Efficacy and Safety Study of SHP647 as Induction Therapy in Participants With Moderate to Severe Ulcerative Colitis

Phase 3

Terminated

Conditions: Ulcerative Colitis

Interventions: Other: Placebo
Drug: Ontamalimab

Registration Number: NCT03259334

Lead Sponsor: Shire

Brief Summary: The purpose of this study is to evaluate the efficacy of SHP647 in inducing remission, based on composite score of participant-reported symptoms and centrally read endoscopy, in participants with moderate to severe ulcerative colitis (UC).

Detailed Description: Not available

Recruitment & Eligibility

Status: TERMINATED

Sex: All

Target Recruitment: 380

Inclusion Criteria

Participants and/or their parent or legally authorized representative must have an understanding, ability, and willingness to fully comply with study procedures and restrictions.
Participants must be able to voluntarily provide written, signed, and dated informed consent and/or assent, as applicable, to participate in the study.
Participants must be between greater than or equal to (>=)16 and <=80 years of age at the time of the signing of the informed consent/assent form.
Participants less than (<) 18 years of age must weigh >=40 kg and must have body mass index (BMI) >=16.5 kilogram per square meter (kg/m^2).
Participants must have a documented diagnosis of UC for >=3 months before screening. The following must be available in each participant's source documentation:
1. A biopsy report to confirm the histological diagnosis.
2. A report documenting disease duration based upon prior colonoscopy. Note: If this documentation is not available at the time of screening, a colonoscopy with biopsy to confirm the diagnosis is required during the screening period.
Participants must be willing to undergo a flexible sigmoidoscopy or colonoscopy, including biopsy sample collection, during screening after all other inclusion criteria have been met.
Participants must have moderate to severe active UC, defined as a total Mayo score of >=6, including a centrally read endoscopic subscore >=2, rectal bleeding subscore >=1, and stool frequency subscore >=1 at baseline.
Participants must have evidence of UC extending proximal to the rectum (ie, not limited to proctitis).
Participants must have had an inadequate response to, or lost response to, or had an intolerance to at least 1 conventional treatment such as mesalamine (5-aminosalicylate [ASA]), glucocorticoids, immunosuppressants (azathioprine [AZA], 6-mercaptopurine [6-MP], or methotrexate [MTX]), or anti-tumor necrosis factor (TNF).
Participants receiving any treatment(s) for UC are eligible provided they have been, and are anticipated to be, on a stable dose for the designated period of time.
Participants are males or nonpregnant, nonlactating females who, if sexually active, agree to comply with the contraceptive requirements of the protocol, or females of nonchildbearing potential.

Exclusion Criteria

Participants with indeterminate colitis, microscopic colitis, non-steroidal anti-inflammatory drug-induced colitis, ischemic colitis, infectious colitis, or clinical/histologic findings suggestive of Crohn's disease.

Participants with colonic dysplasia or neoplasia. (Participants with prior history of adenomatous polyps will be eligible if the polyps have been completely removed.)
Participants with past medical history or presence of toxic megacolon.
Participants with colonic stricture, past medical history of colonic resection, a history of bowel surgery within 6 months before screening, or who are likely to require surgery for UC during the treatment period.
Participants at risk for colorectal cancer must have a colonoscopy performed during the screening period with results available within 10 days before the baseline visit, unless the participant has had a surveillance colonoscopy performed within 1 year prior to screening, and any adenomatous polyps found at that examination have been excised. Colonoscopy report and pathology report (if biopsies are obtained) from the colonoscopy performed during screening or in the prior year confirming no evidence of dysplasia and colon cancer must be available in the source documents.

Participants at risk for colorectal cancer include, but are not limited to:

Participants with extensive colitis for >=8 years or disease limited to left side of colon (ie, distal to splenic flexure) for >=10 years before screening, regardless of age.
Participants >=50 years of age at the time of signing of the informed consent form.
- Participants have had prior treatment with SHP647.
- Participants with known or suspected intolerance or hypersensitivity to the investigational product(s), closely related compounds, or any of the stated ingredients.
- Participants have received anti-TNF treatment within 60 days before baseline.
- Participants have received any biologic with immunomodulatory properties (other than anti-TNFs) within 90 days before baseline.
- Participants have received any nonbiologic treatment with immunomodulatory properties (other than their current background UC treatment) within 30 days before baseline.
- Participants have ever received anti-integrin/adhesion molecule treatment (example (eg): natalizumab, vedolizumab, efalizumab, etrolizumab, or any other investigational anti-integrin/adhesion molecule).
- Participants have received parenteral or rectal glucocorticoids, or rectal 5-ASA, within 14 days before screening endoscopic procedure.
- Participants have received leukocyte apheresis or selective lymphocyte, monocyte, or granulocyte apheresis or plasma exchange within 30 days before baseline.
- Participants have participated in other investigational studies within either 30 days or 5 half-lives of investigational product used in the study (whichever is longer) before baseline.
- Participants have received a live (attenuated) vaccine within 30 days before the baseline visit.
- Participants with active enteric infections (positive stool culture and sensitivity), Clostridium difficile infection or pseudomembranous colitis [Participants with C. difficile infection at screening may be allowed re-test after treatment], evidence of active cytomegalovirus infection or Listeria monocytogenes, known active invasive fungal infections such as histoplasmosis or parasitic infections, clinically significant underlying disease that could predispose the participants to infections, or a history of serious infection (requiring parenteral antibiotic and/or hospitalization) within 4 weeks before the baseline visit.
- Participants with abnormal chest x-ray findings at screening, such as presence of active tuberculosis, general infections, heart failure, or malignancy.
- Participants with evidence of active or latent infection with Mycobacterium tuberculosis (TB) or participants with this history who have not completed a generally accepted full course of treatment before randomization are excluded. All other participants must have either the Mantoux (purified protein derivative [PPD]) tuberculin skin test or interferon gamma release assay (IGRA) performed.

Participants who have no history of previously diagnosed active or latent tuberculosis are excluded if they have a positive Mantoux (PPD) tuberculin skin test (ie >=5 millimeter [mm] induration) or a positive IGRA (the latter to be tested at the site's local laboratory) during screening or within 12 weeks before screening. If IGRA test cannot be performed locally, a central laboratory may be used, with prior agreement from the sponsor.

An IGRA is strongly recommended for participants with a prior Bacillus Calmette-Guerin (BCG) vaccination, but may be used for any participant. Documentation of IGRA product used and the test result must be in the participant's source documentation if performed locally. Acceptable IGRA products include QuantiFERON TB Gold Plus In-Tube Test.
If the results of the IGRA are indeterminate, the test may be repeated, and if a negative result is obtained, enrollment may proceed. In participants with no history of treated active or latent tuberculosis, a positive test on repeat will exclude the participant. Participants with a history of active or latent TB infection must follow instructions for "participants with a prior diagnosis of active or latent TB are excluded unless both of the following criteria are met" in this criterion.
Participants with repeat indeterminate IGRA results, with no prior TB history, may be enrolled after consultation with a pulmonary or infectious disease specialist who determines low risk of infection (ie, participant would be acceptable for immunosuppressant [eg, anti-TNF] treatment without additional action). This consultation must be included in source documentation.

Results from a chest x-ray, taken within the 12 weeks before or during screening must show no abnormalities suggestive of active TB infection as determined by a qualified medical specialist.

Participants with a prior diagnosis of active or latent TB are excluded unless both of the following criteria are met:

The participant has previously received an adequate course of treatment for either latent (eg, 9 months of isoniazid or an acceptable alternative regimen, in a locale where rates of primary multidrug TB resistance are <5%. Participants from regions with higher rates of primary multidrug TB resistance are excluded) or active (acceptable multidrug regimen) TB infection. Evidence of diagnosis and treatment must be included in source documentation. Consultation with a pulmonary or infectious disease specialist to confirm adequate treatment (ie, participant would be acceptable for immunosuppressant [eg, anti-TNF] treatment without additional action) must be performed during the screening period. The consultation report must be included in source documentation prior to enrollment.
A chest x-ray performed within 12 weeks before or during screening indicates no evidence of active or recurrent disease, and documentation of interpretation by a qualified medical specialist must be included in source documentation.
- Participants with a pre-existing demyelinating disorder such as multiple sclerosis or new onset seizures, unexplained sensory motor, or cognitive behavioral, neurological deficits, or significant abnormalities noted during screening.
- Participants with any unexplained symptoms suggestive of progressive multifocal leukoencephalopathy (PML) based on the targeted neurological assessment during the screening period.
- Participants with a transplanted organ. Skin grafts to treat pyoderma gangrenosum are allowed.
- Participants with a significant concurrent medical condition at the time of screening or baseline, including, but not limited to, the following:

Any major illness/condition or evidence of an unstable clinical condition (eg, renal, hepatic, hematologic, gastrointestinal (except disease under study), endocrine, cardiovascular, pulmonary, immunologic [eg, Felty's syndrome], or local active infection/infectious illness) that, in the investigator's judgment will substantially increase the risk to the participant if he or she participates in the study.
Cancer or history of cancer or lymphoproliferative disease within the previous 5 years (other than resected cutaneous basal cell carcinoma, squamous cell carcinoma, or carcinoma in situ of the uterine cervix that has been treated with no evidence of recurrence).
Presence of acute coronary syndrome (eg, acute myocardial infarction, unstable angina pectoris) within 24 weeks before screening.
History of significant cerebrovascular disease within 24 weeks before screening.
- Participants who have had significant trauma or major surgery within 4 weeks before the screening visit, or with any major elective surgery scheduled to occur during the study.
- Participants with evidence of cirrhosis with or without decompensation.
- Participants with primary sclerosing cholangitis.
- Participants with evidence of positive hepatitis B surface antigen (HBsAg) or hepatitis B core antibody (HBcAb).

Note: If a participant tests negative for HBsAg, but positive for hepatitis B virus (HBcAb), the participant would be considered eligible if no presence of HBV DNA is confirmed by HBV DNA polymerasechainreaction(PCR) reflex testing performed in the central laboratory.

Participants with chronic hepatitis C (HCV) (positive HCVAb and HCVRNA). Note: Participants who are HCVAb positive without evidence of HCVRNA may be considered eligible (spontaneous viral clearance or previously treated and cured [defined as no evidence of HCV RNA at least 12 weeks prior to baseline]).
Participants with any of the following abnormalities in hematology and/or serum chemistry profiles during screening.

Note: Screening laboratory tests, if the results are considered by the investigator to be transient and inconsistent with the participant's clinical condition, may be repeated once during the screening period for confirmation. Results must be reviewed for eligibility prior to the screening endoscopy procedure.

Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels >=3.0×upper limit of normal (ULN).
Total bilirubin level >=1.5×ULN or >2.0×ULN if the participant has a known documented history of Gilbert's syndrome.
Hemoglobin level <=80 gram per liter (g/L) (8.0 gram per deciliter [g/dL]).
Platelet count <=100×10^9 per liter (/L) (100,000 cells per cubic millimeter [mm^3]) or >=1000×10^9/L (1,000,000 cells/mm^3).
White blood cell count <=3.5×10^9/L (3500 cells/mm^3). - Absolute neutrophil count (ANC)<2×10^9/L (2000 cells/mm^3).
- Serum creatinine level >1.5 × ULN or estimated glomerular filtration rate <30 ml/min/1.73m^2 based on the abbreviated Modification of Diet in Renal Disease Study Equation.

Note: If platelet count is <150,000 cells/mm^3, a further evaluation should be performed to rule out cirrhosis, unless another etiology has already been identified.

Participants with known human immunodeficiency virus (HIV) infection based on documented history, with positive serological test, or positive HIV serologic test at screening, tested at the site's local laboratory in accordance with country requirements or tested at the central laboratory.

Note: A documented negative HIV test within 6 months of screening is acceptable and does not need to be repeated.

Participants who have, or who have a history of (within 2 years before screening), serious psychiatric disease, alcohol dependency, or substance/drug abuse or dependency of any kind, including abuse of medical marijuana (cannabis).
Participants with any other severe acute or chronic medical or psychiatric condition or laboratory or electrocardiogram (ECG) abnormality that may increase the risk associated with study participation or investigational product administration or may interfere with the interpretation of study results and, in the judgment of the investigator, would make the participant inappropriate for entry into this study.

Female participants who are planning to become pregnant during study period.
Participants who do not agree to postpone donation of any organ or tissue, including male participants who are planning to bank or donate sperm and female participants who are planning to harvest or donate eggs, for the duration of the study and through 16 weeks after last dose of investigational product.
Participants who are investigational site staff members or relatives of those site staff members or Participants who are Shire employees directly involved in the conduct of study.

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Placebo	Placebo	Participants will receive placebo matched to ontamalimab (SHP647) SC injection using PFS on Week 0, Week 4 and Week 8.
Ontamalimab 25 mg	Ontamalimab	Participants will receive 25 milligrams (mg) of ontamalimab (SHP647) subcutaneous (SC) injection using a prefilled syringe (PFS) on Week 0, Week 4 and Week 8.
Ontamalimab 75 mg	Ontamalimab	Participants will receive 75 mg of ontamalimab (SHP647) SC injection using PFS on Week 0, Week 4 and Week 8.

Primary Outcome Measures

Name	Time	Method
Number of Participants With Remission at Week 12	At Week 12	Remission was defined as a composite score of patient-reported symptoms using daily e-diary and centrally read endoscopy as stool frequency sub-score of 0 or 1 with at least a 1-point change from baseline, rectal bleeding sub-score of 0 and endoscopic sub-score of 0 or 1 (modified, excluded friability). The composite score was a recommended measure consisted of the Mayo score without the physician global assessment (PGA) sub-score and ranged from 0 to 9 points. The Mayo score was a measure of Ulcerative Colitis (UC) disease activity. It ranged from 0 to 12 points and consisted of 4 sub-scores, each graded from 0 to 3 with higher scores indicating more severe disease. The sub-scores were stool frequency (0-3); rectal bleeding (0-3); findings of endoscopy (0-3); PGA (0-3).

Secondary Outcome Measures

Name	Time	Method
Number of Participants With Clinical Remission With Stool Frequency Sub-scores of 0 or 1 and Rectal Bleeding Sub-score of 0 at Weeks 4 and 8	At Weeks 4 and 8	Clinical remission was defined as stool frequency sub-score of 0 or 1 with at least a 1-point change from baseline in stool frequency sub-score, and a rectal bleeding sub-score of 0. Rectal bleeding was assessed on a scale from 0-3, where 0: no blood seen, 1: streaks of blood with stool less than half time, 2: obvious blood or streaks of blood with stool most of the time, and 3: blood alone passes. Stool frequency was assessed on a scale from 0-3, where 0: normal number of stools for this participant, 1: 1 to 2 stools more than normal, 2: 3 to 4 stools more than normal, and 3: 5 or more stools more than normal. Higher scores indicated more severe disease
Number of Participants With Endoscopic Remission at Week 12	At Week 12	Endoscopic remission was defined by centrally read endoscopic sub-score 0 or 1 (modified, excluded friability). The centrally read endoscopic sub-score of Mayo score ranged from 0 to 3 with higher scores indicating more severe disease.
Number of Participants With Clinical Response Based on Composite Score at Week 12	At Week 12	Clinical response based on composite score was defined as a decrease from baseline in the composite score of patient-reported symptoms using daily e-diary and centrally read endoscopy of at least 2 points and at least 30 percent (%), with an accompanying decrease in the sub-score for rectal bleeding greater than or equal to (\>=) 1 point or a sub-score for rectal bleeding less than or equal to (\<=) 1. The composite score was a recommended measure derived from the Mayo score without the PGA sub-score and ranged from 0 to 9 points. The Mayo score was a measure of UC disease activity. It ranged from 0 to 12 points and consisted of 4 sub-scores, each graded from 0 to 3 with higher scores indicating more severe disease The sub-scores were stool frequency (0-3); rectal bleeding (0-3); findings of endoscopy (0-3); PGA (0-3).
Number of Participants With Remission Based on Total Mayo Score at Week 12	At Week 12	Remission was defined as a total Mayo score of \<=2 with no individual sub-score (stool frequency, rectal bleeding, endoscopy \[modified, excluded friability\], and PGA) exceeding 1. The Total Mayo score ranged from 0 to 12 points and consisted of 4 sub-scores, each graded from 0 to 3 with higher scores indicating more severe disease: stool frequency (0-3); rectal bleeding (0-3); findings of endoscopy (0-3); PGA (0-3).
Number of Participants With Clinical Remission With Both Rectal Bleeding and Stool Frequency Sub-scores of 0 at Weeks 4, 8, and 12	At Weeks 4, 8, and 12	Clinical remission was defined as both rectal bleeding and stool frequency sub-scores of 0. Rectal bleeding was assessed on a scale from 0-3, where 0: no blood seen, 1: streaks of blood with stool less than half time, 2: obvious blood or streaks of blood with stool most of the time, and 3: blood alone passes. Stool frequency was assessed on a scale from 0-3, where 0: normal number of stools for this participant, 1: 1 to 2 stools more than normal, 2: 3 to 4 stools more than normal, and 3: 5 or more stools more than normal. Higher scores indicated more severe disease.
Change From Baseline in Total Sign/Symptom Score Based on PRO-UC Daily e-Diary at Week 12	Baseline, Week 12	Total sign/symptom score was the average of the average scores of worst abdominal pain over the past 24 hours and the conversion scale values for number of bowel movements blood, number of bowel movements with urgency, number of bowel movements and number of loose bowel movements, with scale ranged of 0-10, with higher scores indicating higher severity.
Change From Baseline in Inflammatory Bowel Disease Questionnaire (IBDQ) Domains Scores at Weeks 8 and 12	Baseline, Weeks 8 and 12	IBDQ was a psychometrically validated participant-reported outcome (PRO) instrument for measuring the disease-specific health-related quality of life (HRQL) in participants with inflammatory bowel disease, including UC. The IBDQ consisted of 32 items, which were grouped into 4 domains: bowel function, emotional status, systemic symptoms, and social function The 4 domains were scored as follows: Bowel symptoms: 10 to 70; Systemic symptoms: 5 to 35; Emotional function: 12 to 84; Social function: 5 to 35. Higher scores indicating a better quality of life.
Change From Baseline in Short Form-36 Health Survey (SF-36), Version 2, Acute (Individual Domain Scores) at Week 12	Baseline, Week 12	SF-36 was a generic quality-of-life instrument that had been widely used to assess HRQL of participants. The SF-36 consisted of 36 items that were aggregated into 8 multi-item scales (physical functioning \[1=yes, limited a lot to 3=no, not limited at all\], role-physical \[1=all of the time to 5=none of the time\], bodily pain \[1=very severe to 6=none\], general health \[1=poor to 5=excellent\], vitality \[1=none of the time to 5=all of the time\], social functioning \[1=all of the time: to 5=none of the time\], role emotional \[1=all of the time to 5=none of the time\] and mental health \[1=all of the time to 5=none of the time\]), with scores ranged from 0 to 100. Higher scores indicating better HRQL.
Number of Participants With Clinical Remission at Week 12	At Week 12	Clinical remission was defined by stool frequency (SF) sub-score of 0 or 1 with at least a 1-point change from baseline in stool frequency sub-score, and rectal bleeding sub-score of 0. Rectal bleeding is assessed on a scale from 0-3, where 0: no blood seen, 1: streaks of blood with stool less than half time, 2: obvious blood or streaks of blood with stool most of the time, and 3: blood alone passes. Stool frequency is assessed on a scale from 0-3, where 0: normal number of stools for this participant, 1: 1 to 2 stools more than normal, 2: 3 to 4 stools more than normal, and 3: 5 or more stools more than normal. Higher scores indicated more severe disease.
Number of Participants With Partial Mayo Score <=2 With no Individual Sub-score Greater Than (>) 1 at Weeks 4, 8, and 12	At Weeks 4, 8, and 12	The partial Mayo score ranged from 0 to 9 points and consisted of the following 3 sub-scores, each graded from 0 to 3 with higher scores indicating more severe disease: Stool frequency (0-3); Rectal bleeding (0-3); PGA (0-3). The partial Mayo score did not include the endoscopy sub-score.
Number of Participants With Endoscopic Remission With Sub-score of 0 at Week 12	At Week 12	Endoscopic remission was defined by centrally read endoscopic sub-score 0 (modified, excluded friability). The centrally read endoscopic sub-score of Mayo score ranged from 0 to 3 with higher scores indicating more severe disease.
Change From Baseline in Average Worst Abdominal Pain Score Based on Patient Reported Outcome-ulcerative Colitis (PRO-UC) Daily e-Diary at Week 12	Baseline, Week 12	PRO-UC daily e-diary data was collected using a daily e-diary during the treatment period. Collection of the daily e-diary data was begun at least 10 days before the baseline visit. Participants were asked to record the signs and symptom data of abdominal pain worst severity, as experienced over the previous 24 hours, in the e-diary. Participant's signs and symptom average scores at each scheduled visit were calculated based on data recorded over the most recent 3 days (consecutive or non-consecutive) of the last 10 days prior to scheduled visit start date excluding the following days: day of any bowel preparation, day of endoscopy, any days between day of bowel preparation and day of endoscopy, and the 2 days after the day of endoscopy. Abdominal pain's worst severity assessment was based on an 11-point numerical rating scale with 0 anchor at "No pain" and 10 at "Worst Imaginable Pain" as experienced over the previous 24 hours, in e-diary. Higher scores indicating more severe pain.
Number of Participants With Deep Remission at Week 12	At Week 12	Deep remission was defined as both endoscopic and rectal bleeding sub-scores of 0, and stool frequency sub-score \<=1 and a centrally read Geboes score of \<=2. The stool frequency sub-score, rectal bleeding sub-score and endoscopic sub-score of Mayo score ranged from 0 to 3 with higher scores indicating more severe disease. The composite score was a recommended measure consisted of the Mayo score without the PGA sub-score and ranged from 0 to 9 points. Geboes score grading system was a validated score for evaluating histologic disease activity in UC as follows: Grade 0 = structural and architectural changes; Grade 1 = chronic inflammatory infiltrate; Grade 2 = lamina propria neutrophils and eosinophils; Grade 3 = neutrophils in the epithelium; Grade 4 = crypt destruction; Grade 5 = erosions or ulceration. A higher Geboes score indicating more severe disease.
Change From Baseline in Average Bowel Movements With Urgency Score Based on PRO-UC Daily e-Diary at Week 12	Baseline, Week 12	PRO-UC daily e-diary data was collected using a daily e-diary during the treatment period. Collection of the daily e-diary data was begun at least 10 days before the baseline visit. Participants were asked to record the signs and symptom data for number of bowel movement with urgency, as experienced over the previous 24 hours. Participant's signs and symptom average scores at each scheduled visit were calculated based on data recorded over the most recent 3 days (consecutive or nonconsecutive) of the last 10 days prior to the scheduled visit start date excluding the following days: day of any bowel preparation, day of endoscopy, any days between day of bowel preparation and day of endoscopy, and the 2 days after the day of endoscopy. Average number bowel movements urgency ranged from 0 to 27. Higher scores indicating more frequent bowel movements.
Change From Baseline in Short Form-36 Health Survey (SF-36), Version 2, Acute (Physical and Mental Component Summary Scores) at Week 12	Baseline, Week 12	SF-36 was a generic quality-of-life instrument that had been widely used to assess health-related quality of life (HRQL) of participants). SF-36 consisted of 36 items that were aggregated into 8 multi-item scales (physical functioning \[1=yes, limited a lot to 3=no, not limited at all\], role-physical \[1=all of the time to 5=none of the time\], bodily pain \[1=very severe to 6=none\], general health \[1=poor to 5=excellent\], vitality \[1=none of the time to 5=all of the time\], social functioning \[1=all of the time: to 5=none of the time\], role emotional \[1=all of the time to 5=none of the time\] and mental health \[1=all of the time to 5=none of the time\]). Four domains comprised physical component summary (PCS) score (physical functioning, role-physical, bodily pain, general health) and remaining 4 domains comprised mental component summary (MCS) score (vitality, social functioning, role-emotional, mental health). The scores ranged from 0 to 100. Higher scores indicating better HRQL.
Median Duration of Total In-patient Days	Baseline up to Week 12	In-patient days were calculated as Date of discharge - Date of admission + 1. Median duration of total inpatient days during the entire study period was reported.
Number of Participants With Mucosal Healing Based on Endoscopic and Histological Assessment Using the Geboes Score Grading System at Week 12	At Week 12	Mucosal healing was defined by centrally read endoscopic sub-score 0 or 1 (modified, excluded friability) and centrally read Geboes score of \<=2. The centrally read endoscopic sub-score of Mayo score ranged from 0 to 3 with higher scores indicating more severe disease. Geboes score grading system was a validated score for evaluating histologic disease activity in UC as follows: Grade 0 equal to (=) structural and architectural changes; Grade 1 = chronic inflammatory infiltrate; Grade 2 = lamina propria neutrophils and eosinophils; Grade 3 = neutrophils in the epithelium; Grade 4 = crypt destruction; Grade 5 = erosions or ulceration. A higher Geboes score indicating more severe disease.
Number of Participants With Clinical Response Based on Total Mayo Score at Week 12	At Week 12	Clinical response (Mayo) was defined as a decrease from baseline in the total Mayo score of at least 3 points and at least 30%, with an accompanying decrease in the sub-score for rectal bleeding \>=1 point or an absolute sub-score for rectal bleeding \<=1. The Total Mayo score ranged from 0 to 12 points and consisted of the following 4 sub-scores, each graded from 0 to 3 with higher scores indicating more severe disease: stool frequency (0-3); rectal bleeding (0-3); findings of endoscopy (0-3); PGA (0-3).
Change From Baseline in Diarrhea (Average Loose Bowel Movements) Score Based on PRO-UC Daily e-Diary at Week 12	Baseline, Week 12	PRO-UC daily e-diary data was collected using a daily e-diary during the treatment period. Collection of the daily e-diary data was begun at least 10 days before the baseline visit. Participants were asked to record the signs and symptom data for number of loose bowel movement, as experienced over the previous 24 hours, in the e-diary. Participant's signs and symptom average scores at each scheduled visit were calculated based on data recorded over the most recent 3 days (consecutive or nonconsecutive) of the last 10 days prior to the scheduled visit start date excluding the following days: day of any bowel preparation, day of endoscopy, any days between day of bowel preparation and day of endoscopy, and the 2 days after the day of endoscopy. Average number of loose bowel movement ranged from 0-27. Higher scores indicating more frequent bowel movements.
Change From Baseline in Absolute Stool Frequency (Average Number of Bowel Movements) Score Based on PRO-UC Daily e-Diary at Week 12	Baseline, Week 12	PRO-UC daily e-diary data was collected using a daily e-diary during the treatment period. Collection of the daily e-diary data was begun at least 10 days before the baseline visit. Participants were asked to record the signs and symptom data for average number of bowel movements, as experienced over the previous 24 hours. Participant's signs and symptom average scores at each scheduled visit were calculated based on data recorded over the most recent 3 days (consecutive or nonconsecutive) of the last 10 days prior to the scheduled visit start date excluding the following days: day of any bowel preparation, day of endoscopy, any days between day of bowel preparation and day of endoscopy, and the 2 days after the day of endoscopy. Average number bowel movements ranged from 0 to 27. Higher scores indicating more frequent bowel movements.
Change From Baseline in Absolute Rectal Bleeding (Average Number Bowel Movements With Blood) Score Based on PRO-UC Daily e-Diary at Week 12	Baseline, Week 12	PRO-UC daily e-diary data was collected using a daily e-diary during the treatment period. Collection of the daily e-diary data was begun at least 10 days before the baseline visit. Participants were asked to record the signs and symptom data for average number of bowel movements with blood, as experienced over the previous 24 hours. Participant's signs and symptom average scores at each scheduled visit were calculated based on data recorded over the most recent 3 days (consecutive or nonconsecutive) of the last 10 days prior to the scheduled visit start date excluding the following days: day of any bowel preparation, day of endoscopy, any days between day of bowel preparation and day of endoscopy, and the 2 days after the day of endoscopy. Average number bowel movements with blood ranged from 0 to 27. Higher scores indicating more frequent bowel movements.
Change From Baseline in IBDQ Total Scores at Weeks 8 and 12	Baseline, Weeks 8 and 12	IBDQ was a psychometrically validated PRO instrument for measuring the disease-specific HRQL in participants with inflammatory bowel disease, included UC. The IBDQ consisted of 32 items, which were grouped into 4 domains: bowel function, emotional status, systemic symptoms, and social function. The 4 domains were scored as follows: Bowel symptoms: 10 to 70; Systemic symptoms: 5 to 35; Emotional function: 12 to 84; Social function: 5 to 35. The total IBDQ score ranged from 32 to 224. For the total score and each domain, a higher score indicating better HRQL. A score of at least 170 corresponds to clinical remission and an increase of at least 16 points was considered to indicate a clinically meaningful improvement.
Number of Participants Based on In-patient Hospitalization	Baseline up to Week 12	Number of participants based on inpatient hospitalization due to all-cause hospitalization, gastrointestinal related, other illness/problem, and who had undergone gastrointestinal related procedures during the entire study period was reported.

Trial Locations

Locations (204): DM Clinical Research - ERN - PPDS
🇺🇸
Tomball, Texas, United States
Royal Brisbane & Women's Hospital
🇦🇺
Herston, Queensland, Australia
Royal Adelaide Hospital
🇦🇺
Adelaide, South Australia, Australia
CEMEC - Centro Multidisciplinar de Estudos Clínicos
🇧🇷
Santo André, São Paulo, Brazil
Piedmont Healthcare
🇺🇸
Statesville, North Carolina, United States
Advanced Gastroenterology-Union City
🇺🇸
Union City, Tennessee, United States
Exemplar Research, Inc. - Elkins
🇺🇸
Elkins, West Virginia, United States
Louisiana Research Center LLC
🇺🇸
Shreveport, Louisiana, United States
Baruch Padeh Poriya Medical Center
🇮🇱
Tiberias, Israel
Lexmedica
🇵🇱
Wroclaw, Dolnoslaskie, Poland
Centrum Diagnostyczno - Lecznicze Barska sp. z o.o.
🇵🇱
Wloclawek, Kujawsko-pomorskie, Poland
Atria Clinical Research - Clinedge - PPDS
🇺🇸
Little Rock, Arkansas, United States
Digestive Health Center PA
🇺🇸
Ocean Springs, Mississippi, United States
Instytut Centrum Zdrowia Matki Polki
🇵🇱
Lódz, Lódzkie, Poland
Klinikum Klagenfurt Am Woerthersee
🇦🇹
Klagenfurt am Wörthersee, Austria
Salzburger Landeskliniken
🇦🇹
Salzburg, Austria
Onomichi General Hospital
🇯🇵
Onomichi, Japan
Academisch Medisch Centrum Amsterdam
🇳🇱
Amsterdam, Netherlands
Endoskopia Sp. z o.o.
🇵🇱
Sopot, Pomorskie, Poland
Twoja Przychodnia - Szczecińskie Centrum Medyczne
🇵🇱
Szczecin, Zachodniopomorskie, Poland
Szpital Uniwersytecki Nr 2 im. Dr Jana Biziela w Bydgoszczy
🇵🇱
Bydgoszcz, Poland
Szpital Zakonu Bonifratrow pw. Aniolow Strozow w Katowicach
🇵🇱
Katowice, Poland
Centrum Medyczne A-Z Clinic Mateusz Sidor, Piotr Puc-Lekarze Spolka Partnerska
🇵🇱
Krakow, Poland
Tel Aviv Sourasky Medical Center PPDS
🇮🇱
Tel Aviv, Israel
Sapporo Tokushukai Hospital
🇯🇵
Sapporo-shi, Hokkaidô, Japan
Dokkyo Medical University Saitama Medical Center
🇯🇵
Koshigaya, Japan
NWZ, location Alkmaar
🇳🇱
Alkmaar, Noord-Holland, Netherlands
VU Medisch Centrum
🇳🇱
Amsterdam, Netherlands
West Virginia University Hospital
🇺🇸
Morgantown, West Virginia, United States
Kitasato University Kitasato Institute Hospital
🇯🇵
Minato-ku, Tokyo, Japan
Hakodate Koseiin Hakodate Goryoukaku Hospital
🇯🇵
Hakodate, Japan
Hidaka Coloproctology Clinic
🇯🇵
Kurume-shi, Japan
Vilnius City Clinical Hospital
🇱🇹
Vilnius, Lithuania
Leids Universitair Medisch Centrum
🇳🇱
Leiden, Zuid-Holland, Netherlands
Melita Medical
🇵🇱
Wroclaw, Dolnoslaskie, Poland
Niepubliczny Zakład Opieki Zdrowotnej VIVAMED
🇵🇱
Warszawa, Mazowieckie, Poland
Centrum Zdrowia MDM
🇵🇱
Warsaw, Poland
Dr. Goldis Gastroenterology Center SRL
🇷🇴
Timisoara, Romania
Research Institute of Physiology and Basic Medicine
🇷🇺
Novosibirsk, Russian Federation
University Clinical Center Nis
🇷🇸
Nis, Serbia
Jikei University Hospital
🇯🇵
Minato-ku, Tokyo, Japan
Aichi Medical University Hospital
🇯🇵
Nagakute, Japan
Vitamed Galaj i Cichomski sp.j.
🇵🇱
Bydgoszcz, Kujawsko-pomorskie, Poland
Gastromed Kopon Zmudzinski i Wspolnicy Sp.j.Specjalistyczne Centrum Gastrologii i Endoskopii Specj
🇵🇱
Torun, Kujawsko-pomorskie, Poland
Centralny Szpital Kliniczny MSW
🇵🇱
Warszawa, Poland
Dr.Carol Davila Emergency University Central Military Hospital
🇷🇴
Bucharest, Romania
Russian Medical Military Academy n.a. S.M. Kirov
🇷🇺
Saint Petersburg, Russian Federation
Stavropol State Medical University
🇷🇺
Stavropol, Russian Federation
Ospedale Sacro Cuore Don Calabria
🇮🇹
Negrar, Veneto, Italy
Azienda Ospedale Università Padova - Dipartimento Salute della Donna e del Bambino - INCIPIT - PIN
🇮🇹
Padova, Veneto, Italy
Moscow Clinical Scientific Center
🇷🇺
Moscow, Russian Federation
Moscow Regional Research Clinical Institute Na Mfvladimirskiy
🇷🇺
Moscow, Russian Federation
SPZOZ Uniwersytecki Szpital Kliniczny im. Wojskowej Akademii Medycznej UM w Lodzi
🇵🇱
Lódz, Lódzkie, Poland
Krakowskie Centrum Medyczne
🇵🇱
Krakow, Malopolskie, Poland
Centrum Medyczne Czestochowa - PRATIA - PPDS
🇵🇱
Czestochowa, Poland
Sana Monitoring SRL
🇷🇴
Bucharest, Romania
Centrul Medical Hifu Terramed Conformal S.R.L.
🇷🇴
Bucuresti, Romania
Gastromedica SRL
🇷🇴
Iasi, Romania
Nizhegorodskaya Regional Clinical Hospital n.a. Semashko
🇷🇺
Nizhny Novgorod, Russian Federation
SHI Regional Clinical Hospital
🇷🇺
Saratov, Russian Federation
Smolensk Regional Clinical Hospital
🇷🇺
Smoensk, Russian Federation
First St. Petersburg State Medical University n.a. I.P Pavlov
🇷🇺
St. Petersburg, Russian Federation
Centrum Medyczne Warszawa - PRATIA - PPDS
🇵🇱
Warszawa, Mazowieckie, Poland
Szpital Specjalistyczny sw Lukasza - Oddzial Gastroenterologii
🇵🇱
Konskie, Swietokrzyskie, Poland
NZOZ All Medicus
🇵🇱
Katowice, Poland
Centrum Opieki Zdrowotnej Orkan-Med Stec-Michalska Sp. J.
🇵🇱
Ksawerow, Poland
Med Gastr Sp.z.o.o Sp.k
🇵🇱
Lodz, Poland
Twoja Przychodnia - Centrum Medyczne Nowa Sol
🇵🇱
Nowa Sól, Poland
Cluj-Napoca Emergency Clinical County Hospital
🇷🇴
Cluj-Napoca, Cluj, Romania
Kazan State Medical University
🇷🇺
Kazan, Russian Federation
Samodzielny Publiczny Szpital Wojewodzki im. Papieza Jana Pawla II
🇵🇱
Zamosc, Poland
Fundeni Clinical Institute
🇷🇴
Bucharest, Romania
Affidea Romania SRL
🇷🇴
Constanta, Romania
Clinical Hospital Center ''Bezanijska Kosa''
🇷🇸
Belgrade, Serbia
Regional Consulting and Diagnostics Centre
🇷🇺
Tyumen, Russian Federation
General Hospital Vrsac
🇷🇸
Vrsac, Serbia
University Clinical Center Kragujevac
🇷🇸
Kragujevac, Šumadijski Okrug, Serbia
Gastrointestinal Diseases, Inc. Research
🇺🇸
Columbus, Georgia, United States
Asthma and Allergy Associates PC - CRN - PPDS
🇺🇸
Colorado Springs, Colorado, United States
OM Research LLC - Lancaster - ClinEdge - PPDS
🇺🇸
Lancaster, California, United States
Peak Gastroenterology Associates
🇺🇸
Colorado Springs, Colorado, United States
Northwestern University
🇺🇸
Chicago, Illinois, United States
Medisphere Medical Research Center LLC
🇺🇸
Evansville, Indiana, United States
New York Total Medical Care PC
🇺🇸
Brooklyn, New York, United States
Massachusetts General Hospital
🇺🇸
Boston, Massachusetts, United States
Clinical Trials of SWLA LLC
🇺🇸
Lake Charles, Louisiana, United States
Northside Gastroenterology
🇺🇸
Cypress, Texas, United States
Allegheny Center For Digestive Health
🇺🇸
Pittsburgh, Pennsylvania, United States
Gastro One
🇺🇸
Germantown, Tennessee, United States
Consultants For Clinical Research Inc
🇺🇸
Fairfield, Ohio, United States
Inquest Clinical Research/Coastal Gastroenterology Associates, PA
🇺🇸
Baytown, Texas, United States
Concord Repatriation General Hospital
🇦🇺
Concord, New South Wales, Australia
LKH-Universitätsklinikum Klinikum Graz
🇦🇹
Graz, Steiermark, Austria
HP Clinical Research
🇺🇸
Bountiful, Utah, United States
A.ö. Krankenhaus der Barmherzigen Brüder
🇦🇹
St. Veit an der Glan, Kärnten, Austria
Clinical Hospital Centre Osijek
🇭🇷
Osijek, Croatia
Nemocnice Pardubickeho kraje, a.s. Orlickoustecka nemocnice
🇨🇿
Usti nad Orlici, Czechia
CHI Franciscan Digestive Care Associates
🇺🇸
Tacoma, Washington, United States
Liverpool Hospital
🇦🇺
Liverpool, New South Wales, Australia
St Vincents Hospital Melbourne - PPDS
🇦🇺
Fitzroy, Victoria, Australia
The Alfred Hospital
🇦🇺
Melbourne, Victoria, Australia
Instituto Goiano de Gastroenterologia E Endoscopia Digestiva Ltda
🇧🇷
Goiânia, Goiás, Brazil
Universitätsklinikum St. Pölten
🇦🇹
St. Pölten, Austria
Klinikum Wels-Grieskirchen GmbH
🇦🇹
Wels, Austria
Medizinische Universitat Wien (Medical University of Vienna)
🇦🇹
Wien, Austria
Opca Bolnica Karlovac
🇭🇷
Karlovac, Karlovacka Županija, Croatia
Opca bolnica Bjelovar
🇭🇷
Bjelovar, Croatia
General County Hospital Vukovar and Croatian Veterans Hospital
🇭🇷
Vukovar, Croatia
General Hospital Zadar
🇭🇷
Zadar, Croatia
Hospital Da Cidade de Passo Fundo
🇧🇷
Passo Fundo, Rio Grande Do Sul, Brazil
University Hospital Center Zagreb
🇭🇷
Zagreb, Grad Zagreb, Croatia
University Hospital Centre Split
🇭🇷
Split, Croatia
General Hospital Virovitica
🇭🇷
Virovitica, Croatia
PreventaMed s.r.o.
🇨🇿
Olomouc, Olomoucký Kraj, Czechia
Nazareth EMMS Hospital
🇮🇱
Nazareth, Israel
Azienda Ospedaliera San Camillo Forlanini
🇮🇹
Roma, Lazio, Italy
ISCARE I.V.F. a.s.
🇨🇿
Praha 7, Czechia
Hepato-Gastroenterologie HK, s. r. o.
🇨🇿
Hradec Kralove, Královéhradecký Kraj, Czechia
Institut Klinicke A Experimentalni Mediciny
🇨🇿
Praha 4, Czechia
Uniklinik Köln
🇩🇪
Köln, Germany
Gastro Campus Research GbR
🇩🇪
Münster, Nordrhein-Westfalen, Germany
Universitätsklinikum Ulm
🇩🇪
Ulm, Baden-Württemberg, Germany
Krajska zdravotni, a.s. - Masarykova nemocnice v Usti nad Labem, o.z.
🇨🇿
Usti nad Labem, Czechia
Universitatsklinikum Schleswig-Holstein
🇩🇪
Kiel, Schleswig-Holstein, Germany
Universitätsklinikum der RWTH Aachen
🇩🇪
Aachen, Nordrhein-Westfalen, Germany
Universitätsklinikum Jena
🇩🇪
Jena, Thüringen, Germany
Shaare Zedek Medical Center
🇮🇱
Jerusalem, Israel
Hadassah Medical Center - PPDS
🇮🇱
Jerusalem, Israel
Galilee Medical Center
🇮🇱
Nahariya, Israel
Asklepios Westklinikum Hamburg Ggmbh
🇩🇪
Hamburg, Germany
Azienda Ospedaliero Universitaria Di Modena Policlinico
🇮🇹
Modena, Emilia-Romagna, Italy
Azienda Ospedaliera Mater Domini Di Catanzaro
🇮🇹
Catanzaro, Calabria, Italy
Tokatsu Tsujinaka Hospital
🇯🇵
Abiko-shi, Chiba, Japan
Sagamihara Kyodo Hospital
🇯🇵
Sagamihara, Kanagawa, Japan
Ome Municipal General Hospital
🇯🇵
Ome, Tokyo, Japan
Kawabe Clinic
🇯🇵
Koganei, Japan
Yuai Memorial Hospital
🇯🇵
Koga, Japan
Nishinomiya Municipal Central Hospital
🇯🇵
Nishinomiya, Japan
Sapporo Higashi Tokushukai Hospital
🇯🇵
Sapporo, Japan
Shinbeppu Hospital
🇯🇵
Beppu, Ôita, Japan
ETZ-Elisabeth
🇳🇱
Tilburg, Noord-Brabant, Netherlands
Niepubliczny Zaklad Opieki Zdrowotnej CENTRUM MEDYCZNE Szpital Swietej Rodziny
🇵🇱
Lódz, Lódzkie, Poland
Hospital of Lithuanian University of Health Sciences Kaunas Clinics
🇱🇹
Kaunas, Lithuania
Uniwersytecki Szpital Kliniczny w Bialymstoku
🇵🇱
Bialystok, Podlaskie, Poland
Centrum Medyczne Pratia Bydgoszcz
🇵🇱
Bydgoszcz, Poland
Centrum Medyczne Gdynia - PRATIA - PPDS
🇵🇱
Gdynia, Poland
Nuren Medical and Research Center
🇺🇸
Miami, Florida, United States
H-T. Centrum Medyczne Endoterapia
🇵🇱
Tychy, Slaskie, Poland
BioVirtus Centrum Medyczne
🇵🇱
Józefów, Poland
Centrum Innowacyjnych Terapii
🇵🇱
Piaseczno, Poland
Korczowski Bartosz, Gabinet Lekarski
🇵🇱
Rzeszow, Poland
Clinical Research Center Spółka z Ograniczoną Odpowiedzialnością, Medic-R Spółka Komandytowa
🇵🇱
Poznan, Poland
Sonomed Sp. z o.o.
🇵🇱
Szczecin, Poland
Aberdeen Royal Infirmary - PPDS
🇬🇧
Aberdeen, United Kingdom
Dr. J Breedt
🇿🇦
Pretoria, Gauteng, South Africa
Colentina Clinical Hospital
🇷🇴
Bucharest, Romania
Prof. Dr. Matei Bals Institute of Infectious Diseases
🇷🇴
Bucharest, Romania
Dr. Tirnaveanu Amelita Private Practice
🇷🇴
Oradea, Romania
Union Clinic, LLC
🇷🇺
Saint-Petersburg, Russian Federation
Medical University Reaviz
🇷🇺
Samara, Russian Federation
Medical Company Hepatolog, LLC
🇷🇺
Samara, Russian Federation
Pennine Acute Hospitals Trust
🇬🇧
Lancashire, Bury, United Kingdom
Private Healthcare Institution Clinical Hospital RZD-Medicina of Samara city
🇷🇺
Samara, Russian Federation
North Tyneside General Hospital
🇬🇧
North Shields, Northumberland, United Kingdom
Royal Shrewsbury Hospital
🇬🇧
Shrewsbury, Shropshire, United Kingdom
Dr JP Wright
🇿🇦
Claremont, Western Cape, South Africa
CLINRESCO, ARWYP Medical Suites
🇿🇦
Johannesburg, Gauteng, South Africa
Fairfield General Hospital - PPDS
🇬🇧
Lancashire, Bury, United Kingdom
Vanderbilt University Medical Center
🇺🇸
Nashville, Tennessee, United States
Digestive Health Center at UWMC
🇺🇸
Seattle, Washington, United States
University of Washington
🇺🇸
Seattle, Washington, United States
Ospedale Casa Sollievo Della Sofferenza IRCCS
🇮🇹
San Giovanni Rotondo (FG), Puglia, Italy
Azienda Ospedaliera Universitaria Careggi
🇮🇹
Firenze, Toscana, Italy
Azienda Ospedaliero Universitaria Di Bologna - Policlinico S Orsola Malpighi
🇮🇹
Bologna, Italy
A.O.U. Maggiore della Carità
🇮🇹
Novara, Italy
La Sapienza-Università di Roma-Policlinico Umberto I
🇮🇹
Roma, Italy
Azienda Ospedaliera Ordine Mauriziano di Torino
🇮🇹
Torino, Italy
Fondazione Policlinico Universitario A Gemelli
🇮🇹
Roma, Italy
Western General Hospital Edinburgh - PPDS
🇬🇧
Edinburh, United Kingdom
Royal Gwent Hospital - PPDS
🇬🇧
Newport, United Kingdom
New Cross Hospital
🇬🇧
Wolverhampton, United Kingdom
Klinikum rechts der Isa der Technischen Universitaet Muenchen
🇩🇪
Munich, Germany
Gastroenterologische Facharztpraxis am Mexikoplatz
🇩🇪
Berlin-Zehlendorf, Germany
Sana Klinikum Biberach
🇩🇪
Biberach an der Riss, Germany
Universitätsklinikum Frankfurt
🇩🇪
Frankfurt, Germany
Charité - Universitätsmedizin Berlin
🇩🇪
Berlin, Germany
Digestive Disease Associates
🇺🇸
Wyomissing, Pennsylvania, United States
University of Chicago Medical Center
🇺🇸
Chicago, Illinois, United States
Gastroenterology Group of Naples
🇺🇸
Naples, Florida, United States
Mater Hospital Brisbane
🇦🇺
South Brisbane, Queensland, Australia
Fondazione IRCCS Policlinico San Matteo di Pavia
🇮🇹
Pavia, Italy
Istituto Clinico Humanitas
🇮🇹
Rozzano (MI), Italy
Azienda Ospedaliera Città della Salute e della Scienza di Torino
🇮🇹
Torino, Italy
Shiga University of Medical Science Hospital
🇯🇵
Otsu-Shi, Japan
Vilnius University Hospital Santaros Klinikos
🇱🇹
Vilnius, Lithuania
Miedzyleski Szpital Specjalistyczny w Warszawie
🇵🇱
Warszawa, Mazowieckie, Poland
Rostov State Medical University
🇷🇺
Rostov-on-Don, Russian Federation
St. Elizabeth Municipal Clinical Hospital
🇷🇺
St. Petersburg, Russian Federation
Whipps Cross University Hospital
🇬🇧
London, London, City Of, United Kingdom
Omega Research Consultants LLC - Clinedge - PPDS
🇺🇸
Orlando, Florida, United States
Inland Empire Liver Foundation
🇺🇸
Rialto, California, United States
Advanced Clinical Research Network
🇺🇸
Coral Gables, Florida, United States
East Coast Institute for Research, LLC
🇺🇸
Saint Augustine, Florida, United States
Laporte County Institute For Clinical Research
🇺🇸
Michigan City, Indiana, United States