A Study of the Efficacy and Safety of Guselkumab in Participants With Moderately to Severely Active Crohn's Disease (GALAXI)
Sponsor: Janssen
Purpose of this study?
The purpose of the study is to evaluate the clinical efficacy (GALAXI 1), clinical and endoscopic efficacy (GALAXI 2 and GALAXI 3) and safety of guselkumab in participants with Crohn's disease.
Inclusion Criteria:
• ≥18 years of age at screening
- Have Crohn's disease (CD) or fistulizing Crohn's disease of at least 3 months duration (defined as a minimum of 12 weeks), with colitis, ileitis, or ileocolitis, confirmed at any time in the past by radiography, histology, and/or endoscopy
- Have moderate to severe CD as assessed by CDAI, stool frequency (SF), and abdominal pain (AP) scores, and Simple Endoscopic Score for Crohn's Disease (SES-CD)
- Have screening laboratory test results within the protocol specified parameters
- A female participant of childbearing potential must have a negative urine pregnancy test result at screening and baseline
- Demonstrated intolerance or inadequate response to conventional or to biologic therapy for CD
Exclusion Criteria:
- Current diagnosis of ulcerative colitis or indeterminate colitis
- Has complications of Crohn's disease, such as symptomatic strictures or stenoses, short gut syndrome, or any other manifestation
- Unstable doses of concomitant Crohn's disease therapy
- Receipt of Crohn's disease approved biologic agents, investigational agents, or procedures outside of permitted timeframe as specified in the protocol
- Prior exposure to p40 inhibitors or p19 inhibitors
- Any medical contraindications preventing study participation
Primary outcome measures:
- Phase 2: Change from Baseline in the Crohn's Disease Activity Index (CDAI) Score at Week 12 [ Time Frame: Baseline and Week 12 ]
The CDAI score will be assessed by collecting information on 8 different Crohn's
disease-related variables, with scores ranging from 0 to approximately 600. A
decrease over time indicates improvement in disease activity.
2. Phase 3: Clinical Remission at Week 12 [ Time Frame: Week 12 ]
Clinical remission is defined as CDAI score less than (<) 150 points.
3. Phase 3: Endoscopic Response at Week 12 [ Time Frame: Week 12 ]
Endoscopic Response is measured by the Simple Endoscopic Score for Crohn's Disease (SES-CD). The SES-CD is based on the evaluation of 4 endoscopic components across 5 ileocolonic segments, with a total score ranging from 0 to 56.
Secondary outcome measures:
- Phase 2: Clinical Remission at Week 12 [ Time Frame: Week 12 ]
Clinical remission is defined as CDAI score <150.
2. Phase 2: Clinical Response at Week 12 [ Time Frame: Week 12 ]
Clinical response is defined as greater than or equal to (>=) 100-point reduction from baseline in CDAI score or CDAI score <150.
3. Phase 2 and Phase 3: Patient-Reported Outcome (PRO)-2 Remission at Week 12
[Time Frame: Week 12 ]
PRO-2 remission is defined based on average daily stool frequency (SF), average daily
abdominal pain (AP) score and no worsening of AP or SF from baseline.
4. Phase 2: Clinical-Biomarker Response at Week 12 [ Time Frame: Week 12 ]
Clinical-biomarker response is defined using clinical response based on the CDAI score and reduction from baseline in C-reactive protein (CRP) or fecal calprotectin.
5. Phase 2: Endoscopic Response at Week 12 [ Time Frame: Week 12 ]
Endoscopic Response is measured by the SES-CD. The SES-CD is based on the
evaluation of 4 endoscopic components across 5 ileocolonic segments, with a total
score ranging from 0 to 56.
6. Phase 3: Clinical Remission at Week 48 [ Time Frame: Week 48 ]
Clinical remission is defined as CDAI score <150.
7. Phase 3: Endoscopic Response at Week 48 [ Time Frame: Week 48 ]
Endoscopic Response is measured by the SES-CD. The SES-CD is based on the
evaluation of 4 endoscopic components across 5 ileocolonic segments, with a total
score ranging from 0 to 56.
8. Phase 3: Durable Clinical Remission at Week 48 [ Time Frame: Week 48 ]
Durable clinical remission is defined as CDAI<150 for most of all visits between Week
12 and Week 48.
9. Phase 3: Corticosteroid-Free Clinical Remission at Week 48 [ Time Frame: Week 48 ]
Corticosteroid-free clinical remission is defined as CDAI score <150 at Week 48 and
not receiving corticosteroids at Week 48.
10. Phase 3: PRO-2 Remission at Week 48 [ Time Frame: Week 48 ]
PRO-2 remission is defined based on average daily stool frequency (SF) and average
daily abdominal pain (AP) score.
11. Phase 3: Endoscopic Remission at Week 12 [ Time Frame: Week 12 ]
Endoscopic remission is defined as SES-CD score <=2.
12. Phase 3: Endoscopic Remission at Week 48 [ Time Frame: Week 48 ]
Endoscopic remission is defined as SES-CD score <=2.
13. Phase 3: Fatigue Response at Week 12 [ Time Frame: Week 12 ]
Fatigue response will be based on the Patient-Reported Outcomes Measurement
Information System (PROMIS). Fatigue Short Form 7a contains 7 items that evaluate
the severity of fatigue, with higher scores indicating greater fatigue.
Study Locations in Europe:
Austria, Belarus, Belgium, Bosnia-Herzegovina, Croatia, Czech Republic, France, Georgia, Germany, Greece, Hungary, Italy, Latvia, Lithuania, Netherlands, Poland, Portugal, Russian Federation, Serbia, Slovakia, Spain, Ukraine, United Kingdom
Estimated Study Completion Date: December 31, 2024
Further information on clinicaltrial.gov with trial number NCT03466411