Helminth-induced Immunomodulation Therapy (HINT) in Relapsing-remitting Multiple Sclerosis (HINT)
Primary Purpose
Relapsing Remitting Multiple Sclerosis
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Helminth ova
Sponsored by
About this trial
This is an interventional treatment trial for Relapsing Remitting Multiple Sclerosis
Eligibility Criteria
Inclusion Criteria:
- McDonald Committee (2010) criteria for RRMS (MS) .
- ambulatory patients with disability scores of EDSS 0.-5.0
- male or female subjects; ages 18-50
- diagnosis within three years of study entry, based on either a) two or more clinical attacks in the three years prior to entry or b) one attack within three years of entry, coupled with MRI evidence of dissemination in space and time by strict application of McDonald Committee MRI criteria
- active MRI at entry, as evidenced by at least one gd+ enhancing lesion during screening
- explicit refusal to be treated with conventional disease-modifying medications (DMT) for RRMS, after full discussion of the potential benefits and risks of these agents and after review of the National Multiple Sclerosis Advisory Statement DMT.
- ability to provide written informed consent
Exclusion Criteria:
- patients who are unwilling or unable to give written informed consent or to follow the protocol successfully
- allergy to Trichuris species
- treatment with metronidazole (Flagyl) or other medications with anti-helminth effects (IB 5.7)
- previous or anticipated treatment with FDA-approved or other experimental medications for RRMS
- previous treatment with immunosuppressive therapy, cytotoxic chemotherapy, or lymphoid irradiation for any reason
- insulin dependent diabetes mellitus
- history of HIV-1, HTLV-1, viral hepatitis, or Lyme disease.
- requirement for chronic, sustained aspirin or non-steroidal anti-inflammatory medications (e.g., use of more than 5-6 days per month for transient symptoms)
- significant physical or mental disease which would preclude successful compliance and participation in the study or, in the opinion of the principal investigator, constitute a hazard, such that enrollment in the study would not be in the patient's best interest.
- presence or history of cancer of any type (except successfully treated basal cell or squamous cell carcinoma of skin)
- history of alcohol or drug abuse in last 12 months; chronic liver or biliary disease; AST or ALT determination greater than two times the upper limit of normal
- any of the following laboratory abnormalities: serum creatinine > 1.7 mg/DL, white blood count < 3,500/mm3, lymphocyte count < 800/mm3
- special subjects such as minor children, mentally disabled persons, or prisoners
- any contraindication to MRI scanning, including significant claustrophobia or sensitivity to gadolinium contrast agent
- pregnancy and lactation; women of childbearing potential must have a documented negative serum beta HCG pregnancy test at entry and during the study and must be willing to practice adequate birth control for the duration of the study
- any MS attack or treatment with corticosteroid medication within 30 days of study entry (corticosteroids may be used during the study for MS relapses per the judgment of the treating physician, IB 5.7, IB 6.1.3)
- immediate household or family contacts who are immunodeficient or immunosuppressed
- history of parasitism or positive determination ova and parasite stool at screening
Sites / Locations
- University of Wisconsin Hospital and Clinics
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Helminth ova
Arm Description
Subjects serving as their own controls (baseline - end-of-treatment) will receive a dose of 2,500 ova, in liquid form, every 2 weeks
Outcomes
Primary Outcome Measures
MS activity, as judged by the number of new gadolinium-enhancing lesions on serial MRI scans
MS activity will be assessed based on the number of new gadolinium-enhancing lesions on serial MRI scans.
Secondary Outcome Measures
Full Information
NCT ID
NCT00645749
First Posted
March 25, 2008
Last Updated
February 4, 2019
Sponsor
University of Wisconsin, Madison
Collaborators
National Multiple Sclerosis Society
1. Study Identification
Unique Protocol Identification Number
NCT00645749
Brief Title
Helminth-induced Immunomodulation Therapy (HINT) in Relapsing-remitting Multiple Sclerosis
Acronym
HINT
Official Title
Helminth-induced Immunomodulation Therapy (HINT) in Relapsing-remitting Multiple Sclerosis
Study Type
Interventional
2. Study Status
Record Verification Date
February 2019
Overall Recruitment Status
Completed
Study Start Date
July 2008 (undefined)
Primary Completion Date
August 13, 2015 (Actual)
Study Completion Date
August 13, 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Wisconsin, Madison
Collaborators
National Multiple Sclerosis Society
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The hypothesis of this study is that helminth-induced immunomodulation therapy (HINT) will be safe and effective when administered orally in patients with relapsing-remitting multiple sclerosis (RRMS).
Detailed Description
Phase 1 of the HINT trial was completed with enrollment of 5 subjects. HINT Phase 2 is now closed to enrollment of 15 subjects. Recruitment sites are the UW-Madison and the Marshfield Clinic.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Relapsing Remitting Multiple Sclerosis
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
17 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Helminth ova
Arm Type
Experimental
Arm Description
Subjects serving as their own controls (baseline - end-of-treatment) will receive a dose of 2,500 ova, in liquid form, every 2 weeks
Intervention Type
Biological
Intervention Name(s)
Helminth ova
Other Intervention Name(s)
Therapy with Helminths
Intervention Description
2500 ova per dose (liquid form)
Primary Outcome Measure Information:
Title
MS activity, as judged by the number of new gadolinium-enhancing lesions on serial MRI scans
Description
MS activity will be assessed based on the number of new gadolinium-enhancing lesions on serial MRI scans.
Time Frame
Up to 19 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
McDonald Committee (2010) criteria for RRMS (MS) .
ambulatory patients with disability scores of EDSS 0.-5.0
male or female subjects; ages 18-50
diagnosis within three years of study entry, based on either a) two or more clinical attacks in the three years prior to entry or b) one attack within three years of entry, coupled with MRI evidence of dissemination in space and time by strict application of McDonald Committee MRI criteria
active MRI at entry, as evidenced by at least one gd+ enhancing lesion during screening
explicit refusal to be treated with conventional disease-modifying medications (DMT) for RRMS, after full discussion of the potential benefits and risks of these agents and after review of the National Multiple Sclerosis Advisory Statement DMT.
ability to provide written informed consent
Exclusion Criteria:
patients who are unwilling or unable to give written informed consent or to follow the protocol successfully
allergy to Trichuris species
treatment with metronidazole (Flagyl) or other medications with anti-helminth effects (IB 5.7)
previous or anticipated treatment with FDA-approved or other experimental medications for RRMS
previous treatment with immunosuppressive therapy, cytotoxic chemotherapy, or lymphoid irradiation for any reason
insulin dependent diabetes mellitus
history of HIV-1, HTLV-1, viral hepatitis, or Lyme disease.
requirement for chronic, sustained aspirin or non-steroidal anti-inflammatory medications (e.g., use of more than 5-6 days per month for transient symptoms)
significant physical or mental disease which would preclude successful compliance and participation in the study or, in the opinion of the principal investigator, constitute a hazard, such that enrollment in the study would not be in the patient's best interest.
presence or history of cancer of any type (except successfully treated basal cell or squamous cell carcinoma of skin)
history of alcohol or drug abuse in last 12 months; chronic liver or biliary disease; AST or ALT determination greater than two times the upper limit of normal
any of the following laboratory abnormalities: serum creatinine > 1.7 mg/DL, white blood count < 3,500/mm3, lymphocyte count < 800/mm3
special subjects such as minor children, mentally disabled persons, or prisoners
any contraindication to MRI scanning, including significant claustrophobia or sensitivity to gadolinium contrast agent
pregnancy and lactation; women of childbearing potential must have a documented negative serum beta HCG pregnancy test at entry and during the study and must be willing to practice adequate birth control for the duration of the study
any MS attack or treatment with corticosteroid medication within 30 days of study entry (corticosteroids may be used during the study for MS relapses per the judgment of the treating physician, IB 5.7, IB 6.1.3)
immediate household or family contacts who are immunodeficient or immunosuppressed
history of parasitism or positive determination ova and parasite stool at screening
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John O Fleming, MD
Organizational Affiliation
University of Wisconsin, Madison
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Wisconsin Hospital and Clinics
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53972
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
29064315
Citation
Fleming J, Hernandez G, Hartman L, Maksimovic J, Nace S, Lawler B, Risa T, Cook T, Agni R, Reichelderfer M, Luzzio C, Rolak L, Field A, Fabry Z. Safety and efficacy of helminth treatment in relapsing-remitting multiple sclerosis: Results of the HINT 2 clinical trial. Mult Scler. 2019 Jan;25(1):81-91. doi: 10.1177/1352458517736377. Epub 2017 Oct 24.
Results Reference
result
PubMed Identifier
21372112
Citation
Fleming JO, Isaak A, Lee JE, Luzzio CC, Carrithers MD, Cook TD, Field AS, Boland J, Fabry Z. Probiotic helminth administration in relapsing-remitting multiple sclerosis: a phase 1 study. Mult Scler. 2011 Jun;17(6):743-54. doi: 10.1177/1352458511398054. Epub 2011 Mar 3.
Results Reference
derived
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Helminth-induced Immunomodulation Therapy (HINT) in Relapsing-remitting Multiple Sclerosis
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