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Ulcerative ColitisPhase 2COMBO-UCNCT06453317

Comparison of Ustekinumab, Infliximab and Combination Therapy in Moderately to Severely Active Ulcerative Colitis

A Phase 2 study testing Infliximab and Ustekinumab in people with Ulcerative Colitis and Inflammatory Bowel Diseases, run by Medical University of Lodz at 1 site in Poland.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The goal of this clinical trial is to learn if combined therapy with infliximab and ustekinumab works better than using these drugs alone in adult patients with ulcerative colitis. It will also learn about the safety of this combination. Read more about this study

Who is it for?
Ages 18 to 64 years
What is being tested?
Infliximab and Ustekinumab
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
172 participants
Where
1 sitePoland
Study dates
17 Feb 2025to 30 Jun 2028
Phase
Phase 2
Are there results?
Not yet: the study is under way

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 to 64 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • Obtaining informed, written consent for the patient's participation in the in the study and for all planned procedures.
  • Age ≥ 18 years and ≤65 at the time of screening.
  • In the case of women of reproductive potential, agreement to not donate oocytes for the entire period of participation in the in the study and 6 months after receiving the last dose of the drug.
  • For women of reproductive potential, agreement to use effective contraception (Table 4) during the entire period, during which the patient participates in the study and for a period counted from the last dose of 15 weeks if using UST (patients in arms B and C) or 6 months if using IFX (patients in arm A).
  • Negative serum or urine pregnancy test in women of childbearing age.
  • Diagnosis of UC a minimum of. 3 months prior to screening documented by:
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  • medical source documentation of the patient with the result of an endoscopic examination that diagnosed features typical of UC.
  • a histopathological examination result consistent with UC. In the absence of a histopathological result, it is possible to take sections during the endoscopic examination for histopathological evaluation at the time of eligibility for the study with subsequent sending of the material to the local pathomorphology laboratory to confirm the diagnosis of UC before randomization.
  • UC with moderate or severe activity defined as a Mayo scale score (Appendix 2) of 7 to 12 including the following sub-item values (each sub-item 0-3 points depending on the severity of the lesions):
  • Frequency of bowel movements
  • Bowel bleeding
  • Endoscopic image of the colonic mucosa
  • General medical evaluation and:
  • with inadequate response to standard treatment, including corticosteroids and 6-mercaptopurine or azathioprine, or.
  • intolerant of treatment with corticosteroids and 6-mercaptopurine or azathioprine, or
  • having contraindications to treatment with corticosteroids and 6-mercaptopurine or azathioprine, or
  • with loss of response to standard treatment, including to treatment with corticosteroids and 6-mercaptopurine or azathioprine, including patients:
  • Steroid-resistant - in whom there is no clinical improvement despite the use of a daily steroid up to 0.75 mg/kg prednisolone for 4 weeks;
  • Steroid-dependent - in whom failure to reduce the steroid dose below 10 mg/day, converted to prednisolone, within 3 months of starting steroid therapy or relapse of complaints within 3 months of steroid withdrawal.
  • Refractory patients/about inadequate response to immunosuppressive treatment, defined as lack of remission or recurrence of complaints despite immunosuppressive treatment for at least 3 months at appropriate doses (azathioprine 2-2.5 mg/kg/day or 6-mercaptopurine 1-1.5 mg/kg/day).
  • Patients taking 5-ASA derivatives, corticosteroids, immunosuppressants may be included in the study if they are taking a fixed and specified dose of the above drugs 14 days before the day of randomization.

Who cannot join

  • Previous use of the study drug IFX or UST.
  • Hypersensitivity to the active substance or excipients.
  • Moderate or severe myocardial insufficiency (NYHA III or IV).
  • Unstable coronary artery disease.
  • History of serious cerebrovascular disease (stroke, intracranial hemorrhage, transient cerebral ischemia) within the last 24 weeks prior to screening.
  • Chronic respiratory failure.
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  • Severe chronic renal failure.
  • Severe chronic liver failure.
  • Demyelinating syndrome or symptoms resembling the syndrome.
  • Alcoholic disease, post-alcoholic liver damage.
  • Diagnosis of malignant neoplasms, including within 5 years preceding the time of eligibility for the program (except for carcinoma in situ of the cervix, and non-melanoma skin cancers).
  • 12 Complications requiring other management (e.g., surgery). 13. Current or recent (defined as an incident within 12 weeks prior to randomization) documented episode of fulminant colitis, or intra-abdominal abscess, or acute colonic distension, or bowel perforation.
  • 14. Status after extensive colorectal resection, subtotal or total colectomy with or without colostomy, or J-pouch reservoir.
  • 15. Indication of surgical intervention due to underlying disease or when there is a suspicion of need for such intervention during the course of the study.
  • 16. History of current or previously documented unclassified colitis or ischemic colitis.
  • 17. History of colonic diverticulitis within the last 60 days prior to the randomization visit.
  • 18. Current adenomatous polyps of the colon, small- or large-grade dysplasia in colon specimens, or previously diagnosed foci of large-grade dysplasia that have not been treated.
  • 19. Enteral nutrition or total parenteral nutrition. 20. Pregnancy or breastfeeding. 21. Taking medications on the prohibited drugs list (Section 7.4.6). 22. daily dose of prednisone> 40 mg (or equivalent other corticosteroid) or budesonide MMX > 9 mg.
  • 23. Status after bone marrow transplantation. 24. Condition after apheresis 12 months prior to the randomization visit. 25. Period after administration of allowed biologic drugs shorter than the drug's washout period from the body (Section 7.2).
  • 26. Period after intestinal microbiota transplantation less than 8 weeks before signing informed consent to participate in the study.
  • 27. Active or latent form of tuberculosis. 28. HIV infection. 29. Treatment period for active lesions of chronic infections (including pneumocystodosis, CMV, HPV, HSV infection, atypical mycobacteriosis, invasive bacterial or fungal infections).
  • 30 History of HSV, HPV, influenza virus, SARS-CoV2 infection within 12 weeks prior to randomization or history of disseminated or complicated HSV infection.
  • 31. History of congenital or acquired immunodeficiency. 32. receipt of live vaccine within 30 days prior to randomization. 33. infection with HBV or HCV. 34. Clinically significant changes on chest X-ray or ECG. 35 Clinically significant changes observed in laboratory test results:
  • ALT activity >3x the upper limit of normal (GGN)
  • AST activity >3x GGN
  • Total bilirubin level >2x GGN (exception is Gilbert syndrome when other causes of isolated hyperbilirubinemia are excluded).
  • ALP or GGTP activity >3x GGN
  • Creatinine level >2x GGN or impaired renal function (eGFR) <45mL/min calculated by MDRD formula.
  • Hemoglobin level <9g/dL
  • Absolute leukocyte count <3000/mm3
  • Absolute lymphocyte count <750/mm3
  • Neutrophil level <1000/mm3
  • Platelet level <100000/mm3. 36. Positive stool culture for bacteria/fungus (if clinically relevant in the opinion of the investigator).
  • 37.Positive stool culture for Clostridioides difficile. 38. Use of treatment not permitted under this protocol.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Renata Talar-Wojnarowska, Prof. contact

+48426776664

renata.talar-wojnarowska@umed.lodz.pl

Adam Fabisiak, PhD, MD contact

+48500316396

adam.fabisiak@umed.lodz.pl

Poland1 site, 1 recruiting
  • Oddział Kliniczny Gastroenterologii Ogólnej i Onkologicznej USK nr 1 im. N. Barlickiego w Łodzi

    Lodz, 90-153

    Adam Fabisiak, PhD, +48426776667, adam.fabisiak@umed.lodz.pl

    Recruiting

Other trials in Poland

About this study

Official title: Comparison of Ustekinumab, Infliximab and Combination Therapy in Moderately to Severely Active Ulcerative Colitis (COMBO-UC)

The goal of this clinical trial is to learn if combined therapy with infliximab and ustekinumab works better than using these drugs alone in adult patients with ulcerative colitis. It will also learn about the safety of this combination. The main questions it aims to answer are:

Does the combination therapy improve the symptoms and heal the intestine quicker and better than these drugs administered alone? Does the combination therapy improve the quality of life better than these drugs administered alone? What medical problems do participants have when taking the combination therapy?

Read more

Participants:

Patients diagnosed with UC will be qualified to biologic therapy (infliximab/ustekinumab/infliximab + ustekinumab).

Visit the clinic in stated periods for assessment and to apply medication. Take drugs based on the schedule.

Being tested
Infliximab, Ustekinumab
Keywords
dual biological therapy, infliximab, ustekinumab, Inflammatory Bowel Diseases, Ulcerative Colitis
Medical subject headings
Colitis, Ulcerative, Inflammatory Bowel Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • InfliximabBiological

    Infliximab 5 mg/kg i.v at Weeks 0, 2, 6 and then every 8 weeks for 52 weeks.

  • UstekinumabBiological

    Ustekinumab: first dose i.v. at Week 0 (Patients with body weight ≤55 kg - 260 mg, patients with body weight >55-≤85 kg 390 mg, patients with body weight >85 kg - 520 mg) then 90 mg s.c. every 8/12 weeks for 52 weeks.

Study groups in NCT06453317
Study groupRoleWhat they receive
InfliximabActive comparatorInfliximab 5 mg/kg i.v at Weeks 0, 2, 6 and then every 8 weeks for 52 weeks.
Receives: Biological: Infliximab
UstekinumabActive comparatorUstekinumab: first dose i.v. at Week 0 (Patients with body weight ≤55 kg - 260 mg, patients with body weight >55-≤85 kg 390 mg, patients with body weight >85 kg - 520 mg) then 90 mg s.c. every 8/12 weeks for 52 weeks.
Receives: Biological: Ustekinumab
Infliximab + UstekinumabExperimentalInfliximab 5 mg/kg i.v. at Week 0, 2, 6. + Ustekinumab: first dose i.v. at Week 0 (Patients with body weight ≤55 kg - 260 mg, patients with body weight >55-≤85 kg 390 mg, patients with body weight >85 kg - 520 mg) then 90 mg s.c. every 8/12 weeks for 52 weeks
Receives: Biological: Infliximab; Biological: Ustekinumab

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of patients with clinical and endoscopic remission after the induction phase.

    Clinical remission: PRO-2 score ≤1 points, total Mayo score <3 Endoscopic remission: endoscopic Mayo score ≤1

    Measured: Week 14 for Infliximab arm and Week 16 for Ustekinumab and Infliximab + Ustekinumab arms

Secondary outcomes (8)
  1. Percentage of patients with clinical response after the induction phase.

    Clinical response: change in PRO-2 score ≥50% or a change in total Mayo score ≥3 points

    Measured: Week 14 for Infliximab arm and Week 16 for Ustekinumab and Infliximab + Ustekinumab arms

  2. Percentage of patients with clinical response at Week 52.

    Clinical response: change in PRO-2 score ≥50% or a change in total Mayo score ≥3 points

    Measured: Week 52

  3. Percentage of patients with clinical remission at Week 52.

    Clinical remission: PRO-2 score ≤1 points, total Mayo score <3

    Measured: Week 52

  4. Percentage of patients with endoscopic response or remission after the induction phase and at Week 52

    Endoscopic response: change in endoscopic Mayo score ≥1 point Endoscopic remission: endoscopic Mayo score ≤1

    Measured: Week 14 for Infliximab arm and Week 16 for Ustekinumab and Infliximab + Ustekinumab arms and Week 52

  5. Percentage of patients with biochemical remission after the induction phase and at Week 52.

    Biochemical remission: calprotectin level ≤125 µg/g of stool

    Measured: Week 14 for Infliximab arm and Week 16 for Ustekinumab and Infliximab + Ustekinumab arms and Week 52

  6. Percentage of patients with histological remission after the induction phase.

    Deep remission: PRO-2 score = 0 points, endoscopic Mayo score = 0 points and Picasso Histologic Remission Index = 0 points

    Measured: Week 14 for Infliximab arm and Week 16 for Ustekinumab and Infliximab + Ustekinumab arms

  7. Comparison of patients' quality of life after the induction phase and at Week 52 using 36-Item Short Form Survey (SF-36) and Inflammatory Bowel Disease Questionnaire (IBDQ).

    SF-36: 0-100 points (a score of zero is equivalent to maximum disability and a score of 100 is equivalent to no disability).

    IBDQ: 32-224 points (higher scores representing better quality of life).

    Measured: Week 14 for Infliximab arm and Week 16 for Ustekinumab and Infliximab + Ustekinumab arms and Week 52

  8. Comparison of incidence of treatment-emergent adverse events after the induction phase and at Week 52.

    Treatment-emergent adverse events and serious adverse events will be assessed

    Measured: Week 14 for Infliximab arm and Week 16 for Ustekinumab and Infliximab + Ustekinumab arms and Week 52

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted11 Jun 2024
  2. Study start17 Feb 2025
  3. Primary completion30 Apr 2028 (estimated)
  4. Study completion30 Jun 2028 (estimated)

Resources

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
172 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06453317
Sponsor's protocol ID
Combo/2022/3
Other IDs
2023-506452-25, 2023
Acronym
COMBO-UC
Status last verified
Nov 2024
First submitted
24 May 2024
Last updated
15 May 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Infliximab and Ustekinumab in people with Ulcerative Colitis and Inflammatory Bowel Diseases, run by Medical University of Lodz at 1 site in Poland.

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 21 inclusion and 34 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: looking for participants now, as of the sponsor's last update on 15 May 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Poland. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Renata Talar-Wojnarowska, Prof. (+48426776664, renata.talar-wojnarowska@umed.lodz.pl), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of patients with clinical and endoscopic remission after the induction phase. (time frame: Week 14 for Infliximab arm and Week 16 for Ustekinumab and Infliximab + Ustekinumab arms). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 15 May 2025.

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