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A Study Testing How BI 655130 Works in Patients With Fistulizing Crohn's Disease

Phase 2
Completed
Conditions
Crohn Disease
Interventions
Drug: Spesolimab
Drug: Placebo
Registration Number
NCT03752970
Lead Sponsor
Boehringer Ingelheim
Brief Summary

This is a study in adults with Crohn's Disease who also have fistulas near the anus. The study has 2 parts. The first part is to find out more about what causes the fistulas. In this part of the study, tissue samples are taken from patients. The second part of the study tests whether a medicine called spesolimab (BI 655130) helps patients with Crohn's Disease.

Participants get study medication for 24 weeks. The participants are put into 2 groups. It is decided by chance who gets into which group. One group gets an intravenous drip that contains spesolimab every 4 weeks. The other group gets a placebo drip every 4 weeks. The placebo drip looks like the spesolimab drip, but contains no medicine.

The doctors regularly examine fistulas of the participants. The results of the fistula examinations are compared between the groups. The doctors also check the general health of the patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
27
Inclusion Criteria

Not provided

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Exclusion Criteria

Not provided

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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Study Cohort - PlaceboPlaceboPatients with perianal fistulising Crohn's disease received Placebo intravenously every 4 weeks (week 0, 4, 8). At week 12 achievement of combined perianal fistula remission was determined, patients without combined perianal fistula remission were switched to spesolimab and were treated with spesolimab 1200 milligram intravenously every 4 weeks (week 12, 16 and 20). Patients with combined perianal fistula remission remained on Placebo and were treated with placebo intravenously every 4 weeks (week 12, 16 and 20).
Study Cohort - SpesolimabSpesolimabPatients with perianal fistulising Crohn's disease received Spesolimab 1200 milligram intravenously every 4 weeks (week 0, 4, 8, 12, 16 and 20). At week 12 Placebo patients without combined perianal fistula remission were switched to spesolimab and were treated with spesolimab 1200 milligram intravenously every 4 weeks (week 12, 16 and 20).
Study Cohort - PlaceboSpesolimabPatients with perianal fistulising Crohn's disease received Placebo intravenously every 4 weeks (week 0, 4, 8). At week 12 achievement of combined perianal fistula remission was determined, patients without combined perianal fistula remission were switched to spesolimab and were treated with spesolimab 1200 milligram intravenously every 4 weeks (week 12, 16 and 20). Patients with combined perianal fistula remission remained on Placebo and were treated with placebo intravenously every 4 weeks (week 12, 16 and 20).
Primary Outcome Measures
NameTimeMethod
The Total Number of Deregulated Genes at Week 4Biopsies taken at screening (Week -3) and at week 4 of treatment.

The total number of deregulated genes based on biopsies from the inner fistula orifice at Week 4 comparing changes in gene expression from baseline between the two treatment groups. For each gene, a repeated measures linear regression model was utilized with treatment (BI 655130 or Placebo), visit (baseline, week 4), treatment by visit interaction as fixed effect and patient as a blocking factor.

Changes will be quantified by log2 fold changes (FC) and associated False Discovery Rate (FDR) adjusted p-values.

Genes will be considered deregulated if they fulfil the following criteria:

* FDR adjusted p-value ≤ 0.05

* \|fold change\| ≥ 1.5 (\|log2 fold change\| ≥ 0.58)

Secondary Outcome Measures
NameTimeMethod
Number of Patients With Perianal Fistula Response at Week 12At baseline (day 1) and week 12 (day 85) of treatment.

Number of patients with perianal fistula response at Week 12 defined as closure of at least 50% of external openings, no drainage/discharge despite gentle finger compression of fistulas that were draining at baseline and without new emerging fistulas.

The no response imputation (NRI) approach is applied: missing visits where imputed whereby all subsequent visits after a patient took rescue medication for the disease under study or died due to any cause were considered to be missing.

Number of Patients With Perianal Fistula Remission at Week 12At baseline (day 1) and week 12 (day 85) of treatment.

Proportion of patients with perianal fistula remission at Week 12 defined as closure of all external openings, no drainage/discharge despite gentle finger compression of fistulas that were draining at baseline and without new emerging fistulas.

The no response imputation (NRI) approach is applied: missing visits where imputed whereby all subsequent visits after a patient took rescue medication for the disease under study or died due to any cause were considered to be missing.

Number of Patients With Combined Perianal Fistula Remission at Week 12At baseline (day 1) and week 12 (day 85) of treatment.

Number of patients with combined perianal fistula remission at Week 12 defined as closure of all external openings, no drainage/discharge despite gentle finger compression of fistulas that were draining at baseline and without new emerging fistulas, AND absence collections of \>2 centimeter, confirmed by magnetic resonance imaging (MRI) in at least 2 of 3 dimensions - blinded and centrally read.

The no response imputation (NRI) approach is applied: missing visits where imputed whereby all subsequent visits after a patient took rescue medication for the disease under study or died due to any cause were considered to be missing.

Trial Locations

Locations (10)

AKH - Medical University of Vienna

🇦🇹

Wien, Austria

UZ Leuven

🇧🇪

Leuven, Belgium

Universitätsklinikum Erlangen

🇩🇪

Erlangen, Germany

Amsterdam UMC, Locatie AMC

🇳🇱

Amsterdam, Netherlands

Universitätsklinikum Ulm

🇩🇪

Ulm, Germany

Semmelweis University

🇭🇺

Budapest, Hungary

Hospital Universitari de Girona Doctor Josep Trueta

🇪🇸

Girona, Spain

Herlev and Gentofte Hospital

🇩🇰

Herlev, Denmark

Inje University Haeundae Paik Hospital

🇰🇷

Busan, Korea, Republic of

Centre Hospitalier Universitaire de Liège

🇧🇪

Liège, Belgium

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