A Study to Test Whether Spesolimab Helps People With Crohn's Disease Who Have Symptoms of Bowel Obstruction
Condition: Fibrostenotic Crohn´s Disease
MeSH terms: Crohn Disease
Intervention: Spesolimab; Placebo
Intervention description: Spesolimab; Placebo
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Enrollment: 5.0
Sex: All
Minimum age: 18 Years
Maximum age: 75 Years
Healthy volunteers: No

Summary:

      This study is open to adults, between 18 and 75 years of age, who have narrowings in the
      small bowel (strictures) due to Crohn's disease. Strictures can lead to bowel obstruction
      (blockage). People whose symptoms got worse because of strictures can join the study.
      Participants get standard treatment for Crohn's disease and the strictures. The purpose of
      the study is to test whether the strictures improve further when treated with a medicine
      called spesolimab added to standard treatment.

      Participants are in the study for about 1 year and 4 months. In the first 3 months,
      participants get standard treatment only. After 3 months, participants whose condition
      improved are put into 2 groups randomly, which means by chance. One group gets spesolimab
      added to their standard treatment. The other group gets placebo added to their standard
      treatment. Both spesolimab and placebo are given as infusions into a vein. Placebo infusions
      look like spesolimab infusions but do not contain any medicine. For the first 2 months,
      participants get the infusions every month. Thereafter, participants get the infusions every
      2 months.

      During the study, participants have about 11 visits to the study site. The doctors regularly
      check participants' health and take note of any unwanted effects. At 3 of the visits, doctors
      take images of the bowel using Magnetic Resonance Imaging and with an endoscope. At these
      visits, the doctors also take a small sample of bowel tissue (biopsy). The participants note
      their symptoms of Crohn's disease and how the symptoms affect daily life in an electronic
      diary. At the end of the study, results from the diaries and bowel imaging are compared
      between the spesolimab group and the placebo group.
    

Eligibility criteria:

        Inclusion Criteria:

          -  18 to 75 years of legal age

          -  Established diagnosis of clinical Crohn's Disease

          -  Suspicion of symptomatic small bowel obstruction at screening

          -  1 or 2 naïve or anastomotic stenoses in the terminal ileum, with at least one being in
             reach of ileocolonoscopy as defined by the CrOhN´S disease antifibrotic STRICTure
             Therapies (CONSTRICT) criteria, confirmed by MRE

          -  Have achieved a Symptomatic Stenosis Response after optimized anti-inflammatory
             therapy

          -  Absent, mild or moderate endoscopic activity defined by Simple Endoscopic Score in
             Crohn's Disease (SES-CD) ≤12 Further criteria apply

        Exclusion Criteria:

          -  More than 2 small intestinal stenoses

          -  No stenosis is in reach of ileocolonoscopy

          -  Patients who require immediate endoscopic balloon dilation or surgical intervention as
             per the investigator´s discretion or who have undergone any of the two within the 6
             months prior to the study

          -  Failure of >2 different biological drug classes

          -  Current complications of Crohn's Disease such as enterocutaneous, internal or
             rectovaginal fistules, short gut syndrome or abscess,

          -  Use of any prohibited concomitant medications as described in the study protocol

          -  Active tuberculosis (TB) or history of latent TB that has not been treated Further
             criteria apply