VECTORS - A Study to Evaluate Transmural Healing as a Treatment Target in Crohn's Disease

NCT ID: NCT06257706

Last Updated: 2026-01-15

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE4

Total Enrollment

304 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-08-07

Study Completion Date

2029-02-06

Brief Summary

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Transmural healing (TMH) is recognized as a potentially important measure of Crohn's disease (CD) activity but not a formal target. Observational studies suggest that TMH may be associated with better long-term outcomes. The study will evaluate TMH using noninvasive intestinal ultrasound (IUS), a patient-friendly technique that can be performed routinely in clinical practice. The aim of the study is to determine if treating to a target of corticosteroid-free (CS-free) IUS outcomes + clinical symptoms + biomarkers is superior to a target of clinical symptoms + biomarkers alone in achieving CS-free endoscopic remission measured by the Simple Endoscopic Score for Crohn's Disease (SES-CD).

Qualified participants will be randomly assigned in a 1:1 ratio to one of 2 different target treatment groups.

Group 1: Participants will be treated over 48 weeks to achieve a target of corticosteroid-free IUS-based outcomes + clinical remission + biomarker remission. At Week 22 and 30, the IUS-based component of the target will be IUS response and at Week 38, the final treatment target will be TMH. Group 2: Participants will be treated over 48 weeks to achieve a target of corticosteroid-free clinical remission + biomarker remission.

Detailed Description

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Conditions

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Moderately to Severely Active Crohn's Disease Crohn Disease Disease Crohn

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is an interventional, randomized, parallel-group, multicenter, controlled study. A total of approximately 304 participants with moderately-to-severely active CD from multiple international sites will be enrolled into this study. All qualified participants will be randomly assigned in a 1:1 ratio to one of 2 different treatment target groups: Group 1 will be treated over 48 weeks to achieve a target of corticosteroid-free IUS-based outcomes + clinical remission + biomarker remission. Group 2 will be treated over 48 weeks to achieve a target of corticosteroid-free clinical remission + biomarker remission. Randomization will be stratified by the following 3 baseline factors each with 2 levels: prior exposure (within the last 5 years of the screening date) to an approved biologic/small molecule for CD (yes or no), disease location (ileal or colonic), and disease duration (≤ 2 years or \>2 years, based on date of diagnosis).
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study participants and investigators will be unblinded to the treatment target group assignment.

Central readers performing the assessment of IUS, endoscopy, and histology assessments will be blinded to treatment target randomization, participant, treatment received, and timepoint which will be used to determine treatment escalation.

Study Groups

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Group 1: Corticosteroid-free IUS-based outcomes + clinical remission + biomarker remission

Group 1 will be treated over 48 weeks to achieve a target of corticosteroid-free IUS-based outcomes + clinical remission + biomarker remission. At Week 22 and 30, the IUS-based component of the target will be IUS response and at Week 38, the final treatment target will be TMH.

Group Type OTHER

Vedolizumab

Intervention Type BIOLOGICAL

All participants will begin a vedolizumab induction regimen of 300 mg IV at Weeks 0, 2, 6, and 10 followed by vedolizumab 300 mg IV every 8 weeks starting at Week 14. Treatment may be modified at Weeks 22, 30, and/or 38 based on the results of the target assessment at each of these time points.

Group 2: Corticosteroid-free clinical remission + biomarker remission.

Group 2 will be treated over 48 weeks to achieve a target of corticosteroid-free clinical remission + biomarker remission.

Group Type OTHER

Vedolizumab

Intervention Type BIOLOGICAL

All participants will begin a vedolizumab induction regimen of 300 mg IV at Weeks 0, 2, 6, and 10 followed by vedolizumab 300 mg IV every 8 weeks starting at Week 14. Treatment may be modified at Weeks 22, 30, and/or 38 based on the results of the target assessment at each of these time points.

Interventions

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Vedolizumab

All participants will begin a vedolizumab induction regimen of 300 mg IV at Weeks 0, 2, 6, and 10 followed by vedolizumab 300 mg IV every 8 weeks starting at Week 14. Treatment may be modified at Weeks 22, 30, and/or 38 based on the results of the target assessment at each of these time points.

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

1. Adults aged 18 to 80 years, inclusive, at the time of consent;
2. Moderately to severely active CD at baseline defined by a CDAI score of 220 to 450 inclusive and SES-CD, excluding the presence of narrowing component, ≥6 (or ≥4 for participants with isolated ileal disease);
3. BWT on IUS of \>4.0 mm in the terminal ileum or any colonic segment (excluding the rectum) as assessed by the mean of 2 longitudinal and 2 cross-sectional measurements of the same segment;
4. Biologic-naïve or have previous exposure (within the last 5 years of the screening date) to no more than 1 advanced therapeutic compound (approved biologic or small molecule drug) for the treatment of their CD. Note: only approximately 15% to 30% of the enrolled population will have had prior exposure to an advanced therapeutic;
5. Participants may continue stable dose (initiated at least 4 weeks prior to Screening) of 5-ASA for CD;
6. Persons of childbearing potential must have a negative serum pregnancy test prior to randomization and must use a highly effective method of contraception throughout the study. Females unable to bear children must have documentation of such in the source records;
7. Able to participate fully in all aspects of this clinical trial;
8. Written informed consent must be obtained and documented.

Exclusion Criteria

1. Current or previous treatment with vedolizumab, etrolizumab, or natalizumab;
2. Previously exposed to 2 or more compounds or classes of an advanced therapeutic compound (approved biologic or small molecule drug) for the treatment of their CD;
3. Change to oral corticosteroid therapy dosing within 2 weeks prior to randomization or a corticosteroid dose of \>40 mg of prednisone or equivalent at randomization;
4. Only have inflammation proximal to the terminal ileum that cannot be reached by ileocolonoscopy;
5. Have a CD complication, such as symptomatic strictures in the small bowel with \>3 cm prestenotic dilatation on any imaging modality, requiring procedural intervention;
6. Previous extensive colonic resection or missing \>2 segments out of 5 (terminal ileum, right colon, transverse colon, sigmoid and left colon, and rectum), ileorectal anastomosis, or a proctocolectomy;
7. Ostomy or ileoanal pouch;
8. Short bowel syndrome;
9. Fibrotic-only stricture in the ileum or colon without evidence of active inflammation (in the investigator's judgment), including any impassable stenosis;
10. Abscess \>2 cm, detected by IUS or endoscopy; participants with draining fistulas are not excluded;
11. Serious underlying disease other than CD that, in the opinion of the investigator, may interfere with the participant's ability to participate fully in the study or would compromise participant safety;
12. Positive stool test for Clostridioides difficile infection (as demonstrated by positive toxin);
13. Known HIV or hepatitis B or C infection. If a negative test result is available in the 12 months prior to randomization, retesting is not required;
14. Known active or latent tuberculosis (TB); if a negative test result is available in the 12 months prior to randomization, confirmatory testing (per standard of care) is not required before randomization;
15. Other systemic or opportunistic infection (including cytomegalovirus), any other clinically significant extraintestinal infection, or recurring infection within 6 months of randomization;
16. Has active cerebral/meningeal disease, signs, symptoms, or any history of progressive multifocal leukoencephalopathy (PML) prior to randomization;
17. Hypersensitivity, allergy, or intolerance to any excipient of vedolizumab or any other contraindication to vedolizumab;
18. Active severe infection such as sepsis, cytomegalovirus, listeriosis, or opportunistic infection.
19. Unwillingness to withhold protocol-prohibited medications during the trial;
20. Concurrent or previous participation in another clinical trial and received any investigational therapy within 30 days prior to randomization;
21. History of alcohol or drug abuse that in the opinion of the investigator may interfere with the participant's ability to comply with the study procedures;
22. Prior enrolment in the current study and had received study treatment;
23. Pregnant, lactating, or intending to become pregnant/impregnate a partner before, during, or within 18 weeks after the last dose; or intending to donate ova or sperm during such time period;
24. Vaccination with a live or live-attenuated vaccine within 4 weeks prior to randomization, or planned vaccination with a live or live-attenuated vaccine during participation in the study;
25. Any person performing mandatory military service, deprived of liberty, in a residential care setting, or any person who, due to a judicial decision, cannot take part in clinical studies;
26. The person is an immediate family member, study site employee, or is in a dependent relationship with a study site employee who is involved in conduct of this study (e.g., spouse, parent, child, sibling).
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Takeda

INDUSTRY

Sponsor Role collaborator

Alimentiv Inc.

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Vipul Jairath, MD

Role: PRINCIPAL_INVESTIGATOR

Alimentiv Inc.

Locations

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TLC Clinical Research Inc - Los Angeles

Los Angeles, California, United States

Site Status WITHDRAWN

Medical University of South Carolina (MUSC)

Charleston, South Carolina, United States

Site Status NOT_YET_RECRUITING

Houston Methodist Hospital

Houston, Texas, United States

Site Status RECRUITING

Concord Repatriation General Hospital

Concord, New South Wales, Australia

Site Status RECRUITING

Mater Misericordiae Ltd

South Brisbane, Queensland, Australia

Site Status RECRUITING

Calvary Adelaide Hospital

Adelaide, South Australia, Australia

Site Status RECRUITING

Royal Adelaide Hospital

Adelaide, South Australia, Australia

Site Status RECRUITING

The Queen Elizabeth Hospital

Woodville, South Australia, Australia

Site Status RECRUITING

Northern Hospital Epping

Epping, Victoria, Australia

Site Status RECRUITING

Austin Health

Heidelberg, Victoria, Australia

Site Status RECRUITING

The Alfred Hospital

Melbourne, Victoria, Australia

Site Status RECRUITING

Royal Melbourne Hospital

Melbourne, Victoria, Australia

Site Status RECRUITING

Harry Perkins institute of Medical Research - Fiona Stanley Hospital

Murdoch, Western Australia, Australia

Site Status RECRUITING

VITAZ - AZ Nikolaas

Sint-Niklaas, Antwerpen, Belgium

Site Status RECRUITING

Imelda Ziekenhuis Bonheiden

Bonheiden, Antwerp, Belgium

Site Status RECRUITING

University Hospital Ghent

Ghent, East Flanders, Belgium

Site Status RECRUITING

UZ Leuven-University Hospital Gasthuisberg

Leuven, Flemish Brabant, Belgium

Site Status RECRUITING

AZ Delta - Rumbeke Campus

Roeselare, West Flanders, Belgium

Site Status RECRUITING

ULB Hopital Erasme

Brussels, , Belgium

Site Status RECRUITING

University of Calgary

Calgary, Alberta, Canada

Site Status RECRUITING

University of Alberta, Dept of Medicine, Division of Gastroenterology

Edmonton, Alberta, Canada

Site Status RECRUITING

Viable Clinical Research - Bridgewater

Bridgewater, Nova Scotia, Canada

Site Status RECRUITING

LHSC - University Campus

London, Ontario, Canada

Site Status RECRUITING

LHSC - Victoria Hospital

London, Ontario, Canada

Site Status NOT_YET_RECRUITING

Toronto Immune and Digestive Health Institute Inc. (TIDHI)

Toronto, Ontario, Canada

Site Status RECRUITING

Vojenska nemocnice Brno

Brno, South Moravian, Czechia

Site Status NOT_YET_RECRUITING

Fakultni Nemocnice Brno

Brno, South Moravian, Czechia

Site Status NOT_YET_RECRUITING

Herlev Hospital

Herlev, Capital Region, Denmark

Site Status RECRUITING

Nordsjaellands Hospital - Hillerod

Hillerød, Capital Region, Denmark

Site Status RECRUITING

Bispebjerg Hospital

Copenhagen NV, Capital, Denmark

Site Status RECRUITING

Hvidovre Hospital

Hvidovre, Capital, Denmark

Site Status RECRUITING

Aarhus Universitetshospital

Aarhus, Central Denmark, Denmark

Site Status RECRUITING

Randers Regional Hospital

Randers, Central Denmark, Denmark

Site Status RECRUITING

Sjaellands Universitets hospitall Koge

Køge, Region Sjælland, Denmark

Site Status WITHDRAWN

Svendborg Hospital

Svendborg, , Denmark

Site Status WITHDRAWN

Hopital Lyon Sud

Pierre-Bénite, Auvergne-Rhône-Alpes, France

Site Status RECRUITING

APHM

Marseille, Provence-Alpes-Côte d'Azur Region, France

Site Status RECRUITING

Groupe Hospitalier Prive Ambroise Pare - Hartmann

Neuilly-sur-Seine, , France

Site Status WITHDRAWN

Universitatsklinikum Augsburg

Augsburg, Bavaria, Germany

Site Status NOT_YET_RECRUITING

Universitatsklinkum Frankfurt - Goethe Universitat

Frankfurt am Main, Hesse, Germany

Site Status WITHDRAWN

Klinikum Luneburg

Lüneburg, Lower Saxony, Germany

Site Status RECRUITING

Universitaetsklinikum Schleswig-Holstein (UKSH)- Campus Kiel

Kiel, Schleswig-Holstein, Germany

Site Status RECRUITING

Universitats Klinikum Freiburg

Freiburg im Breisgau, , Germany

Site Status WITHDRAWN

Ospedale Casa Sollievo della Sofferenza IRCCS

San Giovanni Rotondo, Foggia, Italy

Site Status RECRUITING

Ospedale Luigi Sacco

Milan, Lombardy, Italy

Site Status RECRUITING

Ospedale San Raffaele S.r.I.

Milan, Milan, Italy

Site Status NOT_YET_RECRUITING

Policlinico Universitario Agostino Gemelli

Roma, Rome, Italy

Site Status RECRUITING

Radboud University Nijmegen Medical Centre

Nijmegen, Gelderland, Netherlands

Site Status RECRUITING

Amsterdam UMC - VU Medisch Centrum

Amsterdam, North Holland, Netherlands

Site Status RECRUITING

Erasmus Medisch Centrum (MC)

Rotterdam, South Holland, Netherlands

Site Status NOT_YET_RECRUITING

ETZ - St. Elisabeth Hospital

Tilburg, , Netherlands

Site Status WITHDRAWN

Oddzial Gastroenterologiczny SP ZOZ w Lecznej

Łęczna, Gmina Leczna, Poland

Site Status RECRUITING

SOLUMED Centrum Medyczne

Poznan, Greater Poland Voivodeship, Poland

Site Status RECRUITING

GASTROMED - Kopon, Zmudzinski I Wspolnicy Sp.j.

Torun, Kuyavian-Pomeranian Voivodeship, Poland

Site Status RECRUITING

Melita Medical Sp Zoo

Wroclaw, Lower Silesian Voivodeship, Poland

Site Status RECRUITING

Bodyclinic Sp.z.o.o. Sp.K

Warsaw, Masovia, Poland

Site Status RECRUITING

WIP Warsaw IBD Point Profesor Kierkus

Warsaw, Masovia, Poland

Site Status RECRUITING

Centrum Medyczne Medyk

Rzeszów, Podkarpackie Voivodeship, Poland

Site Status RECRUITING

Vita Longa Sp. z o.o.

Katowice, Silesian, Poland

Site Status RECRUITING

Sonomed Sp. z o.o. - Centrum Medyczne

Szczecin, West Pomerianian, Poland

Site Status RECRUITING

Twoja Przychodnia-Centrum Medyczne Opole

Opole, , Poland

Site Status WITHDRAWN

EuroMediCare (EMC) Instytut Medyczny SA

Wroclaw, , Poland

Site Status RECRUITING

LisbonCentro Hospitalar Lisboa Norte, EPE- Hospital de Santa Maria

Lisbon, , Portugal

Site Status NOT_YET_RECRUITING

Nottingham University Hospitals NHS Trust - QMC

Nottingham, East Midlands, United Kingdom

Site Status RECRUITING

London North West University Healthcare NHS Trust - Northwick Park Hospital

Harrow, Middlesex, United Kingdom

Site Status WITHDRAWN

Western General Hospital

Edinburgh, , United Kingdom

Site Status NOT_YET_RECRUITING

Barts Health NHS Trust - The Royal London Hospital

London, , United Kingdom

Site Status RECRUITING

University College London Hospitals NHS Foundation Trust

London, , United Kingdom

Site Status RECRUITING

Kings College Hospital NHS Foundation Trust

London, , United Kingdom

Site Status RECRUITING

Countries

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United States Australia Belgium Canada Czechia Denmark France Germany Italy Netherlands Poland Portugal United Kingdom

Central Contacts

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Elena van Hest

Role: CONTACT

31205630316

Facility Contacts

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Debbie Alexander

Role: primary

+ 44 131 537 3858

Other Identifiers

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TAK01769

Identifier Type: -

Identifier Source: org_study_id

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