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Ulcerative ColitisPhase 2NCT02647866

Study of a Monoclonal Antibody KHK4083 in Moderate Ulcerative Colitis

A Phase 2 study testing KHK4083 in people with Ulcerative Colitis and Digestive System Diseases, run by Kyowa Kirin, Inc. at 23 sites in 7 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to determine the safety and tolerability of administration of multiple ascending doses of KHK4083 and to select the highest dose tolerated by subjects with moderately active Ulcerative Colitis (UC) followed by a Long-term Extension Therapy (LTE) phase for eligible subjects with a clinical… Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
KHK4083
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
66 participants
Where
23 sitesin 7 countries
Study dates
Jun 2016to Oct 2018
Phase
Phase 2
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 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Subject is able and willing to comply with study procedures, and to adhere to dosing, visit schedules and follow-up procedures as described in the protocol and ICF;
  • Subject voluntarily signs/dates an Institutional Review Board (IRB)/Independent Ethics Committee (IEC)-approved ICF in accordance with regulatory and Institutional Guidelines;
  • Male and female subjects ≥ 18 years of age at the time of enrollment;
  • Subject has UC that was diagnosed at least 6 months prior to the Screening visit;
  • Subject has moderately active UC with a total Mayo score of 4-9 and an endoscopic sub-score of at least 2, with disease that extends at least 15 cm from the anal verge;
  • Subject has had previous treatment (within 5 years prior to Screening) with one or more of the following: corticosteroids, immunosuppressive medications or TNF antagonist therapy that was unsuccessful because of a lack of efficacy response.
  • Female subjects (WOCBP) must have a negative pregnancy test at Screening and Baseline. WOCBP must agree to use effective contraception;
  • Male subjects (including those who have had a vasectomy) must use adequate contraception during the study and for at least 6 months after the last dose of investigational product.

Who cannot join

  • Subject, who, for any reason, is judged by the Investigator to be inappropriate for this study;
  • Subject has a medical history of other clinically significant diseases/disorders;
  • Two or more biologic treatments with different mechanisms of action (e.g., infliximab, vedolizumab and golimumab) or Three or more anti-TNF biologics e.g. infliximab, adalimumab
  • Subject requires prescription treatment for UC, except for the stable, oral treatment of UC for 4 weeks prior to screening.
  • Subject has received any of the following prior treatments or treatments within the specified time prior to the Baseline visit:
  • Natalizumab, efalizumab, rituximab or other lymphocyte-depleting treatments, including but not limited, to alkylating agents (such as cyclophosphamide or chlorambucil) and total lymphoid irradiation at any time;
Show all 36Show fewer
  • TNF antagonists within 8 weeks, or 5 half-lives (up to 12 weeks);
  • Vedolizumab within 16 weeks;
  • Methotrexate, cyclosporine, mycophenolate, tacrolimus, thalidomide, or other immune altering drugs within 4 weeks (ophthalmologic preparations are permitted);
  • 5-ASA enema, steroid enema or suppository use within 2 weeks ; and/or Investigational agents within 8 weeks or 5 half-lives (whichever is longer).
  • Subject with recent, suspected or confirmed symptomatic stenosis of the colon, abdominal abscess, or ischemic colitis based on clinical or radiographic data; a history of toxic megacolon; or who had any previous surgery for UC;
  • Subject with known colonic dysplasia, adenomas or polyposis;
  • Subject had major surgery within 4 weeks prior to Screening or an anticipated requirement for major surgery;
  • Subject with enteric pathogens (including Clostridium difficile);
  • Subject with any of the following hematological and chemistry laboratory values:
  • Platelet count < 100,000/mm3;
  • Neutrophils < 1500/mm3;
  • Serum creatinine ≥ 1.6 mg/dL (≥ 144.4 μmol/L);
  • Alkaline phosphatase > 3 times the upper limit of normal (ULN);
  • AST or ALT > 2 times ULN;
  • Total bilirubin > 2 mg/dL, unless due to Gilbert's Syndrome;
  • Serum albumin < 3 g/dL;
  • Hemoglobin < 9 g/dL;
  • Glycated serum hemoglobin A1c ≥ 9%.
  • Subject has clinically significant cardiac disease;
  • Subject is pregnant or breastfeeding;
  • Subject has had major immunologic reaction;
  • Subject is Hepatitis B core antibody or surface antigen positive and/or Hepatitis C antibody positive with detectable RNA;
  • Subject has a history of human immunodeficiency virus (HIV) positivity, tests positive for HIV, or has congenital or acquired immunodeficiency;
  • Subject has or has had active TB, suspected extra-pulmonary TB, a history of incompletely treated TB, or latent TB or other latent infection. Subjects with latent TB (clinical findings, purified protein derivative [PPD] or interferon gamma release assay [IGRA]) may be included in the study if prophylactic therapy for latent TB is started at least 4 weeks prior to Screening. Subjects with a potentially untreated other infection (clinical findings) are to be excluded.
  • Subject has bacterial infections requiring treatment with oral or parenteral antibiotics, within 2 and 4 weeks, respectively.
  • Subject has a history of systemic opportunistic infection or recurrent infections
  • Subject has malignancy or history of malignancy, except for adequately treated basal cell skin cancer or adequately treated carcinoma in-situ of the cervix without recurrence at least 5 years.
  • Subject who received a bacille Calmette-Guérin (BCG) vaccine within 6 months of randomization or live vaccination (e.g., measles, mumps, rubella [MMR]; herpes zoster; varicella, intranasal influenza; and oral poliomyelitis) within 4 weeks of randomization.
  • Subject with a history of or active substance abuse.
  • Subject has other severe acute or chronic medical or psychiatric condition or laboratory abnormality.

Trial locations and contacts

23 sites in 7 countries.

23 sites in 7 countries

Poland7 sites
  • Study site

    Bydgoszcz, 85-168

  • Study site

    Rzeszów, 35-302

  • Study site

    Sopot, 81-756

  • Study site

    Tychy, 43-100

  • Study site

    Warsaw, 00-632

  • Study site

    Warsaw, 03-580

  • Study site

    Warsaw, 54-239

Other trials in Poland

Russia6 sites
  • Study site

    Krasnoyarsk, 660022

  • Study site

    Moscow, 129110

  • Study site

    Novosibirsk, 630091

  • Study site

    Penza, 440026

  • Study site

    Saint Petersburg, 194354

  • Study site

    Saint Petersburg, 196247

Other trials in Russia

Hungary3 sites
  • Study site

    Budapest, 1125

  • Study site

    Budapest, H-1032

  • Study site

    Budapest, H-1083

Other trials in Hungary

Serbia3 sites
  • Bežanija Kosa

    Belgrade, 11080

  • Study site

    Kragujevac, 34 000

  • Study site

    Zemun, Belgrade, 11080

Other trials in Serbia

Czechia2 sites
  • Study site

    Hradec Králové, 500 12

  • Study site

    Znojmo, 669 02

Other trials in Czechia

United States1 site
  • Study site

    Greenville, South Carolina, 29615

Other trials in United States

Romania1 site
  • Study site

    Bucharest, Sector 2, 020125

Other trials in Romania

About this study

Official title: A Phase 2, Multicenter, Randomized, Double-blind, Placebo-controlled Multiple Ascending Dose Study (Induction Therapy) & Long-term Extension Therapy of an Anti-OX40 Monoclonal Antibody (KHK4083) in Subjects With Moderately Active UC

The purpose of this study is to determine the safety and tolerability of administration of multiple ascending doses of KHK4083 and to select the highest dose tolerated by subjects with moderately active Ulcerative Colitis (UC) followed by a Long-term Extension Therapy (LTE) phase for eligible subjects with a clinical response.

Read the detailed description

A Phase 2, double-blind clinical study of multiple ascending doses of KHK4083 (or placebo) with an Long-term Extension Therapy (LTE) phase will be conducted in approximately 60 randomized adult subjects with moderately active UC who have a documented unsuccessful previous treatment.

The Treatment Period includes double-blind Induction Therapy (12 weeks) and Open-label Therapy (OLE) phase (40 weeks) for eligible subjects at Week 12. Subjects already enrolled in the double-blind, long-term extension (LTE) under preceding versions of the protocol who worsen may be eligible to transition to the OLE up to Week 28.

The Follow Up Period after the last administration will be for up to 16 weeks.

Being tested
KHK4083, Placebo
Keywords
4083-002, Intestinal Diseases, Ulcerative Colitis, UC, Mayo Clinic Scoring, Gastrointestinal Tract
Medical subject headings
Colitis, Ulcerative, Digestive System Diseases, Colitis, Gastrointestinal Diseases, Inflammatory Bowel Diseases, Intestinal Diseases, Colonic Diseases, Autoimmune Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • KHK4083Drug

    IV Infusion

  • PlaceboDrug

    IV Infusion

Study groups in NCT02647866
Study groupRoleWhat they receive
KHK4083 Cohort 1ExperimentalSubjects received one 1.0 mg/kg IV infusion treatment of KHK4083 every two weeks from Week 0 to Week 10 of Induction Therapy. Subjects who chose to continue into extension therapy and were eligible received one IV infusion every 4 weeks (at the same dose as Induction Therapy) from Week 12 to Week 48.
Receives: Drug: KHK4083
KHK4083 Cohort 2ExperimentalSubjects received one 3.0 mg/kg IV infusion treatment of KHK4083 every two weeks from Week 0 to Week 10 of Induction Therapy. Subjects who chose to continue into extension therapy and were eligible received one IV infusion every 4 weeks (at the same dose as Induction Therapy) from Week 12 to Week 48.
Receives: Drug: KHK4083
KHK4083 Cohort 3ExperimentalSubjects received one 10.0 mg/kg IV infusion treatment of KHK4083 every two weeks from Week 0 to Week 10 of Induction Therapy. Subjects who chose to continue into extension therapy and were eligible received one IV infusion every 4 weeks (at the same dose as Induction Therapy) from Week 12 to Week 48.
Receives: Drug: KHK4083
KHK4083 Cohort 4ExperimentalSubjects received one maximum tolerated dose (10.0 mg/kg) IV infusion treatment of KHK4083 every two weeks from Week 0 to Week 10 of Induction Therapy. Subjects who chose to continue into extension therapy and were eligible received one IV infusion every 4 weeks (at the same dose as Induction Therapy) from Week 12 to Week 48.
Receives: Drug: KHK4083
PlaceboPlacebo comparatorSubjects received one IV infusion treatment of Placebo every two weeks from Week 0 to Week 10 of Induction Therapy. Subjects who chose to continue into extension therapy and were eligible received one IV infusion every 4 weeks (at the same dose as Induction Therapy) from Week 12 to Week 48. Subjects who participated in Open-Label Therapy received KHK4083 instead of placebo.
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Subjects With Treatment-related Adverse Events

    To determine the safety and tolerability of KHK4083

    Measured: Up to 52 weeks

  2. Number of Subjects With Treatment-related Serious Adverse Events

    To determine the safety and tolerability of KHK4083

    Measured: Up to 52 weeks

  3. Number of Subjects Who Show Improvement in the Mucosa at Week 12

    Measured by the modified Mayo endoscopy sub-score (mMES), which ranges from 0-3 with higher scores = more severe disease.

    Measured: 12 weeks

  4. Proportion of Subjects Who Show Improvement in the Mucosa at Week 52

    Measured by the modified Mayo endoscopy sub-score (mMES), which ranges from 0-3 with higher scores = more severe disease.

    Measured: 52 weeks

Secondary outcomes (9)
  1. Number of Subjects With Confirmed Anti-KHK4083 Antibodies (Immunogenicity)

    The immunogenicity was assessed by determination of the development of anti-drug antibodies (ADA) against KHK4083.

    Measured: 52 weeks

  2. Number of Subjects Who Achieve Mucosal Healing at Week 12

    The endoscopic Mayo Score (Mayo endoscopic subscore) evaluates ulcerative colitis stage, based only on endoscopic exploration. The scale ranges from 0 to 3, with higher scores = more severe activity. Mucosal healing is defined as modified Mayo endoscopy sub-score (mMES) of 0 or 1 at Week 12.

    Measured: 12 weeks

  3. Number of Subjects Who Achieve Mucosal Healing at Week 52

    The endoscopic Mayo Score (Mayo endoscopic subscore) evaluates ulcerative colitis stage, based only on endoscopic exploration. The scale ranges from 0 to 3, with higher scores = more severe activity. Mucosal healing is defined as modified Mayo endoscopy sub-score (mMES) of 0 or 1.

    Measured: 52 weeks

  4. Number of Subjects Who Achieve Clinical Improvement at Week 12

    The Mayo Clinic Score is comprised of 4 parts: stool frequency, rectal bleeding, endoscopic findings and physician's global assessment, each scored from 0-3. The total score ranges from 0-12 with higher scores indicating increased severity of disease. Improvement will be based on a reduction in the total Mayo Clinic score.

    Measured: 12 weeks

  5. Change From Baseline in Total Mayo Scale Score at Week 52

    The Mayo Clinic Score is comprised of 4 parts: stool frequency, rectal bleeding, endoscopic findings and physician's global assessment, each scored from 0-3. The total score ranges from 0-12 with higher scores indicating increased severity of disease. Improvement was based on a reduction (mean change from Baseline [Week 0] to Week 52) in the total Mayo Clinic score.

    Measured: 52 weeks

  6. Number of Subjects Who Achieve a Clinical Response at Week 12

    The Mayo Clinic Score is comprised of 4 parts: stool frequency, rectal bleeding, endoscopic findings and physician's global assessment, each scored from 0-3. The total score ranges from 0-12 with higher scores indicating increased severity of disease. Clinical Response is a reduction in the total Mayo Clinic score of at least 3 points.

    Measured: 12 weeks

  7. Number of Subjects Who Achieve a Clinical Response at Week 52

    The Mayo Clinic Score is comprised of 4 parts: stool frequency, rectal bleeding, endoscopic findings and physician's global assessment, each scored from 0-3. The total score ranges from 0-12 with higher scores indicating increased severity of disease. Clinical Response indicates the change from Baseline in the Total Mayo Clinic score <= -3 and the percentage change from Baseline in the Total Mayo Clinic score <= -30% to Week 12, with an accompanying decrease in the rectal bleeding subscore of at least 1 point or an absolute rectal bleeding subscore of <= 1.

    Measured: 52 weeks

  8. Number of Subjects Who Achieve Clinical Remission at Week 12

    The Mayo Clinic Score is comprised of 4 parts: stool frequency, rectal bleeding, endoscopic findings and physician's global assessment, each scored from 0-3. The total score ranges from 0-12 with higher scores indicating increased severity of disease. Clinical remission is defined as a total Mayo Clinic score of ≤ 2 and no subscores > 1.

    Measured: 12 weeks

  9. Number of Subjects Who Achieve Clinical Remission at Week 52

    The Mayo Clinic Score is comprised of 4 parts: stool frequency, rectal bleeding, endoscopic findings and physician's global assessment, each scored from 0-3. The total score ranges from 0-12 with higher scores indicating increased severity of disease. Clinical remission is defined as a total Mayo Clinic score of ≤ 2 and no subscores > 1.

    Measured: 52 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Jan 2016 (estimated)
  2. Study startJun 2016
  3. Primary completionSep 2018
  4. Study completionOct 2018

Resources

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Sequential
Model description
Double-blind Induction Therapy was separated into Part A for administration of multiple ascending IV doses of KHK4083 (or placebo) to subjects in Cohorts 1-3 and Part B for administration of the maximally tolerated dose (as determined in cohorts 1-3) in expansion cohort 4. Subjects in Part A were prohibited from participating in Part B. Subjects in each cohort were randomly assigned in a 3:1 ratio to receive KHK4083 or placebo by IV infusion over 60 minutes (± 10 min.). Each subject received a total of 6 treatments (1 IV infusion per treatment) every 2 weeks from Week 0 (Day 1) to Week 10. Subjects who completed double-blind Induction Therapy (i.e., at least 5 of 6 treatments) and had a clinical response or mucosal healing, as defined above, were eligible to continue in double-blind Long Term Extension Therapy (Weeks 12-52) \& after protocol amendment all subjects who received at least 5 of 6 treatments were eligible for Open Label Extension Therapy (Weeks 12-52).
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
66 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02647866
Sponsor's protocol ID
4083-002
Status last verified
Apr 2024
First submitted
8 Dec 2015
Last updated
26 Apr 2024
Data monitoring committee
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing KHK4083 in people with Ulcerative Colitis and Digestive System Diseases, run by Kyowa Kirin, Inc. at 23 sites in 7 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 36 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 26 Apr 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 23 sites in Poland, Russia, Hungary, Serbia, Czechia and 2 more countries. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 5 Mar 2020). 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?

Number of Subjects With Treatment-related Adverse Events (time frame: Up to 52 weeks). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 26 Apr 2024.

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