A Study to Evaluate Safety and Efficacy of DC-TAB in Multiple Sclerosis
Primary Purpose
Multiple Sclerosis
Status
Completed
Phase
Phase 2
Locations
Bulgaria
Study Type
Interventional
Intervention
recombinant human alpha B-crystallin
Placebo comparator
Sponsored by

About this trial
This is an interventional treatment trial for Multiple Sclerosis focused on measuring alpha B-crystallin, immune tolerance
Eligibility Criteria
Inclusion Criteria:
- Clinically definite relapsing multiple sclerosis, according to the McDonald criteria
- Abnormal MRI consistent with MS
- Neurologically stable for at least one month
- At least one clinical relapse over the previous year, or two relapses over the past two years, or one or more gadolinium-enhancing MRI lesion(s) at the time of screening.
- An EDSS score less than 6
- Body weight less than 130 kg
- Use of adequate and stable contraception for 3 months prior to study initiation, during the course of the study and 30 days thereafter or must have undergone clinically documented total hysterectomy and/or oophorectomy, surgical sterilization, or be postmenopausal defined by amenorrhea for at least 12 months and confirmed with a FSH greater than 40 mIU/mL.
- If patients claim abstinence as their method of contraception, they must be willing to agree to use condoms if they became sexually active from 14 days prior to the first dose of the study drug through 90 days beyond the conclusion of the study.
- Being informed of the nature and aims of the study, and having given written consent to participate in this study in accordance with local laws and requirements
- Being willing to comply with the protocol, and understand the information given, and the text of the consent form
Exclusion Criteria:
- Primary progressive multiple sclerosis
- Use of systemic corticosteroid treatment for more than 3 days within 30 days prior to screening
- Plasmapheresis, or intravenous gammaglobulins less than 2 months before screening
- Treatment with natalizumab less than one year before screening
- Previous immunosuppressive treatment
- Previous treatment with any leukocyte-targeting monoclonal antibody
- Previous treatment with oral immune-modulatory agents (cladribine, fingolimod, laquinimod, fumarate)
- Pregnant women, women planning to become pregnant and breastfeeding women
- A history of or currently active clinically significant cardiac (including clinically significant ECG abnormalities in the opinion of the PI), pulmonary, gastrointestinal, hepatic, renal, pancreatic, or neurological disease
- ALT, AST and/or gamma-GT above 3 times the upper limit of normal
- Serum creatinine above 1.5 times the upper limit of normal or an eGFR < 60 mL/min/1.73 m2
- Hemoglobin < 7.0 mmol/l for females and < 8 mmol/l for males; leukocytes > 20*109/l or < 3.5*109/l; platelets < 125*109/l
- SBP > 160 mmHg and/or DBP > 100 mmHg
- Acute respiratory or other active infections
- Fever (body temperature > 38.0 °C on day 1)
- Blood donation or significant blood loss within 90 days of first study medication dosing
- Plasma donation within 7 days of first study medication dosing
- Having received blood or blood products in the last 6 months
- Participation in another clinical study within 90 days of the start of this trial or planning participation in another clinical trial during this study or in the 4 weeks after last visit
- Taking anti-coagulation or anti-platelet medication with the exception of NSAID's.
- History of drug addiction (positive drug screen) or excessive use of alcohol (weekly intake more than 28 units of alcohol), or psychological or other emotional problems that are likely to invalidate informed consent, or limit the ability of the patient to comply with the protocol requirements
- Vaccination with any vaccine within 4 weeks prior to dosing of the study medication
- History of serious adverse reactions or hypersensitivity to any medicinal product
- History of a malignancy other than skin cell basalioma 5 years prior to screening
- Any physical condition that would, in the opinion of the investigator, place the patient at an unacceptable health risk or risk of injury or render the patient unable to meet the requirements of the protocol
Sites / Locations
- Sveti Naum Hospital
- National Cardiology Hopsital
- Tokuda Hospital Sofia
- Aleksandrovska Hospital
- Military Medical Academy
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm Type
Active Comparator
Active Comparator
Active Comparator
Placebo Comparator
Arm Label
DC-TAB 7.5 mg
DC-TAB 12.5 mg
DC-TAB 17.5 mg
placebo
Arm Description
three intravenous injections of 7.5 mg DC-TAB (recombinant human alpha B-crystallin), 2 months apart
three intravenous injections of 12.5 mg DC-TAB (recombinant human alpha B-crystallin), 2 months apart
three intravenous injections of 17.5 mg DC-TAB (recombinant human alpha B-crystallin), 2 months apart
three intravenous injections of placebo, 2 months apart
Outcomes
Primary Outcome Measures
Safety (adverse events)
Frequency of adverse events
Secondary Outcome Measures
Tolerability (Injection site abnormalities)
Injection site abnormalities
Clinical efficacy (Number of Gadolinium-enhancing MRI lesions)
Number of Gadolinium-enhancing MRI lesions
Pharmacokinetics (serum levels of DC-TAB)
Serum levels of DC-TAB
Antigen-specific T-cell response
Strength of antigen-specific T cell responses
Antibody response
Serum levels of anti-DC-TAB antibodies
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02442570
Brief Title
A Study to Evaluate Safety and Efficacy of DC-TAB in Multiple Sclerosis
Official Title
A Phase IIa, Randomized, Double-blind, Placebo-controlled, Exploratory, Dose-ranging Study to Evaluate the Safety, Effectiveness and Pharmacokinetics of Three Courses of DC-TAB Treatment in Patients With Multiple Sclerosis
Study Type
Interventional
2. Study Status
Record Verification Date
May 2015
Overall Recruitment Status
Completed
Study Start Date
September 2012 (undefined)
Primary Completion Date
June 2014 (Actual)
Study Completion Date
February 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Delta Crystallon BV
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to evaluate safety and clinical efficacy of DC-TAB in multiple sclerosis.
Detailed Description
This study is a randomized, double-blind, placebo-controlled, exploratory, dose-ranging Phase IIa study in multiple sclerosis patients to evaluate the safety, tolerability, T-cell tolerance inducing effect, clinical effects and pharmacokinetics of intravenous DC-TAB, a solution of recombinant human alpha B-crystallin.
At entry, patients were randomized to one of the treatments, placebo, 7.5 mg DC-TAB, 12.5 mg DC-TAB or 17.5 mg DC-TAB in a 1:1:1:1 fashion. Patients received a single intravenous bolus injection which was repeated twice with 2-month intervals during the 6-month monitoring period. The goal of such injection was to induce antigen-specific T-cell tolerance. The study consisted of two parts, a treatment period of 24 weeks, and a follow-up period of an additional 24 weeks. Patients returned to the hospital weekly during the first month, and monthly thereafter.
The primary analysis was performed on data collected in the treatment period, and was performed after all patients had completed 24 weeks into the study. An additional analysis was performed once all patients had completed the full 48 weeks of the study. Patients and site study personnel remained blinded throughout the study.
After 12 and 24 patients completed 4 weeks into the study, and after 24 patients had completed 12 weeks of follow-up, a partially blinded safety review was conducted by an independent drug safety monitoring board to verify safety of the intervention in MS patients.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Multiple Sclerosis
Keywords
alpha B-crystallin, immune tolerance
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderOutcomes Assessor
Allocation
Randomized
Enrollment
32 (Actual)
8. Arms, Groups, and Interventions
Arm Title
DC-TAB 7.5 mg
Arm Type
Active Comparator
Arm Description
three intravenous injections of 7.5 mg DC-TAB (recombinant human alpha B-crystallin), 2 months apart
Arm Title
DC-TAB 12.5 mg
Arm Type
Active Comparator
Arm Description
three intravenous injections of 12.5 mg DC-TAB (recombinant human alpha B-crystallin), 2 months apart
Arm Title
DC-TAB 17.5 mg
Arm Type
Active Comparator
Arm Description
three intravenous injections of 17.5 mg DC-TAB (recombinant human alpha B-crystallin), 2 months apart
Arm Title
placebo
Arm Type
Placebo Comparator
Arm Description
three intravenous injections of placebo, 2 months apart
Intervention Type
Biological
Intervention Name(s)
recombinant human alpha B-crystallin
Other Intervention Name(s)
HspB5; CRYAB; DC-TAB
Intervention Description
intravenous injections
Intervention Type
Other
Intervention Name(s)
Placebo comparator
Other Intervention Name(s)
phosphate-buffered saline
Intervention Description
intravenous injection
Primary Outcome Measure Information:
Title
Safety (adverse events)
Description
Frequency of adverse events
Time Frame
48 weeks
Secondary Outcome Measure Information:
Title
Tolerability (Injection site abnormalities)
Description
Injection site abnormalities
Time Frame
48 weeks
Title
Clinical efficacy (Number of Gadolinium-enhancing MRI lesions)
Description
Number of Gadolinium-enhancing MRI lesions
Time Frame
48 weeks
Title
Pharmacokinetics (serum levels of DC-TAB)
Description
Serum levels of DC-TAB
Time Frame
8 hours
Title
Antigen-specific T-cell response
Description
Strength of antigen-specific T cell responses
Time Frame
48 weeks
Title
Antibody response
Description
Serum levels of anti-DC-TAB antibodies
Time Frame
48 weeks
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Clinically definite relapsing multiple sclerosis, according to the McDonald criteria
Abnormal MRI consistent with MS
Neurologically stable for at least one month
At least one clinical relapse over the previous year, or two relapses over the past two years, or one or more gadolinium-enhancing MRI lesion(s) at the time of screening.
An EDSS score less than 6
Body weight less than 130 kg
Use of adequate and stable contraception for 3 months prior to study initiation, during the course of the study and 30 days thereafter or must have undergone clinically documented total hysterectomy and/or oophorectomy, surgical sterilization, or be postmenopausal defined by amenorrhea for at least 12 months and confirmed with a FSH greater than 40 mIU/mL.
If patients claim abstinence as their method of contraception, they must be willing to agree to use condoms if they became sexually active from 14 days prior to the first dose of the study drug through 90 days beyond the conclusion of the study.
Being informed of the nature and aims of the study, and having given written consent to participate in this study in accordance with local laws and requirements
Being willing to comply with the protocol, and understand the information given, and the text of the consent form
Exclusion Criteria:
Primary progressive multiple sclerosis
Use of systemic corticosteroid treatment for more than 3 days within 30 days prior to screening
Plasmapheresis, or intravenous gammaglobulins less than 2 months before screening
Treatment with natalizumab less than one year before screening
Previous immunosuppressive treatment
Previous treatment with any leukocyte-targeting monoclonal antibody
Previous treatment with oral immune-modulatory agents (cladribine, fingolimod, laquinimod, fumarate)
Pregnant women, women planning to become pregnant and breastfeeding women
A history of or currently active clinically significant cardiac (including clinically significant ECG abnormalities in the opinion of the PI), pulmonary, gastrointestinal, hepatic, renal, pancreatic, or neurological disease
ALT, AST and/or gamma-GT above 3 times the upper limit of normal
Serum creatinine above 1.5 times the upper limit of normal or an eGFR < 60 mL/min/1.73 m2
Hemoglobin < 7.0 mmol/l for females and < 8 mmol/l for males; leukocytes > 20*109/l or < 3.5*109/l; platelets < 125*109/l
SBP > 160 mmHg and/or DBP > 100 mmHg
Acute respiratory or other active infections
Fever (body temperature > 38.0 °C on day 1)
Blood donation or significant blood loss within 90 days of first study medication dosing
Plasma donation within 7 days of first study medication dosing
Having received blood or blood products in the last 6 months
Participation in another clinical study within 90 days of the start of this trial or planning participation in another clinical trial during this study or in the 4 weeks after last visit
Taking anti-coagulation or anti-platelet medication with the exception of NSAID's.
History of drug addiction (positive drug screen) or excessive use of alcohol (weekly intake more than 28 units of alcohol), or psychological or other emotional problems that are likely to invalidate informed consent, or limit the ability of the patient to comply with the protocol requirements
Vaccination with any vaccine within 4 weeks prior to dosing of the study medication
History of serious adverse reactions or hypersensitivity to any medicinal product
History of a malignancy other than skin cell basalioma 5 years prior to screening
Any physical condition that would, in the opinion of the investigator, place the patient at an unacceptable health risk or risk of injury or render the patient unable to meet the requirements of the protocol
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lilly Boneva, MSc
Organizational Affiliation
Population Services International
Official's Role
Study Director
Facility Information:
Facility Name
Sveti Naum Hospital
City
Sofia
ZIP/Postal Code
1113
Country
Bulgaria
Facility Name
National Cardiology Hopsital
City
Sofia
ZIP/Postal Code
1309
Country
Bulgaria
Facility Name
Tokuda Hospital Sofia
City
Sofia
ZIP/Postal Code
1407
Country
Bulgaria
Facility Name
Aleksandrovska Hospital
City
Sofia
ZIP/Postal Code
1431
Country
Bulgaria
Facility Name
Military Medical Academy
City
Sofia
ZIP/Postal Code
1431
Country
Bulgaria
12. IPD Sharing Statement
Citations:
PubMed Identifier
26599332
Citation
van Noort JM, Bsibsi M, Nacken PJ, Verbeek R, Venneker EH. Therapeutic Intervention in Multiple Sclerosis with Alpha B-Crystallin: A Randomized Controlled Phase IIa Trial. PLoS One. 2015 Nov 23;10(11):e0143366. doi: 10.1371/journal.pone.0143366. eCollection 2015.
Results Reference
derived
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A Study to Evaluate Safety and Efficacy of DC-TAB in Multiple Sclerosis
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