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Study to Evaluate Efficacy and Safety of Two Drug Regimens in Subjects With Moderate to Severe Crohn's Disease

A Multicenter, Randomized, Double-Blind Study to 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

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02065570
Enrollment
514
Registered
2014-02-19
Start date
2014-05-01
Completion date
2020-01-30
Last updated
2021-02-18

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Crohn's Disease

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

DRUGAdalimumab
DRUGPlacebo

Sponsors

AbbVie
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No

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

MeasureTime frameDescription
Percentage of Participants Who Achieved Clinical Remission at Week 4Week 4Crohn'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 12Week 12Endoscopic 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

MeasureTime frameDescription
Percentage of Participants Who Discontinued Corticosteroid Use and Achieved Clinical Remission at Week 12 Among Participants Taking Corticosteroids at BaselineWeek 12Clinical 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 12Week 12Endoscopic 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 4Baseline, Week 4
Percentage of Participants With Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g at Week 4Week 4
Percentage of Participants With Clinical Remission, Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g at Week 4Week 4Clinical 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 12Week 12Clinical 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 12Week 4 and Week 12CDAI 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 4Week 4Clinical 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 12Week 12Clinical 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 4Week 4The 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 12Week 12The 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 12Week 12The 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 12Week 12The 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 12Week 12Clinical 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 12Week 12Clinical 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

ArmCount
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
Total514

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003
Induction StudyAdverse Event51200
Induction StudyLost to Follow-up1100
Induction StudyOther, Not Specified6500
Induction StudyWithdrawal by Subject2300
Maintenance StudyAdverse Event0088
Maintenance StudyLost to Follow-up0022
Maintenance StudyOther, Not Specified00115
Maintenance StudyWithdrawal by Subject0014

Baseline characteristics

CharacteristicInduction: Higher Induction DoseTotalInduction: Standard Induction Dose
Age, Continuous36.4 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 Participants15 Participants5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
298 Participants499 Participants201 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants1 Participants0 Participants
Race (NIH/OMB)
Asian
6 Participants11 Participants5 Participants
Race (NIH/OMB)
Black or African American
11 Participants29 Participants18 Participants
Race (NIH/OMB)
More than one race
1 Participants2 Participants1 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants1 Participants0 Participants
Race (NIH/OMB)
White
288 Participants470 Participants182 Participants
Sex: Female, Male
Female
158 Participants267 Participants109 Participants
Sex: Female, Male
Male
150 Participants247 Participants97 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
0 / 2060 / 3080 / 1090 / 109
other
Total, other adverse events
54 / 20658 / 30841 / 10933 / 109
serious
Total, serious adverse events
10 / 20614 / 3085 / 1097 / 109

Outcome results

Primary

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.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
Induction: Standard Induction DoseNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any TEAE133 Participants
Induction: Standard Induction DoseNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any TEAE leading to death0 Participants
Induction: Standard Induction DoseNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any TEAE leading to discontinuation of study drug8 Participants
Induction: Standard Induction DoseNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)TEAE w/reasonable possibility of being related to study drug54 Participants
Induction: Standard Induction DoseNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Deaths0 Participants
Induction: Standard Induction DoseNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any severe TEAE13 Participants
Induction: Standard Induction DoseNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any SAE10 Participants
Induction: Higher Induction DoseNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any TEAE leading to death0 Participants
Induction: Higher Induction DoseNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any SAE14 Participants
Induction: Higher Induction DoseNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any severe TEAE17 Participants
Induction: Higher Induction DoseNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any TEAE leading to discontinuation of study drug13 Participants
Induction: Higher Induction DoseNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Deaths0 Participants
Induction: Higher Induction DoseNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)TEAE w/reasonable possibility of being related to study drug75 Participants
Induction: Higher Induction DoseNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any TEAE185 Participants
Maintenance: Clinically Adjusted (CA) RegimenNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any SAE5 Participants
Maintenance: Clinically Adjusted (CA) RegimenNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any TEAE77 Participants
Maintenance: Clinically Adjusted (CA) RegimenNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)TEAE w/reasonable possibility of being related to study drug29 Participants
Maintenance: Clinically Adjusted (CA) RegimenNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any severe TEAE7 Participants
Maintenance: Clinically Adjusted (CA) RegimenNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any TEAE leading to discontinuation of study drug8 Participants
Maintenance: Clinically Adjusted (CA) RegimenNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any TEAE leading to death0 Participants
Maintenance: Clinically Adjusted (CA) RegimenNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Deaths0 Participants
Maintenance: Therapeutic Drug Monitoring (TDM) RegimenNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any severe TEAE6 Participants
Maintenance: Therapeutic Drug Monitoring (TDM) RegimenNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Deaths0 Participants
Maintenance: Therapeutic Drug Monitoring (TDM) RegimenNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any TEAE leading to death0 Participants
Maintenance: Therapeutic Drug Monitoring (TDM) RegimenNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)TEAE w/reasonable possibility of being related to study drug33 Participants
Maintenance: Therapeutic Drug Monitoring (TDM) RegimenNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any TEAE76 Participants
Maintenance: Therapeutic Drug Monitoring (TDM) RegimenNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any TEAE leading to discontinuation of study drug9 Participants
Maintenance: Therapeutic Drug Monitoring (TDM) RegimenNumber of Participants With Treatment-Emergent Adverse Events (TEAEs)Any SAE7 Participants
Primary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants Who Achieved Clinical Remission at Week 443.7 percentage of participants
Induction: Higher Induction DosePercentage of Participants Who Achieved Clinical Remission at Week 443.5 percentage of participants
p-value: 0.93995% CI: [-8.1, 8.8]Cochran-Mantel-Haenszel
Primary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants With Endoscopic Response at Week 1239.3 percentage of participants
Induction: Higher Induction DosePercentage of Participants With Endoscopic Response at Week 1242.9 percentage of participants
p-value: 0.46295% CI: [-5.3, 11.7]Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (MEAN)Dispersion
Induction: Standard Induction DoseChange From Baseline in Fecal Calprotectin Level at Week 4-1045.7 µg/gStandard Deviation 1648.51
Induction: Higher Induction DoseChange From Baseline in Fecal Calprotectin Level at Week 4-1157.0 µg/gStandard Deviation 2000.69
p-value: 0.94695% CI: [-192.3, 205.9]Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants Achieving Response in IBDQ Bowel Symptom Domain at Week 1273.3 percentage of participants
Induction: Higher Induction DosePercentage of Participants Achieving Response in IBDQ Bowel Symptom Domain at Week 1276.9 percentage of participants
p-value: 0.34995% CI: [-4, 11.2]Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants Achieving Response in IBDQ Fatigue Item at Week 1268.4 percentage of participants
Induction: Higher Induction DosePercentage of Participants Achieving Response in IBDQ Fatigue Item at Week 1276.0 percentage of participants
p-value: 0.05495% CI: [-0.1, 15.3]Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants Achieving Response in Inflammatory Bowel Disease Questionnaire (IBDQ) Bowel Symptom Domain at Week 471.4 percentage of participants
Induction: Higher Induction DosePercentage of Participants Achieving Response in Inflammatory Bowel Disease Questionnaire (IBDQ) Bowel Symptom Domain at Week 474.7 percentage of participants
p-value: 0.39495% CI: [-4.4, 11.1]Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants Who Achieve Clinical Response at Week 4 and Endoscopic Response at Week 1220.4 percentage of participants
Induction: Higher Induction DosePercentage of Participants Who Achieve Clinical Response at Week 4 and Endoscopic Response at Week 1222.1 percentage of participants
p-value: 0.6195% CI: [-5.1, 8.7]Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants Who Achieved an SES-CD ≤ 2 at Week 1216.0 percentage of participants
Induction: Higher Induction DosePercentage of Participants Who Achieved an SES-CD ≤ 2 at Week 1220.1 percentage of participants
p-value: 0.27895% CI: [-2.9, 10.2]Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants Who Discontinued Corticosteroid Use and Achieved Clinical Remission at Week 12 Among Participants Taking Corticosteroids at Baseline48.0 percentage of participants
Induction: Higher Induction DosePercentage of Participants Who Discontinued Corticosteroid Use and Achieved Clinical Remission at Week 12 Among Participants Taking Corticosteroids at Baseline52.9 percentage of participants
p-value: 0.33695% CI: [-6.2, 18.2]Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants With Clinical Remission at Week 1251.5 percentage of participants
Induction: Higher Induction DosePercentage of Participants With Clinical Remission at Week 1262.3 percentage of participants
p-value: 0.00895% CI: [2.9, 19.6]Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants With Clinical Remission, Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g and Endoscopic Remission at Week 127.3 percentage of participants
Induction: Higher Induction DosePercentage of Participants With Clinical Remission, Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g and Endoscopic Remission at Week 1211.7 percentage of participants
p-value: 0.09295% CI: [-0.7, 9.1]Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants With Clinical Remission, Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g at Week 411.2 percentage of participants
Induction: Higher Induction DosePercentage of Participants With Clinical Remission, Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g at Week 414.3 percentage of participants
p-value: 0.30495% CI: [-2.7, 8.6]Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants With Clinical Response at Week 1274.8 percentage of participants
Induction: Higher Induction DosePercentage of Participants With Clinical Response at Week 1283.4 percentage of participants
p-value: 0.01595% CI: [1.8, 16]Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants With Clinical Response at Week 470.9 percentage of participants
Induction: Higher Induction DosePercentage of Participants With Clinical Response at Week 474.4 percentage of participants
p-value: 0.35395% CI: [-4.1, 11.5]Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants With Endoscopic Remission at Week 1226.2 percentage of participants
Induction: Higher Induction DosePercentage of Participants With Endoscopic Remission at Week 1228.6 percentage of participants
p-value: 0.69495% CI: [-6.1, 9.1]Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants With Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g at Week 427.7 percentage of participants
Induction: Higher Induction DosePercentage of Participants With Hs-CRP < 5 mg/L and Fecal Calprotectin < 250 µg/g at Week 432.5 percentage of participants
p-value: 0.29395% CI: [-3.5, 11.5]Cochran-Mantel-Haenszel
Secondary

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.

ArmMeasureValue (NUMBER)
Induction: Standard Induction DosePercentage of Participants With Sustained Clinical Remission (Per CDAI) at Both Weeks 4 and 1235.0 percentage of participants
Induction: Higher Induction DosePercentage of Participants With Sustained Clinical Remission (Per CDAI) at Both Weeks 4 and 1239.0 percentage of participants
p-value: 0.26995% CI: [-3.6, 12.8]Cochran-Mantel-Haenszel

Source: ClinicalTrials.gov · Data processed: Feb 13, 2026