LY4268989 (MORF-057) Co-Administered With Mirikizumab in Adults With Moderately to Severely Active Ulcerative Colitis: (TOPAZ-UC)

Lilly

Status and phase: Enrolling; Phase 2

Conditions: Ulcerative Colitis

Treatments: Drug: LY4268989; Drug: Mirikizumab; Drug: LY4268989 Placebo

Study type: Interventional

Funder types: Industry

Identifiers

NCT07186101

MORF-057 (Other Identifier)

J6E-MC-KWAN (Other Identifier)

27704

Details and patient eligibility

About

The main purpose of the study is to evaluate the effectiveness and safety of LY4268989 when given with mirikizumab compared to mirikizumab alone in adult participants with moderately to severely active ulcerative colitis (UC).

Study participation will last approximately 118 weeks, including 104 weeks of treatment and may include up to 21 visits.

Enrollment: 252 estimated patients

Sex: All

Ages: 18 to 80 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Have had an established diagnosis of ulcerative colitis (UC) of ≥3 months in before baseline, which includes endoscopic evidence of UC and a histopathology report that supports a diagnosis of UC
• Have moderately to severely active UC as defined by a Modified Mayo Score (mMS) of 5 to 9 with an Endoscopic Score (ES) ≥2 confirmed by central reader and rectal bleeding (RB) ≥1, with endoscopy performed within 21 days before baseline
• Participants with greater than 8 years of UC symptoms have documented evidence of having had a surveillance colonoscopy within 1 year, or according to local country or regional medical guidelines, to evaluate for polyps, dysplasia, or malignancy, prior to randomization
• Are up-to-date on colorectal cancer surveillance per local society guidelines
• Have an inadequate response to, loss of response to, or intolerance to at least 1 of the medications:
• Conventional-failed participants: Participants who have had an inadequate response to or a loss of response to or are intolerant to at least 1 of the following medications: corticosteroids or immunomodulators (Does not apply to US)

NOTE: After the interim analysis, participants with inadequate response, loss of response, or intolerance to conventional UC therapy without prior exposure to biologics may be enrolled if deemed appropriate (Applies to the US)

• Advanced therapy-failed participants: Participants who have an inadequate response to or a loss of response to, or are intolerant to advanced therapy for UC, defined as:

  • a biologic or biosimilar medication such as anti-tumor necrosis factor (anti-TNF) antibodies or anti-interleukin antibodies (IL-12/23, or IL-23p19), except for

    • mirikizumab.

  • Janus kinase inhibitors (JAK) such as filgotinib, tofacitinib, or upadacitinib

  • sphingosine 1-phosphate receptor 1 inhibitors (S1PR) such as etrasimod or ozanimod

Exclusion criteria

• Have a current diagnosis of

  • Crohn's disease
  • Inflammatory Bowel Disease (IBD) unclassified (formerly known as indeterminate colitis), or
  • primary sclerosing cholangitis

• Have had or will need bowel resection or intestinal or intra-abdominal surgery

• Have evidence of toxic megacolon, intra-abdominal abscess, or stricture or stenosis within small bowel or colon that cannot be traversed by a colonoscope or that are symptomatic

• Have any adenomatous polyp occurring in areas of the colon not involved by colitis, that has not been removed

Note: If such an adenomatous polyp has been completely removed and shows only low-grade dysplasia, this criterion would no longer apply

• Have a current or recent acute, active infection

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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252 participants in 2 patient groups

LY4268989 + Mirikizumab

Experimental group

Description:

LY4268989 administered orally (PO) + Mirikizumab administered intravenously (IV), then subcutaneously (SC). Responders will be re-randomized for Study Period 2.

Treatment:

Drug: Mirikizumab

Drug: LY4268989

Mirikizumab + LY4268989 Placebo

Experimental group

Description:

Mirikizumab administered IV, then SC + LY4268989 placebo administered PO. Responders and Non-responders will re-randomized for Study Period 2.

Treatment:

Drug: LY4268989 Placebo

Drug: Mirikizumab