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Safety and Effectiveness of CNDO 201Trichuris Suis Ova (TSO) for the Treatment of Moderate to Severe Plaque Psoriasis

Primary Purpose

Psoriasis

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
TSO 2500
TSO 7500
Sponsored by
Mark Lebwohl
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Psoriasis focused on measuring psoriasis, oral therapy, ova, Trichuris suis ova, TSO, CNDO 201 Trichuris suis ova

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  • Males or females, 18 to 75 years old.
  • Diagnosis of stable plaque type psoriasis for at least 6 months prior to baseline
  • Baseline moderate to severe psoriasis, defined as both of the following:

    1. Psoriasis covering a body surface area (BSA) ≥ 10%, and;
    2. PGA ≥ 3, and;
    3. PASI ≥ 12
  • Must be in good health (except for psoriasis and psoriatic arthritis) as judged by the Investigator, based on medical history, physical examination, and clinical laboratories
  • In the opinion of the investigator, must be a candidate for systemic therapy or phototherapy of psoriasis
  • If a woman, before entry she must be:

    1. Postmenopausal, defined as 45 years of age with amenorrhea for at least 18 months, or > 45 years of age with amenorrhea for at least 6 months and a serum follicle stimulating hormone (FSH) level > 40 IU/mL, or Surgically postmenopausal (bilateral oophorectomy), or
    2. Surgically sterile (have had a hysterectomy or tubal ligation or otherwise be incapable of pregnancy), or
    3. If heterosexually active, practicing a highly effective method of birth control, including hormonal prescription oral contraceptives, contraceptive injections, contraceptive patch, intrauterine device, double-barrier method (eg, condoms, diaphragm, or cervical cap, with spermicidal foam, cream, or gel), or male partner sterilization, consistent with local regulations regarding the use of birth control methods for subjects participating in clinical trials, for the duration of their participation in the study and for 2 months after receiving the last administration of any study agent, or
    4. Not heterosexually active
  • Women of childbearing potential must have a negative pregnancy test (urine and serum) prior to randomization
  • Agree to avoid prolonged exposure to natural sunlight or tanning beds or phototherapy devices for the duration of the study
  • Agree to avoid any prohibited concomitant medications as detailed below for the duration of the study and for 4 weeks prior to baseline unless indication otherwise
  • Negative stool culture.
  • Patient has the ability to provide informed consent.

Exclusion Criteria:

  • Patients with known history of intestinal parasitic infection, even if adequately treated, in the past 5 years.
  • Patient received antibiotic, antifungal or antiparasitic medication in the last 2 weeks prior to Screening and/or would potentially require this during the study treatment period.
  • Patient with history of drug or alcohol abuse within 6 months prior to Screening.
  • Patient with evidence of poor compliance with medical advice and instruction including diet or medication.
  • Patient is unable or unwilling to swallow study medication suspension.
  • Patient with a significant medical condition which puts the patient at risk for study participation and/or for any reason is considered by the Investigator to be an unsuitable candidate to receive TSO or is potentially put at risk by study procedures.
  • Patients who has participated in another clinical trial within 30 days of Screening for this trial and/or any experimental treatment for this population.
  • White blood cell count ≤ 3,000/mm3 (≤ 3.0 x 109/L) or ≥ 14,000/mm3 (≥14 x 109/L)
  • Platelet count ≤ 100,000/μL (≤100 x 109/L)
  • Serum creatinine >2 x upper limit of normal (ULN)
  • AST (SGOT) or ALT (SGPT) > 2 x ULN
  • Total bilirubin >2 mg/dL (34 μmol/L)
  • Hemoglobin < 9 g/dL
  • Patients who are currently taking or have taken in the past 30 days, for any reason, any medication that, in the opinion of the investigator, suppressed the immune response. This may include but is not limited to systemic steroids, azathioprine, cyclosporine, FK506, mycophenolate mofetil, mycophenolic acid, etanercept, adalimumab, infliximab, ustekinumab, cimzia, or any other biologic agent targeted to any cell or cytokine in the immune system.
  • Patients who are refractory to 2 or more biological agent plaque psoriasis therapies due to lack of efficacy.
  • Patients currently taking or who have taken in the past 2 weeks, topical steroids.
  • Patients on a non-stable dose of vitamin D analog in the past 30 days.
  • Patients currently taking or who have taken in the past 30 days any medications likely to improve psoriasis and thus interfere with evaluation. This may include, in addition to the medications listed above, phototherapy, methotrexate, hydroxyurea, or acitretin.
  • Patients with a diagnosis of inflammatory bowel disease (ulcerative colitis or Crohn's disease) or of irritable bowel syndrome
  • Patients with HIV-1/HIV-2 antibody, hepatitis B surface antigen, hepatitis C antibody.
  • Patient received non-steroidal anti-inflammatory drugs (NSAIDS) within 2 weeks before Baseline visit for more than 3 consecutive days, except acetylsalicylic acid ≤ 350 mg/d which is allowed.
  • Women who are pregnant, intending to become pregnant, breastfeeding or planning to breastfeed during the study.

Sites / Locations

  • Icahn School of Medicine at Mount Sinai

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

TSO 2500

TSO 7500

Arm Description

TSO 2500: 2500 embryonated, viable TSO/15 mL/day every 2 weeks X 10 weeks

TSO 7500: 7500 embryonated, viable TSO/15 mL/day every 2 weeks X 10 weeks

Outcomes

Primary Outcome Measures

Psoriasis Area and Severity Index (PASI)
The PASI score will be calculated within each patient at each protocol-specified time point. Changes and percent changes from pretreatment to each on-treatment time point will then be derived. Mean percent change from pre-treatment to Week 12.

Secondary Outcome Measures

psoriasis severity
Percentage of patients who experience an improvement in disease severity as defined by a 50%, 75%, and 90% reduction of psoriasis severity (PASI 50, PASI 75, and PASI 90 response, respectively).
psoriasis severity
Percentage of patients who experience an improvement in disease severity as defined by a 50%, 75%, and 90% reduction of psoriasis severity (PASI 50, PASI 75, and PASI 90 response, respectively).
psoriasis severity
Percentage of patients who experience an improvement in disease severity as defined by a 50%, 75%, and 90% reduction of psoriasis severity (PASI 50, PASI 75, and PASI 90 response, respectively).
Physicians Global Assessment (PGA)
Percentage of patients with plaque type psoriasis who experience an improvement in disease severity as defined by a PGA ≤ 1.
Physicians Global Assessment (PGA)
Percentage of patients with plaque type psoriasis who experience an improvement in disease severity as defined by a PGA ≤ 1.
Physicians Global Assessment (PGA)
Percentage of patients with plaque type psoriasis who experience an improvement in disease severity as defined by a PGA ≤ 1.
Change in Body surface area (BSA)
Body surface area (BSA) mean and percent change from pre-treatment
Change in Dermatology Life Quality Index (DLQI)
DLQI mean (and percent) change from pre-treatment to Week 12
safety of TSO
The safety and tolerability of TSO will be evaluated via the frequency and severity of adverse events, changes in physical examinations, stool cultures, clinical laboratories, and vital signs.

Full Information

First Posted
March 26, 2013
Last Updated
January 13, 2015
Sponsor
Mark Lebwohl
Collaborators
Coronado Biosciences, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01836939
Brief Title
Safety and Effectiveness of CNDO 201Trichuris Suis Ova (TSO) for the Treatment of Moderate to Severe Plaque Psoriasis
Official Title
A Randomized Open-label Two-arm Pilot Study to Assess the Safety and Efficacy of Trichuris Suis Ova for the Treatment of Moderate to Severe Chronic Plaque Psoriasis. Protocol: Psoriasis IIT
Study Type
Interventional

2. Study Status

Record Verification Date
January 2015
Overall Recruitment Status
Completed
Study Start Date
March 2013 (undefined)
Primary Completion Date
September 2014 (Actual)
Study Completion Date
September 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Mark Lebwohl
Collaborators
Coronado Biosciences, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety and effectiveness of CNDO 201Trichuris suis ova (TSO) for the treatment of moderate to severe plaque psoriasis.
Detailed Description
The purpose of this study is to evaluate the safety and effectiveness of CNDO 201Trichuris suis ova (TSO) for the treatment of moderate to severe plaque psoriasis. Psoriasis is driven by T-cell infiltration in the epidermis. The T-cells involved in psoriasis exhibit a Th17-like and a Th1-like cytokine secretion profile. This excess Th17/Th1 response is thought to play a critical role in the development of psoriasis, and reducing Th17/Th1 activity would be a potential way of halting the inflammatory process leading to psoriasis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Psoriasis
Keywords
psoriasis, oral therapy, ova, Trichuris suis ova, TSO, CNDO 201 Trichuris suis ova

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
8 (Actual)

8. Arms, Groups, and Interventions

Arm Title
TSO 2500
Arm Type
Active Comparator
Arm Description
TSO 2500: 2500 embryonated, viable TSO/15 mL/day every 2 weeks X 10 weeks
Arm Title
TSO 7500
Arm Type
Active Comparator
Arm Description
TSO 7500: 7500 embryonated, viable TSO/15 mL/day every 2 weeks X 10 weeks
Intervention Type
Drug
Intervention Name(s)
TSO 2500
Intervention Description
TSO 2500: 2500 embryonated, viable TSO/15 mL/day every 2 weeks X 10 weeks
Intervention Type
Drug
Intervention Name(s)
TSO 7500
Other Intervention Name(s)
CNDO 201 Trichuris suis ova (TSO), Trichuris suis ova, TSO, CNDO 201 Trichuris suis ova
Intervention Description
12 weeks of treatment with TSO 2500 ova or TSO 7500 ova given every 2 weeks (a total of 6 doses).
Primary Outcome Measure Information:
Title
Psoriasis Area and Severity Index (PASI)
Description
The PASI score will be calculated within each patient at each protocol-specified time point. Changes and percent changes from pretreatment to each on-treatment time point will then be derived. Mean percent change from pre-treatment to Week 12.
Time Frame
up to 12 weeks
Secondary Outcome Measure Information:
Title
psoriasis severity
Description
Percentage of patients who experience an improvement in disease severity as defined by a 50%, 75%, and 90% reduction of psoriasis severity (PASI 50, PASI 75, and PASI 90 response, respectively).
Time Frame
week 4
Title
psoriasis severity
Description
Percentage of patients who experience an improvement in disease severity as defined by a 50%, 75%, and 90% reduction of psoriasis severity (PASI 50, PASI 75, and PASI 90 response, respectively).
Time Frame
week 8
Title
psoriasis severity
Description
Percentage of patients who experience an improvement in disease severity as defined by a 50%, 75%, and 90% reduction of psoriasis severity (PASI 50, PASI 75, and PASI 90 response, respectively).
Time Frame
week 12
Title
Physicians Global Assessment (PGA)
Description
Percentage of patients with plaque type psoriasis who experience an improvement in disease severity as defined by a PGA ≤ 1.
Time Frame
week 4
Title
Physicians Global Assessment (PGA)
Description
Percentage of patients with plaque type psoriasis who experience an improvement in disease severity as defined by a PGA ≤ 1.
Time Frame
week 8
Title
Physicians Global Assessment (PGA)
Description
Percentage of patients with plaque type psoriasis who experience an improvement in disease severity as defined by a PGA ≤ 1.
Time Frame
week 12
Title
Change in Body surface area (BSA)
Description
Body surface area (BSA) mean and percent change from pre-treatment
Time Frame
baseline and week 12
Title
Change in Dermatology Life Quality Index (DLQI)
Description
DLQI mean (and percent) change from pre-treatment to Week 12
Time Frame
baseline and at week 12
Title
safety of TSO
Description
The safety and tolerability of TSO will be evaluated via the frequency and severity of adverse events, changes in physical examinations, stool cultures, clinical laboratories, and vital signs.
Time Frame
up to week 38

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Males or females, 18 to 75 years old. Diagnosis of stable plaque type psoriasis for at least 6 months prior to baseline Baseline moderate to severe psoriasis, defined as both of the following: Psoriasis covering a body surface area (BSA) ≥ 10%, and; PGA ≥ 3, and; PASI ≥ 12 Must be in good health (except for psoriasis and psoriatic arthritis) as judged by the Investigator, based on medical history, physical examination, and clinical laboratories In the opinion of the investigator, must be a candidate for systemic therapy or phototherapy of psoriasis If a woman, before entry she must be: Postmenopausal, defined as 45 years of age with amenorrhea for at least 18 months, or > 45 years of age with amenorrhea for at least 6 months and a serum follicle stimulating hormone (FSH) level > 40 IU/mL, or Surgically postmenopausal (bilateral oophorectomy), or Surgically sterile (have had a hysterectomy or tubal ligation or otherwise be incapable of pregnancy), or If heterosexually active, practicing a highly effective method of birth control, including hormonal prescription oral contraceptives, contraceptive injections, contraceptive patch, intrauterine device, double-barrier method (eg, condoms, diaphragm, or cervical cap, with spermicidal foam, cream, or gel), or male partner sterilization, consistent with local regulations regarding the use of birth control methods for subjects participating in clinical trials, for the duration of their participation in the study and for 2 months after receiving the last administration of any study agent, or Not heterosexually active Women of childbearing potential must have a negative pregnancy test (urine and serum) prior to randomization Agree to avoid prolonged exposure to natural sunlight or tanning beds or phototherapy devices for the duration of the study Agree to avoid any prohibited concomitant medications as detailed below for the duration of the study and for 4 weeks prior to baseline unless indication otherwise Negative stool culture. Patient has the ability to provide informed consent. Exclusion Criteria: Patients with known history of intestinal parasitic infection, even if adequately treated, in the past 5 years. Patient received antibiotic, antifungal or antiparasitic medication in the last 2 weeks prior to Screening and/or would potentially require this during the study treatment period. Patient with history of drug or alcohol abuse within 6 months prior to Screening. Patient with evidence of poor compliance with medical advice and instruction including diet or medication. Patient is unable or unwilling to swallow study medication suspension. Patient with a significant medical condition which puts the patient at risk for study participation and/or for any reason is considered by the Investigator to be an unsuitable candidate to receive TSO or is potentially put at risk by study procedures. Patients who has participated in another clinical trial within 30 days of Screening for this trial and/or any experimental treatment for this population. White blood cell count ≤ 3,000/mm3 (≤ 3.0 x 109/L) or ≥ 14,000/mm3 (≥14 x 109/L) Platelet count ≤ 100,000/μL (≤100 x 109/L) Serum creatinine >2 x upper limit of normal (ULN) AST (SGOT) or ALT (SGPT) > 2 x ULN Total bilirubin >2 mg/dL (34 μmol/L) Hemoglobin < 9 g/dL Patients who are currently taking or have taken in the past 30 days, for any reason, any medication that, in the opinion of the investigator, suppressed the immune response. This may include but is not limited to systemic steroids, azathioprine, cyclosporine, FK506, mycophenolate mofetil, mycophenolic acid, etanercept, adalimumab, infliximab, ustekinumab, cimzia, or any other biologic agent targeted to any cell or cytokine in the immune system. Patients who are refractory to 2 or more biological agent plaque psoriasis therapies due to lack of efficacy. Patients currently taking or who have taken in the past 2 weeks, topical steroids. Patients on a non-stable dose of vitamin D analog in the past 30 days. Patients currently taking or who have taken in the past 30 days any medications likely to improve psoriasis and thus interfere with evaluation. This may include, in addition to the medications listed above, phototherapy, methotrexate, hydroxyurea, or acitretin. Patients with a diagnosis of inflammatory bowel disease (ulcerative colitis or Crohn's disease) or of irritable bowel syndrome Patients with HIV-1/HIV-2 antibody, hepatitis B surface antigen, hepatitis C antibody. Patient received non-steroidal anti-inflammatory drugs (NSAIDS) within 2 weeks before Baseline visit for more than 3 consecutive days, except acetylsalicylic acid ≤ 350 mg/d which is allowed. Women who are pregnant, intending to become pregnant, breastfeeding or planning to breastfeed during the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mark Lebwohl, MD
Organizational Affiliation
Icahn School of Medicine at Mount Sinai
Official's Role
Principal Investigator
Facility Information:
Facility Name
Icahn School of Medicine at Mount Sinai
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
18587394
Citation
Barrett JC, Hansoul S, Nicolae DL, Cho JH, Duerr RH, Rioux JD, Brant SR, Silverberg MS, Taylor KD, Barmada MM, Bitton A, Dassopoulos T, Datta LW, Green T, Griffiths AM, Kistner EO, Murtha MT, Regueiro MD, Rotter JI, Schumm LP, Steinhart AH, Targan SR, Xavier RJ; NIDDK IBD Genetics Consortium; Libioulle C, Sandor C, Lathrop M, Belaiche J, Dewit O, Gut I, Heath S, Laukens D, Mni M, Rutgeerts P, Van Gossum A, Zelenika D, Franchimont D, Hugot JP, de Vos M, Vermeire S, Louis E; Belgian-French IBD Consortium; Wellcome Trust Case Control Consortium; Cardon LR, Anderson CA, Drummond H, Nimmo E, Ahmad T, Prescott NJ, Onnie CM, Fisher SA, Marchini J, Ghori J, Bumpstead S, Gwilliam R, Tremelling M, Deloukas P, Mansfield J, Jewell D, Satsangi J, Mathew CG, Parkes M, Georges M, Daly MJ. Genome-wide association defines more than 30 distinct susceptibility loci for Crohn's disease. Nat Genet. 2008 Aug;40(8):955-62. doi: 10.1038/ng.175. Epub 2008 Jun 29.
Results Reference
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PubMed Identifier
17499606
Citation
Baumgart DC, Sandborn WJ. Inflammatory bowel disease: clinical aspects and established and evolving therapies. Lancet. 2007 May 12;369(9573):1641-57. doi: 10.1016/S0140-6736(07)60751-X.
Results Reference
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PubMed Identifier
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Citation
Crohn BB, Ginzburg L, Oppenheimer GD. Regional ileitis: a pathologic and clinical entity. 1932. Mt Sinai J Med. 2000 May;67(3):263-8. No abstract available.
Results Reference
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Citation
Loftus EV Jr, Schoenfeld P, Sandborn WJ. The epidemiology and natural history of Crohn's disease in population-based patient cohorts from North America: a systematic review. Aliment Pharmacol Ther. 2002 Jan;16(1):51-60. doi: 10.1046/j.1365-2036.2002.01140.x.
Results Reference
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Safety and Effectiveness of CNDO 201Trichuris Suis Ova (TSO) for the Treatment of Moderate to Severe Plaque Psoriasis

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