A Phase 3 interventional study of 25 mg Ontamalimab and 75 mg Ontamalimab in Crohn's Disease and Ulcerative Colitis, sponsored by Shire. Completed at 419 sites in 37 countries. Open to participants aged 16 Years to 80 Years. Per ClinicalTrials.gov, last updated 2024-06-21.
Sponsored by Shire · Phase 3, Interventional, and Treatment
The purpose of this study is to evaluate the safety and tolerability of long-term treatment with ontamalimab in participants with moderate to severe Ulcerative Colitis (UC) or Crohn's disease (CD)
Participants with Ulcerative Colitis (UC):
Participants must have been enrolled previously in study SHP647-301 (NCT03259334), SHP647-302 (NCT03259308), and are in the treatment period of Study SHP647-303, completed the early termination (ET) or Week 52 visit in maintenance study SHP647-303 (NCT03290781), had responded to ontamalimab treatment (in the induction and/or maintenance studies), and meet one of the following criteria:
a. Participants are on placebo at the maintenance study ET or Week 52 visit: they received ontamalimab in the induction studies and fulfilled the maintenance study response criteria, OR b. Participants have received ontamalimab at the maintenance study ET or Week 52 visit: i) Clinical composite score that has decreased by >or=2 points and >or=30%, with an accompanying decrease in the subscore for RB >or=1 point or a subscore for RB \<or=1, compared to the baseline value for induction studies, and/or ii) Composite score that has decreased by >or=30% and >or=3 points compared to the baseline value for induction studies.
Participants with Crohn's Disease:
Participants must have been enrolled previously in Study SHP647-305 (NCT03559517) or SHP647-306 (NCT03566823) and are in the treament period of Study SHP647-307 (NCT03627091), completed the ET or Week 52 visit in maintenance study SHP647-307, had responded to ontamalimab treatment (in the induction or maintenance studies) and meet one of the following criteria:
i) CDAI score that has decreased by >or=100 points at EOT visit compared to the baseline value for induction studies, and/or ii) SES-CD that has decreased by >or=25% compared to the baseline value for induction studies.
Exclusion Criteria:
Participants with UC:
Participants with Crohn's Disease:
Participants received 25 milligrams (mg) of ontamalimab solution for injection subcutaneously (SC), every 4 weeks (Q4W), for up to 3 years.
Drug: 25 mg Ontamalimab
Participants received 25 mg of ontamalimab solution for injection SC, Q4W, and later progressed to receive 75 mg in a similar manner for up to 5.79 years.
Drug: 25 mg Ontamalimab · Drug: 75 mg Ontamalimab
Participants received 75 mg of ontamalimab solution for injection SC, Q4W, for up to 5.79 years.
Drug: 75 mg Ontamalimab
Participants received 25 mg of ontamalimab solution for injection SC, Q4W, for up to 3 years.
Drug: 25 mg Ontamalimab
Participants received 25 mg of ontamalimab solution for injection SC, Q4W, and later progressed to receive 75 mg in a similar manner for up to 5.79 years.
Drug: 25 mg Ontamalimab · Drug: 75 mg Ontamalimab
Participants received 75 mg of ontamalimab solution for injection SC, Q4W, for up to 5.79 years.
Drug: 75 mg Ontamalimab
Ontamalimab SC solution for injection
Also known as: PF-00547659, SHP647
Ontamalimab SC solution for injection
Also known as: SHP647, PF-00547659
Number of Participants With Treatment Emergent Adverse Events (TEAEs)
An adverse event (AE) was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. Treatment-emergent AEs (TEAEs) were defined as AEs with start dates or worsening dates at the time of or following the first exposure to investigational product.
Time frame: From first dose of study drug up to end of study [EOS] (up to 5.79 years)
Number of Participants With Serious Infections
Serious infections were defined as any infections that were life-threatening or those requiring hospitalization or intravenous antibiotics based on the investigator's assessment.
Time frame: From first dose of study drug up to EOS (up to 5.79 years)
Number of Participants With Notable Changes in Clinical Laboratory Parameters Over Time
Clinical laboratory assessments included hematology, serum chemistry and urinalysis. Any notable changes in the clinical laboratory value over time based on the investigator interpretation were reported.
Time frame: From first dose of study drug up to EOS (up to 5.79 years)
Number of Participants With Discernible Changes in Electrocardiogram (ECG) Over Time
ECG included heart rhythm, heart rate, QRS intervals, QT intervals, RR intervals and corrected QT (QTc) intervals parameters measurement. Any discernible changes in the ECG value over time based on investigator interpretation were reported.
Time frame: From first dose of study drug up to EOS (up to 5.79 years)
Number of Participants With Discernible Changes in Vital Signs Over Time
Vital sign assessments included blood pressure, pulse, respiratory rate, and temperature. Any discernible changes in vital signs over time per investigator interpretation were reported.
Time frame: From first dose of study drug up to EOS (up to 5.79 years)
Number of Participants With Ulcerative Colitis With Treatment Response Over Time
Treatment response over time was defined as clinical composite score that has decreased by greater than or equal to (≥2) points and ≥30 percentage (%), with an accompanying decrease in the sub score for rectal bleeding (RB) ≥1 point or a subscore for RB ≤ 1, and/or composite score that has decreased by ≥30% and ≥3 points compared to the baseline value for induction studies. The clinical composite score is a measure consisting of sub scores RB (0-3) plus stool frequency (0-3) with higher scores indicating more severe disease. With the implementation of amendment 4 of the protocol the study became a single arm study with all participants receiving the 75 mg dose of ontamalimab. Hence, only those UC participants who were receiving the 75 mg dose of ontamalimab every 4 weeks and participating in amendment 4 of the protocol were analyzed in this outcome measure.
Time frame: Up to 5.79 years
Number of Participants With Crohn's Disease With Treatment Response Over Time
Treatment response over time=Crohn's Disease Activity Index(CDAI)score that has decreased ≥100 points and/or simple endoscopic score for Crohn's disease(SES-CD)that has decreased by ≥25%,both compared to baseline value for induction studies.SES-CD is simple scoring system with 4 endoscopic variables measured in same 5 ileocolonic segments as CD index of severity. Overall values on SES-CD range from 0-56,higher values=more severe disease.4 endoscopic variables are scored from 0-3 in each bowel segment:ileum,right/transverse/left colon,rectum. Presence \& size of ulcers(none=0;diameter 0.1-0.5centimeter(cm)=1;0.5-2cm=2;\>2cm=3);extent of ulcerated surface(none=0;\<10%=1;10%-30%=2; \>30%= 3);extent of affected surface(none=0;\<50%=1;50%-75%=2;\>75%=3);Presence \& type of narrowing (none=0;single can be passed=1;multiple can be passed=2;cannot be passed=3).
Time frame: Up to 5.79 years
Participants took part in the study at 225 investigative sites in 33 countries from 27 February 2018 to 13 December 2023.
| Milestone | UC: Ontamalimab 25 mg | UC: Ontamalimab 25 mg Then 75 mg | UC: Ontamalimab 75 mg | CD: Ontamalimab 25 mg | CD: Ontamalimab 25 mg Then 75 mg | CD: Ontamalimab 75 mg |
|---|---|---|---|---|---|---|
| Started | 89 | 159 | 268 | 5 | 10 | 26 |
| Completed | 0 | 117 | 129 | 0 | 6 | 12 |
| Not completed | 89 | 42 | 139 | 5 | 4 | 14 |
| Withdrew: Adverse event | 18 | 3 | 13 | 0 | 0 | 5 |
| Withdrew: Death | 0 | 0 | 3 | 1 | 0 | 0 |
| Withdrew: Withdrawal by subject | 42 | 21 | 66 | 3 | 3 | 5 |
| Withdrew: Physician decision | 14 | 8 | 19 | 0 | 0 | 2 |
| Withdrew: Site terminated by sponsor | 1 | 0 | 3 | 0 | 0 | 0 |
| Withdrew: Lost to follow-up | 2 | 0 | 2 | 0 | 0 | 1 |
| Withdrew: Pregnancy | 0 | 0 | 1 | 0 | 0 | 0 |
| Withdrew: Lack of efficacy | 12 | 6 | 24 | 1 | 1 | 0 |
| Withdrew: Reason not specified | 0 | 4 | 8 | 0 | 0 | 1 |
An adverse event (AE) was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship. Treatment-emergent AEs (TEAEs) were defined as AEs with start dates or worsening dates at the time of or following the first exposure to investigational product.
| Participants | UC: Ontamalimab 25 mg | UC: Ontamalimab 25 mg Then 75 mg | UC: Ontamalimab 75 mg | CD: Ontamalimab 25 mg | CD: Ontamalimab 25 mg Then 75 mg | CD: Ontamalimab 75 mg |
|---|---|---|---|---|---|---|
| Number of Participants With Treatment Emergent Adverse Events (TEAEs) | 67 | 122 | 203 | 4 | 8 | 17 |
Serious infections were defined as any infections that were life-threatening or those requiring hospitalization or intravenous antibiotics based on the investigator's assessment.
| Participants | UC: Ontamalimab 25 mg | UC: Ontamalimab 25 mg Then 75 mg | UC: Ontamalimab 75 mg | CD: Ontamalimab 25 mg | CD: Ontamalimab 25 mg Then 75 mg | CD: Ontamalimab 75 mg |
|---|---|---|---|---|---|---|
| Number of Participants With Serious Infections | 5 | 4 | 17 | 0 | 0 | 0 |
Clinical laboratory assessments included hematology, serum chemistry and urinalysis. Any notable changes in the clinical laboratory value over time based on the investigator interpretation were reported.
| Participants | UC: Ontamalimab 25 mg | UC: Ontamalimab 25 mg Then 75 mg | UC: Ontamalimab 75 mg | CD: Ontamalimab 25 mg | CD: Ontamalimab 25 mg Then 75 mg | CD: Ontamalimab 75 mg |
|---|---|---|---|---|---|---|
| Number of Participants With Notable Changes in Clinical Laboratory Parameters Over Time | 0 (0 to 0) | 0 (0 to 0) | 0 (0 to 0) | 0 (0 to 0) | 0 (0 to 0) | 0 (0 to 0) |
ECG included heart rhythm, heart rate, QRS intervals, QT intervals, RR intervals and corrected QT (QTc) intervals parameters measurement. Any discernible changes in the ECG value over time based on investigator interpretation were reported.
| Participants | UC: Ontamalimab 25 mg | UC: Ontamalimab 25 mg Then 75 mg | UC: Ontamalimab 75 mg | CD: Ontamalimab 25 mg | CD: Ontamalimab 25 mg Then 75 mg | CD: Ontamalimab 75 mg |
|---|---|---|---|---|---|---|
| Number of Participants With Discernible Changes in Electrocardiogram (ECG) Over Time | 0 (0 to 0) | 0 (0 to 0) | 0 (0 to 0) | 0 (0 to 0) | 0 (0 to 0) | 0 (0 to 0) |
Vital sign assessments included blood pressure, pulse, respiratory rate, and temperature. Any discernible changes in vital signs over time per investigator interpretation were reported.
| Participants | UC: Ontamalimab 25 mg | UC: Ontamalimab 25 mg Then 75 mg | UC: Ontamalimab 75 mg | CD: Ontamalimab 25 mg | CD: Ontamalimab 25 mg Then 75 mg | CD: Ontamalimab 75 mg |
|---|---|---|---|---|---|---|
| Number of Participants With Discernible Changes in Vital Signs Over Time | 0 (0 to 0) | 0 (0 to 0) | 0 (0 to 0) | 0 (0 to 0) | 0 (0 to 0) | 0 (0 to 0) |
Treatment response over time was defined as clinical composite score that has decreased by greater than or equal to (≥2) points and ≥30 percentage (%), with an accompanying decrease in the sub score for rectal bleeding (RB) ≥1 point or a subscore for RB ≤ 1, and/or composite score that has decreased by ≥30% and ≥3 points compared to the baseline value for induction studies. The clinical composite score is a measure consisting of sub scores RB (0-3) plus stool frequency (0-3) with higher scores indicating more severe disease. With the implementation of amendment 4 of the protocol the study became a single arm study with all participants receiving the 75 mg dose of ontamalimab. Hence, only those UC participants who were receiving the 75 mg dose of ontamalimab every 4 weeks and participating in amendment 4 of the protocol were analyzed in this outcome measure.
| Participants | UC: Ontamalimab 25 mg Then 75 mg | UC: Ontamalimab 75 mg |
|---|---|---|
| Number of Participants With Ulcerative Colitis With Treatment Response Over Time | 116 | 129 |
Treatment response over time=Crohn's Disease Activity Index(CDAI)score that has decreased ≥100 points and/or simple endoscopic score for Crohn's disease(SES-CD)that has decreased by ≥25%,both compared to baseline value for induction studies.SES-CD is simple scoring system with 4 endoscopic variables measured in same 5 ileocolonic segments as CD index of severity. Overall values on SES-CD range from 0-56,higher values=more severe disease.4 endoscopic variables are scored from 0-3 in each bowel segment:ileum,right/transverse/left colon,rectum. Presence \& size of ulcers(none=0;diameter 0.1-0.5centimeter(cm)=1;0.5-2cm=2;\>2cm=3);extent of ulcerated surface(none=0;\<10%=1;10%-30%=2; \>30%= 3);extent of affected surface(none=0;\<50%=1;50%-75%=2;\>75%=3);Presence \& type of narrowing (none=0;single can be passed=1;multiple can be passed=2;cannot be passed=3).
| Participants | CD: Ontamalimab 25 mg Then 75 mg | CD: Ontamalimab 75 mg |
|---|---|---|
| Number of Participants With Crohn's Disease With Treatment Response Over Time | 6 | 12 |
Collected over From first dose of study drug up to EOS (up to 5.79 years). Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| UC: Ontamalimab 25 mg | 0/89 (0%) | 15/89 (16.9%) | 47/89 (52.8%) |
| UC: Ontamalimab 25mg Then 75 mg | 0/159 (0%) | 21/159 (13.2%) | 109/159 (68.6%) |
| UC: Ontamalimab 75mg | 3/268 (1.1%) | 46/268 (17.2%) | 155/268 (57.8%) |
| CD: Ontamalimab 25 mg | 1/5 (20%) | 2/5 (40%) | 3/5 (60%) |
| CD: Ontamalimab 25 mg Then 75 mg | 0/10 (0%) | 2/10 (20%) | 8/10 (80%) |
| CD: Ontamalimab 75 mg | 0/26 (0%) | 4/26 (15.4%) | 14/26 (53.8%) |
| Event | UC: Ontamalimab 25 mg | UC: Ontamalimab 25mg Then 75 mg | UC: Ontamalimab 75mg | CD: Ontamalimab 25 mg | CD: Ontamalimab 25 mg Then 75 mg | CD: Ontamalimab 75 mg |
|---|---|---|---|---|---|---|
| DeathGeneral disorders | 0/89 | 0/159 | 1/268 | 1/5 | 0/10 | 0/26 |
| Drug eruptionSkin and subcutaneous tissue disorders | 0/89 | 0/159 | 0/268 | 1/5 | 0/10 | 0/26 |
| Acoustic neuromaNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/89 | 0/159 | 0/268 | 0/5 | 1/10 | 0/26 |
| Calculus urinaryRenal and urinary disorders | 0/89 | 1/159 | 0/268 | 0/5 | 1/10 | 0/26 |
| Renal colicRenal and urinary disorders | 0/89 | 0/159 | 0/268 | 0/5 | 1/10 | 0/26 |
| Tendon injuryInjury, poisoning and procedural complications | 0/89 | 0/159 | 0/268 | 0/5 | 1/10 | 0/26 |
| Colitis ulcerativeGastrointestinal disorders | 6/89 | 3/159 | 10/268 | 0/5 | 0/10 | 0/26 |
| Anal fistulaGastrointestinal disorders | 0/89 | 0/159 | 0/268 | 0/5 | 0/10 | 1/26 |
| EnterocolitisGastrointestinal disorders | 0/89 | 0/159 | 0/268 | 0/5 | 0/10 | 1/26 |
| ProctitisGastrointestinal disorders | 0/89 | 1/159 | 1/268 | 0/5 | 0/10 | 1/26 |
| Event | UC: Ontamalimab 25 mg | UC: Ontamalimab 25mg Then 75 mg | UC: Ontamalimab 75mg | CD: Ontamalimab 25 mg | CD: Ontamalimab 25 mg Then 75 mg | CD: Ontamalimab 75 mg |
|---|---|---|---|---|---|---|
| Corona virus infectionInfections and infestations | 2/89 | 40/159 | 57/268 | 0/5 | 2/10 | 4/26 |
| Colitis ulcerativeGastrointestinal disorders | 22/89 | 21/159 | 28/268 | 0/5 | 0/10 | 0/26 |
| ArthralgiaMusculoskeletal and connective tissue disorders | 3/89 | 10/159 | 13/268 | 0/5 | 2/10 | 1/26 |
| Asthma-chronic obstructive pulmonary disease overlap syndromeRespiratory, thoracic and mediastinal disorders | 0/89 | 0/159 | 0/268 | 1/5 | 0/10 | 0/26 |
| Back painMusculoskeletal and connective tissue disorders | 1/89 | 11/159 | 10/268 | 0/5 | 2/10 | 1/26 |
| Blood pressure increasedInvestigations | 0/89 | 1/159 | 1/268 | 1/5 | 0/10 | 0/26 |
| BronchitisInfections and infestations | 0/89 | 9/159 | 8/268 | 0/5 | 2/10 | 0/26 |
| Colon adenomaNeoplasms benign, malignant and unspecified (incl cysts and polyps) | 0/89 | 1/159 | 0/268 | 1/5 | 0/10 | 0/26 |
| ConstipationGastrointestinal disorders | 0/89 | 1/159 | 3/268 | 1/5 | 0/10 | 0/26 |
| Dental cariesGastrointestinal disorders | 1/89 | 0/159 | 1/268 | 1/5 | 0/10 | 1/26 |
The Safety Set included all participants who received at least 1 dose of investigational product (IP) in the SHP647-304 study.
| Age, Categorical(Participants) | UC: Ontamalimab 25 mg | UC: Ontamalimab 25 mg Then 75 mg | UC: Ontamalimab 75 mg | CD: Ontamalimab 25 mg | CD: Ontamalimab 25 mg Then 75 mg | CD: Ontamalimab 75 mg | Total |
|---|---|---|---|---|---|---|---|
| <=18 years | 0 | 2 | 7 | 0 | 1 | 1 | 11 |
| Between 18 and 65 years | 87 | 148 | 239 | 4 | 9 | 25 | 512 |
| >=65 years | 2 | 9 | 22 | 1 | 0 | 0 | 34 |
| Sex: Female, Male(Participants) | UC: Ontamalimab 25 mg | UC: Ontamalimab 25 mg Then 75 mg | UC: Ontamalimab 75 mg | CD: Ontamalimab 25 mg | CD: Ontamalimab 25 mg Then 75 mg | CD: Ontamalimab 75 mg | Total |
|---|---|---|---|---|---|---|---|
| Female | 29 | 67 | 111 | 1 | 5 | 14 | 227 |
| Male | 60 | 92 | 157 | 4 | 5 | 12 | 330 |
| Ethnicity (NIH/OMB)(Participants) | UC: Ontamalimab 25 mg | UC: Ontamalimab 25 mg Then 75 mg | UC: Ontamalimab 75 mg | CD: Ontamalimab 25 mg | CD: Ontamalimab 25 mg Then 75 mg | CD: Ontamalimab 75 mg | Total |
|---|---|---|---|---|---|---|---|
| Hispanic or Latino | 5 | 12 | 15 | 0 | 1 | 2 | 35 |
| Not Hispanic or Latino | 84 | 146 | 251 | 5 | 9 | 24 | 519 |
| Unknown or Not Reported | 0 | 1 | 2 | 0 | 0 | 0 | 3 |
| Race (NIH/OMB)(Participants) | UC: Ontamalimab 25 mg | UC: Ontamalimab 25 mg Then 75 mg | UC: Ontamalimab 75 mg | CD: Ontamalimab 25 mg | CD: Ontamalimab 25 mg Then 75 mg | CD: Ontamalimab 75 mg | Total |
|---|---|---|---|---|---|---|---|
| American Indian or Alaska Native | 0 | 2 | 4 | 0 | 0 | 1 | 7 |
| Asian | 7 | 14 | 24 | 1 | 0 | 0 | 46 |
| Native Hawaiian or Other Pacific Islander | 1 | 0 | 0 | 0 | 0 | 0 | 1 |
| Black or African American | 0 | 2 | 4 | 0 | 0 | 2 | 8 |
| White | 77 | 135 | 231 | 4 | 9 | 23 | 479 |
| More than one race | 2 | 2 | 3 | 0 | 0 | 0 | 7 |
| Unknown or Not Reported | 2 | 4 | 2 | 0 | 1 | 0 | 9 |
Showing the first 100 of 419 sites across 37 countries.
Documents are hosted by the registry — open the source record to download them.
Plan to share: Yes — Takeda provides access to the de-identified individual participant data (IPD) for eligible studies to aid qualified researchers in addressing legitimate scientific objectives (Takeda's data sharing commitment is available on https://clinicaltrials.takeda.com/takedas-commitment?commitment=5). These IPDs will be provided in a secure research environment following approval of a data sharing request, and under the terms of a data sharing agreement.
Supporting information: Study protocol, Sap, Icf, Csr
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