GSK1605786 is an oral antagonist specific for the chemokine receptor CCR9 in development for treatment of small bowel and colonic Crohn's disease (CD). The purpose of this Phase II proof of concept study is to investigate the efficacy and safety of GSK1605786 (500 mg twice daily) administered orally for 16 weeks for the treatment of patients with active ulcerative colitis (UC). A key secondary objective is to understand the mechanism by which GSK1605786 is acting and to this end samples will be collected to confirm the degree of inhibition of CCR9 on T lymphocytes in the blood of patients, and to explore the relationship between concentration of drug and changes in lymphocyte and antigen presenting cell populations in the peripheral circulation and in the colon. Patients recruited at specified investigational sites will be invited to participate in an optional sub-study to explore the effects of GSK1605786 on trafficking of technetium labelled T cells using Single Photon Emission Computerized Tomography (SPECT). Specifically, the technique will be used to follow trafficking to large intestine and thymus and findings linked to pharmacokinetics of GSK1605786, receptor occupancy and clinical efficacy outcomes
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
500 mg twice daily administered orally
500 mg twice daily administered orally
GSK Investigational Site
Leuven, Belgium
GSK Investigational Site
Amsterdam, Netherlands
GSK Investigational Site
Cambridge, Cambridgeshire, United Kingdom
GSK Investigational Site
Southampton, Hampshire, United Kingdom
GSK Investigational Site
Oxford, Oxfordshire, United Kingdom
Efficacy of GSK1605786 at week 12 following twice daily administration at 500 mg in patients with active UC.
Ordinal response (remission, response, or no response) to treatment as assessed by the MAYO score at week 12.
Time frame: 12 weeks
safety and tolerability of GSK1605786 in patients with active UC following repeat dosing continued for up to 16 weeks
Adverse events (AEs), Treatment effects on blood pressure, heart rate, electrocardiography (ECG) parameters and haematology, clinical chemistry and urinalysis findings
Time frame: 16 weeks
The time course of the efficacy of GSK1605786
Incidence of remission (MAYO score ≤ 2 with no individual subscale exceeding 1) at Week 12, incidence of response (MAYO score decreased for ≥ 3 points in comparison with baseline) at Week 12, change in partial MAYO score compared to baseline through week 16, change in SCCAI score compared to baseline through week 16, incidence of endoscopic remission (mucosal healing) rate at Week 12 (defined as proportion of patients with endoscopy score of 0 or 1 on the MAYO endoscopic sub-scale) and time to withdrawal and/or use of rescue medication
Time frame: 16 Weeks
The anti-inflammatory activity of GSK1605786 in patients with active UC
Circulating soluble biomarkers (CRP, CXL10), faecal calprotectin levels, receptor occupancy (CCR9 internalization).
Time frame: 16 Weeks
The effects of GSK1605786 on quality of life in patients with UC
Quality of Life (IBDQ) Questionnaire.
Time frame: Baseline, week 12, week 16
The systemic pharmacokinetics (PK) of GSK1605786 following twice daily administration at 500 mg in patients with active UC.
The maximum observed concentration (Cmax) on Day 28; Trough concentration (Cτ) on Day 28; Plasma clearance and volume of distribution estimated based on population pharmacokinetic analysis of healthy volunteers (historical data) and patient data, if possible
Time frame: DaysBaseline, week 4, week 8, week 12, week 16
CCR9 occupancy (RO) in peripheral blood
TECK/CCL25 and CCR9 expression in colon biopsy at baseline and at 12 weeks
Time frame: 12 Weeks
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