Clinical trial • Phase IV • Gastroenterology
MIRIKIZUMAB for Ulcerative colitis
Phase IV trial of MIRIKIZUMAB for Ulcerative colitis.
Overview
- Trial Therapeutic Area
- Gastroenterology
- Trial Disease
- Ulcerative colitis
- Trial Stage
- Phase IV
- Drug Modality
- Monoclonal antibody | Small molecule
Key dates
- Initial CTIS Submission Date
- 04-07-2025
- First CTIS Authorization Date
- 26-09-2025
Trial design
Randomised, open-label, azathioprine (oral) and glucocorticoids (oral prednisolone): azathioprine reported with max daily dose 2.5 mg/kg (doseuom mg/kg); glucocorticoids reported with max daily dose 60 mg. used as standard of care comparator (azathioprine/glucocorticoids) without step-up treatment.-controlled Phase IV trial in Germany.
- Randomised
- Yes
- Open Label
- Yes
- Comparator
- Azathioprine (oral) and glucocorticoids (oral prednisolone): azathioprine reported with max daily dose 2.5 mg/kg (doseUom mg/kg); glucocorticoids reported with max daily dose 60 mg. Used as standard of care comparator (azathioprine/glucocorticoids) without step-up treatment.
- Target Sample Size
- 300
- Trial Duration For Participant
- 364
Eligibility
Recruits 300 No vulnerable populations selected (isVulnerablePopulationSelected=false). All participants must "Have given written informed consent prior to any study-specific procedures being completed." Age inclusion is 18-75 years; consent is provided by the participant. No mention of assent or minor consent procedures; subject information and informed consent documents are listed in the trial documents..
- Pregnancy Exclusion
- Women who are pregnant, lactating or planning pregnancy.
- Vulnerable Population
- No vulnerable populations selected (isVulnerablePopulationSelected=false). All participants must "Have given written informed consent prior to any study-specific procedures being completed." Age inclusion is 18-75 years; consent is provided by the participant. No mention of assent or minor consent procedures; subject information and informed consent documents are listed in the trial documents.
Inclusion criteria
- {"criterion_text":"- Have given written informed consent prior to any study-specific procedures being completed.\n- The oral 5-ASA therapy must have been ongoing for at least 8 weeks and dose must be stable for at least 2 weeks before baseline.\n- Modified Mayo score (mMS) 5-9.\n- Endoscopic Mayo (eMayo) score ≥2 (local).\n- Robarts Histopathology Index (RHI) >4 (central).\n- Elevated CRP (above the upper limit of normal) or Fcal (above 250 ug/g stool).\n- Disease localization involving at least the rectum and sigmoid colon (>15 cm).\n- Are willing and able to complete the scheduled study assessments, including endoscopy and daily diary entry.\n- Are willing to comply with contraception requirements (as specified in section 7.7)\n- Age between 18 and 75 years.\n- Naïve to azathioprine and its metabolite 6-MP\n- Naïve to advanced therapies.\n- Early disease (duration < 12 months since first diagnosis).\n- Patients with active ulcerative colitis (UC) for whom a previous therapy with 5-aminosalicylic acid (5-ASA) or steroids have not worked well enough, have stopped working, or have caused unacceptable side effects.\n- The steroid oral therapy must have been stable for at least two weeks before baseline and may consist of prednisone ≤20 mg/day (or equivalent) per os."}
Exclusion criteria
- {"criterion_text":"- Fulminant ulcerative colitis patients who do not respond to steroid treatment or requiring >20 mg of prednisolone (or equivalent) at baseline and/or fulfilling the criteria for severe UC (requirement of hospitalization).\n- Have been diagnosed with clinically important infection including, but not limited to, hepatitis B, hepatitis C, HIV/AIDS, and active tuberculosis (TB).\n- Have detectable hepatitis B virus (HBV) DNA. or hepatitis C virus (HCV) RNA.\n- Have been diagnosed with latent TB and are not willing to comply with completing TB treatment as appropriate.\n- Intend to receive a Bacillus Calmette-Guerin (BCG) vaccination or live attenuated vaccine(s) during the study.\n- Have been diagnosed with systemic mycoses and parasitosis.\n- Have an unstable or uncontrolled illness, including, but not limited to, cerebro-cardiovascular, respiratory, gastrointestinal (excluding UC), hepatic, renal, endocrine, hematologic or neurological disorders or malignancy that would potentially affect patient safety within the study or confound efficacy assessment.\n- Have a known systemic hypersensitivity to any component of this investigational product or has experienced an acute systemic hypersensitivity event with previous study drug administration, that precludes mirikizumab therapy.\n- Women who are pregnant, lactating or planning pregnancy.\n- Became a Lilly employee or employee of any of the organizations involved with this study or study site personnel directly affiliated with this study and/or their immediate families.\n- Have participated in another clinical trial involving an investigational product or nonapproved use of a drug during the last twelve weeks before screening or are currently enrolled in any other clinical study involving an investigational product or any other type of medical research judged not to be scientifically or medically compatible with this study.\n- Patients with complex UC who have required cyclosporine and tacrolimus for previous treatment.\n- Treatment with MTX within 8 weeks before baseline.\n- Rectal 5-ASA or rectal steroids treatment within 2 weeks prior to baseline.\n- History of malignancy, except for non-melanoma skin cancer.\n- Planned or foreseeable surgery at the time of inclusion.\n- Known thiopurine methyltransferase deficiency.\n- Known hereditary problems of galactose intolerance, total lactase deficiency, or glucose-galactose malabsorption.\n- Diagnosis of Crohn’s disease.\n- Are unwilling or unable to comply with the use of a data collection device to directly record data from the patient daily for the duration of Study MIRACLE or are unable to complete other study procedures.\n- Have been committed to an institution by virtue of an order issued either by the judicial or the administrative authorities."}
Endpoints
Primary endpoints
- {"endpoint_text":"- The proportion of patients achieving comprehensive disease control at Week 52.","definition_or_measurement_approach":"Measured as the proportion of patients achieving comprehensive disease control at Week 52. The main objective states mirikizumab induction and maintenance therapy (with possibility of extended induction or re-induction) is compared to azathioprine/glucocorticoids and that step-up treatment at any time point in the azathioprine arm is classified as outcome failure due to non-response."}
Recruitment
- Digital Remote Recruitment
- Yes
- Planned Sample Size
- 300
- Recruitment Window Months
- 30
- Consent Approach
- Written informed consent required: 'Have given written informed consent prior to any study-specific procedures being completed.' Participants are adults (age 18-75) and provide consent themselves. Subject information and informed consent documents are listed among trial documents. No assent procedures or languages specified in the available data.
Geography
- Total Number Of Sites
- 15
- Total Number Of Participants
- 300
Germany
- Earliest CTIS Part Ii Submission Date
- 28-08-2025
- Latest Decision Or Authorization Date
- 24-04-2026
- Processing Time Days
- 239
- Number Of Sites
- 15
- Number Of Participants
- 300
Sites
- Site Name
- Studiengesellschaft BSF UG (haftungsbeschraenkt)
- Department Name
- Studiengesellschaft BSF UG (haftungsbeschraenkt)
- Contact Person Name
- Lars Fechner
- Contact Person Email
- dr.fechner@bsf-halle.de
- Site Name
- Practice for Gastroenterology
- Department Name
- Practice for Gastroenterology
- Contact Person Name
- Jens Müller-Ziehm
- Contact Person Email
- mz@gastro-han.de
- Site Name
- Specialist Internal Medicine Practice
- Department Name
- Specialist Internal Medicine Practice
- Contact Person Name
- Matthias Kahl
- Contact Person Email
- kahl2000@gmx.de
- Site Name
- Dr. med. Thomas Brunk Gastroenterologie Berlin
- Department Name
- CED Studienzentrum Karlshorst
- Contact Person Name
- Thomas Brunk
- Contact Person Email
- ced@gastroenterologie-brunk.de
- Site Name
- Siloah St Trudpert Klinikum
- Department Name
- Zentrum für Innere Medizin
- Contact Person Name
- Oliver Bachmann
- Contact Person Email
- oliver.bachmann@siloah.de
- Site Name
- Medical Care Center Gastroenterology Friedrichshain
- Department Name
- Medical Care Center Gastroenterology Friedrichshain
- Contact Person Name
- Peer van Heteren
- Contact Person Email
- vanheteren@gastroenterologie-friedrichshain.de
- Site Name
- Philipps-Universitaet Marburg
- Department Name
- Gastroenterology
- Contact Person Name
- Jan Granseyer
- Contact Person Email
- jan.granseyer@uk-gm.de
- Site Name
- Klinikum Ernst von Bergmann gGmbH
- Department Name
- Clinic for Gastroenterology, Hepatology, Infectious Disease and Rheumatology
- Contact Person Name
- Daniel Baumgart
- Contact Person Email
- daniel.baumgart@uni-potsdam.de
- Site Name
- Staedtisches Klinikum Lueneburg gGmbH
- Department Name
- Internal Medicine and Gastroenterology
- Contact Person Name
- Torsten Kucharzik
- Contact Person Email
- Torsten.kucharzik@klinikum-lueneburg.de
- Site Name
- Gastropraxis Magdeburg
- Department Name
- Gastroenterology
- Contact Person Name
- Lars Zimmermann
- Contact Person Email
- zimmermann@gastropraxis-md.de
- Site Name
- Gastropraxis an der St. Barbara-Klinik
- Department Name
- Gastroenterology
- Contact Person Name
- Ulrich Tappe
- Contact Person Email
- tappe@gastro-praxis-hamm.de
- Site Name
- Gastroenterologische Schwerpunktpraxis Prof. Dr. Ludwig & Dr. med. Güthle
- Department Name
- Gastroenterologische Schwerpunktpraxis Prof. Dr. Ludwig & Dr. med. Güthle
- Contact Person Name
- Leopold Ludwig
- Contact Person Email
- l.ludwig@praxis-endoskopie.de
- Site Name
- Surgery Dr. med. Thomas Zeisler
- Department Name
- Surgery Dr. med. Thomas Zeisler
- Contact Person Name
- Thomas Zeisler
- Contact Person Email
- gastrozeisler@yahoo.de
- Site Name
- Martin-Luther-Universitaet Halle-Wittenberg
- Department Name
- Clinic and Polyclinic for Internal Medicine I
- Contact Person Name
- Jens Walldorf
- Contact Person Email
- jens.walldorf@uk-halle.de
- Site Name
- Universitaetsklinikum Schleswig-Holstein AöR
- Department Name
- Department for Internal Medicine I
- Contact Person Name
- Susanna Nikolaus
- Contact Person Email
- s.nikolaus@mucosa.de
Sponsor
Primary sponsor
- Full Name
- Universitaetsklinikum Schleswig-Holstein AöR
- Organisation Type
- Hospital/Clinic/Other health care facility
- Country Of Registered Address
- Germany
Investigational products
- Investigational Product Name
- MIRIKIZUMAB
- Active Substance
- MIRIKIZUMAB
- Modality
- Monoclonal antibody
- Routes Of Administration
- SUBCUTANEOUS; INTRAVENOUS
- Route
- SUBCUTANEOUS; INTRAVENOUS
- Authorisation Status
- Authorised (prodAuthStatus=2)
- Maximum Dose
- 200 mg (subcutaneous formulation); 300 mg (intravenous formulation)
- Investigational Product Name
- AZATHIOPRINE
- Active Substance
- AZATHIOPRINE
- Modality
- Small molecule
- Routes Of Administration
- ORAL
- Route
- ORAL
- Authorisation Status
- Authorised (prodAuthStatus=2)
- Maximum Dose
- 2.5 mg/kg per day (maxDailyDoseAmount)
- Investigational Product Name
- Glucocorticoids (Prednisolone)
- Active Substance
- Glucocorticoids (e.g., prednisolone)
- Modality
- Small molecule
- Routes Of Administration
- ORAL
- Route
- ORAL
- Authorisation Status
- Authorised (prodAuthStatus=2)
- Maximum Dose
- 60 mg per day (maxDailyDoseAmount)
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