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Ontamalimab

Phase 3

Crohn's Disease | Monoclonal antibody | Gastrointestinal |Takeda Pharmaceutical Company Limited|Trials Updated: Jun 21, 2024

Ontamalimab development status

Highest phase Phase 3
Registered trials 8 across 2 sponsors since Feb 2011

Ontamalimab target and mechanism

Molecular targetMADCAM1
Target classInhibitor
ModalityMonoclonal antibody

Also known as PF-00547659, SHP647

Success Probability

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Market & Valuation

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Trial Design

RandomizedDouble-BlindCONTROLLEDDMC
Total Trials6
Total Enrollment2,143

FDA Designations

No designations recorded

Ontamalimab clinical trials

Ontamalimab · 6 trials · 2 indications

Phase 3 2Phase 2 4
NCT03290781An Efficacy and Safety Study of Ontamalimab as Maintenance Therapy in Participants With Moderate to Severe Ulcerative ColitisUlcerative Colitis
COMPLETED366 Analytics
NCT03283085A Safety Extension Study of Ontamalimab in Participants With Moderate to Severe Ulcerative Colitis or Crohn's Disease (AIDA)Crohn's Disease
COMPLETED557 Analytics
PHASE3COMPLETED
An Efficacy and Safety Study of Ontamalimab as Maintenance Therapy in Participants With Moderate to Severe Ulcerative Colitis
Ulcerative ColitisUnlock trial analytics
PHASE3COMPLETED
A Safety Extension Study of Ontamalimab in Participants With Moderate to Severe Ulcerative Colitis or Crohn's Disease (AIDA)
Crohn's DiseaseUnlock trial analytics

Study Endpoints

Primary Endpoints

Number of Participants With Remission Based on Composite Score at Week 52
At Week 52

Remission: a composite score of participant reported symptoms using daily e-diary and centrally read endoscopy as follows: stool frequency sub-score 0 or 1 with at least a 1-point change from induction study baseline; and rectal bleeding sub-score of 0; and endoscopic sub-score 0 or 1 (modified, excludes friability). The composite score was a recommended measure consisted of Mayo score without the Physician global assessment (PGA) sub-score and ranges from 0-9 points. The Mayo score was a measure of UC disease activity ranged from 0-12 points and consisted of 4 sub-scores, each graded from 0-3 with higher scores indicating more severe disease. Sub-scores were rectal bleeding (range: 0-3, where 0= no blood \& 3=blood alone passes), stool frequency (range: 0-3, where 0= normal number of stools and 3=at least 5 stools more than normal), PGA sub-score (range: 0-3- higher score= severe disease), and an endoscopic sub-score (range: 0-3, where 0= normal/inactive disease; 3= severe disease).

Number of Participants With Treatment Emergent Adverse Events (TEAEs)
From first dose of study drug up to end of study [EOS] (up to 5.79 years)

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.

Number of Participants With Serious Infections
From first dose of study drug up to EOS (up to 5.79 years)

Serious infections were defined as any infections that were life-threatening or those requiring hospitalization or intravenous antibiotics based on the investigator's assessment.

Number of Participants With Notable Changes in Clinical Laboratory Parameters Over Time
From first dose of study drug up to EOS (up to 5.79 years)

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.

Number of Participants With Discernible Changes in Electrocardiogram (ECG) Over Time
From first dose of study drug up to EOS (up to 5.79 years)

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.

Number of Participants With Discernible Changes in Vital Signs Over Time
From first dose of study drug up to EOS (up to 5.79 years)

Vital sign assessments included blood pressure, pulse, respiratory rate, and temperature. Any discernible changes in vital signs over time per investigator interpretation were reported.

Number of Participants With Treatment-Emergent Adverse Events (TEAEs), Treatment-Emergent Serious Adverse Events (TESAEs), and Who Withdrew From Treatment Due to Treatment-Emergent Adverse Events (TEAEs)
From start of study drug administration up to 168 weeks

An adverse event (AE) was defined as any untoward medical occurrence in a clinical investigation participant who was administered a product or medical device; the event did not need to necessarily have a causal relationship with the treatment or usage. A serious adverse event (SAE) was any untoward medical occurrence at any dose that resulted in death, was life threatening (immediate risk of death), required inpatient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, resulted in congenital anomaly/birth defect. Number of participants with TEAEs, STEAEs, and those withdrew from treatment due to TEAEs were reported.

Percentage of Participants in Clinical Remission at Week 12
Week 12

Clinical remission was defined as a Total Mayo Score of less than or equal (\<=) 2 points with no individual subscore exceeding 1 point and rectal bleed subscore of 0 or 1. The Mayo Score is a tool designed to measure disease activity for ulcerative colitis (UC). Scoring ranges from 0 to 12 points and consists of 4 subscores, each graded 0 to 3 with higher score indicating more severe disease activity. Endoscopic readings from the local and the central reader were considered for analysis. The central reading was used as the primary analysis and the local readings were used for the sensitivity analyses.

Number of Participants With On-Treatment Adverse Events (AEs), AEs Led to Withdrawal, and Serious Adverse Events (SAEs)
From start of study treatment up to Week 72 (Treatment Period)

AEs included adverse drug reactions, illnesses with onset during the study, exacerbation of previous illnesses, clinically significant changes in physical examination findings and abnormal objective test findings (ECG, laboratory). An SAE was defined as any AE at any dose that resulted in death; was life threatening (immediate risk of death); required in-subject hospitalization or prolongation of existing hospitalization; resulted in a persistent or significant disability/incapacity (substantial disruption of the ability to conduct normal life functions); or resulted in congenital anomaly/birth defect.

Percentage of Participants With Crohn's Disease Activity Index (CDAI) 70 Response Rate
Week 8 and week 12

Crohn's Disease Activity Index (CDAI) is a number which consists of information collected from a 7-day diary from the participants regarding symptoms. Remission is considered a score of 150 or less. Active disease is considered 200 or greater. A response to therapy is considered a decline in CDAI score of 70-points from baseline. CDAI response rate at week 8 and week 12 was measured between the investigational product group and the placebo group.

Secondary Endpoints

Number of Participants With Endoscopic Remission at Week 52
At Week 52
Number of Participants With Clinical Remission at Week 52
At Week 52
Number of Participants With Sustained Remission at Week 52
At Week 52
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Study Design & Arms

AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Ontamalimab 25 mgEXPERIMENTALParticipants will receive 25 milligram (mg) of ontamalimab or placebo and achieved a clinical response in one of the induction studies (SHP647-301 \[NCT03259334\] and SHP647-302 \[NCT03259308\]) will receive 25 mg of ontamalimab as maintenance treatment subcutaneously using a prefilled syringe once in every 4 weeks (Q4W) up to Week 52.
Ontamalimab 75 mgEXPERIMENTALParticipants will receive 75 mg of ontamalimab or placebo and achieved a clinical response in one of the induction studies (SHP647-301 \[NCT03259334\] and SHP647-302 \[NCT03259308\]) will receive 75 mg of ontamalimab as maintenance treatment subcutaneously using a prefilled syringe Q4W up to Week 52.
PlaceboPLACEBO_COMPARATORParticipants will receive 25 mg or 75 mg ontamalimab or placebo matched to ontamalimab in the induction studies (SHP647-301 \[NCT03259334\] and SHP647-302 \[NCT03259308\]) will receive placebo matched to ontamalimab as maintenance treatment subcutaneously using a prefilled syringe Q4W up to Week 52.
Ulcerative Colitis (UC): Ontamalimab 25 mgEXPERIMENTALParticipants received 25 milligrams (mg) of ontamalimab solution for injection subcutaneously (SC), every 4 weeks (Q4W), for up to 3 years.
UC: Ontamalimab 25mg then 75 mgEXPERIMENTALParticipants 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.
UC: Ontamalimab 75 mgEXPERIMENTALParticipants received 75 mg of ontamalimab solution for injection SC, Q4W, for up to 5.79 years.
Crohn's disease (CD): Ontamalimab 25 mgEXPERIMENTALParticipants received 25 mg of ontamalimab solution for injection SC, Q4W, for up to 3 years.
CD: Ontamalimab 25mg then 75 mgEXPERIMENTALParticipants 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.
CD: Ontamalimab 75 mgEXPERIMENTALParticipants received 75 mg of ontamalimab solution for injection SC, Q4W, for up to 5.79 years.
SHP647 75 mgEXPERIMENTALParticipants will receive 75 milligrams (mg) of SHP647 subcutaneous (SC) injection every 4 weeks for 72 weeks in the anterolateral right/left thigh or the deltoid area or the abdomen. During the first 72 weeks, a one time dose escalation to 225 mg of SHP647 SC injection every 4 weeks is allowed after 8 weeks of the study for participants who experience clinical deterioration or unacceptably low level of response to the investigational product. The decision to escalate will be guided by the response and relapse criteria tempered by clinical judgment. Following the first 72 weeks, participants will receive 75 mg of SHP647 SC injection every 4 weeks for an additional 72 weeks in the anterolateral right/left thigh or the deltoid area or the abdomen.
SHP647 225 mgEXPERIMENTALParticipants will receive 225 mg of SHP647 SC injection every 4 weeks for 72 weeks followed by 75 mg of SHP647 SC injection every 4 weeks for an additional 72 weeks in the anterolateral right/left thigh or the deltoid area or the abdomen.
Drug Dose Level 1EXPERIMENTAL -
Drug Dose Level 2EXPERIMENTAL -
Drug Dose Level 3EXPERIMENTAL -
Drug Dose Level 4EXPERIMENTAL -
Open-Label TreatmentEXPERIMENTALSubjects eligible for this study will have completed the 12 week double blind induction period in study A7281006 and will be stratified by responders or non responders based on change in CDAI in that study, without unblinding treatment assignment from study A7281006. Additionally, subjects who have completed study A7281008
Placebo-SC InjectionPLACEBO_COMPARATORPlacebo delivered SC, 3 doses separated by 4 weeks.
Drug Dose level 1- SC injectionEXPERIMENTALDrug dose level 1 delivered SC, 3 doses separated by 4 weeks.
Drug Dose level 2-SC injectionEXPERIMENTALDrug dose level 2 delievered SC, 3 doses separated by 4 weeks.
Drug Dose level 3- SC injectionEXPERIMENTALDrug dose level 3 delivered SC, 3 doses separated by 4 weeks.

Interventions

NameTypeDescription
OntamalimabDRUGParticipants will receive 1 milliliter (mL) of ontamalimab sterile aqueous buffered solution at an appropriate oncentration to provide an intended dose of drug (25 or 75 mg).
PlaceboOTHERParticipants will receive 1 mL of sterile aqueous buffered solution.
25 mg OntamalimabDRUGOntamalimab SC solution for injection
75 mg OntamalimabDRUGOntamalimab SC solution for injection
75mg SHP647 (PF-00547659)DRUG75 mg sterile liquid injected subcutaneously every 4 weeks.
225mg SHP647 (PF-00547659)DRUG225 mg sterile liquid injected subcutaneously every 4 weeks.
PF-00547659 SC InjectionDRUGDrug Dose Level 1 delivered subcutaneous injection, 3 doses separated by 4 weeks
PF-00547659DRUG75 mg SC once monthly for 72 weeks. Subjects may escalate to 225 mg or de-escalate to 22.5 mg one time.
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Eligibility Criteria

Age Range16 Years to 81 Years
SexALL
Healthy VolunteersNo
Study Sites401

Inclusion Criteria: * Participants and/or their parent or legally authorized representative must have an understanding, ability, and willingness to fully comply with study procedures and restrictions. * Participants must be able to voluntarily provide written, signed, and dated (personally or via a...

Countries:United StatesArgentinaAustraliaAustriaBelgiumBosnia and HerzegovinaBulgariaCanadaColombiaCroatiaCzechiaEstoniaGermanyGreeceHungaryIrelandIsraelItalyJapanLebanonLithuaniaMexicoNetherlandsNew ZealandPolandPortugalRomaniaRussiaSerbiaSlovakiaSouth AfricaSouth KoreaSpainSwitzerlandTurkey (Türkiye)UkraineUnited KingdomFranceNorway
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Frequently asked questions about Ontamalimab

What is ontamalimab used for?

Ontamalimab is an investigational monoclonal antibody being developed for the treatment of moderate to severe ulcerative colitis and Crohn's disease. It is designed as a maintenance therapy for these inflammatory bowel diseases. It has not been approved by the FDA and remains in clinical development.

What does ontamalimab target?

Ontamalimab targets MADCAM1, also known as mucosal addressin cell adhesion molecule 1. It acts as an inhibitor of this target. By binding to MADCAM1, ontamalimab is thought to interfere with the migration of inflammatory cells into the gastrointestinal tract, which may help reduce inflammation in ulcerative colitis and Crohn's disease.

Who is developing ontamalimab?

Ontamalimab is being developed by Takeda Pharmaceutical Company Limited, which trades under the ticker symbol TAK. Takeda is the sponsor of the clinical trials evaluating ontamalimab in ulcerative colitis and Crohn's disease.

What phase is ontamalimab in?

Ontamalimab is in Phase 3 clinical development. It is an investigational drug and has not been approved by the FDA for any indication. The Phase 3 program includes completed trials in ulcerative colitis and Crohn's disease.

What clinical trials is ontamalimab in?

Ontamalimab has been studied in two completed Phase 3 trials. NCT03290781 evaluated ontamalimab as maintenance therapy in 366 participants with moderate to severe ulcerative colitis. NCT03283085, known as the AIDA study, was a safety extension study in 557 participants with moderate to severe ulcerative colitis or Crohn's disease.