A Study of TAK-062 in Treatment of Active Celiac Disease in Participants Attempting a Gluten-Free Diet
Study Details
Study Description
Brief Summary
The main aim is to see how TAK-062 works to reduce celiac-related symptoms and improve small intestinal damage due to gluten exposure, in participants with celiac disease (CeD) attempting to maintain a gluten-free diet (GFD) in treated participants versus placebo controls.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Phase 2 |
Detailed Description
The drug being tested in this study is called TAK-062. TAK-062 designed to break down gluten in the stomach and is being tested to treat people who have active CeD, attempting to maintain a GFD.
The study will enroll approximately 350 patients. Participants will be randomly assigned (by chance, like flipping a coin) to one of the two treatment groups in Cohort 1:
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Cohort 1 (Age 18-75): TAK-062 Dose 1 + SIGE Gluten-Bar and Gluten-free SIGE Bar
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Cohort 1 (Age 18-75): TAK-062 Placebo + SIGE Gluten-Bar and Gluten-free SIGE Bar
After the interim analysis, Cohort 1 data will be reviewed by an internal review committee (IRC), and based on the Sponsor's decision, 210 adult participants will be enrolled in Cohort 2 and randomly assigned to one of the five drug and SIGE treatment groups, and approximately 20 adolescent participants will be enrolled and randomly assigned to Groups 4 and 5.
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Cohort 2 (Age 18-75): TAK-062 Placebo + SIGE Gluten-Bar and Gluten-free SIGE Bar
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Cohort 2 (Age 18-75): TAK-062 Dose 2 + SIGE Gluten-Bar and Gluten-free SIGE Bar
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Cohort 2 (Age 18-75): TAK-062 Dose 3 + SIGE Gluten-Bar and Gluten-free SIGE Bar
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Cohort 2 (Age 12-75): TAK-062 Dose 1 + Gluten-free SIGE bar
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Cohort 2 (Age 12-75): TAK-062 Placebo + Gluten-free SIGE bar
This multi-center trial will be conducted in the United States, Canada, United Kingdom and the European Union. The overall time to participate in this study is approximately 36 weeks.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Cohort 1: TAK-062 Dose 1 + SIGE Gluten-Bar and Gluten-free SIGE Bar TAK-062 Dose 1, tablets, orally, taken within pre-determined time at the start of a meal and SIGE gluten and gluten free bar, orally, with a meal, at protocol defined timepoints, for up to 24 weeks. |
Drug: TAK-062
TAK-062 tablets.
Dietary Supplement: Simulated Inadvertent Gluten Exposure (SIGE) Gluten-Bar
SIGE gluten bars.
Dietary Supplement: Simulated Inadvertent Gluten Exposure (SIGE) Gluten-free Bar
SIGE gluten-free bars.
|
| Placebo Comparator: Cohort 1: TAK-062 Placebo + SIGE Gluten-Bar and Gluten-free SIGE Bar TAK-062 placebo-matching tablets, orally, taken within pre-determined time at the start of a meal and SIGE gluten and gluten free bar, orally, with a meal, at protocol defined timepoints, for up to 24 weeks. |
Dietary Supplement: Simulated Inadvertent Gluten Exposure (SIGE) Gluten-Bar
SIGE gluten bars.
Drug: TAK-062 Placebo
TAK-062 placebo-matching tablets.
Dietary Supplement: Simulated Inadvertent Gluten Exposure (SIGE) Gluten-free Bar
SIGE gluten-free bars.
|
| Placebo Comparator: Cohort 2: TAK-062 Placebo + SIGE Gluten-Bar and Gluten-free SIGE Bar TAK-062 placebo-matching tablets, orally, taken within pre-determined time at the start of a meal and SIGE gluten and gluten free bar, orally, with a meal, at protocol defined timepoints, for up to 24 weeks. |
Dietary Supplement: Simulated Inadvertent Gluten Exposure (SIGE) Gluten-Bar
SIGE gluten bars.
Drug: TAK-062 Placebo
TAK-062 placebo-matching tablets.
Dietary Supplement: Simulated Inadvertent Gluten Exposure (SIGE) Gluten-free Bar
SIGE gluten-free bars.
|
| Experimental: Cohort 2: TAK-062 Dose 2 + SIGE Gluten-Bar and Gluten-free SIGE Bar TAK-062 Dose 2 tablets, orally, taken within pre-determined time at the start of a meal and SIGE gluten and gluten free bar, orally, with a meal, at protocol defined timepoints, for up to 24 weeks. |
Drug: TAK-062
TAK-062 tablets.
Dietary Supplement: Simulated Inadvertent Gluten Exposure (SIGE) Gluten-Bar
SIGE gluten bars.
Dietary Supplement: Simulated Inadvertent Gluten Exposure (SIGE) Gluten-free Bar
SIGE gluten-free bars.
|
| Experimental: Cohort 2: TAK-062 Dose 3 + SIGE Gluten-Bar and Gluten-free SIGE Bar TAK-062 Dose 3 tablets, orally, taken within pre-determined time at the start of a meal and SIGE gluten and gluten free bar, orally, with a meal, at protocol defined timepoints, for up to 24 weeks. |
Drug: TAK-062
TAK-062 tablets.
Dietary Supplement: Simulated Inadvertent Gluten Exposure (SIGE) Gluten-Bar
SIGE gluten bars.
Dietary Supplement: Simulated Inadvertent Gluten Exposure (SIGE) Gluten-free Bar
SIGE gluten-free bars.
|
| Experimental: Cohort 2: TAK-062 Dose 1 + Gluten-free SIGE Bar TAK-062 Dose 1 tablets, orally, taken within pre-determined time at the start of a meal and gluten-free SIGE bar, orally, with a meal, at protocol defined timepoints, for up to 24 weeks. |
Drug: TAK-062
TAK-062 tablets.
Dietary Supplement: Simulated Inadvertent Gluten Exposure (SIGE) Gluten-free Bar
SIGE gluten-free bars.
|
| Placebo Comparator: Cohort 2: TAK-062 Placebo + Gluten-free SIGE Bar TAK-062 placebo-matching tablets, orally, taken within pre-determined time at the start of a meal and gluten-free SIGE bar, orally, with a meal, at protocol defined timepoints, for up to 24 weeks. |
Drug: TAK-062 Placebo
TAK-062 placebo-matching tablets.
Dietary Supplement: Simulated Inadvertent Gluten Exposure (SIGE) Gluten-free Bar
SIGE gluten-free bars.
|
Outcome Measures
Primary Outcome Measures
- Change in Celiac Disease Symptom Diary (CDSD) Gastrointestinal (GI) Symptom Severity Score from Baseline to Week 12 [Baseline (Week -1, the last week of the Run-in Period) to Week 12]
CDSD GI symptom severity score is an average of the daily GI symptom severity scores during the week. The daily GI symptom severity score is the average of the severity score for diarrhea, abdominal pain, bloating and nausea, ranging from 0 to 4. Symptom severity is evaluated using 5-point Likert-type scales (none, mild, moderate, severe, and very severe). Higher scores indicate severe symptoms.
Secondary Outcome Measures
- Change in Villous Height to Crypt Depth Ratio (Vh:Cd) from Baseline to Week 24 [Baseline (Week -4) to Week 24]
The Vh:Cd ratio represents mucosal architectural changes and a lower Vh:Cd ratio indicates more severe intestinal injury characterized by a flattening of the mucosa.
- Percentage of Participants Experiencing at Least One Treatment-Emergent Adverse Event (TEAE), Serious Adverse Events (SAEs) and Treatment-Related TEAEs [Up to Week 28]
Adverse event(AE) is defined as any untoward medical occurrence in a clinical investigation participant administered a drug; it does not necessarily have to have a causal relationship with this treatment. AE can therefore be any unfavorable and unintended sign (e.g., a clinically significant abnormal laboratory value,electrocardiogram[ECG] value,or vital sign measurement), symptom, or disease temporally associated with the use of a drug whether or not it is considered related to the drug.TEAE is defined as an adverse event with an onset that occurs after receiving study drug.SAE is any untoward medical occurrence that at any dose that results in death, is life threatening, requires inpatient hospitalization or prolongation of existing hospitalization, results in persistent or significant disability/incapacity, leads to a congenital anomaly/birth defect, or is an important medical event. TEAEs considered related to the study drug as assessed by the Investigator will be reported.
- Percentage of Participants With Positive Antidrug Antibodies (ADA) in Serum for TAK-062 [Up to Week 28]
A positive ADA participant is defined as a participant who has at least 1 positive ADA result during the study and is further categorized as: Transiently positive- defined as participants with confirmed positive ADA in at least 1 sample and no consecutive samples; Persistently positive- defined as participants with confirmed positive ADA in 2 or more consecutive positive ADA samples.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Has an adequate comprehension of a GFD assessed by completion of a knowledge test after viewing of educational materials.
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Has at least 1 CeD-related GI symptom of moderate or greater severity, as measured by the CDSD, on at least 3 days out of any consecutive 7-day period during the screening period (Week -8 visit until Week -4 visit), felt by the investigator to be related to gluten exposure. The CeD-related symptoms may vary day-by-day as long as the severity of at least 1 symptom is moderate or greater. The participants must meet symptom criteria to undergo esophagogastroduodenoscopy (EGD)/video capsule endoscopy (VCE).
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Has biopsy-confirmed CeD.
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Has been attempting to maintain a GFD for at least 12 months as self-reported by the participant.
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Has small intestinal villous atrophy on duodenal biopsy defined as Vh:Cd <3.0 at Week -4.
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The participant is human leukocyte antigen (HLA)-DQ2 and/or HLA-DQ8 positive.
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The participant is in a good general state of health according to clinical history and physical examination, in the opinion of the investigator.
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Have a body mass index (BMI) between 16 and 35 kilogram per meter square (kg/m^2), inclusive.
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The participant is willing and able to continue any current dietary and/or medical regimens (including gastric acid suppression) in effect at the Screening visit (Visit 1).
There should be no changes to diet, medications (prescription or over-the-counter) or supplements during study participation.
Exclusion Criteria:
- Has the presence of other inflammatory GI disorders or systemic autoimmune diseases (including but not limited to the following: inflammatory bowel disease, eosinophilic esophagitis, gastroenteritis or colitis, microscopic colitis diagnosed at screening or requiring treatment in the 6 months before screening, scleroderma, psoriatic or rheumatoid arthritis, lupus) other than those noted below:
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Thyroid disease that has been well-controlled for at least 6 months.
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Well-controlled type 1 diabetes (glycosylated hemoglobin <8% and no hospitalization or emergency room visit in the last 12 months for hyperglycemia or hypoglycemia).
- Has ongoing systemic immunosuppressant, systemic corticosteroid treatment, or treatment with systemic immunosuppressants or systemic corticosteroids in the 12 weeks before Screening.
• The participant is receiving immunosuppressive doses of corticosteroids: 3 mg per day or more of budesonide for more than 3 consecutive days within 3 months before Screening, more than 20 mg of prednisone given daily or on alternative days for 2 weeks or more within 6 months before the first dose, any dose of oral or intravenous (IV) corticosteroids within 30 days of the first dose, or high-dose inhaled corticosteroids (>960 micrograms per day [μg/d] of beclomethasone dipropionate or equivalent), or other systemic immunosuppressive agents.
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Has ongoing use of over-the-counter digestive enzymes or digestive supplements, other than lactase, including those for gluten digestion. Probiotics are allowable if they were started before Screening and not discontinued or changed in dose or type during the study.
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Has completed the CDSD on ≤75% of the days during Week -8 until randomization.
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Has active microscopic colitis requiring treatment in the 6 months before Screening.
- Microscopic colitis detected at screening if sigmoidoscopy is performed would exclude the participant.
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Has known or suspected type 2 refractory CeD or ulcerative jejunitis.
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Has ongoing chronic use (defined as >7 days continuous use) of a nonsteroidal anti-inflammatory drug aside from <100 mg aspirin, daily, for prophylactic use.
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Has ongoing use, or use in the 3 months before screening, of medications known to cause villous abnormalities (e.g., mycophenolate mofetil, angiotensin receptor blockers, colchicine).
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Has used treatments for GI symptoms including antiemetics, antidiarrheals, constipation agents other than fiber, antispasmodics and medical marijuana within 2 weeks of Screening.
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Has a known or suspected severe enteric infection (viral, bacterial, or parasitic) within 6 months before randomization. Severe enteric infection is defined as requiring emergency room visit or hospitalization or treatment with antibiotics or anti-infectives due to infection. Non enteric viral infections, either resolved or well-controlled are not exclusionary.
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Has a contraindication to endoscopy with duodenal biopsy.
--Contraindication to VCE (strictures, anastomoses, etc) is not an exclusion if the participant is able to complete the other aspects of the study.
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Has additional food allergies (e.g., almond, nuts) to nongluten ingredients in the SIGE bar study food or significant symptoms upon ingestion of the gluten-free SIGE bar during screening.
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Has a history of intolerance, hypersensitivity, or idiosyncratic reaction to an aminoglycoside.
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Has a known human immunodeficiency virus (HIV) infection or positive tests for hepatitis B or C. The participant has a known clinically significant chronically active hepatopathy of any origin, including cirrhosis, and participants with persistent positive hepatitis B virus surface antigen and quantitative hepatitis B virus polymerase chain reaction (PCR), or positive serology for hepatitis C virus (HCV) and quantitative HCV PCR within 6 months before the screening visit.
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Has known or suspected coronavirus disease 2019 (COVID-19) as determined by the investigator within the past month or COVID-19-related symptoms that have not resolved (direct viral or serologic testing may be performed according to site procedures at the discretion of the investigator).
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Has a known hypersensitivity reaction and/or allergy, including anaphylaxis, to wheat and/or gluten.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Om Research LLC | Lancaster | California | United States | 93534 |
Sponsors and Collaborators
- Takeda
Investigators
- Study Director: Study Director, Takeda
Study Documents (Full-Text)
None provided.More Information
Additional Information:
Publications
None provided.- TAK-062-2001
- 2020-005438-14