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A Study of Guselkumab in Pediatric Participants With Moderately to Severely Active Crohn's Disease

Phase 3
Recruiting
Conditions
Crohn's Disease
Interventions
Registration Number
NCT05923073
Lead Sponsor
Janssen Research & Development, LLC
Brief Summary

The purpose of this study is to evaluate the clinical and endoscopic efficacy of guselkumab in pediatric participants with Crohn's Disease (CD) at the end of maintenance therapy (Week 52) among participants who were in clinical response to guselkumab at Week 12.

Detailed Description

Participants screened in the MACARONI-23 platform study could be randomized to guselkumab to participate in this intervention specific arm of the study.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
120
Inclusion Criteria
  • Participants must have a diagnosis of Crohn's Disease (CD) or fistulizing CD, with active colitis, ileitis, or ileocolitis, confirmed at any time in the past by clinical, endoscopic, and histologic criteria.
  • Participants must have moderately to severely active CD (as defined by a baseline Pediatric Crohn's Disease Activity Index [PCDAI] score greater than or equal to [>=] 30)
  • Participants must have endoscopy with evidence of active CD defined as Simple Endoscopic Score for Crohn's Disease (SES-CD) score greater than or equal to (>=) 6 (or >=4 for participants with isolated ileal disease) within 1 month of receiving study intervention at Week 0
  • Participants must have a history of inadequate response, loss of response, or intolerance to immunomodulators (6-MP, AZA, or MTX), oral or IV corticosteroids, or biologic therapy/JAK inhibitor therapy; OR have a history of corticosteroid dependence; OR have a history of inadequate response to exclusive enteral nutrition (EEN)
Exclusion Criteria
  • Participants has complications of CD such as symptomatic strictures or stenosis, short gut syndrome, or any other manifestation that might be anticipated to require surgery.
  • Participants must not have an abscess
  • Participants must not have any kind of bowel resection within 26 weeks or any other intra-abdominal surgery within 12 weeks of baseline

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Open-label induction phase: Guselkumab Intravenously (IV)GuselkumabParticipants will receive guselkumab dose IV based on their body weight during the 12-week open-label induction phase.
Open-label induction phase: Guselkumab Subcutaneously (SC)GuselkumabParticipants will receive guselkumab dose SC based on their body weight during the 12-week open-label induction phase.
Double-blind maintenance phase: Guselkumab SC Dose Regimen 1GuselkumabAt the end of the induction phase, Week 12 responders will be randomized into the double-blind maintenance phase to receive guselkumab dose regimen 1 SC based on their body weight up to Week 48.
Double-blind Maintenance Phase: Guselkumab SC Dose Regimen 2GuselkumabAt the end of the induction phase, Week 12 responders will be randomized into the double-blind maintenance phase to receive guselkumab dose regimen 2 SC based on their body weight up to Week 48.
Open-label maintenance phase: Guselkumab SCGuselkumabWeek 12 non-responders will not be randomized and will enter an open-label maintenance phase to receive guselkumab SC dosing regimen based on their body weight up to Week 48.
Primary Outcome Measures
NameTimeMethod
Percentage of Participants with Clinical Remission at Week 52Week 52

Percentage of participants with clinical remission at Week 52 will be assessed. Clinical remission is defined as pediatric Crohn's Disease activity index (PCDAI) less than or equal to (\<=) 10.

Percentage of Participants Who Achieve Endoscopic Response at Week 52Week 52

Percentage of participants who achieve endoscopic response at Week 52 will be assessed. Endoscopic response is defined as greater than or equal to (\>=) 50 percent (%) reduction (global) and greater than (\>) 50% reduction (U.S specific) from simplified endoscopic score-Crohn's Disease (SES-CD) score at baseline.

Secondary Outcome Measures
NameTimeMethod
Percentage of Participants with Clinical Response at Week 12Week 12

Percentage of participants with clinical response at Week 12 will be assessed. Clinical responder is defined as a decrease from baseline in the PCDAI score of \>=12.5 points with a total PCDAI score \<30.

Percentage of Participants with Clinical Response at Week 52Week 52

Percentage of participants with clinical response at Week 52 will be assessed. Clinical responder is defined as a decrease from baseline in the PCDAI score of \>=12.5 points with a total PCDAI score \<30.

Percentage of Participants with Clinical Remission at Week 12Week 12

Percentage of participants with clinical remission at Week 12 will be assessed. Clinical remission is defined as PCDAI score \<=10.

Percentage of Participants with Endoscopic Remission at Week 52Week 52

Percentage of participants with endoscopic remission at Week 52 will be assessed. Endoscopic remission is defined as SES-CD total score \<=4 and at least a 2-point reduction from baseline and no subscore \>1.

Percentage of Participants with Corticosteroid-free Remission at Week 52Week 52

Percentage of participants with corticosteroid-free remission at Week 52 will be assessed. Corticosteroid-free remission is defined as PCDAI score \<=10 at Week 52 and not receiving corticosteroids for at least 90 days before Week 52.

Percentage of Participants with Sustained Clinical Remission at Weeks 12, 24, and 52Weeks 12, 24, and 52

Percentage of participants with sustained clinical remission at Weeks 12, 24, and 52 will be assessed. Sustained clinical remission is defined as PCDAI \<=10 at Weeks 12, 24, and 52.

Percentage of Participants with Clinical remission by Patient-Reported Outcome (PRO-2)Week 12 and/or Week 52

Percentage of participants with clinical remission by PRO-2 will be assessed. Clinical remission by PRO-2 is defined as stool frequency (SF) \<=3 and abdominal pain (AP) \<=1 and no worsening of SF and AP from baseline.

Serum Concentration of Guselkumab During Induction PhaseFrom Week 0 to Week 12

Serum concentrations of guselkumab will be assessed. Serum samples will be analyzed to determine concentrations of guselkumab using a validated, specific, and sensitive immunoassay method.

Trough Plasma Concentration (Ctrough) of Guselkumab During Maintenance PhaseAt Weeks 16, 24, 36, 48 and 52

Ctrough is defined as the serum concentration of guselkumab immediately prior (pre-dose) to the next drug administration.

Change from Baseline in Body Weight at Weeks 12, 24, and 52Baseline, Weeks 12, 24, and 52

Change from baseline in body weight at Weeks 12, 24, and 52 will be assessed.

Change from Baseline in Body Weight Percentiles at Weeks 12, 24, and 52Baseline, Weeks 12, 24, and 52

Change from baseline in body weight percentiles at Weeks 12, 24, and 52 will be assessed.

Change from Baseline in Body Weight z-scores at Weeks 12, 24, and 52Baseline, Weeks 12, 24, and 52

Change from baseline in body weight z-scores at Weeks 12, 24, and 52 will be assessed.

Change from Baseline in Height at Weeks 12, 24, and 52Baseline, Weeks 12, 24, and 52

Change from baseline in height at Weeks 12, 24, and 52 will be assessed.

Change from Baseline in Height Percentiles at Weeks 12, 24, and 52Baseline, Weeks 12, 24, and 52

Change from baseline in height percentiles at Weeks 12, 24, and 52 will be assessed.

Change from Baseline in Height z-scores at Weeks 12, 24, and 52Baseline, Weeks 12, 24, and 52

Change from baseline in height z-scores at Weeks 12, 24, and 52 will be assessed.

Change from Baseline in Height Velocity at Weeks 12, 24, and 52Baseline, Weeks 12, 24, and 52

Change from baseline in height velocity at Weeks 12, 24, and 52 will be assessed.

Percentage of Participants with Clinical RemissionWeek 52

Percentage of participants with clinical remission who were assigned to guselkumab dose regimen 1 and did not receive rescue therapy at Week 52 will be assessed. Clinical remission is defined as PCDAI score \<=10.

Percentage of Participants Who Achieve Endoscopic ResponseWeek 52

Percentage of participants who achieve endoscopic response who were assigned to q4w maintenance therapy and did not receive rescue therapy at Week 52 will be assessed. Endoscopic response is defined as \>=50% reduction (global) and \>50% reduction (U.S specific) from SES-CD score at baseline.

Number of Participants with Adverse Events (AEs) and Serious Adverse Events (SAEs)Up to Week 64

An AE is any untoward medical occurrence in a clinical study participant administered a pharmaceutical (investigational or non-investigational) product that does not necessarily have a causal relationship with the intervention. An SAE is is any untoward medical occurrence that at any dose: results in death, is life-threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, is a congenital anomaly/birth defect, is a suspected transmission of any infectious agent via a medicinal product and is medically important.

Trial Locations

Locations (71)

Kaplan Medical Center

🇮🇱

Rehovot, Israel

Connecticut Children's Medical Center

🇺🇸

Hartford, Connecticut, United States

Emory University

🇺🇸

Atlanta, Georgia, United States

Children's Center for Digestive Health Care

🇺🇸

Atlanta, Georgia, United States

Riley Hospital for Children

🇺🇸

Indianapolis, Indiana, United States

Boston Childrens Hospital

🇺🇸

Boston, Massachusetts, United States

Weill Cornell Medical College - Judith Jaffe Multiple Sclerosis Center

🇺🇸

New York, New York, United States

Icahn School of Medicine at Mount Sinai

🇺🇸

New York, New York, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

The Children's Medical Center of Dayton

🇺🇸

Dayton, Ohio, United States

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Kaplan Medical Center
🇮🇱Rehovot, Israel

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