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Clinical Trial of CDX-1135 in Pediatric and Adult Patients With Dense Deposit Disease

Primary Purpose

Dense Deposit Disease, Membranoproliferative Glomerulonephritis Type II, C3 Glomerulonephritis

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
CDX-1135
Sponsored by
Celldex Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dense Deposit Disease focused on measuring Dense Deposit Disease, DDD

Eligibility Criteria

4 Years - undefined (Child, Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Among other criteria, patients must be

  1. Patient and/or parent/legal guardian (as appropriate) must give written informed consent
  2. Four (4) years of age or older
  3. Must have DDD, confirmed by renal biopsy within 6 months of study enrollment (Confirmation by University of Iowa investigators is required). If the patient is post transplant, the repeat renal transplant biopsy must show C3 dominant glomerulonephritis, and the patient must have a history of known DDD in the native kidney
  4. Signs of abnormal complement pathway activity
  5. Serum creatinine level must be abnormal
  6. Screening lab values criteria:

    1. Hgb ≥ 9.0 g/dL
    2. Platelets ≥ 100,000/mm^3
    3. ALT and AST ≤ 3.0 x upper limit of normal
    4. C3 serum <50% of the lower limit of normal
    5. 24 hour urine protein >1000 mg/day, or urine protein:creatinine ratio >1.0
  7. Both male and female patients of childbearing potential enrolled must use adequate birth control during the trial and for 1 month after stopping study drug
  8. Willing and able to comply with study procedures, including pre-study vaccinations (meningitis, haemophilus and pneumococci) and agree to a renal biopsy at Week 13 and at the end of the study
  9. Any anti-proteinuric medications (eg, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers) must be at a stable dose for 4 weeks prior to first dose of CDX-1135

Exclusion Criteria:

Among other criteria, patients must not be

  1. Dialysis or a low estimated glomerular filtration rate <30 ml/min/1.73m^2 over a 4-week period prior to Screening
  2. Active or untreated systemic bacterial infection
  3. Pregnant or lactating
  4. Rituximab therapy (unless discontinued with B cell levels and immunoglobulin levels normalized by study entry)
  5. Immunosuppressive therapies (except for low dose steroids [≤10 mg per day] given for non-DDD related conditions such as asthma). Exceptions will be made for renal transplant patients, who may receive any appropriate therapies as needed to maintain the transplant (i.e., to prevent rejection)
  6. Treatment with any complement inhibitor within 3 months of study entry or any other investigational drug, device, or experimental procedure within 4 weeks prior to enrollment
  7. For renal transplant patients only: histology findings of treatable rejection (i.e. that the usual transplant physician would seek to treat). Chronic allograft nephropathy is not exclusionary provided the patient's glomerular filtration rate meets other entry criteria
  8. Preexisting condition with an association as a potential cause of DDD (i.e., Monoclonal Gammopathy of Undetermined Significance) or an alternate glomerular disease
  9. Cancer except for adequately treated and cured basal or squamous cell skin cancer, curatively treated in situ disease, or other cancer that the patient has been disease-free for ≥ 5 years
  10. Myocardial infarction within 1 year of screening, congestive heart failure, arrhythmia persistent on medication at screening or chronic lung disease
  11. Known HIV, Hepatitis B or Hepatitis C
  12. Any medical or psychological condition that would increase the patient's risk by being in this study or would interfere with interpretation of the study

Sites / Locations

  • University of Iowa Hospitals & Clinics

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Dense Deposit Disease

Arm Description

► Induction Period Patients will receive CDX-1135 as an IV infusion twice weekly (Mon-Thur or Tues-Fri). There will be two doses of 5 mg/kg, with intrapatient dose-escalation in 5 mg/kg increments up to a maximum dose of 30 mg/kg. This period may last up to 8 weeks. ► Maintenance Period The starting dose for CDX-1135 Maintenance will be the same dose level as the last dose during the Induction Period; however, the Maintenance Period allows for dose decrease to 2 mg/kg, which is lower than the starting dose in the Induction Period. Patients will receive CDX-1135 as an IV infusion twice weekly (Mon-Thur or Tues-Fri) for up to a total of 26 weeks.

Outcomes

Primary Outcome Measures

Safety
Incidence and severity of adverse events (AE) will be assessed at every visit. AEs and serious adverse events (SAEs) will be assessed from the first dose of study drug through 33 days after the last dose To evaluate the safety of repeated dosing in patients with DDD. Safety will be assessed based on changes in clinical laboratory tests, physical exams, vital signs, ophthalmic exams and ECGs [for patients ≥ 35 years of age].
C3 and AP Normalization
The proportion of patients with normalization of serum C3, serum C3 breakdown products, or alternative pathway (AP) complement activity. These blood tests will be assessed on each dosing day and upon Study Completion /Termination.

Secondary Outcome Measures

Duration of and time to normalize C3 and AP
Time to normalization of serum levels of C3 or C3 breakdown products and duration of normalization and assays of alternative pathway activity. These blood tests will be assessed on each dosing day and upon Study Completion /Termination.
Renal Function
Stabilization and/or improvement in renal function (as measured by serum creatinine and proteinuria). These lab tests will be performed weekly during the Induction Period, monthly during the Maintenance Period and upon Study Completion /Termination.
Renal biopsy
Improvement on renal biopsy (as measured by reduction in C3 deposition in the glomerular basement membrane). This biopsy may be performed during screening, week 13, and upon Study Completion /Termination.
Immunogenicity
Immunogenicity (development of antibodies to CDX-1135). This sample will be collected prior to dosing on Week 1, monthly during treatment, and upon Study Completion /Termination

Full Information

First Posted
January 29, 2013
Last Updated
March 6, 2014
Sponsor
Celldex Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT01791686
Brief Title
Clinical Trial of CDX-1135 in Pediatric and Adult Patients With Dense Deposit Disease
Official Title
A Pilot, Open-label, Multicenter Clinical Trial of CDX-1135 in Pediatric and Adult Patients With Dense Deposit Disease
Study Type
Interventional

2. Study Status

Record Verification Date
March 2014
Overall Recruitment Status
Terminated
Why Stopped
Portfolio prioritization due to slow enrollment and variable spectrum of potential complement abnormalities in DDD patients.
Study Start Date
January 2013 (undefined)
Primary Completion Date
March 2014 (Actual)
Study Completion Date
March 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Celldex Therapeutics

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is evaluating the study drug (CDX-1135) in patients with dense deposit disease (DDD). The objective is to evaluate the safety and activity of repeated doses of CDX-1135 in pediatric and adult patients with DDD. After screening, eligible patients will be entered into the Induction Period. The Induction Period is up to 4 weeks. Following normalization of complement activity, patients will enter into the Maintenance Period.The total treatment duration is up to 26 weeks.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dense Deposit Disease, Membranoproliferative Glomerulonephritis Type II, C3 Glomerulonephritis
Keywords
Dense Deposit Disease, DDD

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
1 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Dense Deposit Disease
Arm Type
Experimental
Arm Description
► Induction Period Patients will receive CDX-1135 as an IV infusion twice weekly (Mon-Thur or Tues-Fri). There will be two doses of 5 mg/kg, with intrapatient dose-escalation in 5 mg/kg increments up to a maximum dose of 30 mg/kg. This period may last up to 8 weeks. ► Maintenance Period The starting dose for CDX-1135 Maintenance will be the same dose level as the last dose during the Induction Period; however, the Maintenance Period allows for dose decrease to 2 mg/kg, which is lower than the starting dose in the Induction Period. Patients will receive CDX-1135 as an IV infusion twice weekly (Mon-Thur or Tues-Fri) for up to a total of 26 weeks.
Intervention Type
Drug
Intervention Name(s)
CDX-1135
Other Intervention Name(s)
TP10, sCR1
Primary Outcome Measure Information:
Title
Safety
Description
Incidence and severity of adverse events (AE) will be assessed at every visit. AEs and serious adverse events (SAEs) will be assessed from the first dose of study drug through 33 days after the last dose To evaluate the safety of repeated dosing in patients with DDD. Safety will be assessed based on changes in clinical laboratory tests, physical exams, vital signs, ophthalmic exams and ECGs [for patients ≥ 35 years of age].
Time Frame
From first study drug dose for up to 26 weeks
Title
C3 and AP Normalization
Description
The proportion of patients with normalization of serum C3, serum C3 breakdown products, or alternative pathway (AP) complement activity. These blood tests will be assessed on each dosing day and upon Study Completion /Termination.
Time Frame
Regular assessments from study start up to 26 weeks
Secondary Outcome Measure Information:
Title
Duration of and time to normalize C3 and AP
Description
Time to normalization of serum levels of C3 or C3 breakdown products and duration of normalization and assays of alternative pathway activity. These blood tests will be assessed on each dosing day and upon Study Completion /Termination.
Time Frame
Regular assessments from study start up to 26 weeks
Title
Renal Function
Description
Stabilization and/or improvement in renal function (as measured by serum creatinine and proteinuria). These lab tests will be performed weekly during the Induction Period, monthly during the Maintenance Period and upon Study Completion /Termination.
Time Frame
Regularly from study start up to 26 weeks
Title
Renal biopsy
Description
Improvement on renal biopsy (as measured by reduction in C3 deposition in the glomerular basement membrane). This biopsy may be performed during screening, week 13, and upon Study Completion /Termination.
Time Frame
Occurs up to 3 times from study start up to 26 weeks
Title
Immunogenicity
Description
Immunogenicity (development of antibodies to CDX-1135). This sample will be collected prior to dosing on Week 1, monthly during treatment, and upon Study Completion /Termination
Time Frame
Regular assessments from study start up to 26 weeks
Other Pre-specified Outcome Measures:
Title
CDX-1135 concentrations
Description
Serum concentrations of CDX-1135 will be determined from blood samples collected prior to dosing and post-dosing. (on each dosing day)
Time Frame
Regular assessments from study start up to 26 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
4 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Among other criteria, patients must be Patient and/or parent/legal guardian (as appropriate) must give written informed consent Four (4) years of age or older Must have DDD, confirmed by renal biopsy within 6 months of study enrollment (Confirmation by University of Iowa investigators is required). If the patient is post transplant, the repeat renal transplant biopsy must show C3 dominant glomerulonephritis, and the patient must have a history of known DDD in the native kidney Signs of abnormal complement pathway activity Serum creatinine level must be abnormal Screening lab values criteria: Hgb ≥ 9.0 g/dL Platelets ≥ 100,000/mm^3 ALT and AST ≤ 3.0 x upper limit of normal C3 serum <50% of the lower limit of normal 24 hour urine protein >1000 mg/day, or urine protein:creatinine ratio >1.0 Both male and female patients of childbearing potential enrolled must use adequate birth control during the trial and for 1 month after stopping study drug Willing and able to comply with study procedures, including pre-study vaccinations (meningitis, haemophilus and pneumococci) and agree to a renal biopsy at Week 13 and at the end of the study Any anti-proteinuric medications (eg, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers) must be at a stable dose for 4 weeks prior to first dose of CDX-1135 Exclusion Criteria: Among other criteria, patients must not be Dialysis or a low estimated glomerular filtration rate <30 ml/min/1.73m^2 over a 4-week period prior to Screening Active or untreated systemic bacterial infection Pregnant or lactating Rituximab therapy (unless discontinued with B cell levels and immunoglobulin levels normalized by study entry) Immunosuppressive therapies (except for low dose steroids [≤10 mg per day] given for non-DDD related conditions such as asthma). Exceptions will be made for renal transplant patients, who may receive any appropriate therapies as needed to maintain the transplant (i.e., to prevent rejection) Treatment with any complement inhibitor within 3 months of study entry or any other investigational drug, device, or experimental procedure within 4 weeks prior to enrollment For renal transplant patients only: histology findings of treatable rejection (i.e. that the usual transplant physician would seek to treat). Chronic allograft nephropathy is not exclusionary provided the patient's glomerular filtration rate meets other entry criteria Preexisting condition with an association as a potential cause of DDD (i.e., Monoclonal Gammopathy of Undetermined Significance) or an alternate glomerular disease Cancer except for adequately treated and cured basal or squamous cell skin cancer, curatively treated in situ disease, or other cancer that the patient has been disease-free for ≥ 5 years Myocardial infarction within 1 year of screening, congestive heart failure, arrhythmia persistent on medication at screening or chronic lung disease Known HIV, Hepatitis B or Hepatitis C Any medical or psychological condition that would increase the patient's risk by being in this study or would interfere with interpretation of the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Carla Nester, MD, MSA
Organizational Affiliation
University of Iowa
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Richard Smith, MD
Organizational Affiliation
University of Iowa
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Iowa Hospitals & Clinics
City
Iowa City
State/Province
Iowa
ZIP/Postal Code
52242
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Clinical Trial of CDX-1135 in Pediatric and Adult Patients With Dense Deposit Disease

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