Many patients with Crohn's disease (CD) develop fibrotic narrowing (strictures) in their bowel, causing obstructive symptoms such as abdominal pain, cramping, or vomiting after meals. Because of these symptoms, patients often require bowel resection surgery. The objective of this clinical trial is to evaluate the efficacy, safety, and dose-response relationship of ontunisertib in participants with CD and symptomatic strictures, and contribute to the validation of novel endpoints to assess potential treatment benefit in patients with fibrostenosing Crohn's disease (FSCD). The participants will be in the trial for a duration of up to 60 weeks, consisting of a 6-week screening period (with 2 screening visits), a 52-week treatment period, and a 2-week follow-up period. The visit frequency in the treatment period will be every 6 to 8 weeks.
This is a randomized, double-blind, placebo-controlled, dose-ranging, multicenter Phase 2b trial to assess the efficacy and safety of ontunisertib in participants diagnosed with FSCD. The trial population will include adults 18 years of age and older with symptomatic FSCD based on clinical, endoscopic, and radiological criteria. This trial consists of 3 periods (a screening period, a placebo-controlled, double-blind treatment period, and safety follow-up). After signing informed consent, eligibility will be assessed during a 6-week screening period. The presence of qualifying intestinal strictures will be assessed by ileocolonoscopy and magnetic resonance enterography (MRE). The presence of obstructive symptoms will also be evaluated. Eligible participants will be randomized 1:1:1:1 to receive AGMB-129 (Ontunisertib) high dose, medium dose, low dose or placebo for 52 weeks. During Screening and Weeks 24 and 52 visits, participants will undergo ileocolonoscopy with biopsy collection for exploring pharmacodynamics. Participants will have blood sample collection at Weeks 6, 12, 18, 24, 30, 36, 44 and 52 to assess safety, pharmacokinetics, and pharmacodynamics. Throughout the study, participants will undergo routine safety assessments at study visits, which will include physical examination, vital signs, clinical laboratory assessment, electrocardiogram (ECG), and recording of AEs.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
320
Oral capsule
Oral capsule
Oral capsule
Matching oral capsule
Synergy Healthcare, LLC
Bradenton, Florida, United States
RECRUITINGGI Alliance - Fort Worth
Fort Worth, Texas, United States
RECRUITINGProportion of participants achieving endoscopic passability of the ileal index stricture
To evaluate the efficacy and dose-response relationship of multiple doses of ontunisertib
Time frame: At week 24
Proportion of participants achieving endoscopic passability of the ileal index stricture
To evaluate the efficacy of ontunisertib in participants with FSCD, compared to placebo
Time frame: At week 52
Change in reliable MRE imaging features (stricture length, bowel wall thickness, prestenotic dilatation diameter) of the index stricture
To evaluate the efficacy of ontunisertib in participants with FSCD, compared to placebo
Time frame: At week 52 compared to baseline (week 1)
Change in total SES-CD (range, 0-56 points) (Reference: https://www.giejournal.org/article/S0016-5107(04)01878-4/abstract)
To evaluate the efficacy of ontunisertib in participants with FSCD, compared to placebo
Time frame: At week 52 compared to baseline
Proportion of participants with an endoscopic response (≥50% decrease in total SES-CD) and remission (SES-CD ≤4 with no item >1)
To evaluate the efficacy of ontunisertib in participants with FSCD, compared to placebo
Time frame: At week 52 compared to baseline
Change in S-PRO severity score
To evaluate the efficacy of ontunisertib in participants with FSCD, compared to placebo
Time frame: At week 52 compared to baseline
Time to an FSCD- related event
To evaluate the efficacy of ontunisertib in participants with FSCD, compared to placebo
Time frame: From baseline to week 52
Number of participants with adverse events (AEs)
To evaluate the safety and tolerability of ontunisertib in participants with FSCD, compared to placebo
Time frame: From baseline to week 52
Number of participants with abnormal clinical laboratory tests
To evaluate the safety and tolerability of ontunisertib in participants with FSCD, compared to placebo
Time frame: From baseline to week 52
Number of participants with abnormal ECG parameters
To evaluate the safety and tolerability of ontunisertib in participants with FSCD, compared to placebo
Time frame: From baseline to week 52
Number of participants with abnormal vital signs
To evaluate the safety and tolerability of ontunisertib in participants with FSCD, compared to placebo
Time frame: From baseline to week 52
Number of participants with abnormal physical examinations
To evaluate the safety and tolerability of ontunisertib in participants with FSCD, compared to placebo
Time frame: From baseline to week 52
Plasma level concentration of ontunisertib and metabolites
To evaluate the PK (AUC) of ontunisertib in participants with FSCD
Time frame: From baseline to week 52
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