A Study of TAK-018 in Preventing the Recurrence of Crohn's Disease After Surgery
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| ClinicalTrials.gov Identifier: NCT03943446 |
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Recruitment Status :
Terminated
(Sponsor decision to discontinue study due to inability to recruit the expected number of subjects within the requisite time period.)
First Posted : May 9, 2019
Results First Posted : September 7, 2023
Last Update Posted : September 7, 2023
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The main aim is to see if TAK-018 reduces the recurrence of intestinal inflammation after abdominal resection surgery in adults with Crohn's disease.
Participants will take either TAK-018 or placebo tablets by mouth, 2 times each day for up to 26 weeks after surgery. The placebo looks like TAK-018 but will not have any medicine in it.
Participants will have 6 study visits while receiving treatment. Visits 1 and 6 will be conducted at the study clinic. The others can be in the clinic or at the participant's home. Follow-up will occur 4 weeks after final treatment.
| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Crohn Disease | Drug: TAK-018 Drug: TAK-018 Placebo | Phase 2 |
The drug being tested in this study is called TAK-018 (Sibofimloc). TAK-018 is used for the prevention of postoperative CD recurrence. This study will evaluate the efficacy of TAK-018 in reducing endoscopic recurrence of intestinal inflammation in postoperative participants with CD after planned laparoscopic ileocecal resection with primary anastomosis.
The study will enroll approximately 96 participants. Participants will be randomly assigned (by chance, like flipping a coin) in 1:1:1 ratio to one of the three treatment groups-which will remain undisclosed to the participants and study doctor during the study (unless there is an urgent medical need):
- TAK-018 0.30 g Low dose
- TAK-018 1.5 g High dose
- Placebo
All participants will be asked to take the tablets twice daily immediately after a meal (that is, breakfast and dinner) with water, approximately 8 to 12 hours apart.
Participants will have flexibility to either to opt for home health care (HHC) solutions at Screening, Week 3, Week 6, Week 12, Week 18 and Week 30 or travel to the clinic for all scheduled visits per protocol as permitted by local regulations. This flexible approach is designed in response to health care delivery challenges presented by the coronavirus disease (COVID-19) pandemic and to provide additional flexibility during the course of the trial. Assessments after surgery and endoscopy at Week 26 will be conducted at the clinic. All other study visits may be conducted by telehealth and home health care (HHC).
This multi-center trial will be conducted in the United States, United Kingdom, France, Austria and Germany. The overall time to participate in this study is approximately 34 weeks. Participants will make final visit to the clinic or can opt for HHC visit at Week 30 (30 days after the Week 26 endoscopy) for safety follow-up.
| Study Type : | Interventional (Clinical Trial) |
| Actual Enrollment : | 34 participants |
| Allocation: | Randomized |
| Intervention Model: | Parallel Assignment |
| Masking: | Double (Participant, Investigator) |
| Primary Purpose: | Prevention |
| Official Title: | A Randomized, Double-Blind, Placebo-Controlled, Multicenter, Phase 2a Study to Evaluate the Safety, Tolerability, and Early Proof of Concept of TAK-018 for the Prevention of Postoperative Crohn's Disease Recurrence |
| Actual Study Start Date : | August 4, 2020 |
| Actual Primary Completion Date : | August 25, 2022 |
| Actual Study Completion Date : | August 25, 2022 |
| Arm | Intervention/treatment |
|---|---|
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Placebo Comparator: Placebo
TAK-018 placebo-matching tablets, orally, twice daily (BID) for up to 27.7 weeks.
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Drug: TAK-018 Placebo
TAK-018 placebo-matching tablets. |
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Experimental: TAK-018 0.30 g Low Dose
TAK-018 0.30 gram (g), tablets, orally, BID for up to 31.7 weeks.
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Drug: TAK-018
TAK-018 immediate-release tablets.
Other Name: Sibofimloc |
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Experimental: TAK-018 1.5 g High Dose
TAK-018 1.5 g, tablets, orally, BID for up to 26.1 weeks.
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Drug: TAK-018
TAK-018 immediate-release tablets.
Other Name: Sibofimloc |
- Percentage of Participants With Endoscopic Recurrence of CD as Assessed by Rutgeerts Grading Scale at Week 26 [ Time Frame: At Week 26 ]Endoscopic recurrence (ER) is defined as a Rutgeerts' score ≥ i2. The Rutgeerts scoring is a 5-point scale used to assess endoscopic recurrence at the ileocolonic anastomosis and preanastomotic ileum. The total score ranges from i0 to i4; where i0 = no lesions, i1= ≤ 5 aphthous ulcers, i2= > 5 aphthous ulcers with normal mucosa between lesions or lesions are confined to the anastomosis, i3= diffuse aphthous ileitis with diffusely inflamed mucosa and i4= diffuse inflammation with larger ulcers, nodules, and/or narrowing. Higher score indicates worsening. Percentages are rounded off to the nearest single decimal.
- Percentage of Participants With Fecal Calprotectin (FCP) >135 Microgram Per Gram (mcg/g) at Weeks 3, 6, 12, 18, 26 and 30 [ Time Frame: At Weeks 3, 6, 12, 18, 26 and 30 ]Stool samples were collected for analysis of fecal calprotectin, a biomarker of intestinal inflammatory activity. Percentages are rounded off to the nearest single decimal.
- Ctrough: Observed Plasma Trough Concentrations of TAK-018 [ Time Frame: Pre-dose and at multiple time points (up to 12 hours) post-dose at Week 3 ]
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.
| Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Must have a documented diagnosis of CD confirmed by endoscopic biopsy before resection or by tissue obtained at resection.
- Planned to undergo a laparoscopic ileocecal resection with primary anastomosis within 72 hours before randomization Day 1. Confirmation that no active disease has been left behind after resection will be based on surgeon's documentation in the operative report.
- With postoperative discontinuation of all concomitant medications specifically related to the treatment of CD. This includes anti-tumor necrosis factor-alpha (TNF-α) and anti-integrin therapy, anti- interleukin (IL) 12/23, thiopurines and other immunomodulators, steroids, 5-minosalicylates, and prophylactic use of antibiotics for the prevention of postoperative recurrence such as metronidazole.
- Has resumed oral intake and is capable of swallowing tablets within 72 hours after surgery.
Exclusion Criteria:
- Has active perianal CD.
- Has had >3 previous surgical procedures for CD.
- Has macroscopically active CD that was not resected at the time of surgery as documented in the surgeon's operative report.
- With small bowel resection that exceeds 100 centimeter (cm) or a participant who is considered at risk of short bowel syndrome by the surgeon or investigator.
- Has active or latent tuberculosis, regardless of treatment history, as evidenced by any of the following: history of tuberculosis, OR positive QuantiFERON test or 2 successive indeterminate QuantiFERON tests, OR a tuberculin skin test reaction ≥10 millimeter (mm) (≥5 mm in participants receiving the equivalent of >15 milligram per day (mg/day) prednisone).
- Has chronic hepatitis B (hepatitis B surface antigen positive, or positive for both hepatitis B surface antibody and hepatitis B core antibody but negative for hepatitis B surface antigen) or hepatitis C infection (evident by viral replication by polymerase chain reaction) within 30 days of randomization.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03943446
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| Study Director: | Study Director | Takeda |
Documents provided by Takeda:
| Responsible Party: | Takeda |
| ClinicalTrials.gov Identifier: | NCT03943446 |
| Other Study ID Numbers: |
TAK-018-2001 2019-000886-19 ( EudraCT Number ) U1111-1225-5064 ( Registry Identifier: WHO ) NR266345 ( Registry Identifier: IRAS ) NL71098.018.19 ( Registry Identifier: CCMO ) |
| First Posted: | May 9, 2019 Key Record Dates |
| Results First Posted: | September 7, 2023 |
| Last Update Posted: | September 7, 2023 |
| Last Verified: | August 2023 |
| Individual Participant Data (IPD) Sharing Statement: | |
| Plan to Share IPD: | Yes |
| Plan Description: | Takeda provides access to the de-identified individual participant data (IPD) for eligible studies to aid qualified researchers in addressing legitimate scientific objectives (Takeda's data sharing commitment is available on https://clinicaltrials.takeda.com/takedas-commitment?commitment=5). These IPDs will be provided in a secure research environment following approval of a data sharing request, and under the terms of a data sharing agreement. |
| Supporting Materials: |
Study Protocol Statistical Analysis Plan (SAP) Informed Consent Form (ICF) Clinical Study Report (CSR) |
| Access Criteria: | IPD from eligible studies will be shared with qualified researchers according to the criteria and process described on https://vivli.org/ourmember/takeda/. For approved requests, the researchers will be provided access to anonymized data (to respect patient privacy in line with applicable laws and regulations) and with information necessary to address the research objectives under the terms of a data sharing agreement. |
| URL: | https://vivli.org/ourmember/takeda/ |
| Studies a U.S. FDA-regulated Drug Product: | Yes |
| Studies a U.S. FDA-regulated Device Product: | No |
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Drug Therapy |
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Crohn Disease Recurrence Inflammatory Bowel Diseases Gastroenteritis Gastrointestinal Diseases |
Digestive System Diseases Intestinal Diseases Disease Attributes Pathologic Processes |