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Evaluation of Safety, Efficacy, Pharmacokinetic and Pharmacodynamic of Bertilimumab in Patients With Active Moderate to Severe Ulcerative Colitis

Primary Purpose

Ulcerative Colitis, Active Moderate, Ulcerative Colitis, Active Severe

Status
Unknown status
Phase
Phase 2
Locations
Israel
Study Type
Interventional
Intervention
Bertilimumab
Placebo
Sponsored by
Immune Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Ulcerative Colitis, Active Moderate focused on measuring IBD, UC, Colitis, Ulcerative Colitis

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Males or females, 18 to 70 years of age inclusive.
  2. Diagnosed with active moderate to severe UC per standard diagnostic criteria for a minimum of 3 months:

    • Mayo score of 6-12 (inclusive) at the Screening Visit
    • Endoscopic evidence of active mucosal disease, as assessed by flexible sigmoidoscopy, with an Endoscopic Finding Sub-score of ≥2 (assessed centrally)
    • Rectal Bleeding Sub-score of ≥1
    • Physician's Global Assessment (PGA) Sub-score of ≥2.
  3. Levels of eotaxin-1 in biopsied colon tissue of ≥100 pg/mg protein.
  4. Adequate cardiac, renal and hepatic function as determined by the Investigator and demonstrated by screening laboratory evaluations and physical examination results; these findings must all be within normal limits or judged not clinically significant by the Investigator.

Exclusion Criteria:

  1. History of colonic or rectal surgery other than hemorrhoidal surgery or appendectomy.
  2. Currently receiving total parenteral nutrition (TPN).
  3. Positive Clostridium difficile toxin stool assay.
  4. Tested positive for active/latent mycobacterium tuberculosis (TB) infection.
  5. Pregnant or breast-feeding, or plan to become pregnant during the study.
  6. Males who are young and childless or planning to have more children in the future.
  7. Known hypersensitivity to bertilimumab or any of the drug excipients.
  8. History of infection requiring administration of any IV antibiotic, antiviral or antifungal medication within 30 days of Screening or any oral anti-infective agent within 14 days of Screening.
  9. Severe UC evidenced by the following signs of toxicity: heart rate >100 beats/min at rest, temperature >37.8°C, hemoglobin <10.0 g/dL.
  10. Ulcerative proctitis, defined as disease limited to less than 15 cm from the anal verge.
  11. Received a vaccine or other immunostimulator within 4 weeks prior to screening.
  12. Use of >4.8 g mesalazine or equivalent within 2 weeks prior to the screening visit. Mesalazine ≤4.8 g is allowed if the dose during the 2 weeks prior to the screening visit was stable.
  13. Use of systemic corticosteroids exceeding the equivalent of 20 mg/day of prednisone within four weeks prior to the screening visit (see Section 6.9.1).
  14. Change in dose of immunosuppressive drugs (e.g., corticosteroids, 6-mercaptopurine [6-MP], azathioprine) within four weeks prior to the screening visit.
  15. Use of TNF-blockers (e.g., infliximab or adalimumab) within 60 days of the screening visit.
  16. Use of chronic non-steroidal anti-inflammatory (NSAID) therapy. Occasional use of NSAIDs or acetaminophen for headache, arthritis, myalgias, menstrual cramps, etc., or daily use of low dose (81-162 mg) aspirin for cardiovascular prophylaxis is allowed.
  17. Patients diagnosed with:

    • Crohn's disease
    • Diverticulitis or diverticulosis
    • Indeterminate colitis (inability to distinguish between UC and Crohn's disease [as assessed by the Investigator])
    • Microscopic colitis (collagenous or lymphocytic colitis)
    • Ischemic or infectious colitis
    • Clostridium difficile colitis within 90 days of the screening visit
    • Parasitic disease within 90 days of the screening visit
    • Systemic fungal infection within 90 days of the screening visit.
  18. History of positive serology of hepatitis B or C, or human immunodeficiency virus (HIV) infection.
  19. Congenital or acquired immunodeficiency (e.g., common variable immunodeficiency, organ transplantation).
  20. Clinically significant abnormal laboratory test results, unless regarded by the Investigator as related to UC, including but not limited to:

    • Hemoglobin level <10.0 g/dL
    • White blood cell count < 3 x 103/µL
    • Lymphocyte count < 0.5 x 103/µL
    • Platelet count <100 x 103/µL or >1200 x 103/µL
    • Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >3 the upper limit of normal (ULN)
    • Alkaline phosphatase >3 ULN
    • Serum creatinine >2 ULN.
  21. Active abuse of alcohol or drugs.
  22. Known malignancy or history of malignancy that could reduce life expectancy.
  23. Any condition, which in the opinion of the Investigator, would place the patient at an unacceptable risk if participating in the study protocol.
  24. Participation in a clinical trial of an investigational (unapproved) product

Sites / Locations

  • HaEmek Medical CenterRecruiting
  • Wolfson Medical CenterRecruiting
  • Shaare Zedek Medical CentralRecruiting
  • Hadassah Ein KeremRecruiting
  • Meir Medical CenterRecruiting
  • Sourasky-Ichilov Tel Aviv Medical CenterRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Bertilimumab

Placebo

Arm Description

Bertilimumab 10 mg/kg will be administered by IV infusion over 30 minutes

Phosphate buffered saline (PBS) placebo will be administered by IV infusion over 30 minutes.

Outcomes

Primary Outcome Measures

Clinical response
A decrease in Mayo score from baseline of at least 3 points and at least 30% AND Either a decrease in the sub-score for rectal bleeding of at least 1 point, or rectal bleeding sub-score of 0 or 1.

Secondary Outcome Measures

Change in UCEIS score from screening to Day 56
Clinical remission at Day 56, defined as a total Mayo score of 2 points or lower, with no individual sub-score exceeding 1 point
Mucosal healing at Day 56, defined as an absolute sub-score for endoscopy of 0 or 1.
Change in partial Mayo score from Day 0 to all scheduled measurement timepoints (efficacy follow up).

Full Information

First Posted
August 9, 2012
Last Updated
January 3, 2018
Sponsor
Immune Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT01671956
Brief Title
Evaluation of Safety, Efficacy, Pharmacokinetic and Pharmacodynamic of Bertilimumab in Patients With Active Moderate to Severe Ulcerative Colitis
Official Title
A Randomized, Double-Blind, Placebo-Controlled, Parallel Group, Multi-Center Study Designed to Evaluate the Safety, Efficacy, Pharmacokinetic and Pharmacodynamic Profile of Bertilimumab in Patients With Active Moderate to Severe Ulcerative Colitis
Study Type
Interventional

2. Study Status

Record Verification Date
January 2018
Overall Recruitment Status
Unknown status
Study Start Date
July 2015 (undefined)
Primary Completion Date
August 2018 (Anticipated)
Study Completion Date
March 2019 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Immune Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a randomized, double blind, placebo-controlled, parallel group multi-center study in adult patients with active moderate to severe UC . Eligible patients will be randomly assigned in a 2:1 ratio to one of two treatment groups, bertilimumab 10 mg/kg or matching placebo, respectively
Detailed Description
This is a randomized, double blind, placebo-controlled, parallel group multi-center study in adult patients with active moderate to severe UC . Eligible patients will be randomly assigned in a 2:1 ratio to one of two treatment groups, bertilimumab 10 mg/kg or matching placebo, respectively. The study will consist of three periods: a screening period of up to two weeks, a 4-week double-blind treatment period (three IV infusions at 2-week intervals), and a safety and efficacy follow-up period of approximately 9 weeks. Bertilimumab is a recombinant human IgG4 monoclonal antibody that neutralizes human eotaxin-1 (eotaxin). Bertilimumab will be administered every other week for 4-weeks, by IV infusion over 30 minutes.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ulcerative Colitis, Active Moderate, Ulcerative Colitis, Active Severe
Keywords
IBD, UC, Colitis, Ulcerative Colitis

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
42 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Bertilimumab
Arm Type
Experimental
Arm Description
Bertilimumab 10 mg/kg will be administered by IV infusion over 30 minutes
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Phosphate buffered saline (PBS) placebo will be administered by IV infusion over 30 minutes.
Intervention Type
Biological
Intervention Name(s)
Bertilimumab
Intervention Description
IV infusion over 30 minutes, at Day 0, Day 14 and Day 28
Intervention Type
Biological
Intervention Name(s)
Placebo
Intervention Description
IV infusion over 30 minutes, at Day 0, Day 14 and Day 28
Primary Outcome Measure Information:
Title
Clinical response
Description
A decrease in Mayo score from baseline of at least 3 points and at least 30% AND Either a decrease in the sub-score for rectal bleeding of at least 1 point, or rectal bleeding sub-score of 0 or 1.
Time Frame
Day 56
Secondary Outcome Measure Information:
Title
Change in UCEIS score from screening to Day 56
Time Frame
Da 56
Title
Clinical remission at Day 56, defined as a total Mayo score of 2 points or lower, with no individual sub-score exceeding 1 point
Time Frame
Day 56
Title
Mucosal healing at Day 56, defined as an absolute sub-score for endoscopy of 0 or 1.
Time Frame
Day 56
Title
Change in partial Mayo score from Day 0 to all scheduled measurement timepoints (efficacy follow up).
Time Frame
Throughout the study
Other Pre-specified Outcome Measures:
Title
PHARMACOKINETICS
Description
PK analysis for bertilimumab concentration: blood samples will be collected on dosing days (pre-dose and at 30 minutes and 4 hours following initiation of study drug infusion) and at the follow-up visits. The following PK parameters will be calculated, to the degree possible given the number of timepoints: Cmax, Tmax, Cavg, Cmin and t1/2. Additional standard and exploratory PK parameters will be calculated if deemed necessary
Time Frame
Throughout the study
Title
PHARMACODYNAMIC
Description
Fecal calprotectin change from Day 0 (baseline) to all scheduled measurement timepoints. PD analysis of eosinophil shape change: blood samples will be collected on dosing days (pre-dose and on Day 0 only, at 4 hours following initiation of study drug infusion), and at the follow-up visits. Change in eosinophil count, serum eotaxin-1 and hs-CRP from Day 0 to all scheduled measurement timepoints. Change in eotaxin-1 concentration and eosinophil count in biopsy tissue from Screening to Day 56
Time Frame
Throughout the study
Title
Safety
Description
Adverse events (AE) Injection site reactions Physical examination Vital signs (blood pressure, heart rate, temperature and respiratory rate) ECG Concomitant medications Laboratory evaluation (hematology, biochemistry, anti-bertilimumab antibodies).
Time Frame
Throughout the study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males or females, 18 to 70 years of age inclusive. Diagnosed with active moderate to severe UC per standard diagnostic criteria for a minimum of 3 months: Mayo score of 6-12 (inclusive) at the Screening Visit Endoscopic evidence of active mucosal disease, as assessed by flexible sigmoidoscopy, with an Endoscopic Finding Sub-score of ≥2 (assessed centrally) Rectal Bleeding Sub-score of ≥1 Physician's Global Assessment (PGA) Sub-score of ≥2. Levels of eotaxin-1 in biopsied colon tissue of ≥100 pg/mg protein. Adequate cardiac, renal and hepatic function as determined by the Investigator and demonstrated by screening laboratory evaluations and physical examination results; these findings must all be within normal limits or judged not clinically significant by the Investigator. Exclusion Criteria: History of colonic or rectal surgery other than hemorrhoidal surgery or appendectomy. Currently receiving total parenteral nutrition (TPN). Positive Clostridium difficile toxin stool assay. Tested positive for active/latent mycobacterium tuberculosis (TB) infection. Pregnant or breast-feeding, or plan to become pregnant during the study. Males who are young and childless or planning to have more children in the future. Known hypersensitivity to bertilimumab or any of the drug excipients. History of infection requiring administration of any IV antibiotic, antiviral or antifungal medication within 30 days of Screening or any oral anti-infective agent within 14 days of Screening. Severe UC evidenced by the following signs of toxicity: heart rate >100 beats/min at rest, temperature >37.8°C, hemoglobin <10.0 g/dL. Ulcerative proctitis, defined as disease limited to less than 15 cm from the anal verge. Received a vaccine or other immunostimulator within 4 weeks prior to screening. Use of >4.8 g mesalazine or equivalent within 2 weeks prior to the screening visit. Mesalazine ≤4.8 g is allowed if the dose during the 2 weeks prior to the screening visit was stable. Use of systemic corticosteroids exceeding the equivalent of 20 mg/day of prednisone within four weeks prior to the screening visit (see Section 6.9.1). Change in dose of immunosuppressive drugs (e.g., corticosteroids, 6-mercaptopurine [6-MP], azathioprine) within four weeks prior to the screening visit. Use of TNF-blockers (e.g., infliximab or adalimumab) within 60 days of the screening visit. Use of chronic non-steroidal anti-inflammatory (NSAID) therapy. Occasional use of NSAIDs or acetaminophen for headache, arthritis, myalgias, menstrual cramps, etc., or daily use of low dose (81-162 mg) aspirin for cardiovascular prophylaxis is allowed. Patients diagnosed with: Crohn's disease Diverticulitis or diverticulosis Indeterminate colitis (inability to distinguish between UC and Crohn's disease [as assessed by the Investigator]) Microscopic colitis (collagenous or lymphocytic colitis) Ischemic or infectious colitis Clostridium difficile colitis within 90 days of the screening visit Parasitic disease within 90 days of the screening visit Systemic fungal infection within 90 days of the screening visit. History of positive serology of hepatitis B or C, or human immunodeficiency virus (HIV) infection. Congenital or acquired immunodeficiency (e.g., common variable immunodeficiency, organ transplantation). Clinically significant abnormal laboratory test results, unless regarded by the Investigator as related to UC, including but not limited to: Hemoglobin level <10.0 g/dL White blood cell count < 3 x 103/µL Lymphocyte count < 0.5 x 103/µL Platelet count <100 x 103/µL or >1200 x 103/µL Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) >3 the upper limit of normal (ULN) Alkaline phosphatase >3 ULN Serum creatinine >2 ULN. Active abuse of alcohol or drugs. Known malignancy or history of malignancy that could reduce life expectancy. Any condition, which in the opinion of the Investigator, would place the patient at an unacceptable risk if participating in the study protocol. Participation in a clinical trial of an investigational (unapproved) product
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Tony Fiorino, MD
Email
tony.fiorino@immunepharma.com
First Name & Middle Initial & Last Name or Official Title & Degree
Brenda Kolatch
Email
bkolatch@immunepharma.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Dov Wengrower, MD
Organizational Affiliation
Shaare Zedek Medical Center, Jerusalem, Israel
Official's Role
Principal Investigator
Facility Information:
Facility Name
HaEmek Medical Center
City
Afula
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Eran Zittan, MD
First Name & Middle Initial & Last Name & Degree
Ika Davidov
Facility Name
Wolfson Medical Center
City
Holon
ZIP/Postal Code
58100
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Yona Avni, MD
First Name & Middle Initial & Last Name & Degree
Orit Shevah
First Name & Middle Initial & Last Name & Degree
Yona Avni, Dr
Facility Name
Shaare Zedek Medical Central
City
Jerusalem
ZIP/Postal Code
91031
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Dov Wengrower, MD
First Name & Middle Initial & Last Name & Degree
Chava Kaniel
First Name & Middle Initial & Last Name & Degree
Dov Wengrower, Dr
Facility Name
Hadassah Ein Kerem
City
Jerusalem
ZIP/Postal Code
91120
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Eran Israeli, MD
First Name & Middle Initial & Last Name & Degree
Galina Gerber
Facility Name
Meir Medical Center
City
Kfar-Saba
ZIP/Postal Code
44299
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Fred Konikoff, MD
First Name & Middle Initial & Last Name & Degree
Lee Graidy
Facility Name
Sourasky-Ichilov Tel Aviv Medical Center
City
Tel- Aviv
ZIP/Postal Code
64239
Country
Israel
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sigal Fishman, MD
First Name & Middle Initial & Last Name & Degree
Liana Shmialov
First Name & Middle Initial & Last Name & Degree
Sigal Fishman, Dr

12. IPD Sharing Statement

Learn more about this trial

Evaluation of Safety, Efficacy, Pharmacokinetic and Pharmacodynamic of Bertilimumab in Patients With Active Moderate to Severe Ulcerative Colitis

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