Gender
All
Age Group
18 Years to 65 Years
Accepting Healthy Volunteers
No
Inclusion Criteria:
1. Has a confirmed diagnosis of UC established at least 3 months prior to screening, by
clinical and endoscopic evidence and corroborated by a histopathology report.
2. Has moderately to severely active UC as determined by a complete Mayo score
[including physician's global assessment (PGA)] of 6 to 12 with a rectal bleeding
subscore ≥1 and a centrally assessed endoscopic subscore ≥2 at screening.
3. Has evidence of UC extending proximally to the rectum [≥15 centimeter (cm) of
involved colon].
4. Participants with extensive colitis or pancolitis of >8 years duration or left sided
colitis >12 years duration must have documented evidence that a surveillance
colonoscopy was performed within 12 months of the initial screening visit.
5. Participants with a family history of colorectal cancer, personal history of
increased colorectal cancer risk, age >50 years, or other known risk factors must be
up to date on colorectal cancer surveillance.
6. Has demonstrated an inadequate response to, loss of response to, or intolerance to
at least 1, but no more than 2 TNFα antagonists. Participants without prior failure
or intolerance to biologics are not eligible. Participants who discontinued TNFα
antagonist therapy for reasons other than failure or intolerance (eg, pregnancy) may
be eligible after discussion with the medical monitor.
Note: After the interim analysis, participants without prior exposure to biologics
may be enrolled if deemed appropriate. Participants who discontinued biologics for
reasons other than failure or intolerance (eg, pregnancy) may be eligible after
discussion with the Medical Monitor.
7. If using corticosteroids must be on a stable dose of oral corticosteroids up to a
maximum of 40 mg daily of prednisone or 9 mg daily of budesonide, or equivalent for
at least 4 weeks prior to screening endoscopy and must be willing to follow a
mandatory taper of corticosteroids from enrollment.
Exclusion Criteria:
Gastrointestinal Exclusion criteria:
1. Has any of the following UC-related complications:
1. Acute severe UC.
2. The participant has had extensive colonic resection, subtotal or total
colectomy.
3. The participant has clinical evidence of abdominal abscess or toxic megacolon.
4. The participant has an ileostomy, colostomy, or known fixed symptomatic
stenosis of the intestine.
5. Short bowel syndrome.
2. Has Crohn's colitis, indeterminate colitis, ischemic colitis, nonsteroidal
anti-inflammatory drug (NSAID) induced colitis, idiopathic colitis (i.e, colitis not
consistent with UC), radiation colitis, microscopic colitis, colonic mucosal
dysplasia, or untreated bile acid malabsorption. Participants with a history of
colonic mucosal dysplasia are also excluded.
3. Has uncontrolled primary sclerosing cholangitis.
Infectious Disease Exclusion Criteria:
1. Has any evidence of an active systemic infection during screening. Participants with
nonsystemic infections (eg, active fungal infection of nail beds) may be eligible,
if in the opinion of the investigator, inclusion of the participant will not
interfere with the collection or interpretation of study results and poses no risk
to the participant.
2. Has active or latent tuberculosis (TB), regardless of treatment history, as
evidenced by any of the following:
a. History of TB. b. A diagnostic TB test performed during screening that is
positive, as defined by: i. A positive QuantiFERON test or 2 successive
indeterminate QuantiFERON tests or ii. A tuberculin skin test reaction ≥10 mm (≥5 mm
in subjects receiving the equivalent of >15 mg daily prednisone).
3. A positive test for hepatitis B virus (HBV).
4. A positive test for hepatitis C virus (HCV).
5. Evidence of, or treatment for, Clostridium difficile infection or other intestinal
pathogen within 28 days prior to first dose of study treatment. Participants who
test positive for C. difficile or other intestinal pathogens at screening and
receive treatment may be enrolled or rescreened (if required) following confirmation
of infection resolution.
7. Evidence of active Cytomegalovirus (CMV) infection at screening.
Medication exclusion criteria:
1. Has received immunomodulators (eg, 6-mercaptopurine, azathioprine, and methotrexate)
within 4 weeks prior to first dose or immunosuppressants (eg, cyclosporine,
tacrolimus) within 8 weeks prior to first dose.
2. Any medicinal product, herbal medication, or natural health product which might
interfere with cytochrome P450 genotype 3A4 (CYP3A4) within 2 weeks prior to
enrollment, except for any CYP3A4 modulator used to treat a C. difficile or an
intestinal pathogen infection at screening.
3. Has received any of the following medical therapies for UC:
1. IV antibiotics within 8 weeks prior to enrollment.
2. Any rectal therapy for treatment of UC within 2 weeks prior to screening
endoscopy.
3. Chronic NSAID use defined as daily use for >2 consecutive weeks (Note:
occasional use [<2 consecutive weeks] of NSAIDs and acetaminophen [<100 mg
daily] for headache, arthritis, myalgias, or menstrual cramps and chronic low
dose aspirin use [81-162.5 mg daily] for cardiovascular prophylaxis are
permitted).
4. Has received a live virus or live bacterial vaccine within 4 weeks prior to
enrollment, or planned vaccination during the study and for 12 weeks after last
dose.
General Exclusion Criteria:
1. Has any of the following cardiovascular or thrombotic conditions:
1. Recent (within past 6 months) cerebrovascular accident, myocardial infarction,
or coronary stenting.
2. Recent (within past 6 months) moderate to severe congestive heart failure (New
York Heart Association class III or IV).
3. Prior history of thrombotic events, including deep vein thrombosis and
pulmonary embolism.
4. Known inherited conditions that predispose to hypercoagulability.
2. History of lymphoproliferative disease, including lymphoma, or signs and symptoms
suggestive of possible lymphoproliferative disease, such as lymphadenopathy and/or
splenomegaly.
3. A surgical procedure requiring general anesthesia within 3 months prior to screening
or is planning to undergo major surgery during the study period.
4. Any investigational procedure ≤4 weeks prior to screening that, in the
investigator's opinion, may interfere with interpretation of study results.