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NCT Number: NCT06606808

Fluorescence Imaging of Risankizumab-800CW in Inflammatory Bowel Disease

Crohn's Disease (CD) and Ulcerative Colitis (UC) are chronic inflammatory bowel diseases (IBD). Risankizumab is a human monoclonal antibody against IL23 p19, part of a pro-inflammatory cytokine that mediates the inflammatory response in IBD upon binding to its receptor. Primary non-response to risankizumab is high in both CD and UC. Currently, there are no predictors of response to risankizumab and the actual mechanism of action has not yet been elucidated. To gain better understanding of the drug targeting of risankizumab in IBD, the University Medical Center Groningen (UMCG) developed fluorescently labeled risankizumab (risankizumab-800CW). This study aims to assess the safety and the optimal dose of risankizumab-800CW to visualize and potentially quantify the local drug concentration and predict treatment response in IBD patients using in vivo and ex vivo fluorescence molecular imaging (FMI).

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Key information

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1 / Phase 2

Primary location

University Medical Center Groningen

Groningen, 9713GZ, Netherlands

Location status: Recruiting

Location contact

Wouter B Nagengast, MD, PharmD, PhD

CONTACT

[email protected]

+31(0)503612620

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

for part A:

  • Established IBD diagnosis
  • Active disease: clinically active disease of the bowel is defined clinically as at least mild activity using dedicated scoring indices or biochemically active disease as defined by a fecal calprotectin > 60 μg/g
  • Patients must be eligible for risankizumab therapy
  • Minimum age of 18 years
  • Written informed consent
  • Clinical indication for an endoscopic procedure

Inclusion criteria

for part B:

  • Established IBD diagnosis
  • Patients must be on risankizumab therapy for at least 14 weeks
  • Minimum age of 18 years
  • Written informed consent
  • Clinical indication for an endoscopic procedure

Exclusion criteria

for part A:

  • A female study patient who is pregnant or provides breastfeeding
  • A female study patient of premenopausal age who does not use any reliable form of contraception at the time of risankizumab-800CW administration and the following 10 weeks
  • Medical or psychiatric conditions that compromise the patient's ability to give informed consent
  • Prior anti-IL23-specific therapy (IL23/IL12 combination therapy is not an exclusion criteria)
  • Active extra gastrointestinal manifestations of Crohn's disease (e.g. uveitis or pyoderma gangrenosum at vital locations)

Exclusion criteria

for part B:

  • A female study patient who is pregnant or provides breastfeeding
  • A female study patient of premenopausal age who does not use any reliable form of contraception at the time of risankizumab-800CW administration and the following 10 weeks
  • Medical or psychiatric conditions that compromise the patient's ability to give informed consent
  • Active extra gastrointestinal manifestations of Crohn's disease (e.g. uveitis or pyoderma gangrenosum at vital locations)

Treatment and study plan

Risankizumab-800CW 4.5 mg

Drug

Risankizumab-800CW will be administered intravenously. 2-3 days later, a Fluorescence Molecular Imaging procedure will be performed to enable the visualisation and detection of fluorescence signals.

Risankizumab-800CW 15 mg

Drug

Risankizumab-800CW will be administered intravenously. 2-3 days later, a Fluorescence Molecular Imaging procedure will be performed to enable the visualisation and detection of fluorescence signals.

Risankizumab-800CW 25 mg

Drug

Risankizumab-800CW will be administered intravenously. 2-3 days later, a Fluorescence Molecular Imaging procedure will be performed to enable the visualisation and detection of fluorescence signals.

Risankizumab-800CW optimal dose

Drug

Risankizumab-800CW will be administered intravenously. 2-3 days later, a Fluorescence Molecular Imaging procedure will be performed to enable the visualisation and detection of fluorescence signals.

Primary outcomes

  1. Determine the safety of risankizumab-800CW in IBD

    Time frame: 2-3 days after administration (day of FME procedure)

    Evaluating possible (severe) adverse events (SAE and AEs)

  2. Blood pressure

    Time frame: Five minutes before, and five and sixty minutes after tracer administration

    Systolic and diastolic in millimeters of mercure (mmHg)

  3. Heart rate

    Time frame: Five minutes before, and five and sixty minutes after tracer administration

    Beats per minute

  4. Temperature

    Time frame: Five minutes before, and five and sixty minutes after tracer administration

    Degrees Celsius

  5. Investigate the feasibility of using ex vivo FMI to detect risankizumab-800CW

    Time frame: 12 months

    Evaluating the performance of ex vivo FMI for detecting risankizumab-800CW signals. This evaluation will be based on mean fluorescence intensities (MFIs) of biopsies and fluorescence/light sheet microscopy.

  6. Investigate the feasibility of using FME to detect risankizumab-800CW signals_1

    Time frame: 12 months

    Evaluating the performance of FME for detecting risankizumab-800CW signals. This evaluation will be based on MDSFR/SFF measurements.

  7. Investigate the feasibility of using FME to detect risankizumab-800CW signals_2

    Time frame: 12 months

    Evaluating the performance of FME for detecting risankizumab-800CW signals. This evaluation will be based on a visual evaluation during FME (visible signal yes/no).

  8. Investigate the feasibility of using FME to detect risankizumab-800CW signals_3

    Time frame: 12 months

    Evaluating the performance of FME for detecting risankizumab-800CW signals. This evaluation will be based on TBR/CNR calculations.

  9. Determining the optimal imaging dose of risankizumab-800CW

    Time frame: 12 months

    The optimal dose will be based on the risankizumab-800CW signals during FME and ex vivo FMI

Secondary outcomes

  1. Investigate a potential correlation of in vivo fluorescence signal intensities and target saturation to clinical response/remission after 14 weeks of risankizumab therapy regimen in patients with IBD

    Time frame: 12 months

    Evaluation of the potential correlation in vivo will be based on in vivo fluorescence images and the MDSFR/SFF measurements before and after at least 14 weeks of risankizumab treatment

  2. Investigate a potential correlation of ex vivo fluorescence signal intensities and target saturation to clinical response/remission after 14 weeks of risankizumab therapy regimen in patients with IBD

    Time frame: 12 months

    Evaluation of the potential correlation ex vivo will be based on MFIs of biopsies, fluorescence microscopy results, and tracer concentrations inside biopsies before and after at least 14 weeks of risankizumab treatment

  3. Quantify the fluorescence signals of the tracer in vivo by using single-fiber reflectance/single-fiber fluorescence (MDSFR/SFF) spectroscopy and correlate these measurements to tracer dose, in vivo fluorescence intensities and inflammation severity

    Time frame: 12 months

    Quantification of MDSFR/SFF measurements in inflamed tissue compared to measurements in non-inflamed tissue. Positive correlation between MDSFR/SFF measurements and dose/inflammation severity?

  4. To correlate ex vivo fluorescence signals to inflammation severity and tracer dose based on histopathological examination inside the obtained biopsies

    Time frame: 12 months

    Histologically ascertained tissue types (qualitative): Normal (non-inflamed) ileal, colon and rectal tissue inflamed ileum, colon and rectum tissue Random ''high-fluorescent'' tissue Random ''Non-fluorescent'' tissue

  5. To assess tracer stability, tracer distribution and tracer concentration, and to identify the composition of immune cells ex vivo to learn more about risankizumab mucosal target cells

    Time frame: 12 months

    Fluorescence (confocal) microscopy with additional use of immune panels and spatial transcriptomics analysis (before and after at least 14 weeks of risankizumab treatment). Measurements of the risankizumab-800CW concentration by light-sheet microscopy after tissue clearing, insights in risankizumab target cells and presence of immune cells inside the biopsies and blood samples by flow cytometry and assessment of tracer stability by Western Blot

Study contacts

Contact information is provided by the study sponsor or research team.

Wouter B Nagengast, MD, PharmD, PhD

CONTACT

[email protected]

+31(0)503612620

Sponsors and collaborators

Lead sponsor

University Medical Center Groningen

Other

Registry information

Official study title

Investigating the Safety, Feasibility, and Optimal Dose of Risankizumab-800CW for Visualizing Drug Targeting in Inflammatory Bowel Disease

Acronym: NAVIGATE

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Sep 23, 2024
Registry last updated
Mar 5, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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