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Efficacy Study of Trichuris Suis Ova to Treat Chronic Plaque Psoriasis

Primary Purpose

Psoriasis

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Trichuris Suis Ova
Sponsored by
Tufts Medical Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Psoriasis focused on measuring Psoriasis, Trichuris suis ova, T-lymphocytes

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria:

  1. Males or females, 18-75 years old
  2. Diagnosis of stable plaque type psoriasis for at least 6 months prior to baseline
  3. Baseline moderate to severe psoriasis, defined as:

    1. Psoriasis covering a body surface area (BSA) ≥10%;
    2. Physician's global assessment (PGA) ≥3, and;
    3. PASI ≥12
  4. Must be in good health as judged by the PI, based on medical history, physical examination, and clinical laboratories
  5. In the opinion of the PI, must be a candidate for systemic therapy or phototherapy of psoriasis
  6. If a woman, before entry she must be one of the following:

    1. Postmenopausal, defined as 45 years of age with amenorrhea for at least 18 months, or >45 years of age with amenorrhea for >6 months and a serum follicle stimulating hormone (FSH) level >40 IU/mL, or surgically postmenopausal (bilateral oophorectomy)
    2. surgically sterile (have had a hysterectomy or tubal ligation or otherwise be incapable of pregnancy)
    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 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
  7. Women of childbearing potential must have a negative pregnancy test (urine and serum) prior to randomization
  8. Agree to avoid prolonged exposure to natural sunlight or tanning beds or phototherapy devices for the duration of the study
  9. Agree to avoid any prohibited concomitant medications as detailed below for the duration of the study and for 4 weeks prior to baseline
  10. Negative stool culture
  11. Subject has the ability to provide informed consent
  12. Subjects who are on inhaled or ophthalmic steroids are allowed

Exclusion Criteria:

  1. Subjects with known history of intestinal parasitic infection, even if adequately treated, in the past 5 years
  2. Subject 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
  3. Subject with history of drug or alcohol abuse within 6 months prior to screening
  4. Subject with evidence of poor compliance with medical advice and instruction including diet or medication
  5. Subject is unable or unwilling to swallow study medication suspension
  6. Subject with a significant medical condition which puts the subject 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
  7. Subjects who has participated in another clinical trial within 30 days of screening for this trial and/or any experimental treatment for this population
  8. White blood cell count ≤3,000/mm3 (≤3.0 x 109/L) or ≥14,000/mm3 (≥14 x 109/L)
  9. Platelet count ≤ 100,000/μL (≤100 x 109/L)
  10. Serum creatinine >2 x upper limit of normal (ULN)
  11. Aspartate or alanine aminotransferase >2 x ULN
  12. Total bilirubin >2 mg/dL (34 μmol/L)
  13. Hemoglobin < 9 g/dL
  14. Subjects 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, tacrolimus, mycophenolate mofetil, mycophenolic acid, etanercept, adalimumab, infliximab, ustekinumab, cimzia, or any other biologic agent targeted to any cell or cytokine in the immune system.
  15. Subjects who are refractory to 2 or more biological agent plaque psoriasis therapies due to lack of efficacy
  16. Subjects currently taking or who have taken in the past 2 weeks, topical steroids
  17. Subjects on a non-stable dose of vitamin D analog in the past 30 days
  18. Subjects 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
  19. Subjects with a diagnosis of inflammatory bowel disease (ulcerative colitis or Crohn's disease) or of irritable bowel syndrome
  20. Subjects with HIV-1/HIV-2 antibody, hepatitis B surface antigen, hepatitis C antibody
  21. Subject received non-steroidal anti-inflammatory drugs within 2 weeks before Baseline visit for more than 3 consecutive days, except acetylsalicylic acid ≤350 mg/d which is allowed
  22. Women who are intending to become pregnant or who are breastfeeding or planning to breastfeed

Sites / Locations

  • Tufts Medical Center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

TSO 7500

Arm Description

Subjects in this arm will receive doses of 7500 trichuris suis ova every two weeks, starting at the baseline visit, for a total of 8 doses.

Outcomes

Primary Outcome Measures

Physician's area and severity index (PASI)
The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. PASI produces a numeric score that can range from 0 to 72 based on the body surface area of involvement and the severity of disease (induration, erythema and scale). A PASI-50 response is defined as ≥50% improvement in PASI score from baseline; PASI-75 and PASI-90 are similarly defined.

Secondary Outcome Measures

Safety and tolerability
Evaluated via the frequency and severity of adverse events, changes in physical examinations, stool studies (ova and parasites, culture, clostridium difficile toxin, and blood), clinical laboratories (liver function tests, creatine phosphokinase, complete metabolic profile, complete blood count), and vital signs (blood pressure, pulse and temperature).

Full Information

First Posted
September 18, 2013
Last Updated
September 14, 2016
Sponsor
Tufts Medical Center
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1. Study Identification

Unique Protocol Identification Number
NCT01948271
Brief Title
Efficacy Study of Trichuris Suis Ova to Treat Chronic Plaque Psoriasis
Official Title
An Open-label Pilot Study to Assess the Safety and Efficacy of Trichuris Suis Ova for the Treatment of Moderate to Severe Chronic Plaque Psoriasis
Study Type
Interventional

2. Study Status

Record Verification Date
September 2016
Overall Recruitment Status
Terminated
Why Stopped
lack of efficacy
Study Start Date
July 2013 (undefined)
Primary Completion Date
September 2014 (Actual)
Study Completion Date
September 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Tufts Medical Center

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this research study is to better understand whether trichuris suis ova (TSO) ingested orally may be safe and effective in the treatment of psoriasis.
Detailed Description
This is an open-label study to assess the safety and efficacy of 16 weeks of treatment with 7500 trichuris suis ova (TSO 7500) given every 2 weeks (a total of 8 doses) for the treatment of moderate-to-severe, chronic, plaque-type psoriasis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Psoriasis
Keywords
Psoriasis, Trichuris suis ova, T-lymphocytes

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
TSO 7500
Arm Type
Experimental
Arm Description
Subjects in this arm will receive doses of 7500 trichuris suis ova every two weeks, starting at the baseline visit, for a total of 8 doses.
Intervention Type
Drug
Intervention Name(s)
Trichuris Suis Ova
Other Intervention Name(s)
TSO 7500
Intervention Description
During the treatment phase, study drug will be provided in a liquid form and will be administered every 2 weeks, starting with the Baseline visit, through Week 14.
Primary Outcome Measure Information:
Title
Physician's area and severity index (PASI)
Description
The PASI is a system used for assessing and grading the severity of psoriatic lesions and their response to therapy. PASI produces a numeric score that can range from 0 to 72 based on the body surface area of involvement and the severity of disease (induration, erythema and scale). A PASI-50 response is defined as ≥50% improvement in PASI score from baseline; PASI-75 and PASI-90 are similarly defined.
Time Frame
Screening, baseline, weeks 2, 4, 6, 8, 10, 12, 14, and 16
Secondary Outcome Measure Information:
Title
Safety and tolerability
Description
Evaluated via the frequency and severity of adverse events, changes in physical examinations, stool studies (ova and parasites, culture, clostridium difficile toxin, and blood), clinical laboratories (liver function tests, creatine phosphokinase, complete metabolic profile, complete blood count), and vital signs (blood pressure, pulse and temperature).
Time Frame
Screening, baseline, weeks 2, 4, 6, 8, 10, 12, 14, 16, 20, and 38

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Males or females, 18-75 years old Diagnosis of stable plaque type psoriasis for at least 6 months prior to baseline Baseline moderate to severe psoriasis, defined as: Psoriasis covering a body surface area (BSA) ≥10%; Physician's global assessment (PGA) ≥3, and; PASI ≥12 Must be in good health as judged by the PI, based on medical history, physical examination, and clinical laboratories In the opinion of the PI, must be a candidate for systemic therapy or phototherapy of psoriasis If a woman, before entry she must be one of the following: Postmenopausal, defined as 45 years of age with amenorrhea for at least 18 months, or >45 years of age with amenorrhea for >6 months and a serum follicle stimulating hormone (FSH) level >40 IU/mL, or surgically postmenopausal (bilateral oophorectomy) surgically sterile (have had a hysterectomy or tubal ligation or otherwise be incapable of pregnancy) 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 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 Negative stool culture Subject has the ability to provide informed consent Subjects who are on inhaled or ophthalmic steroids are allowed Exclusion Criteria: Subjects with known history of intestinal parasitic infection, even if adequately treated, in the past 5 years Subject 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 Subject with history of drug or alcohol abuse within 6 months prior to screening Subject with evidence of poor compliance with medical advice and instruction including diet or medication Subject is unable or unwilling to swallow study medication suspension Subject with a significant medical condition which puts the subject 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 Subjects 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) Aspartate or alanine aminotransferase >2 x ULN Total bilirubin >2 mg/dL (34 μmol/L) Hemoglobin < 9 g/dL Subjects 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, tacrolimus, mycophenolate mofetil, mycophenolic acid, etanercept, adalimumab, infliximab, ustekinumab, cimzia, or any other biologic agent targeted to any cell or cytokine in the immune system. Subjects who are refractory to 2 or more biological agent plaque psoriasis therapies due to lack of efficacy Subjects currently taking or who have taken in the past 2 weeks, topical steroids Subjects on a non-stable dose of vitamin D analog in the past 30 days Subjects 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 Subjects with a diagnosis of inflammatory bowel disease (ulcerative colitis or Crohn's disease) or of irritable bowel syndrome Subjects with HIV-1/HIV-2 antibody, hepatitis B surface antigen, hepatitis C antibody Subject received non-steroidal anti-inflammatory drugs within 2 weeks before Baseline visit for more than 3 consecutive days, except acetylsalicylic acid ≤350 mg/d which is allowed Women who are intending to become pregnant or who are breastfeeding or planning to breastfeed
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alice B Gottlieb, MD, PhD
Organizational Affiliation
Tufts Medical Center, Department of Dermatology
Official's Role
Principal Investigator
Facility Information:
Facility Name
Tufts Medical Center
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02111
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
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
background
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
background
PubMed Identifier
10828911
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
background
PubMed Identifier
11856078
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
background
Links:
URL
http://www.tuftsmedicalcenter.org/OurServices/Dermatology/?Page=5
Description
Tufts Medical Center, Department of Dermatology, Research

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Efficacy Study of Trichuris Suis Ova to Treat Chronic Plaque Psoriasis

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