A double-blind, placebo-controlled Clinical Trial to evaluate the Safety and Efficacy of JNJ-64304500 in patients with Moderately to Severely Active Crohn¿s Disease

Phase 1

• Conditions: Active Crohn's Disease; MedDRA version: 20.0Level: PTClassification code 10011401Term: Crohn's diseaseSystem Organ Class: 10017947 - Gastrointestinal disorders; Therapeutic area: Diseases [C] - Immune System Diseases [C20]

• Registration Number: EUCTR2016-000634-21-IT
• Lead Sponsor: JANSSEN CILAG INTERNATIONAL NV

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Results First Posted: 1900-01-01
• Study Start: 2021-01-22
• Last Update Posted: 21 July 2021

Recruitment & Eligibility

• Status: ot Recruiting
• Sex: All
• Target Recruitment: 654

Inclusion Criteria

- Have Crohn’s disease or fistulizing Crohn’s disease of at least 3 months’ duration, with colitis, ileitis, or ileocolitis, confirmed at any time in the past by radiography, histology, and/or endoscopy.
- Have active Crohn’s disease, defined as a baseline CDAI score of =220 but =450.
Have at least one of the following at screening:
a. An abnormal CRP (>0.3 mg/dL [>3.0 mg/L]) OR
b. Calprotectin >250 mg/kg.
Study 1: Has previously demonstrated inadequate response, loss of response, or intolerance to 1 or more approved biologic therapies OR
Study 2: Has failed conventional therapy (currently receiving corticosteroids and/or immunomodulators OR has a history of failure to respond to or tolerate an adequate course of corticosteroids and/or immunomodulators OR is corticosteroid dependent or has had a history of corticosteroid dependency).
Part II: Has previously demonstrated inadequate response, loss of response, or intolerance to 1 or more approved biologic therapies or has failed conventional therapy.
All 3 Studies:
- Adhere to the following requirements for concomitant medication for the treatment of Crohn's disease, which are permitted provided that doses meeting these requirements are stable, or have been discontinued, for at least 3 weeks before baseline (Week 0), unless otherwise specified:
a. Oral 5-aminosalicylic acid (5-ASA) compounds.
b. Oral corticosteroids at a prednisone-equivalent dose at or below 40 mg/day, or 9 mg/day of budesonide, or 5 mg/day beclomethasone dipropionate.
c. Antibiotics being used as a primary treatment of Crohn's disease.
d. Conventional immunomodulators (ie, AZA, 6-MP, or MTX): subjects must have been taking them for at least 12 weeks and at a stable dose for at least 4 weeks before baseline.
- A subject with a family history of colorectal cancer, personal history of increased colorectal cancer risk, age >50 years, or other known risk factor must be up-to-date on colorectal cancer surveillance
- A subject who has had extensive colitis for =8 years, or disease limited to the left side of the colon for =12 years, must either have had a colonoscopy to assess for the presence of dysplasia within 1 year before the first administration of study agent or a colonoscopy to assess for the presence of malignancy at the screening visit, with no evidence of malignancy.
- Have screening laboratory test results within the following parameters:
a. Hemoglobin =8.0 g/dL.
b. White blood cell count>=3.0 × 103/µL.
c. Neutrophils =1.5 × 103/µL.
d. Platelets =100 × 103/µL.
e. Serum creatinine <1.7 mg/dL.
f. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) concentrations must be within 2 times the upper limit of the normal range (ULN) range for the laboratory conducting the test.
g. Direct (conjugated) bilirubin <1.0 mg/dL.
- Are considered eligible according to the following tuberculosis (TB) screening criteria (see details in protocol):
a. Have no history of latent or active TB before screening.
b. Have no signs or symptoms suggestive of active TB upon medical history and/or physical examination.
c. Have had no recent close contact with a person with active TB or, if there has been such contact, will be referred to a physician specializing in TB to undergo additional evaluation and, if warranted, receive appropriate treatment for latent TB before or simultaneously with the first administration of study agent.
d. Within 2 months before the first administration of study agent, either have negative QuantiFER

Exclusion Criteria

1 Has complications of Crohn's disease such as symptomatic strictures or stenoses, short gut syndrome, or any other manifestation that might be anticipated to require surgery, could preclude the use of the CDAI, or would possibly confound the ability to assess the effect of treatment with JNJ-64304500 or ustekinumab.
2 Currently has or is suspected to have an abscess (see details in protocol).
3 Has had any kind of bowel resection within 6 months or any other intra-abdominal surgery within 3 months before baseline.
4 Has a draining (ie, functioning) stoma or ostomy.
5 Has received any of the following prescribed medications or therapies within the specified period:
a IV corticosteroids
b Other oral immunomodulatory agents (eg, 6-thioguanine [6-TG], cyclosporine, tacrolimus, sirolimus, or mycophenolate mofetil, tofacitinib and other Janus kinase [JAK] inhibitors)
c Nonbiologic experimental or investigational agents
d Nonautologous stem cell therapy (eg, Prochymal), natalizumab, efalizumab, or biologic agents that deplete B or T cells (eg, rituximab, alemtuzumab, or visilizumab)
e TNFa-antagonist biologic agents (eg, mAb therapies) or other agents intended to suppress or eliminate TNFa
f Vedolizumab
g Other immunomodulatory biologic agents
h Treatment with apheresis (eg, Adacolumn apheresis)
i Initiation of total or partial parenteral nutrition administered through any indwelling catheter or anticipated to require parenteral nutrition administered through an indwelling catheter during enrollment in the study
j Initiation of enteral therapy for Crohn's disease (liquid nutritional formula comprising =80% of total caloric intake administered through the gastrointestinal tract). Subjects who are on a stable regimen of enteral feeds may be considered for enrollment if they plan to continue
enteral feeds as treatment for Crohn's disease.
6 Has a stool culture or other examination positive for an enteric pathogen in the last 4 months unless a repeat examination is negative and there are no signs of ongoing infection with that pathogen.
7 Has previously received a biologic agent targeting IL-12 or IL-23
8 Has previously received JNJ-64304500 or NNC0142-002
9 Has received a Bacille Calmette-Guérin (BCG) vaccination within 12 months or any other live bacterial or live viral vaccination within 12 weeks before baseline
10 Has a history of, or ongoing, chronic or recurrent infectious disease
11 Has current signs or symptoms of infection. Established nonserious infections (eg, acute upper respiratory tract infection, simple urinary tract infection) need not be considered exclusionary at the discretion of the investigator
12 Has a history of serious infection (eg, sepsis, pneumonia, or pyelonephritis)
13 Has evidence of a Herpes zoster infection
14 Has a history of latent or active granulomatous infection before screening
15 Has evidence of current active infection, including TB, or a nodule suspicious for lung malignancy on screening or any other available chest radiograph
16 Has or ever has had a nontuberculous mycobacterial infection or serious opportunistic infection
17 Has a history of HIV antibody positivity, or tests positive for HIV at screening
18 Are seropositive for antibodies to HCV without a history of successful treatment
19 Subjects must undergo screening for HBV:
a Subjects who test negative for all HBV screening tests (ie, HBsAg-, anti-HBc-, and anti-HBs-) are eligible for this study
b Subjects who test positive for surface antigen (HB

Study & Design

• Study Type: Interventional clinical trial of medicinal product
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Main Objective: - To evaluate the efficacy of JNJ-64304500 to reduce the CDAI score from baseline.<br>- To evaluate the safety of JNJ-64304500.;Secondary Objective: - To evaluate the efficacy of JNJ-64304500 to induce clinical remission, clinical response, and endoscopic healing of the mucosa, and to maintain remission<br>- To evaluate the relationship between efficacy and the presence of the NKG2D and/or MICB SNP biomarkers.<br>- To evaluate the efficacy of JNJ-64304500 to improve general and disease-specific healthrelated quality of life and to reduce Crohn¿s disease-related hospitalizations and surgeries.<br>- To evaluate the pharmacokinetics, immunogenicity, pharmacodynamics, and biomarkers (eg, reductions in CRP, fecal calprotectin, and fecal lactoferrin) of JNJ-64304500 therapy.;Primary end point(s): Part I: Change from baseline in the CDAI score at Week 8<br>Part II: Change from baseline in the CDAI score at Week 12;Timepoint(s) of evaluation of this end point: Part I: Week 8<br>Part II: Week 12