A study of AMT-101 in patients with Ulcerative Colitis.

Phase 1

Conditions: lcerative Colitis
MedDRA version: 20.1Level: LLTClassification code 10045365Term: Ulcerative colitisSystem Organ Class: 100000004856
Therapeutic area: Diseases [C] - Digestive System Diseases [C06]

Registration Number: EUCTR2020-000047-31-GB

Lead Sponsor: Applied Molecular Transport Inc.

Brief Summary: Not available

Detailed Description: Not available

Recruitment & Eligibility

Status: Authorised-recruitment may be ongoing or finished

Sex: All

Target Recruitment: 102

Inclusion Criteria

The study will enroll male and female adult subjects with moderate to severe UC.

Inclusion criteria (subjects must meet the following criteria to be randomized into the study):
1. Male and female subjects aged 18 to 75 years, inclusive.
2. Diagnosis of UC for at least 3 months prior to screening.
3. Moderate to severe UC, as defined by a total MCS of 6 to 12 inclusive at baseline, with a MES = 2 (confirmed by central reader).
4. If subjects have previously received any biologic (i.e., tumor necrosis factor [TNF] antagonists, vedolizumab, ustekinumab) or tofacitinib therapy, they must meet the following:
a. Biologics: a washout period of at least 12 weeks or 5 half-lives prior to randomization, or a washout period of at least 4 weeks prior to randomization if biologic drug levels are undetectable.
b. Tofacitinib: a washout period of at least 4 weeks prior to randomization.
c. Cannot have failed both biologic and tofacitinib for UC.
Note: No more than 51 subjects (50% of the total study population) with prior exposure to these therapies will be randomized into the study including no more than 20 subjects (20% of the total study sample) with exposure to more than 1 biologic/tofacitnib therapy.
5. If subjects are receiving the following treatments, they must be on a stable dose for at least 4 weeks prior to randomization:
a. 5-Aminosalicylates (5-ASAs) (not exceeding 4.8 g per day).
b. Oral corticosteroids (not exceeding prednisone 20 mg, budesonide 9 mg, or equivalent).
c. 6-Mercaptopurine (6-MP) (any stable dose).
d. Azathioprine (AZA) (any stable dose).
e. Methotrexate (MTX) (any stable dose).
6. If subjects are receiving bile-salt sequestrant, they must be on a stable dose for at least 3 months prior to randomization.
7. If subjects are receiving any nonprohibited medications, they must agree to maintain stable doses of concomitant medications for UC until the end of the safety follow-up period.
8. Unlikely to conceive.
9. Women of childbearing potential (WOCBP) must have a negative pregnancy test at screening and at the randomization visit prior to the first dose of study drug.
10. Able to participate fully in all aspects of this clinical trial.
11. Written informed consent must be obtained and documented.
Are the trial subjects under 18? no
Number of subjects for this age range:
F.1.2 Adults (18-64 years) yes
F.1.2.1 Number of subjects for this age range 87
F.1.3 Elderly (>=65 years) yes
F.1.3.1 Number of subjects for this age range 15

Exclusion Criteria

Exclusion criteria (subjects who exhibit any of the following criteria are to be excluded from the study):
1. A diagnosis of Crohn’s disease (CD), indeterminate colitis, or presence or history of fistula with CD.
2. Disease activity limited to distal 15 cm (proctitis).
3. Current evidence of toxic megacolon, abdominal abscess, symptomatic colonic stricture, or stoma.
4. History or current evidence of colonic dysplasia or adenomatous colonic polyps.
5. Current bacterial or parasitic pathogenic enteric infection, including Clostridium difficile, known active cytomegalovirus infection, known infection with hepatitis B or C virus; known infection with human immunodeficiency virus; infection requiring hospitalization or intravenous (IV) antimicrobial therapy, or opportunistic infection within 6 months prior to screening; any infection requiring antimicrobial therapy within 2 weeks prior to screening; history of more than 1 episode of herpes zoster or any episode of disseminated zoster.
6. A positive diagnostic tuberculosis (TB) test at screening (defined as a positive QuantiFERON test). In cases where the QuantiFERON test is indeterminate, the participant may have the test repeated once and if their second test is negative, they will be eligible. In the event a second test is also indeterminate, or QuantiFERON is unavailable, the investigator has the option to perform a purified protein derivative (PPD) skin test. If the PPD reaction is < 5 mm, then the subject is eligible. If the reaction is = 5 mm, or PPD testing is not done, the subject is not eligible. An exception is made for subjects with a history of latent TB who are currently receiving treatment for latent TB, will initiate treatment for latent TB before the first dose of study treatment, or have documentation of completing appropriate treatment for latent TB within 3 years prior to the first dose of study treatment).
7. Live virus vaccination within 1 month prior to screening.
8. Treatment with sirolimus, cyclosporine, mycophenolate, or tacrolimus within 8 weeks prior to randomization.
9. Treatment with IV corticosteroids, rectal corticosteroids, or rectal 5-ASA within 4 weeks prior to randomization.
10. Fecal microbiota transplantation within 1 month prior to screening.
11. A concurrent clinically significant, serious, unstable, or uncontrolled underlying cardiovascular, pulmonary, hepatic, renal, gastrointestinal, genitourinary, hematological, coagulation, immunological, endocrine/metabolic, or other medical disorder that, in the opinion of the investigator, might confound the study results, pose additional risk to the subject, or interfere with the subject’s ability to participate fully in the study.
12. Known primary or secondary immunodeficiency.
13. History of myocardial infarction, unstable angina, transient ischemic attack, decompensated heart failure requiring hospitalization, congestive heart failure (New York Heart Association Class 3 or 4), uncontrolled arrhythmias, cardiac revascularization, stroke, uncontrolled hypertension, or uncontrolled diabetes within 6 months of screening.
14. Clinically meaningful laboratory abnormalities at screening that would affect subject safety, as determined and documented by the investigator.
15. Pregnant or lactating females.
16. Any surgical procedure requiring general anesthesia within 1 month prior to screening or planned elective surgery during the study.
17. History of malignant neoplasms or carcinoma in situ within 5 years pri

Study & Design

Study Type: Interventional clinical trial of medicinal product

Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Main Objective: To assess the efficacy of repeated oral doses of AMT-101 versus placebo to reduce Mayo Endoscopic Subscore (MES) at Week 12 in adult subjects with moderate to severe UC;Secondary Objective: Secondary Objectives:<br>- To evaluate the effects of AMT-101 on disease activity as measured by<br>symptoms, endoscopy, histology, and biomarkers over 12 weeks<br>- To evaluate safety and tolerability of oral AMT-101 over 12 weeks<br>- To assess the pharmacokinetic (PK) parameters of AMT-101<br>- To assess health-related quality of life (HRQOL)<br><br>Exploratory Objectives:<br>- To assess the pharmacodynamic (PD) effect of AMT-101 on inflammation<br>- To assess the PK parameters of AMT-101 in mucosal tissue<br>- To assess the PD effect of AMT-101 on biomarkers<br>- To assess target engagement and mechanism of action;Primary end point(s): Mean change in MES (Mayo endoscopic subscore) from baseline to Week 12<br><br><br>;Timepoint(s) of evaluation of this end point: Week 12

Secondary Outcome Measures

Name	Time	Method

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