RecruitingPhase 4

A Study of Vedolizumab With Tofacitinib in Adults With Ulcerative Colitis (UC)

An Open-Label, Phase 4, Single-Arm, Multicenter Study to Evaluate the Induction of Response and Remission of Vedolizumab Dual Targeted Therapy With Tofacitinib in Adult Patients With Moderately to Severely Active Ulcerative Colitis

Who can join

As published by the study on ClinicalTrials.gov. "Not stated" means the study hasn't said — ask the study team.

Age
18 Years to 65 Years
Sex
All sexes
Healthy volunteers
Not accepted
Compensation
Not stated

Other requirements are listed under Eligibility below. Only the study team can confirm whether you can join.

What to expect

No one can promise a trial will help you personally — that is what the research is trying to find out.

What participation involves

  • Time periods mentioned: 8 weeks, 44 weeks, 76 weeks, 26 weeks

Only what the study's summary and detailed description on ClinicalTrials.gov say. Time periods may describe the whole study or a part of it — ask the study team what applies to you.

Show the study's own words
  • "All participants will receive vedolizumab together with tofacitinib for 8 weeks and will be checked for response."
  • "All the participants will be enrolled in a single treatment group to receive dual targeted treatment with Vedolizumab and Tofacitinib for the first 8 weeks: Vedolizumab 300 mg + Tofacitinib 10 mg Only those participants who show a clinical response at Week 8 will transition to Vedolizumab monotherapy for 44 weeks."
  • "The overall duration of the study is up to 76 weeks."
  • "Participants will be followed up for 26 weeks after the last dose of the study drug for safety."
Compensation
Not stated
  • Study-related exams and procedures are typically provided at no cost. This is how many trials work in general — confirm the details for this study with the study team.
  • Participants are monitored closely by the research team throughout the study.
  • Some participants may receive access to an investigational treatment, which is still being studied.
  • Your participation helps researchers learn whether this approach could help future patients.

About this study

In plain language

This study tests vedolizumab given through a vein with tofacitinib in adults with moderate to severe ulcerative colitis (UC), which causes swelling and sores in the large bowel. Everyone gets both drugs for 8 weeks; those who improve get vedolizumab alone for 44 more weeks. Participants are followed for at least 26 weeks after their last vedolizumab dose.

The main aim of this study is to learn about the effect of treatment with vedolizumab IV (vedolizumab) together with tofacitinib in adults with moderate and severe ulcerative colitis (UC). Another aim is to learn about treatment with vedolizumab alone after the double treatment. All participants will receive vedolizumab together with tofacitinib for 8 weeks and will be checked for response. Participants who show a response to the treatment after 8 weeks will be treated with vedolizumab alone for an additional 44 weeks. Each participant will be followed up for at least 26 weeks after the last dose of vedolizumab.

Compensation is read from the study's own description and may be missing — always confirm with the study team.

Eligibility

Who can join

  • Have UC confirmed at least 3 months before screening by medical exams, a bowel scope exam, and a tissue sample.
  • Have moderate to severe active UC, with rectal bleeding and swelling seen during a bowel scope exam.
  • Have UC that reaches beyond the rectum and affects at least 15 centimeters of the large bowel.
  • Have had a colonoscopy in the past 12 months if UC has affected most or all of the large bowel for over 8 years, or the left side for over 12 years.
  • Be up to date on bowel cancer checks if older than 50 or at higher risk because of family history or other factors.
  • Have tried 1 or 2 TNF blocker drugs for UC that did not work well, stopped working, or caused side effects you could not tolerate. Stopping for other reasons may be allowed after review.
  • After an early review of study results, people whose standard UC treatments failed or caused side effects may join without having tried biologic drugs, a type of immune system treatment.
  • If taking steroid pills, keep the dose steady for at least 2 weeks before the screening bowel exam and agree to lower it as directed. Daily limits are 40 mg prednisone, 9 mg budesonide, or an equal dose of another steroid.

Who can't join

  • Have a sudden, severe UC flare; major large bowel removal; a pocket of infection in the belly; a dangerously swollen large bowel; a bowel opening through the belly; a fixed bowel narrowing causing symptoms; or short bowel syndrome.
  • Have another type of bowel inflammation, abnormal cells in the large bowel now or in the past, untreated problems absorbing bile acids, or uncontrolled disease that scars the bile ducts.
  • Have an active infection affecting the body, active CMV infection, or an intestinal infection. People with an intestinal infection may qualify after treatment confirms it has cleared.
  • Have current or past tuberculosis (TB), inactive TB, or screening results that meet the study’s TB exclusion rules; or test positive for hepatitis B or C.
  • Recently used certain immune system drugs, medicines or supplements that affect how drugs are broken down, IV antibiotics for UC, rectal UC treatments, or a live vaccine. Daily use of certain pain drugs called NSAIDs for over 2 weeks also excludes you, with some exceptions.
  • Had a stroke, heart attack, heart artery stent, or moderate to severe heart failure in the past 6 months; have a history of blood clots; or have an inherited condition that raises clot risk.
  • Have a history of lymphoma or other diseases involving too many immune cells, or signs of these diseases, such as swollen glands or an enlarged spleen.
  • Had surgery requiring medicine to make you sleep within 3 months before screening, plan major surgery during the study, or had a research procedure within 4 weeks that could affect study results.

Simplified for readability. The official criteria below are what the study team uses.

Official eligibility criteria

Inclusion Criteria: 1. Has a confirmed diagnosis of UC established at least 3 months prior to screening, by clinical and endoscopic evidence and corroborated by a histopathology report. 2. Has moderately to severely active UC as determined by a complete Mayo score \[including PGA\] of 6 to 12 with a rectal bleeding subscore ≥1 and a centrally assessed endoscopic subscore ≥2 at screening. 3. Has evidence of UC extending proximally to the rectum \[≥15 centimeter (cm) of involved colon\]. 4. Participants with extensive colitis or pancolitis of \>8 years duration or left sided colitis \>12 years duration must have documented evidence that a surveillance colonoscopy was performed within 12 months of the initial screening visit. 5. Participants with a family history of colorectal cancer, personal history of increased colorectal cancer risk, age \>50 years, or other known risk factors must be up to date on colorectal cancer surveillance. 6. Has demonstrated an inadequate response to, loss of response to, or intolerance to at least 1, but no more than 2 TNFα antagonists. Determination of inadequate response, loss of response, or intolerance is based upon investigator's clinical judgment. Participants who discontinued TNFα antagonist therapy for reasons other than failure or intolerance (eg, pregnancy) may be eligible after discussion with the medical monitor. Note: After the interim analysis, participants with inadequate response, loss of response, or intolerance to conventional UC therapy per standard of care treatment without prior exposure to biologics may be enrolled if deemed appropriate. Determination of inadequate response, loss of response, or intolerance is based upon investigator's clinical judgment. Participants who discontinued biologics for reasons other than failure or intolerance (eg, pregnancy) may be eligible after discussion with the Medical Monitor. If using corticosteroids must be on a stable dose of oral corticosteroids up to a maximum of 40 mg daily of prednisone or 9 mg daily of budesonide, or equivalent for at least 2 weeks prior to screening endoscopy and must be willing to follow a mandatory taper of corticosteroids. Exclusion Criteria: Gastrointestinal Exclusion criteria: 1. Has any of the following UC-related complications: 1. Acute severe UC. 2. The participant has had extensive colonic resection, subtotal or total colectomy. 3. The participant has clinical evidence of abdominal abscess or toxic megacolon. 4. The participant has an ileostomy, colostomy, or known fixed symptomatic stenosis of the intestine. 5. Short bowel syndrome. 2. Has Crohn's colitis, indeterminate colitis, ischemic colitis, nonsteroidal anti-inflammatory drug (NSAID) induced colitis, idiopathic colitis (i.e, colitis not consistent with UC), radiation colitis, microscopic colitis, colonic mucosal dysplasia, or untreated bile acid malabsorption. Participants with a history of colonic mucosal dysplasia are also excluded. 3. Has uncontrolled primary sclerosing cholangitis. Infectious Disease Exclusion Criteria: 1. Has any evidence of an active systemic infection during screening. Participants with nonsystemic infections (eg, active fungal infection of nail beds) may be eligible, if in the opinion of the investigator, inclusion of the participant will not interfere with the collection or interpretation of study results and poses no risk to the participant. 2. Has active or latent tuberculosis (TB), regardless of treatment history, as evidenced by any of the following: 1. History of TB. 2. A diagnostic TB test performed during screening that is positive, as defined by: i. A positive QuantiFERON test or 2 successive indeterminate QuantiFERON tests or ii. A tuberculin skin test reaction ≥10 mm (≥5 mm in participants receiving the equivalent of \>15 mg daily prednisone). 3. A positive test for hepatitis B virus (HBV). 4. A positive test for hepatitis C virus (HCV). 5. Evidence of, or treatment for, Clostridium difficile infection or other intestinal pathogen during screening. Participants who test positive for C. difficile or other intestinal pathogens at screening and receive treatment may be enrolled or rescreened (if required) following confirmation of infection resolution. 6. Evidence of active Cytomegalovirus (CMV) infection at screening. Medication exclusion criteria: 1. Has received immunomodulators (eg, 6-mercaptopurine, azathioprine, and methotrexate) within 4 weeks prior to first dose or immunosuppressants (eg, cyclosporine, tacrolimus) within 8 weeks prior to first dose. 2. Any medicinal product, herbal medication, or natural health product which might interfere with cytochrome P450 genotype 3A4 (CYP3A4) within 2 weeks prior to enrollment, except for any CYP3A4 modulator used to treat a C. difficile or an intestinal pathogen infection at screening. 3. Has received any of the following medical therapies for UC: 1. IV antibiotics within 8 weeks prior to enrollment. 2. Any rectal therapy for treatment of UC within 2 weeks prior to screening endoscopy. 3. Chronic NSAID use defined as daily use for \>2 consecutive weeks (Note: occasional use \[\<2 consecutive weeks\] of NSAIDs and acetaminophen \[\<100 mg daily\] for headache, arthritis, myalgias, or menstrual cramps and chronic low dose aspirin use \[81-162.5 mg daily\] for cardiovascular prophylaxis are permitted). 4. Has received a live vaccine within 4 weeks prior to first dose. General Exclusion Criteria: 1. Has any of the following cardiovascular or thrombotic conditions: 1. Recent (within past 6 months) cerebrovascular accident, myocardial infarction, or coronary stenting. 2. Recent (within past 6 months) moderate to severe congestive heart failure (New York Heart Association class III or IV). 3. Prior history of thrombotic events, including deep vein thrombosis and pulmonary embolism. 4. Known inherited conditions that predispose to hypercoagulability. 2. History of lymphoproliferative disease, including lymphoma, or signs and symptoms suggestive of possible lymphoproliferative disease, such as lymphadenopathy and/or splenomegaly. 3. A surgical procedure requiring general anesthesia within 3 months prior to screening or is planning to undergo major surgery during the study period. 4. Any investigational procedure ≤4 weeks prior to screening that, in the investigator's opinion, may interfere with interpretation of study results.

Study sites (37)

AL

AZ

CA

FL

GA

IL

KS

KY

LA

MD

MI

MN

MO

NC

NY

OH

PA

RI

SD

TX

UT

WA