Efficacy and Safety of Oral BT-11 in Mild to Moderate Ulcerative Colitis

Clinical Trial ID: NCT03861143

Description

This is a phase 2 randomized, placebo-controlled, double-blind, parallel-group multicenter induction study. The purpose of this study is to evaluate the efficacy and safety of oral BT-11 induction compared to placebo in subjects with mild to moderate UC. Approximately 46 sites will participate from Europe and the USA.

A total of 195 subjects with mild to moderate UC (total Mayo Score 4-10; Mayo endoscopic subscore MES ≥ 2) will be randomized in a 1:1:1 ratio to receive BT-11 low-dose (500 mg), BT-11 high-dose (1,000 mg) or placebo. Each of the treatment arms will comprise 65 subjects. The randomization will be stratified by prior exposure to biologic therapy for UC (yes/no) and corticosteroid use at baseline (yes/no). The study consists of a 28-day screening period, a 12-week induction phase, and a 2-week posttreatment safety follow-up period.


Criteria

Inclusion Criteria: 1. . Male and female subjects aged 18 to 75 years, inclusive. 2. . Diagnosis of UC for at least 3 months prior to screening. 3. . Mild to moderate UC, as defined by a total Mayo Score of 4 to I 0 inclusive at baseline with a MES 2 (confirmed by central reader). 4. . If subjects have previously received biologic therapy for UC (i.e., tumor necrosis factor TNF antagonists, vedolizumab or ustekinumab), they must have a washout period of 8 weeks prior to randomization, and any previous failure of biologic treatment is limited to only one class of biologic. (Note: this inclusion criterion is only applicable until 58 subjects with prior exposure to biologic therapy have been randomized). 5. . If subjects are receiving the following UC treatments, they must be on a stable dose for at least I month prior to random ization: 5- aminosal icylates (5-ASAs) (not exceed i ng 4.8 g per day), oral corticosteroids (not exceeding prednison e 20 mg, budesonide 9 mg, or equivalent). 6. . If subjects are receiving bile-salt sequestrant, they must be on a stable dose for at least 3 months prior to randomization. 7. . If subjects are receiving any non-prohibited medications, they must agree to maintain stable doses of concomitant medication s for UC for the duration of the trial. 8. . Unlikely to conceive, as defined by 1 of the following: a) subject is surgically sterilized female, (b) subject is postmenopausal female 2: 45 years of age with clinical documentation of menopause (i.e., 12 months without menses), or c) matter is male or subject is woman of childbearing potential (WOCBP), and agrees to abstain from heterosexual activity, use adequate hormonal contraception, or use double barrier contraception. 9. . For WOCBP, the subject must have a negative pregnancy test at screening and within 24 hours prior to the first dose of study drug. 10. . Able to participate fully in all aspects of this clinical trial. 11. . Written informed consent must be obtained and documented. Exclusion Criteria: 1. ). A diagnosis of CD, indeterminate colitis, or presence or history of the fistula with CD. (2). Severe UC as per modified Truelove and Witts criteria (2: 6 bloody stools per day and one or more of the following: pulse > 90 bpm, temperature > 37.8°C, hemoglobin < 10.5 g/dl, or hs-CRP > 30 mg/I). (3). Disease activity limited to distal 15 cm (proctitis). (4). Treatment with an immunosuppressant (azathioprine, 6- mercaptopurine 6-MP) within 25 days prior to randomization. (5). History of toxic megacolon, abdominal abscess, symptomatic colonic stricture, or stoma; history or is at imminent risk of colectomy. (6). History or current evidence of colonic dysplasia or adenomatous colonic polyps. (7). Current bacterial or parasitic pathogenic enteric infection, including Clostridium, d difficult, known infection with hepatitis B or C virus, known infection with human immunodeficiency virus, infection requiring hospitalization or intravenous s antimicrobial therapy, or opportunistic infection within 6 months prior to screening, any infection requiring antimicrobial therapy within 2 weeks prior to screening, history of more than I episode of herpes zoster or any episode of disseminated zoster. (8). Live virus vaccination within 1 month prior to screening. (9). Treatment with cyclosporine, mycophenolate, tacrolimus, or tofacitinib within 4 weeks prior to randomization. (10). Treatment with intravenous corticosteroids, rectal corticosteroids, or rectal 5-ASA within 2 weeks prior to randomization. (11). Fecal microbiota transplantation within 1 month prior to screening. (12). A concurrent clinically significant, unstable, or uncontrolled cardiovascular, pulmonary, hepatic, renal, Gl, genitourinary, hematological, coagulation, immunological, endocrine/metabolic, or other medical disorder that, in the opinion of the investigator, might confound the study results or poses additional risk to the subject. (13). Known primary or secondary immunodeficiency. (14). History of myocardial infarction, unstable angina, transient ischemic attack, decompensated heart failure requiring hospitalization, congestive heart failure (New York Health Association NYHA Class 3 or 4), uncontrolled arrhythmias, cardiac revascularization, stroke, uncontrolled hypertension, or uncontrolled diabetes within 6 months of screening. (15). Laboratory abnormalities at screening, as determined and documented by the investigator. (16). Pregnant or lactating females. (17). Any surgical procedure anesthesia within I month prior to screening, or planned elective surgery during the study. (18). History of malignant neoplasms or carcinoma in situ within 5 years prior to screening. (19). Current or recent history of alcohol dependence or illicit drug use that in the opinion of the investigator may interfere with the subject's ability to comply with the study procedures. (20). Mental or legal incapacitation at the time of screening visit or a history of clinically significant psychiatric disorders that would impact the ability to participate in the trial according to the investigator. (21). Unable to attend study visits or comply with procedures. (22). Concurrent participation in any other interventional study. (23). Received any investigational therapy within 30 days of initiation of study drug. (24). Serious underlying disease other than UC that in the opinion of the investigator may interfere with the subject's ability to participate fully in the study. (25). Previous exposure to BT-11. (26). Prior enrollment in the current study and had received study treatment.

  • Start Date

    2019-08-14

  • Last Updated

    2020-01-03

  • Sponsor

    Landos Biopharma Inc.

  • Condition Name

    Ulcerative Colitis

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