A study to test whether BI 706321 combined with ustekinumab helps people with Crohn's Disease

Prior treatment

• Have any current or prior abscesses, unless they have been drained and treated at least 6 weeks prior to randomization and are not anticipated to require surgery. Patients with active fistulas may be included if there is no anticipation of a need for surgery and there are currently no abscesses present based on investigator`s judgement
• Have complications of CD such as strictures, stenosis, short bowel syndrome, or any other manifestation that might require surgery, or could preclude the use of SESCD/ CDAI to assess response to therapy, or would possibly confound the evaluation of benefit from treatment with BI 706321
• Have had any kind of bowel resection or diversion within 4 months or any other intraabdominal surgery within 3 months prior to visit 1. Patients with current ileostomy, colostomy, or ileorectal anastomosis are excluded.
• Treatment with: - any non-biologic medication for IBD (tacrolimus or mycophenolate mofetil, systemic corticosteroids), other than those allowed per inclusion criteria, within 30 days prior to randomization - any biologic treatment with a TNF-alpha antagonist (adalimumab, infliximab, golimumab, certolizumab pegol) or vedolizumab (or a biosimilar) within 4 weeks prior to randomization. - any previous treatment with ustekinumab (or a biosimilar of this drug) - any previous treatment with an investigational (or subsequently approved) non-biologic/biologic drug for CD (including but not limited to JAK inhibitors [e.g. upadacitinib], S1P modulators, IL-23 inhibitors [e.g. risankizumab], antiintegrins). - any investigational drug for an indication other than CD during the course of the actual study and within 30 days or 5 half-lives (whichever is longer) prior to randomisation. - any prior exposure to rituximab within 1 year prior to randomisation.
• Positive stool examination for C difficile (toxin A/B and GDH ag – test positive) or other intestinal pathogens <30 days prior to randomization.
• Increased risk of infectious complications (e.g. recent pyogenic inf, any congenital or acquired immunodeficiency (e.g. Human immunodeficiency virus), past organ or stem cell transplantation (with exception of a corneal transplant > 12 weeks prior to screening) or have ever received stem cell therapy (e.g., Prochymal). Prior treatment with a somatic cell therapy product (e.g., Alofisel) is not excluded, provided it was administered > 8 w prior to randomization BCG vaccines ≤ 1 year prior to randomization
• Live or attenuated vaccination within 4 weeks prior to randomization

Other illness

• Presence of clinically significant acute or chronic infections not otherwise listed, including viral hepatitis, COVID-19, or others based on investigator's judgement.

Lab values

• A marked baseline prolongation of QT/QTc interval (such as QTcF intervals that are greater than 450 ms for men, 470 ms for female) or any other relevant ECG finding at screening. Both have to be confirmed by repeated ECG recording.

Other

• Further exclusion criteria apply
• Patient with an IBD diagnosis other than CD
• Evidence of colonic moderate/severe mucosal dysplasia or colonic adenomas, unless properly removed

• Diagnosis of CD for at least 3 months prior to visit 1, as confirmed at any time in the past by endoscopy and/OR radiology, and supported by histology.
• Elevated CRP (≥ 5 mg/L) OR elevated fecal calprotectin (≥ 250 μg/g)
• Symptomatic CD defined as ≥ CDAI 150
• Presence of mucosal ulcers in at least one segment of the ileum or colon and a SESCD score ≥ 7 (for patients with isolated ileitis ≥4)
• Patients who are experienced to at least 1 tumor necrosis factor (TNF) antagonist at a dose approved for CD. Patients may have stopped TNF antagonist treatment due to primary or secondary non -responsiveness, intolerance, or for other reasons.
• May be receiving a therapeutic dose of the following: Oral 5-ASA compounds Oral corticosteroids AZA, MP, 6-TG, or MTX
• Women of childbearing potential (WOCBP)1 must be ready and able to use highly effective methods of birth control
• Further inclusion criteria apply.