Ulcerative Colitis
Conditions
Keywords
IL-23 antibody
Brief summary
The main purpose of this study is to test the hypothesis that treatment with mirikizumab is superior to placebo in providing clinical benefit to participants with moderate to severe ulcerative colitis (UC). This study will also investigate how the body processes the drug.
Interventions
Sponsors
Study design
Eligibility
Inclusion criteria
* Have moderate to severe active UC as defined by a Mayo score of 6 to 12 with an endoscopic subscore ≥2 within 14 days before the first dose of study treatment (note: a partial Mayo score of at least 4 and other eligibility criteria must have been met before endoscopy is performed as a study procedure) * Have evidence of UC extending proximal to the rectum (≥15 centimeters \[cm\] of involved colon) * Up-to-date colorectal cancer surveillance (performed according to local standard), for subjects with family history of colorectal cancer, personal history of increased colorectal cancer risk, age \>50 years, or other known risk factor * Participants must either: be naive to biologic therapy (eg, tumor necrosis factor \[TNF\] antagonists or vedolizumab) and have at least 1 of the following: inadequate response or failure to tolerate current treatment with oral or intravenous corticosteroids or immunomodulators (6-mercaptopurine or azathioprine) or history of corticosteroid dependence (an inability to successfully taper corticosteroids without return of UC) OR have received treatment with 1 or more biologic agents (eg, TNF antagonists or vedolizumab) at doses approved for the treatment of UC with documented history of failure to respond to or tolerate such treatment
Exclusion criteria
* Have been diagnosed with indeterminate colitis, proctitis (distal disease involving the rectum only; less than 15 cm from the anal verge) or Crohn's Disease * Have had surgery for treatment of UC or are likely to require surgery for UC during the study * Have received any of the following for treatment of UC: cyclosporine or thalidomide within 30 days of screening, corticosteroid enemas, corticosteroid suppositories, or topical treatment with 5-aminosalicyclic acid within 30 days of screening
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Induction Period: Percentage of Participants With Clinical Remission at Week 12 | Week 12 | Clinical remission at week 12 is a defined as achieving a 9-pt Mayo subscore for rectal bleeding=0, stool frequency=0 or 1 with ≥ 1 point decrease from baseline, and endoscopy=0 or 1, excluding Physician's Global Assessment (PGA). * Stool Frequency Subscore, based on the participant's diary and scored from 0 (normal number of stools) to 3 (5 or more stools than normal); * Rectal Bleeding Subscore, based on the participant's diary and scored from 0 (no blood) to 3 (blood only passed); * Endoscopy Subscore, based on colonoscopy or sigmoidoscopy and scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration); * Physician's Global Assessment subscore, based on the physician's overall assessment, and scored from 0 (normal) to 3 (severe disease). The total score ranges from 0 to 9 points, with higher scores representing more severe disease. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Induction Period: Percentage of Participants With Endoscopic Remission at Week 12 | Week 12 | Endoscopic remission at week 12 is defined as achieving a Mayo endoscopic score of 0 at Week 12. Endoscopy Subscore is based on colonoscopy or sigmoidoscopy and scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration); The total score ranges from 0 to 3 points, with higher scores representing more severe disease. |
| Maintenance Period: Percentage of Participants With Endoscopic Remission at Week 52 | Week 52 | Endoscopic remission at week 52 is defined as achieving a Mayo endoscopic subscore of 0 at Week 52. Endoscopy Subscore is based on colonoscopy or sigmoidoscopy and scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration); The total score ranges from 0 to 3 points, with higher scores representing more severe disease. |
| Induction Period: Change From Baseline to Week 12 in Inflammatory Bowel Disease Questionnaire (IBDQ) Total Score | Baseline, Week 12 | The IBDQ is a 32-item subject-completed questionnaire that measures 4 aspects of subjects' lives: symptoms directly related to the primary bowel disturbance, systemic symptoms, emotional function, and social function (Guyatt et al. 1989). Responses are graded on a 7-point. Likert scale in which 7 denotes not a problem at all and 1 denotes a very severe problem. Scores range from 32 to 224; a higher score indicates a better quality of life. LS Mean was calculated using MMRM model for post-baseline measures: Variable = Baseline + Geographical Region + Prior Biologic Therapy Group (N) + Treatment + Time + Treatment\*Time (Type III sum of squares). |
| Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Baseline, Week 12 | SF-36 Health Status Survey is a generic, health-related scale assessing participant's quality of life on 8 domains: physical functioning, social functioning, bodily pain, vitality, mental health, role-physical, role-emotional and general health. Domain scores: general health (range: 5-25); physical functioning (range: 10-30); role-physical (range: 4-8); role-emotional (range: 3-15); social functioning (range: 2-10); bodily pain (range: 2-12); vitality (range: 4-20); mental health (range: 5-25). Each raw scale score was converted to a scale score ranging from 0-100 points, with higher values representing a better outcome \[(Raw score) - min{raw score}\] / (max {raw score} - min{raw score}) x 100\]. LS Mean was calculated using Mixed effect Model Repeat Measurement (MMRM) model for post-baseline measures: Variable = Baseline + Geographical Region + Prior Biologic Therapy Group (N) + Treatment + Time + Treatment\*Time (Type III sum of squares). |
| Induction Period: Change From Baseline to Week 12 in Patient's Global Impressions of Severity (PGI-S) Score | Baseline, Week 12 | PGI-S is a 1-item subject-rated questionnaire designed to assess the subject's impression of their disease symptoms at baseline (Guy 1976; Yalcin and Bump 2003). Responses are graded on a 7-point scale in which a score of 1 indicates that the subject's symptom(s) are normal, a score of 2 indicates that the subject feels borderline ill, a score of 3 indicates that the subject feels mildly ill, a score of 4 indicates that the subject(s) feel moderately ill, and scores of 5, 6, and 7 indicate that the subject feels markedly ill, severely ill, and extremely ill, respectively. LS Mean was calculated using MMRM model for post-baseline measures: Variable = Baseline + Geographical Region + Prior Biologic Therapy Group (N) + Treatment + Time + Treatment\*Time (Type III sum of squares). |
| Induction Period: Percentage of Participants With Clinical Response at Week 12 | Week 12 | Clinical response at week 12 is defined as a decrease in the 9-point Mayo subscores (rectal bleeding, stool frequency and the endoscopic findings) inclusive of \>= 2 points and \>=35% from baseline with either a decrease of rectal bleeding subscore of \>=1 or rectal bleeding subscore of 0 or 1. The Mayo score is a composite score of ulcerative colitis disease activity calculated as the sum of four subscores: * Stool Frequency Subscore, based on the participant's diary and scored from 0 (normal number of stools) to 3 (5 or more stools than normal); * Rectal Bleeding Subscore, based on the participant's diary and scored from 0 (no blood) to 3 (blood only passed); * Endoscopy Subscore, based on colonoscopy or sigmoidoscopy and scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration). The total score ranges from 0 to 9 points, with higher scores representing more severe disease. |
| Pharmacokinetics (PK): Area Under the Concentration-Time Curve During Dosing Interval at Steady State (AUCss, Tau) of Mirikizumab | Induction Period: Day (D) 1, D15 ± 2d, D29 ± 2d, D43 ± 2d, D57 ± 2d, D78-85; Maintenance Period: D85-92,D113± 7d,D141± 7d,D169± 7d,D225 ±7d,D281 ±7d,D337 ±7d,D393± 7d,D448± 7d,D504± 7d,D560± 7d,D616± 7d,D672± 7d,D728± 7d,D784± 7d,D840± 7d | Pharmacokinetics (PK): Area Under the Concentration-Time Curve During Dosing Interval at Steady State (AUCss, tau) of Mirikizumab |
| Induction Period: Percentage of Participants With Symptomatic Remission at Week 12 | Week 12 | Symptomatic remission is defined as a stool frequency score of 0 or 1 and a rectal bleeding score of 0. * Stool Frequency Subscore is based on the participant's diary and scored from 0 (normal number of stools) to 3 (5 or more stools than normal). * Rectal Bleeding Subscore is based on the participant's diary and scored from 0 (no blood) to 3 (blood only passed). The total score ranges from 0 to 1 points, with higher scores representing more severe disease. The percentage of response is calculated by dividing number of participants in the specified category by number of participants with non-missing values multiplied by 100. |
| Maintenance Period: Percentage of Participants With Symptomatic Remission at Week 52 | Week 52 | Symptomatic remission is defined as a stool frequency score of 0 or 1 and a rectal bleeding score of 0. * Stool Frequency Subscore , based on the participant's diary and scored from 0 (normal number of stools) to 3 (5 or more stools than normal); * Rectal Bleeding Subscore , based on the participant's diary and scored from 0 (no blood) to 3 (blood only passed); * Endoscopy Subscore , based on colonoscopy or sigmoidoscopy and scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration); * Physician's Global Assessment subscore, based on the physician's overall assessment, and scored from zero (normal) to 3 (severe disease). The total score ranges from 0 to 1 points, with higher scores representing more severe disease. The percentage of response is calculated by dividing number of participants in the specified category by number of participants with non-missing values multiplied by 100. |
| Induction Period: Percentage of Participants With Endoscopic Improvement at Week 12 | Week 12 | Endoscopic Improvement defined as achieving an endoscopic findings subscore of 0 or 1. Endoscopy Subscore is based on colonoscopy or sigmoidoscopy and scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration). The percentage of response is calculated by dividing number of participants in the specified category by number of participants with non-missing values multiplied by 100. |
| Maintenance Period: Percentage of Participants With Endoscopic Improvement at Week 52 | Week 52 | Endoscopic Improvement defined as achieving an endoscopic findings subscore of 0 or 1. Endoscopy Subscore is based on colonoscopy or sigmoidoscopy and scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration). The percentage of response is calculated by dividing number of participants in the specified category by number of participants with non-missing values multiplied by 100. |
| Induction Period: Patient's Global Impressions of Improvement (PGI-I) Score at Week 12 | Week 12 | PGI-I scale is a subject-rated instrument designed to assess the subject's impression of change in their symptom(s) (Guy 1976; Yalcin and Bump 2003). Responses are graded on a 7-point Likert scale in which a score of 1 indicates that the subject's symptom(s) is very much better, a score of 4 indicates that the subject's symptom(s) has experienced no change, and a score of 7 indicates that the subject's symptom(s) is very much worse. |
Countries
Australia, Belgium, Canada, Czechia, Denmark, France, Georgia, Hungary, Japan, Lithuania, Moldova, Netherlands, Poland, Romania, United Kingdom, United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Induction: Placebo IV Q4W Placebo administered every 4 weeks (Q4W) intravenously (IV). | 63 |
| Induction: 50 mg Mirikizumab IV Q4W 50 mg mirikizumab administered every 4 weeks (Q4W) intravenously (IV).
Participants who do not have a clinical response may choose to participate in the unblinded study extension period. | 63 |
| Induction: 200 mg Mirikizumab IV Q4W 200 mg mirikizumab administered every 4 weeks (Q4W) intravenously (IV).
Participants who do not have a clinical response may choose to participate in the unblinded study extension period. | 62 |
| Induction: 600 mg Mirikizumab IV Q4W 600 mg mirikizumab administered every 4 weeks (Q4W) intravenously (IV).
Participants who do not have a clinical response may choose to participate in the unblinded study extension period. | 61 |
| Total | 249 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 | FG004 | FG005 | FG006 | FG007 | FG008 | FG009 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Induction Extension Period | Adverse Event | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 4 | 0 |
| Induction Extension Period | Lack of Efficacy | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 3 | 0 |
| Induction Extension Period | Physician Decision | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 |
| Induction Extension Period | Reason Not Collected | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 0 |
| Induction Extension Period | Withdrawal by Subject | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 3 | 0 |
| Induction Period | Adverse Event | 3 | 0 | 2 | 2 | 0 | 0 | 0 | 0 | 0 | 0 |
| Induction Period | Did not receive drug | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
| Induction Period | Protocol Violation | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Induction Period | Withdrawal by Subject | 0 | 1 | 0 | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
| Maintenance Extension Period | Adverse Event | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 2 |
| Maintenance Extension Period | Lack of Efficacy | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 4 |
| Maintenance Extension Period | Non-responder | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 1 |
| Maintenance Extension Period | Rolled Over to Study AMAP (NCT03519945) | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 57 |
| Maintenance Extension Period | Withdrawal by Subject | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 4 |
| Maintenance Period | Adverse Event | 0 | 0 | 0 | 0 | 0 | 0 | 2 | 0 | 0 | 0 |
| Maintenance Period | Lack of Efficacy | 0 | 0 | 0 | 0 | 2 | 1 | 0 | 0 | 0 | 0 |
| Maintenance Period | Lost to Follow-up | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 |
| Maintenance Period | Physician Decision | 0 | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 |
| Maintenance Period | Reason Not Collected | 0 | 0 | 0 | 0 | 0 | 1 | 1 | 0 | 0 | 0 |
| Maintenance Period | Rolled Over to Study AMAP (NCT03519945) | 0 | 0 | 0 | 0 | 7 | 41 | 39 | 0 | 0 | 0 |
| Maintenance Period | Withdrawal by Subject | 0 | 0 | 0 | 0 | 4 | 2 | 4 | 0 | 0 | 0 |
Baseline characteristics
| Characteristic | Induction: 600 mg Mirikizumab IV Q4W | Total | Induction: Placebo IV Q4W | Induction: 50 mg Mirikizumab IV Q4W | Induction: 200 mg Mirikizumab IV Q4W |
|---|---|---|---|---|---|
| Age, Continuous | 42.44 years STANDARD_DEVIATION 13.371 | 42.56 years STANDARD_DEVIATION 13.85 | 42.62 years STANDARD_DEVIATION 13.47 | 41.83 years STANDARD_DEVIATION 14.06 | 43.35 years STANDARD_DEVIATION 14.75 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 2 Participants | 7 Participants | 0 Participants | 3 Participants | 2 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 54 Participants | 231 Participants | 60 Participants | 58 Participants | 59 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 5 Participants | 11 Participants | 3 Participants | 2 Participants | 1 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Asian | 5 Participants | 33 Participants | 10 Participants | 5 Participants | 13 Participants |
| Race (NIH/OMB) Black or African American | 0 Participants | 7 Participants | 1 Participants | 1 Participants | 5 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 56 Participants | 209 Participants | 52 Participants | 57 Participants | 44 Participants |
| Region of Enrollment Australia | 2 Participants | 7 Participants | 1 Participants | 3 Participants | 1 Participants |
| Region of Enrollment Belgium | 7 Participants | 21 Participants | 4 Participants | 7 Participants | 3 Participants |
| Region of Enrollment Canada | 3 Participants | 6 Participants | 2 Participants | 1 Participants | 0 Participants |
| Region of Enrollment Czechia | 1 Participants | 2 Participants | 1 Participants | 0 Participants | 0 Participants |
| Region of Enrollment Denmark | 1 Participants | 1 Participants | 0 Participants | 0 Participants | 0 Participants |
| Region of Enrollment Georgia | 1 Participants | 14 Participants | 4 Participants | 7 Participants | 2 Participants |
| Region of Enrollment Hungary | 4 Participants | 18 Participants | 5 Participants | 3 Participants | 6 Participants |
| Region of Enrollment Japan | 5 Participants | 31 Participants | 8 Participants | 5 Participants | 13 Participants |
| Region of Enrollment Lithuania | 1 Participants | 9 Participants | 4 Participants | 1 Participants | 3 Participants |
| Region of Enrollment Moldova | 7 Participants | 24 Participants | 5 Participants | 7 Participants | 5 Participants |
| Region of Enrollment Netherlands | 2 Participants | 11 Participants | 1 Participants | 4 Participants | 4 Participants |
| Region of Enrollment Poland | 8 Participants | 49 Participants | 15 Participants | 14 Participants | 12 Participants |
| Region of Enrollment United Kingdom | 2 Participants | 6 Participants | 2 Participants | 2 Participants | 0 Participants |
| Region of Enrollment United States | 17 Participants | 50 Participants | 11 Participants | 9 Participants | 13 Participants |
| Sex: Female, Male Female | 23 Participants | 100 Participants | 27 Participants | 25 Participants | 25 Participants |
| Sex: Female, Male Male | 38 Participants | 149 Participants | 36 Participants | 38 Participants | 37 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk | EG004 affected / at risk | EG005 affected / at risk | EG006 affected / at risk | EG007 affected / at risk | EG008 affected / at risk | EG009 affected / at risk |
|---|---|---|---|---|---|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 63 | 0 / 63 | 0 / 62 | 0 / 60 | 0 / 13 | 0 / 47 | 0 / 46 | 0 / 32 | 0 / 96 | 0 / 68 |
| other Total, other adverse events | 18 / 63 | 14 / 63 | 8 / 62 | 14 / 60 | 11 / 13 | 27 / 47 | 30 / 46 | 9 / 32 | 8 / 96 | 30 / 68 |
| serious Total, serious adverse events | 2 / 63 | 0 / 63 | 2 / 62 | 3 / 60 | 2 / 13 | 2 / 47 | 1 / 46 | 1 / 32 | 5 / 96 | 3 / 68 |
Outcome results
Induction Period: Percentage of Participants With Clinical Remission at Week 12
Clinical remission at week 12 is a defined as achieving a 9-pt Mayo subscore for rectal bleeding=0, stool frequency=0 or 1 with ≥ 1 point decrease from baseline, and endoscopy=0 or 1, excluding Physician's Global Assessment (PGA). * Stool Frequency Subscore, based on the participant's diary and scored from 0 (normal number of stools) to 3 (5 or more stools than normal); * Rectal Bleeding Subscore, based on the participant's diary and scored from 0 (no blood) to 3 (blood only passed); * Endoscopy Subscore, based on colonoscopy or sigmoidoscopy and scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration); * Physician's Global Assessment subscore, based on the physician's overall assessment, and scored from 0 (normal) to 3 (severe disease). The total score ranges from 0 to 9 points, with higher scores representing more severe disease.
Time frame: Week 12
Population: Induction Period: All randomized participants.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Placebo IV Q4W | Induction Period: Percentage of Participants With Clinical Remission at Week 12 | 4.8 percentage of participants |
| 50 mg Mirikizumab IV Q4W | Induction Period: Percentage of Participants With Clinical Remission at Week 12 | 15.9 percentage of participants |
| 200 mg Mirikizumab IV Q4W | Induction Period: Percentage of Participants With Clinical Remission at Week 12 | 22.6 percentage of participants |
| 600 mg Mirikizumab IV Q4W | Induction Period: Percentage of Participants With Clinical Remission at Week 12 | 11.5 percentage of participants |
Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36)
SF-36 Health Status Survey is a generic, health-related scale assessing participant's quality of life on 8 domains: physical functioning, social functioning, bodily pain, vitality, mental health, role-physical, role-emotional and general health. Domain scores: general health (range: 5-25); physical functioning (range: 10-30); role-physical (range: 4-8); role-emotional (range: 3-15); social functioning (range: 2-10); bodily pain (range: 2-12); vitality (range: 4-20); mental health (range: 5-25). Each raw scale score was converted to a scale score ranging from 0-100 points, with higher values representing a better outcome \[(Raw score) - min{raw score}\] / (max {raw score} - min{raw score}) x 100\]. LS Mean was calculated using Mixed effect Model Repeat Measurement (MMRM) model for post-baseline measures: Variable = Baseline + Geographical Region + Prior Biologic Therapy Group (N) + Treatment + Time + Treatment\*Time (Type III sum of squares).
Time frame: Baseline, Week 12
Population: Induction Period: All randomized participants who had a baseline and at least one post-baseline SF-36 value.
| Arm | Measure | Group | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|---|
| Placebo IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Role-Emotional | 3.0 score on a scale | Standard Error 1.22 |
| Placebo IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Social Functioning | 6.5 score on a scale | Standard Error 1.22 |
| Placebo IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Vitality | 3.3 score on a scale | Standard Error 1.25 |
| Placebo IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Mental Component Score | 3.2 score on a scale | Standard Error 1.22 |
| Placebo IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Mental Health | 1.9 score on a scale | Standard Error 1.18 |
| Placebo IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | General Health | 3.1 score on a scale | Standard Error 0.93 |
| Placebo IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Physical Component Score | 3.4 score on a scale | Standard Error 0.83 |
| Placebo IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Bodily Pain | 3.7 score on a scale | Standard Error 1.15 |
| Placebo IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Physical Functioning | 2.1 score on a scale | Standard Error 0.76 |
| Placebo IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Role-Physical | 4.5 score on a scale | Standard Error 1.19 |
| 50 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Role-Physical | 7.5 score on a scale | Standard Error 1.22 |
| 50 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Social Functioning | 8.0 score on a scale | Standard Error 1.26 |
| 50 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Bodily Pain | 7.9 score on a scale | Standard Error 1.18 |
| 50 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | General Health | 3.8 score on a scale | Standard Error 0.96 |
| 50 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Vitality | 6.5 score on a scale | Standard Error 1.28 |
| 50 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Role-Emotional | 3.7 score on a scale | Standard Error 1.26 |
| 50 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Mental Health | 3.7 score on a scale | Standard Error 1.22 |
| 50 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Physical Component Score | 6.2 score on a scale | Standard Error 0.86 |
| 50 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Mental Component Score | 4.5 score on a scale | Standard Error 1.26 |
| 50 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Physical Functioning | 3.7 score on a scale | Standard Error 0.78 |
| 200 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | General Health | 4.3 score on a scale | Standard Error 0.92 |
| 200 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Bodily Pain | 8.9 score on a scale | Standard Error 1.14 |
| 200 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Mental Component Score | 6.8 score on a scale | Standard Error 1.2 |
| 200 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Role-Emotional | 5.5 score on a scale | Standard Error 1.2 |
| 200 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Mental Health | 6.4 score on a scale | Standard Error 1.17 |
| 200 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Role-Physical | 7.2 score on a scale | Standard Error 1.17 |
| 200 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Physical Functioning | 4.6 score on a scale | Standard Error 0.74 |
| 200 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Social Functioning | 9.4 score on a scale | Standard Error 1.21 |
| 200 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Physical Component Score | 5.9 score on a scale | Standard Error 0.83 |
| 200 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Vitality | 7.5 score on a scale | Standard Error 1.23 |
| 600 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Mental Health | 7.6 score on a scale | Standard Error 1.21 |
| 600 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Vitality | 9.7 score on a scale | Standard Error 1.28 |
| 600 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Social Functioning | 11.6 score on a scale | Standard Error 1.26 |
| 600 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Role-Emotional | 7.6 score on a scale | Standard Error 1.25 |
| 600 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Physical Component Score | 6.9 score on a scale | Standard Error 0.85 |
| 600 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Mental Component Score | 8.8 score on a scale | Standard Error 1.25 |
| 600 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Physical Functioning | 6.2 score on a scale | Standard Error 0.77 |
| 600 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Role-Physical | 8.0 score on a scale | Standard Error 1.22 |
| 600 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | Bodily Pain | 10.0 score on a scale | Standard Error 1.18 |
| 600 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in 36-Item Short Form Health Survey (SF-36) | General Health | 5.1 score on a scale | Standard Error 0.96 |
Induction Period: Change From Baseline to Week 12 in Inflammatory Bowel Disease Questionnaire (IBDQ) Total Score
The IBDQ is a 32-item subject-completed questionnaire that measures 4 aspects of subjects' lives: symptoms directly related to the primary bowel disturbance, systemic symptoms, emotional function, and social function (Guyatt et al. 1989). Responses are graded on a 7-point. Likert scale in which 7 denotes not a problem at all and 1 denotes a very severe problem. Scores range from 32 to 224; a higher score indicates a better quality of life. LS Mean was calculated using MMRM model for post-baseline measures: Variable = Baseline + Geographical Region + Prior Biologic Therapy Group (N) + Treatment + Time + Treatment\*Time (Type III sum of squares).
Time frame: Baseline, Week 12
Population: Induction Period: All randomized participants who had a baseline and at least one post-baseline IBDQ value.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Placebo IV Q4W | Induction Period: Change From Baseline to Week 12 in Inflammatory Bowel Disease Questionnaire (IBDQ) Total Score | 22.3 score on a scale | Standard Error 4.41 |
| 50 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in Inflammatory Bowel Disease Questionnaire (IBDQ) Total Score | 33.0 score on a scale | Standard Error 4.52 |
| 200 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in Inflammatory Bowel Disease Questionnaire (IBDQ) Total Score | 42.8 score on a scale | Standard Error 4.4 |
| 600 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in Inflammatory Bowel Disease Questionnaire (IBDQ) Total Score | 45.2 score on a scale | Standard Error 4.54 |
Induction Period: Change From Baseline to Week 12 in Patient's Global Impressions of Severity (PGI-S) Score
PGI-S is a 1-item subject-rated questionnaire designed to assess the subject's impression of their disease symptoms at baseline (Guy 1976; Yalcin and Bump 2003). Responses are graded on a 7-point scale in which a score of 1 indicates that the subject's symptom(s) are normal, a score of 2 indicates that the subject feels borderline ill, a score of 3 indicates that the subject feels mildly ill, a score of 4 indicates that the subject(s) feel moderately ill, and scores of 5, 6, and 7 indicate that the subject feels markedly ill, severely ill, and extremely ill, respectively. LS Mean was calculated using MMRM model for post-baseline measures: Variable = Baseline + Geographical Region + Prior Biologic Therapy Group (N) + Treatment + Time + Treatment\*Time (Type III sum of squares).
Time frame: Baseline, Week 12
Population: Induction Period: All randomized participants who had a baseline and at least one post-baseline PGI-S value.
| Arm | Measure | Value (LEAST_SQUARES_MEAN) | Dispersion |
|---|---|---|---|
| Placebo IV Q4W | Induction Period: Change From Baseline to Week 12 in Patient's Global Impressions of Severity (PGI-S) Score | -0.84 score on a scale | Standard Error 0.19 |
| 50 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in Patient's Global Impressions of Severity (PGI-S) Score | -1.43 score on a scale | Standard Error 0.2 |
| 200 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in Patient's Global Impressions of Severity (PGI-S) Score | -1.90 score on a scale | Standard Error 0.18 |
| 600 mg Mirikizumab IV Q4W | Induction Period: Change From Baseline to Week 12 in Patient's Global Impressions of Severity (PGI-S) Score | -1.74 score on a scale | Standard Error 0.19 |
Induction Period: Patient's Global Impressions of Improvement (PGI-I) Score at Week 12
PGI-I scale is a subject-rated instrument designed to assess the subject's impression of change in their symptom(s) (Guy 1976; Yalcin and Bump 2003). Responses are graded on a 7-point Likert scale in which a score of 1 indicates that the subject's symptom(s) is very much better, a score of 4 indicates that the subject's symptom(s) has experienced no change, and a score of 7 indicates that the subject's symptom(s) is very much worse.
Time frame: Week 12
Population: Induction Period: All randomized participants who had a baseline and at least one post-baseline PGI-I value.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Placebo IV Q4W | Induction Period: Patient's Global Impressions of Improvement (PGI-I) Score at Week 12 | 3.37 score on a scale | Standard Deviation 1.46 |
| 50 mg Mirikizumab IV Q4W | Induction Period: Patient's Global Impressions of Improvement (PGI-I) Score at Week 12 | 2.69 score on a scale | Standard Deviation 1.31 |
| 200 mg Mirikizumab IV Q4W | Induction Period: Patient's Global Impressions of Improvement (PGI-I) Score at Week 12 | 2.39 score on a scale | Standard Deviation 0.99 |
| 600 mg Mirikizumab IV Q4W | Induction Period: Patient's Global Impressions of Improvement (PGI-I) Score at Week 12 | 2.53 score on a scale | Standard Deviation 1.16 |
Induction Period: Percentage of Participants With Clinical Response at Week 12
Clinical response at week 12 is defined as a decrease in the 9-point Mayo subscores (rectal bleeding, stool frequency and the endoscopic findings) inclusive of \>= 2 points and \>=35% from baseline with either a decrease of rectal bleeding subscore of \>=1 or rectal bleeding subscore of 0 or 1. The Mayo score is a composite score of ulcerative colitis disease activity calculated as the sum of four subscores: * Stool Frequency Subscore, based on the participant's diary and scored from 0 (normal number of stools) to 3 (5 or more stools than normal); * Rectal Bleeding Subscore, based on the participant's diary and scored from 0 (no blood) to 3 (blood only passed); * Endoscopy Subscore, based on colonoscopy or sigmoidoscopy and scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration). The total score ranges from 0 to 9 points, with higher scores representing more severe disease.
Time frame: Week 12
Population: Induction Period: All randomized participants.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Placebo IV Q4W | Induction Period: Percentage of Participants With Clinical Response at Week 12 | 20.6 percentage of participants |
| 50 mg Mirikizumab IV Q4W | Induction Period: Percentage of Participants With Clinical Response at Week 12 | 41.3 percentage of participants |
| 200 mg Mirikizumab IV Q4W | Induction Period: Percentage of Participants With Clinical Response at Week 12 | 59.7 percentage of participants |
| 600 mg Mirikizumab IV Q4W | Induction Period: Percentage of Participants With Clinical Response at Week 12 | 49.2 percentage of participants |
Induction Period: Percentage of Participants With Endoscopic Improvement at Week 12
Endoscopic Improvement defined as achieving an endoscopic findings subscore of 0 or 1. Endoscopy Subscore is based on colonoscopy or sigmoidoscopy and scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration). The percentage of response is calculated by dividing number of participants in the specified category by number of participants with non-missing values multiplied by 100.
Time frame: Week 12
Population: Induction Period: All randomized participants.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Placebo IV Q4W | Induction Period: Percentage of Participants With Endoscopic Improvement at Week 12 | 6.3 percentage of participants |
| 50 mg Mirikizumab IV Q4W | Induction Period: Percentage of Participants With Endoscopic Improvement at Week 12 | 23.8 percentage of participants |
| 200 mg Mirikizumab IV Q4W | Induction Period: Percentage of Participants With Endoscopic Improvement at Week 12 | 30.6 percentage of participants |
| 600 mg Mirikizumab IV Q4W | Induction Period: Percentage of Participants With Endoscopic Improvement at Week 12 | 13.1 percentage of participants |
Induction Period: Percentage of Participants With Endoscopic Remission at Week 12
Endoscopic remission at week 12 is defined as achieving a Mayo endoscopic score of 0 at Week 12. Endoscopy Subscore is based on colonoscopy or sigmoidoscopy and scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration); The total score ranges from 0 to 3 points, with higher scores representing more severe disease.
Time frame: Week 12
Population: Induction Period: All randomized participants.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Placebo IV Q4W | Induction Period: Percentage of Participants With Endoscopic Remission at Week 12 | 1.6 percentage of participants |
| 50 mg Mirikizumab IV Q4W | Induction Period: Percentage of Participants With Endoscopic Remission at Week 12 | 3.2 percentage of participants |
| 200 mg Mirikizumab IV Q4W | Induction Period: Percentage of Participants With Endoscopic Remission at Week 12 | 3.2 percentage of participants |
| 600 mg Mirikizumab IV Q4W | Induction Period: Percentage of Participants With Endoscopic Remission at Week 12 | 1.6 percentage of participants |
Induction Period: Percentage of Participants With Symptomatic Remission at Week 12
Symptomatic remission is defined as a stool frequency score of 0 or 1 and a rectal bleeding score of 0. * Stool Frequency Subscore is based on the participant's diary and scored from 0 (normal number of stools) to 3 (5 or more stools than normal). * Rectal Bleeding Subscore is based on the participant's diary and scored from 0 (no blood) to 3 (blood only passed). The total score ranges from 0 to 1 points, with higher scores representing more severe disease. The percentage of response is calculated by dividing number of participants in the specified category by number of participants with non-missing values multiplied by 100.
Time frame: Week 12
Population: Induction Period: All randomized participants.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Placebo IV Q4W | Induction Period: Percentage of Participants With Symptomatic Remission at Week 12 | 20.6 percentage of participants |
| 50 mg Mirikizumab IV Q4W | Induction Period: Percentage of Participants With Symptomatic Remission at Week 12 | 36.5 percentage of participants |
| 200 mg Mirikizumab IV Q4W | Induction Period: Percentage of Participants With Symptomatic Remission at Week 12 | 58.1 percentage of participants |
| 600 mg Mirikizumab IV Q4W | Induction Period: Percentage of Participants With Symptomatic Remission at Week 12 | 45.9 percentage of participants |
Maintenance Period: Percentage of Participants With Endoscopic Improvement at Week 52
Endoscopic Improvement defined as achieving an endoscopic findings subscore of 0 or 1. Endoscopy Subscore is based on colonoscopy or sigmoidoscopy and scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration). The percentage of response is calculated by dividing number of participants in the specified category by number of participants with non-missing values multiplied by 100.
Time frame: Week 52
Population: Maintenance period: All randomized participants in maintenance period.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Placebo IV Q4W | Maintenance Period: Percentage of Participants With Endoscopic Improvement at Week 52 | 15.4 Percentage of Participants |
| 50 mg Mirikizumab IV Q4W | Maintenance Period: Percentage of Participants With Endoscopic Improvement at Week 52 | 57.4 Percentage of Participants |
| 200 mg Mirikizumab IV Q4W | Maintenance Period: Percentage of Participants With Endoscopic Improvement at Week 52 | 47.8 Percentage of Participants |
Maintenance Period: Percentage of Participants With Endoscopic Remission at Week 52
Endoscopic remission at week 52 is defined as achieving a Mayo endoscopic subscore of 0 at Week 52. Endoscopy Subscore is based on colonoscopy or sigmoidoscopy and scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration); The total score ranges from 0 to 3 points, with higher scores representing more severe disease.
Time frame: Week 52
Population: Maintenance period: All randomized participants in maintenance period.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Placebo IV Q4W | Maintenance Period: Percentage of Participants With Endoscopic Remission at Week 52 | 7.7 percentage of participants |
| 50 mg Mirikizumab IV Q4W | Maintenance Period: Percentage of Participants With Endoscopic Remission at Week 52 | 14.9 percentage of participants |
| 200 mg Mirikizumab IV Q4W | Maintenance Period: Percentage of Participants With Endoscopic Remission at Week 52 | 28.3 percentage of participants |
Maintenance Period: Percentage of Participants With Symptomatic Remission at Week 52
Symptomatic remission is defined as a stool frequency score of 0 or 1 and a rectal bleeding score of 0. * Stool Frequency Subscore , based on the participant's diary and scored from 0 (normal number of stools) to 3 (5 or more stools than normal); * Rectal Bleeding Subscore , based on the participant's diary and scored from 0 (no blood) to 3 (blood only passed); * Endoscopy Subscore , based on colonoscopy or sigmoidoscopy and scored from 0 (normal or inactive disease) to 3 (severe disease, spontaneous bleeding, ulceration); * Physician's Global Assessment subscore, based on the physician's overall assessment, and scored from zero (normal) to 3 (severe disease). The total score ranges from 0 to 1 points, with higher scores representing more severe disease. The percentage of response is calculated by dividing number of participants in the specified category by number of participants with non-missing values multiplied by 100.
Time frame: Week 52
Population: Maintenance period: All randomized participants in maintenance period.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Placebo IV Q4W | Maintenance Period: Percentage of Participants With Symptomatic Remission at Week 52 | 53.8 Percentage of Participants |
| 50 mg Mirikizumab IV Q4W | Maintenance Period: Percentage of Participants With Symptomatic Remission at Week 52 | 76.6 Percentage of Participants |
| 200 mg Mirikizumab IV Q4W | Maintenance Period: Percentage of Participants With Symptomatic Remission at Week 52 | 65.2 Percentage of Participants |
Pharmacokinetics (PK): Area Under the Concentration-Time Curve During Dosing Interval at Steady State (AUCss, Tau) of Mirikizumab
Pharmacokinetics (PK): Area Under the Concentration-Time Curve During Dosing Interval at Steady State (AUCss, tau) of Mirikizumab
Time frame: Induction Period: Day (D) 1, D15 ± 2d, D29 ± 2d, D43 ± 2d, D57 ± 2d, D78-85; Maintenance Period: D85-92,D113± 7d,D141± 7d,D169± 7d,D225 ±7d,D281 ±7d,D337 ±7d,D393± 7d,D448± 7d,D504± 7d,D560± 7d,D616± 7d,D672± 7d,D728± 7d,D784± 7d,D840± 7d
Population: All participants who received at least one dose of mirikizumab in the induction and maintenance period who had evaluable PK data.
| Arm | Measure | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|
| Placebo IV Q4W | Pharmacokinetics (PK): Area Under the Concentration-Time Curve During Dosing Interval at Steady State (AUCss, Tau) of Mirikizumab | 3330 Microgram*hour/milligram(ug*hr/ml) | Geometric Coefficient of Variation 42.5 |
| 50 mg Mirikizumab IV Q4W | Pharmacokinetics (PK): Area Under the Concentration-Time Curve During Dosing Interval at Steady State (AUCss, Tau) of Mirikizumab | 10100 Microgram*hour/milligram(ug*hr/ml) | Geometric Coefficient of Variation 35 |
| 200 mg Mirikizumab IV Q4W | Pharmacokinetics (PK): Area Under the Concentration-Time Curve During Dosing Interval at Steady State (AUCss, Tau) of Mirikizumab | 24900 Microgram*hour/milligram(ug*hr/ml) | Geometric Coefficient of Variation 36.6 |
| 600 mg Mirikizumab IV Q4W | Pharmacokinetics (PK): Area Under the Concentration-Time Curve During Dosing Interval at Steady State (AUCss, Tau) of Mirikizumab | 3700 Microgram*hour/milligram(ug*hr/ml) | Geometric Coefficient of Variation 41.5 |
| 200 mg Mirikizumab SC Q12W | Pharmacokinetics (PK): Area Under the Concentration-Time Curve During Dosing Interval at Steady State (AUCss, Tau) of Mirikizumab | 1270 Microgram*hour/milligram(ug*hr/ml) | Geometric Coefficient of Variation 42.3 |