Crohn's Disease
Conditions
Keywords
Crohn's Disease
Brief summary
This study will evaluate higher versus standard adalimumab dosing regimens for induction and maintenance therapy in subjects with moderately to severely active Crohn's Disease and evidence of mucosal ulceration.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* Diagnosis of Crohn's disease (CD) for at least 90 days, confirmed by endoscopy during the Screening Period. * Active CD with a Crohn's Disease Activity Index (CDAI) despite treatment with oral corticosteroids and/or immunosuppressants. * Mucosal ulceration on endoscopy.
Exclusion criteria
* Subject with ulcerative colitis or indeterminate colitis. * Subject who has had surgical bowel resections in the past 6 months or is planning resection. * Subjects with an ostomy or ileoanal pouch. * Subject with symptomatic bowel stricture or abdominal or peri-anal abcess. * Subject who has short bowel syndrome. * Chronic recurring infections or active Tuberculosis (TB).
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants Who Achieved Clinical Remission at Week 4 | Week 4 | Crohn's Disease Activity Index (CDAI) is used to assess the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450. |
| Percentage of Participants With Endoscopic Response at Week 12 | Week 12 | Endoscopic response was scored using the Simplified Endoscopic Score for Crohn's Disease (SES-CD). The SES-CD evaluates 4 endoscopic variables (ulcer size ranging from 0 \[none\] to 3 \[very large\]; ulcerated surface ranging from 0 \[none\] to 3 \[\>30%\]; affected surface ranging from 0 \[none\] to 3 \[\>75%\], and narrowing ranging from 0 \[none\] to 3 \[cannot be passed\]) in 5 segments assessed during ileocolonoscopy (ileum, right colon, transverse colon, sigmoid and left colon, and rectum). The total score is the sum of the 4 endoscopic variable scores and range from 0 to 56, where higher scores indicate more severe disease. Endoscopic response was defined as SES-CD total score \> 50% from Baseline (or for a Baseline SES-CD of 4, at least a 2 point reduction from Baseline) at Week 12. |
| Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | From first dose of study drug until 70 days following last dose of study drug in the induction study (up to 12 weeks) or maintenance study (up to 56 weeks). | Adverse event (AE): any untoward medical occurrence that does not necessarily have a causal relationship with this treatment. The investigator assessed the relationship of each event to the use of study drug as either probably related, possibly related, probably not related or not related. Serious AE (SAE) is an event that results in death, is life-threatening, requires or prolongs hospitalization, results in a congenital anomaly, persistent or significant disability/incapacity or is an important medical event that, based on medical judgment, may jeopardize the subject and may require medical or surgical intervention to prevent any of the outcomes listed above. TEAEs: any event that began or worsened in severity after the first dose of study drug in the induction or maintenance study. Events with unknown severity were counted as severe. Events with unknown relationship to study drug were counted as drug-related. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants Who Discontinued Corticosteroid Use and Achieved Clinical Remission at Week 12 Among Participants Taking Corticosteroids at Baseline | Week 12 | Clinical remission was scored using the CDAI. CDAI assesses the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450. |
| Percentage of Participants With Endoscopic Remission at Week 12 | Week 12 | Endoscopic remission was scored using the SES-CD.The SES-CD evaluates 4 endoscopic variables (ulcer size ranging from 0 \[none\] to 3 \[very large\]; ulcerated surface ranging from 0 \[none\] to 3 \[\>30%\]; affected surface ranging from 0 \[none\] to 3 \[\>75%\], and narrowing ranging from 0 \[none\] to 3 \[cannot be passed\]) in 5 segments assessed during ileocolonoscopy (ileum, right colon, transverse colon, sigmoid and left colon, and rectum). The total score is the sum of the 4 endoscopic variable scores and range from 0 to 56, where higher scores indicate more severe disease. Endoscopic remission was defined as SES-CD ≤ 4 and at least a 2-point reduction versus baseline and no subscore greater than 1 in any individual variable. |
| Change From Baseline in Fecal Calprotectin Level at Week 4 | Baseline, Week 4 | — |
| Percentage of Participants With Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g at Week 4 | Week 4 | — |
| Percentage of Participants With Clinical Remission, Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g at Week 4 | Week 4 | Clinical remission was scored using the CDAI. CDAI assesses the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450. |
| Percentage of Participants With Clinical Remission, Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g and Endoscopic Remission at Week 12 | Week 12 | Clinical remission was scored using the CDAI. CDAI assesses the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450. Endoscopic remission was scored using the SES-CD.The SES-CD evaluates 4 endoscopic variables (ulcer size ranging from 0 \[none\] to 3 \[very large\]; ulcerated surface ranging from 0 \[none\] to 3 \[\>30%\]; affected surface ranging from 0 \[none\] to 3 \[\>75%\], and narrowing ranging from 0 \[none\] to 3 \[cannot be passed\]) in 5 segments assessed during ileocolonoscopy. The total score is the sum of the 4 endoscopic variable scores and range from 0 to 56, where higher scores indicate more severe disease. Endoscopic remission was defined as SES-CD ≤ 4 and at least a 2-point reduction versus baseline and no subscore greater than 1 in any individual variable. |
| Percentage of Participants With Sustained Clinical Remission (Per CDAI) at Both Weeks 4 and 12 | Week 4 and Week 12 | CDAI is used to assess the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450. |
| Percentage of Participants With Clinical Response at Week 4 | Week 4 | Clinical response was scored using CDAI is used to assess the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450. Clinical response was defined as a decrease in CDAI ≥ 70 points from baseline. |
| Percentage of Participants With Clinical Response at Week 12 | Week 12 | Clinical response was scored using CDAI. CDAI assesses the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450. Clinical response was defined as a decrease in CDAI ≥ 70 points from Baseline. |
| Percentage of Participants Achieving Response in Inflammatory Bowel Disease Questionnaire (IBDQ) Bowel Symptom Domain at Week 4 | Week 4 | The IBDQ is a self-administered 32-item questionnaire to evaluate quality of life across 4 dimensional scores: bowel, systemic, social and emotional. Responses to each question range from 1 (severe problem) to 7 (normal health). The range for Bowel Symptom domain score is 10 (severe problem) to 70 (normal health). Response in IBDQ Bowel Symptom domain is defined as an increase of IBDQ Bowel Symptom domain score ≥ 8. |
| Percentage of Participants Achieving Response in IBDQ Bowel Symptom Domain at Week 12 | Week 12 | The IBDQ is a self-administered 32-item questionnaire to evaluate quality of life across 4 dimensional scores: bowel, systemic, social and emotional. Responses to each question range from 1 (severe problem) to 7 (normal health). The range for Bowel Symptom domain score is 10 (severe problem) to 70 (normal health). Response in IBDQ Bowel Symptom domain is defined as an increase of IBDQ Bowel Symptom domain score ≥ 8. |
| Percentage of Participants Achieving Response in IBDQ Fatigue Item at Week 12 | Week 12 | The IBDQ is a self-administered 32-item questionnaire to evaluate quality of life across 4 dimensional scores: bowel, systemic, social and emotional. Responses to each question range from 1 (severe problem) to 7 (normal health). The IBDQ Fatigue item score range is from 1 (severe problem) to 7 (normal health). Response is defined as an increase of IBDQ Fatigue item score ≥ 1. |
| Percentage of Participants Who Achieved an SES-CD ≤ 2 at Week 12 | Week 12 | The SES-CD evaluates 4 endoscopic variables (ulcer size ranging from 0 \[none\] to 3 \[very large\]; ulcerated surface ranging from 0 \[none\] to 3 \[\>30%\]; affected surface ranging from 0 \[none\] to 3 \[\>75%\], and narrowing ranging from 0 \[none\] to 3 \[cannot be passed\]) in 5 segments assessed during ileocolonoscopy (ileum, right colon, transverse colon, sigmoid and left colon, and rectum). The total score is the sum of the 4 endoscopic variable scores and range from 0 to 56, where higher scores indicate more severe disease. |
| Percentage of Participants Who Achieve Clinical Response at Week 4 and Endoscopic Response at Week 12 | Week 12 | Clinical response was scored using CDAI, which assesses the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450. Clinical response was defined as a decrease in CDAI ≥ 70 points from Baseline. Endoscopic response was scored using the SES-CD, which evaluates 4 endoscopic variables (ulcer size ranging from 0 \[none\] to 3 \[very large\]; ulcerated surface ranging from 0 \[none\] to 3 \[\>30%\]; affected surface ranging from 0 \[none\] to 3 \[\>75%\], and narrowing ranging from 0 \[none\] to 3 \[cannot be passed\]) in 5 segments assessed during ileocolonoscopy. The total score is the sum of the 4 endoscopic variable scores and range from 0 to 56, where higher scores indicate more severe disease. Endoscopic response was defined as SES-CD total score \>50% from Baseline (or for Baseline SES-CD of 4, at least a 2-point reduction from Baseline) at Week 12. |
| Percentage of Participants With Clinical Remission at Week 12 | Week 12 | Clinical remission was scored using the CDAI. CDAI assesses the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450. |
Countries
Austria, Belgium, Canada, Czechia, Denmark, France, Germany, Hungary, Israel, Italy, Netherlands, Poland, Puerto Rico, Romania, Slovakia, Spain, Switzerland, Ukraine, United Kingdom, United States
Participant flow
Pre-assignment details
Participants were randomized in a 3:2 ratio at Baseline to receive a higher induction adalimumab regimen or standard induction adalimumab regimen during the double-blind Induction Study. At Week 12, participants were re-randomized in a 1:1 ratio to a double-blind exploratory treatment regimen (adalimumab clinically adjusted \[CA\] regimen or adalimumab therapeutic drug monitoring \[TDM\] regimen).
Participants by arm
| Arm | Count |
|---|---|
| Induction: Standard Induction Dose Participants randomized to receive received blinded adalimumab 160 mg at Baseline and matching placebo at Week 1, adalimumab 80 mg and matching placebo at Week 2, matching placebo at Week 3, and then adalimumab 40 mg every other week (eow) starting at Week 4 through Week 12. | 206 |
| Induction: Higher Induction Dose Participants randomized to receive blinded adalimumab 160 mg at Baseline, Week 1, Week 2, and Week 3. At Week 4, participants receive adalimumab 40 mg eow through Week 12. | 308 |
| Total | 514 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 |
|---|---|---|---|---|---|
| Induction Study | Adverse Event | 5 | 12 | 0 | 0 |
| Induction Study | Lost to Follow-up | 1 | 1 | 0 | 0 |
| Induction Study | Other, Not Specified | 6 | 5 | 0 | 0 |
| Induction Study | Withdrawal by Subject | 2 | 3 | 0 | 0 |
| Maintenance Study | Adverse Event | 0 | 0 | 8 | 8 |
| Maintenance Study | Lost to Follow-up | 0 | 0 | 2 | 2 |
| Maintenance Study | Other, Not Specified | 0 | 0 | 11 | 5 |
| Maintenance Study | Withdrawal by Subject | 0 | 0 | 1 | 4 |
Baseline characteristics
| Characteristic | Induction: Higher Induction Dose | Total | Induction: Standard Induction Dose |
|---|---|---|---|
| Age, Continuous | 36.4 years STANDARD_DEVIATION 13.02 | 36.4 years STANDARD_DEVIATION 12.92 | 36.4 years STANDARD_DEVIATION 12.79 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 10 Participants | 15 Participants | 5 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 0 Participants | 0 Participants | 0 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 298 Participants | 499 Participants | 201 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 6 Participants | 11 Participants | 5 Participants |
| Race (NIH/OMB) Black or African American | 11 Participants | 29 Participants | 18 Participants |
| Race (NIH/OMB) More than one race | 1 Participants | 2 Participants | 1 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 1 Participants | 1 Participants | 0 Participants |
| Race (NIH/OMB) White | 288 Participants | 470 Participants | 182 Participants |
| Sex: Female, Male Female | 158 Participants | 267 Participants | 109 Participants |
| Sex: Female, Male Male | 150 Participants | 247 Participants | 97 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 206 | 0 / 308 | 0 / 109 | 0 / 109 |
| other Total, other adverse events | 54 / 206 | 58 / 308 | 41 / 109 | 33 / 109 |
| serious Total, serious adverse events | 10 / 206 | 14 / 308 | 5 / 109 | 7 / 109 |
Outcome results
Number of Participants With Treatment-Emergent Adverse Events (TEAEs)
Adverse event (AE): any untoward medical occurrence that does not necessarily have a causal relationship with this treatment. The investigator assessed the relationship of each event to the use of study drug as either probably related, possibly related, probably not related or not related. Serious AE (SAE) is an event that results in death, is life-threatening, requires or prolongs hospitalization, results in a congenital anomaly, persistent or significant disability/incapacity or is an important medical event that, based on medical judgment, may jeopardize the subject and may require medical or surgical intervention to prevent any of the outcomes listed above. TEAEs: any event that began or worsened in severity after the first dose of study drug in the induction or maintenance study. Events with unknown severity were counted as severe. Events with unknown relationship to study drug were counted as drug-related.
Time frame: From first dose of study drug until 70 days following last dose of study drug in the induction study (up to 12 weeks) or maintenance study (up to 56 weeks).
Population: Safety Set: all participants who received at least one injection of study drug.
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Induction: Standard Induction Dose | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any TEAE | 133 Participants |
| Induction: Standard Induction Dose | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any TEAE leading to death | 0 Participants |
| Induction: Standard Induction Dose | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any TEAE leading to discontinuation of study drug | 8 Participants |
| Induction: Standard Induction Dose | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | TEAE w/reasonable possibility of being related to study drug | 54 Participants |
| Induction: Standard Induction Dose | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Deaths | 0 Participants |
| Induction: Standard Induction Dose | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any severe TEAE | 13 Participants |
| Induction: Standard Induction Dose | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any SAE | 10 Participants |
| Induction: Higher Induction Dose | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any TEAE leading to death | 0 Participants |
| Induction: Higher Induction Dose | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any SAE | 14 Participants |
| Induction: Higher Induction Dose | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any severe TEAE | 17 Participants |
| Induction: Higher Induction Dose | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any TEAE leading to discontinuation of study drug | 13 Participants |
| Induction: Higher Induction Dose | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Deaths | 0 Participants |
| Induction: Higher Induction Dose | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | TEAE w/reasonable possibility of being related to study drug | 75 Participants |
| Induction: Higher Induction Dose | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any TEAE | 185 Participants |
| Maintenance: Clinically Adjusted (CA) Regimen | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any SAE | 5 Participants |
| Maintenance: Clinically Adjusted (CA) Regimen | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any TEAE | 77 Participants |
| Maintenance: Clinically Adjusted (CA) Regimen | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | TEAE w/reasonable possibility of being related to study drug | 29 Participants |
| Maintenance: Clinically Adjusted (CA) Regimen | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any severe TEAE | 7 Participants |
| Maintenance: Clinically Adjusted (CA) Regimen | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any TEAE leading to discontinuation of study drug | 8 Participants |
| Maintenance: Clinically Adjusted (CA) Regimen | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any TEAE leading to death | 0 Participants |
| Maintenance: Clinically Adjusted (CA) Regimen | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Deaths | 0 Participants |
| Maintenance: Therapeutic Drug Monitoring (TDM) Regimen | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any severe TEAE | 6 Participants |
| Maintenance: Therapeutic Drug Monitoring (TDM) Regimen | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Deaths | 0 Participants |
| Maintenance: Therapeutic Drug Monitoring (TDM) Regimen | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any TEAE leading to death | 0 Participants |
| Maintenance: Therapeutic Drug Monitoring (TDM) Regimen | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | TEAE w/reasonable possibility of being related to study drug | 33 Participants |
| Maintenance: Therapeutic Drug Monitoring (TDM) Regimen | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any TEAE | 76 Participants |
| Maintenance: Therapeutic Drug Monitoring (TDM) Regimen | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any TEAE leading to discontinuation of study drug | 9 Participants |
| Maintenance: Therapeutic Drug Monitoring (TDM) Regimen | Number of Participants With Treatment-Emergent Adverse Events (TEAEs) | Any SAE | 7 Participants |
Percentage of Participants Who Achieved Clinical Remission at Week 4
Crohn's Disease Activity Index (CDAI) is used to assess the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450.
Time frame: Week 4
Population: Intent to Treat Population: all participants who were randomized. Non-responder imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants Who Achieved Clinical Remission at Week 4 | 43.7 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants Who Achieved Clinical Remission at Week 4 | 43.5 percentage of participants |
Percentage of Participants With Endoscopic Response at Week 12
Endoscopic response was scored using the Simplified Endoscopic Score for Crohn's Disease (SES-CD). The SES-CD evaluates 4 endoscopic variables (ulcer size ranging from 0 \[none\] to 3 \[very large\]; ulcerated surface ranging from 0 \[none\] to 3 \[\>30%\]; affected surface ranging from 0 \[none\] to 3 \[\>75%\], and narrowing ranging from 0 \[none\] to 3 \[cannot be passed\]) in 5 segments assessed during ileocolonoscopy (ileum, right colon, transverse colon, sigmoid and left colon, and rectum). The total score is the sum of the 4 endoscopic variable scores and range from 0 to 56, where higher scores indicate more severe disease. Endoscopic response was defined as SES-CD total score \> 50% from Baseline (or for a Baseline SES-CD of 4, at least a 2 point reduction from Baseline) at Week 12.
Time frame: Week 12
Population: Intent to Treat Population: all participants who were randomized. Non-responder imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants With Endoscopic Response at Week 12 | 39.3 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants With Endoscopic Response at Week 12 | 42.9 percentage of participants |
Change From Baseline in Fecal Calprotectin Level at Week 4
Time frame: Baseline, Week 4
Population: Intent to Treat Population: all participants who were randomized. Participants with a baseline and Week 4 assessment. Observed cases.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Induction: Standard Induction Dose | Change From Baseline in Fecal Calprotectin Level at Week 4 | -1045.7 µg/g | Standard Deviation 1648.51 |
| Induction: Higher Induction Dose | Change From Baseline in Fecal Calprotectin Level at Week 4 | -1157.0 µg/g | Standard Deviation 2000.69 |
Percentage of Participants Achieving Response in IBDQ Bowel Symptom Domain at Week 12
The IBDQ is a self-administered 32-item questionnaire to evaluate quality of life across 4 dimensional scores: bowel, systemic, social and emotional. Responses to each question range from 1 (severe problem) to 7 (normal health). The range for Bowel Symptom domain score is 10 (severe problem) to 70 (normal health). Response in IBDQ Bowel Symptom domain is defined as an increase of IBDQ Bowel Symptom domain score ≥ 8.
Time frame: Week 12
Population: Intent to Treat Population: all participants who were randomized. Non-responder imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants Achieving Response in IBDQ Bowel Symptom Domain at Week 12 | 73.3 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants Achieving Response in IBDQ Bowel Symptom Domain at Week 12 | 76.9 percentage of participants |
Percentage of Participants Achieving Response in IBDQ Fatigue Item at Week 12
The IBDQ is a self-administered 32-item questionnaire to evaluate quality of life across 4 dimensional scores: bowel, systemic, social and emotional. Responses to each question range from 1 (severe problem) to 7 (normal health). The IBDQ Fatigue item score range is from 1 (severe problem) to 7 (normal health). Response is defined as an increase of IBDQ Fatigue item score ≥ 1.
Time frame: Week 12
Population: Intent to Treat Population: all participants who were randomized. Non-responder imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants Achieving Response in IBDQ Fatigue Item at Week 12 | 68.4 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants Achieving Response in IBDQ Fatigue Item at Week 12 | 76.0 percentage of participants |
Percentage of Participants Achieving Response in Inflammatory Bowel Disease Questionnaire (IBDQ) Bowel Symptom Domain at Week 4
The IBDQ is a self-administered 32-item questionnaire to evaluate quality of life across 4 dimensional scores: bowel, systemic, social and emotional. Responses to each question range from 1 (severe problem) to 7 (normal health). The range for Bowel Symptom domain score is 10 (severe problem) to 70 (normal health). Response in IBDQ Bowel Symptom domain is defined as an increase of IBDQ Bowel Symptom domain score ≥ 8.
Time frame: Week 4
Population: Intent to Treat Population: all participants who were randomized. Non-responder imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants Achieving Response in Inflammatory Bowel Disease Questionnaire (IBDQ) Bowel Symptom Domain at Week 4 | 71.4 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants Achieving Response in Inflammatory Bowel Disease Questionnaire (IBDQ) Bowel Symptom Domain at Week 4 | 74.7 percentage of participants |
Percentage of Participants Who Achieve Clinical Response at Week 4 and Endoscopic Response at Week 12
Clinical response was scored using CDAI, which assesses the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450. Clinical response was defined as a decrease in CDAI ≥ 70 points from Baseline. Endoscopic response was scored using the SES-CD, which evaluates 4 endoscopic variables (ulcer size ranging from 0 \[none\] to 3 \[very large\]; ulcerated surface ranging from 0 \[none\] to 3 \[\>30%\]; affected surface ranging from 0 \[none\] to 3 \[\>75%\], and narrowing ranging from 0 \[none\] to 3 \[cannot be passed\]) in 5 segments assessed during ileocolonoscopy. The total score is the sum of the 4 endoscopic variable scores and range from 0 to 56, where higher scores indicate more severe disease. Endoscopic response was defined as SES-CD total score \>50% from Baseline (or for Baseline SES-CD of 4, at least a 2-point reduction from Baseline) at Week 12.
Time frame: Week 12
Population: Intent to Treat Population: all participants who were randomized. Non-responder imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants Who Achieve Clinical Response at Week 4 and Endoscopic Response at Week 12 | 20.4 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants Who Achieve Clinical Response at Week 4 and Endoscopic Response at Week 12 | 22.1 percentage of participants |
Percentage of Participants Who Achieved an SES-CD ≤ 2 at Week 12
The SES-CD evaluates 4 endoscopic variables (ulcer size ranging from 0 \[none\] to 3 \[very large\]; ulcerated surface ranging from 0 \[none\] to 3 \[\>30%\]; affected surface ranging from 0 \[none\] to 3 \[\>75%\], and narrowing ranging from 0 \[none\] to 3 \[cannot be passed\]) in 5 segments assessed during ileocolonoscopy (ileum, right colon, transverse colon, sigmoid and left colon, and rectum). The total score is the sum of the 4 endoscopic variable scores and range from 0 to 56, where higher scores indicate more severe disease.
Time frame: Week 12
Population: Intent to Treat Population: all participants who were randomized. Non-responder imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants Who Achieved an SES-CD ≤ 2 at Week 12 | 16.0 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants Who Achieved an SES-CD ≤ 2 at Week 12 | 20.1 percentage of participants |
Percentage of Participants Who Discontinued Corticosteroid Use and Achieved Clinical Remission at Week 12 Among Participants Taking Corticosteroids at Baseline
Clinical remission was scored using the CDAI. CDAI assesses the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450.
Time frame: Week 12
Population: Intent to Treat Population: all participants who were randomized. Participants taking corticosteroids at Baseline.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants Who Discontinued Corticosteroid Use and Achieved Clinical Remission at Week 12 Among Participants Taking Corticosteroids at Baseline | 48.0 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants Who Discontinued Corticosteroid Use and Achieved Clinical Remission at Week 12 Among Participants Taking Corticosteroids at Baseline | 52.9 percentage of participants |
Percentage of Participants With Clinical Remission at Week 12
Clinical remission was scored using the CDAI. CDAI assesses the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450.
Time frame: Week 12
Population: Intent to Treat Population: all participants who were randomized. Non-responder imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants With Clinical Remission at Week 12 | 51.5 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants With Clinical Remission at Week 12 | 62.3 percentage of participants |
Percentage of Participants With Clinical Remission, Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g and Endoscopic Remission at Week 12
Clinical remission was scored using the CDAI. CDAI assesses the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450. Endoscopic remission was scored using the SES-CD.The SES-CD evaluates 4 endoscopic variables (ulcer size ranging from 0 \[none\] to 3 \[very large\]; ulcerated surface ranging from 0 \[none\] to 3 \[\>30%\]; affected surface ranging from 0 \[none\] to 3 \[\>75%\], and narrowing ranging from 0 \[none\] to 3 \[cannot be passed\]) in 5 segments assessed during ileocolonoscopy. The total score is the sum of the 4 endoscopic variable scores and range from 0 to 56, where higher scores indicate more severe disease. Endoscopic remission was defined as SES-CD ≤ 4 and at least a 2-point reduction versus baseline and no subscore greater than 1 in any individual variable.
Time frame: Week 12
Population: Intent to Treat Population: all participants who were randomized. Non-responder imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants With Clinical Remission, Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g and Endoscopic Remission at Week 12 | 7.3 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants With Clinical Remission, Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g and Endoscopic Remission at Week 12 | 11.7 percentage of participants |
Percentage of Participants With Clinical Remission, Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g at Week 4
Clinical remission was scored using the CDAI. CDAI assesses the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450.
Time frame: Week 4
Population: Intent to Treat Population: all participants who were randomized. Non-responder imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants With Clinical Remission, Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g at Week 4 | 11.2 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants With Clinical Remission, Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g at Week 4 | 14.3 percentage of participants |
Percentage of Participants With Clinical Response at Week 12
Clinical response was scored using CDAI. CDAI assesses the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450. Clinical response was defined as a decrease in CDAI ≥ 70 points from Baseline.
Time frame: Week 12
Population: Intent to Treat Population: all participants who were randomized. Non-responder imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants With Clinical Response at Week 12 | 74.8 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants With Clinical Response at Week 12 | 83.4 percentage of participants |
Percentage of Participants With Clinical Response at Week 4
Clinical response was scored using CDAI is used to assess the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450. Clinical response was defined as a decrease in CDAI ≥ 70 points from baseline.
Time frame: Week 4
Population: Intent to Treat Population: all participants who were randomized. Non-responder imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants With Clinical Response at Week 4 | 70.9 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants With Clinical Response at Week 4 | 74.4 percentage of participants |
Percentage of Participants With Endoscopic Remission at Week 12
Endoscopic remission was scored using the SES-CD.The SES-CD evaluates 4 endoscopic variables (ulcer size ranging from 0 \[none\] to 3 \[very large\]; ulcerated surface ranging from 0 \[none\] to 3 \[\>30%\]; affected surface ranging from 0 \[none\] to 3 \[\>75%\], and narrowing ranging from 0 \[none\] to 3 \[cannot be passed\]) in 5 segments assessed during ileocolonoscopy (ileum, right colon, transverse colon, sigmoid and left colon, and rectum). The total score is the sum of the 4 endoscopic variable scores and range from 0 to 56, where higher scores indicate more severe disease. Endoscopic remission was defined as SES-CD ≤ 4 and at least a 2-point reduction versus baseline and no subscore greater than 1 in any individual variable.
Time frame: Week 12
Population: Intent to Treat Population: all participants who were randomized. Non-responder imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants With Endoscopic Remission at Week 12 | 26.2 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants With Endoscopic Remission at Week 12 | 28.6 percentage of participants |
Percentage of Participants With Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g at Week 4
Time frame: Week 4
Population: Intent to Treat Population: all participants who were randomized. Non-responder imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants With Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g at Week 4 | 27.7 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants With Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g at Week 4 | 32.5 percentage of participants |
Percentage of Participants With Sustained Clinical Remission (Per CDAI) at Both Weeks 4 and 12
CDAI is used to assess the symptoms of participants with Crohn's Disease. Scores generally range from 0 to 600, where clinical remission of Crohn's disease is defined as CDAI \< 150, and very severe disease is defined as CDAI \> 450.
Time frame: Week 4 and Week 12
Population: Intent to Treat Population: all participants who were randomized. Non-responder imputation.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Induction: Standard Induction Dose | Percentage of Participants With Sustained Clinical Remission (Per CDAI) at Both Weeks 4 and 12 | 35.0 percentage of participants |
| Induction: Higher Induction Dose | Percentage of Participants With Sustained Clinical Remission (Per CDAI) at Both Weeks 4 and 12 | 39.0 percentage of participants |