotil or opiates for diarrhea;
- Presence of an abdominal mass (0 as none, 2 as questionable, 5 as definite);
- Hematocrit of < 0.47 in men and < 0.42 in women;
- Percentage deviation from standard weight.
The total score ranges from 0 to 600 with higher scores indicating greater disease activity.
All participants who prematurely discontinued for any reason were considered as not achieving enhanced clinical response.
Measured: Baseline and Week 52
Maintenance Phase: Percentage of Participants in Corticosteroid-free Clinical Remission at Week 52
Participants using oral corticosteroids at Baseline, who discontinued corticosteroids and were in clinical remission (CDAI score ≤ 150) at Week 52 achieved corticosteroid-free clinical remission. The CDAI quantifies the symptoms of patients with Crohn's disease and consists of eight factors, summed after adjustment with a weighting factor. The total score ranges from 0 to 600 with higher scores indicating greater disease activity.
All participants who prematurely discontinued for any reason were considered as not achieving corticosteroid-free clinical remission.
Measured: Week 52
Maintenance Phase: Percentage of Participants With Durable Clinical Remission
Durable clinical remission is defined as CDAI score ≤ 150 points at 80% or more of study visits during the Maintenance Phase, including the Week 52 visit (11 of 13 study visits). The CDAI quantifies the symptoms of patients with Crohn's disease and consists of eight factors, summed after adjustment with a weighting factor. The total score ranges from 0 to 600 with higher scores indicating greater disease activity.
All participants who prematurely discontinued for any reason were considered as not achieving durable clinical remission
Measured: Assessed every 4 weeks from Week 6 to Week 50, and at Week 52
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted3 Nov 2008 (estimated)
- Study startDec 2008
- Primary completionMar 2012
- Study completionMay 2012
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for Crohn's DiseaseStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- Triple blind
- Who is masked
- Participant, Care provider, Investigator
- Enrolment
- 1,116 participants (actual)
Sponsor and investigators
- Lead sponsor
- Millennium Pharmaceuticals, Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Medical Monitor, Study director, Millennium Pharmaceuticals, Inc.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00783692
- Sponsor's protocol ID
- C13007
- Other IDs
- 2008-002783-33, U1111-1157-7675, CTRI/2009/091/000135, NMRR-08-1047-2202, 09/H1102/65, NL25208.096.08, C13007CTIL, 2008
- Acronym
- GEMINI II
- Status last verified
- Jun 2014
- First submitted
- 31 Oct 2008
- Last updated
- 21 Jul 2014
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
Publications
Wyant T, Yang L, Rosario M. Comparison of the ELISA and ECL Assay for Vedolizumab Anti-drug Antibodies: Assessing the Impact on Pharmacokinetics and Safety Outcomes of the Phase 3 GEMINI Trials. AAPS J. 2020 Nov 16;23(1):3. doi: 10.1208/s12248-020-00518-0.
PubMed 33200296Okamoto H, Dirks NL, Rosario M, Hori T, Hibi T. Population pharmacokinetics of vedolizumab in Asian and non-Asian patients with ulcerative colitis and Crohn's disease. Intest Res. 2021 Jan;19(1):95-105. doi: 10.5217/ir.2019.09167. Epub 2020 Jul 10.
PubMed 32635680Sands BE, Van Assche G, Tudor D, Akhundova-Unadkat G, Curtis RI, Tan T. Vedolizumab in Combination With Corticosteroids for Induction Therapy in Crohn's Disease: A Post Hoc Analysis of GEMINI 2 and 3. Inflamm Bowel Dis. 2019 Jul 17;25(8):1375-1382. doi: 10.1093/ibd/izy384.
PubMed 30615117Feagan BG, Sandborn WJ, Colombel JF, Byrne SO, Khalid JM, Kempf C, Geransar P, Bhayat F, Rubin DT. Incidence of Arthritis/Arthralgia in Inflammatory Bowel Disease with Long-term Vedolizumab Treatment: Post Hoc Analyses of the GEMINI Trials. J Crohns Colitis. 2019 Jan 1;13(1):50-57. doi: 10.1093/ecco-jcc/jjy125.
PubMed 30203005Feagan BG, Lasch K, Lissoos T, Cao C, Wojtowicz AM, Khalid JM, Colombel JF. Rapid Response to Vedolizumab Therapy in Biologic-Naive Patients With Inflammatory Bowel Diseases. Clin Gastroenterol Hepatol. 2019 Jan;17(1):130-138.e7. doi: 10.1016/j.cgh.2018.05.026. Epub 2018 May 29.
PubMed 29857145Feagan BG, Schwartz D, Danese S, Rubin DT, Lissoos TW, Xu J, Lasch K. Efficacy of Vedolizumab in Fistulising Crohn's Disease: Exploratory Analyses of Data from GEMINI 2. J Crohns Colitis. 2018 Apr 27;12(5):621-626. doi: 10.1093/ecco-jcc/jjy019.
PubMed 29471381Colombel JF, Sands BE, Rutgeerts P, Sandborn W, Danese S, D'Haens G, Panaccione R, Loftus EV Jr, Sankoh S, Fox I, Parikh A, Milch C, Abhyankar B, Feagan BG. The safety of vedolizumab for ulcerative colitis and Crohn's disease. Gut. 2017 May;66(5):839-851. doi: 10.1136/gutjnl-2015-311079. Epub 2016 Feb 18.
PubMed 26893500Rosario M, Dirks NL, Gastonguay MR, Fasanmade AA, Wyant T, Parikh A, Sandborn WJ, Feagan BG, Reinisch W, Fox I. Population pharmacokinetics-pharmacodynamics of vedolizumab in patients with ulcerative colitis and Crohn's disease. Aliment Pharmacol Ther. 2015 Jul;42(2):188-202. doi: 10.1111/apt.13243. Epub 2015 May 20.
PubMed 25996351Sandborn WJ, Feagan BG, Rutgeerts P, Hanauer S, Colombel JF, Sands BE, Lukas M, Fedorak RN, Lee S, Bressler B, Fox I, Rosario M, Sankoh S, Xu J, Stephens K, Milch C, Parikh A; GEMINI 2 Study Group. Vedolizumab as induction and maintenance therapy for Crohn's disease. N Engl J Med. 2013 Aug 22;369(8):711-21. doi: 10.1056/NEJMoa1215739.
PubMed 23964933
Study at a glance
From the registry record, last updated by the sponsor on 21 Jul 2014. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3, Randomized, Placebo-Controlled, Blinded, Multicenter Study of the Induction and Maintenance of Clinical Response and Remission by Vedolizumab (MLN0002) in Patients With Moderate to Severe Crohn's Disease
- ClinicalTrials.gov ID
- NCT00783692
- Acronym / sponsor ID
- GEMINI II / C13007
- Conditions
- Crohn's Disease
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 1,116 participants (actual)
- Lead sponsor
- Millennium Pharmaceuticals, Inc.Industry (pharma, biotech, devices)
- Study start
- Dec 2008
- Primary completion
- Mar 2012 (actual)
- Study completion
- May 2012 (actual)
- First posted
- 3 Nov 2008 (estimated)
- Results
- Posted 21 Jul 2014
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary purpose of this study was to determine the effect of vedolizumab induction treatment on clinical response and remission at 6 weeks and to determine the effect of vedolizumab maintenance treatment on clinical remission at 52 weeks.
Detailed description
Study C13007 comprised 2 randomized, double-blind, placebo-controlled studies conducted under 1 protocol which, operationally, consisted of 2 phases.
- The Induction Phase, designed to establish the efficacy and safety of vedolizumab for the induction of clinical response and clinical remission, and
- The Maintenance Phase, designed to establish the efficacy and safety of vedolizumab for the maintenance of clinical response and clinical remission.
The 6-week Induction Phase contained 2 cohorts of participants: Cohort 1 participants were randomized and treated with double-blind study drug, and Cohort 2 participants were treated with open-label vedolizumab. The second cohort was enrolled to ensure that the sample size of Induction Phase responders randomized into the Maintenance Study provided sufficient power for the Maintenance Study primary efficacy analysis. These participants did not contribute to the efficacy analyses performed for the Induction Study. Participants in both cohorts were assessed for treatment response at Week 6.
In the Maintenance Phase vedolizumab-treated participants from both Cohort 1 and Cohort 2 who demonstrated a clinical response were randomized in a 1:1:1 ratio to double-blind treatment with vedolizumab administered every 4 weeks (Q4W), vedolizumab administered every 8 weeks (Q8W), or placebo. Vedolizumab-treated participants who did not demonstrate response at Week 6 continued treatment with open-label vedolizumab, administered Q4W. Participants treated with double-blind placebo in the Induction Phase continued on double-blind placebo during the Maintenance Phase, regardless of treatment response during induction. The Maintenance Phase began at Week 6 and concluded with Week 52 assessments.
After the Week 52 assessments, participants may have been eligible to enroll in Study C13008 (NCT00790933; Long-term Safety Study) to receive open-label vedolizumab treatment. Participants who withdrew early (prior to Week 52) due to sustained nonresponse, disease worsening, or the need for rescue medications may have been eligible to enroll in Study C13008. Participants who did not enroll into Study C13008 were to complete a final on-study safety assessment at Week 66 (or Final Safety visit 16 weeks after the last dose) in the Maintenance Phase of Study C13007.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- Triple blind (participant, care provider, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Vedolizumab | Experimental | Drug: vedolizumabIn the Induction Phase participants received vedolizumab 300 mg, administered by intravenous infusion at Week 0 and Week 2 (Days 1 and 15). In the Maintenance Phase, participants who demonstrated a clinical response at Week 6 according to protocol-specified criteria were randomized in a 1:1:1 ratio to double-blind treatment with vedolizumab administered every 4 weeks, vedolizumab administered every 8 weeks, or placebo for up to Week 50. Participants who did not demonstrate response at Week 6 of the Induction Phase continued treatment with vedolizumab, administered every 4 weeks during the Maintenance Phase. |
| Placebo | Placebo comparator | Other: PlaceboIn the Induction Phase participants received placebo intravenous infusion at Week 0 and Week 2 (Days 1 and 15). Participants continued to receive placebo during the Maintenance Phase, regardless of treatment response during Induction. |
Who may qualify
- Ages
- 18 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (8 listed)
- Age 18 to 80
- Diagnosis of moderately to severely active Crohn's disease (CD)
- CD involvement of the ileum and/or colon
- Demonstrated, over the previous 5 year period, an inadequate response to, loss of response to, or intolerance of at least 1 of the following agents, within protocol-specified parameters:
- May be receiving a therapeutic dose of conventional therapies for irritable bowel disease (IBD) defined by the protocol
Key exclusion criteria (7 listed)
- Evidence of abdominal abscess at the initial screening visit, other than a minimum of 10 aphthous ulcerations involving a minimum of 10 contiguous cm of intestine
- Extensive colonic resection, subtotal or total colectomy
- History of >3 small bowel resections or diagnosis of short bowel syndrome
- Ileostomy, colostomy, or known fixed symptomatic stenosis of the intestine
- Have received non permitted IBD therapies within either 30 or 60 days, depending on the medication, as stated in the protocol
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| vedolizumabAlso: Entyvio, MLN0002, MLN02, LDP-02Vedolizumab for intravenous infusion | Drug | Vedolizumab |
| PlaceboPlacebo intravenous infusion | Other | Placebo |
Primary outcome
Induction Phase: Percentage of Participants Achieving Clinical Remission at Week 6
Time frame: Week 6
Clinical remission is defined as a Crohn's Disease Activity Index (CDAI) score ≤ 150 points. The CDAI is used to quantify the symptoms of patients with Crohn's disease and consists of eight factors, each summed after adjustment with a weighting factor. The components of the CDAI are: * Number of liquid or soft stools each day for 7 days; * Abdominal pain (graded from 0-3 on severity) each day for 7 days; * General well-being, subjectively assessed from 0 (well) to 4 (terrible) each day for 7 days; * Presence of complications; * Taking Lomotil or opiates for diarrhea; * Presence of an abdominal mass (0 as none, 2 as questionable, 5 as definite); * Hematocrit of < 0.47 in men and < 0.42 in women; * Percentage deviation from standard weight. The total score ranges from 0 to approximately 600 and with higher scores indicating greater disease activity. All participants who prematurely discontinued for any reason were considered as not achieving clinical remission.
Induction Phase: Percentage of Participants With Enhanced Clinical Response at Week 6
Time frame: Baseline and Week 6
Enhanced clinical response is defined as a CDAI score at least 100 points lower than Baseline. The CDAI is used to quantify the symptoms of patients with Crohn's disease and consists of eight factors, each summed after adjustment with a weighting factor. The components of the CDAI are: * Number of liquid or soft stools each day for 7 days; * Abdominal pain (graded from 0-3 on severity) each day for 7 days; * General well-being, subjectively assessed from 0 (well) to 4 (terrible) each day for 7 days; * Presence of complications; * Taking Lomotil or opiates for diarrhea; * Presence of an abdominal mass (0 as none, 2 as questionable, 5 as definite); * Hematocrit of < 0.47 in men and < 0.42 in women; * Percentage deviation from standard weight. The total score ranges from 0 to 600 with higher scores indicating greater disease activity. All participants who prematurely discontinued for any reason were considered as not achieving enhanced clinical response.
Maintenance Phase: Percentage of Participants Achieving Clinical Remission at Week 52
Time frame: Week 52
Clinical remission is defined as a CDAI score ≤ 150. The CDAI is used to quantify the symptoms of patients with Crohn's disease and consists of eight factors, each summed after adjustment with a weighting factor. The components of the CDAI are: * Number of liquid or soft stools each day for 7 days; * Abdominal pain (graded from 0-3 on severity) each day for 7 days; * General well-being, subjectively assessed from 0 (well) to 4 (terrible) each day for 7 days; * Presence of complications; * Taking Lomotil or opiates for diarrhea; * Presence of an abdominal mass (0 as none, 2 as questionable, 5 as definite); * Hematocrit of < 0.47 in men and < 0.42 in women; * Percentage deviation from standard weight. The total score ranges from 0 to 600 with higher scores indicating greater disease activity. All participants who prematurely discontinued for any reason were considered as not achieving clinical remission.
4 secondary outcomes
Induction Phase: Change From Baseline in C-Reactive Protein (CRP) Levels at Week 6
Time frame: Baseline and Week 6
Maintenance Phase: Percentage of Participants With Enhanced Clinical Response at Week 52
Time frame: Baseline and Week 52
Maintenance Phase: Percentage of Participants in Corticosteroid-free Clinical Remission at Week 52
Time frame: Week 52
Maintenance Phase: Percentage of Participants With Durable Clinical Remission
Time frame: Assessed every 4 weeks from Week 6 to Week 50, and at Week 52
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 21 Jul 2014.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 33200296Wyant T, Yang L, Rosario M. Comparison of the ELISA and ECL Assay for Vedolizumab Anti-drug Antibodies: Assessing the Impact on Pharmacokinetics and Safety Outcomes of the Phase 3 GEMINI Trials. AAPS J. 2020 Nov 16;23(1):3. doi: 10.1208/s12248-020-00518-0.
- Derived from this study: PubMed 32635680Okamoto H, Dirks NL, Rosario M, Hori T, Hibi T. Population pharmacokinetics of vedolizumab in Asian and non-Asian patients with ulcerative colitis and Crohn's disease. Intest Res. 2021 Jan;19(1):95-105. doi: 10.5217/ir.2019.09167. Epub 2020 Jul 10.
- Derived from this study: PubMed 30615117Sands BE, Van Assche G, Tudor D, Akhundova-Unadkat G, Curtis RI, Tan T. Vedolizumab in Combination With Corticosteroids for Induction Therapy in Crohn's Disease: A Post Hoc Analysis of GEMINI 2 and 3. Inflamm Bowel Dis. 2019 Jul 17;25(8):1375-1382. doi: 10.1093/ibd/izy384.
- Derived from this study: PubMed 30203005Feagan BG, Sandborn WJ, Colombel JF, Byrne SO, Khalid JM, Kempf C, Geransar P, Bhayat F, Rubin DT. Incidence of Arthritis/Arthralgia in Inflammatory Bowel Disease with Long-term Vedolizumab Treatment: Post Hoc Analyses of the GEMINI Trials. J Crohns Colitis. 2019 Jan 1;13(1):50-57. doi: 10.1093/ecco-jcc/jjy125.
- Derived from this study: PubMed 29857145Feagan BG, Lasch K, Lissoos T, Cao C, Wojtowicz AM, Khalid JM, Colombel JF. Rapid Response to Vedolizumab Therapy in Biologic-Naive Patients With Inflammatory Bowel Diseases. Clin Gastroenterol Hepatol. 2019 Jan;17(1):130-138.e7. doi: 10.1016/j.cgh.2018.05.026. Epub 2018 May 29.
- Derived from this study: PubMed 29471381Feagan BG, Schwartz D, Danese S, Rubin DT, Lissoos TW, Xu J, Lasch K. Efficacy of Vedolizumab in Fistulising Crohn's Disease: Exploratory Analyses of Data from GEMINI 2. J Crohns Colitis. 2018 Apr 27;12(5):621-626. doi: 10.1093/ecco-jcc/jjy019.
- Derived from this study: PubMed 26893500Colombel JF, Sands BE, Rutgeerts P, Sandborn W, Danese S, D'Haens G, Panaccione R, Loftus EV Jr, Sankoh S, Fox I, Parikh A, Milch C, Abhyankar B, Feagan BG. The safety of vedolizumab for ulcerative colitis and Crohn's disease. Gut. 2017 May;66(5):839-851. doi: 10.1136/gutjnl-2015-311079. Epub 2016 Feb 18.
- Derived from this study: PubMed 25996351Rosario M, Dirks NL, Gastonguay MR, Fasanmade AA, Wyant T, Parikh A, Sandborn WJ, Feagan BG, Reinisch W, Fox I. Population pharmacokinetics-pharmacodynamics of vedolizumab in patients with ulcerative colitis and Crohn's disease. Aliment Pharmacol Ther. 2015 Jul;42(2):188-202. doi: 10.1111/apt.13243. Epub 2015 May 20.
- Derived from this study: PubMed 23964933Sandborn WJ, Feagan BG, Rutgeerts P, Hanauer S, Colombel JF, Sands BE, Lukas M, Fedorak RN, Lee S, Bressler B, Fox I, Rosario M, Sankoh S, Xu J, Stephens K, Milch C, Parikh A; GEMINI 2 Study Group. Vedolizumab as induction and maintenance therapy for Crohn's disease. N Engl J Med. 2013 Aug 22;369(8):711-21. doi: 10.1056/NEJMoa1215739.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Medical Monitor study director
Millennium Pharmaceuticals, Inc.
114 sites in 3 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing vedolizumab in people with Crohn's Disease, run by Millennium Pharmaceuticals, Inc. at 114 sites in 3 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 8 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 21 Jul 2014. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 114 sites in United States, Canada, Puerto Rico. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 21 Jul 2014). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Induction Phase: Percentage of Participants Achieving Clinical Remission at Week 6 (time frame: Week 6). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00783692, which also lists 9 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Jul 2014.