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A Study to Investigate the Efficacy and Safety of Dupilumab Therapy Compared With Placebo in Participants Aged ≥18 Years With Moderately to Severely Active Ulcerative Colitis With an Eosinophilic Phenotype (LIBERTY-UC SUCCEED (Study in UC for Clinical Efficacy Evaluation of Dupilumab))

Phase 2
Recruiting
Conditions
Colitis Ulcerative
Interventions
Drug: Placebo
Registration Number
NCT05731128
Lead Sponsor
Sanofi
Brief Summary

The protocol of this Phase 2 clinical trial consists of a double-blind, placebo-controlled, parallel-group, multicenter study to evaluate the efficacy and safety of dupilumab in participants with moderately to severely active Ulcerative Colitis (UC) with an eosinophilic phenotype.

Screening period: 2 to up to 4 weeks

Treatment period:

52-week investigational medicinal product (IMP) intervention (dupilumab or matching placebo) from Week 0 to Week 52 Open-label arm (optional): administration of open-label dupilumab therapy for study participants who qualify. Follow-up period: 12 weeks The maximum duration of study per participant is up to 68 weeks.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
84
Inclusion Criteria
  • Participants must be ≥18 years of age at the time of signing the informed consent.
  • Evidence of biomarker enrichment at time of screening.
  • Moderately to severely active UC, defined as a baseline modified Mayo score of 5 to 9, inclusive, using the Mayo endoscopic subscore assigned during the concurrent local and central reading of the video endoscopy.
  • Has a screening endoscopy with ≥2 endoscopic subscore in the Mayo score component assessment as determined by concurrent local and central reading of the video endoscopy.
  • Has a baseline rectal bleeding subscore of ≥1 and baseline a stool frequency score of ≥1 as determined by the Mayo score component assessment.
  • Participants with inadequate response/non-response, loss of response, or are intolerant of standard biologic therapy for their UC AND/OR Inadequate or non-responders, have shown loss of response, or are intolerant to at least 1 of the following treatments: oral corticosteroids (≤20 mg/day), 5-aminosalicylic acid (ASA) compounds, immunomodulators, small molecules.
Exclusion Criteria

Participants are excluded from the study if any of the following criteria apply:

  • Severe extensive colitis as evidenced by:

    • Current hospitalization
    • Likely to require surgery for the treatment of UC within 12 weeks of Screening Visit
  • UC limited to the rectum only or to <20 cm of the colon as determined by central reading.

  • Presence of an ileal pouch, ostomy, stoma or fistula or history of a fistula.

  • Require, or required within the 2 months before screening, surgery for active gastrointestinal bleeding, peritonitis, intestinal obstruction, or intra-abdominal or pancreatic abscess requiring surgical drainage, or other conditions possibly confounding the evaluation of benefit from study agent treatment.

  • Has a prior medical history of eosinophilic colitis.

  • Participants with abdominal abscess, fulminant disease, or toxic megacolon.

  • Participants with intestinal failure or short bowel syndrome.

  • Presence of symptomatic colonic or small bowel obstruction, confirmed by objective radiographic or endoscopic evidence of a stricture with resulting obstruction (dilation of the colon or small bowel proximal to the stricture on barium radiograph or an inability to traverse the stricture at endoscopy).

  • History of extensive colonic resection (eg, less than 30 cm of colon remaining) that would prevent adequate evaluation of the effect of study agent on clinical disease activity.

  • History of colonic mucosal dysplasia or presence of adenomatous colonic polyps not removed OR presence of colonic mucosal dysplasia or adenomatous colonic polyps not removed during colonoscopy at screening visit.

  • If the participant has extensive colitis for ≥8 years or disease limited to left side of colon (ie, distal to splenic flexure) for >10 years, regardless of age, a colonoscopy within 1 year of the screening visit is required to survey for dysplasia. Participants with dysplasia or cancer identified on biopsies will be excluded.

  • Diagnosis of indeterminate colitis, microscopic colitis, ischemic colitis, or Crohn's disease or clinical findings suggestive of Crohn's disease.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
DupilumabDupilumabInitial loading dose followed by regular administration for the duration of the treatment period.
PlaceboPlaceboInitial loading dose followed by regular administration for the duration of the treatment period.
Open-label arm (optional)DupilumabRegular administration of open label dupilumab
Primary Outcome Measures
NameTimeMethod
Proportion of participants who are in clinical remission at Week 24Week 24

Clinical remission by modified Mayo score is defined as a modified Mayo score of ≤2 with a stool frequency score ≤1, a rectal bleeding score = 0, AND a Mayo endoscopic subscore ≤1 with absence of friability. The modified Mayo score consists of 3 subscores; a patient-reported subscore for rectal bleeding, a patient-reported subscore for stool frequency, and a Mayo endoscopic subscore. Each subscore ranges 0-3 with higher scores indicating greater disease severity. The total modified Mayo score ranges 0-9 with higher scores indicating greater disease severity.

Secondary Outcome Measures
NameTimeMethod
Proportion of participants achieving clinical response by modified Mayo score at Week 24 and Week 52Week 24 and Week 52

Clinical response by modified Mayo score is defined as a decrease from baseline in the modified Mayo score of ≥2 points and at least a 30% reduction from baseline, and a decrease in rectal bleeding subscore of ≥1 OR an absolute rectal bleeding subscore of 0 or 1. The modified Mayo score consists of 3 subscores; a patient-reported subscore for rectal bleeding, a patient-reported subscore for stool frequency, and a Mayo endoscopic subscore. Each subscore ranges 0-3 with higher scores indicating greater disease severity. The total modified Mayo score ranges 0-9 with higher scores indicating greater disease severity.

Concentration of dupilumab in serum over time.Baseline up to Week 64
Proportion of participants who are in clinical remission by modified Mayo score at Week 52Week 52

Clinical remission by modified Mayo score is defined as a modified Mayo score of ≤2 with a stool frequency score ≤1, a rectal bleeding score = 0, AND a Mayo endoscopic subscore ≤1 with absence of friability. The modified Mayo score consists of 3 subscores; a patient-reported subscore for rectal bleeding, a patient-reported subscore for stool frequency, and a Mayo endoscopic subscore. Each subscore ranges 0-3 with higher scores indicating greater disease severity. The total modified Mayo score ranges 0-9 with higher scores indicating greater disease severity.

Proportion of participants in clinical remission at Week 52 who are off concomitant oral corticosteroids (OCS) at least 4 weeks prior to Week 52 among participants receiving OCS at baselineBaseline up to Week 52

Clinical remission by modified Mayo score is defined as a modified Mayo score of ≤2 with a stool frequency score ≤1, a rectal bleeding score = 0, AND a Mayo endoscopic subscore ≤1 with absence of friability. The modified Mayo score consists of 3 subscores; a patient-reported subscore for rectal bleeding, a patient-reported subscore for stool frequency, and a Mayo endoscopic subscore. Each subscore ranges 0-3 with higher scores indicating greater disease severity. The total modified Mayo score ranges 0-9 with higher scores indicating greater disease severity.

Change from baseline (Screening visit) in the normalized enrichment scores (NES) in type 2 inflammation transcriptome signature at Week 24 and Week 52.Baseline to Week 24 and Week 52

NES is a summary score of the expression of a specified set of genes defining a molecular phenotype.

Change from baseline in the partial Mayo score at Week 8, Week 24, and Week 52Baseline to Week 8, Week 24 and Week 52

The partial Mayo score consists of 3 subscores; a patient-reported subscore for rectal bleeding, a patient-reported subscore for stool frequency, and a Physician's global assessment (PGA) subscore. Each subscore ranges 0-3 with higher scores indicating greater disease severity. The partial Mayo score ranges 0-9 with higher scores indicating greater disease severity.

Proportion of participants in clinical remission at Week 52 who are off concomitant oral corticosteroids (OCS) at least 4 weeks prior to Week 52Baseline up to Week 52

Clinical remission by modified Mayo score is defined as a modified Mayo score of ≤2 with a stool frequency score ≤1, a rectal bleeding score = 0, AND a Mayo endoscopic subscore ≤1 with absence of friability. The modified Mayo score consists of 3 subscores; a patient-reported subscore for rectal bleeding, a patient-reported subscore for stool frequency, and a Mayo endoscopic subscore. Each subscore ranges 0-3 with higher scores indicating greater disease severity. The total modified Mayo score ranges 0-9 with higher scores indicating greater disease severity.

Proportion of participants in symptomatic remission over timeBaseline up to Week 52

Symptomatic remission is defined as Mayo stool frequency score = 0, or Mayo stool frequency score = 1 with a ≥1-point decrease from baseline, and Mayo rectal bleeding score = 0.

Proportion of participants with a Mayo endoscopic subscore of 0 or 1 without friability at Week 24, and Week 52Week 24 and Week 52

The Mayo endoscopic subscore ranges 0-3 with higher scores indicating greater disease severity.

Proportion of participants with a Mayo endoscopic subscore of 0 at Week 24, and Week 52Week 24 and Week 52

The Mayo endoscopic subscore ranges 0-3 with higher scores indicating greater disease severity.

Change from baseline in abdominal pain assessed by Abdominal Pain Numerical Rating Scale (NRS) at Week 8, Week 24, and Week 52Baseline to Week 8, Week 24 and Week 52

Abdominal pain NRS is a single item patient report outcome (PRO) tool that patients will use to report intensity of their worst abdominal pain during a daily recall period with 0 being 'no pain' and 10 being the 'worst pain imaginable'.

Incidence of treatment-emergent adverse events (TEAEs) or serious adverse events (SAEs)Baseline up to Week 64
Proportion of participants achieving histologic-endoscopic healing at Week 24, and Week 52Week 24 and Week 52

Histologic-endoscopic healing is defined by Mayo endoscopic subscore of 0 or 1 and histological healing (Geboes score \<2). Mayo endoscopic subscore ranges 0-3 with higher scores indicating greater disease severity. The Geboes Index score is a six-grade classification system for inflammation: Grade 0 - structural change only; Grade 1 -chronic inflammation; Grade 2 - lamina propria neutrophils; Grade 3 - neutrophils in epithelium; Grade 4 - crypt destruction; and Grade 5 - erosions or ulcers.

Incidence of treatment-emergent antidrug antibodies (ADA) against dupilumab.Baseline up to Week 64

Trial Locations

Locations (77)

Investigational Site Number : 7100002

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Cape Town, South Africa

Investigational Site Number : 7100007

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Cape Town, South Africa

Investigational Site Number : 7100003

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Gqeberha, South Africa

Om Research- Site Number : 8400029

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Apple Valley, California, United States

TLC Clinical Research- Site Number : 8400020

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Beverly Hills, California, United States

Ventura County Gastroenterology Medical Group- Site Number : 8400028

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Camarillo, California, United States

Palmtree Clinical Research- Site Number : 8400048

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Palm Springs, California, United States

Investigational Site Number : 7100008

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Johannesburg, South Africa

Clinical Trials Management Services - Thousand Oaks- Site Number : 8400034

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Thousand Oaks, California, United States

Wellness Clinical Research - Miami Lakes- Site Number : 8400009

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Miami Lakes, Florida, United States

Homestead Associates in Research- Site Number : 8400004

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Miami, Florida, United States

GI PROS Research- Site Number : 8400046

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Naples, Florida, United States

Advanced Research Institute - New Port Richey- Site Number : 8400026

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New Port Richey, Florida, United States

Digestive Disease Consultants - Orange Park- Site Number : 8400042

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Orange Park, Florida, United States

Tellabio International Research Services- Site Number : 8400041

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Pembroke Pines, Florida, United States

GCP Clinical Research- Site Number : 8400014

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Tampa, Florida, United States

Gastroenterology Consultants - Roswell- Site Number : 8400022

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Roswell, Georgia, United States

Sanmora Bespoke Clinical Research Solutions- Site Number : 8400043

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East Orange, New Jersey, United States

Smart Medical Research Inc- Site Number : 8400037

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Jackson Heights, New York, United States

DiGiovanna Family Care- Site Number : 8400006

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Massapequa, New York, United States

Tryon Medical Partners - Charlotte - Piedmont Row Drive South- Site Number : 8400008

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Charlotte, North Carolina, United States

Care Access - Lumberton- Site Number : 8400018

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Lumberton, North Carolina, United States

UPMC Presbyterian- Site Number : 8400038

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Pittsburgh, Pennsylvania, United States

Advanced Gastroenterology Associates, PA- Site Number : 8400047

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Decatur, Texas, United States

Katy Integrative Gastroenterology- Site Number : 8400027

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Katy, Texas, United States

Medrasa Clinical Research - Medrasa Sherman- Site Number : 8400039

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Sherman, Texas, United States

Texas Digestive Disease Consultants - Southlake- Site Number : 8400013

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Southlake, Texas, United States

Washington Gastroenterology - Tacoma- Site Number : 8400030

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Tacoma, Washington, United States

Investigational Site Number : 0320006

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Mar Del Plata, Buenos Aires, Argentina

Investigational Site Number : 0320004

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San Miguel de Tucumán, Tucumán, Argentina

Investigational Site Number : 0320007

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Buenos Aires, Argentina

Digestive Health Specialists of Tyler- Site Number : 8400031

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Tyler, Texas, United States

Victoria Gastroenterology- Site Number : 8400019

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Victoria, Texas, United States

Washington Gastroenterology - Bellevue- Site Number : 8400025

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Bellevue, Washington, United States

Investigational Site Number : 0320001

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San Miguel de Tucumán, Tucumán, Argentina

Investigational Site Number : 0320002

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Buenos Aires, Argentina

Investigational Site Number : 0320008

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Buenos Aires, Argentina

Investigational Site Number : 1240007

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Edmonton, Alberta, Canada

Investigational Site Number : 1240010

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Scarborough, Ontario, Canada

Investigational Site Number : 1240006

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Montreal, Quebec, Canada

Investigational Site Number : 1240003

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Montreal, Quebec, Canada

Investigational Site Number : 1520001

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Concepción, Biobío, Chile

Investigational Site Number : 1520005

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Santiago, Reg Metropolitana De Santiago, Chile

Investigational Site Number : 1520003

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Santiago, Reg Metropolitana De Santiago, Chile

Investigational Site Number : 1520006

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Santiago, Reg Metropolitana De Santiago, Chile

Investigational Site Number : 1520002

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Santiago, Reg Metropolitana De Santiago, Chile

Investigational Site Number : 3920006

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Nagoya, Aichi, Japan

Investigational Site Number : 3920005

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Kashiwa, Chiba, Japan

Investigational Site Number : 3920008

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Kitakyushu, Fukuoka, Japan

Investigational Site Number : 3920002

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Sapporo, Hokkaido, Japan

Investigational Site Number : 3920001

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Sapporo, Hokkaido, Japan

Investigational Site Number : 3920011

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Kamakura, Kanagawa, Japan

Investigational Site Number : 3920010

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Shimizu, Shizuoka, Japan

Investigational Site Number : 3920004

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Bunkyo, Tokyo, Japan

Investigational Site Number : 3920007

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Kyoto, Japan

Investigational Site Number : 3920009

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Saitama, Japan

Investigational Site Number : 4100003

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Haeundae-gu, Busan-gwangyeoksi, Korea, Republic of

Investigational Site Number : 4100005

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Daegu, Daegu-gwangyeoksi, Korea, Republic of

Investigational Site Number : 4100006

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Daejeon, Daejeon-gwangyeoksi, Korea, Republic of

Investigational Site Number : 4100002

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Wonju-si, Gangwon-do, Korea, Republic of

Investigational Site Number : 4100004

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Daegu, Gyeongsangbuk-do, Korea, Republic of

Investigational Site Number : 4840004

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Mexico City, Ciudad De Mexico, Mexico

Investigational Site Number : 4840005

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Saltillo, Coahuila De Zaragoza, Mexico

Investigational Site Number : 4840002

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Torreón, Coahuila De Zaragoza, Mexico

Investigational Site Number : 4840007

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Guadalajara, Jalisco, Mexico

Investigational Site Number : 4840003

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Chihuahua, Mexico

University of Puerto Rico - Medical Sciences Campus- Site Number : 6300002

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San Juan, Puerto Rico

Investigational Site Number : 7100005

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Cape Town, South Africa

Investigational Site Number : 7100009

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Cape Town, South Africa

Investigational Site Number : 7100006

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Johannesburg, South Africa

Investigational Site Number : 7100001

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Johannesburg, South Africa

Investigational Site Number : 7100004

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Pretoria, South Africa

Investigational Site Number : 1580002

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Taichung, Taiwan

Investigational Site Number : 7920001

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Akdeniz, Turkey

Investigational Site Number : 7920003

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Gaziantep, Turkey

Investigational Site Number : 7920005

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Istanbul, Turkey

Investigational Site Number : 7920006

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Zonguldak, Turkey

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