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Etrasimod Dose-Ranging Versus Placebo as Induction Therapy Study in Adult Japanese Subjects With Moderately to Severely Active Ulcerative Colitis

A Phase 2, Randomized, Double-Blind, Placebo-Controlled, 12-Week Dose-Ranging Study to Assess the Efficacy and Safety of Etrasimod in Japanese Participants With Moderately to Severely Active Ulcerative Colitis

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05061446
Enrollment
54
Registered
2021-09-29
Start date
2021-09-10
Completion date
2023-10-06
Last updated
2024-10-29

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

Conditions

Ulcerative Colitis

Keywords

Ulcerative Colitis, APD334, Etrasimod

Brief summary

The purpose of this Japan-only study is to assess the safety and efficacy of etrasimod at 2 doses in Japanese subjects with moderately to severely active ulcerative colitis (UC) when administered for 12 weeks.

Interventions

DRUGEtrasimod

Etrasimod tablet by mouth, once daily for 12 weeks

DRUGPlacebo

Etrasimod matching placebo tablet by mouth, once daily up to 12 weeks

Sponsors

Arena is a wholly owned subsidiary of Pfizer
CollaboratorINDUSTRY
Pfizer
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No

Inclusion criteria

* Japanese ancestry * Diagnosed with ulcerative colitis (UC) ≥ 3 months prior to screening * Having active UC confirmed by endoscopy * Moderately to severely active UC

Exclusion criteria

* Severe extensive colitis * Diagnosis of Crohn's disease (CD) or indeterminate colitis or the presence, history of a fistula consistent with CD * Diagnosis of microscopic colitis, ischemic colitis, or infectious colitis

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants Who Achieved Clinical Remission at Week 12Week 12Clinical remission:Participants with stool frequency (SF)subscore=0(or of 1 with greater than or equal to(\>=)1 point decrease from baseline,rectal bleeding(RB)subscore=0 and endoscopic score(ES)less than or equal to(\<)=1(excluding friability).SF subscore:number of stools in 24-hours relative to normal number of stools for that participant in same period,score ranged from 0(normal number of stools) to 3(5 or more stools than normal),higher scores=more severity.RB subscore:most severe amount of blood passed per rectum in 24-hours,score ranged from 0(no blood seen)to 3(blood alone passes),higher scores=more severity.ES:reported worst appearance of mucosa on flexible sigmoidoscopy or colonoscopy,score ranged from 0(normal or inactive disease) to 3(severe disease \[spontaneous bleeding,ulceration\]),higher scores=more severity.Modified Mayo score:measure disease activity for UC,score:0(normal) to 9(maximum severity),comprised subscores for SF,RB,ES.higher score=more severe disease activity.

Secondary

MeasureTime frameDescription
Percentage of Participants Who Achieved Endoscopic Improvement at Week 12Week 12Endoscopic improvement was defined as ES \<= 1 (excluding friability). ES reported worst appearance of mucosa on flexible sigmoidoscopy or colonoscopy, score ranged from 0 (normal or inactive disease) to 3 (severe disease \[spontaneous bleeding, ulceration\]), higher scores = more severity. Modified Mayo score (MMS): measure disease activity for UC, score: 0 (normal) to 9 (maximum severity),and comprised the subscores for SF, RB, ES. Higher score = more severe disease activity.
Percentage of Participants Who Achieved Symptomatic Remission at Week 12Week 12Symptomatic remission was defined as SF sub score = 0 (or = 1 with a \>= 1 point decrease from baseline) and RB sub score = 0. SF subscore: reported number of stools in a 24-hour period relative to normal number of stools for that participant in the same period, score ranged from 0 (normal number of stools) to 3 (5 or more stools than normal), higher scores = more severity. RB subscore: reported the most severe amount of blood passed per rectum in a 24-hour period, score ranged from 0 (no blood seen) to 3 (blood alone passes), higher scores = more severity. MMS: measure disease activity for UC, score: 0 (normal) to 9 (maximum severity), and comprised the subscores for SF, RB, ES. Higher score = more severe disease activity.
Percentage of Participants Who Achieved Clinical Response at Week 12Week 12Clinical response was defined as a \>= 2-point and \>= 30 percentage (%) decrease from baseline in MMS, and a \>= 1-point decrease from baseline in RB subscore or an absolute RB subscore \<= 1. MMS: measure disease activity for UC, score: 0 (normal) to 9 (maximum severity), and comprised the subscores for SF, RB, ES. Higher score = more severe disease activity. RB subscore: reported the most severe amount of blood passed per rectum in a 24-hour period, score ranged from 0 (no blood seen) to 3 (blood alone passes), higher scores = more severity.
Percentage of Participants Who Achieved Endoscopic Normalization at Week 12Week 12Endoscopic normalization was defined as ES= 0. ES reported worst appearance of mucosa on flexible sigmoidoscopy or colonoscopy, score ranged from 0 (normal or inactive disease) to 3 (severe disease \[spontaneous bleeding, ulceration\]), higher scores = more severity. MMS: measure disease activity for UC, score: 0 (normal) to 9 (maximum severity), and comprised the subscores for SF, RB, ES. Higher score = more severe disease activity.
Percentage of Participants Who Achieved Mucosal Healing at Week 12Week 12Mucosal healing was defined as ES \<= 1 (excluding friability) with histologic remission defined as a Geboes index score \< 2.0). ES reported worst appearance of mucosa on flexible sigmoidoscopy or colonoscopy, score ranged from 0 (normal or inactive disease) to 3 (severe disease \[spontaneous bleeding, ulceration\]), higher scores = more severity. The Geboes score grading system, was a validated score for evaluating histologic disease activity in UC as follows: grade 0 = structural and architectural changes; grade 1 = chronic inflammatory infiltrate; grade 2 = lamina propria neutrophils and eosinophils; grade 3 = neutrophils in the epithelium; grade 4 = crypt destruction; grade 5 = erosions or ulceration. A higher Geboes score indicated more severe disease. Modified Mayo score (MMS): measure disease activity for UC, score: 0 (normal) to 9 (maximum severity), comprised subscores for SF, RB, ES. Higher score = more severe disease activity.

Other

MeasureTime frameDescription
Number of Participants With Adverse Events According to SeverityDay 1 of first dose of study treatment up to 4 weeks after administration of the final dose of study treatment (maximum up to 16 weeks)An adverse event was any untoward medical occurrence in a participant or clinical investigational participant administered a medicinal product and which does not necessarily have a causal relationship with this treatment. An adverse event was therefore any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. Severity was classified using common terminology criteria for adverse events (CTCAE), version 5.0, such as Grade 1 for mild, Grade 2 for moderate, Grade 3 for severe, Grade 4 for life-threatening, Grade 5 for death related to adverse event.

Countries

Japan

Participant flow

Recruitment details

A total of 54 Japanese participants with moderate to severely active ulcerative colitis (UC) were enrolled in the study.

Participants by arm

ArmCount
Placebo
Participants received placebo matched to etrasimod once daily, orally for 12 weeks.
18
Etrasimod 1 mg
Participants received etrasimod 1 milligram (mg) tablets once daily, orally for 12 weeks.
17
Etrasimod 2 mg
Participants received etrasimod 2 mg tablets once daily, orally for 12 weeks.
19
Total54

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyAdverse Event200
Overall StudyParticipant no longer available due to personal reason010

Baseline characteristics

CharacteristicTotalPlaceboEtrasimod 1 mgEtrasimod 2 mg
Age, Continuous43.3 Years
STANDARD_DEVIATION 12.45
38.5 Years
STANDARD_DEVIATION 9.28
41.6 Years
STANDARD_DEVIATION 14.04
49.5 Years
STANDARD_DEVIATION 11.55
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
54 Participants18 Participants17 Participants19 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
54 Participants18 Participants17 Participants19 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
0 Participants0 Participants0 Participants0 Participants
Sex: Female, Male
Female
19 Participants5 Participants6 Participants8 Participants
Sex: Female, Male
Male
35 Participants13 Participants11 Participants11 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
0 / 180 / 170 / 19
other
Total, other adverse events
10 / 189 / 1713 / 19
serious
Total, serious adverse events
0 / 180 / 170 / 19

Outcome results

Primary

Percentage of Participants Who Achieved Clinical Remission at Week 12

Clinical remission:Participants with stool frequency (SF)subscore=0(or of 1 with greater than or equal to(\>=)1 point decrease from baseline,rectal bleeding(RB)subscore=0 and endoscopic score(ES)less than or equal to(\<)=1(excluding friability).SF subscore:number of stools in 24-hours relative to normal number of stools for that participant in same period,score ranged from 0(normal number of stools) to 3(5 or more stools than normal),higher scores=more severity.RB subscore:most severe amount of blood passed per rectum in 24-hours,score ranged from 0(no blood seen)to 3(blood alone passes),higher scores=more severity.ES:reported worst appearance of mucosa on flexible sigmoidoscopy or colonoscopy,score ranged from 0(normal or inactive disease) to 3(severe disease \[spontaneous bleeding,ulceration\]),higher scores=more severity.Modified Mayo score:measure disease activity for UC,score:0(normal) to 9(maximum severity),comprised subscores for SF,RB,ES.higher score=more severe disease activity.

Time frame: Week 12

Population: FAS consisted of all randomized participants who received at least 1 dose of study treatment. Here, number of participants analyzed signifies only those participants who had a baseline MMS score between 5 and 9.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieved Clinical Remission at Week 120 Percentage of participants
Etrasimod 1 mgPercentage of Participants Who Achieved Clinical Remission at Week 126.7 Percentage of participants
Etrasimod 2 mgPercentage of Participants Who Achieved Clinical Remission at Week 1226.3 Percentage of participants
95% CI: [-5.96, 19.29]
95% CI: [6.52, 46.12]
Secondary

Percentage of Participants Who Achieved Clinical Response at Week 12

Clinical response was defined as a \>= 2-point and \>= 30 percentage (%) decrease from baseline in MMS, and a \>= 1-point decrease from baseline in RB subscore or an absolute RB subscore \<= 1. MMS: measure disease activity for UC, score: 0 (normal) to 9 (maximum severity), and comprised the subscores for SF, RB, ES. Higher score = more severe disease activity. RB subscore: reported the most severe amount of blood passed per rectum in a 24-hour period, score ranged from 0 (no blood seen) to 3 (blood alone passes), higher scores = more severity.

Time frame: Week 12

Population: FAS consisted of all randomized participants who received at least 1 dose of study treatment. Here, number of participants analyzed signifies only those participants who had a baseline MMS score between 5 and 9.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieved Clinical Response at Week 127.1 Percentage of participants
Etrasimod 1 mgPercentage of Participants Who Achieved Clinical Response at Week 1233.3 Percentage of participants
Etrasimod 2 mgPercentage of Participants Who Achieved Clinical Response at Week 1252.6 Percentage of participants
95% CI: [-1.22, 53.6]
95% CI: [19.3, 71.68]
Secondary

Percentage of Participants Who Achieved Endoscopic Improvement at Week 12

Endoscopic improvement was defined as ES \<= 1 (excluding friability). ES reported worst appearance of mucosa on flexible sigmoidoscopy or colonoscopy, score ranged from 0 (normal or inactive disease) to 3 (severe disease \[spontaneous bleeding, ulceration\]), higher scores = more severity. Modified Mayo score (MMS): measure disease activity for UC, score: 0 (normal) to 9 (maximum severity),and comprised the subscores for SF, RB, ES. Higher score = more severe disease activity.

Time frame: Week 12

Population: FAS consisted of all randomized participants who received at least 1 dose of study treatment. Here, number of participants analyzed signifies only those participants who had a baseline MMS score between 5 and 9.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieved Endoscopic Improvement at Week 120 Percentage of participants
Etrasimod 1 mgPercentage of Participants Who Achieved Endoscopic Improvement at Week 126.7 Percentage of participants
Etrasimod 2 mgPercentage of Participants Who Achieved Endoscopic Improvement at Week 1226.3 Percentage of participants
95% CI: [-5.96, 19.29]
95% CI: [6.52, 46.12]
Secondary

Percentage of Participants Who Achieved Endoscopic Normalization at Week 12

Endoscopic normalization was defined as ES= 0. ES reported worst appearance of mucosa on flexible sigmoidoscopy or colonoscopy, score ranged from 0 (normal or inactive disease) to 3 (severe disease \[spontaneous bleeding, ulceration\]), higher scores = more severity. MMS: measure disease activity for UC, score: 0 (normal) to 9 (maximum severity), and comprised the subscores for SF, RB, ES. Higher score = more severe disease activity.

Time frame: Week 12

Population: FAS consisted of all randomized participants who received at least 1 dose of study treatment. Here, number of participants analyzed signifies only those participants who had a baseline MMS score between 5 and 9.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieved Endoscopic Normalization at Week 120 Percentage of participants
Etrasimod 1 mgPercentage of Participants Who Achieved Endoscopic Normalization at Week 120 Percentage of participants
Etrasimod 2 mgPercentage of Participants Who Achieved Endoscopic Normalization at Week 120 Percentage of participants
Secondary

Percentage of Participants Who Achieved Mucosal Healing at Week 12

Mucosal healing was defined as ES \<= 1 (excluding friability) with histologic remission defined as a Geboes index score \< 2.0). ES reported worst appearance of mucosa on flexible sigmoidoscopy or colonoscopy, score ranged from 0 (normal or inactive disease) to 3 (severe disease \[spontaneous bleeding, ulceration\]), higher scores = more severity. The Geboes score grading system, was a validated score for evaluating histologic disease activity in UC as follows: grade 0 = structural and architectural changes; grade 1 = chronic inflammatory infiltrate; grade 2 = lamina propria neutrophils and eosinophils; grade 3 = neutrophils in the epithelium; grade 4 = crypt destruction; grade 5 = erosions or ulceration. A higher Geboes score indicated more severe disease. Modified Mayo score (MMS): measure disease activity for UC, score: 0 (normal) to 9 (maximum severity), comprised subscores for SF, RB, ES. Higher score = more severe disease activity.

Time frame: Week 12

Population: FAS consisted of all randomized participants who received at least 1 dose of study treatment. Here, number of participants analyzed signifies only those participants who had a baseline MMS score between 5 and 9.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieved Mucosal Healing at Week 120 Percentage of participants
Etrasimod 1 mgPercentage of Participants Who Achieved Mucosal Healing at Week 126.7 Percentage of participants
Etrasimod 2 mgPercentage of Participants Who Achieved Mucosal Healing at Week 125.3 Percentage of participants
95% CI: [-5.96, 19.29]
95% CI: [-4.78, 15.3]
Secondary

Percentage of Participants Who Achieved Symptomatic Remission at Week 12

Symptomatic remission was defined as SF sub score = 0 (or = 1 with a \>= 1 point decrease from baseline) and RB sub score = 0. SF subscore: reported number of stools in a 24-hour period relative to normal number of stools for that participant in the same period, score ranged from 0 (normal number of stools) to 3 (5 or more stools than normal), higher scores = more severity. RB subscore: reported the most severe amount of blood passed per rectum in a 24-hour period, score ranged from 0 (no blood seen) to 3 (blood alone passes), higher scores = more severity. MMS: measure disease activity for UC, score: 0 (normal) to 9 (maximum severity), and comprised the subscores for SF, RB, ES. Higher score = more severe disease activity.

Time frame: Week 12

Population: FAS consisted of all randomized participants who received at least 1 dose of study treatment. Here, number of participants analyzed signifies only those participants who had a baseline MMS score between 5 and 9.

ArmMeasureValue (NUMBER)
PlaceboPercentage of Participants Who Achieved Symptomatic Remission at Week 120 Percentage of participants
Etrasimod 1 mgPercentage of Participants Who Achieved Symptomatic Remission at Week 1220.0 Percentage of participants
Etrasimod 2 mgPercentage of Participants Who Achieved Symptomatic Remission at Week 1231.6 Percentage of participants
95% CI: [-0.24, 40.24]
95% CI: [10.68, 52.48]
Other Pre-specified

Number of Participants With Adverse Events According to Severity

An adverse event was any untoward medical occurrence in a participant or clinical investigational participant administered a medicinal product and which does not necessarily have a causal relationship with this treatment. An adverse event was therefore any unfavorable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product, whether or not considered related to the medicinal product. Severity was classified using common terminology criteria for adverse events (CTCAE), version 5.0, such as Grade 1 for mild, Grade 2 for moderate, Grade 3 for severe, Grade 4 for life-threatening, Grade 5 for death related to adverse event.

Time frame: Day 1 of first dose of study treatment up to 4 weeks after administration of the final dose of study treatment (maximum up to 16 weeks)

Population: The safety set included all randomized participants who received at least 1 dose of study treatment.

ArmMeasureGroupValue (COUNT_OF_PARTICIPANTS)
PlaceboNumber of Participants With Adverse Events According to SeverityGrade 40 Participants
PlaceboNumber of Participants With Adverse Events According to SeverityGrade 30 Participants
PlaceboNumber of Participants With Adverse Events According to SeverityGrade15 Participants
PlaceboNumber of Participants With Adverse Events According to SeverityGrade 25 Participants
PlaceboNumber of Participants With Adverse Events According to SeverityGrade 50 Participants
Etrasimod 1 mgNumber of Participants With Adverse Events According to SeverityGrade 30 Participants
Etrasimod 1 mgNumber of Participants With Adverse Events According to SeverityGrade16 Participants
Etrasimod 1 mgNumber of Participants With Adverse Events According to SeverityGrade 23 Participants
Etrasimod 1 mgNumber of Participants With Adverse Events According to SeverityGrade 40 Participants
Etrasimod 1 mgNumber of Participants With Adverse Events According to SeverityGrade 50 Participants
Etrasimod 2 mgNumber of Participants With Adverse Events According to SeverityGrade 50 Participants
Etrasimod 2 mgNumber of Participants With Adverse Events According to SeverityGrade 40 Participants
Etrasimod 2 mgNumber of Participants With Adverse Events According to SeverityGrade111 Participants
Etrasimod 2 mgNumber of Participants With Adverse Events According to SeverityGrade 30 Participants
Etrasimod 2 mgNumber of Participants With Adverse Events According to SeverityGrade 22 Participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026