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
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
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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