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Study to Evaluate the Efficacy and Safety of Oxabact (OC5) in Patients With Primary Hyperoxaluria

Primary Purpose

Primary Hyperoxaluria

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
Oxabact OC5 capsules
Placebo capsules
Sponsored by
OxThera
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Primary Hyperoxaluria focused on measuring hyperoxaluria, oxalate, PH

Eligibility Criteria

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

Inclusion Criteria:

  • Signed informed consent (as applicable for the age of the subject).
  • Male or female subjects ≥ 2 years of age (Germany & France) / Male or female subjects ≥ 5 years of age (United Kingdom)
  • A diagnosis of PH type I, II or III (as determined by standard diagnostic methods).
  • A mean urinary oxalate excretion of > 1.0 mmol/24h/1.73m2, based on at least three eligible urine collections performed during baseline (weeks 1-4).
  • Renal function defined as an estimated GFR ≥ 40 ml/min normalised to 1.73m2 body surface area, or a creatinine clearance of ≥ 40 ml/min normalised to 1.73m2 body surface area.
  • Subjects receiving vitamin B6 must be receiving a stable dose for at least 3 months prior to screening and must not change the dose during the study. Subjects not receiving vitamin B6 at study entry must be willing to refrain from initiating pyridoxine during study participation.

Exclusion Criteria:

  • Inability to collect complete 24-hour urine samples. Each urine collection will be evaluated for completeness based on urine qualitative criteria.
  • Inability to swallow size 4 capsules twice daily for 8 to 10 weeks.
  • Subjects that have undergone transplantation (solid organ or bone marrow).
  • The existence of secondary hyperoxaluria, e.g. hyperoxaluria due to bariatric surgery or chronic gastrointestinal diseases such as cystic fibrosis, chronic inflammatory bowel disease and short-bowel syndrome.
  • Use of antibiotics to which O. formigenes is sensitive, including chronic use, a history of more than two courses of antibiotic use during the past 6 months, current antibiotic use, or antibiotics use within 14 days of initiating study medication.
  • Subjects who require immune suppressive therapy.
  • Current treatment with ascorbic acid preparation.
  • Pregnancy.
  • Women of child-bearing potential who are not using adequate contraceptive precautions such as oral, transdermal, injectable, or implanted contraceptives, IUD, complete abstinence, use of a condom by the sexual partner, or sterile sexual partner.
  • Presence of a medical condition that the Principal Investigator considers likely to make the subject susceptible to adverse effect of study treatment or unable to follow study procedures.
  • Participation in any study of an investigational product, biologic, device, or other agent within 30 days prior to screening or not willing to forego other forms of investigational treatment during this study.

Sites / Locations

  • Hôpital Robert-Debré, Néphrologie Pédiatrique
  • Hôpital des Enfants, Centre de référence maladies rénales rares du Sud-Ouest (SORARE), CHU de Bordeaux
  • Hôpital Femme Mère Enfant, Lyon - Paediatric Dept
  • Hôpital Necker-Enfants Malades,Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA)
  • Universitätsklinikum Bonn, Dept of Paediatric Nephrology
  • Birmingham Children's Hospital NHS Foundation Trust - Dept of Nephrology
  • Royal Free Hospital -UCL Centre for Nephrology
  • Great Ormond Street Hospital for Children NHS Trust

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Oxabact OC5 capsules

Placebo capsules

Arm Description

The active study drug consists of Oxalobacter formigenes OC5 in enteric-coated size-4 capsules. The dose (not less than (NLT) 1E+09 colony forming units (CFU)) will be administrated orally with breakfast and dinner as one capsule two times per day for 8 to 10 weeks.

The placebo study drug consists of microcrystalline cellulose in enteric-coated size-4 capsules. It has been manufactured to mimic the OC5 capsule. The dose will be administrated orally with breakfast and dinner as one capsule two times per day for 8 to 10 weeks.

Outcomes

Primary Outcome Measures

Change in urinary oxalate levels from Baseline to week 8 of treatment.

Secondary Outcome Measures

Change in urinary oxalate levels from Baseline to week 8 of treatment in subsets of subjects
Change in urinary oxalate levels from Baseline to week 8 of treatment in subsets of subjects defined by: baseline urinary oxalate level, above and below 1.5 mmol/24h/1.73m2 concomitant vitamin B6 therapy and no vitamin B6 therapy eGFR of ≥90 mL/min/1.73m2 (normal renal function) and < 90 mL/min/1.73m2 (mild to moderate reduction in renal function) age below 18 and age 18 or above
Number of subjects who reach urinary oxalate levels below 0.5, 0.7 and 1.0 mmol/24h/1.73m2 respectively from Baseline to week 8 of treatment.
Change in plasma oxalate levels from Baseline to week 8 of treatment.
Change in urinary oxalate levels from Baseline to week 4 of treatment.
Correlation between change in plasma oxalate levels and change in urinary oxalate levels, from Baseline to week 8 of treatment.
Change in number of O. formigenes in faeces from Baseline to week 8 of treatment.
Adverse events
Haematology
Blood samples taken for hematology at weeks 0, 5, 10 and 14. Complete blood count with differential and platelet count evaluated.
Clinical Chemistry
Blood samples taken for clinical chemistry at weeks 0, 5, 10 and 14. Blood Urea Nitrogen, creatinine, electrolytes (Na+, K+, Mg++, Ca++, HCO3+, Cl), glucose, pH, albumin, alkaline phosphatase, ALT, AST, total bilirubin and total protein evaluated.
Urinalysis
Urine samples will be taken at weeks 0, 5, 10 and 14 of the study. Protein, glucose and pH evaluated.

Full Information

First Posted
December 11, 2013
Last Updated
October 14, 2015
Sponsor
OxThera
Collaborators
FP7-SME-2013 Research for the benefit of SMEs program
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1. Study Identification

Unique Protocol Identification Number
NCT02012985
Brief Title
Study to Evaluate the Efficacy and Safety of Oxabact (OC5) in Patients With Primary Hyperoxaluria
Official Title
A Phase 1/2, Randomised, Placebo-controlled, Double-blind, Multi-centre Study to Evaluate the Efficacy and Safety of OC5 to Reduce Urinary Oxalate in Subjects With Primary Hyperoxaluria
Study Type
Interventional

2. Study Status

Record Verification Date
October 2015
Overall Recruitment Status
Completed
Study Start Date
December 2013 (undefined)
Primary Completion Date
January 2015 (Actual)
Study Completion Date
January 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
OxThera
Collaborators
FP7-SME-2013 Research for the benefit of SMEs program

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine if Oxalobacter formigenes is effective at lowering urinary oxalate levels in patients with primary hyperoxaluria.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Primary Hyperoxaluria
Keywords
hyperoxaluria, oxalate, PH

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
28 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Oxabact OC5 capsules
Arm Type
Experimental
Arm Description
The active study drug consists of Oxalobacter formigenes OC5 in enteric-coated size-4 capsules. The dose (not less than (NLT) 1E+09 colony forming units (CFU)) will be administrated orally with breakfast and dinner as one capsule two times per day for 8 to 10 weeks.
Arm Title
Placebo capsules
Arm Type
Placebo Comparator
Arm Description
The placebo study drug consists of microcrystalline cellulose in enteric-coated size-4 capsules. It has been manufactured to mimic the OC5 capsule. The dose will be administrated orally with breakfast and dinner as one capsule two times per day for 8 to 10 weeks.
Intervention Type
Biological
Intervention Name(s)
Oxabact OC5 capsules
Other Intervention Name(s)
Oxalobacter formigenes
Intervention Description
The dose will be not less than (NLT) 1E+09 colony forming units (CFU) twice daily for 8 to 10 weeks. The dose (an enteric-coated size 4 capsule) will be administered orally with breakfast and dinner.
Intervention Type
Drug
Intervention Name(s)
Placebo capsules
Intervention Description
An enteric-coated placebo capsule manufactured to mimic the OC5 capsule. The capsule will be administered orally with breakfast and dinner twice daily for 8 to 10 weeks.
Primary Outcome Measure Information:
Title
Change in urinary oxalate levels from Baseline to week 8 of treatment.
Time Frame
8 weeks of active treatment (i.e. between Weeks 7 and 14 of the study)
Secondary Outcome Measure Information:
Title
Change in urinary oxalate levels from Baseline to week 8 of treatment in subsets of subjects
Description
Change in urinary oxalate levels from Baseline to week 8 of treatment in subsets of subjects defined by: baseline urinary oxalate level, above and below 1.5 mmol/24h/1.73m2 concomitant vitamin B6 therapy and no vitamin B6 therapy eGFR of ≥90 mL/min/1.73m2 (normal renal function) and < 90 mL/min/1.73m2 (mild to moderate reduction in renal function) age below 18 and age 18 or above
Time Frame
8 weeks of active treatment (i.e. between Weeks 7 and 14 of the study)
Title
Number of subjects who reach urinary oxalate levels below 0.5, 0.7 and 1.0 mmol/24h/1.73m2 respectively from Baseline to week 8 of treatment.
Time Frame
8 weeks of active treatment (i.e. between Weeks 7 and 14 of the study)
Title
Change in plasma oxalate levels from Baseline to week 8 of treatment.
Time Frame
8 weeks of active treatment (i.e. between Weeks 7 and 14 of the study)
Title
Change in urinary oxalate levels from Baseline to week 4 of treatment.
Time Frame
8 weeks of active treatment (i.e. between Weeks 7 and 10 of the study)
Title
Correlation between change in plasma oxalate levels and change in urinary oxalate levels, from Baseline to week 8 of treatment.
Time Frame
8 weeks of active treatment (i.e. between Weeks 7 and 14 of the study)
Title
Change in number of O. formigenes in faeces from Baseline to week 8 of treatment.
Time Frame
8 weeks of active treatment (i.e. between Weeks 7 and 14 of the study)
Title
Adverse events
Time Frame
8 weeks of active treatment (i.e. between Weeks 7 and 14 of the study)
Title
Haematology
Description
Blood samples taken for hematology at weeks 0, 5, 10 and 14. Complete blood count with differential and platelet count evaluated.
Time Frame
14 weeks (Throughout the study)
Title
Clinical Chemistry
Description
Blood samples taken for clinical chemistry at weeks 0, 5, 10 and 14. Blood Urea Nitrogen, creatinine, electrolytes (Na+, K+, Mg++, Ca++, HCO3+, Cl), glucose, pH, albumin, alkaline phosphatase, ALT, AST, total bilirubin and total protein evaluated.
Time Frame
14 weeks (Throughout the study)
Title
Urinalysis
Description
Urine samples will be taken at weeks 0, 5, 10 and 14 of the study. Protein, glucose and pH evaluated.
Time Frame
14 weeks (Throughout the study)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consent (as applicable for the age of the subject). Male or female subjects ≥ 2 years of age (Germany & France) / Male or female subjects ≥ 5 years of age (United Kingdom) A diagnosis of PH type I, II or III (as determined by standard diagnostic methods). A mean urinary oxalate excretion of > 1.0 mmol/24h/1.73m2, based on at least three eligible urine collections performed during baseline (weeks 1-4). Renal function defined as an estimated GFR ≥ 40 ml/min normalised to 1.73m2 body surface area, or a creatinine clearance of ≥ 40 ml/min normalised to 1.73m2 body surface area. Subjects receiving vitamin B6 must be receiving a stable dose for at least 3 months prior to screening and must not change the dose during the study. Subjects not receiving vitamin B6 at study entry must be willing to refrain from initiating pyridoxine during study participation. Exclusion Criteria: Inability to collect complete 24-hour urine samples. Each urine collection will be evaluated for completeness based on urine qualitative criteria. Inability to swallow size 4 capsules twice daily for 8 to 10 weeks. Subjects that have undergone transplantation (solid organ or bone marrow). The existence of secondary hyperoxaluria, e.g. hyperoxaluria due to bariatric surgery or chronic gastrointestinal diseases such as cystic fibrosis, chronic inflammatory bowel disease and short-bowel syndrome. Use of antibiotics to which O. formigenes is sensitive, including chronic use, a history of more than two courses of antibiotic use during the past 6 months, current antibiotic use, or antibiotics use within 14 days of initiating study medication. Subjects who require immune suppressive therapy. Current treatment with ascorbic acid preparation. Pregnancy. Women of child-bearing potential who are not using adequate contraceptive precautions such as oral, transdermal, injectable, or implanted contraceptives, IUD, complete abstinence, use of a condom by the sexual partner, or sterile sexual partner. Presence of a medical condition that the Principal Investigator considers likely to make the subject susceptible to adverse effect of study treatment or unable to follow study procedures. Participation in any study of an investigational product, biologic, device, or other agent within 30 days prior to screening or not willing to forego other forms of investigational treatment during this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bernd Hoppe, MD PhD
Organizational Affiliation
Universitätsklinikum Bonn, Dept of Paediatric Nephrology
Official's Role
Principal Investigator
Facility Information:
Facility Name
Hôpital Robert-Debré, Néphrologie Pédiatrique
City
Paris
State/Province
Cedex 19
ZIP/Postal Code
75945
Country
France
Facility Name
Hôpital des Enfants, Centre de référence maladies rénales rares du Sud-Ouest (SORARE), CHU de Bordeaux
City
Bordeaux
ZIP/Postal Code
33076
Country
France
Facility Name
Hôpital Femme Mère Enfant, Lyon - Paediatric Dept
City
Lyon
ZIP/Postal Code
69677 Bron
Country
France
Facility Name
Hôpital Necker-Enfants Malades,Centre de référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte (MARHEA)
City
Paris
ZIP/Postal Code
75015
Country
France
Facility Name
Universitätsklinikum Bonn, Dept of Paediatric Nephrology
City
Bonn
ZIP/Postal Code
DE-53113
Country
Germany
Facility Name
Birmingham Children's Hospital NHS Foundation Trust - Dept of Nephrology
City
Birmingham
ZIP/Postal Code
B4 6NH
Country
United Kingdom
Facility Name
Royal Free Hospital -UCL Centre for Nephrology
City
London
ZIP/Postal Code
NW3 2QG
Country
United Kingdom
Facility Name
Great Ormond Street Hospital for Children NHS Trust
City
London
ZIP/Postal Code
WCIN 3JH
Country
United Kingdom

12. IPD Sharing Statement

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Study to Evaluate the Efficacy and Safety of Oxabact (OC5) in Patients With Primary Hyperoxaluria

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