Crohn DiseasePhase 3POWERNCT03782376
A Study to Evaluate Efficacy and Safety of Ustekinumab Re-induction Therapy in Participants With Moderately to Severely Active Crohn's Disease
A Phase 3 study testing Ustekinumab approximately 6 mg/kg (IV), Ustekinumab 90 mg (SC) Group 1 and Ustekinumab 90 mg (SC) Group 2 in people with Crohn Disease, run by Janssen-Cilag Ltd. at 104 sites in 12 countries.
Trial summary
The primary purpose of this study is to evaluate the efficacy and safety of a single intravenous (IV) re-induction dose of approximately 6 milligram per kilogram (mg/kg) ustekinumab in participants with secondary loss of response (LoR) to subcutaneous (SC) every 8 Weeks (q8w) 90 mg ustekinumab maintenance therapy. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Crohn Disease
- What is being tested?
- Ustekinumab approximately 6 mg/kg (IV), Ustekinumab 90 mg (SC) Group 1 and Ustekinumab 90 mg (SC) Group 2
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 215 participants
- Where
- 104 sitesin 12 countries
- Study dates
- 20 Dec 2018to 10 Jan 2023
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- A history of Crohn's disease or fistulizing Crohn's disease of at least 3 months' duration, with colitis, ileitis, or ileocolitis, confirmed at any time in the past by radiography, histology, and/or endoscopy
- Currently receiving subcutaneous 90 mg every 8 weeks (q8w) ustekinumab maintenance therapy and initially responded to ustekinumab induction therapy, administered according to the local label, followed by secondary loss of response (LoR) to ustekinumab. Secondary LoR to ustekinumab is defined as active disease at study baseline, proven by a Crohn's Disease Activity Index (CDAI) score of greater than or equal to (>=) 220 and <=450 with at least one of the following: Elevated C-reactive protein (CRP) (>3.0 milligram per liter [mg/L]); and/or elevated Fecal calprotectin (fCal) >250 milligram per kilogram [mg/kg]); and/or endoscopy (performed less than or equal to (<=) 3 months before baseline) with evidence of active Crohn's disease, (defined as one or more ulcerations in the ileum and/or colon)
- Participants receiving either oral 5-aminosalicylic acid (5-ASA) compounds, oral corticosteroids (for example {e.g.}, prednisone, budesonide) at a prednisone-equivalent dose of <=40 mg/day or <=9 mg/day of budesonide, antibiotics used as the primary treatment of Crohn's disease, or conventional immunomodulators (i.e., azathioprine [AZA], 6-mercaptopurine [6-MP], or methotrexate [MTX]) are permitted providing the doses indicated are stable before baseline or have been discontinued before baseline within the protocol defined durations
Who cannot join
- Complications of Crohn's disease, such as symptomatic strictures or stenoses, short gut syndrome, or any other manifestation that might be anticipated to require surgery, could preclude the use of the CDAI to assess response to therapy, or would possibly confound the ability to assess the effect of treatment with ustekinumab
- Currently has or is suspected to have an abscess. Recent cutaneous and perianal abscesses are not exclusionary if drained and adequately treated at least 3 weeks before baseline (or 8 weeks before baseline for intra-abdominal abscesses) provided there is no anticipated need for any further surgery. Participants with active fistulas may be included if there is no anticipation of a need for surgery and there are currently no abscesses identified
- Any kind of bowel resection within 6 months or any other intra-abdominal surgery within 3 months before baseline
- A draining (i.e., functioning) stoma or ostomy
- Received ustekinumab intravenous re-induction after the initial weight-tiered-based IV induction dose of ustekinumab
- Any known history of shortened frequency of SC dose administration (<q8w) for a secondary loss of response where the participant did not, in the opinion of the treating physician, benefit from the dose interval shortening
Trial locations and contacts
104 sites in 12 countries.
104 sites in 12 countries
United States28 sites
Emory University
Atlanta, Georgia, 30322
Atlanta Gastroenterology Associates, (AGA) LLC - Emory Saint Joseph's
Atlanta, Georgia, 30342-5020
Brigham And Women's Hospital
Boston, Massachusetts, 02115
Texas Digestive Disease Consultants
Cedar Park, Texas, 78613
Medical University of South Carolina
Charleston, South Carolina, 29425
Chevy Chase Clinical Research
Chevy Chase, Maryland, 20815
Peak Gastroenterology Associates
Colorado Springs, Colorado, 80907
Florida Research Network, LLC
Gainesville, Florida, 32605
Ohio State University Hospital
Hilliard, Ohio, 43026
Baylor College of Medicine
Houston, Texas, 77025
Houston Methodist Hospital
Houston, Texas, 77030-2740
University of Mississippi Medical Center
Jackson, Mississippi, 39202
Mayo Clinic Jacksonville
Jacksonville, Florida, 32224
University of California, San Diego
La Jolla, California, 92093
University of Kentucky Chandler Medical Center
Lexington, Kentucky, 40536
Vanderbilt University Medical Center
Nashville, Tennessee, 37212
Mount Sinai School of Medicine
New York, New York, 10029
Oklahoma Digestive Disease Specialists
Oklahoma City, Oklahoma, 73112
Advent Health
Orlando, Florida, 32803
Gastroenterology Research of America, LLC
San Antonio, Texas, 78229
Virginia Mason Medical Center
Seattle, Washington, 98101
University of Washington
Seattle, Washington, 98195
Washington University School Of Medicine
St Louis, Missouri, 63110
Atlanta Gastroenterology Specialists
Suwanee, Georgia, 30024
Washington Gastroenterology, PLLC
Tacoma, Washington, 98405
Florida Hospital Tampa
Tampa, Florida, 33613
Tyler Research Institute, LLC
Tyler, Texas, 75701
Northshore Gastroenterology Research, LLC
Westlake, Ohio, 44145
Germany21 sites
Klinikum Augsburg
Augsburg, D-86158
GASTRO-Studien
Berlin, 10825
Charite - Universitaetsmedizin Berlin (CCM)
Berlin, 12203
Medizinisches Versorgungszentrum (MVZ) Dachau
Dachau, 85221
University Hospital Dresden
Dresden, 1307
Agaplesion Frankfurter Diakonie Kliniken GmbH, Markus Krankenhaus
Frankfurt, 60431
Universitatsklinikum Frankfurt/ Medizinische Klinik 1
Frankfurt, 60590
Universitatsklinikum Freiburg
Freiburg im Breisgau, 79106
Städtisches Krankenhaus Martha-Maria Halle-Dölau gGmbH
Halle, 06120
Hamburgisches Forschungsinstitut fuer CED, HaFCED e.K.
Hamburg, 20251
Gastroenterologie Opernstrasse
Kassel, 34117
Universitatsklinikum Schleswig Holstein Kiel
Kiel, 24105
Staedtisches Klinikum Lueneburg
Lüneburg, 21339
Universitätsklinikum Otto-von-Guericke-Universität Magdeburg
Magdeburg, 39120
Medizinische Fakultät Mannheim der Universität Heidelberg
Mannheim, 68167
Gastroenterologische Gemeinschaftspraxis Minden
Minden, 32423
Klinikum der Universitaet Muenchen
München, 81377
Praxis Dr. med. Ulf Helwig
Oldenburg, 26123
Zentrum für Gastroenterologie Saar MVZ GmbH
Saarbrücken, 66111
Universitaetsklinik Tuebingen
Tübingen, 72076
Universitaetsklinikum Ulm, Klinik fuer Innere Medizin II
Ulm, 89081
Spain15 sites
Hosp. Univ. Fundacion Alcorcon
Alcorcón, 28922
Hosp. Arquitecto Marcide
Ferrol, 15405
Hosp. Gral. Univ. Gregorio Maranon
Madrid, 28007
Hosp. Univ. La Paz
Madrid, 28046
Hosp Virgen de La Victoria
Málaga, 29010
Hosp. Univ. Virgen de La Arrixaca
Murcia, 30120
Hosp. de Navarra
Pamplona, 31008
Hosp. Montecelo
Pontevedra, 36071
Corporacio Sanitari Parc Tauli
Sabadell, 08208
Hosp Clinico Univ de Salamanca
Salamanca, 37007
Hosp. Univ. Marques de Valdecilla
Santander, 39008
Hosp. Clinico Univ. de Valencia
Valencia, 46010
Hosp. Alvaro Cunqueiro
Vigo, 36213
Hosp. Clinico Univ. Lozano Blesa
Zaragoza, 50009
Hosp. Univ. Miguel Servet
Zaragoza, 50009
France7 sites
Hopital Beaujon
Clichy, 92110
CHRU de Lille Hopital Claude Huriez
Lille, 59037
CHRU Montpellier - Hopital Saint-Eloi
Montpellier, 34295
CHU Hopital Saint Antoine
Paris, 75571
Hospices Civils de Lyon HCL
Pierre-Bénite, 69495
CHRU Hopital de Pontchaillou
Rennes, 35033
CHU de Nancy_ Hopital Brabois
Vandœuvre-lès-Nancy, 54511
Italy6 sites
Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico
Milan, 20122
Ospedale Villa Sofia-Cervello
Palermo, 90146
Azienda Ospedaliera G.Salvini Ospedale di Rho
Rho
Fondazione Policlinico Gemelli Università Cattolica
Roma, 168
Istituto Clinico Humanitas
Rozzano, 20089
AO Ordine Mauriziano
Torino, 10128
Netherlands6 sites
Onze Lieve Vrouwe Gasthuis
Amsterdam, 1091 AC
Leiden University Medical Center
Leiden, 2333 ZA
Maastricht Universitair Medisch Centrum
Maastricht, 6229 HX
Radboudumc
Nijmegen, 6525 GA
Erasmus MC
Rotterdam, 3015 GD
Sint Franciscus Gasthuis
Rotterdam, 3045 PM
United Kingdom6 sites
Pennine Acute Hospitals-Fairfield General Hospital
Bury, BL9 7TD
Gloucestershire Hospitals NHS Foundation Trust - Cheltenham
Cheltenham, GL53 7AN
Royal Devon & Exeter Hospital
Exeter, EX2 5DW
King's College Hospital NHS Foundation Trust
London, SE5 9RS
St George's Hospital
London, SW17 OQT
Southampton University Hospitals NHS Trust
Southampton, SO16 6YD
South Korea5 sites
Inje University Haeundae Paik Hospital
Busan, 48108
Seoul National University Hospital
Seoul, 03080
Severance Hospital Yonsei University Health System
Seoul, 03722
Asan Medical Center
Seoul, 05505
KyungHee University Hospital
Seoul, 102-1703
Russia4 sites
Irkutsk State Medical Academy of Postgraduate Education
Irkutsk, 664079
Olla-Med, Llc
Moscow, 105554
City Clinical Hospital #31
Saint Petersburg, 197110
GBUZ Respublican Clinical Hospital n.a. GG Kuvatova
Ufa, 450005
Austria2 sites
Krankenhaus der Barmherzigen Brüder
Vienna, 1020
Medizinische Universitaet Wien
Vienna, 1090
Czechia2 sites
Hepato-gastroenterologie HK, s.r.o.
Hradec Králové, 500 12
ISCARE a.s.
Prague, 190 00
Sweden2 sites
Gastromottagningen
Malmö, 20502
Gastromottagningen
Stockholm, 18288
About this study
Official title: A Phase 3b, Randomized, Double-blind, Multicenter Study to Evaluate the Safety and Efficacy of Intravenous Re-induction Therapy With Ustekinumab in Patients With Moderately to Severely Active Crohn's Disease
The primary purpose of this study is to evaluate the efficacy and safety of a single intravenous (IV) re-induction dose of approximately 6 milligram per kilogram (mg/kg) ustekinumab in participants with secondary loss of response (LoR) to subcutaneous (SC) every 8 Weeks (q8w) 90 mg ustekinumab maintenance therapy.
Read the detailed description
This study compares the efficacy and safety of a single weight-tiered based IV re-induction dose of approximately 6 mg/kg ustekinumab versus continuing with regular SC q8w 90 mg ustekinumab administration. It consists of screening (5 weeks); treatment period (Week 0 to 24); and safety follow up visit (20 weeks after last dose). The primary hypothesis is that a single IV re-induction dose of ustekinumab is superior to continuing with regular SC q8w maintenance treatment as measured by clinical response after 16 weeks of treatment. Study assessments will include Crohn's disease activity index (CDAI), video ileocolonoscopy, patient-reported outcomes (PROs), laboratory evaluations, biomarkers, review of concomitant medications and adverse events (AEs), and evaluation of serum concentrations of study agent as well as development of antibodies to study agent. All participants will be randomly assigned to receive either ustekinumab IV re-induction or regular SC q8w 90 mg ustekinumab injection at baseline in a double dummy design. No participants will be treated with placebo only.
- Conditions
- Crohn Disease
- Being tested
- Ustekinumab approximately 6 mg/kg (IV), Placebo (SC), Placebo (IV), Ustekinumab 90 mg (SC) Group 1, Ustekinumab 90 mg (SC) Group 2
- Medical subject headings
- Crohn Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Ustekinumab approximately 6 mg/kg (IV)Drug
Also called STELARA
Participants will receive ustekinumab approximately 6mg/kg intravenously at Week 0.
Placebo (SC)Drug
Participants will receive SC injection of placebo at Week 0.
Placebo (IV)Drug
Participants will receive IV infusion of placebo at Week 0.
Ustekinumab 90 mg (SC) Group 1Drug
Also called STELARA
Participants will receive SC injection of ustekinumab 90 mg at Weeks 8 and 16.
Ustekinumab 90 mg (SC) Group 2Drug
Also called STELARA
Participants will receive SC injection of ustekinumab 90 mg at Weeks 0, 8 and 16.
| Study group | Role | What they receive |
|---|---|---|
| Group 1: Ustekinumab (IV re-induction) | Experimental | Participants who experience a secondary loss of response (LoR) to 90 mg ustekinumab maintenance treatment, administered subcutaneously every 8 weeks (q8w) will receive a weight-tiered based ustekinumab IV re-induction dose of approximately 6 mg/kg and matching placebo subcutaneously at Week 0. At Weeks 8 and 16, all participants will receive SC maintenance injections of 90 mg ustekinumab. Participants will resume their standard-of-care therapy at Week 24 at the discretion of the treating physician. Receives: Drug: Ustekinumab approximately 6 mg/kg (IV); Drug: Placebo (SC); Drug: Ustekinumab 90 mg (SC) Group 1 |
| Group 2: Ustekinumab (Continuous q8w SC maintenance) | Active comparator | Participants who experience a secondary LoR to 90 mg ustekinumab maintenance treatment, administered subcutaneously q8w will receive ustekinumab 90 mg subcutaneously and matching placebo intravenously at Week 0. At Weeks 8 and 16, all participants will receive SC maintenance injections of 90 mg ustekinumab. Participants will resume their standard-of-care therapy at Week 24 at the discretion of the treating physician. Receives: Drug: Placebo (IV); Drug: Ustekinumab 90 mg (SC) Group 2 |
What is being measured
The primary outcome is the main question the study is designed to answer.
Percentage of Participants With Clinical Response at Week 16
Clinical response was defined as greater than or equal to (>=) 100-point reduction from baseline in Crohn's disease activity index (CDAI) score or a CDAI score < 150 points. CDAI is validated multi-item measure of severity of illness derived as weighted sum of 8 different Crohn's disease (CD)-related variables (extra-intestinal manifestations, abdominal mass, weight, hematocrit, total number of liquid stools, abdominal pain/cramping, use of antidiarrheal drug(s) and/or opiates, and general well-being). The last 4 variables were scored over 7 days by participant on diary card. In general, CDAI score ranges from 0 to approximately 600; higher score=higher disease activities. Participants who had prohibited CD-related surgery, prohibited concomitant medication changes or discontinued study agent due to lack of efficacy or adverse event indicated to be of worsening CD prior to designated analysis timepoint were considered not to be in clinical response, regardless of their CDAI score.
Measured: Week 16
Secondary outcomes (17)
Percentage of Participants With Clinical Remission at Week 16
Percentage of participants with clinical remission at Week 16 were reported. Clinical remission was defined as CDAI score of <150 points. CDAI is a validated multi-item measure of severity of illness derived as weighted sum of 8 different CD-related variables (extra-intestinal manifestations, abdominal mass, weight, hematocrit, total number of liquid stools, abdominal pain/cramping, use of antidiarrheal drug(s) and/or opiates and general well-being). The last 4 variables were scored over 7 days by participant on diary card. In general, CDAI score ranges from 0 to approximately 600; higher score=higher disease activities. Participants who had prohibited CD-related surgery, prohibited concomitant medication changes or discontinued study agent due to lack of efficacy or adverse event indicated to be of worsening CD prior to designated analysis timepoint were considered not to be in clinical remission, regardless of their CDAI score.
Measured: Week 16
Percentage of Participants With Clinical Response at Week 8
Clinical response was defined as a >=100-point reduction from the baseline in CDAI score or a CDAI score <150 point. The CDAI is a validated multi-item measure of severity of illness derived as a weighted sum of 8 different CD-related variables (extra-intestinal manifestations, abdominal mass, weight, hematocrit, total number of liquid stools, abdominal pain/cramping, use of antidiarrheal drug(s) and/or opiates, and general well-being). The last 4 variables were scored over 7 days by the participant on a diary card. In general, CDAI score ranges from 0 to approximately 600; higher score indicates higher disease activities. Participants who had prohibited CD-related surgery, prohibited concomitant medication changes or discontinued study agent due to lack of efficacy or adverse event indicated to be of worsening CD prior to designated analysis timepoint were considered not to be in clinical response, regardless of their CDAI score.
Measured: Week 8
Percentage of Participants With Clinical Remission at Week 8
Percentage of participants with clinical remission at Week 8 were reported. Clinical remission was defined as CDAI score of <150 points. CDAI is a validated multi-item measure of severity of illness derived as weighted sum of 8 different CD-related variables (extra-intestinal manifestations, abdominal mass, weight, hematocrit, total number of liquid stools, abdominal pain/cramping, use of antidiarrheal drug(s) and/or opiates and general well-being). The last 4 variables were scored over 7 days by participant on diary card. In general, CDAI score ranges from 0 to approximately 600; higher score=higher disease activities. Participants who had prohibited CD-related surgery, prohibited concomitant medication changes or discontinued study agent due to lack of efficacy or adverse event indicated to be of worsening CD prior to designated analysis timepoint were considered not to be in clinical remission, regardless of their CDAI score.
Measured: Week 8
Percentage of Participants With Normalization of C-reactive Protein (CRP) and/or Normalization of Fecal Calprotectin (fCal) Concentration at Week 16
Percentage of participants with normalization at Week 16, among participants with elevated CRP and/or fCal at baseline were reported. Participants were considered to be normalized if at least one biomarker (fCal or CRP) was normalized. Normalized CRP=CRP value less than or equal to (<=) 3 milligrams per liter(mg/L). Normalized fCal concentrations was defined as <=250 micrograms per gram(mcg/g). When either CRP or FCal value was abnormal at baseline and value of same parameter normalizes at designated analysis timepoint, participants were considered to be normalized at designated analysis timepoint. Participants who had prohibited CD-related surgery, prohibited concomitant medication changes, or discontinued study agent due to lack of efficacy or adverse event indicated to be of worsening CD prior to designated analysis timepoint are considered not to be normalized. Participants who had insufficient data at designated analysis timepoint had their last value carried forward.
Measured: Week 16
Percentage of Participants With Clinical Remission at Week 24
Percentage of participants with clinical remission at Week 24 were reported. Clinical remission was defined as CDAI score of <150 points. CDAI is a validated multi-item measure of severity of illness derived as weighted sum of 8 different CD-related variables (extra-intestinal manifestations, abdominal mass, weight, hematocrit, total number of liquid stools, abdominal pain/cramping, use of antidiarrheal drug(s) and/or opiates and general well-being). The last 4 variables were scored over 7 days by participant on diary card. In general, CDAI score ranges from 0 to approximately 600; higher score=higher disease activities. Participants who had prohibited CD-related surgery, prohibited concomitant medication changes or discontinued study agent due to lack of efficacy or adverse event indicated to be of worsening CD prior to designated analysis timepoint were considered not to be in clinical remission, regardless of their CDAI score.
Measured: Week 24
Percentage of Participants With Clinical Response at Week 24
Clinical response was defined as a >=100-point reduction from the baseline in CDAI score or a CDAI score <150 point. The CDAI is a validated multi-item measure of severity of illness derived as a weighted sum of 8 different Crohn's disease-related variables (extra-intestinal manifestations, abdominal mass, weight, hematocrit, total number of liquid stools, abdominal pain/cramping, use of antidiarrheal drug(s) and/or opiates, and general well-being). The last 4 variables were scored over 7 days by the participant on a diary card. In general, CDAI score ranges from 0 to approximately 600; higher score indicates higher disease activities. Participants who had prohibited CD-related surgery, prohibited concomitant medication changes or discontinued study agent due to lack of efficacy or adverse event indicated to be of worsening CD prior to designated analysis timepoint were considered not to be in clinical response, regardless of their CDAI score.
Measured: Week 24
Percentage of Participants With Normalization of C-reactive Protein (CRP) and/or Normalization of Fecal Calprotectin (fCal) Concentration at Week 24
Percentage of participants with normalization at Week 24, among participants with elevated CRP and/or fCal at baseline were reported. Participants were considered to be normalized if at least one biomarker (fCal or CRP) was normalized. Normalized CRP=CRP value less than or equal to (<=) 3 milligrams per liter(mg/L). Normalized fCal concentrations was defined as <=250 micrograms per gram(mcg/g). When either CRP or FCal value was abnormal at baseline and value of same parameter normalizes at designated analysis timepoint, participants were considered to be normalized at designated analysis timepoint. Participants who had prohibited CD-related surgery, prohibited concomitant medication changes, or discontinued study agent due to lack of efficacy or adverse event indicated to be of worsening CD prior to designated analysis timepoint are considered not to be normalized. Participants who had insufficient data at designated analysis timepoint had their last value carried forward.
Measured: Week 24
Percentage of Participants With Treatment-emergent Adverse Events (TEAEs)
An adverse event was any untoward medical occurrence in a clinical study participant administered a medicinal (investigational or non-investigational) product. An adverse event does not necessarily have a causal relationship with the treatment. TEAEs were adverse events with onset during the intervention phase or that were a consequence of a pre-existing condition that had worsened since baseline. Any AE occurring at or after the initial administration of study agent through the end of the trial was considered to be treatment emergent. In this outcome measure, TEAEs including all AEs irrespective of being serious or non-serious AE are reported.
Measured: From baseline (Week 0) up to Week 36
Percentage of Participants With Treatment-emergent Serious Adverse Events (TESAEs)
A serious adverse event (SAE) was an adverse event resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly; a suspected transmission of any infectious agent via a medicinal product; medically important. TESAEs were adverse events with onset during the intervention phase or that are a consequence of a pre-existing condition that had worsened since baseline. Any AE occurring at or after the initial administration of study agent through the end of the trial was considered to be treatment emergent.
Measured: From baseline (Week 0) up to Week 36
Percentage of Participants With Treatment-emergent Infections
Percentage of participants with treatment-emergent infections were reported. Any infection occurring at or after the initial administration of study agent through the end of the trial was considered to be treatment emergent.
Measured: From baseline (Week 0) up to Week 36
Percentage of Participants With Treatment-emergent Serious Infections
Percentage of participants with treatment-emergent serious infections was reported. Any infection occurring at or after the initial administration of study agent through the end of the trial was considered to be treatment emergent.
Measured: From baseline (Week 0) up to Week 36
Change From Baseline in Clinical Laboratory Values for Hematology (Hemoglobin) and Chemistry (Albumin, Total Protein)
Change from baseline in clinical laboratory values for hematology (hemoglobin) and chemistry (albumin, total protein) was reported.
Measured: Baseline, Weeks 8, 16, 24
Change From Baseline in Clinical Laboratory Values for Hematology (Hematocrit)
Change from baseline in clinical laboratory values for hematology (hematocrit) was reported.
Measured: Baseline, Weeks 8, 16, 24
Change From Baseline in Clinical Laboratory Values for Hematology (Total White Blood Cell [WBC], Neutrophils, Absolute Lymphocyte, Eosinophils, Platelets)
Change from baseline in clinical laboratory values for hematology (total WBC, neutrophils, absolute lymphocyte, eosinophils, platelets) was reported.
Measured: Baseline, Weeks 8, 16, 24
Change From Baseline in Clinical Laboratory Values for Chemistry (Alkaline Phosphatase, Alanine Transaminase [ALT], Aspartate Transaminase [AST])
Change from baseline in clinical laboratory values for chemistry (alkaline, ALT, AST) was reported.
Measured: Baseline, Weeks 8, 16, 24
Change From Baseline in Clinical Laboratory Values for Chemistry (Total Bilirubin, Direct Bilirubin, Creatinine)
Change from baseline in clinical laboratory values for chemistry (total bilirubin, direct bilirubin, creatinine) was reported.
Measured: Baseline, Weeks 8, 16, 24
Change From Baseline in Clinical Laboratory Values for Chemistry (Sodium, Potassium, Chloride, Blood Urea Nitrogen [BUN]/Urea, Calcium, Phosphate)
Change from baseline in clinical laboratory values for chemistry (sodium, potassium, chloride, BUN/urea, calcium, phosphate) was reported.
Measured: Baseline, Weeks 8, 16, 24
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted20 Dec 2018
- Study start20 Dec 2018
- Primary completion19 Aug 2022
- Study completion10 Jan 2023
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Crohn DiseaseStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 215 participants (actual)
Sponsor and investigators
- Lead sponsor
- Janssen-Cilag Ltd.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Janssen-Cilag Ltd. Clinical Trial, Study director, Janssen-Cilag Ltd.
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03782376
- Sponsor's protocol ID
- CR108533
- Other IDs
- 2018-002629-51, CNTO1275CRD3008, 2018
- Acronym
- POWER
- Status last verified
- Apr 2025
- First submitted
- 11 Dec 2018
- Last updated
- 29 Apr 2025
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: The data sharing policy of the Janssen Pharmaceutical Companies of Johnson \& Johnson is available at www.janssen.com/clinical-trials\\transparency. As noted on this site, requests for access to the study data can be submitted through Yale open and Access (YODA) Project site at yoda.yale.edu
Publications
Schreiber S, Lee SD, van der Woude CJ, Marin-Jimenez I, Wolf DC, Schnoy E, Salzberg B, Busse C, Nazar M, Ma T, Borghorst S, Gasink C, Baker T, Godwin B, Adedokun OJ, Feagan BG; POWER Study Group. Ustekinumab Intravenous Reinduction after Secondary Loss of Response in Patients with Crohn's Disease. Inflamm Bowel Dis. 2025 Dec 1;31(12):3286-3297. doi: 10.1093/ibd/izaf163.
PubMed 40971924Hasskamp J, Meinhardt C, Timmer A. Anti-IL-12/23p40 antibodies for induction of remission in Crohn's disease. Cochrane Database Syst Rev. 2025 May 13;5(5):CD007572. doi: 10.1002/14651858.CD007572.pub4.
PubMed 40357993Ten Bokkel Huinink S, Biemans V, Duijvestein M, Pierik M, Hoentjen F, West RL, van der Woude CJ, de Vries AC. Re-induction with intravenous Ustekinumab after secondary loss of response is a valid optimization strategy in Crohn's disease. Eur J Gastroenterol Hepatol. 2021 Dec 1;33(1S Suppl 1):e783-e788. doi: 10.1097/MEG.0000000000002256.
PubMed 34334713
Study at a glance
From the registry record, last updated by the sponsor on 29 Apr 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 3b, Randomized, Double-blind, Multicenter Study to Evaluate the Safety and Efficacy of Intravenous Re-induction Therapy With Ustekinumab in Patients With Moderately to Severely Active Crohn's Disease
- ClinicalTrials.gov ID
- NCT03782376
- Acronym / sponsor ID
- POWER / CR108533
- Conditions
- Crohn Disease
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 215 participants (actual)
- Lead sponsor
- Janssen-Cilag Ltd.Industry (pharma, biotech, devices)
- Study start
- 20 Dec 2018 (actual)
- Primary completion
- 19 Aug 2022 (actual)
- Study completion
- 10 Jan 2023 (actual)
- First posted
- 20 Dec 2018 (actual)
- Results
- Posted 13 Sep 2023
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The primary purpose of this study is to evaluate the efficacy and safety of a single intravenous (IV) re-induction dose of approximately 6 milligram per kilogram (mg/kg) ustekinumab in participants with secondary loss of response (LoR) to subcutaneous (SC) every 8 Weeks (q8w) 90 mg ustekinumab maintenance therapy.
Detailed description
This study compares the efficacy and safety of a single weight-tiered based IV re-induction dose of approximately 6 mg/kg ustekinumab versus continuing with regular SC q8w 90 mg ustekinumab administration. It consists of screening (5 weeks); treatment period (Week 0 to 24); and safety follow up visit (20 weeks after last dose). The primary hypothesis is that a single IV re-induction dose of ustekinumab is superior to continuing with regular SC q8w maintenance treatment as measured by clinical response after 16 weeks of treatment. Study assessments will include Crohn's disease activity index (CDAI), video ileocolonoscopy, patient-reported outcomes (PROs), laboratory evaluations, biomarkers, review of concomitant medications and adverse events (AEs), and evaluation of serum concentrations of study agent as well as development of antibodies to study agent. All participants will be randomly assigned to receive either ustekinumab IV re-induction or regular SC q8w 90 mg ustekinumab injection at baseline in a double dummy design. No participants will be treated with placebo only.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Group 1: Ustekinumab (IV re-induction) | Experimental | Drug: Ustekinumab approximately 6 mg/kg (IV), Drug: Placebo (SC), Drug: Ustekinumab 90 mg (SC) Group 1Participants who experience a secondary loss of response (LoR) to 90 mg ustekinumab maintenance treatment, administered subcutaneously every 8 weeks (q8w) will receive a weight-tiered based ustekinumab IV re-induction dose of approximately 6 mg/kg and matching placebo subcutaneously at Week 0. At Weeks 8 and 16, all participants will receive SC maintenance injections of 90 mg ustekinumab. Participants will resume their standard-of-care therapy at Week 24 at the discretion of the treating physician. |
| Group 2: Ustekinumab (Continuous q8w SC maintenance) | Active comparator | Drug: Placebo (IV), Drug: Ustekinumab 90 mg (SC) Group 2Participants who experience a secondary LoR to 90 mg ustekinumab maintenance treatment, administered subcutaneously q8w will receive ustekinumab 90 mg subcutaneously and matching placebo intravenously at Week 0. At Weeks 8 and 16, all participants will receive SC maintenance injections of 90 mg ustekinumab. Participants will resume their standard-of-care therapy at Week 24 at the discretion of the treating physician. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (3 listed)
- A history of Crohn's disease or fistulizing Crohn's disease of at least 3 months' duration, with colitis, ileitis, or ileocolitis, confirmed at any time in the past by radiography, histology, and/or endoscopy
- Currently receiving subcutaneous 90 mg every 8 weeks (q8w) ustekinumab maintenance therapy and initially responded to ustekinumab induction therapy, administered according to the local label, followed by secondary loss of response (LoR) to ustekinumab. Secondary LoR to ustekinumab is defined as active disease at study baseline, proven by a Crohn's Disease Activity Index (CDAI) score of greater than or equal to (>=) 220 and <=450 with at least one of the following: Elevated C-reactive protein (CRP) (>3.0 milligram per liter [mg/L]); and/or elevated Fecal calprotectin (fCal) >250 milligram per kilogram [mg/kg]); and/or endoscopy (performed less than or equal to (<=) 3 months before baseline) with evidence of active Crohn's disease, (defined as one or more ulcerations in the ileum and/or colon)
- Participants receiving either oral 5-aminosalicylic acid (5-ASA) compounds, oral corticosteroids (for example {e.g.}, prednisone, budesonide) at a prednisone-equivalent dose of <=40 mg/day or <=9 mg/day of budesonide, antibiotics used as the primary treatment of Crohn's disease, or conventional immunomodulators (i.e., azathioprine [AZA], 6-mercaptopurine [6-MP], or methotrexate [MTX]) are permitted providing the doses indicated are stable before baseline or have been discontinued before baseline within the protocol defined durations
Key exclusion criteria (6 listed)
- Complications of Crohn's disease, such as symptomatic strictures or stenoses, short gut syndrome, or any other manifestation that might be anticipated to require surgery, could preclude the use of the CDAI to assess response to therapy, or would possibly confound the ability to assess the effect of treatment with ustekinumab
- Currently has or is suspected to have an abscess. Recent cutaneous and perianal abscesses are not exclusionary if drained and adequately treated at least 3 weeks before baseline (or 8 weeks before baseline for intra-abdominal abscesses) provided there is no anticipated need for any further surgery. Participants with active fistulas may be included if there is no anticipation of a need for surgery and there are currently no abscesses identified
- Any kind of bowel resection within 6 months or any other intra-abdominal surgery within 3 months before baseline
- A draining (i.e., functioning) stoma or ostomy
- Received ustekinumab intravenous re-induction after the initial weight-tiered-based IV induction dose of ustekinumab
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Ustekinumab approximately 6 mg/kg (IV)Also: STELARAParticipants will receive ustekinumab approximately 6mg/kg intravenously at Week 0. | Drug | Group 1: Ustekinumab (IV re-induction) |
| Placebo (SC)Participants will receive SC injection of placebo at Week 0. | Drug | Group 1: Ustekinumab (IV re-induction) |
| Placebo (IV)Participants will receive IV infusion of placebo at Week 0. | Drug | Group 2: Ustekinumab (Continuous q8w SC maintenance) |
| Ustekinumab 90 mg (SC) Group 1Also: STELARAParticipants will receive SC injection of ustekinumab 90 mg at Weeks 8 and 16. | Drug | Group 1: Ustekinumab (IV re-induction) |
| Ustekinumab 90 mg (SC) Group 2Also: STELARAParticipants will receive SC injection of ustekinumab 90 mg at Weeks 0, 8 and 16. | Drug | Group 2: Ustekinumab (Continuous q8w SC maintenance) |
Primary outcome
Percentage of Participants With Clinical Response at Week 16
Time frame: Week 16
Clinical response was defined as greater than or equal to (>=) 100-point reduction from baseline in Crohn's disease activity index (CDAI) score or a CDAI score < 150 points. CDAI is validated multi-item measure of severity of illness derived as weighted sum of 8 different Crohn's disease (CD)-related variables (extra-intestinal manifestations, abdominal mass, weight, hematocrit, total number of liquid stools, abdominal pain/cramping, use of antidiarrheal drug(s) and/or opiates, and general well-being). The last 4 variables were scored over 7 days by participant on diary card. In general, CDAI score ranges from 0 to approximately 600; higher score=higher disease activities. Participants who had prohibited CD-related surgery, prohibited concomitant medication changes or discontinued study agent due to lack of efficacy or adverse event indicated to be of worsening CD prior to designated analysis timepoint were considered not to be in clinical response, regardless of their CDAI score.
17 secondary outcomes
Percentage of Participants With Clinical Remission at Week 16
Time frame: Week 16
Percentage of Participants With Clinical Response at Week 8
Time frame: Week 8
Percentage of Participants With Clinical Remission at Week 8
Time frame: Week 8
Percentage of Participants With Normalization of C-reactive Protein (CRP) and/or Normalization of Fecal Calprotectin (fCal) Concentration at Week 16
Time frame: Week 16
Percentage of Participants With Clinical Remission at Week 24
Time frame: Week 24
Percentage of Participants With Clinical Response at Week 24
Time frame: Week 24
Percentage of Participants With Normalization of C-reactive Protein (CRP) and/or Normalization of Fecal Calprotectin (fCal) Concentration at Week 24
Time frame: Week 24
Percentage of Participants With Treatment-emergent Adverse Events (TEAEs)
Time frame: From baseline (Week 0) up to Week 36
Percentage of Participants With Treatment-emergent Serious Adverse Events (TESAEs)
Time frame: From baseline (Week 0) up to Week 36
Percentage of Participants With Treatment-emergent Infections
Time frame: From baseline (Week 0) up to Week 36
Percentage of Participants With Treatment-emergent Serious Infections
Time frame: From baseline (Week 0) up to Week 36
Change From Baseline in Clinical Laboratory Values for Hematology (Hemoglobin) and Chemistry (Albumin, Total Protein)
Time frame: Baseline, Weeks 8, 16, 24
Change From Baseline in Clinical Laboratory Values for Hematology (Hematocrit)
Time frame: Baseline, Weeks 8, 16, 24
Change From Baseline in Clinical Laboratory Values for Hematology (Total White Blood Cell [WBC], Neutrophils, Absolute Lymphocyte, Eosinophils, Platelets)
Time frame: Baseline, Weeks 8, 16, 24
Change From Baseline in Clinical Laboratory Values for Chemistry (Alkaline Phosphatase, Alanine Transaminase [ALT], Aspartate Transaminase [AST])
Time frame: Baseline, Weeks 8, 16, 24
Change From Baseline in Clinical Laboratory Values for Chemistry (Total Bilirubin, Direct Bilirubin, Creatinine)
Time frame: Baseline, Weeks 8, 16, 24
Change From Baseline in Clinical Laboratory Values for Chemistry (Sodium, Potassium, Chloride, Blood Urea Nitrogen [BUN]/Urea, Calcium, Phosphate)
Time frame: Baseline, Weeks 8, 16, 24
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Apr 2025.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Derived from this study: PubMed 40971924Schreiber S, Lee SD, van der Woude CJ, Marin-Jimenez I, Wolf DC, Schnoy E, Salzberg B, Busse C, Nazar M, Ma T, Borghorst S, Gasink C, Baker T, Godwin B, Adedokun OJ, Feagan BG; POWER Study Group. Ustekinumab Intravenous Reinduction after Secondary Loss of Response in Patients with Crohn's Disease. Inflamm Bowel Dis. 2025 Dec 1;31(12):3286-3297. doi: 10.1093/ibd/izaf163.
- Derived from this study: PubMed 40357993Hasskamp J, Meinhardt C, Timmer A. Anti-IL-12/23p40 antibodies for induction of remission in Crohn's disease. Cochrane Database Syst Rev. 2025 May 13;5(5):CD007572. doi: 10.1002/14651858.CD007572.pub4.
- Derived from this study: PubMed 34334713Ten Bokkel Huinink S, Biemans V, Duijvestein M, Pierik M, Hoentjen F, West RL, van der Woude CJ, de Vries AC. Re-induction with intravenous Ustekinumab after secondary loss of response is a valid optimization strategy in Crohn's disease. Eur J Gastroenterol Hepatol. 2021 Dec 1;33(1S Suppl 1):e783-e788. doi: 10.1097/MEG.0000000000002256.
- Individual participant dataSharing planned: Yes. The data sharing policy of the Janssen Pharmaceutical Companies of Johnson \& Johnson is available at www.janssen.com/clinical-trials\transparency. As noted on this site, requests for access to the study data can be submitted through Yale open and Access (YODA) Project site at yoda.yale.edu
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Janssen-Cilag Ltd. Clinical Trial study director
Janssen-Cilag Ltd.
104 sites in 12 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Ustekinumab approximately 6 mg/kg (IV), Ustekinumab 90 mg (SC) Group 1 and Ustekinumab 90 mg (SC) Group 2 in people with Crohn Disease, run by Janssen-Cilag Ltd. at 104 sites in 12 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 3 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 29 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 104 sites in United States, Germany, Spain, France, Italy and 7 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 13 Sep 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Percentage of Participants With Clinical Response at Week 16 (time frame: Week 16). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03782376, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Apr 2025.