Comparison of the Efficacy and Safety of Infliximab, as Monotherapy or in Combination With Azathioprine, Versus Azathioprine Monotherapy in Moderate to Severe Active Ulcerative Colitis (Part 1).Comparison of Maintenance Versus Intermittent Infliximab Treatment in Maintaining Remission: A Follow-up of Efficacy and Safety (Part 2) - UC SUCCESS

Conditions: lcerative Colitis
MedDRA version: 9.1Level: LLTClassification code 10045365Term: Ulcerative colitis

Registration Number: EUCTR2006-002670-22-CZ

Lead Sponsor: Schering-Plough Research Institute, a division of Schering Corporation

Brief Summary: Not available

Detailed Description: Not available

Recruitment & Eligibility

Status: ot Recruiting

Sex: All

Target Recruitment: 600

Inclusion Criteria

The subject must meet ALL the criteria listed below for entry:
1. Must be =21 years of age at the time of informed consent, of either sex, and of any race
2. Must have endoscopic evidence of UC, as determined by sigmoidoscopy, within 14 days prior to Baseline
3. Must have a total Mayo score of 6 to 12 points at Baseline
4. Must have responded inadequately to corticosteroid treatment (ie, the last or current UC flare did not respond adequately to a standard course of corticosteroids) with or without 5 aminosalicylic acid (5-ASA)
5. Must be off corticosteroids or on a stable dose of corticosteroid for at least 2 weeks prior to enrollment. The maximal daily dose of corticosteroid at Baseline must not exceed the equivalent of 30 mg of prednisone
6. Must be naïve to infliximab and other tumor necrosis factor-alpha (TNF-a) antagonists
7. Must be either naïve to AZA/6-MP or have not received AZA/6-MP for at least 3 months before enrollment in the study
8 Are considered eligible according to the following tuberculosis (TB) screening criteria:
a. Have no history of latent or active TB prior to 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 prior to or simultaneously with the first administration of infliximab
d. Within 1 month prior to the first administration of inflixmab, either have negative tuberculin skin test, as outlined in Appendix 6 OR have a newly identified positive tuberculin test during screening in which active TB has been ruled out, and for which appropriate treatment for latent TB has been initiated either prior to or simultaneously with the first administration of infliximab
e. Must have a chest X-ray (posterior-anterior and lateral views), taken within the 3 months prior to the first administration of study agent and read by a qualified radiologist, with no evidence of current active TB or old inactive TB.
9. Who have had UC for more than 10 years should have had a full colonoscopy within 2 years prior to Screening for the surveillance of dysplasia;
10. Subjects’ Screening and Baseline clinical laboratory tests (complete blood count [CBC] and blood chemistries) must be within the following parameters:
a. White blood cells (WBCs) =3.5 x 10 power of 9/L
b. Neutrophils =1.5 x 10 power of 9/L
c. Platelets =100 x 10 power of 9/L
d. Serum creatinine <1.5 mg/dL (or <133 µmol/L)
e. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) =1.5 x upper limit of normal (ULN), alkaline phosphatase and gamma-glutamyltransferase =2.5 x ULN
f. Total bilirubin =1 x ULN
11. Subjects who had been on antibiotics for the treatment of UC (eg, ciprofloxacin and metronidazole) must have been discontinued from them at least 3 weeks prior to Screening
12. Must be free of any clinically significant condition or situation, other than UC that, in the opinion of the investigator, would interfere with the study evaluations or optimal participation in the study
13. Are willing and able to adhere to the study visit schedule and other protocol requirements
14. Are capable of providing written informed consent, which must be obtained prior to conducting any protocol-specified procedures
15. Women of child-bearing potential and all men mus

Exclusion Criteria

The subject will be excluded from entry if ANY of the criteria listed below are met:
1. Have severe extensive colitis as evidenced by:
a. Investigator judgment that the subject is likely to require colectomy within 12 wks of Baseline
OR
b. Subjects with at least 4 of these symptoms at Screening or Baseline visits as described in the protocol.
2. Require, or are required within the 2 mths prior to baseline, surgery for active gastrointestinal bleeding, peritonitis, intestinal obstruction, or intra-abdominal or pancreatic abscess requiring surgical drainage or other conditions possibly confounding the evaluation of disease activity;
3. Have severe, fixed symptomatic stenosis of the large or small intestine;
4. Have current evidence of colonic obstruction or history within the 6 mths prior to baseline, confirmed with objective radiographic or endoscopic evidence of a stricture with resulting
5. Have a history of colonic mucosal dysplasia;
6. Presence on screening endoscopy of adenomatous colonic polyps, if not removed prior to study entry, or history of adenomatous colonic polyps that were not removed;
7. Have the presence of a stoma;
8. Have a history of extensive colonic resection that would prevent adequate evaluation of clinical disease activity
9. Have a positive stool culture for enteric pathogens, pathogenic ova or parasites within 4 months prior to Baseline unless subject has received treatment and had a negative stool examination 1 wk or longer after the end of treatment;
10. Have a concomitant diagnosis of CHF, including medically controlled asymptomatic subjects;
11. Have had serious infections within 2 mths of screening. Less serious infections need not be considered as an exclusion at the discretion of the investigator;
12. Have had a nontuberculous mycobacterial infection or opportunistic infection within 6 months prior to screening;
13. Have a known infection with HIV and/or hepatitis B or hepatitis C;
14. Have a history of a known allergy to murine proteins or allergy/sensitivity to study drug or its excipients;
15. Have current signs and symptoms of systemic lupus erythematosus, or severe, progressive, or uncontrolled renal, hepatic, hematologic, endocrine, pulmonary, cardiac, neurologic, or cerebral diseases;
16. Have a known history of demyelinating disease suggestive of multiple sclerosis or optic neuritis;
17. Presence of a transplanted organ (with the exception of a corneal transplant >3 months prior to screening);
18. Have a history of lymphoproliferative disease including lymphoma, or signs and symptoms suggestive of possible lymphoproliferative disease, such as lymphadenopathy of unusual size or location (eg, nodes in the posterior triangle of the neck, infra-clavicular, epitrochlear, or periaortic areas), or splenomegaly;
19. Have any current known malignancy or malignancy within 5 years prior to screening (except for squamous or basal cell carcinoma of the skin that has been treated with no evidence of recurrence);
20. Have poor tolerability of venipuncture or lack of adequate venous access for required blood sampling and infusion of study drug during the study period;
21. Have had a known substance abuse or dependency (drug or alcohol) within 3 years of Screening;
22. Require chronic (=1 month) and frequent use (=3 days per wk) of NSAIDs except low-dose aspirin for prevention of heart attacks, unstable angina, or transient ischemic attacks;
23. Have other inflammatory diseases that