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The Efficacy of Cobitolimod in Patients With Moderate to Severe Active Ulcerative Colitis

Phase 2
Completed
Conditions
Ulcerative Colitis
Interventions
Drug: Placebo
Registration Number
NCT03178669
Lead Sponsor
InDex Pharmaceuticals
Brief Summary

The purpose of this study was to evaluate efficacy of cobitolimod treatment at different dose levels and frequencies compared to placebo in patients with moderate to severe left-sided ulcerative colitis.

Detailed Description

This was a Phase IIb study in patients with moderate to severe left-sided ulcerative colitis. Patients either received cobitolimod 31 mg, 125 mg or 250 mg at two occasions or 125 mg or placebo at four occasions during a 3-weeks period. To ensure blindness, patients received active treatment at two occasions and placebo at the other two occasions. Blood, stool, and tissue samples was collected at various time points throughout the study to evaluate safety and efficacy. Primary endpoint was evaluated at week 6.

Duration of participation for patients was approximately 12 weeks (from screening to final follow-up visit).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
213
Inclusion Criteria
  • Age ≥ 18 years old

  • Established diagnosis of Ulcerative Colitis (UC)

  • Moderately to severely active left sided UC assessed by central reading

  • Current oral 5-Aminosalicylic Acid (5-ASA)/ Sulphasalazine (SP) use or a history of oral 5-ASA/SP use

  • Current Glucocorticosteroids (GCS) use or history of GCS dependency, refractory, or intolerance

  • Demonstrated an inadequate response, loss of response, or intolerance to at least one of the following agents:

    • Immunomodulators
    • Tumor Necrosis Factor alpha (TNF-α) inhibitors and/or anti-integrins
Exclusion Criteria
  • Suspicion of differential diagnosis
  • Acute fulminant UC and/or signs of systemic toxicity
  • UC limited to the rectum (disease which extend <15 cm above the anal verge)
  • History of malignancy
  • History or presence of any clinically significant disorder
  • Concomitant treatment with cyclosporine, methotrexate, tacrolimus, TNF-α inhibitors, anti-integrins or similar immunosuppressants and immunomodulators
  • Treatment with rectal GCS, 5-ASA/SP or tacrolimus
  • Long term treatment with antibiotics or non-steroidal anti-inflammatory drugs (NSAIDs)
  • Serious active infection
  • Gastrointestinal infections
  • Currently receiving parenteral nutrition or blood transfusions
  • Females who are lactating or have a positive serum pregnancy test
  • Women of childbearing potential not using reliable contraceptive methods
  • Concurrent participation in another clinical study
  • Previous exposure to cobitolimod

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboPlacebo at four occasions
Cobitolimod Dose 4x125 mgcobitolimodDose 125 mg of cobitolimod, at 4 occasions
Cobitolimod Dose 2x31 mgcobitolimodDose 31 mg of cobitolimod at 2 occasions, placebo at 2 occasions
Cobitolimod Dose 2x125 mgcobitolimodDose 125 mg of cobitolimod at 2 occasions, placebo at 2 occasions
Cobitolimod Dose 2x250 mgcobitolimodDose 250 mg of cobitolimod at 2 occasions, placebo at 2 occasions
Primary Outcome Measures
NameTimeMethod
Clinical Remission6 weeks after first treatment

Patients with clinical remission at Week 6 (yes=1, no=0), defined by Modified Mayo sub scores, i) rectal bleeding of 0, ii) stool frequency of 0 or 1 (with at least one point decrease from Baseline, Week 0), and iii) endoscopy score of 0 or 1 (excluding friability).

Secondary Outcome Measures
NameTimeMethod
Modified Clinical RemissionWeek 6

Patients with modified clinical remission at Week 6 (yes=1, no=0), defined by the Modified Mayo score ≤ 2 and sub scores, i) rectal bleeding of 0, ii) stool frequency of 0 or 1 (with at least one point decrease from Baseline, Week 0), iii) endoscopy score of 0 or 1 (excluding friability ) and iiii) physician´s global assessment (PGA) of 0 or 1

Symptomatic RemissionWeek 6

Patients with symptomatic remission at Week 6 (yes=1, no=0), defined by the Mayo sub scores, i) rectal bleeding of 0, ii) stool frequency of 0 or 1 (with at least one point decrease from Baseline, Week 0), (patient reported outcome)

Clinical ResponseWeek 6

Patients with clinical response at Week 6 (yes=1, no=0), defined as clinical remission or a three point and ≥30 % decrease from Baseline, Week 0 in the sum of the Modified Mayo score, i) rectal bleeding, ii) stool frequency and iii) endoscopy score (excluding friability), iiii) physicians global assessment (PGA)

Endoscopic RemissionWeek 6

Patients with endoscopic remission at Week 6 (yes=1, no=0), defined by the Modified Mayo endoscopic sub score of 0 or 1 (excluding friability)

Histological RemissionWeek 6

Patients with histological remission at Week 6 (yes=1, no=0), defined by the Nancy histological index of grade 0 or 1

Trial Locations

Locations (62)

34

🇷🇺

Cheboksary, Russian Federation

53

🇺🇦

Dnipropetrovs'k, Ukraine

56

🇺🇦

Kiev, Ukraine

6

🇫🇷

Nice, France

12

🇩🇪

Berlin, Germany

2

🇫🇷

Amiens, France

20

🇩🇪

München, Germany

17

🇩🇪

Leipzig, Germany

14

🇩🇪

Hamburg, Germany

5

🇫🇷

Grenoble, France

13

🇩🇪

Erlangen, Germany

16

🇩🇪

Heidelberg, Germany

21

🇭🇺

Budapest, Hungary

11

🇩🇪

Augsburg, Germany

27

🇵🇱

Kraków, Poland

31

🇵🇱

Sopot, Poland

24

🇭🇺

Mosonmagyarovar, Hungary

55

🇺🇦

Kharkiv, Ukraine

45

🇷🇸

Belgrad, Serbia

1

🇨🇿

Prague, Czechia

3

🇫🇷

Caen, France

7

🇫🇷

Pierre-Bénite, France

15

🇩🇪

Hanover, Germany

8

🇫🇷

Saint-Étienne, France

10

🇫🇷

Vandœuvre-lès-Nancy, France

22

🇭🇺

Békéscsaba, Hungary

23

🇭🇺

Debrecen, Hungary

18

🇩🇪

Lüneburg, Germany

19

🇩🇪

Mannheim, Germany

32

🇵🇱

Włocławek, Poland

25

🇭🇺

Pécs, Hungary

26

🇵🇱

Czestochowa, Poland

30

🇵🇱

Poznań, Poland

28

🇵🇱

Ksawerów, Poland

29

🇵🇱

Lublin, Poland

35

🇷🇺

Ekaterinburg, Russian Federation

33

🇵🇱

Łódź, Poland

37

🇷🇺

Kirov, Russian Federation

39

🇷🇺

Novosibirsk, Russian Federation

40

🇷🇺

Ryazan', Russian Federation

41

🇷🇺

Saint Petersburg, Russian Federation

43

🇷🇺

Tver, Russian Federation

42

🇷🇺

Stavropol', Russian Federation

44

🇷🇺

Ufa, Russian Federation

57

🇺🇦

Luts'k, Ukraine

46

🇪🇸

Ferrol, Spain

47

🇪🇸

Fuenlabrada, Spain

48

🇪🇸

Madrid, Spain

49

🇪🇸

Sevilla, Spain

50

🇪🇸

Valencia, Spain

52

🇺🇦

Chernivtsi, Ukraine

54

🇺🇦

Ivano-Frankivs'k, Ukraine

51

🇸🇪

Uppsala, Sweden

58

🇺🇦

Lviv, Ukraine

59

🇺🇦

Odesa, Ukraine

60

🇺🇦

Sumy, Ukraine

61

🇺🇦

Zaporizhzhya, Ukraine

62

🇺🇦

Úzhgorod, Ukraine

38

🇷🇺

Moscow, Russian Federation

4

🇫🇷

Clichy, France

36

🇷🇺

Kazan, Russian Federation

9

🇫🇷

Toulouse, France

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