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A Study of Vedolizumab in Children and Teenagers With Moderate to Severe Crohn's Disease (CD)

NCT04779320 · Takeda
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Official title
A Randomized, Double-Blind, Phase 3 Study to Evaluate the Efficacy and Safety of Vedolizumab Intravenous as Maintenance Therapy in Pediatric Subjects With Moderately to Severely Active Crohn's Disease Who Achieved Clinical Response Following Open-Label Vedolizumab Intravenous Therapy
About this study
The drug being tested in this study is called vedolizumab. Vedolizumab is being tested to treat pediatric participants who have moderately to severely active CD. The drug is tested and approved in adults in approximately 70 countries. Participants to be enrolled must have failed response to, lost response to, or been intolerant to at least 1 of the current standard of care (SOC) induction and maintenance therapies for CD including exclusive and/or partial enteral nutrition therapy, immunomodulators (e.g., azathioprine \[AZA\], 6-mercaptopurine \[6-MP\], methotrexate \[MTX\]), and tumor necrosis factor-alpha (TNF-α) antagonists. The study will enroll approximately 120 patients. During the Induction Period participants will receive 3 doses of vedolizumab IV infusion at Day 1, Week 2, and Week 6 based on their weight at Baseline as: * Participants 10 to 15 kg, Vedolizumab 150 mg * Participants \>15 to \<30 kg, Vedolizumab 200 mg * Participants ≥30 kg, Vedolizumab 300 mg At Week 14, participants who achieve clinical response will be randomly assigned (by chance, like flipping a coin) in a 1:1 ratio to one of the 2 double-blind dose groups (high dose and low dose), stratified by previous exposure/failure to TNF-α antagonists therapy or naive to TNF-α antagonists therapy, and by weight groups. Participants will receive vedolizumab IV infusions every 8 weeks (Q8W) up to Week 46 during the Maintenance Period as follows: * Participants ≥30 kg, Vedolizumab 300 mg (High dose) or 150 mg (Low dose) * Participants \>15 to \<30 kg, Vedolizumab 200 mg (High dose) 100 mg (Low dose) * Participants 10 to 15 kg, Vedolizumab 150 mg (High dose) or 100 mg (Low dose) The dose will remain blinded to the participant and study doctor during the study (unless there is an urgent medical need). All participants will be administered vedolizumab via IV infusion. In participants who demonstrate lack of maintenance of clinical response during the Maintenance Period the dose will be escalated in a blinded fashion to the high dose in their weight group based on the weight at the time of the worsening of disease. In addition one-time rescue therapy with corticosteroids is allowed during Maintenance Period. This multi-center trial will be conducted worldwide. After the Week 54, participants may be eligible to continue receiving vedolizumab in extension study MLN0002-3029. Participants who do not maintain corticosteroid-free clinical response at week 54 will undergo an end-of-study (EOS) or ET visit, and a safety visit 18 weeks after the last dose of vedolizumab followed by 2 years of long term follow-up (up to 104 weeks), in addition these participants will then be eligible to enter study MLN0002-3029 for an observational LTFU period of 2 years after the last dose of study drug.
Eligibility criteria
Main Inclusion Criteria: 1. The participants has moderately to severely active CD, unresponsive or intolerant to their current standard of care (SOC). 2. The participants weigh ≥10 kg at the time of screening and enrollment into the study. 3. Participants with Crohn's disease (CD) diagnosed at least 1 month before screening. Participants with moderately to severely active CD defined by a Pediatric Crohn's Disease Activity Index (PCDAI) \>30 and an simple endoscopic score for Crohn's Disease (SES-CD) \>6 (or an SES-CD ≥4 if disease is confined to terminal ileum) at screening endoscopy. 4. Participants who have failed, lost response to, or been intolerant to treatment with at least 1 of the following agents: corticosteroids, immunomodulators (eg, azathioprine (AZA), 6-mercaptopurine (6-MP), methotrexate \[MTX\]), and/or tumor necrosis factor (TNF)-α antagonist therapy (eg, infliximab, adalimumab). This includes participants who are dependent on corticosteroids or exclusive or partial enteral nutrition to control symptoms and who are experiencing worsening of disease in the moderate-to-severe range when attempting to wean off corticosteroids or discontinue exclusive enteral nutrition. 5. Participants with extensive colitis or pancolitis of \>8 years' duration or left-sided colitis of \>12 years' duration must have documented evidence of a negative surveillance colonoscopy within 12 months before screening. 6. Participants with vaccinations that are up-to-date based on the countrywide accepted schedule of childhood vaccines. Main Exclusion Criteria: 1. Participants who have received either (1) an investigational biologic (other than those listed in Exclusion Criterion #1) within 60 days or 5 half-lives before screening (whichever is longer); or (2) an approved biologic or biosimilar agent within 2 weeks before the first dose of study drug or at any time during the screening period. 2. Participants with active cerebral/meningeal disease, signs/symptoms or history of progressive multifocal leukoencephalopathy (PML) or any other major neurological disorders including stroke, multiple sclerosis, brain tumor or neurodegenerative disease. 3. The participants had a clinically significant infection (eg, pneumonia, pyelonephritis, coronavirus disease 2019 \[COVID-19\]) within 30 days prior to first dose of study drug. 4. The participants has received any live vaccinations within 30 days prior to first dose. 5. Participants who currently require surgical intervention or are anticipated to require surgical intervention for CD during this study. 6. Participants who have had subtotal or total colectomy or have a jejunostomy, ileostomy, colostomy, ileo-anal pouch, known fixed stenosis of the intestine, short bowel syndrome, or \>3 small intestine resections. 7. Participants with a current diagnosis of indeterminate colitis. 8. Participants with clinical features suggesting monogenic very early-onset inflammatory bowel disease. 9. Active or latent tuberculosis (TB), as evidenced by a diagnostic TB test performed within 30 days of screening or during the screening Period that is positive, defined as: * Positive QuantiFERON test or 2 successive indeterminate QuantiFERON tests, OR * A TB skin test reaction ≥5 mm. 10. Participants with evidence of positive hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb). Hepatitis B virus (HBV) immune participants(i.e., hepatitis B surface antigen \[HBsAg\]-negative and hepatitis B antibody-positive) may, however, be included. Note: If a participant tests negative for HBsAg, but positive for HBcAb, the participant would be considered eligible if the absence of HBV DNA is confirmed by HBV DNA polymerase chain reaction reflex testing performed in the central laboratory. 11. Participants with chronic hepatitis C virus (HCV) (ie, positive HCV antibody \[HCVAb\] and HCV RNA). Note: Participants who are HCVAb-positive without evidence of HCV RNA may be considered eligible (spontaneous viral clearance or previously treated and cured \[defined as no evidence of HCV RNA at least 12 weeks before baseline\]). 12. The participants has any identified congenital or acquired immunodeficiency (eg, common variable immunodeficiency, human immunodeficiency virus \[HIV\] infection, organ transplantation). 13. The participant has evidence of dysplasia or history of malignancy other than a successfully treated non-metastatic cutaneous squamous cell or basal cell carcinoma or localized carcinoma in situ of the cervix. 14. Participants with positive stool studies for ova and/or parasites or stool culture at screening visit. 15. Participants with positive Clostridioides difficile (C difficile) stool test at screening visit. Other inclusion/exclusion criteria may apply.
Study design
Enrollment target: 120 participants
Allocation: randomized
Masking: quadruple
Age groups: child
Timeline
Starts: 2022-02-10
Estimated completion: 2026-05-22
Last updated: 2025-10-20
Interventions
Drug: Vedolizumab IV
Primary outcomes
  • Percentage of Participants With Clinical Remission at Week 54 Based on Pediatric Crohn's Disease Activity Index (PCDAI) Score ≤10 (Week 54)
  • Percentage of Participants With Endoscopic Response at Week 54 Based on Simple Endoscopic Score for Crohn's Disease [SES-CD] Score (Week 54)
Sponsor
Takeda · industry
Contacts & investigators
ContactTakeda Contact · contact · medinfoUS@takeda.com · +1-877-825-3327
All locations (96)
Phoenix Childrens HospitalNot Yet Recruiting
Phoenix, Arizona, United States
Cedars Sinai Medical CenterWithdrawn
Los Angeles, California, United States
Rady Childrens Hospital San Diego - PINNot Yet Recruiting
San Diego, California, United States
University of California San FranciscoWithdrawn
San Francisco, California, United States
I.H.S Health LLCWithdrawn
Kissimmee, Florida, United States
Childrens Center For Digestive HealthcareRecruiting
Atlanta, Georgia, United States
Advocate Children's Hospital Park RidgeRecruiting
Park Ridge, Illinois, United States
Riley Hospital For ChildrenWithdrawn
Indianapolis, Indiana, United States
Johns Hopkins UniversityNot Yet Recruiting
Baltimore, Maryland, United States
Boston Children's HospitalNot Yet Recruiting
Boston, Massachusetts, United States
MNGI Digestive Health, PARecruiting
Minneapolis, Minnesota, United States
Mayo Clinic - PINNot Yet Recruiting
Rochester, Minnesota, United States
Goryeb Children's HospitalRecruiting
Morristown, New Jersey, United States
The Steven and Alexandra Cohen Childrens Medical Center of New York - BRANY - PPDSRecruiting
New Hyde Park, New York, United States
University of Rochester Medical Center PPDSWithdrawn
Rochester, New York, United States
Stony Brook University Medical CenterRecruiting
Stony Brook, New York, United States
SUNY Upstate Medical CenterWithdrawn
Syracuse, New York, United States
University Hospitals Cleveland Medical CenterNot Yet Recruiting
Cleveland, Ohio, United States
Children's Hospital of PittsburghNot Yet Recruiting
Pittsburgh, Pennsylvania, United States
Hasbro Children's HospitalWithdrawn
Providence, Rhode Island, United States
Texas Children's HospitalRecruiting
Houston, Texas, United States
Carilion Children's Tanglewood CenterRecruiting
Roanoke, Virginia, United States
Children's Hospital at WestmeadNot Yet Recruiting
Westmead, New South Wales, Australia
Queensland Childrens HospitalRecruiting
South Brisbane, Queensland, Australia
Monash Health, Monash Medical CentreNot Yet Recruiting
Clayton, Victoria, Australia
Royal Children's Hospital Melbourne - PINNot Yet Recruiting
Parkville, Victoria, Australia
UZ AntwerpenNot Yet Recruiting
Edegem, Antwerpen, Belgium
Universitair Ziekenhuis Brussel - PINNot Yet Recruiting
Jette, Brussels Capital, Belgium
UZ LeuvenNot Yet Recruiting
Leuven, Vlaams Brabant, Belgium
University of Alberta HospitalNot Yet Recruiting
Edmonton, Alberta, Canada
British Columbia Children's HospitalNot Yet Recruiting
Vancouver, British Columbia, Canada
London Health Sciences CentreNot Yet Recruiting
London, Ontario, Canada
Centre Hospitalier Universitaire Sainte-JustineNot Yet Recruiting
Montreal, Quebec, Canada
Beijing Children Hospital,Capital Medical UniversityNot Yet Recruiting
Beijing, Beijing Municipality, China
Henan Children's Hospital(Zhengzhou Children's Hospital)Not Yet Recruiting
Zhengzhou, Henan, China
Children's Hospital of Fudan UniversityNot Yet Recruiting
Shanghai, Shanghai Municipality, China
The Children's Hospital Zhejiang UniversitySchool of MedicineNot Yet Recruiting
Hangzhou, Zhejiang, China
Klinika Za Djecje Bolesti ZagrebRecruiting
Zagreb, City of Zagreb, Croatia
University Hospital Center ZagrebRecruiting
Zagreb, City of Zagreb, Croatia
University Hospital Centre SplitRecruiting
Split, Croatia
Fakultni nemocnice Kralovske VinohradyNot Yet Recruiting
Prague, Praha, Hlavni Mesto, Czechia
Fakultni Thomayerova NemocniceNot Yet Recruiting
Prague, Praha, Hlavni Mesto, Czechia
Fakultni nemocnice OstravaNot Yet Recruiting
Ostrava, Czechia
Attikon University General HospitalRecruiting
Athens, Attica, Greece
Children's Hospital "Agia Sofia"Recruiting
Athens, Greece
Ippokratio General Hospital of ThessalonikiNot Yet Recruiting
Thessaloniki, Greece
Ippokratio General Hospital of ThessalonikiRecruiting
Thessaloniki, Greece
Borsod-Abauj-Zemplen Megyei Kozponti Korhaz es Egyetemi Oktato KorhazRecruiting
Miskolc, Borsod-Abauj Zemplen county, Hungary
Szegedi Tudomanyegyetem Szent-Gyorgyi Albert Klinikai KozpontRecruiting
Szeged, Csongrád megye, Hungary
Semmelweis EgyetemNot Yet Recruiting
Budapest, Hungary
Schneider Childrens Medical Center of Israel Petah Tikvah PINNot Yet Recruiting
Petah Tikva, Central District, Israel
Tel Aviv Sourasky Medical Center PPDSNot Yet Recruiting
Jerusalem, Jerusalem, Israel
Soroka University Medical CentreNot Yet Recruiting
Beersheba, Israel
Rambam Medical Center - PPDSNot Yet Recruiting
Haifa, Israel
Carmel Medical CenterNot Yet Recruiting
Haifa, Israel
Shaare Zedek Medical CenterNot Yet Recruiting
Jerusalem, Israel
Hadassah Medical Center - PPDSNot Yet Recruiting
Jerusalem, Israel
AOU dell'Universita degli Studi della Campania Luigi VanvitelliNot Yet Recruiting
Naples, Campania, Italy
Azienda Ospedaliera Universitaria Federico IINot Yet Recruiting
Naples, Campania, Italy
Azienda USL di BolognaNot Yet Recruiting
Bologna, Emilia-Romagna, Italy
Sapienza University of RomeRecruiting
Rome, Lazio, Italy
ASST di Monza - Azienda Ospedaliera San GerardoNot Yet Recruiting
Monza, Lombardy, Italy
Universita degli Studi di PadovaNot Yet Recruiting
Padova, Veneto, Italy
Kurume University HospitalRecruiting
Kurume-Shi, Hukuoka, Japan
Japanese Red Cross Kumamoto HospitalRecruiting
Kumamoto, Kumamoto, Japan
Juntendo University HospitalRecruiting
Bunkyo-Ku, Tokyo, Japan
National Center for Child Health and DevelopmentRecruiting
Setagaya-Ku, Tokyo, Japan
Hospital of Lithuanian University of Health Sciences Kaunas ClinicsWithdrawn
Kaunas, Kaunas County, Lithuania
Vilnius University Hospital Santaros KlinikosWithdrawn
Vilnius, Vilnius County, Lithuania
Uniwersytecki Szpital DzieciecyNot Yet Recruiting
Krakow, Lesser Poland Voivodeship, Poland
Uniwersytecki Szpital Kliniczny im. Jana Mikulicza Radeckiego we WroclawiuNot Yet Recruiting
Wroclaw, Lower Silesian Voivodeship, Poland
WIP Warsaw IBD Point Profesor KierkusNot Yet Recruiting
Warsaw, Masovian Voivodeship, Poland
Instytut Pomnik Centrum Zdrowia DzieckaRecruiting
Warsaw, Masovian Voivodeship, Poland
Korczowski Bartosz, Gabinet LekarskiRecruiting
Rzeszów, Podkarpackie Voivodeship, Poland
Copernicus Podmiot Leczniczy Sp. z o.o.Not Yet Recruiting
Gdansk, Pomeranian Voivodeship, Poland
Gornoslaskie Centrum Zdrowia Dziecka Im. Sw. Jana Pawla II Spsk Nr 6 Sum W KatowicachNot Yet Recruiting
Katowice, Silesian Voivodeship, Poland
Twoja Przychodnia SCMRecruiting
Szczecin, West Pomeranian Voivodeship, Poland
SPZOZ Centralny Szpital Kliniczny UM w LodziNot Yet Recruiting
Lodz, Poland
Instytut Centrum Zdrowia Matki PolkiNot Yet Recruiting
Lodz, Łódź Voivodeship, Poland
Detska fakultna nemocnica s poliklinikou Banska BystricaTerminated
Banská Bystrica, Slovakia
Narodny ustav detskych chorobTerminated
Bratislava, Slovakia
Kyungpook National University Chilgok hospitalRecruiting
Daegu, Daegu Gwang'yeogsi, South Korea
Gachon University Gil Medical CenterRecruiting
Incheon, Incheon Gwang'yeogsi, South Korea
Seoul National University HospitalRecruiting
Seongnam, South Korea
Samsung Medical Center - PPDSRecruiting
Seoul, South Korea
Hospital Sant Joan de Deu - PINWithdrawn
Esplugues de Llobregat, Barcelona, Spain
Hospital de SaguntoWithdrawn
Sagunto, Valencia, Spain
Hospital Infantil Universitario Nino Jesus - PINWithdrawn
Madrid, Spain
Hospital Regional Universitario de Malaga - Hospital Materno InfantilWithdrawn
Málaga, Spain
Hospital Universitario Virgen del Rocio - PPDSWithdrawn
Seville, Spain
Kings College HospitalNot Yet Recruiting
London, London, City of, United Kingdom
Great Ormond Street Hospital (GOSH)Not Yet Recruiting
London, London, City of, United Kingdom
Noahs Ark Childrens Hospital for Wales - PPDS - PINNot Yet Recruiting
Cardiff, South Glamorgan, United Kingdom
Birmingham Children's Hospital NHS Foundation TrustNot Yet Recruiting
Birmingham, West Midlands, United Kingdom
Barts Health NHS TrustNot Yet Recruiting
London, United Kingdom
Royal Manchester Children's Hospital - PPDSNot Yet Recruiting
Manchester, United Kingdom
A Study of Vedolizumab in Children and Teenagers With Moderate to Severe Crohn's Disease (CD) · TrialPath